Civil War Washington

CASE 1053.—Private C. C. Mulford, Co. K, 6th New York Artillery, aged 42 years, was wounded in the right thigh, at Spottsylvania​, May 19, 1864, and entered Fairfax Seminary Hospital six days afterwards. Assistant Surgeon H. Allen, U. S. A., described the injury as follows: "The wound was caused by a musket ball, which entered at the upper part of the middle third of the thigh and lodged. The case was treated as a simple flesh wound; patient doing well. On June 14th the missile was found and extracted. A severe diarrhœa came on June 19th and continued till June 25th, when it was controlled. Four days afterwards diarrhœa again appeared, and brandy and opium were prescribed. During the night of June 30th the patient had a severe chill, followed by fever, dry tongue, and collections of sordes upon the teeth. I saw the patient for the first time on July 1st, when he was in a dying condition, being bathed in a copious clammy sweat, though his mind was quite clear, and he complained of no pain. There was discoloration of the skin. He died on the following day, July 2, 1864. Autopsy: Emaciation extreme; affected thigh very little swollen: wound open, and the integuments for some distance above and below it of a purplish red color; femoral vein entirely healthy; internal organs healthy. The bone was found to have been grazed by the ball. Upon removing the femur its walls immediately opposite the track of the ball were found to be stripped entirely of periosteum, and that covering the bone above and below this region was thickened and stained of a grayish hue from contact with a dark colored offensive pus, which laid both in the wound and around the bone. At the great trochanter an abscess of about the size of a hen's egg was discovered. This was entirely distinct from the collection before mentioned, being separated from it by a track of comparatively healthy tissue. The pus contained therein was more laudable than that found elsewhere. When the bone was sawed open, which was accomplished with some difficulty on account of the increased thickness and density of its walls, its entire interior was found filled with pus, the fluid being of an ochre-yellow, with large oily globules floating upon the surface. No trace of the original structure could be seen anywhere. The spongy tissue at the head of the bone was completely discolored with a uniform grayish yellow stain, while that of the condyles was perfectly healthy. The walls of the bone were of great thickness and the sawn surface presented a white, glistening, eburnated appearance. No vascularity was seen, and the haversian canals were found not to be enlarged." The greater portion of the injured femur, contributed to the Museum by Surgeon D. P. Smith, U. S. V., constitutes specimen 2675 of the Surgical Section, showing necrosis at the point of contusion on the inner surface in the middle third, above and below which the bone is greatly roughened by suppuration in nearly its whole extent.