R——, Alfred G.a machine readable transcriptionSusan C. LawrenceKenneth M. PriceKenneth J. Winkle2011med.d2e4678Civil 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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this file, as noted:
Kenneth WinkleAJ HowellMatthew BosleyElizabeth LorangStacey BerryElisabeth TraceySarah SynovecThe Medical and Surgical History of the War of the Rebellion.
(1861-65.)Washington, DCGovernment Printing
OfficePart 3Volume
2188385-86Medical and Surgical History of the War of the Rebellionwounds and injuries of the lower extremitieswounds and injuries of the hip jointshot fractures at the hip jointshot fractures at the hip joint unsuccessfully treated by conservationshot injuries of femoral neck and trochanters, or neck, trochanters and shaft of
femurwound in upper part of femur by a round ballball found in scrotumfractured trochanter majorclonic spasms, opisthotonosepileptiform convulsionsgeneral anesthesia, etherblessedadded period to figure headadded figure encodingadditional proofing of transcription and encoding, identified
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CASE 191.— "Alfred G.
R——, Adjutant 134th Pennsylvania,
aged 24 years, was wounded in the upper part of the left femur by a round ball, which partially
fractured the trochanter major, at the battle of Fredericksburg, December 13, 1862. The
wound received no attention for some days, and was then dressed with side splints firmly bound
by a roller, a plug of lint being tightly inserted in the wound. On the 20th of December he was admitted to E
Street Infirmary, Washington. He stated that for some days he had experienced occasional
twitchings in the limb, and had taken large doses of opium. The wound was a little behind the
trochanter major. Upon removing the plug of lint about half a pint of blood and pus was
discharged. There was no crepitus upon rotation, nor shortening. Owing to his weakened
condition, no extended search was made for the missile. Simple dressings were applied, and half
grain doses of sulphate of morphia were given. For the two succeeding days he seemed to improve.
The twitchings of the limb occurred every few minutes, with occasional intermissions of a few
hours. On the 23d the spasms became more violent
and frequent, and it was deemed advisable to extract the missile. He was etherized, and the
wound was enlarged two inches downward and backward. A gum catheter was made to follow the
course of the missile behind and beneath the neck of the femur to the body of the pubis, where
the ball was found in the scrotum near the spermatic cord. A flattened round musket ball was
extracted through an incision at the base of the scrotum. A portion of it had been chipped off.
The patient rested well that night, but on the following day the spasms were increased in
intensity, commencing in the injured limb and extending over the body. Cloths saturated with
chloroform and olive oil were applied to the limb, and an antispasmodic and anodyne mixture was
prescribed. He rested quietly until the following
morning, when clonic spasms returned and persistently increased. The patient's
countenance became pinched, wan, and haggard, and expressive of fright. There was no pain nor
trismus, and he partook freely of nouishmentnourishment. At times there was complete opisthotonos. On December 25th he took four dozen pills
of assafœtida of four grains each, and one half ounce of fluid extract of Cannabis Indica
in divided doses, without any benefit. Sulphate of morphia in doses of one grain was then
prescribed, to be administered every two hours, and a poultice of powdered opium and cinchona
applied to the wound, but, as before, without apparent benefit. The mind, up to this time,
continued clear and undisturbed, his pulse moderately full and strong, ranging at about 100. He
now became drowsy, and at times lay in a semi-comatose condition. His pulse ran up to 150.
Respiration was free, but at times hurried, from 25 to 28 per minute. The skin became bathed in
sweat, which exhaled a peculiar pungent odor. The bowels were regular; the urine was scantily
secreted and high colored, though voided without difficulty. The discharge from the wound was
thin, bloody, and offensive. On December 27th opisthotonos recurred, and was temporarily
relieved by the application of chloroform to the entire extent of the spine. Subsequently,
violent epileptiform convulsions set in, and death resulted from exhaustion, on December 28, 1862." The pathological specimen is
figured in the wood-cut (FIG. 44) and shows a fracture of the great
trochanter of the left femur and a piece of a leaden ball embedded in the neck. The specimen and
history were contributed by Surgeon C. L. Allen, U. S. V.—(Circular 2, S. G.
O., 1869, p.80. CASE 94.)