Machlin, F.a machine readable transcriptionSusan C. LawrenceKenneth M. PriceKenneth J. Winkle2011med.d2e5930Civil War WashingtonUniversity of Nebraska–LincolnCenter for Digital Research in the
Humanities319 Love LibraryUniversity of Nebraska–LincolnLincoln, NE 68588-4100cdrh@unlnotes.unl.edu2011
The following are responsible for particular readings or for changes to
this file, as noted:
Kenneth WinkleAJ HowellMatthew BosleyThe Medical and Surgical History of the War of the Rebellion.
(1861-65.)Washington, DCGovernment Printing
OfficePart 3Volume
21883110Medical 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 jointexcision at the hip after shot injuryintermediary excisionsball entered buttock, emerged below and within anterior superior spinous process of
iliumneck of femur comminuted and shaft uninjuredsurgeon in charge confined to bed by illnessgeneral anesthesia, chloroformblessedadded figure encodingadditional case copied from MSHWR, performed proofing of copy
and XML encoding, and key terms identified
CASE 258.—Private F.
Machlin,¹ 11th Pennsylvania, a robust
man, was wounded at the second battle of Bull Run, August 30, 1862. He laid on the field several days, and
was then transported thirty miles in a wagon to the Warehouse
Hospital, Georgetown, D. C., where he was received on September 8th. A musket ball had entered the right buttock and emerged
an inch and a half below and within the anterior superior spinous process of the ilium. The limb
was shortened, and the foot was everted; any movement gave excessive pain. A thorough
examination was made under the influence of chloroform, and showed that the neck of the bone was
comminuted and the shaft uninjured. The case was considered to be a particularly favorable one
for the operation of excision of the broken fragments, and the general condition of the patient
was such as to offer some hopes of its success, and it was determined to do the operation on the
following day. But the surgeon in charge of the hospital was confined to his bed by illness, and
was unable to see the patient for five days. On September 13th the general condition of the
latter was less favorable. His pulse was 130, quick and weak, and his tongue was dry. He was
placed under very careful nursing, and beef essence, brandy, eggs, and milk, and other
concentrated nourishment and stimulants were administered ad libitum. By
September 20th this treatment had produced slight improvement, and though he was still in a very
unfavorable condition for an operation, it was determined, on consultation, that an excision
might afford the patient relief from the constant pain he suffered, and that it could not
greatly depress him. At noon on September 20th,
accordingly Assistant Surgeon B. A. Clements, U. S. A., assisted by Dr.
George K. Smith, of Brooklyn, and the surgical staff of the
hospital, performed the operation. An incision five inches in length was made from a point two
inches behind and an inch below the anterior superior process of the ilium, downward over the
prominence of the trochanter major. The incision exposed the parts freely, and the muscular
insertions being divided, and several small loose fragments of bone removed, the irregular
broken extremity of the shaft, at its junction with the neck and the tip of the great
trochanter, were excised by a chain saw. The remnant of the capsular ligament and the round
ligament were now cut, the joint being opened from below and in front with a probe-pointed
bistoury. A blade of a long bullet forceps was then introduced as a lever and the head was
disarticulated by gently prying it out of the cotyloid cavity. These steps in the operation were
facilitated by rotating the trochanter outward, and by lifting the extensor muscles by a
metallic retractor. A small vessel was tied at the upper end and another at the lower end of the
wound. The wound was well washed out by means of a syringe and a few stitches were applied, the
middle portion of the wound being left open. The limb was suspended in a Smith's anterior wire
splint. The patient appeared to rally from the operation satisfactorily. At 9 o'clock P. M. he
was free from pain; his pulse was 136, and the skin was cool and natural. He had slept
tranquilly. On the following day, September 21st, his pulse was 120 and very feeble. The
discharge from the wound was dark and thin, and copious. His countenance was placid, the
pinched, distressed expression it had worn having disappeared. But in the afternoon he sank
rapidly, and died in the evening, thirty-six hours after the operation, September 21, 1862. The specimen is No. 329 of the Surgical Section of
the Army Medical Museum, and is represented in the
accompanying wood-cut (FIG. 66).—(Circular 6, S. G. O., 1865, p. 64; Circular 2, S. G. O., 1869, pp.
37, 135.)
¹ BATES (S. P.) (History of Pennsylvania Volunteers, 1861-5, Harrisburg, 1869,
Vol. I, p. 30) records the name of this patient as Philip Mechling, Co. I, 11th Pennsylvania
Volunteers.