Civil War Washington

Private Hiram B——, Co. A, 142 Pennsylvania, aged 18 years, received a gunshot fracture of the zygoma and mastoid process of the temporal bone, left side, on the Weldon Railroad, August 21st, 1864. He was at once conveyed to the hospital of the 1st division, Fifth Corps, and, on the 24th, was transferred to Lincoln Hospital, Washington. The wound extended from within a half inch of the outer canthus of the left eye to just posterior to the left mastoid process. Cold-water dressings were applied. On the 26th, arterial hæmorrhage occurred, which was checked by filling the wound with lint soaked in a solution of persulphate of iron. It, however, recurred on the next day, and Assistant Surgeon J. C. McKee, U. S. A., administered ether and ligated the left common carotid artery above the omo-hyoid, an inch and a half below the bifurcation. Anodynes and stimulants were administered, but the patient sank under the repeated and copious hæmorrhages, and death ensued September 2d, 1864. At the autopsy, the meatus auditorius was found to be cut across. It was impossible to detect from what artery or arteries the hæmorrhage proceeded. Both lungs were anæmic. The adjoining wood-cut (FIG. 1) represents a portion of the aorta, the commencement of the left subclavian, the common carotid, and its bifurcation. A firm fibrinous coagulum extends from the seat of ligature to the bifurcation. The coagulum on the proximal side of the ligature is much shorter, occupying less than half an inch. The drawing is of the natural size of the vessels, shrunken in alcohol. The notes of the case, and specimen, were contributed by Acting Assistant Surgeon H. M. Dean.