Civil War Washington

CASE 1506.—Private G. H. Fiske, Co. H, 8th New York, was wounded at Fair Oaks, May 31, 1862, and was sent to Washington and admitted to Judiciary Square hospital. Acting Assistant Surgeon D. W. Cheever forwarded, together with the pathological specimen, the following description and abstract of the case, by Acting Assistant Surgeon Calvin G. Page: "Specimen of humerus after exsection​ of portion of the head of the humerus for gunshot wound, the missile entering over the sternum, and passing under the pectoralis major and through the humerus near the head of the bone, shattering the head, and passing out on the external side of the arm. The patient was wounded May 31, 1862; the operation was on the day of the injury. The man entered hospital June 4th; did well till August 5th, when bleeding commenced at the interior wound. August 7th, profuse hæmorrhage. On attempting to reach the artery by laying open the track of the original wound, and finding the vessel, the bleeding was so profuse that the patient died while operating. An ulcerated opening was found in the artery near the junction of the axillary and brachial. It appears to have occurred the sixty-sixth day after the accident. The exfoliated portions of the upper end of the lower extremity of the humerus and the processes of absorption of the glenoid cavity are well shown by a section thereof; at the point of ulceration the artery was adherent to the muscular tissues." Acting Medical Cadet Burt G. Wilder reported: "In searching for the artery, after death, it was cut so as to remove the upper border of the ulcerated opening, but the lower border is entire; a part of the deltoid is removed to show the cavity from which the bone was excised." The specimen (No. 1062, Cat. Surg. Sect., 1866, p. 97) consists of "a wet preparation of the upper fourth of the left humerus. The head has been broken into several fragments, which have retained their vitality and become consolidated in new positions, with new muscular attachments. One of these consolidated fragments has been again fractured, possibly in the removal of the specimen. A formation, as if of a cyst surrounding a lodged bullet, appears in the outer and anterior region. The axillary artery presents a large opening from ulceration, indicating death from secondary hæmorrhage." The catalogue refers to the preparation as received without a history; but the foregoing notes of the case were subsequently identified.