Civil War Washington

CASE 34.—Private W. H. King, Co. E, 17th Maine, aged 24 years, was wounded at Bartlett's Mill, November 27, 1863, and admitted to Prince Street Hospital, Alexandria, one week afterwards. Acting Assistant Surgeon J. Cass contributed the specimen (FIG. 4), with the following history: "He was wounded by a musket ball which struck two pocket knives, breaking them and driving the fragments with the ball into the anterior side of the middle third of the left thigh. A hundred fragments of the knives and four of the ball were removed on the field. Lime-water dressings applied to the wound, and fifteen drops of tincture of iron given before meals. On December 13th, he suffered considerable pain in the wound, and on the following day an incision was made two and a half inches from the wound, and a jagged piece of ball an inch long and three- fourths of an inch wide was extracted. 16th, complained of strangury and some pain in the limb. A teaspoonful of spirits of nitre given three times a day. 17th, was restless during the night; sweats profusely, and had a chill this morning. Gave morphia and whiskey, also half an ounce of castor-oil. Has had no stool for forty-eight hours; pulse 115 and feeble; tongue coated; very thirsty; some soreness in inguinal glands. Prescribed extract of ginger and turpentine ten drops each, to be repeated in six hours if it does not operate, and gave tonics and stimulants. 18th, pulse 100, tongue moist and coated. Sweats all the time, and vomited in the night. Bowels moved freely and urinates more freely; appetite better. There is a greater discharge of pus from the wound. 19th, pulse 115 and feeble; vomited considerable during the day. Ordered two quinine pills to be taken before meals, and an anodyne injection at bedtime. 20th, about the same; had a chill yesterday; granulations are pale and flabby. 21st, pulse 140 and very feeble; great prostration; had a chill this morning and is delirious. Takes stimulants every hour. 22d, rested well, but is more prostrated and shows tendency to coma. Died at 4.30 P. M. Autopsy eighteen hours after death: On cutting through the muscles of the thigh, an inch and a half from the surface and an inch from the main channel of the wound, a sliver of horn from a knife-handle was found, half an inch long and one-sixteenth of an inch wide; also a brass rivet one-sixteenth of an inch in diameter and one-fourth of an inch long. In another place two pieces of horn from the other knife-handle, one three-eighths of an inch long and one-fourth wide, and the other one-eighth each way, were found; also a piece of a blade one-fourth of an inch long and one-eighth wide; and two pieces of brass, one being three-eighths of an inch long and one-sixteenth wide at one end and tapering to a sharp point at the other, and the other piece measuring one-eighth of an inch each way. Opposite the external wound the periosteum was found in places thickened, inflamed, jagged, discolored, slightly ossified, and separated from the bone for the space of two and a quarter inches longitudinally, and one inch transversely, with some pus beneath it." Dr. Cass also contributed five inches of the shaft of the femur of the injured thigh, which constitutes specimen 1985 of the Surgical Section of the Army Medical Museum. It is sawn longitudinally, and shows the shaft to be denser than usual and apparently somewhat hypertrophied. (See Cat. Surg. Sect., 1866, pp. 258, 617.)