Civil War Washington

CASE.—Corporal Samuel Foulkrod, Co. G, 56th Pennsylvania Volunteers, aged 34 years, was wounded at the the Wilderness, Virginia, May 6th, 1864, by a conoidal ball, which entered the back in the lumbar region, and lodged. He was treated in the field, and, on May 12th, sent to the 3d division hospital, Alexandria. It was thought that some of the vertebral processes were shattered. Several fragments of bone came away, and the wound healed very slowly. After the wound healed, abscesses formed in the sacral region from time to time, which gave vent to considerable purulent collections. He was transferred, on October 8th 1864, to the 102d company, 2d battalion, Veteran Reserve Corps. On February 11th, 1865, the patient had an attack of acute pleurisy. Wet cups were applied to the right chest, and six or eight ounces of blood withdrawn. This was followed by fomentations and purgatives, with an anodyne at night. February 12th: Abatement of febrile action. Effusion in right pleural sac, extending up to the fifth rib anteriorly. Patient placed in an upright position. February 20th, accumulation in right pleural sac has increased. Flatness, on percussion, as high as the third rib anteriorly; no respiratory act audible below this point. No dyspnœa. Decubitus on right side. Appetite fair; pulse 90, and soft. Patient complained of weakness. February 28th, marked increase of fluid in chest. On March 2d, a rapid accumulation was noticeable; complete flatness on right side, extending under. Liver depressed three or four inches. Apex of heart, two inches to the left of the nipple. Great dyspnœa; pulse, 130. Hectic fever, followed by profuse perspiration. The operation of thoracentesis was decided upon, and was performed by Assistant Surgeon Samuel B. Ward, U. S. V. A straight trochar was passed into the pleural sac between the fifth and sixth ribs, in the lateral region of the thorax, and fourteen and a half pints of healthy pus withdrawn. The patient experienced no faintness during the operation and felt greatly relieved. After the operation, the heart and liver returned to their positions. The condition of pneumo-hydro-thorax appeared, giving rise to the metallic tinkling and amphoric voice. Stimulants, anodynes, and nutritious diet, with absorbents, expectorants, and counter-irritants constituted the main treatment. During the month of March, the accumulation returned to a great extent, the dullness extending as high as the fourth rib. On April 1st, the incision of operation burst open, giving vent to over a pint of blood, and afterward continued discharging. Several abscesses were opened on the right thigh and leg. On April 15th, erysipelas appeared on the face, terminating favorably in a few days. On the 25th, he was transferred to the Sickel branch hospital, at which time he was gaining strength, and his case was very hopeful. Phthisis pulmonalis supervened, and death resulted on June 16th, 1865. The case is reported by Surgeon Edwin Bentley, U. S. V.