CASE 17.—Sergeant Hiram H. Terwilliger, Co. E, 80th New York Volunteers, aged 29 years, was wounded at Bull Run, Virginia, August 30th, 1862, by a minié ball, which struck just below the calf, on the inner side of the left leg, and split upon the bone, one part passing through and issuing near its point of entrance; the other lodging on the outer side of the leg. This wound bled freely and occasioned considerable pain, but he kept his place, till, as he thinks, about a half hour later, when he was struck again by a round bullet on the left side; the missile passed directly through the cavity of the chest, grazing the lungs and liver, and emerged between the seventh and eighth ribs on the right side. It then entered the right arm and fractured the humerus into the elbow joint, where it lodged; the spiral nerve was injured. The first stunning sensation of the wound having passed, he left the field and walked a distance of about two miles, when, exhausted by loss of blood, he fainted. He was conveyed to Alexandria, and admitted, on September 1st, to Fairfax Street Hospital. On admission, he was insensible. Strong stimulants were administered. Acting Assistant Surgeon Robertson removed the half of the ball which had lodged in the leg; it was found flattened and ragged-edged. The case progressed favorably for about eight weeks, when the wound of the chest closed. This was followed by diarrhœa and feverishness, which symptoms passed off in a few days. His appetite and flesh returned, and he was discharged from service on January 14th, 1863. Soon after his arrival home, a cough set in, followed by severe pain in left side, disturbed sleep, impaired appetite, laborious breathing, swollen limbs, night sweats, and profuse expectoration. These symptoms becoming more and more aggravated, and evidence of pus in pleural cavity being well defined, the operation of thoracocentesis was performed by Dr. Smith Ely, of Newburgh, New York, on April 28th. A trocar​ was plunged into the cavity of the chest, just below the left shoulder blade, and an India-rubber tube inserted in the opening, the ends of which were left hanging down about four inches, the one within and the other on the outside of the chest. The operation was painful in the extreme, but, weak and emaciated as he was, he endured it without flinching. No anesthetic could be administered, owing to his feeble condition. Through the syphon formed by the tube, there was discharged, during the ensuing ten days, about seven quarts of matter. At the end of that time, the tube was removed and the opening immediately closed. The heart, which had been pushed around to the right side, resumed its natural position, and the lungs their proper functions. The cough ceased, swelling disappeared from his limbs, and his health gradually improved, until about September 1st, when he removed to Alexandria, Virginia, and went into business. Pension Examiner R. Loughran reports, October 16th, 1871: Adhesion of pleura and difficulty in expansion of chest and respiration. Almost constant pain in track of ball. Digestion greatly impaired, and general debility of the entire system. Partial anchylosis of elbow-joint. Tibia injured and soft parts consolidated; partial loss of motion of foot.⃰

⃰This case was reported, at great length, in the Proceedings of the Ellenville (Ulster County, New York) Historical Society, July 8th, 1864, and is copied in the Medical and Surgical Reporter, Philadelphia, 1865, Vol. XII, p. 137.