Civil War Washington

Private John Brooks, Co. I, 57th Pennsylvania Volunteers, aged 17 years, was wounded at the battle of the Wilderness, May 6, 1864, by a conoidal musket ball, which entered over the left ear, passed forwards, making an irregular opening through the temporal bone large enough to admit the introduction of two fingers into the cavity of the skull, and escaped three inches anterior to the wound of entrance The membranes of the brain, however, were not injured. He was treated in a field hospital, and, on May 15th, was sent to the Columbian Hospital at Washington. He was pale, emaciated, and complained of acute cephalalgia; otherwise, his bodily functions were normal. On the 17th, the headache had increased, and the pupils had become contracted. Expectant treatment was used, notwithstanding which, delirium gradually came on, and, on May 20th, the patient was comatose and unable to swallow. The pulsations of the heart were rapid and feeble; the pulse at the wrist, imperceptible. He remained in this condition sixty hours, when it was found that if fluids were placed in his mouth in small quantities, he would swallow them. From this time he slowly improved. On June 2d, the patient was able to sit up, but his bowels were constipated, he voided his urine unconsciously, and his mental faculties were much impaired. He was unable to articulate, had no recollection of the past or proper perception of present things, and stared vacantly round the tent. His appetite was ravenous. The pupil of the right eye did not respond to light; otherwise, there was no paralysis. At this date, a hæmorrhage occurred from the posterior wound to the amount of about two ounces, followed by great improvement in all the symptoms. Hæmorrhage recurred every two or three days, and was not altogether checked until the 18th of June, as it seemed to aid much in restoring his mental faculties. On the latter date, an attempt was made to ligate the temporal artery; and this failing, the common carotid was ligated at its upper portion, on June 20th, by Surgeon T. R. Crosby, U. S. V. The bleeding still continuing, the posterior wound was enlarged, and some small fragments of exfoliated bone were removed; the wound was then plugged with lint, which entirely arrested the hæmorrhage. It was estimated that fifty ounces of blood had been lost during the last hæmorrhage. Liberal diet was prescribed, and the patient gained rapidly in flesh. The ligature came away on the tenth day after the operation, and the wound united, except at the point of ligation, where a fistulous opening remained, which discharged daily a small amount of pus. On August 15th, blood was found to ooze from the place of ligation; and, the patient having lost about twenty ounces, the artery was cut down upon by Surgeon Crosby and ligated below the omo-hyoid muscle. The vessel was found dilated to more than double its normal size, and firmly attached to it, on the inner side, was a well-formed clot. Low diet was ordered; tincture of aconite was given to keep the heart's action as much reduced as was consistent with the safety of the patient. On September 15th, the wound had fully healed, and, on November 15th, the patient was furloughed, apparently entirely restored in his bodily functions. He was discharged from service on June 8th, 1865. The case is reported by Surgeon T. R. Crosby, U. S. V., and is figured as No. 284, Surgical Photographs, A. M. M., Vol. VI, p. 34.