Civil War Washington

CASE 796.—Private L. V. Grant, Co. M, 8th Illinois Cavalry, aged 23 years, was wounded in the left ankle, at Beverly Ford, June 9, 1863, and entered Lincoln Hospital, Washington, the following day. Assistant Surgeon J. C. McKee, U. S. A., who amputated the injured limb, reported as follows: "The wound was caused by the ball entering the inner malleolus posteriorly, penetrating the base of the tibia, and remaining embedded on the semi-cylindrical face of the astragalus​. Upon taking charge of the hospital (December, 1863) I found the patient's condition as follows: Appetite capricious but well guarded by taking acceptable food; constant pain in left breast, accompanied by headache; eyes constantly suffused and face flushed, wakefulness, restlessness, and night-sweats; also a strong aortic direct murmur of the heart, with considerable hypertrophy and consequent labored heart action. He had to be propped up in bed to allow him any rest, his expression being anxious, appetite declining, pain of wound unremitting and excruciating, tissues inflamed and œdematous, and the joint immovable and firmly anchylosed, rendering it impossible for the patient to put his foot on the ground. He begged again and again to have the limb removed. An examination by the probe indicated diseased bone or foreign substance. The opinion of Acting Assistant Surgeon W. F. Peck—under whose care he had been for some months—as confirmed by the statement of the patient was that the ball had been extracted. Uninfluenced by the patient's constant and urgent solicitation I proceeded carefully to examine the case further; and not being satisfied that I had sufficient authority to remove the diseased and injured joint by amputation, I delayed for accumulative evidence, which was not long in presenting itself. The bad symptoms increasing, it became evident that some measure for relief must be promptly taken to save the life of the patient. Assistant Surgeon R. Bartholow, U. S. A., under whose care the patient had also been for some time, favored immediate amputation, and stated that he had intended to operate before my arrival. Assistant Surgeon H. Allen, U. S. A., was also present and favored the operation. Acting Assistant Surgeon W. F. Peck insisted upon removing the limb some time before I gave my consent; other medical gentlemen present were satisfied that the removal of the limb was called for to rid the patient of a deformity and an encumbrance. Amputation was accordingly performed on December 7, 1863, eight inches below the knee, by circular operation. Sulphuric ether was used and the patient reacted promptly. The stump was left laying open on a pillow and strapped, when the healing process commenced. Simple water dressings were applied. The aggravated symptoms of the heart disease became greatly modified after the operation. The patient's appetite improved, his night-sweats ceased, and he was delighted to be able to sleep and rest, stating that he had not enjoyed any comfort or relief from pain for months before. He obtained an excellent and useful stump. The ligatures came away two weeks after the operation. The patient was furloughed February 11th, and subsequently he was transferred to Judiciary Square Hospital to have an artificial limb applied." On September 24, 1864, his term of service expired and he was mustered out. He was a pensioner until August 21, 1865, when he died. The cause of his death has not been ascertained. The amputated part of the wounded limb, longitudinally bisected and exhibiting the place of lodgement of the missile, was contributed to the Museum by the operator and constitutes specimen 1899 of the Surgical Section.