CASE 387.—Private T. Miller, Co. G, 116th Pennsylvania, aged 18 years, was wounded at the Wilderness, May 5, 1864, and admitted to Armory Square Hospital, Washington, three weeks afterwards. Surgeon D. W. Bliss, U. S. V., described the injury as a "fracture of the upper third of the left femur, caused by a minié ball," but the progress of the case, further than an attack of pleuro-pneumonia, in March, 1865, was not reported. On August 15, 1865, the patient was transferred to Harewood Hospital, whence Surgeon R. B. Bontecou, U. S. V., reported the following history: "When admitted he was convalescent from a wound of the thigh, the missile entering and fracturing the femur at the junction of the upper and middle thirds, passing through and coming out on the inner side, near the tuberosity of the ischium. According to the patient's statement his constitutional condition at the time of the injury was very good, although the wound was very painful. Severe hæmorrhage followed the injury, with great tumefaction of the whole limb. The fracture box was used and counter-extension, and the treatment was supporting throughout. The patient had so far recovered as to be able to be about on crutches. The thigh had shortened about two inches and three-fourths; but otherwise the man was in good condition and in a fair way of having a useful limb." Two weeks afterwards he was transferred to Mower Hospital, and subsequently to the Post Hospital at Philadelphia, and in October he was finally sent to Harrisburg to be mustered out, his term of service having expired July 14, 1865. An apparatus for the injured limb was furnished on December 6, 1865, by J. M. Gemrig, of Philadelphia. Dr. J. A. McArthur, Surgeon of the Soldiers Home, Philadelphia, October 17, 1866, certified to anchylosis of the knee joint as resulting from the injury, and described the wound as still open and requiring treatment. The Philadelphia Examining Board reported "almost complete anchylosis of the knee," in September, 1873, and two years afterwards the same Board stated: "The femur is curved antero-posteriorly—concavity forward. There are several scars on the front of the thigh, where spiculæ were removed, and the muscular structure of the thigh is much wasted. He alleges constant pain in walking." The pensioner was paid June 4, 1879. A photograph of the patient, taken at the Harewood Hospital in October, 1865, was contributed by Surgeon Bontecou, and copied at the Army Medical Museum. (Photos. of Surgical Cases, Vol. 8, No. 142, and Surg. Phot. Series, No. 114, A. M. M.) A representation is shown in FIG. 2 of PLATE LXI, opp.

PLATE LXI. — CONSOLIDATED GUNSHOT FRACTURES OF THE FEMUR. Fig. 2. Case of Private T. Miller, 116th Pennsylvania