Title: M——, James D.

Source text: Surgeon General Joseph K. Barnes, United States Army, The Medical and Surgical History of the War of the Rebellion. (1861–65.), Part 1, Volume 2 (Washington, D.C.: Government Printing Office, 1870), 250-251.

Keywords:on special wounds and injuries of the headwounds and injuries of the headgunshot woundsgunshot fractures of the cranial bonesremoval of fragments after gunshot fractures of the skullfatal cases of gunshot fractures of the skull treated by the removal or elevation fragmentstreated by operation, not by formal trephiningextent of injury ascertained with precision, organic alterations accurately observedconoidal ball lacerated scalp over upper anterior portion of left parietal bonegunshot wound of scalpconvulsions affected right side, tonic spasmscoma, constant rigidity of right side, right pupil dilatedpiece of bone driven into brain matterimmense abscess occupied anterior left cerebral hemisphere, penetrated into left lateral ventricleseptum lucidumseptum pellucidum broken down, right ventricle also filled with pusmeninges of brain inflamed, pus formed under arachnoidcranium fractured below anterior superior angle of parietal bonepost-mortem examination performed

Civil War Washington ID: med.d1e16357

TEI/XML: med.d1e16357.xml


CASE.—Corporal James D. M——, Co. D, 108th New York Volunteers, was wounded at the battle of Fredericksburg, Virginia, December 13th, 1862, by a conoidal ball, which lacerated the scalp over the upper anterior portion of the left parietal bone. He was admitted into Grace Church Hospital, Alexandria, on the 19th, where the wound was diagnosticated​ as a gunshot wound of the scalp. He was able to walk about, and stated that he had been unconscious only a short time. After a few days he was attacked with convulsions, which affected only the right side, producing tonic spasms, only lasting about one hour. He recovered from these sufficiently to be again able to walk about. About the 18th or 19th of January, 1863, the convulsions returned and grew more frequent, until he sank into a comatose state, with constant rigidity of the right side. He could be aroused sufficiently to answer questions by yes and no. The right pupil was dilated, and the pulse slow and intermitting. Acting Assistant Surgeon A. W. Tryon, cut down on the skull and removed several pieces of bone, one of which, triangular in shape, and about half an inch in length, had been driven into the brain matter. The operation afforded no relief, and the symptoms above described gradually increased, till death supervened on January 30th. At the post-mortem examination an immense abscess was found, which occupied nearly the whole anterior lobe of the left hemisphere, and penetrated into the ventricle of that side. The septum lucidum​ was broken down, and the right ventricle filled with pus. The under portions of the meninges of the brain were inflamed, being much injected with blood. At a number of places pus had formed under the arachnoid. There were congested spots in the brain matter, about the sac of the abscess, and nearly the whole mass of brain matter was much softer than natural. The pathological specimen is No. 1723, Sect. I, A. M. M. The vault of the cranium is fractured just below the anterior superior angle of the left parietal bone. Fragments have been removed from an opening three-fourths of an inch in diameter. Two fragments of the outer and inner tables remain attached, being depressed two lines on the free edge. The surrounding bone is soft and porous. The specimen and history were contributed by Acting Assistant Surgeon A. W. Tryon.