Civil War Washington

CASE 5.—Private John W. Hills, Co. A, 145th Pennsylvania Volunteers, aged 24 years, was wounded at Fredericksburg, Virginia, December 13th, 1862; the ball entered the integuments at the middle third, external edge of the scapula, passed through the axilla, and lodged in front, just below the insertion of the pectoralis minor. He was carried to the field hospital, where the ball was removed a few hours after the reception of the injury. Simple dressings were applied. On the 17th, he was transferred to Harewood Hospital, Washington. The case progressed well until the 23d, when hæmorrhage to the amount of about six ounces occurred from the posterior wound. The wound was enlarged and the bleeding vessel searched for, but it could not be found, although it was supposed to be the suprascapular artery, as pressure below the clavicle arrested the hæmorrhage. The edge of the scapula was denuded and rough for about one inch. The axillary artery was ligated immediately after its emergence from beneath the clavicle and the incision brought together by adhesive strips. December 24th: Some febrile disturbance. A diaphoretic was administered, and milk diet ordered. 25th: Nervous delirium; stimulants, with morphia, beef tea and chicken diet. 26th: The delirium has subsided. On the 27th, he refused to take the stimulants and morphia, and the delirium returned. It was with the greatest difficulty that nourishment could be administered to him, as he closed his teeth and rejected everything. He continued in this condition until the 29th, when a capillary hæmorrhage occurred to the amount of about one ounce from the posterior wound. Compress and bandage were applied, which entirely arrested it. He would occasionally take a spoonful of milk punch with a small quantity of morphia in it. Death resulted on the night of December 29th, 1862. The ligatures had not come away. The wound of incision had suppurated freely but there was no attempt at union. Surgeon Thomas Antisell, U. S. V., reports the case.