Civil War Washington

CASE.—Private Louis Miller, Co. D, 46th New York Volunteers, aged 34 years, was wounded at Petersburg, Virginia, June 30th, 1864, by a shell, which fractured the cranium near the superior parietal angle. He was at once admitted to the hospital of the 3d division, Ninth Corps, where fragments of the parietal, temporal, and frontal bones were removed, and the flaps united by a slight suture. On July 3d, he was sent to Washington, and entered Harewood Hospital on the 4th, being somewhat uneasy but not complaining of pain. The pulse was slightly accelerated, tongue clean, and appetite good. Upon removing the suture the wound was found to be full of maggots. The dura mater was exposed for a space about three inches in circumference, and of a greenish color; the pulsations of the brain were distinctly visible. On the 6th, the flaps became gangrenous and were entirely destroyed. The wound was healthy, but the external layer of the dura mater was sloughing. Flax-seed poultices were applied. The upper margin of the wound granulated finely. An incision was made, and a dressing of chlorinated soda was employed. The granulation of upper margin continued healthy. On July 28th, secondary hæmorrhage occurred from the left temporal artery, which was ligated; about ten ounces of blood having been lost. From that time the wound assumed a healthy appearance. Small pieces of bone were removed as they became detached. Partial necrosis of the parietal bone supervened. The necrosed portion, consisting of both lamellae, was removed. The discharge now became less copious, and the wound healed rapidly. Miller was furloughed on November 3d, 1864, returned on the 16th, and was discharged from the service on July 25th, 1865, being, at the time, in very good health. He is not a pensioner. The case is reported by Surgeon R. B. Bontecou, U. S. V.