Surgeon General's Report
Huerfano County, Pueblo County, Las Animas County

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SURGEON GENERAL'S OFFICE,

WASHINGTON, AUGUST 17, 1871.

A REPORT OF SURGICAL CASES TREATED IN THE ARMY OF THE UNITED STATES FROM 1865 TO 1871.

Remarks on a Case of Gunshot Injury of the Head. By G. McC. MILLER, Assistant Surgeon, U. S. A.

Private George Greenland, Co. D, of the United States Infantry, was wounded, at a fandango, by a pistol ball, on the night of October 10, 1868, near Fort Reynolds, Colorado Territory. The wound was situated on the right side of the head, over the parietal bone, longitudinal in direction, and one inch and a half long. It was deep, extending down to the pericranium. In accordance with some recent views aud results of treatment, I united the lips of the wound by means of a suture, in order to effect a coalescence by the first intention, or, at least without suppuration, if possible. Cold water dressings were applied. On the fifth day after the injury, I removed the suture, the lips of the wound then gradually separated, until a sloughing sore was produced. The use of the suture, however, seemed to reduce the amount of sloughing. On the 17th, unexpected and alarming symptoms presented themselves. The patient became semi-unconscious unable to speak with enormously- dilated pupils, and a wild expression of countenance. These symptoms, however, passed off in an hour, and did not return. The sudden appearance, brief duration, and sudden disappearance of this peculiar condition were quite singular. The wound being foul, I had it washed with a rather strong solution of the sulphate of iron. In twenty-four hours, it showed a healthy granulating surface; it continued to improve, and healed rapidly, and the patient was returned to duty November 2, 1868.

CCCGLXIX. Abstract from Reports of an Arrow Wound of the Thorax. By JOSEPH KIGLER, Acting Assistant Surgeon.

William Livingston, a private of Troop G, 3d Cavalry, was wounded by Indians while herding horses at Fort Stevens, Colorado Territory, on October 6, 1866, an arrow having entered the right side of thorax between the first and second ribs. It was forcibly extracted by the patient, who stated that a great gush of blood followed. After being conveyed in an ambulance over a rough mountain road, he was admitted to hospital at Fort Garland, Colorado Territory, on the 12th, in a very weak condition, and suffering frightfully from dyspnoea. An examination showed effusion of blood into the right pleural cavity, and the lung impervious, owing to the entrance of blood into the bronchii. Hot fomentations were applied to the wound, and stimulants, afterward followed by stimulating expectorants, were administered, under which treatment the patient was gradually improving on the last of October. On the monthly report for November, the patient is borne as convalescent. He was able to walk about, but there was still a collection of serum or pus in right pleural cavity, and the respiration of that side was merely bronchial. The treatment still consisted of stimulating expectorants, with stimulants and generous diet. In December, he is still reported convalescent. The effusion in the right pleural cavity was diminishing, and un- entered more freely into the lung. He was daily gaining strength and spirits, and little doubt was entertained of his making a good recovery. He was returned to duty in February, 1867.

Private John Cooley, Troop G, 3d Cavalry; Purgatory Creek, Colorado Territory, October 3, 1866 ; arrow flesh-wound, a few inches in length, on left side of the thorax; treated in post hospital at Fort Garland, Colorado ; recovered ; duty.

DLII. Note on a Partial Amputation of the Foot. By H. R. TILTON, Assistant Surgeon. U. S. A.

Private Frank Reip, Troop B, 7th Cavalry, aged 23 years, while marching from Pueblo to Fort Lyon, Colorado Territory, January 23 to 27, 1867, had his left foot frozen. He was taken to the post hospital at Fort Lyon, Colorado Territory. The injured parts were gangrenous. On February 19th, I administered an anaesthetic composed of chloroform and ether, and amputated the foot through the metatarsal bones. Simple dressings were applied. He recovered, and was discharged.

DCXXVI. Minute relative to an Excision of a Portion of the Humerus. By H. R. TILTON, Assistant Surgeon, U. S. A.

Private Edward McCarthy, Co. E, 5th Infantry, aged 18 years, was accidentally shot by a guard at Fort Lyon, Colorado Territory. The missile, a Spencer rifle ball, entered the left shoulder posteriorly at the outer edge of the deltoid, three inches from the head of the humerus, passed downward, fracturing and comminuting the shaft of the humerus into about twenty-five pieces, and escaped three inches above the eondyles at the outer edge of the biceps. He was sent to the post hospital; chloroform was administered; an incision made from the lower wound upward five inches in length, and four inches of the shaft of the humerus was excised. Four stitches were introduced and a felt bandage applied. April 24th the wound had healed; there was only one inch and a half shortening. The periosteum remaining after operation had entirely renewed the bone, and on June 30, 1868, union between the upper and lower end of humerus was complete. The musciilospiral nerve being destroyed, there is paralysis of extensor muscles. He can pick up any object with his fingers, and will soon be able to carry his hand to his head. He was discharged on August 7, 1868.

DCLXIIL Account of a Ligation of the Femoral Artery. By E. MCCLELLAN, Assistant Surgeon, U. S. A.

Private George Hastings, Co. K, 37th Infantry, was admitted to the hospital at Fort Garland, Colorado Territory, July 30, 1868, having been accidentally stabbed the same day, in the upper portion of the thigh, with a long, narrow hunting-knife, which had been made exceedingly sharp, and which, passing the femoral artery, partially divided the profunda femoris below the origin of the external circumflex. The haemorrhage was excessive. Some few moments only elapsed after the accident, before complete syncope ensued with all the characteristic symptoms. Pressure on the femoral arrested the haemorrhage, but the extreme prostration prohibited surgical interference at the time, and stimulants and nourishments were administered. At 10 o'clock P. M. hemorrhage again occurring, now from the lower extremity of the artery, the wound was enlarged and the artery secured. The patient was kept for several days under the influence of morphine. Slight pressure continued on the femoral, although not sufficient at any time greatly to impede the circulation in the limb. At no time after the operation was the circulation arrested. On the nineteenth day the upper ligature was removed, but the lower one did not come away until the thirty- fourth, although steady and continual traction upon it was made. The patient was returned to duty in October, 1868.

XLVI. Minute of a Case of Gunshot Fracture of Lower Maxilla. By H. R. TILTON, Assistant Surgeon, U. S. A.

Private Martin O'Brien, Co. C, 7th United States Cavalry, aged 21 years, was shot at Fort Lyon, Colorado Territory, by the first sergeant, on January 9, 1868, for munitous conduct; a pistol-ball entering left cheek, carrying away the angle of the lower jaw without causing its complete fracture, and lodging against the cervical vertebra. He was admitted to the post hospital at Fort Lyon, Colorado Territory, on January 10, 1868. Simple dressings were applied. On January 21, 1868, an abscess opened in the neck, from which a number of small fragments of bone were removed. On February 14, 1868, the ball was removed. The man deserted from the hospital.

LXL Memoranda of Five Cases of Gunshot Wound.

Private John Butler, Co. F, 10th Cavalry ; Colorado Territory; January 9, 1869 ; gunshot flesh-wound of left side of neck. Duty, February 13, 1869.

C. Mention of a Case of Gunshot Wound of the Heart. By H. R. TILTON, Assistant Surgeon, U. S. A.

Private John B. Patterson, Co. B, 7th United States Cavalry, while on duty as sentinel, at Fort Lyon, Colorado Territory, April 17, 1870, was wounded by the accidental discharge of his carbine, the ball having entered the right groin, and escaped through the neck on the left side, killing him instantly. The ball passed through the bowels, stomach, left lobe of the liver, right ventricle of heart, upper lobe of the left lung, and carried away a portion of the left clavicle. He breathed three times, and then gasped and expired. No cry of pain escaped his lips.

CLXXI. Report of a Gunshot Wound of the Abdomen, in a Patient with Chronic Orchitis. By H. R. TILTON, Assistant Surgeon, U. S. A.

Private Patrick Wogan, Troop D, 2d United States Cavalry, while confined in the guard-house at Fort Lyon, Colorado Territory, was wounded February 25, 1868, by the accidental discharge of a Spencer rifle. The missile having passed through the side of the frame guard-house, and the left arm of a prisoner, entered the right thigh of Wogan, six inches below the anterior superior spiuous process, passed under Poupart's ligament, two inches from the anterior superior spinous process, and lodged in the left iliacus muscle; he was in a sitting posture at the time of the reception of the injury. He was immediately carried to the hospital, and complained of intense pain in the abdomen, which was partially controlled by morphia in one half-grain doses. In the course of the evening he voided his urine, which was natural in color. He vomited several times. His pulse increased to 100, with tumultuous action of the heart. He passed a very uncomfortable night, having to be frequently propped up in bed to get his breath; pulse scarcely perceptible at wrist. Heart beating rapidly and with little force. Death resulted at nine o'clock of the morning of February 26, 1868. An autopsy was made six hours subsequently. On opening the abdomen a great quantity of bloody serum escaped; large clots of blood were found in the hypogastric region, and there was general peritonitis. The ball was found in the left iliac fossa, just above the external iliac artery; by tracing its course it was found to have passed four times through the small intestines, making seven open- ings, three times through the mesentery and once through the mesocolon. Wogan had suffered a long time with gonorrhoeal orchitis of the left testicle. The tunica vaginalis was found considerably thickened and adherent to the lower portion of the testicle, while there was hydrocele of the cord.

Sergeant James Stevenson, Co. F, 10th Cavalry. Gunshot flesh-wound of the left fore-arm and left high. Near Fort Lyon, Colorado Territory, March 10, 1869. Duty, May, 1869.

CCLVL Report of a Gunshot Flesh Wound of the Thigh. By H. R. TILTON, Assistant Surgeon, U. S. A.

Private Anthony Welber, Co. I, 3d Infantry, received an accidental gunshot wound of the right thigh on May 4, 1869. A rifle ball entered the front of the thigh at the middle third externally to the femur, and lodged in the biceps muscle. He was admitted to the post hospital at Fort Lyon, Colorado Territory, on May 6, 1869. On May 8th, the ball was removed by a counter opening, and simple dressings were applied. On May 20, an abscess was opened, and a short time afterward a piece of cloth was removed from the wound. By June l0th, the wounds were entirely healed. He was returned to duty July, 1869.

CCLXIX. Memorandum of a Case of Gunshot Flesh Wound of the Thigh. By H. R. TILTON, Assistant Surgeon, U. S. A.

Private Robert Garnet, Co. K, 10th Cavalry, aged 18 years, received October 9, 1868, while on the march, a wound of the left thigh, by a conoidal ball from a pistol in the hands of a sergeant which entered two inches from the great trochanter. He was admitted to the post hospital at Fort Lyon, Colorado Territory, on November llth, where the ball was extracted from the point of entrance. The patient was returned to duty February 7, 1869.

CCLXXV. Report of a Case of Gunshot Wound of the Knee-Joint. By H. R. TILTON, Assistant Surgeon, U. S. A.

Private Thomas Murray, Co. B, 7th Cavalry, who was shot through the knee-joint at Fort Lyons, Colorado Territory, in January, 1867, recovered without an unfavorable symptom. He could move the joint slightly on the 4th of February. February 19th, just four weeks from the date of the injury, he was able to stand on the foot and walk a few steps without crutch or cane. At present, in walking, he has to keep the joint stiff, but eventually there will be very good motion, and little inconvenience from the injury. At the time Murray was shot, January 22, 1867, the only probe which I used was the end of my little finger. I was satisfied that the ball had not passed around the joint. No benefit would have been derived by the patient by making further efforts to determine the exact course of the ball. I was under the impression that it had passed through the head of the tibia. I am satisfied by the result that it could not have done so; but the ball could open the synovial membrane and pass through the joint without injury to either the femur or tibia. The result is remarkable. He was returned to duty on March 4, 1867, but riding caused the knee to swell. He was returned to duty again in March, 1867, able to attend to any duty except riding. I remember a case in the Vicksburg campaign, where the ball struck the patella without fracturing it or opening the joint, and passed up the thigh superficially, escaping four inches above, and yet the man died of inflammation of the knee-joint.

CCLXXX. Mention of a Case in which there was Removal of a Portion of the Fibula after a Gunshot Injury. By H. R. TILTON, Assistant Surgeon, U. S. A.

Private Thomas Kelly, Co. B, 5th Cavalry, aged 22 years, received an accidental gunshot wound of the left leg, on November 15, 1868. The ball entered the inner side of leg, two and a half inches below the tibia, and passed out at the middle third of the leg, externally, fracturing the fibula. He was admitted to the post hospital at Fort Lyon, Colorado Territory, on April 30, 1869. The patient states that a portion of the fibula was removed by Assistant Surgeon Turner, U. S. A. The wound was nearly healed. The patient was in hospital only two days when the 5th Cavalry left the post. [He was returned to duty on May 2, 1869. ED.]

CCXC V. Report of a Gunshot Wound of the Foot. By H. R. TILTON, Assistant Surgeon, U. S. A.

Private James Wilmot, Co. M, 5th Cavalry, aged 18 years, received an accidental gunshot wound. A carbine ball passed by the inner side of the right patella, producing a flesh-wound, and then between the great and second toes of the right foot, wounding both, and fracturing the second phalanx of the second toe. He was admitted to the post hospital at Fort Lyon, Colorado, Terri- tory, on January 23, 1869. Simple dressings were applied. He was returned to duty on March 17, 1869.

Private William O'Neal, Co. B, 5th Cavalry, aged 21 years. Fort Lyon, Colorado Territory, March 16, 1869. Gunshot flesh-wound of foot. Duty, April, 1869.

CCCCX1V. Abridged Account of a Fracture of the Fifth Cervical Vertebra. From reports furnished by H. R. TILTON, Assistant Surgeon, U. S. A.

Private Emmet J, Co. A, 5th Infantry, aged 19 years, and of splendid physical organization, was in the habit of bathing in the Arkansas River, at a place near Fort Lyon, Colorado Territory, where the water was ordinarily from six to eight feet deep, and so muddy as to render an object unseen at a depth of six inches. On July 3, 1868, in diving from the bank he struck his head against the bottom, which, being sandy and constantly shifting, was upon this particular occasion only eighteen inches below the surface. Becoming immediately powerless from the effects of the concussion, he would have drowned had not help been given. The legs and arms being paralyzed he was carried on a stretcher to the hospital, lying on his abdomen. Upon admission, at 1 o'clock P. M., the pulse, respiration, and temperature were not counted, nevertheless they appeared normal; the pupils were unaffected; there was priapism. The power soon returned to the arms, although feeble. The extremities were warm, and when touched the sensation was more acute in the left than in the right leg. The patient complaining of feeling dead below the neck, the spine was carefully examined. No irregularity was found, but there was tenderness over the sixth cervical vertebra. A sinapism was applied to the nape of the neck, and in an hour he requested to be turned over. At 5 o'clock P. M. the pulse was 104 ; respiration 18; temperature 105. The patient was directed to hold small pieces of ice in his mouth; the same was applied to the upper portion of the spine, and a saline aperient was prescribed. At 9 o'clock, the pulse was 100; respiration 24; temperature 102. The urine was drawn off with a catheter, and the patient was placed on a water bed. On the morning of July 4th, the pulse, respiration, and temperature were all diminished. The cold applications to the spine were continued in the form of ice-cold water; a special diet was ordered; and the catheter was used twice during the day. At 5 o'clock the bowels were moved involuntarily. On July 5th, there was considerable diminution of the temperature, sensation was wanting in the lower extremities, and respiration was abdominal. Tonics, nutritious diet, and dry rubbings were prescribed. On the 6th, sensation had partly returned in the left leg, and the breathing was better, there being more movement of the chest. By the llth, the patient was able to pass his urine without a catheter, but there was no improvement in the sensibility of the right leg. The pulse, respiration, and temperature had diminished. On the morning of the 10th he had a chill, which recurred on the morning of the 17th, and again in the afternoon. After this his countenance became dusky, and there was a rise in the temperature. He had not perspired since the injury. On the morning of the 18th the urine became turbid, the patient complained of his lungs feeling like stone, and his stomach was irritable. By the morning of the 20th, the pulse had become so feeble that it could not be counted, the bowels were loose, the urine was ainmoniacal and thick with mucus, and he had an attack of vomiting. These symptoms were followed by increased respiration and a very high temperature, (105.) The patient, at this time, was again able to pass his urine without the use of a catheter, but on the 21st this instrument was used with difficulty, owing to the formation of clots in the bladder. The patient also suffered from decubitus, and by July 24th his stomach became so irritable as to retain scarcely anything. On the day following his appetite was entirely gone. On the 20th, the temperature was 91.8. He died at noon on the 28th. At the post-mortem the brain was found perfectly healthy, so far as the unaided senses could determine. The spinal cord showed nothing abnormal in the dorsal region, except the fluid which escaped. This was filled with transparent, floating globules resembling volatile oil water. The body of the fifth cervical vertebra was fractured, and it was ascertained that haemorrhage had compressed the cord at and around the seat of fracture. There was no displacement of the vertebra. The lungs were healthy, except the posterior portions, which were hypostatically congested. The liver was slightly enlarged, the splenic extremity of the stomach congested, and the kidneys were enlarged.

FRACTURES OF THE BONES OF THE TRUNK. But few cases were reported in detail. Fractures of the ribs were not infrequent accidents; while fractures of the spine and pelvis were rare.

Fractures of the Pelvis. Special reports were made of a fatal case, of a case compli- cated by necrosis, and of a third with fractured clavicle.

CCCCXLIV. Remarks relative to a Subluxation of the Sternal Extremity of the Clavicle. By G. McC. MILLER, Assistant Surgeon, U. S. A.

Sergeant William Dow, Co. D, 5th Infantry, was thrown from a mule, while hunting antelope, near Fort Reynolds, Colorado Territory, on January 3, 1869, striking the ground with the point of his right shoulder. On his return to the fort I examined the injury, and found a subluxation forward of the sternal extremity of the right clavicle, the end of the bone being advanced about the one-sixth of an inch beyond its proper level. He complained of pain at the seat of injury, and there was some tumefaction, as well as tenderness on pressure. I reduced the displaced bone, and applied Fox's apparatus for fractured clavicle. Compresses were also placed over the seat of injury. The apparatus, which was made of stout materials, so long as it was worn and kept moderately tight, maintained the bone in place admirably well, but when it was removed, or became slack, the bone was again displaced. He wore the apparatus until February 28th, a period of two months, when I removed it, and finding that no improvement had taken place, I omitted its further use, believing that if an apparatus does no good for two months after the injury, a reposition of the displaced bone is not to be anticipated. The unsuccessful result of treatment in this case accords with the experience of the best surgeons. Nevertheless, the patient will most probably have a very useful arm, as, according to the best authorities, the functions of the limb in these injuries are but slightly impaired. The ultimate result will be made known at a future time.

Dislocations at the Shoulder. Since the general adoption of the methods of reduction by manipulations under anaesthesia, cases of this class have seldom presented difficulties, unless complicated by fracture, or unless the attempt to reduce was too long postponed. Though the accident was common enough, especially in the cavalry, the particulars were rarely reported.

CCCCLXXXVI. A Report of Two Fatal Cases of Arrow Wounds. By ALFRED D. WILSON, Assistant Surgeon, U. S. A.

A detachment of seven companies of the Fifth Cavalry started from Fort Lyons, Colorado, on May 1, 1869, for Sheridan City, Kansas. On Beaver Creek, Indians were encountered, and a fight ensued. The Indians were pursued towards the Republican River. When they reached Prairie Dog Creek, they dispersed, and it was impossible to follow them further. The command then retraced the route, and then marched in a northwesterly direction to the Platte River, and then westerly to Fort McPherson, Nebraska. There were several casualties from gunshot wounds, and two soldiers were mortally wounded by arrow wounds penetrating the thorax ; viz,
Sergeant John Ford, Troop B, 5th Cavalry.
Private C. A. C. Stone, Troop B, 5th Cavalry.

CCCCXC1V. Remarks on a Fatal Case of Frost Bite. By A. A. WOODHILL, Assistant Surgeon, U. S. A.

Sergeant William Earl, Troop G, 7th Cavalry, of robust physique, and usually a temperate man, visited the neighboring town of Las Animas while intoxicated, after tattoo, on the night of December 21st, 1870. There he grew much more intoxicated, and, it was understood, became involved in a fracas. About or after midnight, he left, or was turned from a saloon, and was found in the morning in a wagon near by, in a badly-frozen condition. The thermometer marked 23 below the zero of Fahrenheit during the period of his exposure, and against this excessive cold he was not specially protected. On admission to the hospital at Fort Lyon, Colorado Territory, about 10 A. M., he was very much prostrated, and both feet and the left hand were frozen. They had been rubbed with snow, and soaked in ice-water before arriving, which treatment was continued for more than two hours in a cold room. When first discovered, both feet were stated to be stiff above the ankle. Moderate reaction having set in, he was provided with food, and his feet and hands were enveloped in lint wet with olive oil and lime-water. There was a slight scalp-wound on the left side, and he complained of severe pain and soreness in the stomach, as if from a blow, and of pain in the left shoulder. An examination of the shoulder could detect no injury. He was much depressed in mind at the extent of his accident and at the circumstances under which it was received, and at no time rallied so as to be either cheerful or sanguine. For the first four days the patient did reasonably well, and in consequence of his usual robust health, no more disastrous result than the partial loss of his hand and feet was anticipated. A little carbolic acid was added to the dressing. About the 24th, although some sensation remained, it was evident he would lose his toes, and a line of demarkation began to show itself the next day, near the tarsus of the right foot, and a little lower on the left. Both heels were also badly vesicated, and amputation was deferred until it could be determined how deeply the slough would descend, and especially the extent of the injury to the heel. No special treatment was adopted, except as to the regulation of his bowels and the use of opiates to subdue nocturnal pains. All this time his comrades noticed his unusual and decided melancholy. On the 27th, perspiration was observed, but it was ascribed to the artificial heat of the ward. On the 28th, his countenance changed, and he rapidly became worse, with some mental aberration. Stimulants were ordered freely. It was then my intention to amputate the next day, if possible. On the 29th both legs, especially the right, were swollen and cedeniatous, and had an erysipelatous blush, pitting deeply on pressure, and precluding the idea of the knife. Beef essence and strong milk punch were freely and constantly given, and two drachms of the tincture of the scsqnichloride of iron were ordered to be taken within twenty-four hours. This was steadily continued night and day throughout the case. The following is from the clinical record, December 29th, 9.30 A. M. : Temp. lOl; 2 o'clock, P. M., 104 ; pulse 134; respiration 28; 7 P. M. : Temp. 104; pulse 125; respiration 32. December 30th, 7 A. M.: Temp. 102; pulse 132; respiration 32; 2 P. M.: Temp. 102; pulse 130 ; respiration 34 ; 7 P. M. : Temp. 104; pulse 122 ; respiration 35. During all this time he was in a typhoid delirium, and he died at 1:10 P. M. December 31st. The right foot was examined three hours after death, with the view of determining how far a Syme's amputation would have been justified. The flesh of the heels was found softened; the ankle was firmer than was anticipated, but a section of the anterior tibial, in the lower part of its course, showed it filled with a purulent-looking fluid. No further examination was considered necessary, the whole course of the symptoms pointing so clearly to blood-poisoning.

DXVIII. Account of an Intermediate Amputation of the Fore-Arm for Gunshot Injury. By H. R. TILTON, Assistant Surgeon, U. S. A.

Private Abraham Wilks, Troop B, 10th Cavalry, aged 23 years, was accidentally wounded November 3, 1868, by a carbine ball, which passed through the left hand, from the palmar to the dorsal aspect, fracturing the second and third metacarpal bones. The third finger was removed on the same day. On November 10, 1868, he was admitted to the post hospital, Fort Lyon, Colorado Territory. There was difuse suppuration extending above the wrist, and secondary hemorrhage from the deep palmar arch. The patient was in great alarm, complaining bitterly of his wound, and desiring amputation. On the llth, chloroform was administered, and the fore-arm amputated through the middle by the circular method. Five ligatures were applied, and simple dressings were used. On November 17th, the first ligature was removed, and on November 29th, the last one came away. The posterior flap sloughed to the extent of half an inch, but by using adhesive straps and weights, the flaps were ample. On December 27th, the stump reopened and discharged freely, but by the 5th of February, 1869, it had entirely healed. He was discharged from the service June 18, 1869.

DXXXIL Report of an Amputation of the Arm for Railway Injury. By W. H. RENICK, M. D., Acting Assistant Surgeon,

Private David Linton, Co. B, 7th Cavalry, was run over by railroad cars at or near Willow Springs, Colorado Territory, on the night of August 1, 1870. The wheels passed obliquely across the right arm, completely destroying the elbow joint. Both bones of the fore-arm were crushed, and a longitudinal fracture extended up the shaft of the humorus, almost to the junction of the upper thirds. One hour after the injury, the patient being chloroformed, the arm was amputated at the junction of the upper thirds, by the circular operation. Cold-water dressings were applied, and occasionally a solution of permanganate of potash. On August 12th the sutures were removed, the patient was allowed the limits of the camp, and on August 17th, he was taken to Fort Lyon. On October 30th, he was sent to the hospital at Fort Leavemvorth, Kansas, at which date one ligature yet remained in the stump ; his general health was good. He was discharged from the service on December 7, 1870.

DCLXXIII. Account of an Operation for the Removal of an Aural Polypus. By J. M. DICKSON, Assistant Surgeon, U. S. A.

Private John Jeffcott, Co. B, 9th Infantry, of strumous diathesis, was admitted to hospital at Fort Sedgwick, Colorado Territory, on July 10, 1870, with deafness of both ears, accompanied by discharge, a small polypus existing in the meatus of the right ear. By July 24th the walls of the meatus, &c., were so thickened that a small speculum could with difficulty be introduced but a short distance. The Eustachian tubes were pervious. On that date the polypus was removed, by torsion, with forceps, the remaining portions by the application of nitrate of silver. The ensuing treatment consisted of astringent injections, the occasional application of a blister over the mastoid portion of the occipital bone. Tonics and alteratives were administered. On September 2, 1870, he was transferred to hospital at Fort Russell, Wyoming Territory, accompanying his company. At that date his hearing was much improved.


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