Civil War Washington

CASE 1224.—Private George Leigh, Co. C, 3d Artillery, aged 19 years, was wounded at Robinson's Ford, September 23, 1863, by a shell fragment which carried away a portion of the right foot. Amputation at the ankle joint was performed on the field by a modification of Syme's method. The heel being injured, the flap was taken from the dorsum of the foot. On September 25th he was admitted into Stanton Hospital, Washington. Surgeon John A. Lidell, U. S. V., reported: "His general condition was then far from satisfactory, as he was pale and very feeble. He was put upon the use of stimulants, tonics, and a good diet. Simple dressings were applied to the stump and he was directed to take an anodyne at night. September 29th: Half of the flap sloughed off; granulations pale; discharge thin and serous; Labarraque's solution, diluted, was applied to the stump. October 11th: had a severe chill this morning, and complains of a good deal of pain in the right knee; twenty grains of sulphate of quinine and an ounce of whiskey were given every six hours. 12th: had another severe chill; knee red, hot, and very much swollen, pulse frequent and weak, tongue dry and coated, complexion assuming a bronzed hue; quinine repeated, and five grains of citrate of iron and quinine, in pill, ordered to be given night and morning. A lotion of acetate of lead and opium was applied to the knee and lime water to the stump. 13th: had another chill today, but it was not so severe as the others; temperature of inflamed knee lessened; had slept well during the night; no change in the treatment. 14th: swelling of the knee much less; treatment unchanged. 15th: had a slight chill about noon, but his general appearance is much better; same treatment continued. 18th: had vomiting, produced apparently by the large doses of sulphate of quinine, which were discontinued; but the other treatment was continued. 20th: bowels constipated; five grains aloes and fifteen of rhubarb were ordered. 25th: swelling disappearing from knee rapidly; stump looks much better; granulations more fluid and healthy; discharge more laudable. October 30th: decided daily improvement; continued the stimulants, together with the citrate of iron and quinine, and the lead and opium lotion to the knee and lime water to the stump. The knee joint remained slightly swollen, hot, and tender for a long time; indeed, the symptoms of inflammatory action in it did not entirely disappear till about the first of February, 1864. February 20th: the amount of mobility at the knee is small (false anchylosis); patella now adherent; knee natural in size and shape. Stump sore on account of having bruised it recently; general condition excellent. March 29th: the stump has refused to heal; there is an indolent excavated ulcer about the size of a franc piece situated at the posterior part of the face of the stump. The stump is otherwise unserviceable on account of the delicate character of its covering, which had been taken from the dorsum of the foot. There being now no prospect that it would ever become useful, the leg was reamputated about the junction of the middle with the inferior third by the double-flap method, the anterior flap being considerably shorter than the posterior one. The tibia was sawn off obliquely, as directed by Sanson; anæsthetic sulphuric ether. April 18th: patient's general condition excellent." This soldier was discharged September 17, 1864, and pensioned; he died September 13, 1871. The amputated stump was contributed to the Army Medical Museum by Dr. Lidell, and is numbered 2165 of the Surgical Section.

FIG. 354.—SYMES'S amputation at the ankle. [After ESMARCH.]