Civil War Washington

CASE 16.—Private John M. Mosher, Co. I, 1st Maine Cavalry, was wounded at Brandy Station, Virginia, October 12th, 1863, by an elongated rifle ball, which struck near the costal cartilage of the fifth rib, coursed inward and to the right, and, passing over the xiphoid appendage, perforated the diaphragm, entered the liver immediately to the right of the suspensory ligament, passed outward and slightly upward and emerged on the posterior surface of the greater lobe to rest beneath the diaphragm. He was taken to the field hospital, where he remained for several days, when he was sent to Washington and admitted to Lincoln Hospital on the 19th. Death resulted on October 20th, 1863, from pericarditis and pleurisy. The necropsy revealed the course of the ball. The right lung was not visible, its site being occupied by a puffy mass of emphysematous cellular tissue in a state of inflammation; toward the median line this infiltration was covered by a thick layer of exudation of a dark purplish red color. The pericardium was covered externally with a layer of lymph of a recent formation. There was about one-half pint of dark and serous fluid in each pleural cavity. On section of the first and second lobes they were found congested, especially at the apex of the first. Bronchial irritation was shown by the excess of the frothy secretion in this part. Immediately to the right of the suspensory ligament a ragged roundish opening was seen; five and a half inches to the right, and, on a line with this, another opening was observed of the same general appearance as the first. At this point, the liver was firmly adherent to the diaphragm by inflammatory products, as, indeed, was the greater part of the right lobe, but the latter were much older adhesions than those around the wound. At this opening, a brass button was found with a portion of clothing attached. The missile, disfigured a very little, with an ordinary military coat button inverted, together with the cloth to which it was sewn, is represented by the wood-cut (FIG. 286). It was contributed, with notes of the case, by Assistant Surgeon H. Allen, U. S. A., from Lincoln Hospital.