CASE 1779.—Private U. Howes, Co. E, 1st Massachusetts, age 22 years, was wounded by a shell, at Spottsylvania​, May 18, 1864, the missile causing a fracture of the left humerus, involving the elbow joint. He was admitted to the field hospital of the 3d division of the Second Corps, where Surgeon C. K. Irwin, 72d New York, performed excision. On May 25th the patient entered the 2d division hospital, Alexandria, and on July 7th he was transferred to Judiciary Square, Washington. Surgeon T. R. Spencer, U. S. V., in charge of the former, and Assistant Surgeon A. Ingram, U. S. A., in charge of the latter hospital, reported: "Gunshot wound of left arm." The specimen (FIG. 601) was contributed by the operator, and consists of two inches of the lower extremity of the humerus. The appearance simulating periosteal disturbance is due to the mode of preparation. The patient left the hospital for his home on August 5, 1864, his term of service having expired on May 25, 1864, from which date he was pensioned. Examiner H. Clark, of Worcester, Mass., September 15, 1864, certified: "I find the left arm rendered useless by an injury to the heads of the bones forming the elbow joint. The condyles of the humerus are wanting, leaving a loose joint, with scarcely any voluntary motion of the forearm. Disability total and chiefly permanent." Examiner E. Barton, of Orange, Mass., reported, on September 1, 1873: "A fragment of shell struck the arm, fracturing and lacerating the elbow severely; the bones of the forearm are drawn up, shortening the arm some three inches and abridging the use of the arm very much. Disability total." The pensioner was paid June 4, 1875. Compare Catalogue of the Surgical Section, Army Medical Museum, 1866, p. 145.