Civil War Washington

CASE 1841.—Private M. Burroughs, Co. A, 148th New York, aged 18 years, was wounded at Cold Harbor, June 2, 1864. Assistant Surgeon C. A. McCall, U. S. A., reported his admission to Mount Pleasant Hospital, Washington, June 6th, with "Gunshot wound of right hand." On June 10th, the patient entered McDougall Hospital, New York, where Acting Assistant Surgeon F. H. Hamilton,jr.​, recorded the following history: "He was wounded by a rifle ball entering the hand on the palmar surface, passing obliquely through, and making its exit on the dorsum. The metacarpal bones of the little and ring fingers were broken and badly comminuted. The wound looked well until the 15th of June, when it was attacked with hospital gangrene. On the first examination of the condition of the wound sloughing had produced an ulcer two inches in diameter, and the hand and forearm were much inflamed. Pure nitric acid was applied twice, which nearly arrested the disease. On June 27th, the patient was seen by Assistant Surgeon H. M. Sprague, U. S. A., in charge, and amputation being advised, it was performed by him the same day. The operation was by double flaps at the lower third of the forearm. The constitutional state of the patient at the time of the operation was in good condition and not much reduced. The stump looked well until about the 2d of July, when it was discovered that gangrene was present and the sutures had given away. The stump was laid open and the bones bare, and pure nitric acid applied, which stayed the progress somewhat. July 16th, since the last application of nitric acid—on July 2d—two applications have been made of bromine one part to three parts alcohol. The bones are now protruding one inch and the gangrene is nearly arrested. The general state of the patient is not very much prostrated, considering the nature of the wound and its result. He is receiving generous diet, with tonics and stimulants." Re-amputation was subsequently performed at the elbow joint, the precise date of which operation has not been ascertained. The patient was discharged from service August 26, 1864, by reason of "loss of right forearm, amputated at the elbow joint." In the following year he was furnished with an artificial forearm by J. M. Grenell & Co., of New York, who in their surgical statement described the case as a "flap amputation at the elbow joint." In his application for commutation the pensioner stated that he wore the artificial limb only a few times; that it was heavy and made the stump sore, etc.; also that the stump was then—in 1870—in a sound condition. Assistant Surgeon Sprague, the operator at the first amputation in this case, is also alleged by the pensioner as having performed the subsequent disarticulation at the elbow joint. The pensioner was paid September 4, 1875.