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)
42/108 page 36
![by the aiitero-posfeiidr tla]i method by Assistant iSurgeon A. C. Crymes, 39th Alabama (Rebel) Eegiment. On being removed to his bed, tlic jwtient manifested extreme prostration, and stimulants ^vere freely administered. After a few hours he was able to take nutriment in a concentrated form, and a supporting and stimulating treatment was perseveringly pursued. In a very few hours after the operation, however, the stump evinced a tendency to unhealtliy action, and the patient sank into an adj'namic condition, and died on the morning of January 8tli, three days after the operation. Details of the foregoing case were communicated to Dr. Eve by Dr. Caleb Tosey, formerly surgeon of the 19th Alabama (Rebel) Regiment, and to this office by the operator. Dr. Crymes, of Fort Browder, Alabama. In his letter relative to the case. Dr. Crymes observes that the mortality among the wounded of General Bragg's army after Mur- freesboro' was fearfully great, in consequence of the unavoidable confusion in the hospital arrangements, the overcrowding. of patients, the inevitable omission of adequate hygienic regulations, the mental depression resulting from defeat, the want of suitable medical supplies, and hasty and rough transportation. All of these causes operated to the disad- vantage of-the patient whose history has been related. Case XXIX.—A private of Co. C, 54th Massachusetts Volunteers, a colored man, was wounded and made a prisoner in the assault on Morris Island on the morning of July 11, 1863. A fragment of a shell from Fort Wagner struck the upper and outer part of his right tliigh, and fractured the neck and head of tlie femur and the rim of the acetabulum, and extensively lacerated the soft parts in its exit through the posterior part of the tliigh. The patient was conveyed to Charleston on the afternoon of July 12th, and was placed in an hospital hastily prepared for the reception of wounded colored prisoners. The contract surgeon in charge of the hospital reports that, the patient's condition, in view of the terrible wound he had suffered, was remarkably good, and that the symptoms of shock were unusually slight. On July 13th, the third day after the reception of the injury, Surgeon E. A. Kinloch, P. A. C. S., saw the case, and amputated at the hip-joint by Manec's method. The knife, being entered midway between the anterior superior spinous process of the ilium and the great trochanter, and carried downwards and inwards until its point emerged just in front of the ischium, was made to form a large antero-internal flap; the soft parts on the outer and posterior part of the thigh were then divided by a semi-circular incision from without inwards, and the head of the femur was then disarticulated. The patient bore the operation well, but a fev/ hours subseqiltntly there was extreme depression, and the case terminated fatally on the following morning, July 14th; twenty hours after tlie operation. It is probable that the fracture of the pelvis was not recognized in this case until the disarticulation was effected, else an operation would hardly have been undertaken. In his narrative of the case. Dr. Kinloch mentions that a surgeon of the U. 8. Navy, a prisoner, .was present at the operation, and subsequently requested him to operate upon several United States officers who required amputation. No pathological preparation was preserved from the case of amputation at the hip-joint. Case XXX.—Private John Chamberlain, of one of the United States regiments engaged at the battle of Chickamauga, was wounded on the morning of the second day of that battle, September 20, 1863. A conoidal musket ball passed through the upper part of the thigh, and produced great comminution of the upper extremity of the femur, the fissures extending to the neck of the bone. The wounded man was left upon the field when the United States forces were driven back, and fell into the hands of the enemy. On September 21st, he underwent amputation at the hip-joint, the operation being performed by Surgeon R. P. Bateman, P. A. C. S., now a practitioner of Mempliis, Tennessee. Tlie man sui'viyed the operation thirty-six hours, and died September 23, 1863. Case XXXI.—Private James Carden, of the army of Major General Eosecrans, was wounded at the battle of Chickamauga, in the second day's fight, Septemlier 20, 1863, by a fragment of shell, which caused great laceration of the soft parts at the upper part of the thigh, with comminuted fracture of the femur. He was left upon the field, and was made a prisoner. On the evening of September 21st, Surgeon E. P. Bateman amputated his thigh at the hip-joint, tie died on September 27,1863, six days after the operation. A letter addressed to Dr. Bateman requesting him to supply further details of the two preceding cases has received no response.](https://iiif.wellcomecollection.org/image/b21289475_0042.jp2/full/800%2C/0/default.jpg)
