Civil War Washington

CASE 1196.—Private John C. Marks, Co. D, 149th Pennsylvania, aged 28 years, was wounded at the Wilderness, May 10, 1864. On May 13th he was admitted into Stanton Hospital, Washington, whence Surgeon John A. Lidell, U. S. V., reported: "Flesh wounds of both arms by a musket ball, which, after passing through the left arm, entered the right near the inner edge of the biceps muscle, and passed through obliquely, outward and downward. At the end of about six weeks both wounds had healed; the cicatrix was firm. The medial nerve was evidently included in the cicatrix of the wound of the right arm, as he suffered intense pain in the course of it, especially in the fingers, which were stiff and extended. The nutrition of the arm was also impaired. He suffered great nervous irritation. September 16th, the pain in the forearm and hand is very severe; he has also partial trismus; his jaws are stiff, but he can open them to the extent of about an inch. He has failed in strength and appetite and is emaciated." Dr. Lidell made an incision about two inches in length through the cicatrix down to the nerve, which was loosened and laid bare to the extent of the incision. The old cicatrix was also removed. The nerve did not appear to be injured in any way. The pain was apparently caused by compression of it by the contraction of the cicatrix. The wound was left open to heal by granulation. He had been treated to date of operation by subcutaneous injections of morphia, which relieved the pain temporarily. September 17th, pain is slight, trismus lessened; passed a comfortable night. September 18th, pain continues, trismus subsided. The injections of morphia were continued at night, and a grain of sulphate of zinc ordered thrice daily. September 30th, treatment continued to date. The operation has only afforded partial relief. The pain continues quite severe. October 6th, the wound of the previous operation has entirely healed, but he cannot use the hand in consequence of the exalted sensibility of it; the pain in it is very severe, and he is suffering much from want of sleep. He has had several paroxysms of severe tetanic irritation, with some stiffness of the jaws, one of which occurred this morning. Assistant Surgeon George A. Mursick, U. S. V., made an incision through the cicatrix of the previous operation and dissected out the median and excutaneous nerves, which were found lying in close apposition, and resected three-fourths of an inch of each of them. They were both involved in the new cicatrix. October 19th, the operation of resection did not avail anything, and his condition is as bad as ever. The pain is now so severe as to deprive him of all rest, and the sensibility of the hand is so great that he will not allow anything to touch it. His general health is suffering severely. His countenance expresses great anxiety and his appetite has failed. Surgeon John A. Lidell, U. S. V., administered chloroform and amputated the right arm at the junction of the upper with the middle third by anteror posterior flaps. Marks recovered, and was discharged May 27, 1865, and pensioned.