Civil War Washington

CASE 1057.—Private G. Cole, Co. A, 91st New York, aged 35 years, was wounded in the right thigh, at Petersburg, March 31, 1865. From a field hospital he passed, on April 3d, to the Fifth Corps Depot Hospital at City Point, and two days later he was transferred to Washington. Assistant Surgeon W. F. Norris, U. S. A., contributed the following history: "The patient was admitted to Douglas Hospital, April 6th, with a wound inflicted by a minié ball, which caused a severe contusion of the femur at the middle third without producing fracture. His constitutional condition at the time of his admission was good and the wound looked healthy. On April 12th a very much flattened bullet was extracted by Acting Assistant Surgeon H. Gibbons. On the 17th, erysipelatous inflammation appeared about the wound, which increased on the following day in spite of the application of poultices and tincture of iodine. On the 20th there was a slight attack of erysipelas of the nose, and the following day the patient had two severe chills, which were repeated on the 22d, 23d, and 24th. On the 25th he again had two chills, and one on the next day. The conjunctivæ now had assumed a yellow tinge, and he had pain in the chest; pulse 132. On the 27th there was another chill, the constitutional condition remaining as before, and on the following day there was one more repetition, and secondary involvement of the knee joint manifested itself. The skin and conjunctivæ were now deeply jaundiced, and the discharge from the wound unhealthy, fetid, and bloody. On the 29th there was hiccough, delirium, and vomiting, and the patient sank rapidly. He died on the following day—April 30, 1865. At the autopsy, both lungs were found to be covered posteriorly with an offensive greenish flaky lymph and to contain a number of small pyæmic abscesses. There was about five ounces of effusion in the thoracic cavities. The other organs were but slightly affected. On removing the femur the periosteum was found to be wanting for five inches in length and one-third of the circumference of the bone, the part so bared showing evidence of absorption of its tissue except at the point struck by the bullet. On sawing open the shaft of the femur longitudinally the lower half was discovered to be in a gangrenous condition, the medulla being greenish, soft, and offensive, and the cancellated structure of the condyles presenting the same appearance. There was about two ounces of thin brownish-yellow fluid in the knee joint, and the femoral vein near the joint as well as the small articular veins were filled with clots, their inner coats in some places being reddened and in others of a greenish hue."