A report on excisions of the head of the femur for gunshot injury.

Date:
1869
Catalogue details

Licence: Public Domain Mark

Credit: A report on excisions of the head of the femur for gunshot injury. Source: Wellcome Collection.

    63/156 (page 55)
    of Helena, and the other after the battle of Franklin. One was conveyed to an hospital at Memphis, and the other either to Mound City or JefFersonville. In one, the operation was performed through a longitudinal incision; in the other, by raising a semi-circular Hap. The records of the hospital steamer and of the hospitals at Memphis, Mound City, and Jeffersonville, throw no light on these cases, and inquiries addressed to surgeons who were on duty at those places at the periods referred to, have been unavailing. Dr. J. W. Brock, formerly Surgeon 66th Ohio Volunteers, states1 that he excised the head of the femur primarily for gunshot injury on two occasions: after Gettysburg, and at Resaca, Georgia; but remembers no particulars of either case, and knows nothing of the results. The very full returns from Gettysburg and Resaca contain no allusion to these operations. Dr. Benjamin Woodward, of Galesburg, Illinois, formerly Surgeon 22d Illinois Vol- unteers, relates2 two cases which he regards as examples of the operation in question: Case.—Private Joseph Derusha, Co. F, 14th Ohio Volunteers, was sent to tlie hospital at Tullahonia, two days after the battle of Lookout Mountain, [November 2.5th, 1863], wounded in the right hip. I found a small hole of entrance over the greater trochanter, and with a Nelaton probe detected a ball firmly lodged in the bone. As I could not remove it with any instrument without doing greater damage to the bone, I made a crucial incision, the ball hole in the centre, and, reflecting the flaps, sawed out with a Hey's saw a wedge-shaped piece of bone with the ball in it. There was little haemorrhage, and the case did well, so that by April he was acting as nurse in the hospital. [The hospital register reports Private Derusha as treated for imflammation of the kidneys, and makes no mention of any wound or operation.] Cash.— The other was that of a negro railroad hand, wounded by guerillas, but, as he was not a soldier, his case, like those of others at the same time, did not go on the hospital reports. This man was shot in the left hip and the head of the bone with two inches of* the shaft shattered. He was chloroformed and the head of the bone with two and a half inches of the shaft excised. There was no haemorrhage requiring any ligation. The cavity was filled with lint, and water dressings used. Sup- puration was profuse, and he sunk in about a month. [The hospital register states that Jenaway Engle, colored laborer on military railway, aged 19, was admitted March Kith, 1864, with a gunshot fracture of the femur by a conoidal musket ball. March 17th, ball and splinters of bone removed. Death, March 24th, 1864.] From the great number of negative responses to a circular letter from this office requesting medical men to communicate any facts within their knowledge in relation to unpublished cases of excision of the head of the femur, it may be concluded that the record of these operations in the United States armies is very complete. For obvious reasons, similar completeness can hardly be hoped for in the reports from the Confederate armies. I am informed by Professor T. G. Richardson,3 of New Orleans, that the opera- tion was not frequently performed in the Confederate service, and this opinion is corrobo- rated by the records that have been preserved, and by the statements of Professor J. F. Heustis,4 of Mobile, of Dr. S. M. Bemiss,5 Director of Hospitals, of Dr. R. H. Taylor,0 of Memphis, and of Dr. A. C. Crymes,7 of Alabama. I have recorded but fifteen operations by Confederate surgeons, and have felt compelled to exclude others on account of the insuf- ficiency of the data. Among these are three cases reported by Dr. C. A. Rice,8 of Brandon, Mississippi, as follows : 1 Letters from Leavenworth, Kansas, dated October 17th, November 9th, 28th, and December 15th, 1868. 2 Letter of October 23, 1868. 3 Letter of October 20, 1868. 4 Letter of October 12, 1868. 6 Letter of October 15, 1868. 6 Letter of October 22, 1868. 7 Letter of November 27, 1868. * Having learned through Dr. P. F. Whitehead, of Vicksburg. that Dr. Rice had excised the head of the femur for gun- shot injury in the case of a stout man wounded at the siege of Vicksburg, I addressed a letter of inquiry to him, and he politely furnished me with the subjoined particulars in a letter from Brandon, Mississippi.