Civil War Washington

CASE 77.—Sergeant W. Walters, Co. B, 87th Pennsylvania, aged 29 years, was wounded at the Wilderness, May 8, 1864. Surgeon N. R. Moseley, U. S. V., reported his admission to Emory Hospital, Washington, May 16th, with "shot wound of foot." Surgeon J. H. Taylor, U. S. V., reported the following result of the injury: "The patient was admitted to Summit House Hospital, Philadelphia, May 20th, having been wounded by a ball striking the plantar surface of the left foot at the first interosseous space, one and a half inches from the metatarso-phalangeal joints, going directly through on the dorsum and producing a flesh wound. Cold-water dressings were applied. The patient is of strumous diathesis, having scars on the side of his neck, the remains of scrofulous abscesses. May 30th, at 8 A. M, he was in excellent health; at 12 A. M.​ he complained of stiffness and pains in the jaws and neck; great pain, referred to articulation of left inferior maxilla with temporal bone, together with constant fixed pains at the epigastrium, shooting around to the spine; jaws seemingly tied, as the patient expressed; mouth gradually closing; twitching of facial muscles; some difficulty of respiration, but none of deglutition. Treatment: Bowels unloaded by injections; brandy and quinine given in large quantities, milk-punch and beef-tea by mouth and rectum. Liquor of morphia, one half ounce, was given every two hours for eight hours or ten hours, but with no effect. Injected one grain of sulphate of morphia, dissolved in one drachm of water, hypodermically just over the temporal region; but even this failed to produce any narcotic effect. Counter-irritation was used at the spine with the chloroform and covered with oiled silk, but so severe was the burning pain that it soon had to be discontinued. On May 31st, the patient was attacked with severe cramps in the abdomen, the muscles here becoming hard and tense, the muscles of the back rigid and prominent; great pain, referred to chest in inspiration; pupils contracted. There was profuse perspiration over the entire body from the commencement of the disease; pulse natural. A solution of sulphate of atropia, one grain to an ounce of water, was now injected, in quantities of one drachm, a little to the left of the median line of the neck at first, and subsequently on each side of the spine, below the scapula, at intervals of one half, one, and two hours, in all seven or eight times. The pupils were now dilated, but there was not the slightest relaxation of muscular spasm; perspiration still profuse. An effort to rouse him from this state with cold douche had but little effect. The spasms continued to increase in frequency and violence until 3 A. M. on June 1, 1864, when he died."