Civil War Washington

CASE 780.—Private L. Smith, Co. D, 12th Infantry, aged 24 years, was wounded in the left foot, at Spottsylvania​, May 12, 1864, and entered Stanton Hospital, Washington, six days afterwards. Surgeon J. A. Lidell, U. S. V., reported: "The nature of the injury was an extensive shell wound on the plantar surface, all the tarsal bones except the cuboid being fractured. The foot became much swollen and inflamed and the wound was sloughing and full of maggots. Acting Assistant Surgeon C. H. Osborn amputated the leg at the lower third, on May 21st, by the circular method, using sulphuric ether as the anæsthetic. But little blood was lost during the operation. The patient reacted promptly and did not suffer much shock. Tonics and stimulants were administered. On May 26th, there was a pyæmic chill, which returned at intervals for two weeks. The stump commenced to slough, abscesses formed in the thigh, and large bed-sores came on over the sacrum. The patient was also troubled with diarrhœa. Death resulted from pyæmia July 3, 1864. At the autopsy the anterior part of the stump was found to have sloughed to within one inch below the tubercle of the tibia, exposing the bone, which was denuded of its periosteum. There were two large abscesses, one in the popliteal space and the other in the middle third of the thigh; small thrombi in the veins. The lungs contained several superficial abscesses; the liver was enlarged, soft, and fatty; spleen soft and enlarged. All the other viscera were in a normal condition." The stump of the leg, showing the tibia to be exposed for the extent of six inches, was contributed to the Museum by Assistant Surgeon G. A. Mursick, U. S. V., and constitutes specimen 2739 of the Surgical Section.