CASE 537.—Private Elden Townsend, Co. F, 7th Maine, aged 19 years, received a wound of the left side at Spottsylvania​, May 12, 1864. He was removed to the hospital of the 2nd division, Sixth Corps, where the injury was treated as a flesh wound. On May 25th, he was transferred to Lincoln Hospital, Washington. Acting Assistant Surgeon E. L. Bliss reports that "the ball had entered just beneath the eleventh rib and six inches from the spinal column. From the first, the patient suffered great mental depression, which continued until his death. The pulse was full and hard, and the skin dry and parched. The tongue was coated and inclined to redness about its edges; the bowels were constipated, and the appetite very poor. These symptoms continued without change until about July 23rd, when they all became gradually aggravated, with the exception of the pulse, which was weak and rapid. This course continued until the skin was excessively husky, the tongue red, dry, and cracked, and the stomach so irritated that food and medicine were constantly rejected. Death resulted, from exhaustion, July 6, 1864. No tympanitis​ nor tenderness of the bowels were present at any time. The treatment was tonic and stimulating." An autopsy was made by Acting Assistant Surgeon H. M. Dean, who furnishes the following record: "The patient was very much emaciated; post-mortem rigidity well marked; the ball on entering had opened the diaphragm at its attachment, slightly injured the lower lobe of the left lung, passed behind the left kidney, lacerating it somewhat; it then coursed backward and a little downward, breaking off the left transverse process of the first lumbar vertebra, and was found with its apex between the spinous processes of the first and second lumbar vertebræ; the lower lobe of the right lung was slightly engorged, but was otherwise healthy; the left lung was healthy, with the exception of the laceration by the ball, above referred to; weight of right lung, twelve ounces; of left, ten and a half ounces; the heart was flabby, and in the right side was a medium-sized fibrinous clot; the left side contained a smaller one; the valves were healthy; the heart weighed nine and a half ounces; the spleen was softer than usual, and weighed eight ounces; liver anæmic, weight sixty-six ounces; the right kidney was partially congested, and weighed seven and a half ounces; the left kidney was very anæmic, and had a laceration across its posterior surface, near its middle, and was much smaller than its fellow; it weighed five and a half ounces."