CASE 459.—Lieutenant-Colonel​ George R. Maxwell, 1st Michigan Cavalry, aged 22 years​, was wounded at Five Forks, Virginia, April 1, 1865. He was taken to the field hospital of the Cavalry Corps and remained there until April 15th, when he was sent to Washington on the hospital steamer Connecticut, and admitted to the Armory Square Hospital on the 16th. Acting Assistant Surgeon C. A. Leale,¹ in a special report of the case, furnishes the following particulars: "The left knee joint was opened by a conoidal ball, which had entered opposite the head of the fibula and was extracted at point of entrance. He was very anæmic and in a generally unfavorable condition; extensive suppuration had taken place, the leg had become infiltrated with serum, the knee joint was filled with pus, and the muscles of the thigh had been separated by extensive abscesses extending as high as the apex of Scarpa's triangle. April 17th, no change in his condition; he was placed under the influence of ether, and the thigh amputated by the circular operation, at the middle third, by Surgeon D. W. Bliss, U. S. V.; the stump was dressed with water, and the patient placed in bed. April 18th, although twelve ligatures had been applied, hæmorrhage continued to take place (he being apparently of a hæmorrhagic diathesis), and altogether about eight ounces of blood was lost. Applied liquor ferri persulphas by a camel's hair brush to the whole of the surface of the wound, which had been left open and exposed to the air for about fifteen minutes; this, with the styptic, entirely checked all oozing. April 20th, the granulations had become healthy; about two drachms of pus discharged daily. On the 30th the stump had nearly closed. June 23d, a piece of necrosed femur of a conical shape, and about four inches in length, was removed. August 8th, he was mustered out of service; his stump (FIG. 192) was solid and in good condition." The pensioner was paid June 4, 1879.

¹ LEALE (C. A.), Intermediary Hæmorrhage, Parenchymatous in Character, following Secondary Amputation of Thigh; Recovery, in United States Sanitary Commission Memoirs, Surgical Volume 1, p. 176.

FIG. 192.—Amputation of left thigh at middle third. [From a photograph.]