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Digitized by the Internet Archive

in 2012 with funding from

Open Knowledge Commons and Harvard Medical School

http://archive.org/details/photographsofsur05unit

/?SS

PHOTOGRAPHS

SURGICAL CASES AND SPECIMENS.

PREPARED BY DIRECTION OF THE SURGEON GENERAL,

Brevet Lieutenant Colonel GEORGE A. OTIS, Assistant Surgeon, U. S. A.,

CURATOR OP THE ARMY MEDICAL MUSEUM.

WASHINGTON:

STXIR/GKEOISr QENBRAL'S OFFICE.

.Mw.lfcLS.U.

CONTENTS OF VOLUME V.

Page.

No of
Photo.

NAME.

RANK, REG'T, Etc.

So. of Specimen
from which taken.

DESCRIPTION.

201

Massey, William T.
Fulton, Henry D.
Swift, Eben E.

Pvt. Co. I, 7th 111.

Result of an excision of a portion of the left humerus.

202
203

Pvt. Co. E, 30th Ind.
Pvt. Co. A, 11th Me.

Successful exeision of the head of the left humerus.
Stump of a reamputation at the right hip.

204

Shutter, Allison

Drum Co. C. 7th Pa, Res.

Recovery after partial excision of the left knee-joint.

205

Decker, Sam'l H.

Pvt. Co. I, 4th U. S. A.

Showing loss of the forearms.

206

Guy, Franklin
Unknown soldier

Citizen

Loss of forearms by machinery.

Amputation of both arms.

Excision of proximal extremity of right humerus.

207

208

Brink, John

Pvt. Co. K, 11th Pa.

209

Powers, Thomas

Pvt Co. D. 30th Me.

2G19

Old united depressed fracture of the cranium.

210
211

Beebe, Dwight
Unknown

Lt. 3d N. Y. V. V.

Successful exeision at the right hip-joint.
Penetrating gunshot fracture of cranium.

2870

212

Volk, Edward

Pvt. Co. D, 55th O.

276

Gunshot fracture of the cranium.

213

Brennen, Thos.

Pvt. Co. I, 65th N. Y.

3413

Gunshot penetrating fracture of frontal bone.

214

Unknown

830

Cranium perforated by a musket ball.

1:")

215

Unknown

3251

i. i< ii

it;

216

Unknown

3254

Gunshot fracture of skull.

217

Knowlton, Chits.

Oapt. 10th La.-

Pvt. Co. I, 9th Minn.

Successful intermediate excision of right knee-joint.

218

Brown, John

Stomach perforated by musket ball.

219

4832

Hypertrophied prostate gland and bladder with calculi.

22)

Unknown

852

Ligamentous preparation of foot affected with talipes.

221

Unknown

5188

Luxation forward of the astragalus.

1 '

222

Fancy, William

Frcedman

5256

Aorta ligated for aneurism.

223

Various patients

Enlisted men

Vesical concretions resulting from gunshot injuries.

224

Urinary calculi.

Transverse fracture of femur.

225

Brown. Elijah

Freedinau

3648

2(i

226

Unknown

5484

Right femur of Mound Builder united after fracture.

227

Donelly, Reuben

Pvt. Co. A, 21st 0.

319

Distal extremity of right femur perforated and fractured
musket ball.

by a

228

Jones, Jesse M.

Pvt Co. K, 21st Ind.

5558

Portion of right femur showing union after gunshot injury.

229

Bowen, C. H.

Pvt. Co. A, 27th Ind.

4914

Portion of left femur successfully amputated.

230

Wager, James IT.

Pvt. Co. H, 125th N. Y.

3168

Showing oblique fracture of right femur from a musket ball.

231

Barrett, Grey Y.

Pvt. Co. F, 5th N. 11.

536

Portions of right femur after an osteoplastic opeiation and
ondary amputation.

a sec-

232

Holmes, Thomas

Pvt. Co. D, 1st Mich.

2486

Longitudinal fracture of left femur from, gunshot injury.

233

Unknown

5251

Reproduction of metacarpals and phalanges after necrosis.

234

Maynard, Herman L

Pvt. Co. C, 17th N. Y.

Right arm after a successful excision.

235

Welch, Thomas

Pvt Co. F, 6th Me.

Partial recovery after gunshot fracture of left thigh.
Partial recovery after gunshot fracture of right thigh.

236

Murtha, Michael

Pvt. Co. H, 159th N. Y.

237

Tyler, O. R.

Lt. Co. 1, 2d Conn. 11. A.

Successful excision of a portion of left tibia.

239

Powell, M. D.

Pvt. Co. II, 26th Ala.

3841

Left femur showing result of a gunshot wound.

238

Unknown

5118

Luxation of the Atlas.

240

Unknowu

5119

u ii

241

3100-144

Tubular sequestra.

242

Connor, Geo. A.

Lt. Co. A, 7th W. Va.

4382

Portion of right femur after gunshot fracture.

243

Sequestra from femurs.

Condition of left femur after gunshot fracture.

244

Keith, John E.

Pvt, Co. C, 13th Mass.

244

245

Manley, S.

Pvt, Co. A, 63d N. Y.

1935

Condition of right femur after gunshot fracture.

246

Jones, Josiah

Pvt. Co. D, 12th N. H.

Partial recovery after gunshot fracture of left femur.

247

Schranz, John

Pvt. 7th Aus.Feldjagers.

Successful secondary amputation at left hip-joint.

248

Read, C. F.

Pvt. Co. I, 37th U. S. 1.

Successful secondary excision at left hip-joint.

249

Fragments of bone removed by operation.

250

Bush, H. P.

Pvt. Co. F, 1st Mass. C.

Fractured bones of right and left forearm.

Trepared under t?te supervision of

^Assistant Burgeon Peorge A. Otis, U. S. y4
BY ORDER OP THE SURGEON GENERAL.

£uRGEON PENERAL'S pFFICE, ^RMV MEDICAL yWuSE

IE lull

(&tnmV& Wut

ARMY MEDICAL MUSEUM.

Photograph No. 201. Results of an Excision of the Head
and Upper Third of the Shaft of the Left Humerus for Gun-
shot Fracture, complicated by a Perforation of the Scapula.

William T. Massey, private Co. I, 7th Illinois Volunteers, was wounded
at the battle of Altoona, Georgia, October 5, 1864, by a conoidal ball
entering anterior aspect of arm and emerging through the body of scap-
ula, below the spine, producing a compound comminuted fracture at
upper third of left humerus. Seven hours after the reception of the
injury, while on the field, Surgeon Sylvester H. Sawyers, 36th Iowa Vol-
unteers, excised the upper third of the shaft, removing four and a half
inches together with the head of the humerus, through a linear incision
between the biceps and deltoid muscles. The wound healed well, with
flexion of fore-arm impaired by contraction of the injured triceps extensor.
The wound through the scapula was yet open, and the arm useless for labor
when the man was discharged the service. His arm was shortened one
and a half inches, but was nearly normal in size. He was discharged
from service March 12, 1865, while at Chattanooga, Tennessee. An
apparatus was furnished him by Dr. E. D. Hudson three years and eleven
months after the excision, which greatly improved the power of moving
the limb.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
BvH Lt. Col. and Ass't Surg. U. S. A,, Curator A. M- M.

liiMt! «?§imm Bit.

Trepared under Hie supervision of

Assistant Surgeon Peorge A. Otis, U. S. ft.

BV ORDER OP THE SURGEON GENERAL.

WAR DiEP'A.StX'fflEEISrX,

Surgeon Peneral's Pffice, /rmy/Ied'ical/Wuseua

ARMY MEDICAL MUSEUM.

— >o *■ o—

PHOTOGRAPH No. 202. Excision of the Head of Left Humerus

for Gunshot Injury.

Henry D. Fulton, private Co. E, 30th Indiana Volunteers, was wounded
at the battle of Chickamauga, Georgia, September 19, 1863, by a
canister shot. The missile entered at the surgical neck of the left
humerus, passed upward and backward, commin ited the head of the
humerus, and made its exit beneath the base of the acromion. The
patient was sent to the Cumberland hospital at Nashville, Tennessee.
Extensive exfoliation followed, and abscesses burrowed beneath the clavi-
cle and scapula. On November 1, 1863, Assistant Surgeon C. F. Haynes,
U. S. V., excised the head of the left humerus, the outer portion of the
acromion process, and a portion of the articular surface of the scapula,
through a linear incision on the anterior aspect of the arm. The case
progressed favorably, suppuration beneath the clavicle and scapula ceased,
the external wound cicatrized, and his general health rapidly amended.
Unfortunately, firm anchylosis took place between the scapula and upper
extremity of the humerus, and the muscles of the shoulder wasted from
disuse. The patient was transferred to hospital at Madison, Indiana, on
March 11, 1864, and was discharged from service April 22, 1864. In
September, 1868, this pensioner went to New York, and was provided
with an apparatus by Dr. E. D. Hudson, who reported that the shortening
of the arm was about half an inch, the motions of the forearm and hand
were normal, that the muscles of the shoulder were much atrophied, and
that the only motion of the shoulder was the limited movements permitted
by the scapula following the humerus. Dr. Hudson was of the opinion
that the apparatus which he applied mechanically aided muscular action
to a satisfactory degree.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
Bo' I Lt. Col. and Ass' t Surg. U. S. A., Curator A. 31. M.

J5UF

iniiii piiTriiii» m. '■■

Trepared under t7ie supervision of

Assistant Surgeon Peorge A Otis, U. S. A.
BY ORDER OP THE SBRGEON GENERAL.

WAR DEPARTaiEST,

.EON (jENERALS Dff I CE, ^RM Y yttEDlCAL. ^WuSEUM.

ARMY MEDICAL MUSEUM.

Photograph No. 203. Stump of a Reamputation at the Right
Hip, Two and a half years Suhsequent to the Operation.
Private Eben E. Smith, Co. A, 11th Maine Volunteers, aged nineteen

years, was wounded at the engagement at Deep

Bottom, near Drury's Bluff, Virginia, on August

16, 1864, by a nmsket ball, which fractured the

head of the right tibia. He was admitted to the

U. S. General Hospital, at Beverly, New Jersey,

on August 22, 1864. On September 12th, the

thigh was amputated at the lower third. On

January 19, 1865, re-amputation at the hip was

performed by Acting Assistaut Surgeon J. H.

Packard. On January 27th, there was secondary

haemorrhage, and the external iliac was tied.

On May 27th, he was discharged from service,

well and strong. He was received as a pensioner

in the Eastern Branch of the U. S. Military

Asylum for Disabled Volunteer Soldiers, in May,

1867. On July 11, 1867, Surgeon B. 13. Breed

had the negative taken from which the photo-
graph is printed, and reported Smith to be in

excellent health. In the spring of 1870 his

health remained good. He had been pensioned

and supplied with an artificial limb. The ne-
crosed upper extremity of the femur is repre-
sented in the wood cut. A more detailed account

of the earlier history of the case will be found with Photograph No. 29.
Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
Bv't Lt. Col. and Ass't Surg. U. S. A„ Curator A. M. 31.

««n watiiiiM m« ,

Trepared under ttie supervision of

/ISSISTANT gURGEON pEORGE A. OtIS, U. S. A.
BY ORDER OF THE SCRGEON GENERAL.

■WAX*. ISEf'ARX'OTSSJSrT.

guRGEON pENERAL'spFPlCE, flRMY MEDICAL ^MUSEUM.

ARMY MEDICAL MUSEUM.

Photograph No. 204. Recovery after Shell Wound of the
Knee-Joint treated by Partial Primary Excision.

Allison Shutter, Drummer, Co. C, 7th Pennsylvania Reserves, received,
in one of the earlier of the seven days' battles before Richmond, in June,
1862, a shell wound of the left knee-joint. He was taken prisoner, and
while he was in the enemy's lines it was decided that primary excision
of the knee-joint should be performed on the field. The operation was
commenced, but was interrupted by an advance of the Union troops, who
regained the ground they had lost earlier in the day. The parts were
brought in apposition, and the limb secured to a splint, and the patient
was sent to Fort Monroe, and admitted to Hygeia Hospital on June 30th.
On July 6th he was sent to Philadelphia on the steamer Daniel Webster.
He was admitted, on July 7th, to the Satterlee Hospital. The wound
cicatrized, and left a comparatively useful limb. This soldier was dis-
charged February 5, 1863, by Surgeon I. I. Hayes, U. S. V., for
"lameness resulting from a shell wound of the left knee." His name
does not appear on the Pension List.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
Bv't Lt. Col. and Ass 't Surg. U. S. A., Curator A. M. M.

Trepared under the supervision of

/ASSISTANT BURGEON pEORGE A. OTIS, U. S. A.
BY ORDER OF THE SURGEON GENERAL.

BURGEON pENERAL'spFPICE, ^RMYyVlEDICALyVlUSEUM.

ARMY MEDICAL MUSEUM.

PHOTOGRAPH No. 205. Double Amputation of the Forearms for
Injury caused by the Premature Explosion of a Gun.
Private Samuel H. Decker, Co. I, 4th U. S. Artillery, while ramming
his piece at the battle of Perryville, Kentucky, October 8, 1862, had half
of his rig-lit forearm, and somewhat less of the left, blown off by the pre-
mature explosion of the gun. At the same time his face and chest were
badly burned. Five hours after the accident, both forearms were ampu-
tated by the circular method, about the middle, by an Assistant Surgeon
of the regular army whose name he cannot recall. He lay in the field
hospital at Perryville until the wounds were partially cicatrized, when,
on November 1st, he went to Louisville, Kentucky, and, on the 3d of
November, 1862, he was discharged the service. About the middle of
January, 1863, the stumps were completely healed. In the Autumn of
18.4, Mr. Decker began to make experiments for providing himself with
artificial limbs. He produced, in March, 1865, an apparatus hitherto
unrivaled Lor its ingenuity and utility. He receives a pension of $300.00
per year, and is a doorkeeper at the House of Representatives. On No-
vember 20, 1867, Mr. Decker visited the Army Medical Museum, where a
number of photographs of his stumps were made. With the aid of his
ingenious apparatus he is enabled to write legibly, to pick up any small
objects, a pin for example, to carry packages of ordinary weight, to feed
and clothe himself, and in one or two instances of disorder in the Con-
gressional gallery has proved himself a formidable police officer
Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
BvH Lt. Col. and Ass' t Surg. U. S. A., Curator A. M. 3L

tiMdt!, WfOHMIFBI ia@.

Trepared under tlie supervision of

^Assistant £urgeon Peorge A. Otis, U. S. ft.
BY ORDER OP THE SDRGEON GENERAL.

c„ "WAR DEJP'AR.xiYEEISr'r.

rROEON MENERAL'S pFFICE, ^RM Y yWEDICAL /AUSEUM

ARMY MEDICAL MUSEUM.

Photograph, 206. Amputation of Forearms for Injury by a
Brick Machine.

Franklin Guy, brick maker, aged thirty-four years, had his hands
caught in a steam press, October 12, 1868. The right hand was torn off
just above the wrist, and the left hand at the wrist. He was conveyed to
Providence Hospital, Washington, D. C, and five and a half hours after
the reception of the injuries both forearms were amputated a little above
the carpus by Dr. J. Ford Thompson. No hemorrhage had taken place
before the operation. The wounds healed with great promptitude. On
October 23, the patient left the hospital, and in three and a half weeks,
both stumps were completely healed. Mr. Guy visited the Army Medical
Museum on January 13, 1869, and a photograph of the stumps was made,
and he was advised to obtain the artificial limbs devised by Mr. Decker, a
sufferer from the same mutilation, figured in Photograph 205.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
Bv't Li. Col. and Ass't Surg. U. S. A., Curator A. M. M.

nimii, (j»w§iimm eia

Trcpared tmder the supervision of

^Assistant £urgeon Peorge A. Otis U. S. A
HY ORDER (IF THE SURGEON GENERAL.

WAS* DEI^AFtTIVEElsrT.

BURGEON (GENERAL'S PFFICE, ^RMYyVlEDICAI-yVlUSEUM-

£nrg?0ti &tnmV* Witt

ARMY MEDICAL MUSEUM.

Photograph No. 207. Amputation of Both Arms for Gunshot
Injur y.

This photograph represents a discharged soldier of many months, who
was seen at the corner of Seventh street and Pennsylvania avenue, with
a one armed companion, who turned a barrel organ, while this more
mutilated man had suspended about his neck a chest for alms, the lid of
which he opened by a backward movement of his left shoulder. He was
photographed at the Museum in 1869. He gave his name as Sergeant War-
den; but a history of the case is not found on the Surgical Records.
After a long seai ch it has been impracticable to identify the case with
any of those of double amputation reported at this Office. A news-
paper item states that this man was found dead in the streets of Buifalo
in 18G9.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. S. A., Curator A. M M.

iiiiM!, iwjfiijwi to.

Trcprired under the supervision of

Assistant Burgeon Peorge A. Otis p. S. A

BY ORDER OP THE SURGEON GENERAL.

WAR DEPARfjiEJfT,

gURGEON pENERAL'spFFICE, /kRMY ^MEDICAL yWuSEUM.

ARMY MEDICAL MUSEUM.

Photograph No. 208. Excision of the Head and three inches of
the Shaft of the Right Humerus for Gunshot Injury.

Private John Brink, Co. K, 11th Pennsylvania Cavalry, aged nineteen
years, was wounded May 21, 1863, by a musket ball, which struck two
inches below the right acromian process and shattered the surgical neck
of the humerus. He was with a scouting party which was fired upon by
a guerilla band, near Windsor, Virginia. He was taken at once to the
regimental hospital at Suffolk, and a few hours after the reception of the
injury, Surgeon George C. Harlan, 11th Pennsylvania Cavalry, excised
the upper extremity of the bone through a straight incision on the outside
of the arm. Surgeon T. H. Squires, 89th New York, who saw the patient
on June 2d, states that the patient was then doing very well, though he
was pale; and adds that Dr. Harlan observed that he had lost much blood
before and during the operation, and also mentioned that the splintering
did not extend beyond the anatomical neck of the bone. On June 23d
the patient was transferred to Chesapeake Hospital. On September 23d he
was discharged, his disability being rated at one-half by Surgeon A. E.
Stocker, U. S. Vols., and was pensioned from that date. He went to
reside at Kingston, Luzerne County, Pennsylvania. The pension examin-
ing surgeon for that district, Dr. G. Urquhart, reported to the Pension
Office, September 22, 1866, that the arm was "entirely powerless to raise
it or to use it in any other position than hanging by his side." It is
probable that the examiner was deceived; for the pensioner was employed
as a telegraph operator, and always used his right hand, and could readily
place that hand on his left shoulder. In March, 1868, Dr. Harlan, ex-
amined the patient in Philadelphia, and found that the arm was shortened
one inch. Two or three inches of the upper extremity of the shaft must
have been regenerated. The arm was nearly normal in size. A few
months subsequently Brink visited the Army Medical Museum, and was
examined by Dr. Otis and others, and it was found that the results of the
excision were very satisfactory. The motion of the upper arm was better
preserved than after most cases of excision of the head of the humerus,
and the functions of the forearm and hand were unimpaired.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Btft Lt. Col. and Ass't Surg. (J. S. A„ Curator A. M. M.

Trepared under t/ie supervision of

^Assistant Burgeon Peorge A. Otis, JJ. S. A.

BY OKDBR OP THE SURGEON GENERAL.

■WAS3L DiEPARTIKKlif'i',

^URGEON pENERAL's PFFICE, y^RMY ^VlEDlCAL JAuSEVK

ARMY MEDICAL MUSEUM.

Photograph No. 209. Old United Depressed Fracture of the

Cranium.

This photograph represents the inner and outer aspects of a segment
of a cranium, deeply indented at a point above and external to the right
frontal eminence, and exhibits the repair of a deeply depressed fracture
of both tables. Outwardly there is a smooth, circular, cup like depres-
sion, and within three firmly consolidated triangular plates, the edges
smoothed otf, and the fissures filled in with callus. Unfortunately there
is no account of this accident on record. The patient, Private Thomas
Powers, Co. D, 30th Maine Volunteers, aged forty-one years, was admitted
to the Jarvis Hospital, Baltimore, Maryland, on April 5, 1865, suffering
from an attack of typhoid fever, tor which he was treated. He had
nearly recovered, when he suddenly grew worse again, and a decided
inability to raise his right arm and leg could be noticed. These symp-
toms gradually increased, and at last his head was turned to the left side,
and also his tongue, and he was entirely unable to move his right side.
He remained in this condition for several days, being unable to take much
medicine or nourishment, and died on the 2d of July, 1865. At the
autopsy, the brain was found turgid with blood, with many minute
extravasations. The right vertebral artery was plugged by a clot. The
specimen, No. 2619, Surgical Section, was presented by Surgeon De Witt
C. Peters, U. S. Army. In endeavoring to trace this case, it has been
found that this patient was a "substitute," that he was "mustered in"
July 28, 1864. and probably did not reach the battle field till many weeks
afterwards, if at all; but it must have required a period of much more
than twelve months to have brought about the extent of repair that is
here observed. The closure of solutions of continuity of the skull by
complete ossification rarely takes place, and when it does, always occu-
pies, as Rokitansky observes, a very long period. It is probable that
long prior to his enlistment as a substitute that this man had received a
punctured fracture of the frontal region, which consolidated, and escaped
the notice of the examining surgeon, as it subsequently escaped the notice
of the hospital physician.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
Bv't Lt. Col. and Ass't Surg. U. S. A„ Curator A. M. M.

iiiiiriua MTiiiii^ m*

Trepared under tfie supervision of

^Assistant Surgeon Peorge A. Otis U S.' A.
BY ORDER OP THE SURGEON GENERAL.

WAR **>*l^&>-&L'EWKJgJm'P.

J5URGEON pENERJL's PffICE, /kRMT^EDICAL/ttuSEUl

ARMY MEDICAL MUSEUM.

Photograph No. 210. Successful Primary Excision of the
Head and Neck of the Right Femur.

This case is fully described in the Report on Excisions at the Head
of the Femur for Gunshot Injury in Circular No. 2, S. G. 0., January,
1869, Case XXX, page 32. There has been much dispute as to who
should have the crdit of the operation. It is claimed by Dr. N. Y. Leet,
late Surgeon 76th Pennsylvania Volunteers, and by Surgeon C. M. Clark,
29th Illinois Volunteers. The statement of Dr. Leet is corroborated by
the entries on the register of the Tenth Corps Field Hospital, and by
reports signed by Surgeon Barlow, 62d Ohio, and Surgeon Kitlinger,
100th New York. That of Dr. Clark is sustained by the patient, and by
his attending physician Dr. G. D. Bailey, of Havana, N. Y., where the
patient now resides.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
Bv't Lt. Col. and Ass't Surg. U. S. A., Curator A. M. M.

Trepared under t/ie supervision of

Assistant Burgeon Peorge A. Otis U. S. A

BY ORDER OF THE SORGEON GENERAL.

^urgeon (jeneral's Office, /kRMYyttEDiCAi. /VIuseuk

fiiwi0» $mt*V& Mm,

ARMY MEDICAL MUSEUM.

PHOTOGRAPH No. 211. Penetrating Gunshot Fracture of the
Cranium.

An unknown rebel was admitted to Lincoln hospital on July 17, 1864
with a gunshot penetrating wound of skull, received at the demonstration
against Fort Stevens, Washington, D. C. He died the same day. The
post-mortem examination revealed a wound of the scalp two inches above
the right ear, and one-half inch in diameter. The ball had entered the
skull through the squamous portion of the right temporal bone, making
an orifice through both tables, one and a half inches perpendicularly, and
one inch horizontally. A fissure extended from the upper and anterior
edge of this orifice, forwards and downwards the whole length of the
squamous suture, and another at the anterior and inferior edge extended
one and a half inches forwards and downwards to the tubercle. The
brain in the region of the wound was pulpy, and contained a large num-
ber of spiculae of bone Avhich had been driven in by the ball. The vessels
of the left hemisphere were very much injected, and the whole brain was
softened. No ball could be found in the skull. The specimen was pre-
sented to the Army Medical Museum by Acting Assistant Surgeon H. M.
Dean, and is numbered 2870 of the Surgical Section.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Bv't It. Col, and Ass't Surg. U. S. A., Curator A. M- M.

Trejtarcd under tj/e st/pervisio?i of

^Assistant £urgeon Peorge A. Otis, U. S. A.

BY ORDEB OP THE SURGEON GENERAL.

WAR DlE£S*.&,B>.Te'DliiIi;jS'^%

^URGEON pENERAL's ptrPICKi ^RMY _/VlEDlCA ' /VlUSEUI*

ARMY MEDICAL MUSEUM.

Photograph No. 212. Gunshot, Fracture of the Cranium caused
by a Musket Ball striking with great obliquity.

Private Edward Volk,"Co. D, 55th Ohio Volunteers, was wounded at the
second battle of Bull Run, August 30, 1862, by a musket ball, which
struck the forehead at a point half an inch above the right eyebrow,
comminuting and carrying away both tables of the os frontis, to the
extent of one and one-fourth by two and one-fourth inches. He remained
on the battle field six days, and was then conveyed to Washington, D. C,
and admitted to the Emory Hospital on the 6th of September. About
one-third of the missile was found lodged against the fractured edge of
the frontal bone. One-half of the plates which compose the frontal sinus
were found in broken fragments piercing the brain, and were carefully
removed. About a teaspoonful of brain matter escaped. There was no
cerebral disturbance, and the patient was perfectly conscious. On Sep-
tember 8th, hernia cerebri appeared, the protrusion being about the size
of a walnut. On the 19ih the edges of the wound were healthy; the
hernia had receded, but diarrhoea supervened, which greatly reduced the
patient's strength. He died on the 25th of September. The post-mortem
examination revealed a more extended fracture than was supposed to
exist, reaching through the parietal to within two inches of the occipital
bone. The orbital place of the right superior maxillary was fractured
and depressed, and a fissure an inch long ran down the body of the bone.
The specimen was contributed by Surgeon W. Clendenin, U. S. V., and is
numbered 276 of the Surgical Section.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Bv't Lt. Col. and Ass 't Surg, U. S. A., Curator A. M. M.

Trepared under the supervision of
Assistant Surgeon Peorge A. Otis USA

BY ORDER OF THE SURGEON ««.»'., K

>F THE SURGEON GENERAL.

<;„Br-„ WAR nEP-AKtXJWEEISi^,

^URGEON pENERAL'sppFICE, ARMY ^MeDICAL yVlUSEUM.

'mpm &

ARMY MEDICAL MUSEUM.

Photograph No. 213. Gunshot pemtratiny Fracture of the
Frontal Bone.

Thomas Brennen, Private, Co. I, 65th New York volunteers, aged
thirty years, was struck at the battle of Cedar Creek, on October 19,
1864, by a musket ball, about the middle of the frontal bone He was
taken to Baltimore and admitted into the Jarvis U. S. A. General Hospital
on the 24th, and died on the following day. For two days previous to his
death, he had hemiplegia of the left side. At the autopsy twenty-four
hours after death, the frontal bone was found to have been perforated
near the right prominence. Two pieces of bone, each the size of a dime
were driven into the dura-mater for the distance of half an inch. The
brain substance near the seat of injury was very much softened. The
left hemisphere was covered with clotttd blood. The veins of both
hemispheres were engorged with blood. A piece of the bullet was found in
the third ventricle of the left hemisphere. The specimen was presented
to the Army Medical Museum by Acting Assistant Surgeon B. B. Miles
and is No. 3418 of the Surgical Section. It consists of the vault of the
cranium, perforated in the frontal region by an opening three-fourths by
one and a fourth inches. Long fissures extend from this perforation,
and on its left edge is a partially fractured fragment of the inner table,
an inch long and a fourth of an inch wide, depressed quarter of an
inch. On the right margin of the perforation the outer table is removed
leaving a sharp edge. It is probable that the ball split, a part passing-
out external^.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Bvt Li. Col. and Ass'i Surg. LI. S. A„ Curator A. M M.

nimtM PiiiiiniFigs m»

Treprtrrd tinder tfie supervisio?i of

/kSSISTANT ^URGEON pEORGE A. DTJS U. S. A
BY ORDER OF THE SURGEON GENERAL. '

WAR »E]P'A3RX3OT3g;»rX.

BURGEON pENERAL'spFFICE, ^RM Y yVlEDICAL yWuSEUIt

§ t!W0Ji &tnmY# Mil

ARMY MEDICAL MUSEUM.

Photograph No. 214. Cranium Perforated hy a Musket Ball.

This cranium was presented to the Army Medical Museum by Surgeon
Jerome B. Green, U. S. V., and is numbered 880 of the Surgical Section.
A musket ball entered at the centre of the left branch of the coronal
suture, and passed out at the posterior inferior angle of the right, parietal
bone, the opening of entrance being three-fourths of an inch, and that of
exit one and one-fourth inches in diameter. There is a fracture of the
right orbital plate of the frontal, of the squamous portion of the right
temporal, and of the body of the right superior maxilla, probably by
contre coup. A fracture of the occipital bone extends from the opening
of exit to the right jugular foramen. The frontal suture remains dis-
tinct, though the skull is that of a middle-aged man. The specimen is
believed to have come from the 12th Army Corps hospital after the second
battle of Bull Run.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
Bv't Li. Col. and Ass t Surg. U. & A., Curator A. 31. 31.

iiiiMi faffiiiiw w@.

Trepureti under the sitperrisio?i of

^Assistant £urgeon Qeorge A. Otis, U. S. A

BY ORDER OP THE SURGEON GENERAL.
BURGEON pENERAI_'SpFFICE, /iRMY ^MEDICAL. /AuSEUM.

ten titnmYfi #ffi«.

ARMY MEDICAL MUSEUM.

Pftotograpii No. 215. Perforation of the Cranium hi/ a Mus-
ket Ball.

This cranium was picked up on the first Bull Run battle-field by Dr. F.
Schafhirt, and presented to the Army Medical Museum. It is numbered
32-">l of the Surgical Section. It displays a fracture caused by a musket
ball which, entering at the right fronto-parietal suture, and temporal
ridge, and fractured the os frontis in a long fissure, which runs in front
one inch above the orbits, and downwards through the greater wing of
sphenoid and squamous portion of the left temporal into the mastoid
process. One fissure branches off above the left orbit and downwards
through the maxillary sinus. Another fissure passes posteriorly from
the wound of entrance and upwards through the right to the left parietal
protuberance Another fissure downwards through the right auditory
meatus has divided the petrous bone. Yet another fissure passes back-
wards through the upper portion of right temporal into the occiput. The
ball passed out at the upper part of occipital near the inter-parietal
suture.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
Bv't Li. Col. and Ass t Surg. U. S. A., Curator A. M. M.

Prepared under /he supervisio?i of '

Assistant Surgeon Peorge A. Otis U S. A

BY ORDER OF THE .SII11GE0N GENERAL.

(bURGEON PENERAL'spFPICE, ^RMY yVlEDICAL /WuSEUA

ARMY MEDICAL MUSEUM.

Photograph No. 216. Gunshot Fracture of ' Skull.

At a post mortem examination of the body of an unknown soldier, at
Lincoln Hospital, September 22, 1864, it was ascertained, that a conoidal
musket ball had entered about one and a half inches above the left ear,
causing a compound comminuted fracture of the squamous portion of the
temporal bone. The ball was found imbedded in the lower portion of the
parotid gland. The vessels of the meninges of the brain were very much
injected. The middle lobe of the left hemisphere was softened to the
middle corner of the lateral ventricle, which contained a small quantity
of fluid, resembling blood. The specimen was contributed to the Army
Medical Museum by Acting Assistant Surgeon H. M. Dean, and is
numbered 8254 of the Surgical Section. It is a section of the cranium,
showing penetration and fracture of the left temporal bone just above
and including the meatus auditorius externus, with fracture of the
occipital by contre-coup, caused by a conoidal ball, which is attached.
The opening is just above the root of the zygoma and is three-fourths of
an inch in diameter. The condyle of the lower jaw and the posterior
half of the glenoid fossa are carried away, together with the extremity
of the petrous portion of the temporal bone, the line of fracture passing
through the internal meatus auditorius. From the left jugular foramen
two lines of fracture pass to the foramen magnum, one in front of and
the other behind the condyle. On the right side the occipital bone is
traversed by a fracture which runs from the foramen magnum to the
posterior angle of the right parietal.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS.
Bv't Lt. Col. and Ass't Surg. U. S. A., Curator A. M- M.

iiiaii <\a !>*«!;« m*

Prepared under the supervision of

Assistant £urgeon Peorge A. Otis, U. S. A.
BY OKDEB OF THE SDRGEON GENERAL.

WAR DEr^aJFtYMENrT.

^URGEON GENERAL'S pPFICE, ^ARMY yVlEDICAL //lUSEUH

ARMY MEDICAL MUSEUM.

Successful Intermediate Excision of the

Photograph No. 217.
Right Knee-Joint.

Captain Charles Knowlton, 10th Louisiana Regiment, of EwelPs Corps, aged twenty-six
years was wounded at Mine Run, Virginia, November 27, 1863, by a conoidal musket ball,
which grooved the outer condyle of the right femur, barely touched the cartilage, opened
the synovial sac, was deflected, and lodged near the upper edge of the patella whence it was
removed, on the field, through an incision, after the wounded man had walked half a mile
to the rear leaning on the shoulder of one of his men. He was then transported over rough
roads in an ambulance to the nearest railway station, and conveyed to Richmond and
entered General Hospital No. 4, two days after receiving the injury. His condition on
admission was good. There appeared to have been no haemorrhage. The movements of the
knee-joint were perfect. Moist dressings, absolute rest, and saline aperients were ordered.
On December 2d a serous or synovial discharge from the wound was observed. This became
slightly puriform on the following day. Still there was no mark of inflammatory reaction.
On December 8th there was much pain in the joint and the discharge was increased. His pulse
rose to 104. On the 9th the joint was excessively inflamed and the pulse was 128. Surgeon
James B. Read, P. A. C. S., in consultation with Surgeons C. B. Gibson, and M. Michel
decided that excision of the joint was expedient. The operation was performed by Surgeon
Read. An elliptical incision with its concavity upwards was made to extend from one
condyle to the other passing below the patella, and dividing its ligament. The joint was
then laid open, and an inch and a half of the condyles of the femur, and an inch of the
tibia were sawn off. The patella was also removed. No ligatures were required. The sec-
tion of the femur was made obliquely downwards and backwards ; the section of the tibia
was the reverse of this, so that when the extremities were approximated the limb was
slightly flexed. The synovial sac was reddened and contained a turbid flocculant fluid.
The sawn ends of the bones were then wired together. The limb was then placed in a long
well padded fracture box. Aftei^a few days a long bracketed splint was substituted for the
fracture box. He had a liberal stimulating diet of eggs, oysters, and beef-tea, with half an
ounce of brandy every two hours. The patient was restless and irritable, and on December
16th, and again on the 20th, had venous haemorrhage to the extent of a few ounces, the
bleeding being arrested on both occasions by the use of persulphate of iron. There was
tumefaction about the joint and burrowing of pus, until Acting Assistant Surgeon
Howell D. Thomas suggested a suspension of the limb by Smith's anterior splint. By
January 3d the internal half of the horse-shoe incision had closed. The patient enjoyed
an excellent appetite, which was appeased by venison, turkey, partridges, and other
hearty food and a pint of porter daily. By the middle of February there was only a
small fistulous orifice remaining of the wound, which discharged a thin, sero-purulent
matter. A starch bandage was now applied, with an aperture over the unhealed portion
of the wound. All the wires had been removed at this date except one. In March the
patient sat up daily and attempted to walk on crutches. In April he was discharged
from the hospital ; his limb was supported by a leathern splint. There was still slight
motion between the femur and tibia; but the ligamentous union appeared quite firm.
He subsequently went to the West Indies. At Nassau, Dr. Hunt, of New Orleans, removed
the starch bandage and found the consolidation was very firm. In a few months Captain
Knowlton laid aside his crutcbes, and walked very satisfactorily. He returned to Louisiana
in I860. He was able not only to walk almost as well as ever, and to dance even the round
dances. His address as a purser on one of the Pacific mail steamers having been discovered,
Surgeon Charles McCormick, U. S. Army, at San Francisco, examined his limb, December 17,
1868, and had made the negative from which this photograph is printed. There was no
evidence of disease about the cicatrix; The muscular development of the limb was good;
and the inability to flex it at the knee was the only inconvenience suffered, a result as grati-
fying as it is unusual.

Photographed at the Army Medical IVSuseum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
BvH Lt. Col. and Ass' t Surg. U. S. A., Curator A. M. M.

tiiioitii wit ii'MM m*

Trcpared under the supervision of

Assistant Surgeon Peorge A. Otis U S. A

BY ORDER OF THE SURGEON GENERAL.
pURGEON pENERALS OFFICE, Army /WeDICAL/WuSEUM.

ARMY MEDICAL MUSEUM.

Peiotograph No. 218. Perforation of Stomach by a Conoidal
Musket Ball.

Private John Brown, Co. I, 9th Minnesota Volunteers, aged twenty-
eight years, was wounded in front of Nashville, Tennessee, December 16,
1864, by a conoidal musket ball, which penetrated the left chest at the
cartilaginous junction of the eighth and ninth ribs, three inches below
the nipple. On the night of the same day he was admitted to Hospital
No. 8, Nashville. The shock of injury was very great, and he sutfered
intensely from sharp pain in the chest and abdomen. There was, also,
paralysis of motion and of sensation in the left lower extremity. Ex-
pectant treatment was used, but the patient soon collapsed, and died at
8.30, P. M., on December 17, 1864. At an autopsy, twenty-two hours
after death, pleuritic adhesions were found; the capacity of left lung was
much diminished; the abdominal cavity showed evidences of intense
peritonitis, and the viscera were softened and of a dark green color. The
missile had passed downwards, inwards and backwards, and piercing the
diaphragm near its anterior border, leaving an opening two inches in
length through which a portion of omentum had escaped into the lower
cavity of thorax, perforated the splenic end of the stomach, leaving an
interval of three inches between the openings; thence, it passed through
the transverse colon, and foecal matter, with a large amount of escaped
blood, was found in the abdominal cavity; it then struck the left anterior
side of the fourth lumbar vertebra, grooving deeply its left border, passed
through the spinal cord to its left, surface, fractured the left horizontal
and spinous processes of the third lumbar vertebra, and was found imme-.
diately to the right of the second lumbar vertebra, underlying the integu-
ment, and fascia of that region, very much changed from its original shape.
The injured vertebrae are shown in Specimen 8748, Army Medical Museum.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. S. A., Curator A. M M.

iiiijiii rain«iiM m*

Prepared under Die supervision of

;4SS.STANT guRGEON pEORGE A. OTIS U S. A
BV ORDER OF THE SDRGEON GENERAL

(surgeon Peneral's Office, ^rmy/4edical/4useu*

ARMY MEDICAL MUSEUM.

Photograph No. 219. Hi/pertrophied Prostate Gland arid
Bladder, containing twelve large Uric Acid Calculi.

This specimen was taken from a private patient, aged sixty-seven, a
native of Frederick. Maryland, who died August 3, 1857. Besides the
large concretions, the bladder contained numerous hemp-seed calculi,
many of which were discharged during life. In 1849 more than three
hundred were discharged through the fenestra of a very large catheter.
The lobes of the piostate are much enlarged. On the right and middle
lobes are several ulcers. The walls of the bladder are much thickened.
The specimen measures as follows: from fundus to membranous portion of
urethra, six inches; across fundus and body of bladder, in which the
calculi are contained, four and one-eighth inches; from external wall of
fundus to top of middle lobe, two inches and seven-sixteenths; thickness
of walls of bladder, seven-eighths of an inch. The width of the left lobe
of enlarged prostate is one inch; 'that of the right lobe two inches.' The
width of the divided and degenerated prostate is four inches and ten-
sixteenths. An analysis of the calculi by Dr. B. F. Craig shows that
they consist almost entirely of uric acid. The specimen with the history
was contributed by Dr. Robert K. Stone, of Washington.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

.4**'* Surg. (J. S. A., Curator A. M. U.

iiiimi, iwiiiMM m*

■3'rejmred under the supervisio?> of

Assistant Surgeon Peorge A Otis U. S. A.
HV ORDER OP THE SURGEON GENERAL.

WAR DEPARTMEWT,

fjURGEON pENERAL'spFFICE, ^RMY _/VlEDlCAL yWuSEUH

Jtargwn dmmVjB (Stltit.

ARMY MEDICAL MUSEUM.

Photograph No. 220. Ligamentous Preparation of the Bones of
the Left Foot and Lower Portions of the Leg Bones, from a Case
of Confirmed Talipes Varus.

This specimen, No. 852, Army Medical Museum, was taken from a Freed-
man, who died of syphilis on November 25, 1860, at the Frecdman's Hos-
pital in Washington. It was contributed, with the history, by Hospital
Steward A. M. Squier. U. S. A. The foot is completely inverted, and the
os calcis, which is small, is nearly parallel with the shafts of the leg
bones, and presents an irregular, knotted appearance. The patient
walked chiefly upon the anterior surface of the calcaneum and the astra-
galus and dorsal surfaces of the other tarsal bones. The metatarsals are
unusually slender, and the great toe overlaps the two adjoining ones.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. S. A., Curator A. M M.

iimim iw?iii<M m.

Prepared under the supervision of

^Assistant Surgeon Peorge A. Otis, U. S. A

BV ORDER OP THE SDKGEON GENERAL.
>urgeon Peneral'sPff.ce, Arm y ^edical yVlUSEUM.

ARMY MEDICAL MUSEUM.

Photograph No. 221.

This is a representation of Specimen 5188 of the Surgical Section of
the Army Medical Museum, showing the bones of the right leg and foot,
with a luxation forward of the astragalus. The fibula exhibits an extra-
ordinary concavity in its external middle third. The specimen is from
the Van Wyck private collection, and was received with the Gibson Col-
lection.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. &. A„ Curator A. M M.

iiiiiiii «?@iiw sj m*

Prepared wider the supervisio?i of

^Assistant Surgeon Peorge A. Otis, p. S. fr

BY ORDER OP TUE SURGEON GENERAL.

WAR BEPAUTMEKT,

rROEON pENER»L'spFFICE, ^RMY ^MEDICAL yVlUSEUH

ARMY MEDICAL MUSEUM.

Photograph No. 222. Ligation of the Abdominal Aorta for
Aneurism.

William Fancy, a negro of thirty years, a wood chopper, was admitted
to the Howard Grove Hospital, at Richmond, Virginia, March 20, 1868.
He stated that a week before while pursuing his ordinary avocation he
felt something give way in the lower part of his abdomen, a sensation
followed by nausea and great pain. l)r. Hunter McGuire examined, and
found in the left iliac and hypogastric regions an aneurismal tumor the
size of a goose egg. No pulsation could be discovered in the left femoral;
but no change in the temperature or size of the left leg was observed.
His generel health was good. The patient said that the tumor gradually
increased in size and was daily growing worse. Rest in bed, with dig-
italis, iron, acetate of lead and opiates seemed to alleviate the pain and to
diminish the size of the tumor; but the relief was but temporary. On
March 26th, compression of the aorta was resorted to; but had to be dis-
continued because of the tenderness of the tumor. On March 30th, at
1, P. M., Dr. McGuire, after consultation with Professors Joynes, Wellford
and others, determined to cut down and to ligate the common iliac above
the aneurism. When the aneurism was exposed, it was found to involve
the whole of the common iliac, and the aorta near its bifurcation. The
sac was very thin. Dr. McGuire now determined to tie the aorta, when the
sac suddenly ruptured, although it had been handled with the utmost
delicacy, and a profuse discharge of blood took place. The aorta was
instantly compressed by the finger an inch above the tumor, and sur-
rounded by an assistant with a ligature and tied. About a pint of blood
was removed from the cavity of the abdomen. The lips of the wound
were brought together. Sutures and bandages were applied. A stim-
ulating enema was given. The patient was put to bed and the lower
extremities were surrounded by warm applications. In a few moments
the effects of chloroform passed off, and slight reaction took place. He
complained much of numbness of the lower extremities. The temperature
of the axilla never rose above 96. He died half an hour after midnight,
eleven and a half hours after the operation. At the autopsy, the ligature
was found to embrace the aorta at the origin of the inferior mesentery
and included the left ureter. The rent in the sac was just ove^r the bifur-
cation of the aorta. A careful report of the case is published by Prof.
H. McGuire in the American Journal of the Medical Sciences, Vol. LVI, p.
415, October, 1868. The pathological specimen was contributed to the
Army Medical Museum by Dr. McGuire, and is numbered 5256, Section I.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

BoH Lt. Col. and Ass 't Surg. U. S. A., Curator A. M. 31.

iitiMi »!»,« m.

Prepared under tr>e supervision of.

Assistant Burgeon pEORGE A. Otis, U. S. A.
BY OBDEBOF THE SDKGEON GENERAL

BURGEON PENERA,_'spPFICE. ^rm Y yVlEDICAL /VluSEUP.

ARMY MEDICAL MUSEUM.

Photograph No. 223. Vesical Concretions resulting from Gun-
shot Injuries.

This photograph represents a series of seven specimens of foreign
bodies removed from the bladder, all of which Avere directly or indi-
rectly the result of gunshot injuries. These cases will be fully described
in the forthcoming Surgical History of the War. A simple memoran-
dum is here given. The left hand figure of the upper row, (Specimen
5019) is a round leaden bullet slightly encrusted, removed from the
bladder of a South Carolinian soldier in 1865, by Dr. F. T. Miles, of
Charleston. The man was struck at the first battle of Bull Run, July,
1861, above the pubes. The wound healed kindly and he returned to
duty, and fought through the war, and never had any dysuria until the
march to Appomattox Court House in April, 1865, when suddenly he had
extreme pain in the bladder, bloody urine, and other symptoms of a
foreign body in the bladder. A few weeks subsequently, the encrusted
ball was successfully removed by lateral lithotomy. The middle figure of
the upper row, (Specimen 4712) represents half of a urinary calculus
formed after a gunshot wound of the fundus of the bladder, with in-
spissated mucous probably as its nucleus, and consisting of mixed phos-
phates. It was successfully removed by lateral lithotomy by Prof. J. J.
Chisolm. The right hand figure, (Specimen 5520) represents an iron
shrapnel ball encrusted with uric acid and triple phosphates, which was
successfully removed by Dr. A. N. Dougherty, at the New Jersey Home
for Disabled Soldiers, in August, 1868. The man was wounded in April,
1865. The operation done by Dr. Dougherty (formerly Medical Director
of the Second Army Corps) was by an external incision as for bilateral
lithotomy, with a deep incision as in the lateral method. The operation
was very successful. The concretion weighed one ounce and twenty-
three grains avoirdupois. The left hand figure in the lower row, (Speci-
men 50-11) represents a large phosphatic calculus sawn in half. Its
nucleus is a portion of the pubic bone, which was driven into the bladder
by a musket ball, which passed out through the rectum. Three and a
half years after the reception of the injury, this calculus was removed by
lateral lithotomy by Prof. Hunter McGuire, who has given an account of
the case in the Richmond Medical Journal, of April, 1868. At the time of
its removal, the calculus weighed two and a quarter ounces. With a good
lens, the Haversian canal in the bone which forms the neucles can be
readily made out. The two middle figures in the lower row, (Specimen
2567) represent two uric acid calculi found post mortem in the case of a
soldier who was shot through the bladder at the second battle of Bull
Run, by a musket ball, which entered above the pubes and passed down-
wards and backwards through the cocyx. The specimen was contributed
by Surgeon D. W, Bliss, U. S. Vols. The right hand lower figure, (Speci-
men 88) represents one view of a fragment of a grenade removed from
the bladder by Surgeon J. F. Randolph, U. S. Army. The case is re-
corded in the Surgical Report in Circular No. 6, Surgeon General's Ofiice,
1865, p. 29.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
Btft Lt. Col. and Ass't Surg. U. S. A., Curator A. M 31.

tiiiitia «w iimm m.

Prepared under the supervision of

Assistant Surgeon Peorge A. Otis, U. S. A

BV ORDEB OF THE SURGEON GENERAL.

f>URGEON General suffice, Army yvUDicAi. yWusEUM

-sV/

ARMY MEDICAL MUSEUM

PHOTOGRAPH No. 224. Four Urinary Calculi in the collection of
the Army Medical Museum.

All the figures in this group are much reduced. That on the left repre-
sents a very large mulberry calculus. Its length is two and a quarter
inches, breadth one and seven-eighths inches, thickness one and five-
sixteenths inches, and weight 2.48 ounces Troy. It was removed by
lateral lithotomy by Dr. N. S. Lincoln, of Washington, who has published
a description of the "case in the Richmond and Louisville Medical Journal.
The next figure, (Specimen 5058) represents a calculus presented to the
late Dr. William Gibson, in 1843, by Dr. Stout, of Easton, Pennsylvania.
The nucleus is a large darning needle. (See Gibson's Surgery, 7th Edi-
tion, Vol. II, p. 230.) It was removed from the bladder of a negro girl.
The next figure, (Specimen 4833] represents a phosphatic calculus sawn
asunder, and weighing 27.054 grammes. It was obtained by exchange
from the National Medical College, at Washington. The nucleus was a
watermelon seed. It was removed by lithotomy from the bladder of a
nasty fellow. The right hand figure, (Specimen 48G6) represents a very
large ovoid phosphatic calculus, weighing 159.53 grammes. It was suc-
cessfully removed from the bladder of a man from Ohio, by Surgeon J.
G. F. Holston, U. S. Vols., by lateral lithotomy. Its surface is quite
smooth, and its composition unusually homogeneous. It is rarely that so
large a concretion is removed by lithotomy without being crushed and
removed in fragments. The long diameter of this calculus is two and
three-eighths inches, and the smallest diameter is two inches. There are
larger vesical calculi in the collection, but they were removed after death*

Photographed at the Army IVSedica! Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

BvH Lt. Col. and Ass' t Surg. U. S. A., Curator A. M. M.

iiii^iii w§?@iiMj m.

Prepared muter the supervision of

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BY ORDER OP THE SURGEON GENERAL.
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mpm mmtm® mP

ARMY MEDICAL MUSEUM.

Photograph No. 225. Transverse Fracture of the Femur in
the Middle Third by an unknown Missile.

Elijah Drown, a colored civilian, aged fifty years, and by occupation a
farm laborer, was injured August 15, 186-1, at City Point, by the explosion
of ordnance stores. An unknown missile produced a compound fracture
of the femur in the middle third, leaving a wound similar to that made
by a conoidal ball. He was sent to Philadelphia, and, on August 20th,
was admitted to Satterlee Hospital. No foreign body could be detected
in the wound. The limb was shortened some two and a half or three
inches; the thigh was much swelled; and there was a profuse discharge
from the wound, and a commencing bed sore over the sacrum. The
patient's bowels were loose, and he was thin and debilitated, but, withal,
was cheerful and had a good appetite. An angular wire splint, thought
not to meet the required indications, was removed, and a straight wooden
one, with the counter-extending band in the perineum, was substituted.
Fifteen drop doses of tincture of iron were also administered three times
a day. This treatment continued until August 27th, when the splint was
removed, and extension made by means of weights suspended from leg
by adhesive strips, husk bags being placed along either side. This ar-
rangement, along with the straight board splint, was extremely incon-
venient, and could not be kept in proper order. The bed sore had become
the source of great discomfort, the discharge being profuse and exhausting.
Simple dressings and expectant treatment were used. On September 1st,
all appliances were removed from the leg. The patient was much reduced
by suppuration from the wound and from the bed sore. He was extremely
restless, and there were no signs of union of the fragments. A profuse
diarrhoea withstanding all treatment now set in, and continued until the
patient's death, which occurred at 8, A. M., on September 12, 1864. The
specimen, showing considerable exfoliation near the two ends of the frag-
ments, was contributed, with the history, by Acting Assistant Surgeon
A. L. Eakin.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass' t Surg, U. S. A., Curator A. M. if.

niiiiM, Miiitii^i m*

Trepnred under ttie supervision of

Assistant (Surgeon Peorge /t. p-ris, p. S. _A
HY ORDER OF THE SURuEON GENERAL.

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Photograph No. 226. United Simple Fracture of the Right
Femur of a Mound Builder.

In 1868, Acting Assistant Surgeon A. J. Comfort made a minute and
painstaking exploration of several tumuli in the vicinity of Fort Wads-
worth, Dakota Territory. He was fortunate enough to obtain from these
mounds, which, from the large size of the trees upon their summits, were
evidently of great antiquity, about forty human skeletons, more or less
complete, which he sent to the Army Medical Museum. They furnish
several examples of fracture of the long bones. In the united fracture
of the long bone of the femur which is exhibited in the photograph, there
was less than two inches shortening, the length being fifteen and seven-
eighths inches, while the companion femur, which shows a kind of post-
mortem fracture, is seventeen and three-fourths inches in length. The
angular deformity is slight, and the result is not discreditable to pre-
historic surgery. The bones are yellow, and very fragile. A full account
of Dr. Comfort's interesting researches, together with other archcalogical
reports, is in process of compilation at this Office for publication in the
next volume of the Smithsonian Contributions to Knowledge.

Photographed at the Army IVIedical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEO ROE A. OTIS,
BvH Li. Col. and Ass't Surg. U. S. A„ Curator A. M- M.

iiWill, MililMKS id,

Prepared under /he supervision of

/tSSISTANT guRGEON pEORGE ft. PTIS, ]}. £. fl.
BY ORDER OF THE SURGEON GENERAL.

WAR DEPARTMEHT,

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•'*

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Photograph No. 227. Distal Extremity of the Rigid Femur
showing a Perforating and Longitudinal Fracture, with Com-
minution, by a Spherical Musket-shot.

Private Reuben Do-nelly, Co. A, 21st Ohio Volunteer, was wounded at
Bull Run, August 30, 1802, by a spherical musket-shot, which entered the
right thigh just above the patella, and, passing directly through the limb
from front to rear, divided the condyles, split the shaft upward several
inches, and comminuted the bone at the interaondyloid notch. He was
admitted to the King Street Hospital at Alexandria on September 3, 1862,
and, two days afterward, Surgeon J. E. Summers, U. S. A., amputated the
thigh at the junction of the lower and middle third by the antero-posterior
flap operation. The case progressed favorably until October 3d, (a cold,
rainy day) when the patient had a severe chill, which recurred on the# fol-
lowing afternoon. Tonics and stimulants were freely administered, not-
withstanding which he gradually sank ; absorption of the new granulations
took place; the edges of the flaps retracting, left the bone exposed; osteo-
myelitis occurred; and there was extreme emaciation, with great prostra-
tion, and inability to take or retain nourishment or stimulants, resulting
in the death of the patient October 20, 1862. The specimen and history
were contributed by Acting Assistant Surgeon Thomas 0. Barker, U. S. A.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. S. A., Curator A. M. M.

^iliilll »f iiiiw KlS,

Trepared under ttie supervision «/'

Assistant Burgeon Peorge fc. Ptis, p. g. /k

BY OKDER OF THE SDBGEOM GENERAL.

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'* Qiixtt.

ARMY MEDICAL MUSEUM.

Photograph No. 228. Amputated Portion of the Right Ferrmr,

showing United Fracture, ivith a Fragment of Lead imbedded
in the Callus.

Private Jesse M. Jones, Co. K, 21st Indiana Volunteers, aged twenty-
nine years, was wounded at Baton Rouge, Louisiana, August 5, 1862, by
a musket ball, which fractured the right femur at the junction of middle
and upper third. He was taken to the regimental hospital the night
after, remained a day, and was thence sent by a transport steamer to
New Orleans, the limb meanwhile being supported by bandages and
pillows. On arrival, August 7th, he was admitted to the St. 'James Hos-
pital, where a long splint was applied, seventeen days after the reception of
the wound. The patient was discharged the service April 15, 1863, since
when, up to January, 1869, he suffered much pain from frequent exfolia-
tions and abscesses. At the latter date, he entered Providence Hospital
at Washington ; and on the 23d, Doctor D. W. Bliss, late Surgeon, U. S. V.,
amputated the thigh in the upper third, and afterwards contributed the
pathological specimen to the Army Medical Museum. It is No. 5558 of
the Surgical Section, and shows great deformity and exfoliations on pos-
terior aspect. On March 9, 1869, he visited the Museum, recovered, and
his photograph was taken to accompany the specimen. (A. M. M. Card
Photographs, Vol. 1, page 27.)

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. S. A., Curator A. M M.

Trepared nndei- the supervisioti of

Assistant ^orgeon Peorge A. Otis, U. S. /4

BY ORDER OF THE SURGEON GENERAL.

WAS* r»EI^>ART'WEE5Sl^?.

^urgeon Penerals Office, Army yWEDicAL/ZluSEUM.

(&tnmY$ #fto,

ARMY MEDICAL MUSEUM.

Photograph No. 229. Lower Half of the Left Femur Success-
fully Amputated.

Private C. H. Bowen, Co. A, 27th Indiana Volunteers, had his left
femur fractured by a musket ball, at the battle of Antietam. on September
17,1802. He was admitted to Hospital No. 1, at Frederick, Maryland,
where Buck's apparatus was applied. Nine months subsequently, he was
removed to Baltimore. There were numerous abscesses, and the patient
underwent two operations for the removal of necrosed bone. On Septem-
ber 7, 1803, he was discharged the service, with the limb greatly deformed.
He received a pension, and was employed in the Interior Department.
Owing to recurrence of abscesses he was admitted to Providence Hospital
in the autumn of 1807, and on November 11th, the limb was amputated in
the middle third by Dr. D. W. Bliss. The wound healed well, and a pho-
tograph was taken at the Army Medical Museum on January 9, 1808, at
which time the stump was firm and healthy. The specimen, with the
history, was contributed by the operator. The fragments are considerably
overlapped, having undergone unusual disturbance, and the amount of
callus exceeds what is necessary for complete union.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass1 1 Surg. U. S. A., Curator A. AI. M.

Trepared wider the supervision of

/ssistant ^urgeon Peorge A. p-ris, fJ. £. ,*■

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ARMY MEDICAL MUSEUM.

Photograph No. 230. The Greater Portion of the Right Femur,
exhibiting an oblique Fracture, from a Conoidal Musket Ball
impinging against the Inner Aspect, a little below the Middle.

Private James H. Wager, Co. H. 125th New York Volunteers, aged
twenty-one years, was wounded at the battle of Hatcher's Run, en April
2, 18G5, by a conoidal musket ball which passing upward and backward
and producing two wounds, fractured the right femur at the junction of
the lower and middle third. He was sent to the field hospital of the 2d
Corps at City Point, Virginia, and, on the 4th, was transferred to the
Douglas Hospital at Washington, where he arrived, on the 5th, in a very
low condition, being aneemic and debilitated, with rapid pulse, flushed
cheeks, and icterus. The knee joint was also much swollen. The fol-
lowing day he was etherized and the wound thoroughly examined by
Acting Assistant Surgeon C. Carvallo, who extracted pieces of bullet
from each wound. Stimulants and concentrated nourishment were freely
administered without effect, and the patient died from exhaustion on
April 10, 18G5. At the autopsy, twelve hours after death, decomposition
was rapidly setting in; the thoracic and abdominal viscera appeared
healthy; the fractured femur was disarticulated and sawn longitudinally,
the medullary substance appearing inflamed, red and hardened. The
case is interesting from the number of pieces into which the bullet was
split; viz., one which made its exit, two taken from the wounds, and one
found near the bone at the post mortem, making four in all. The patho-
logical specimen was contributed by Assistant Surgeon W. F. Norris, U.
S. A., and is No. 3168 of the Surgical Section.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass' t Surg. U. S. A., Curator A. M. M.

iiiiiiii, m#?©ii*m m*

Trepared under the supervisio?i of

Assistant Burgeon Peorge fi. Otis, p. £• fr
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ARMY MEDICAL MUSEUM.

Photograph No. 231. Lower Half of Right Femur, exhibit-
ing an Osteoplastic Operation and a Secondary Amputation.

Private Grey Y. Barrett, Co. F, 5th New Hampshire Volunteers, aged
twenty years, was wounded at Fredericksburg on December 13, 1862, by
a musket ball, which entered the outer condyle, and, escaping posteriorly
in the middle of the lower third of thigh, left the bone much comminuted
at its exit He was admitted to the hospital of the First Division, Ninth
Corps, where, on the 16th, Assistant Surgeon J. "W. S. Gouley, U. S. A., am-
putated the femur a short distance above the wound of entrance, the pa-
tella being included in the anterior flap; the line of section not having
escaped the wound, another third of an inch was removed; the femoral
surface of the patella was then sawn off, and the two cut surfaces of the
bone were brought in apposition. The laminated portion of the femur,
however, was fractured half an inch above this point, and fissures extended
two inches further. On the sixth day sloughing commenced; on the
eighth, signs of gangrene Averc noticed ; and on the ninth, December 25th,
Surgeon J. P. Prince, 36th Massachusetts Volunteers, amputated the
femur in the middle third, on account of the burrowing of pus, for
secondary haemorrhage from the propliteal. No plastic deposit could be
observed immediately after the operation. On the next day he was
transferred to Washington, and admitted to the Douglas Hospital, where
he died on December 27, 1862. The pathological specimen, which is No.
536, Surgical Section, was contributed, with the history, by Surgeon J.
P. Prince, 36th Massachusetts Volunteers.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass 't Surg. U. S. A., Curator A. M. M.

liiiiiiwi WfiiiiM w§.

Trepared under the stipervision of

Assistant ^urgeon Peorge A. Otis, JJ. S, ^
BY OliDER OP THE SURGEON GENERAL.

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Photograph No. 232. Shaft of the Left Femur, exhibiting
Comminution in the Middle Third, loith Extensive Longitudinal
Fracture, produced by a Conoidal Mushet Ball.

Private Thomas Holmes, Co. D, 1st Michigan Sharpshooters, aged
twenty years, was wounded at Spottsylvania Court House on May
10, 1864, by a conoidal musket ball, which entered the inner aspect of
the left thigh, one inch above the patella, and, passing upwards and out-
wards, made its exit ou the outer surface of thigh at the middle third.
He was carried nine miles in an ambulance to the general hospital at
Fredericksburg, and was, afterwards, admitted to the Armory Square
Hospital at Washington on May 26, 1864. No apparatus had been
applied to the limb. Shortly after admission chloroform was adminis-
tered, but, after a consultation, it was decided that he could not bear am-
putation. The injured limb was then placed in a fracture box, and
strong stimulants were given. The patient lingered until June 10, 1864,
when he died from exhaustion. The pathological specimen, which is
superficially necrosed, was contributed, with history, to the Army Med-
ical Museum by Surgeon D. W. Bliss, U. S. V., and is numbered 24S6,
in the Surgical Section.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE, A. OTIS,

AssH Surg. U. S. A., Curator A. M. M.

_m Mit@iii\\» m. ■■■■■■

"Prepared u?ider t/ie supervision of

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Photograph No. 233. Reproduction of the Metacarpals and

Phalanges after Necrosis.

The specimen is from the Gibson Collection, and is numbered 5251 of
the Surgical Section, Army Medical Museum.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. (J. S. A., Curator A. M M.

iiram Mil iiitM m.

Prepared under tfie supervision o/'

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Photograph No. 234. Excision of Five Inches of the Shaft of
the Right Humerus.

Private Herman L. Maynard, Co. C, 17th New Hamshire Volunteers,
aged thirty-one years, was wounded at Olustee, Florida, on February 20,
1864, by a conoidal musket ball, which entered the right arm at the middle
and outer aspect, and fractured the humerus at the upper third. On the
2oth, he was admitted from Jacksonville, Florida, to the hospital at Hilton
Head, South Carolina, where the arm was unsuccessfully treated with
splints. On March 9th, being etherized, a portion of the bone, about five
inches long, was excised. The arm was much swollen, very painful, and
the soft parts were much lacerated. His constitutional condition was
good. Water dressings and a concave coaptation splint were applied. In
about two months, there was sufficient deposit of bone to render the arm
firm without shortening. On June 25th, the patient was admitted to the
Central Park Hospital, New York City. The wound was in a sloughing
condition, and numerous fragments of exfoliated bone were removed.
He was discharged the service on September 7, 1864, at which date the
wound was reported healed and the arm firm. On September 14, 1864,
Pension Examiner J. Clough reported the wound discharging profusely,
and, every few days, pieces of bone were extracted. The arm was
anchylosed, and he rated his disability total and doubtful. On August 12,
1869, a photograph was taken, which was contributed to the Army Medical
Museum by Dr. J. 0. Webster, of the National Asylum for Discharged
Volunteer Soldiers at Augusta, Maine. The limb was almost as strong as
its fellow, but it had shortened nearly two inches, and the wound of exit
had not healed.

Printed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
Ass't Surg. U. S. A., Curator A. M M.

iiMtti mm mmm it.

Trejiared nnrler the supervision of

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Photograph No. 235. Partial Recovery from a, Compound
Fracture of the Left Thigh in the Upper Third, caused by a
Gonoidal Musket Ball.

Private Thomas Welch, Co. F, 6th Maine Volunteers, aged twenty
years, was wounded on November 7, 1863, at Rappahannock Station, Vir-
ginia, by a conoidal musket ball, which entered the front aspect of the
left thigh in the upper third, fractured the femur, and escaped at a point
"nearly opposite. When admitted to Armory Square Hospital, on Novem-
ber 9, 1863, his limb was slung in a frame, with a weight suspended from
the foot, which was removed a few days afterward. Two pieces of bullet
were extracted, and cold water dressings applied. On May 26, 1864, he
was sent to Chester Hospital, Pennsylvania, and on March 7, 1865, was
transferred to the Satterlee Hospital at Philadelphia. He was discharged
the service March 29, 1865, by expiration of enlistment, and pensioned.
On August 29, 1866, Pension Examiner J. Cummiskey reported the in-
jured limb shortened some three inches, and completely anchylosed at the
knee joint. Exfoliation was still going on and the patient suffered much
pain, and was obliged to use a crutch, the limb being entirely useless.
On August 20, 1869, at the time the photograph was taken, he had good
U9e of the limb; but it felt weaker than the other, and was apt to swell
if he walked much. He then walked without a cane, and was an inmate
of the National Asylum for Disabled Volunteer Soldiers at Augusta,
Maine.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. 8. A,, Curator A. M M.

niM^A iwtiiiiM m*

Trepared under the supervision of

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Photograph No. 236. Partial Recovery after Compound Com-
minuted Fracture of the Femur by a Connoidal Bullet

Private Michael Murtha, Co. H, 159th New York" Volunteers, aged
eighteen years, was wounded on April 14, 18G3, in an engagement at Irish
Bend, Louisiana, by a conoidal musket ball, which entered the right thigh
anteriorly in its upper third, and escaping at a point nearly opposite,
lodged in the pants. On the 17th, he was admitted to the Marine Hospital
at New Orleans, where the limb was treated by sand bags, and by manual
extension once daily. It united in bad shape, and another Surgeon com-
ing in charge, it was rcbroken, and Boyer's splint was applied. He was
able to bear his weight on it about, eight months afterward. On March
9, 18G4, he was transferred to the Veteran Reserve Corps, the limb having
shortened three inches. On August 24, 1864, lie was admitted, for chronic
ulcer, to the Augur Hospital at Alexandria, Virginia, from Camp Distri-
bution, and on August 27th was transferred to the Second Division Hos-
pital at the same place. He was discharged the service May 31, 18G5,
and was pensioned. On July 28, 18G5, Pension Examiner Charles Row-
land reported that the patient suffered from a large abscess, from which
many pieces of bone had been extracted. He was quite lame, being
obliged to walk with a crutch. His habits were moral and temperate.
His disability is rated total and permanent. On August 14, 18G9, at
which time a photograph was taken, the patient was an inmate of the
National Asylum for Disabled Volunteer Soldiers at Augusta, Maine.
The wound had not healed, and the thigh discharged in four places, but,
with the assistance of a cane, he was able to walk comfortably.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. S. A., Curator A. M- M.

twm

Prepared under ttie supervisio?i of

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Photograph No. 237. Successful Excision of the Left Tibia.

Lieutenant 0. R. Tyler, Battery I, 2d Connecticut Heavy Artillery, was
wounded at Opcquan Creek, near Winchester, Virginia, on September 19,
18G4, by a conoidal musket ball, which fractured and comminuted the
left tibia in the middle third. On the same day he was sent to the depot
field hospital, where Surgeon Henry Plumb, 2d Connecticut Heavy
Artillery, by a linear incision along the inner anterior aspect, excised
three inches of the bone, which was much comminuted. The patient's
general condition was satisfactory ; simple dressings were applied. On
November 12th he was transferred to the hospital at Frederick, Maryland,
where, on December 15th, the missile and fragments of bone were removed.
By January 1-i, 1865, when he was furloughed, there had been no bony
deposit in the interspace. He was discharged from service March 9, 1865.
In June, 1865, Dr. E. D. Hudson, who furnished the patient an apparatus
for supporting the limb, reported that there was no shortening of the
leg, but that it was considerably atrophied, with lateral excurvature; the
head of the fibula was partially detached by reluxation of the ligaments,
and the flexor muscles of the foot were impaired. A thin osseous tissue,
not continuous or united, supplied the place of the missing bone, but
afforded no support.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Aas'i Surg. U. S. A., Curator A. M M.

Trejtared under Hie supervision of

Assistant ^urgeon pEORGE fs.. pr\s, V ,'-

BY OUDER OF THE SURGEON GENERAL.

war x»iE:jEMfc.i*i*Ba;:eJsri\

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jliirfOT toirafs Office.

ARMY MEDICAL MUSEUM.

Photograph No. 238. A Cranium, with the Atlas luxated to
the Rigid and Firmly Ossified, to the Occipital Condyles.

The specimen is 5119 of the Surgical Section, and formerly "was No.
115 of the Gibson Collection.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. S. A., Curator A. M M.

"Prepared under tfie supervision of

^Assistant £urgeon Peorge A. p-ns, JJ. f>- A
BY OBDEB OF THE SURGEON GENERAL.

WAJE* DiEPARTBSEWT,

gURGEON pENERAL's pFFICE, ARMY MEDICAL yttUSF.UM.

ARMY MEDICAL MUSEUM.

Photograph No. 239 Shaft and Proximal Extremity of the
Left Femur, showing Lateral Deformity , with Necrosis and Ex-
foliation, the Result of a Gunshot Wound.

Private M. D. Powell, Co. H, 26th Alabama Regiment, aged twenty-two
years, was wounded at Antietam, September 17, 1862, by a missile, which
produced a compound comminuted fracture of the upper third of the left
femur and lodged. He was admitted to the Hospital at Frederick, Mary-
land, January 2, 1863. No apparatus was applied; but the limb was
placed in easy position under a pillow, the missile was extracted, and
nitric acid was applied to the sloughing wound. On January 26th, the
wound had an unhealthy appearance, at first supposed to be gangrenous.
The patient had a troublesome cough, for which a stimulating cough-
mixture and cups to chest were prescribed. His general condition im-
proved until erysipelas set in, which was ineffectually treated by the
expectant plan. He died March 16, 1863, from exhaustion. At the
autopsy, the fracture was found united at an angle of forty-five degrees;
the hip-joint contained pus, and the cartilage of the acetabulum was
softened. There was bronchitis in the upper lobe of the right lung, and
a calcareous deposit, of buckshot size, was found in the middle lobe.
The heart and liver were fatty, and in the pelvis of the kidneys phos-
phatic deposits were found. The specimen, which is No. 3841, Surgical
Section, was contributed by Assistant Surgeon R. F. Weir, U. S. A.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

AssHSurg. U. S. A., Curator A. M. M.

J'rejiared under /7/e supervision of

/tSSISTANT £<JRGEON pEORGE ft. pT!S, }}. £■
BY 0IU1ER OF THE SDRGEON GENERAL.

WAR DEPARTMEHX,

^URGEON pENERAL'spFFICE, /iRMY yttEDICAL yVlUSEUJ*

jPirp0» (&tutvnY& $ffire.

ARMY MEDfcAL MUSEUM.

Photograph No. 240. Dislocation of the Occipital Bone from
the Atlas, with Osseous Anchylosis.

This specimen, which is No. 5118 of the Surgical Section, is marked
Paris, 1847, and, formerly, was No. 155 of the Gibson Collection. The
atlas is dislocated laterally and to the right, the lateral masses and right
laminae being strongly united to the occipital bone. The rudimentary
spinous process is wanting, and the laminoe do not unite.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass'r Surg. U. & A., Curator A. M M.

"Prepared under i/ie supervision of

Assistant Burgeon Peorge ft. pris, )J.
BY ORDER OF THE SURGEON GENERAL.

war nbESMkBLxrarJEwrT.

gURGEON pENERAL'spFFICE, ^KMY yVlEDICA L J^USBVl.

ARMY MEDICAL MUSEUM.

Photograph No. 241. Tubular Sequestra from Two Stumps of
Femur after Amputation

Private John Nash, Co. G, 148d Pennsylvania Volunteers, aged twenty-
one years, wis wounded in an engagement at North Anna River, Vir-
ginia, May 24, 1864, by a ball which fractured the right knee-joint. On
the same day, he was admitted to the hospital of the Fourth Division, Fifth
Corps; thence, was conveyed on a transport to Washington, and, admitted,
on May 29th, to the Armory Square Hospital. While on the way, on the
28th, his thigh had been amputated at the lower third. By December 21st,
he was pronounced convalescent, and was transferred to Judiciary Square
Hospital. Suppuration indicating the presence of dead bone, Acting As-
sistant Surgeon F. H. Hill, on April 9, 1865, removed the sequestrum.
The patient was discharged from service on June 22, 1865, and pensioned,
his disability being rated total. The sequestrum was contributed to the
Army Medical Museum by Surgeon E. Griswold, U. S. V., and is num-
bered 144 of the Surgical Section. It is about eight inches long and
completely tubular, and is represented on the right of the photograph.

Private John Glassie, Co. B, 63d New York Volunteers, aged twenty-
two years, was wounded at Cold Harbor, Virginia, June 3, 1864, by a
canister-shot which fractured the left ankle-joint. On the same day, he
was admitted to the hospital of the First Division, Second Corps, where
Surgeon P. E. Hubon, 28th Massachusetts Volunteers, amputated the
lower third of the leg. On the 11th, he arrived at Washington, and was
admitted to the Emory Hospital, where, on the 25th, Surgeon N. R.
Mosely, U. S. V., amputated the lower third of the thigh by the bi-lateral
flap operation. Extensive sloughing ensued, the femur became diseased,
and gangrene supervened. An abscess that had formed, was opened on
October 12th, and poultices were applied. On November 1st, the stump
was much swollen, and was still discharging; and on March 11, 1865,
when he was transferred and admitted to Central Park Hospital, New
York City, the end of stump was reported red and inflamed, with three
sinuses leading to necrosed bone. On March 19th, Acting Assistant Sur-
geon S. Teats made an incision on face of stump and removed the seques-
trum. The patient was discharged from service on August 15, 1865, and
pensioned, his disability being rated total. The sequestrum was con-
tributed to the Army Medical Museum by the operator, and is No. 3100
of the Surgical Section. It is eight inches long, is tubular, and is repre-
sented on the left of the photograph.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. S. A,, Curator A. M M.

'1'repared under t/ie supervision of'

^Assistant £urgeon Peorge ft. pus, V- ?■ A
BY ORDER OF THE SURGEON GENERAL.

WAR X»ES*HUE*1?B«E^Eff T.

^URGEON pENERAL's PFFICE, ^RMY M.EDICAL. ^MUSEUM

ARMY MEDICAL MUSEUM

Photograph No 242. Ujiper Portion of the Right Femur show-
ing its Condition Eleven Months after Fracture by a Conoid al
Musket Ball.

Lieutenant George A. Connor, Co. A, 7th West Virginia Volunteers, aged
twenty-four years, was wounded at Ream's Station, August 25, 1804, by a
conoidal musket ball, which fractured the femur at the junction of the
middle with the upper third, and caused considerable haemorrhage. His
limb was placed on a lateral splint whilst on the field. On August 28th,
he was admitted to the Armory Square Hospital at Washington in a very
feeble condition and suffering intense pain. Stimulants and anodynes
were freely administered, and the limb was placed in a fracture box with-
out extension. On November 5th, the patient had intermittent fever,
which, continuing five days, was checked by quinine. On April 1st, the
femur had united, but sinuses extended to the necrosed bone which the
patient at first refused to have removed; however, becoming much
emaciated and daily loosing strength, he consented to the operation, and,
on June 21th, Surgeon D. W. Bliss, U. S. V., removed portions of necrosed
bone and fragments of lead. He suffered greatly from the effects of the-
operation for three days subsequently, when healthy granulations appeared.
In the meantime, he was treated expectantly. On July 10th, an uncon-
trollable diarrhoea set in, and he died from exhaustion on July 31, 18U5.
The pathological specimen, showing a certain degree of union by folia-
ceous callus, was contributed, with the history, to the Army Medical
Museum by Acting Assistant Surgeon C. B. Porter, and is No. 4382,
Surgical Section.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass" L Surg. U. S. A., Curator A. M. M.

lining mm mmmi it.

'Prepared under t?ie supervisor of

Assistant jSurgeon Peorge ft. pns, }J. £. ,A
BY ORDER OF THE SURGEON GENERAL

WAR Vk'E^^TBe^TSO.-mM'E,

^URGEON pENERAL'spPFICE, y^RMY MEDICAL ^MUSEUM.

ARMY MEDICAL MUSEUM.

PHOTOGRAPH No. 243. Sequestra removed from Femurs after
Amputation.

Private William B. Biddle, Co. K, 138th Pennsylvania Volunteers, aged twenty-seven years,
was wounded at Cedar Creek, Virginia, October 19, 1801, by a conoidal musket ball, which
struck the external condyle of the left femur and penetrated the knee joint. On the same
day, he was admitted to field hospital; his wound was dressed; and, on the 21th, he was
transferred to Baltimore, and admitted to the Jarvis Hospital, where Acting Assistant Sur-
geon B. B. Miles administered ether, and amputated the thigh, at the lower third, by the
circular operation. On February 22, 1S65, a sequestrum, about four inches long, was removed,
and was contributed, by the operator, to the Army Medical Museum, where it is No. 109 of
the Surgical Section. The patient was furloughed on March 20th, and, on April 25th, was
admitted to the South Street Hospital at Philadelphia. On May 9th, lie was sent to the
Hospital at Chester, Pennsylvania, where, on July 18.1865, he was discharged the service
and pensioned, his disability being rated at three-fourths.

Private James M. Runyan, Co. II, 59th New York Volunteers, aged sixteen years, was
wounded at Antietam, September 17, 1862, by a projectile which struck the right thigh. He
was conveyed to the field hospital at the Sherman House, where the wound was considered
so serious that the thigh was amputated in the middle third by the circular method. No
further details of the case can be found until October 17th. when he was admitted to the
hospital at Smoketown, Maryland, suffering from diarrhoea, and the stump, with about two
inches of the bone protruding, and covered with maggots, was secreting an ichorous pus,
and showing some gangrenous spots. The protruding bone was removed with a chain saw:
the diarrhoea was cheeked in a few days, by the use of injections, and a nourishing diet; the
stump was covered with a cold poultice of yeast and charcoal, and as soon as it presented
the desired healthy appearance, a dry linen compress was applied. By January 20, 1S63, the
stump had healed with a slight protrusion of the femur. Attempts were made to remove
the sequestrum without instrumental interference, but it was not till March 11th, that the
result was successful. The specimen is about five inches long, and was contributed to the
Army Medical Museum by the operator, Surgeon B. A. Vanderkieft, where it is No. 1011 of
the Surgical Section. The patient recovered, was discharged from service on May 4, 1863, and
was pensioned, his disability being rated total and permanent.

Private Peter Walker, Co. C, 37th Wisconsin Volunteers, aged thirtj'-eight years, was
wounded at Cold Harbor, Virginia, June 18,1861, by a ball which severely wounded the right
knee joint; he also received a gunshot flesh wound of the left thigh. He was admitted to
the hospital of the Third Division, Ninth Corps. The injured knee being lacerated
and much swollen, Surgeon S. S. French, 20th Michigan Volunteers, amputated the right
thigh, at the junction of the lower thirds, by the circular method. He was sent to Wash-
ington, and was admitted to the Emory Hospital on June 21, 1861, where a tubular seques-
trum of bone, four inches long was extracted from the stump; but the patient died on
August 22, 1861. The sequestrum was contributed to the Army Medical Museum by Surgeon
N. K. Mosely, U. S. V., and is numbered 312S of the Surgical Section.

Private John Frederick, Co. D, 15th Massachusetts Volunteers, aged thirty-five years, was
wounded at Bristow Station, Virginia, October 14, 1863, by a fragment of shell, which
entered the middle third of the left thigh posteriorly, and, passing directly forwards, pro-
duced a C07nminuted fracture of the femur, with great destruction of the muscular tissue.
He lay neglected on the field until the afternoon of the next day, when he was conveyed, a
prisoner, to Gordonsville, where the thigh was amputated, by the circular method, at the
junction of the upper thirds. On November 8th, he arrived at Annapolis, from Kichmond.
and was admitted to the First Division Hospital. The patient gave evidence of having
endured considerable exposure and neglect, and made the above statement. He complained
of diarrhoea and loss of appetite; the wound was open, the skin retracted, and the sawn
extremity of the femur protruded an inch and a half; but it was thought advisable to pur-
sue the expectant plan, and, accordingly, the stump was dressed with alcohol, and generous
diet was ordered. By December 1st, the diarrhoea was no longer troublesome, his appetite
was good, and the stump was granulating finely, and slowly extending towards extremity
of bone, one inch, only, remaining exposed. On January 20, 1861, a sequestrum was first
detected, but not being sufficiently loose, it was allowed to remain for the present. The
thigh gradually enlarged four inches in circumference, and, on the 1st of April, the patient
suffering severely from the presence of necrosed bone, he was chloroformed, and Surgeon B.
A. Vanderkieft, U. S. V.., seized the extremity with large forceps, and, by a combined motion
of traction and rotation, removed the separated portion, entire. The operation was per-
fectly successful ; and, on May 21, 1864, the patient was discharged the service, and was
pensioned for disability, rated at total. The specimen, which is tubular, and nearly five
inches long, was contributed, with the history, by Assistant Surgeon W. S. Ely, U. S. V., and
is numbered 2232 of the Surgical Section.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass'tSurff. U. S. A., Curator A. M. M.

Prepared zincler tfie supervision of

^Assistant £urgeon Peorge /t. p-ns, p. £. A-
BT ORDER OF THE SOKGEON GENERAL,

WAR ESE3PA3RXB«E3SrX.

^URGEON PENERAJL'S PPFICE, (iRMY MEDICAL /WuSEUM.

ARMY MEDICAL MUSEUM.

Photograph No. 244. Necrosis and Exfoliation and Deposits
°f Spon9y Oallvs after a Gunshot Fracture of the Left Femur.

Private John E. Keith, Co. C. 13th Massachusetts Volunteers, aged
twenty years, received a gunshot fracture of the lower third of the left
femur, at the second battle of Bull Run, August 30, 1862. He lay on the
field until September 2d, when he was removed to Washington in a wagon
so heavily laden with wounded that the springs were no protection from
the jolting of the wagon over the rough roads. The fracture being com-
minuted and very oblique, the patient suffered intensely during the
journey, and when he was admitted to the Ascension Hospital, the lower
fragment of the femur was protruding through the external wound to the
extent of an inch. After restoratives had been given him, he was etherized
and the fracture was coaptated without much difficulty. The limb was
then suspended by Smith's anterior splint, and cold water was applied,
and tonics with a nutritious regimen were prescribed. At the beginning
of the third week abscesses began to accumulate in the inner and posterior
lower portion of the thigh, and bursting through the skin in numerous
places discharged profusely. The openings were so numerous that the
rollers used to confine the splint could not be applied without covering
some of them, which necessitated their daily removal, and as the patient
could not endure the slightest handling of the limb he was partially
etherized every day while the warm weather continued and afterwards
every other day, in order to apply clean rollers around the splint and
renew the dressings. Liquor sodse chlorinatoe, diluted with four parts of
water was freely used at each dressing, being injected through the open-
ings by a syringe. To add to the discomfort of the patient, about the end
of the fifth week gangrene of the integuments of the sacro-lumbar region
and the iliac projections set in, and the patient was transferred to a water
bed, but now it was found impossible to keep the limb from rolling and
causing great agony. The anterior splint was removed, and one similar
to Desault's substituted, with a short anterior one, it being impossible to
apply them either laterally or posteriorly on account of the number of
openings. The fragments remained in apposition rather better by this
apparatus ; but it was so uncomfortable that it was removed in a few days
and there being no hope of union, short splints covered with oiled silk
were placed around the thigh, and the leg swung in a fracture box, this
being the most comfortable support that could be devised. He died on
October 24 1862. The limb was examined six hours after death. The
soft parts from the knee to the groin were utterly disorganized. The
femur was removed and sent to the Army Medical Museum. The broken
extremities were covered with spongy callus ; but a cylindrical seques-
trum interposed between the fragments, and there was no union.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
Bv't I A. Col. and Ass't Surg. U. S. A., Curator A. M. M.

1'repared wider t?/e supervision of

/ASSISTANT guRGEON pEORGE fr. pTIS, )J. £. f-
BY ORDER OF THE SURGEON GENERAL.

^URGEON pENERAL'spFFICE, ^RMT MEDICAL yWuSEUM

ARMY MEDICAL MUSEUM.

Photograph No. 245. Upper Portion of the Right Femur
fractured hy a Conoidai Musket Ball just below the Trochanters,
with Profuse Deposit of Callus without Union.

Private S. Manley, Co. A, 63d New York Volunteers, aged twenty-six
years, was wounded at tbe battle of Gettysburg, July 2, 1863, by a con-
oidai musket ball, which fractured the upper third of the right femur.
He was sent to Camp Letterman Hospital at Gettysburg on August 4th,
where the limb was treated by the double inclined plane and simple
dressings. Partial union had taken place. On September 3d there was
a profuse discharge from the wound, and the patient was rapidly sinking.
There was, also, great shortening of the limb. He died October 8, 1863.
The history reports "a complete false joint, the head and socket being
covered with a dense, smooth, and apparently fibrous membrane;" but
this is not seen in the pathological specimen, which is No. 1935 of the
Surgical Section, and was contributed by Acting Assistant Surgeon E. P.
Townsend.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

AssH Surg. U. S. A., Curator A. M. M.

»ii!iiM, mm iii^M ii.

Trepared wider the supervision of

^Assistant ^urgeon Peorge jk. pns, ]J. p. p~
BY ORDER OF THE SURGEON GENERAL.

WAR X*EIE*A.3Bl,3E,;B!EJSJM"S\

>URGEON pENER&L's pFFICE, /iRMY MEDICAL MuSEl«

ARMY MEDfcAL MUSEUM.

Photograph No. 246. Gunshot Fracture of Upper Third of
Left Femur, treated by Smith's Anterior Splint with Partial
Recover i/.

Private Josiah Jones, Co. D, 12th New Hampshire Volunteers, aged
twenty-four years, was wounded at Chancellorsville on May 8, 1863, by a
missile which fractured the left femur in the upper third. On May 15th
he was admitted to the hospital of Whipple's Division, Third Corps ; and
on June 14th he was sent to the Second Division Hospital at Alexandria,
where, on November 20, 1863, he was discharged on surgeon's certificate
of disability; afterwards, he was pensioned. A communication from
Surgeon Isaac F. Galloupe, U. S. V., dated September 22, 1869, states,
that the patient received no appropriate treatment until he arrived at
Alexandria, where Smith's Anterior Splint was applied, and the limb kept
suspended nearly four months. The upper posterior cicatrix, as shown
in the photograph, represents the wound of entrance; the one below it,
the location of the last fistulous opening which closed in November, 1868,
after discharging, from time to time, fragments of necrosed bone. The
outer scar, in front, indicates the wound of exit; the remaining two, the
result of abscesses.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. S. A„ Curator A. M M.

1111M1 MitiiilM it,

"Prepared under tfie supervision of

^Assistant j5urgeon Peorge jk. pris, ]J. f>. f<-
BY ORDER OP THE SURGEON GENERAL.

WAR DiEJ^A.SaXJMEJKWX.

^URGEON pENERAL's pFFICE, ARM Y /VIeDICAL MUSEUM-

ARMY MEDICAL MUSEUM.

Photograph No. 247. Successful Secondary Amputation at
the Hip- Joint, following an Excision of the Head of the Femur
for Gunshot Injury.

Private John Schranz, 7th Austrian Feldjiigers, was wounded at the
battle of Palestro, May 30, 1859, by a ball which fractured the trochanter
of the left femur, the splintering involving the joint, either directly or by
exciting traumatic arthritis. The formation of abscesses in the thigh
rendered some operative interference necessary, and on November 27,
1859, Dr. Neudorfer, chief surgeon of the Eighth Austrian Army Corps,
excised the head, neck, and trochanters of the bone. The operation did
not result favorably, and four days subsequently Dr. Neudorfer removed
the entire limb by the double flap method. A rapid recovery followed,
and on January 1, 1860, the patient was walking about. A photograph,
presented to Dr. Otis by Dr. Neudorfer, which now hangs in the Army
Medical Museum, was taken April 12, 1868, represents the patient in
excellent condition more than eight years after the operation. This
photograph is a copy from that referred to. A detailed account of this
case will be found in Dr. Neudorfer's Handbuch der Kreigschirurgie.
Leipzig, 1864.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
BvH Lt. Col. and Ass't Surg. 0. S. A„ Curator A. M. M.

tuiim Miiniiw m*

Prepared under tfie supervision of

/tSSISTANX ^URGEON pEORGE ft. pTIS, }J. £• ft
BY ORDER OF THE SURGEON GENERAL.

war nEjp>A.stTE«aE3e]srx»

^URGEON pENERAL's pFFICE, ^RMyMeDOL /VlUSEUM.

ARMY MEDICAL MUSEUM.

Photographs No. 248, 260, and 261. Successful Secondary
Excision of the Head of the Femur for Gunshot Injury.

These three photographs illustrate the case of Private C. F. Read, Co.
I, 37th Infantry, who received a gunshot fracture of the head of the left
femur, while on picket, sixty miles from Fort Stanton, New Mexico, June
8, 1868. The nature of the injury to the bone

will be understood from the adjacent wood cut, / "''^f^|^^^,
copied from the specimen contributed to the
Museum by the operator, Assistant Surgeon
J. R. Gibson, U. S. Army, and numbered 5576,
Section 1, A. M. M. The case is very fully
detailed in the Report in Circular No. 2, S.
G. 0., 1869, page 117. The operation was per-
formed on August 14, 1868, through a T shaped incision. By November
20, the patient was able to walk about the hospital building, and the
further progress of the case was as rapid as it was favorable. Early in
1869, this soldier was discharged from the service. He came across the
plains by the next train, and in September, 1869, reported at the Surgeon
General's Office, where the photograph, No. 248, was taken. At that
time the patient's general health was excellent. The cicatrix was per-
fectly firm and sound, and the strength of the ligamentous attachments
and the amount of control over the movements of the limb were very
remarkable. He could bear much weight on the limb. Assistant Surgeon
Otis, U. S. Army, who was instructed to recommend a suitable
apparatus, suggested one; but advised that he should not use it at
present, but should continue to exercise the limb cautiously for some
months, to increase by exercise the strength of the muscles and liga-
mentous attachments, and the freedom of the newly formed joint. The
next week Read went to New York, and the apparatus proposed, and
figured in photograph 261, was ingeniously adapted by Dr. E. D. Hudson.
In the summer of 1870, it was reported that this man could walk very
comfortably with a cane, either with or without his apparatus.

Photographed at the Army SVHedical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,
Bv't Lt. Col. and Ass't Surg. U. S. A„ Curator A. M. M.

Prepared under the supervision of

/tSSISTANT gllRGEON pEORGE ft. pTIS, (J. |3.
BY OKDEK OP THE SURGEON GENERAL.

^URGEON pENERAL's pFPICE, Arm Y M EDICAL ^VlUSEUM.

ARMY MEDICAL MUSEUM.

Photograph No. 249.

The figure on the left of the group represents a section of the left radius and ulna, show-
ing a fracture of each, for which amputation was performed. The ulna is transversely
fractured, with necrosis of the borders ; the radius is broken into four pieces. The patient
was B. F. Surby, a civilian attache of the army, who was wounded at Fredericksburg, on
December 14, 1862, by a projectile which produced the above described injury. He was sent
to the Douglas Hospital at Washington on the 26th, where, on December 29th, the forearm
was amputated, just below the elbow, by Surgeon Peter Pineo, U. S. V. The patient recovered ;
and on September 29, 1S65, he visited the Army Medical Museum, when the stump, which
was in excellent condition, was photographed. The specimen is No. 711 of the Surgical
Section, and was contributed by the operator.

The figure on the right represents the upper portion of the right radius and ulna fractured
in their upper thirds. A ball has apparently passed between the two, fracturing the radius in
an irregularly transverse manner, and chipped off two inches from the posterior surface of
the ulna. A longitudinal fissure extends one and a half inches on the posterior surface of
the radius, and the borders of the fracture are necrosed. The patient was Thomas A. Mar-
tin, a private of Co. G, 91st New York Volunteers, aged twenty-two years, who was wounded
at the South Side Railroad on March 30, 1865. He was sent to Philadelphia, and was ad-
mitted to the Mower Hospital on April 7, 1865. After his admission several slight haemorr-
hages took place, and, on the evening of April 16th, a profuse one occurred from the ulnar
artery, high up, which necessitated ligation of the brachial artery in its lowest third. On
the 18th, the haemorrhage recurring, led to the conclusion that the artery had bifurcated
above the point of the ligature ; and; as the prospect of checking the haemorrhage was un-
favorable, and the injury to the bones aud soft parts extensive, amputation at the middle
third of humerus, by the circular method, was decided on, ond was, accordingly, immedi-
ately performed. The patient reacted well. The case progressed favorably, and, by June
6th, the stump had nearly healed, it being kept open only by a slight exfoliation from the
end of the bone. A dissection of the amputated arm confirmed the opinion held in reference
to the artery: two large trunks had formed, showing bifurcation above the point of ligation.
On August 17, 1S65, the patient was sent to the head-quarters of his regiment to be mus-
tered out. The specimen is No. 1588 of the Surgical Section, and was contributed, with the
history, by Acting Assistant Surgeon W. S. Hendrie.

The central figure represents the lower two-thirds of the left radius and ulna, apparently
amputated. About two inches of the ulna in the lowest third is wanting; and the radius,
directly opposite, is transversely fractured without displacement, (probably by the same
missile nearly spent,) with slight Assuring, extending, posteriorly, to the styloid process.
The specimen is No. 2571 of the Surgical Section ; the contributor and history are unknown.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. 8. A„ Curator A. M M.

Prepared under the supervise

Assistant JSurgeon Peobge ft. pns

BY ORDER OF THE SUROE0H OEKERAL,

WAR DiES»'A.3R.1,a«EEJWX,

gURGEON PENERAL'S pFFlCE, ^RMY yWEDICA

ARMY MEDICAL MUSEUM.

Photograph No. 250. Specimens exhibiting Comminuted Frac-
tures of the Right and Left Forearm

The Left shows a transverse fracture of the radius in the middle third,
without displacement. The ulna is fractured, with the loss of one inch
in the middle third. This specimen, in which no pathological changes are
noticeable, was contributed by Surgeon J. E. Summers, U. S. A., and is
No 320 of the Surgical Section.

The Right shows a transverse fracture of the radius in the lower third,
with both fragments longitudinally fissured. The ulna has two transverse
fractures ; one in the middle third, and one just above the lower extremity .
These bones are the result of an unsuccessful amputation, performed on
Private A. P. Bush, Troop F, 1st Massachusetis Cavalry, aged twenty-
nine years, who was wounded at Bristow Station, Virginia, in October,
1863, by a solid shot, which caused the above mentioned injury. On
October 15th, he was admitted to the First Division Hospital at Alexandria,
in a feeble and exhausted condition. The limb was extensively swollen,
and the patient suffered intense pain. Three days subsequently, the arm
was amputated in the middle third by the circular operation. On the 23d,
he seemed to improve; but, on the 25th, the flaps sloughed apart. On the
29th, the stump was granulating finely, and he continued to improve. On
November 1st, the patient had a violent chill, which, lasting twenty min-
utes, was followed by a fever of two hours duration. The chills recurred
on the 6th, 7th and 8th, and, by the 19th, he was in a very low condition.
On the 20th, he was much improved, and the wound looked finely ; but
he did not seem to rally sufficiently to warrant hopes of his recovery.
Pyaemia supervened, and death occurred on November 21, 1863. The
autopsy revealed an abscess at the shoulder joint, filled with six ounces
of pus. The abdominal viscera were normal, with the exception of the
stomach, which was highly congested. This specimen, exhibiting no
noticeable pathological changes, was contributed by Surgeon E. Bentley,
U. S. V., and is No. 1841 of the Surgical Section.

Photographed at the Army Medical Museum.

BY ORDER OF THE SURGEON GENERAL:

GEORGE A. OTIS,

Ass't Surg. U. S. A,, Curator A. M M.

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