Title: W——, R.

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), 361.

Keywords:wounds and injuries of the facegunshot wounds of the facegunshot fractures of the facial bonesfractures involving upper and lower maxillæfracture of upper maxillaimpeded deglutitionparalysis of facial nerves of one side, nerves presiding over deglutitionparalysis of brachial nerves of one sidegunshot fracture of surgical neck of humerusautopsy performedball entered side of face at infra-orbital foramen of the superior maxilla, emerged between ascending branch of lower jaw and transverse process of atlasfractured malar bone below infra-orbital edgeperforated superior maxilla

Civil War Washington ID: med.d1e18126

TEI/XML: med.d1e18126.xml


CASE.—Private R. W——, Co. F, 95th Pennsylvania Volunteers, aged 39 years, was wounded at Chancellorsville, Virginia, May 3d, 1863, by a conoidal ball, which entered the left side of the face at the infra-orbital foramen of the superior maxilla, and emerged between the ascending branch of the lower jaw and the transverse process of the atlas, half an inch external to the latter, in the left nuchal region, fracturing the malar bone below its infra-orbital edge and perforating the superior maxilla. He also received a gunshot fracture of the surgical neck of the right humerus. Being taken to Washington, he entered the Douglas Hospital on May 8th, 1863, suffering considerably from cough and impeded deglutition. On May 11th, there was paralysis of the facial nerves of the left side, the nerves presiding over deglutition, and the brachial nerves of the right side. The point of the tongue pointed toward the left side, on being stretched out. Several pieces of bone were removed from the superior maxilla and its sinus. The wound of the face was plugged with charpie. Desault's bandage was applied to the right arm, and stimulating diet was given. On May 19th, the fauces were red and inflamed. On May 24th, the patient, while drinking a cup of tea, became suddenly suffocated and expired. At the autopsy, it was found that ulceration of the œsophagus had taken place. The ball had barely escaped the lateral process of the atlas. There was an effusion of blood into the muscles of the neck, causing compression, doubtless, on important nerves. No manifest cause for his sudden death was discovered. The pathological specimen is No. 1239, Sect. I, A. M. M., showing the left superior maxilla and a part of the malar bone fractured by a musket ball, which carried away the upper part of the body and the orbital process and the zygomatic process of the malar broken off at its root. The pathological specimen of the fractured humerus is No. 1238, Sect. I, A. M. M. The specimens, with the history, were contributed by Assistant Surgeon W. Thomson, U. S. A.