Civil War Washington

CASE 663.—Private N. Hollenbeck, Co. F, 7th New York Heavy Artillery, aged 37 years, was wounded at Tolopotomy Creek, May 30, 1864. He was admitted to Emory Hospital, Washington, June 8th, with "shot wound of left leg, over tibia." Acting Assistant Surgeon A. McLetchie contributed a specimen (Cat. Surg. Sect., 1866, p. 519, Spec. 3133), with the following report: "The wound was caused by a minié ball, which entered the leg directly over the spine of the tibia, middle third, injuring the periosteum but not splintering the bone itself. The missile was extracted through the wound of entrance. The wounded man was admitted to Patterson Park Hospital, Baltimore, June 11th. He was in a very asthenic condition, and I ordered stimulants and good nourishing diet. About the 18th of June gangrene set in, manifesting itself by constitutional symptoms, fever, loss of appetite, etc., some days before the distinctive symptoms appeared in the wound. The disease was treated with nitric acid, cautery, dressings of chlorinate of soda, linseed poultices, charcoal, turpentine, and linseed oil, with frequent use of the syringe. On August 11th, he was returned from the gangrene ward with the wound much enlarged, but entirely free from gangrene, and nearly four inches of the bone exposed. Tincture of chloride of iron was administered daily, and milk punch, from the first appearance of the disease. Diarrhœa, which had been checked on his entrance into the hospital, now set in again, complicated with acute dysentery, and was treated with chalk mixture, vegetable astringents, and pulverized iron and opium. But the patient gradually wasted away from the steady strain on his system, and died August 26, 1864." The specimen is a wet preparation of the leg, showing a contusion in the middle third of the tibia, and necrosis extending up the shaft of the bone on its posterior surface to near its head, also two openings from ulceration in the lower third.