A report on amputations at the hip-joint in military surgery / [by George A. Otis].
- Surgeon General of the United States Army
- Date:
- 1867
Licence: Public Domain Mark
Credit: A report on amputations at the hip-joint in military surgery / [by George A. Otis]. Source: Wellcome Collection.
Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)
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![groin. A teu-iiich catling was then introduced abont midway lietween tlii'troelianter nnijor and the anterior superior spitioiis j)rocess of the ilium, the point at first directed slightly upwards in order to open the cajisule of the joint; then the handle was raised and the point made to come out about an inch in advance of the tuberosity' of the ischium. A large flap was then cut from the anterior and inner side of the thigh, about six inches in length; the liromorrliage being controlled by Surgeon James B. Murdock. '24th New Yoik Volunteers, who grasped the flap and compressed the femoral artery before it wa.s cut. The heel of the knife was then placed where the point came out, and the points of entrance and exit were connected by an incision cutting to the bone. Part of the capsule being opened by the first incision, the remainder of it was divided, the round ligament cut, and the head of the femur removed from the acetabulum. The hfemorrhage was then arrested, the femoral artery being tied last. The loss of blood was very slight, less even than in an ordinar}' aniputati(]n of the tliigh. The stump having been dressed, the patient was placed in an hospital tent, and remained under Dr. Shippen's charge for tliree days. The operation was admirably borne, and the case was progressing most favorably on May 2d, ^vlien the patient was transferred to the Corps Hospital at the Fitzhugh House, under charge of Surgeon A. W. Whitney, 13th Massachusetts Volunteers, in consequence of the movement of the First Division to the battlefield of Cliancellorsville. No unfavorable symptoms occurred. The patient improved daily, the stump granulating finely. He had an excellent appetite, and was quite content with the soldier's ration. But Di'. B. A. Clements, Assistant Medical Director and Dr. Taylor, Medical Inspector, visited him and provided that he should be furnished with such delicacies as the resources of the hospital could not supplj'. In the latter part of May, Surgeon Shi])j)en having returned from Cliancellorsville, saw the patient frequently and removed the ligatures until, on May 28th, the last had come away. The case continued to progress favorably until June 15th, when the greater portion of the Army of the Potomac having moved northward, the wounded and sick at the Fitzhugh House were captured by the rebels. Kelly \vas taken to Fredericks- burg in a wagon, and thence to Eichniond by rail, and was incarcerated in Libby Prison. The extraordinary nature of his case appears nut to have ]U'ocured I'or liim any modification of the amenities of that ])lace of confinement. According to his report, he lay upon the floor on his blanket, and received a diet of diluted tea and corn bread, and twice a week a bowl of soup. He was not subjected to any surgical attendance. After a week of the prison regimen, the wound became gangrenous and a troublesome diarrhoea supervened. On July 14th, the prisoner was exchanged. He was sent to Annapolis, and entered the liospital there in an exhausted state. His normal weight before the removal of the limlj was one hundred and fifty-five pounds; he now weighed sixty-three pounds. There was a sloughing sore extending from the upper outer angle of the wound downwards over a space larger than the hand. There was profuse diarrhoea. He was ordered to take pills of opium and bismuth, with tincture of sesquichloride of iron, and beef essence and rice jelly for nourishment Bromine was applied to the sloughing parts on three successive days, but without apparent benefit. A <iilute lotion of chlorinated soda was then substituted. On July 24th the slougli separated, leaving a clean, healthy, granulating surface. On August 19th, Acting- Assistant Surgeon Stovell, who had innnediate charge of the case, reported that the patient liad steadily improved since his admission and might be considered <mt of danger. On September 17th, Surgeon T. A. McParlin, U. S. A., reported that Kelly was rapidly improving; that the wound was healed, except at a point where there was a slight purulent iliscliarge and over an ulcerated space as large as a walnut, which was granulating kindly. The jjatient had been removed to the tent colony or camp of convalescents. On December 23, 18G3, the wound had entirely healed, and Kelly visited Washington and obtained his discharge from service and a pension of one hundred and eigiity dollars a year. He then went to his home at Blairsville, near Black Lick post office, Indiana county, Pennsylvania. His general health was then good and his weight had increased to one hundred and twenty-four pounds. In the autumn of 18ti3, before the wound had completely cicatrized, an excellent picture of Kelly, in water color, was made by Mr. Stauch, under the direction of Surgeon J. H. Brinton, Cni'ator of the Army Medical Museum. In December, 1864, Lieutenant Colonel G. K. Johnson, Medical Inspector U. S. A., ])rocured a very satisfactory photograph of Kelly's stump. From these two pictures the plate whicli accompanies this history was prepared. Kelly still resides at Blairsville, and his general health continues good. The next is one of the three cases reported by Dr. M. Compton: Case X.—Private Cooper, of an Alabama (Rebel) Regiment, aged twenty j'ears, was wounded at the siege of Vicksliurg. on May 22, 1863, by a fragment of shell, which inflicted a terrible laceration of the upper exterior part of the right thigh, com- minuted the upper tlurd of the femur, and fractured the tuberosity of the ischium. There was profuse liffimorrliage. Surgeon W. M. Compton, 2d Texas (Rebel) Regiinent, decided to operate, because the wounded man most earnestly begged tliat an attempt should be made by amputation to save his life. A few hours after the reception of the injury, he was placed under chloroform, and amputation at the right hip-joint was rapidly performed by making a large anterior flap and dividing the soft [larts postei'iorly by a circidar sweep of the knife. The stump was dressed and the patient actively stimulated, but he never rallied from the shock of the (q)eration, and died in less than an hour after its acconqdishment. Professor P. F. Eve and Dr. S. L. Nidelet, of Mobile, Alabama, formerly t~im'geon-in- chief of General Maury's (Pv-ebel) Division, communicated the facts of the following case Wdiile this rejDort was in tlie printer's hands a letter was received from the operator, Benjamin D. Lay, now of Paducah, Iventucky, giving some tidditiontil ptirticulars respect- ing the operation: Ca.se XI.—A ])rivate of ihe 3d Missouri (Rebel) Regiment was wounded at the siege of Vicksburg, in June, 1863, by a large fragment of shell. The projectile produced a frightful laceration of the tissues on the inner and posterior parts of the](https://iiif.wellcomecollection.org/image/b21289475_0033.jp2/full/800%2C/0/default.jpg)
