Civil War Washington

CASE 619.—Corporal G. W. Hays, Co. K, 2d Michigan, aged 19 years, was wounded in both knees, at Petersburg, June 17, 1864. Surgeon R. B. Bontecou, U. S. V., reported: "He was admitted to Harewood Hospital, Washington, June 20th, suffering from amputation at the lower third of the thigh, performed on the field for a shot wound of the knee joint by a ball, which fractured the condyles of the femur and the patella. The right knee was also wounded, a ball entering the joint, fracturing the patella, and denuding the condyles of the femur and the head of the tibia. Extensive suppuration followed in the right knee, and an abscess burrowed half way up the thigh; the joint itself became entirely disorganized and much swollen." On June 24th, resection of about two-thirds of the condyles of the femur, with the entire patella and the articular face of the tibia, was performed by Surgeon R. B. Bontecou, U. S. V. Sulphuric ether was used as the anaesthetic. The stump of the left thigh progressed very satisfactorily towards healing, while the resected joint commenced to fill up with healthy granulations also and looked well in other respects. Profuse suppuration of healthy looking pus, however, continued. The constitutional treatment was mainly directed towards supporting the strength of the patient, and consisted of stimulants, tonics, and nourishing diet. The right thigh and leg were supported and kept in place by means of a wide board, to which a bag of bran was attached and so arranged as to embrace the parts on either side, it being readily adjusted and kneaded to suit the manipulations during dressing. The entire extremity, from the foot to the great trochanter, was confined in a Scultetus' bandage. The patient did tolerably well up to June 30th, from which date he became drowsy and was only waked with difficulty. He continued so, with intervals of wakefulness, until his death, which occurred on July 2, 1864, from exhaustion. There were no pyæmic symptoms. The exsected​ patella and condyles of the femur were contributed to the Museum by the operator and are represented in the cut (FIG. 244).³

³ Circular No. 6, War Department, S. G. O., Washington, 1865, p. 59; CULBERTSON (H.), Excision of the Larger Joints of the Extremities. Prize Essay, in Transact. Am. Med. Assoc., 1876. Supplement to Vol. XXVII, p. 184, Case 17.