A report of surgical cases treated in the Army of the United States from 1865 to 1871 / War Department, Surgeon General's Office.
- Date:
- 1871
Licence: Public Domain Mark
Credit: A report of surgical cases treated in the Army of the United States from 1865 to 1871 / War Department, Surgeon General's Office. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![forced to reveal this sacred.secret, as it is regarded by these Indians, and to apply/or medical aid. His urine had often been stopped for many hoars, at which time he had learned to obtain relief by elevating the hips, or lying iu different positions. The urine was loaded with blood a;nd mucus, with a few pus globules, and the introduction of a sound indicated a large hard calculus iu the bladder. The Indiaus advised me of the depth approximately to which the shaft had pene- trated and the direction it took, and judging from the situation of the cicatrix and all the circum- stances it was apparent that the arrow-head had passed through the glutei muscles'and tlie obturator foramen and entered the cavity of the bladder, where it remained and formed the nucleus of the stone. Stone in the bladder is extremely rare among the wild Indians, owing no doubt to their almost exclusive meat diet, and the very healthy condition of their digestive organs, and this fact, iu connection with the age of the jiatient, and the unobstructed condition of his urethra, went very far to sustain this conclusion. On August 23d I removed the stone without difficulty by the lateral operation through the perinteum. The lobe of the prostate was enlarged, which seemed to favor the extent of the incision beyond what would otherwise have been safe. The perinteum was deep and the tuberosities of the ischii unnaturally approximated. The calculus, of the mixed ammouiaco- magnesian variety, was egg-shapped, and weighed nineteen drachms. The arrow-point was comjiletely covered and imbedded near the centre of the stone. It was of iron, and had been originally about two and one-half inches long, by seven-eighths of an inch at its widest part, some- wliat reduced at the point and edges by oxidation. The removal of the stone was facilitated by the use of two pairs of forceps, one with broad blades by which I succeeded iu bringing the small end of the stone to the opening in the prostate, while the other, loug and narrow, seized and held it until the former were withdrawn. In this way the forceps did not occupy a part of the opening while the large en d of the stone was passing through it. The capacity of the bladder was reduced and its inner walls were in a state of chronic inflammation. The patient quickly recovered from the effects of the chloroform, and felt great relief both in body and mind after the operation, and up to the eighth day the case did not present a single unfavorable symptom. The urine began to pass by the natural channel on the third day, and continued more or less until on the seventh it had nearly ceased to flow at the wound. But the restless spirit of the patient's friends could no longer be restrained. Open hostility with the whites was expected to begin at every moment, and they insisted on his removal. He needed purgative medicine on the eighth day, which they refused to allow him to take. They assumed entire charge of the case, and the foUowiiig day started with him to their camps sixty miles away. jSTineteeu days after he is reported to have died. But his immediate relatives have since assured me that his wound was well, and that no trouble arose from it. They described his symptoms as those of bilious remitting fever, a severe epidemic of which was r)revailing at the time, and from which several white men and many Indiaus died in that vicinity. The calculus was contributed to the Museum at Washington. A section is represented in the wood-cut (Fig. GI) of natural size. [The weight of the concretion is eight hundred and fifteen grains, and it consists of an almost uniform deposit of triple phosphates about the nucleus.—Ed.] DOOYI.—Report of a Case in wJdch a Gonoklal Mmlcet Ball teas Suceessfulhj Removed from the Bladder by Lithotomy. By J. L. Forwood, M. D. Edwin T. Mason, a private of Co. K, 198tli Pennsylvania Volunteers, aged 49 years, was wounded near Hatcher's Euu, Virginia, on March 31, 18G5. He was sent to Lincoln Hospital at Washington, from which he was discharged per general order on June 9, 1865. His wound remained open, but did not require medical aid. He returned home, and followed his ordinary occupation up to February, 1809. At this date the wound healed up and the patient thought himself well; but on February, 1870, vesical trouble, bloody urine, &e., appeared. On April 16th the operation of lithotomy was performed, and there was removed a conoidal musket ball weighiug one ounce and x quarter, and having two small pieces of phosphatic deposit attached. On May 30th the patient was up and about, but the wound had not entirely healed. There were no symptoms of calcidus until six weeks before the operation, notwithstanding there seems but little doubt of the ball having been in the bladder previous to that time.](https://iiif.wellcomecollection.org/image/b21970695_0277.jp2/full/800%2C/0/default.jpg)
