Sims, J.a machine readable transcriptionSusan C. LawrenceKenneth M. PriceKenneth J. Winkle2011med.d2e16616Civil War WashingtonUniversity of Nebraska–LincolnCenter for Digital Research in the Humanities319 Love LibraryUniversity of Nebraska–LincolnLincoln, NE 68588-4100cdrh@unlnotes.unl.edu2011
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Kenneth WinkleAJ HowellMatthew BosleyElizabeth LorangThe Medical and Surgical History of the War of the Rebellion.
(1861-65.)Washington, DCGovernment Printing OfficePart 3Volume 21883394Medical and Surgical History of the War of the Rebellionwounds and injuries of the lower extremitieswounds and injuries of the knee jointexcisions at the knee joint for shot injuryintermediary excisions at the knee jointfatal instances of intermediary excision at the knee jointball entered knee joint below patella on inner and anterior aspect, fractured inner
condyle and opened joint, extracted four inches from point of entrancewhole joint suppurating mass, pus far down under gastrocnemius and between the muscles of
thighlung infiltrated with pus, single large abscess upon surface of inferior lobegeneral anesthesia, chloroformpost-mortem examination performedblessedcorrected caption for figureadded figure encodingadditional case copied from MSHWR, performed proofing of copy
and XML encoding, and key terms identified
CASE 627.—Corporal J.
Sims, Co. B, 4th Ohio,¹ aged 23 years,
was wounded at Mine Run, November 27, 1863, by a conoidal ball, which entered the right knee
joint just below the patella, on the inner and anterior aspect, fracturing the inner condyle and
opening the joint, passed downward and forward, and was extracted about four inches from point
of entrance. He was admitted to the Second Division
Hospital, Alexandria, December 5th. "At the time of admission the joint and thigh were very much inflamed
and discharging pus copiously, and the man was much prostrated and terribly anxious as to the
result of the wound. But after being washed and fed and otherwise cared for, he appeared much
recruited. On the 8th of December the operation
of excision of the knee joint was performed by Surgeon E.
Bentley, U. S. V., who removed one inch of
the femur and about one and a half inches of the tibia and fibula. The hæmorrhage was
slight, but the condition of the tissues was not very satisfactory. The patient endured the
operation well under the influence of chloroform, and reacted well. On the following day he
complained of severe pain over the lung on the right side of the chest, which continued for
several days. On the 10th, he had a severe chill at night, which was followed by two, more
severe, on the 11th. Stimulants were freely given with raw eggs well beaten up, and beef essence
for diet. He continued to have chills till the night of the 13th, when he was seized with a very
severe one, from which he never rallied. He died on the morning of December 14, 1863. The post-mortem examination
showed no attempt at repair, there being considerable sloughing, while on the inside of the
thigh there were numerous small abscesses. The heart and left lung were healthy, but the right
lung was infiltrated with pus, and a single large abscess appeared upon the surface of the
inferior lobe. There was no pus nor abscess found in the liver, but it was very much
softened." The history, with the post-mortem specimen, represented in
the cut (FIG. 246), was contributed to the Museum by the operator. Surgeon J. B. BrintonJ. H. Brinton, U. S. V., who examined the limb
two days after the patient's decease, found "the whole joint one suppurating mass; pus
extending up and down, far down under the gastrocnemius and up between the muscles on the inside
of the thigh; a long abscess in the sheath of the vessels, extending up to the middle of the
thigh; small clot in femoral artery, thin and three inches long; none in femoral vein;
surrounding tissues of vessels hardened in some places where pus had not readied; long membrane
of femoral vein of dirty gray color and softened; clot in saphena vein."
¹ See Circular No. 6, War Department, S. G. O.. Washington, 1865,
p. 59; CULBERTSON (H.), Excision of the Larger Joints of the Extremities. Prize Essay, in Trans. Am. Med. Assoc., Philadelphia, 1876. Supplement to Vol. XXVII, p. 184, Case
13.