Gunshot wounds and other injuries of nerves / by S. Weir Mitchell, George R. Morehouse, and William W. Keen.

  • Mitchell, S. Weir (Silas Weir), 1829-1914.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Gunshot wounds and other injuries of nerves / by S. Weir Mitchell, George R. Morehouse, and William W. Keen. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    has some physiological interest, we think fit to re- late it at length. Gunshot wound of inferior dental branch of the fifth-pair. Case 8.—John Schultze, aet. 23, German, enlisted August, 1862, Co. G, 26th Wises. Vols. Previous health good. At Gettysburg, July 3, 1863, while marching at a long dis- tance from the enemy, a single shot, from some remote picket, took effect on his left cheek, over the lower edge of the malar prominence. It was probably fired from an elevation, since it passed across the ramus of the jaw, and entered the anterior margin of the trapezius muscle, whence, two weeks later, it was removed by Dr. Keen. The ball, a Minie, was very much deformed. It somewhat injured the ear in its passage, but although it crossed the ramus of the jaw obliquely, and probably broke off some splinters, it did not fracture the bone so as to affect masti- cation. The patient fell senseless when hit, and remained thus for at least half an hour. He had no pain. The whole left side of the face was devoid of feeling, and so continued until the second day, when sensation came back rather suddenly, except in a space, which included a large part of the ultimate distribution of the left mental nerve. The first and larger loss of sensory appreciation was prob- ably a result of the local shock. When he recovered his senses, he found that the left arm was almost useless from loss of i^ower. The fingers could be moved well enough, but the arm could not be flexed at the elbow. Sensation was but slightly altered. The arm was merely numbed. The right arm was also weakened, though to a less degree, but in it the sense of touch was defective to a remarkable extent, so that when he sought to undo his belt he could not feel the buckle. This was not merely a general shock or weakness, for his legs were as strong as usual, and he was able to walk to the rear unassisted. Mo- tion and feeling returned within four days to the right arm, but the left recovered more gradually, and was still weak as late as August 10, 1863. During the first w^eek there was great swelling of the neck, which was relieved when the ball was cut out. Dur- ing September two or more small spiculie of bone escaped 5