Civil War Washington

CASE 303.—Sergeant X. Mehler, Co. E, 74th Pennsylvania, was wounded at Rappahannock, August 22, 1862. He was admitted into Judiciary Square Hospital at Washington on August 24th, where he died. Acting Assistant Surgeon F. H. Brown states: "Gunshot wound; entrance two inches to the left of the median line, on a level with the top of the sacrum; the track of the ball was not marked; it was excised from beneath the integument four inches to the right of the median line, at the level of the umbilicus. On the 26th, there was considerable fever, and peritonitis commenced and increased rapidly, and the patient died, rather suddenly, on the 27th, having had considerable trouble in respiration during the day. At the autopsy, the descending colon was found pierced opposite the wound of exit; there was a considerable quantity of liquid fæces in the cavity of the abdomen, and adhesions of the peritoneum and pleura about the seat of injury. In this case, though some tenderness existed, no symptoms at all commensurate with the lesion were present until within thirty-six hours of death, and on the supervention of peritonitis. The presence of the fæces in the abdomen did not cause the usual acute pain produced by foreign bodies in the peritoneal cavity."