Civil War Washington

CASE 802.—Private C. W. Fox, Co. I, 111th New York, aged 18 years, was wounded in the right foot during the engagement at the South Side Railroad, March 31, 1865. He was admitted to Harewood Hospital, Washington, five days afterwards, where amputation was performed by Surgeon R. B. Bontecou, U. S. V., who made the following report: "The metatarsal bone of the big toe was fractured and the os calcis severely injured. When admitted the patient appeared to be considerably debilitated; the condition of the injured parts, however, was tolerably good. The parts subsequently became gangrenous, with disorganization of the ankle joint, sloughing of soft parts, and necrosis of bone. Sinuses formed and extended up the leg. The limb was amputated at the lower third by the circular method on May 3d. The patient did well after the operation under simple dressings, aided by a supporting and nourishing diet throughout. The parts had nearly healed when he was transferred to Armory Square Hospital July 20th." About one month later he was transferred to Stanton Hospital, where a second operation became necessary and was performed by Surgeon B. B. Wilson, U. S. V., who describes it as follows: "The first amputation had been performed about one inch above the ankle joint. At the time of the patient's admission to Stanton Hospital the stump had entirely healed, but it was swollen and painful and presented evidence of suppurative inflammation within. Poultices were applied and abscesses soon pointed in two or three places, one in or near the cicatrix of the operation and the other along the lower part of the shaft of the tibia, which, on rupturing, discharged a bloody and ill-conditioned pus pretty freely. Upon examination with a probe the existence of necrosed bone was detected, and at the earnest request of the patient, who desired to get rid of his trouble as quickly and fully as possible, it was determined to re-amputate the stump as far as the sequestrum extended. The operation was performed on September 6th, three inches of the bones being removed by the ordinary circular method and the sequestrum found to extend quite up to the point severed by the saw. The integument was brought together laterally and secured by interrupted sutures and adhesive straps. The patient did well and the healing process progressed rapidly. At the closing of Stanton Hospital, on September 19th, he was sent to Douglas Hospital, where I saw him two weeks afterwards, when the stump was almost entirely healed and looked admirably." In October, 1865, the patient was discharged from service, to date from September 6th, and pensioned, having been previously supplied with an artificial leg. In his applications for commutation he described the stump as being in "sound" and "good condition." His pension was paid September 4,1880. The bones removed at the second amputation were contributed to the Museum by the operator and constitute specimen 2454 of the Surgical Section, exhibiting the fibula in a state of caries and a large spongy involucrum surrounding a small sequestrum of the tibia.