Civil War Washington

CASE 1194.—Private B. F. Brown, Co. C, 22d Massachusetts, aged 23 years, was admitted into Emory Hospital, Washington, May 13, 1864, with gunshot wounds of the thigh, leg, and neck, received at the battle of the Wilderness, May 7, 1864. The thigh had been amputated on the field on May 7th, in the lower third, by lateral flaps. A ball had entered the neck below the angle of the jaw, passed through the larynx, and lodged near where the carotid crosses the omo-hyoid muscles. On May 16th the ball was extracted from its position against the carotid by an incision one and a half inches long, one inch below the mastoid process of the temporal bone, by Acting Assistant Surgeon W. H. Ensign, U. S. A. At this date the thigh was healing kindly by first intention. The wound of the neck had an extraordinary appearance. The patient's constitution was slender but not much impaired. Some trouble in swallowing and breathing; cheerful, sleeps well, shows little signs of distress; pulse 90, bowels regular. No medicine given; but good liquid diet with local water dressings. Food has to be administered with a stomach pump. On May 17th hæmorrhage to the amount of one quart occurred from the internal jugular vein. Air was supposed to have passed through the vein into the heart. A post-mortem examination showed the cause of hæmorrhage to be ulceration of the anterior surface of the internal jugular vein. The case is reported by Surgeon N. R. Moseley, U. S. V.