Cavanaugh, J.a machine readable transcriptionSusan C. LawrenceKenneth M. PriceKenneth J. Winkle2011med.d2e19287Civil 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 M. PriceAJ HowellMatthew BosleyElizabeth LorangStacey BerryElisabeth TraceySarah SynovecThe Medical and Surgical History of the War of the Rebellion.
(1861-65.)Washington, DCGovernment Printing
OfficePart 3Volume
21883492Medical and Surgical History of the War of the Rebellionwounds and injuries of the lower extremitieswounds and operations in the legshot fractures of the bones of the legamputations in the continuity of the leg for shot fracturesprimary amputations in the continuity of the leg for shot injuryprimary amputations in the lower third of the leg for shot injurysuccessful primary amputations in the lower third of the bones of the legshell caused fracture of lower portion of leg, involving ankle jointamputation of leg at lower thirdinjured leg amputated at field hospitalabscesses formed in middle third of tibia, left fistulous openings, indicating necrosis
of shaft of tibiaerysipelasreamputation below tubercle of tibiareceived artificial limbblessedadded figure encodingadditional proofing of transcription and encoding, identified
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CASE 742.—Private J.
Cavanaugh, Co. C, 7th Wisconsin, aged 27
years, was wounded before Petersburg, June 18, 1864, by a shell, which caused a fracture of the lower
portion of the left leg, involving the ankle joint. Surgeon C. N.
Chamberlain, U. S. V., reported that the
injured leg was amputated at the field hospital of the 4th division, Fifth Corps. Surgeon B. B. Wilson, U. S.
V., contributed the pathological specimen, No. 1526, Surg. Sect.,
A. M. M., shown in the adjoining wood-cut (FIG. 291), and reported
the following history of the case: "The patient was admitted to Stanton Hospital, Washington, from City Point, July 1st. He had suffered amputation of the leg at the
lower third, by the circular method, the day after he
was wounded, being, according to his statement, in a high fever at the time of the
operation. He was treated with stimulants, and ice dressings locally. During the month of
September the limb became much swollen and abscesses formed in the line of the middle third of
the bone, which, after discharging, left fistulous openings, clearly indicating necrosis of the
shaft of the tibia. His term of service having expired, the patient was discharged October 5, 1864, but being unable to leave, he
was retained as a patient in the hospital. The shaft of the tibia being evidently extensively
necrosed, I determined to perform another amputation above the diseased portion. This
operation—though opposed by the medical staff of this hospital and by Surgeon A. N. Dougherty, U. S. V.,
as well as Surgeon T. F. Betton, 1st U. S. V. V., who saw the case—was preferred by me to that of exsectingexcising the sequestrum for the reason that it involved no more danger and would give the
patient a much better stump (though six inches shorter) for fitting an artificial limb. The
operation was performed one inch below the tubercle of the tibia, by the circular method, on
February 25, 1865, and the stump was treated
with cold-water dressings. Traumatic erysipelas followed (an epidemic of erysipelas breaking out
in the hospital the same week), and for a few days fears were apprehended as to the result. The
patient, however, made a good recovery, and by March 15th the inflammation, which had extended
to the abdomen, had subsided. Before he finally left the hospital the patient received an
artificial limb, on which he walked with great ease and comfort. The specimen indicates clearly
and in a marked degree the efforts of nature in throwing off dead bone and supplying its place
by new growth. The adventitious process, thrown out to unite the amputated ends of the tibia and
fibula and thus give the extremities of those two bones firmness and solidity, shows to how
great an extent the reparative process can be carried. By what agency the want of bony matter at
this point was perceived and its deposit determined at the proper place and in the proper form
is beyond the scope of human knowledge at the present time. The fact, however, evidences the
powers of nature to accommodate herself to circumstances and to repair in a limited degree the
effects of losses which are irremediable." The specimen, consisting of the re-amputated stumps
of the bones of the leg joined by osseous deposit at their lower extremities, shows a massive
involucrum except on the anterior border, where a heavy sequestrum is visible. The patient
became a pensioner after leaving the hospital. On September 2, 1874, he was examined by Dr. C.
F.Falley, pension examiner at Lancaster, Wisconsin, who
certified to the loss of the leg and reported: "The amputation has left rather an irritable
stump, but, as his cork leg does not press on it, I do not think it any great injury in wearing
an artificial limb. He can flex and extend the stump freely," etc. The pensioner was paid March 4, 1880. In his application for an artificial leg
he reported that Surgeon D. C. Ayres, 7th Wisconsin, performed the first amputation.