Civil War Washington

CASE 760.—Private J. N. Coder, Co. K, 46th Pennsylvania, was wounded in the left leg, at Cedar Mountain, August 9, 1862. He was admitted to Wolfe Street Hospital, Alexandria, five days afterwards, where amputation was performed by Acting Assistant Surgeon S. E. Fuller, who reported the following history: "A rifle ball passed through the leg, fracturing the tibia about its middle. The limb was amputated three inches below the knee joint by the circular method, by order of Surgeon J. E. Summers, U. S. A., in charge of the hospital, on August 27th. Three days after the operation the stump had become much swollen, with red streaks extending up the limb; no suppuration. Quinine and brandy were ordered internally and warm-water dressings were applied to the stump. August 31st, patient much the same; treatment continued, and limb painted with muriated tincture of iron as far as the redness extended. September 1st, swelling great and no suppuration; sutures removed and some thick dark-colored fetid matter washed out of the stump. September 4th, redness disappeared; swelling less; no suppuration; treatment continued. On September 7th some sloughing of the stump appeared, when lint wet with solution of chloride of soda was applied, and the parts were occasionally touched with nitric acid. On September 14th about two inches of the soft parts came entirely away, leaving a granulating surface, and the patient appeared better and had good appetite. On September 16th, I called at 2 A. M., found the peroneal artery bleeding freely, and applied a tourniquet to the femoral, giving brandy and opium internally. There was no return of the hæmorrhage, but the patient gradually sunk, and died September 19, 1862." The amputated tibia, showing periostitis to have covered the shaft with a delicate coating of callus, was contributed by the operator, and is specimen 321 of the Surgical Section A. M. M.