SMITH, WILLIAM, Private, Co. G, 4th New York Heavy Artillery,
aged 18 years, was wounded, at the battle of Hatcher's Run, Virginia, March
31st, 1865, by a conoidal ball, which caused a contusion of the left
parietal bone. He was, on the following day, admitted to the hospital of the
Second Corps. On April 5th, he
was transferred to the Emory Hospital,
Washington, D. C., and on April
9th, sent to the Cuyler Hospital, Philadelphia, Pennsylvania. On
admittance no osseous lesion could be detected. The case progressed favorably
until April 16th, when the patient had two or three slight convulsive paroxysms,
lying in a somewhat soporose condition during the intervals. He afterwards
became delirious, and finally almost completely comatose. The muscles of the
left side of the body were observed to be in a state of spasmodic contraction,
and a large collection of pus formed beneath the left side of the scalp,
anterior to the wound, and was opened on April 29th. The pathological condition
was supposed to be, that an abscess, resulting from the original shock to the
brain substance, was exciting irritation, and would probably eventually burst
into one of the lateral ventricles. Mercurials, tartarized antimony, and the
fluid extract of veratrum viride were exhibited internally, while the head was
kept somewhat elevated. Death ensued on the night of April 30th, 1865, one month from the reception of
injury. An autopsy was made about fourteen hours after death, with the following
results: there was no fracture of the skull to be detected when the scalp was
removed, and the bone was not bared beneath the abscess, which has been
described as having formed a few hours before death, but was manifestly necrosed
just below the original wound. On removing the skull cap it was found that a
plate of bone, about one inch long and three-quarters of an inch broad, had been
separated by exfoliation from the inner table, and was adherent to the dura
mater immediately beneath the position of the original scalp wound. The brain
was removed with the membranes entire, but a moderate quantity of blood and
serum being found beneath the dura mater and the skull. On reflecting the dura
mater of the right hemisphere, the arachnoid over the middle lobe of the
cerebrum was found to be acutely inflamed, presenting an abundant deposit of
soft coagulable lymph. The membranes of the left side presented merely a slight
pearliness, and the adhesion of the dura mater to the sequestrum, already
referred to. The brain substance on the right side was healthy; on the left side, it was softened beneath the position of the wound, and, at the depth of
about three-quarters of an inch, was a small abscess, not larger than a small
hickory-nut. All other parts of the body examined appeared normal. The muscular
contraction on the same side of the body as the wound was now accounted for by
the existence of intracranial disease upon the opposite side. The case is
reported by Henry S. Schell, Assistant Surgeon U. S. Army.