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favorable symptoms followed. The usual separation of the parts destroyed in the course of the ball took place, succeeded by a healthy suppuration, at the usual period of gun-shot wounds, and a hope was entertained by his friends of his speedy recovery. This hope was still more strengthened when, on the tenth day after the wound was received, the catheter, by some accident, became obstructed, and remained so some time before it was discovered, and on its withdrawal and re-insertion, upwards of twelve ounces of urine were drawn off, showing conclusively that the wound in the bladder must have entirely closed, to enable it thus to retain so large a quantity of fluid. The expression of his countenance, and cheerfulness of manner, would hardly have indicated any great pain or suffering. It was only on the twentieth day that any alarm was excited in the minds of his friends, by his suddenly being attacked by rigors, followed by fever and profuse night-sweats, which, notwithstanding all the means made use of, rapidly reduced his strength, and he expired on the night of the 13th October, and on the twenty-second day after being wounded. A post-mortem examination of this case would have proved highly interesting, showing how far wounds of this description, affecting internal hollow organs, may heal, and the manner in which a restoration of the parts destroyed takes place; but the pressure of professional duties at the time has prevented so desirable a finish to the history of the case.
Case 9.-Private Capers, of the Baltimore Battalion, was wounded early on the 21st September. The ball entered directly above the os pubis, and taking a direction downwards and obliquely backwards, wounding in its course the bladder, passed out of the pelvis between the sacrum and tuberosity of the ischium on the left side. It was found lodged between the integuments and glutei muscles, from which point I extracted it. Urine passed freely at the time, from the wound over the pubis, but ceased shortly after the introduction of the catheter, which was constantly maintained in the bladder, as in the former case.
Very little tension or tenderness of the abdomen followed, nor any symptoms of peritoneal inflammation, showing that the ball had entered the bladder without wounding the peritoneum." Neither were there any signs of extravasation or infiltration of urine, and but little or no febrile action. About the tenth day after its reception the wound over the pubis, which had by this time entirely closed, broke out again, discharging urine; this was shortly after. wards followed by the opening of that in the nates, made for the exit of the ball. Through the latter, both fæces and urine, passed, showing that sloughing had taken place, and a communication formed between the rectum and bladder. The contenis of both of these were occasionally discharged from the anterior wound. The patient lin
The ball entered the bladder externally to the point were the perito. neum is reflected from the posterior wall of the abdomen upon the sundus of the bladder.-M.
gered in this miserable situation until the sixteenth day, when he expired, worn out by pain and suffering.
Case 10.—Private Young, of the 1st Tennessee Regiment, was wounded nearly at the same time and place as the above. The ball entered just above the os pubis, and about one inch to the right of the symphysis. It ranged diagonally across the pelvis, inclining downwards, wounding both the bladder and rectum, and passing out through che left sacro-ischiatic foramen, just above the os coccygis ; urine and fæces passed out from both orifices of the wound. When brought in, it was supposed, from his general appearance, that he would survive his wound but a very short time. A catheter was introduced immediately, which was retained with considerable difficulty. The wounds were dressed in the usual manner; urine and fæces continued, however, to pass out of the wounds, attended by considerable irritation and febrile action. In this condition he lingered twenty-three days, when he expired, worn out, as in the case of Capers, by long-continued suffering.
Having given a brief description, of a few of the gun-shot wounds in the different assaults on Monterey, I will conclude my communiCation, with a statement of the number and results of the larger amputations, performed on those occasions. The total number in the ihree divisions of the army was twenty-eight, viz: ten in the first division, four in the second, and fourteen in the third or volunteer division. Twenty were performed on the field, or on the following morning, in the camp; the remaining eight, at subsequent periods, varying from five to lwenty days. Twelve of the number, including two in those taken prisoners and operated upon by the Mexican surgeons, proved fatal, and the remaining sixteen, have nearly or quite recovered. This average of mortality was not confined io our wounded. I was told by Dr. Hidalgo, surgeon in charge of the Mexican military hospital, that of thirteen amputations performed there, fire had proved unsuccessful, and one case, that had recently been operated upon, appeared to me to be in a critical condition, but whether the patient died or recovered I have not learned.* In addition to unfavorable causes, not enumerated among those I have heretofore noticed, and from which the Mexicans were happily exempt, was the repeated removals to which our wounded were subjected. In carrying them from the field to the camp, a distance of three or four miles, they suffered greatly ; and the subsequent removal to town, still farther increased the pain and danger, and in one or two cases, evidently, was productive of a fatal termination.
With a few remarks, on the appearance and condition presented by the two cases of amputations of the thigh, performed by the Mexican surgeons, in their hospital alluded to above, I will close. One of these had been operated upon on the same day with the injury, and the other some four or five days after. Neither stump on examina.
* This case subsequently proved fatal.
tion, after the removal of the dressings, presented any unusual appearance ; on the contrary, the flaps had been neatly adjusted and brought together, and kept so by a number of interrupted sutures and adhesive straps, encircling it in every direction, and adhesion had apparently taken place, in one case along the line of divided integuments. No one, judging by the external appearance of the wound, if we except a degree of paleness of the integuments of the flap and some fætor, would have suspected the condition and extent of disease within. On dressing the first case and removing the lint and adhesive straps, which had become somewhat offensive, the edges of the flap receded or partially separated, so as to reveal a large cavity or excavation, the whole surface of which was dark and ill-conditioned, and from the centre projected the end of the bone. There were no signs or appearance of suppuration or granulatio having ever taken place in the divided muscles; on the contrary, they appeared absorbed or attenuated by previous discharge, of which none existed at this time. The patient rapidly sunk, and died on the fourth day after his admission into the Division hospital.
Private Alexander, of the Baltimore Battalion, the other case, was brought to our hospital some two days after the one above. His stump presented nearly the same appearance as the first, with no indications whatever of the diseased condition within. Eleven days after his admission, the flap gave way, disclosing the same appearance as in the former case, with most intolerable fætor. Gangrene rapidly extended, and he died on the twelfth day after his admission, and the thirteenth from the time of the operation.
Among other consequences arising from gun-shot wounds, in my hospital, were two cases of traumatic tetanus, both of which proved fatal. The first case manifested itself seven days after the injury, which was a wound of the knee-joint, with a fraciure of the patella by a grape-shot. The man was brought from the camp of the 4th Infantry to the Division hospital, and was attacked a few hours afterwards, by opisthotonos, followed by trismus and severe spasmodic action of all the muscles of the body. He died the same night. The other case originated from a gunshot wound of the left thigh, in which the ball passed down to the femur, six inches below the trochanters, and taking a direction upwards on the outer side of that bone, denuded it entirely of the periosteum for the distance of three or four inches, and was cut out from beneath the gluteus maximus muscle of the same side. Here the first semptoms manifesting an attack of this dreadful disease was violent spasmodic action of the muscles of the injured limb, which soon extended to those of the whole body, followed by trismus and a certain degree of opisthutonos. He expired on the fifteenth day after receiving his wound, and nine days after being received from the Mexican hospital; having been taken prisoner and carried thither on the 21st September, the day on which he was wounded,- New York Jour. of Med.
Remarks on the Medical Topography of Texas, and on the diseases of the army of invasion. By GEORGE Johnson, M. D., late Surgeon in the United States Army.-The Brazos Santiago Island, Texas, has become a place of much importance since the present war with Mexico commenced. From May last to the present time, all troops, destined for the army of occupation and invasion,” have
" been landed at the Brazos, and on account of the difficulties of transportation at the commencement of the war, many of the regiments remained encamped upon the island for several weeks. During the last summer, most of the volunteer regiments have been stationed along the banks of the Rio Grande, between Matamoras and the mouth of the river. Much has been said in the
and elsewhere, of the unhealthfulness of this region, but I have not seen the true causes assigned for the great mortality which has occurred amongst our troops upon the Rio Grande; I will, therefore, at your request, give you a brief sketch of the medical topograpy of this region, together with some of the causes which have led to this mortality. Hereafter I hope to see this subject discussed by the medical officers of the army, many of whom have had far better opportunities than fell to my lot for obtaining correct information on this head, particularly those accomplished surgeons, Drs. Wood and Wells, at Point Isabel, and Dr. Wright and his assistants, at the general hospi. tal at Matamoras.
The Brazos Island, it might be inferred from the many statements that have been made, is particularly unhealthy, from its location. This, I think, cannot be the case. Though a dreary and uninteresting sand bar, I believe it to be as healthy as Galveston, or any other spot along the Gulf coast. The island is about four miles in length, and one and a half in breadth. It would be almost level with the Gulf, but for the sand hills which line its southern extremity for half a mile. There are some two or three ponds on the island, called on the maps of the country, fresh water ponds, though I found them quite salty on trial. These ponds are situated about a mile and a half from the sand hills, (the place of encampment of the troops,) and to the north. The sea breeze blows almost continually from the south-west, so that no deleterious effects can arise from them. This breeze usually commences about 9 A. M. and continues throughout the night, making sleep delightful and refreshing. By it the sun's heat is rendered less oppressive, and there was not a day so warm, during our stay upon the Island, which was during the month of June, as to prevent the men of our regiment from perambulating it from end to end, on fishing and hunting excursions. Here, too, the men enjoyed the pleasure and benefit of bathing. I have understood that the Mexicans considered the Brazos healthy, prior to the arrival of our troops, and I learned from an American woman, a native of North Carolina, who has lived upon the Island for several years, that her family, consisting of six children, had enjoyed excellent health since her residence there. Yet she had occupied, during the whole time, a miserable little shed, only partially covered with ox hides.
The Mexicans who were taken prisoners at Palo Alto and Resaca de la Palma, were employed in the Quartermaster's department, at the Brazos, and though these men were exposed, day after day, to the heat of the sun, in their labours about the shipping, yet I never knew a case of sickness to occur amongst them. The other employees of the Quartermaster's department, such as teamsters, carpenters, etc., also retained their health, whilst the troops at the same period, were suffering with diarrhæas and dysenteries. I accounted for this circumstance, thus: these teamsters were making daily trips to the mouth of the Rio Grande, (nine miles,) and they kept their messes well supplied with the excellent water of that river. Besides, they had learned to cook their food properly, and they slept in the dry and comfortable Government storehouses, whilst the troops were lying under tents, upon the wet sand, eating food that was only partially cooked, and drinking the brackish water from the wells that it was almost impossible to retain upon the stomach.
It is known io all military men, and to the profession, that dysenteries and diarrhæas are camp diseases, and are common to every location where troops are encamped for a few weeks. Our regiment was encamped for about a week at Algiers, opposite New Orleans, and it was very rainy weather during the time ; in consequence, dysenteric affections became numerous. At the present time, the troops stationed at Santa Fe are suffering severely with these diseases, and it will not be denied that Santa Fe is a healthy town.
The water used by the troops at the Brazos, is obtained by digging small wells in the sand, usually to the depth of two feet. The water obtained from a well recently made was not very unpalatable, being the rain water contained in the upper surface of the sand, but in a short time the salt water from beneath would be mixed with it, thus rendering the well useless, so that new wells were constantly being made, and as the space occupied by the troops was only about half a mile in extent, and one hundred and fifty yards wide, (in rainy and stormy weather all the rest of the island being covered with water,) and as this sand hill ridge has been occupied by troops since the 20th of May last, even as many as three regiments have been stationed here at one time, it can readily be understood how the water of this ridge is affected.
The troops that have, from time to time, sojourned at the Brazos, have been for the most part volunteers, and they have had much more to learn than the drill and discipline. They have been compelled to take a few lessons in the culinary art-particularly so far as related to the cooking of pork and beans-a knowledge of which was not obtained until the pains of colic had been experienced more than once. It would be fair to say that the beans of every volunteer regiment are not half cooked, for, at least, the first month of service. Besides, the young soldier is apt to indulge in every excess. He will lie down on the wet ground without his blanket. The old soldier is more prudent-he may drink a little too much whiskey, (if he can get it,) but he will not expose himself unnecessarily to the sun's heat at mid-day,