CASE 503.—Private Grey Y. Barrett, Co. F, 5th New Hampshire, aged 20 years, was wounded at Fredericksburg, December 13, 1862, by a musket ball, which entered at the outer condyle of the femur, passed inward and upward, and, escaping posteriorly in the middle of the lower third of thigh, left the bone much comminuted at its exit. He was admitted to the hospital of the 1st division, Ninth Corps, where, on December 16th, Assistant Surgeon J. W. S. Gouley, U. S. A., amputated the femur a short distance above the wound of entrance, the patella being included in the anterior flap; the line of section not having escaped the wound, another third of an inch was removed (FIG. 219); the femoral surface of the patella was then sawn off, and the two cut surfaces of the bone were brought in apposition (FIG. 220). The laminated portion of the femur, however, was fractured half an inch above this point, and fissures extended two inches further. The operation was well borne, and the case continued to do well until the sixth day, when sloughing commenced; on the eighth, signs of gangrene were noticed; and, on the ninth, December 25th, Surgeon J. P. Prince, 36th Massachusetts Volunteers, amputated the femur in the middle third, on account of the burrowing of pus, for secondary hæmorrhage from the popliteal. No plastic deposit could be observed immediately after the operation. On the next day he was transferred to Washington, and admitted to the Douglas Hospital, where he died on December 27, 1862. The pathological specimen, which was contributed to the Army Medical Museum by Dr. Prince, with a history of the case, is numbered 536 of the Surgical Section.

FIG. 219.—The lower half of right femur amputated above the condyles. Spec. 536.
FIG. 220.—The same with the sawn surfaces of the patella and femur in apposition.