Civil War Washington

CASE.—Private Philip R——, Co. I, 10th New York Volunteers, was wounded at the battle of Fredericksburg, Virginia, December 13th, 1862, by a gunshot missile, which fractured and depressed the left parietal bone, just below the tuberosity. He was admitted into the Ascension Church Hospital, Washington, on the 17th, partially insensible, but answering when spoken to sharply. The pupils were nearly normal, pulse 72, and gradually becoming slower and more suggestive of approaching coma. On the 19th, the patient was placed under the influence of chloroform, and Surgeon J. H. Brinton, U. S. V., assisted by Surgeon J. C. Dorr, U. S. V., and Dr. Brodie of Edinborough, performed the operation of trephining. The depressed fragments were elevated and removed, causing considerable hæmorrhage, which gradually ceased after the operation. At seven o'clock P. M., the pulse was 66, thready end sharp; patient semi-conscious and complaining of cold. The next morning the pupils were nearly normal; pulse 78; breathing natural, but bowels not open. There was considerable hæmorrhage at noon, which was readily checked. Afterward, coma gradually supervened, the pupils became dilated and insensible to light, and involuntary urinations occurred. He continued to sink rapidly, and died on the morning of December 22d, 1862, in a state of complete coma. The pathological specimens are Nos. 528, 965, and 966. The former shows a section of the vault of cranium, with one disk and seven fragments from the left parietal bone. The two latter are wet preparations of the dura mater and the left cerebral hemisphere containing an abscess. The specimens were contributed by Surgeon J. C. Dorr, U. S. V.