Reports on the extent and nature of the materials available for the preparation of a medical and surgical history of the Rebellion.

Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: Reports on the extent and nature of the materials available for the preparation of a medical and surgical history of the Rebellion. Source: Wellcome Collection.

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    uniformly proved fatal such cases. A single extract will suffice to show the usual progress of -L 9 Fig. 29.—Gunshot fracture of the second and third lumbar verte- bra;. Sjjec.3583,A.M.M. Corporal John E , Co. M, 14th New York Heavy Artillery, was wounded before Petersburg, in July, 18G4. He was sent to Washington, and admitted to Douglas Hospital, with peritonitis and complete paraplegia. A musket-ball had entered at the right hypo- chondriac region, passed downwards through the right lobe of the liver and the abdominal cavity, and fractured the second and third lumbar vertebra;. He died on August 3d, 1864. At the Army Medical Museum are specimens of 18 gunshot wounds of the stomach or intestines, 10 of the liver, 8 of the spleen, 10 of the kidneys, 4 of the bladder, and G of the genito- urinary organs. GUNSHOT FRACTURES OF THE PELVIS. The records under this head include only the cases in which the abdominal cavity was not penetrated. From the beginning of the war to October 1st, 1864, 359 such cases have been reported. Recovery took place in 97, death in 77, and the result is still to be ascertained in 185. In 256 cases the ilium alone was injured, the ischium alone in 19, the pubes in 12, the sacrum in 32, and in 40 cases the lesions extended to two or more portions of the innominata. The gravity of these cases depended upon the location and extent of the fracture. The majority of recoveries were from fracture of the ilium by musket-balls, in which the crest was grooved, or comparatively slight injury was inflicted. Yet there were many examples of perforation of the body of the ilium with ultimate recovery. The following is an abstract of such a case: Major H. A. Barnum, 12th New York Vols., was wounded at Malvern Hill, July 1st, 1862, by a conoidal musket- ball, which entered midway between the umbilicus and the anterior superior spinous process of the left ilium, passed through the middle of the ilium, and emerged posteriorly. On July 2d, he was captured and taken to Libby Prison, a distance of eighteen miles, in an express wagon. On July 17th, he was taken to Aikens' Landing in an ambulance, a distance of seventeen miles, and exchanged. He was conveyed by water to Albany, and thence by rail to Syracuse, New York. At no time were any symptoms of peritonitis manifested. On October 1st, Major Barnum went to Albany, where Dr. March dilated the anterior wound by an incision and extracted several fragments of the ilium, and directed that a tent should be worn. Promoted to the command of the 149th New York Vols., Colonel Barnum took the field in January, 1863. He wore the tent about a month, when the anterior wound healed. About the middle of March, a large abscess formed, and evacuated itself at the site of the anterior wound. In April, Dr. March again cut down to the ilium, and introduced a tent. No loose fragments of bone were found. The Colonel resumed his duties, and commanded his regiment at Gettysburg. In January, 1864, another large abscess formed, and discharged pos- teriorly. The orifice was enlarged by Dr. L. A. Sayre, of New York, and a seton of oakum was passed from before backwards through the entire track of the ball. This was worn for several weeks, when Surgeon M. K. Hogan, U. S. Vols., substituted a seton of candle-wick, which was gradually reduced in size, and finally replaced by a single linen thread. A photograph of the patient was taken at the Army Medical Museum in August, 18G5. The wound still discharged slightly, and the thread seton was still worn. Promoted to be a brigade commander, General Barnum has Keen almost continually in the field for the past two years. He participated in the campaigns of Atlanta, Georgia, and Carolina, was shot through the right forearm at Kenesaw Mountain, and received a shell wound of the side at Peach Tree Creek. In most cases of injury of the pelvic bones, very tedious suppuration ensued, and surgery could do but little, except to facilitate the escape of pus, and to remove dead bone as it became separated. The returns corroborate the observation of Stromeyer, that there is a great liability to pyaemia in gunshot fractures of the pelvis.