Civil War Washington

CASE.—Private Edward V——, Co. D, 55th Ohio Volunteers, was wounded at the battle of Bull Run, Virginia, August 29th, 1862, by a conoidal ball, which struck half an inch above the right eyebrow, and the same distance from the median line of the os frontis, comminuting and carrying away both tables to the extent of one and one-fourth to two and one-fourth inches. He was wounded while in the act of discharging his gun, staggered considerably under the shock, but recovered immediately, so that he fired, loaded, and fired a second time before he fell. He lay on the field for six days, during which time a considerable amount of brain matter oozed from the wound. He was afterward conveyed to Washington, and admitted, on the 7th of September, into the Emory Hospital, where the wound was dressed for the first time. Half of the plates composing the frontal sinus were found turned in upon the brain, and about one-third of the ball was battered up against the fractured edge of the bone. When the missile and fragments of bone were removed a large quantity of fœtid pus and a teaspoonful of cerebral matter exuded. The most remarkable feature of the case was that there were no symptoms of injury to the brain, either in articulation, memory, sight, or animation. The wound was dressed with adhesive strips to keep the eyebrow from falling on the cheek. On the morning of the 8th, a hernia cerebri, an inch in diameter, made its appearance, pulsating with the heart's action. The depressed walls of the frontal sinus were now removed by Assistant Surgeon J. D. Hall, 24th New York Volunteers, the operation being attended with slight hæmorrhage, a plentiful discharge of pus, and the escape of a teacupful of softened brain matter. On the 9th, the tongue was covered with a thick white fur; lips red, pulse nearly normal. No change occurred until the 19th, except that the wound became more painful, though it continued perfectly healthy. The hernia had gradually receded when, on the 20th, a colliquative diarrhœa set in, which, though arrested by astringents and opiates greatly reduced his strength; his mind, however, continued perfectly clear. Tonics, with nouishing diet, were administered, but he failed to rally, and died on the morning of the 25th. At the autopsy a large clot was found between the dura mater and the skull, at the coronal suture; and the meninges and brain exhibited a much greater degree of congestion and inflammation than any recent symptoms had indicated. The ventricles, on section, were found filled with serum and pus. The pathological specimen is No. 276, Sect. I, A. M. M. The cranium shows an extensive fracture of the right supra-orbital arch; a small fragment of the bone is attached. The entire arch is removed, leaving an opening into the cranium, two and one-half inches long and one and one-fourth wide, extending from the inner angle of the orbit to the anterior inferior angle of the right parietal. The orbital plate of the right superior maxilla is fractured and depressed and a fissure an inch long extends down the body of the bone. The specimen and history were contributed by Surgeon William Clendenin, U. S. V.