Hospital Cases. Reported by J. M. Steiner, M. D., Assistant
Surgeon U. S. Army, Fort Graham, Texas.
Private White of “ I ” Company, 2d Dragoons, came into the
Hospital, on the 11th of November, 1849, with the conjunctiva
and cornea of the right eye severely inflamed. Constitution natu-
rally strong, but depraved by vicious habits ; complained of great
pain in and around the orbit, and states that his eye became affect-
ed on the 6th. The inflammatory symptoms being high, he was
bled copiously from the arm ; cups were applied to the right tem-
ple; a solution of nit. argenti xx. grs. to the ounce of water, drop-
ped in the eye, ter die; bowels freely moved, and a mercurial
course adopted. Under this treatment the inflammation rapidly
subsided. On the 25th the left eye became involved, but the in-
flammation disappeared in a few days, the nit. argenti alone being
used. The eyes remained weak and irritable until the 20th of
January, when the following complication occurred. From the
appearance of the right eye, it seemed-as if the crystalline lens
had become detached on the inner side, from its attachment to the
hyaloid membrane, which protruded into the anterior chamber, in
the form of a small, semi-transparent pouch. He complained of a
dull, aching pain, in and about the orbit, and the right temple.
Several ounces of blood were abstracted by means of cups from the
temple; blisters applied back of the ears, and the mercurial treat-
ment resumed. On the 25th the pain had subsided ; gums slight-
ly touched; pouch gradually enlarging and assuming a hazy, or
less transparent hue. Feb. 10th, anterior chamber nearly filled
with pouch, which has assumed a milky color; vision almost en-
tirely destroyed. From this time, until the 23rd of March, when
the company to which he belongs, left this Post, no appreciable
change took place. Among other medicines, the iodide of potassium
was administered, but without benefit. If the hyaloid membrane
has not become disorganized—which I believe to be the case—
possibly an operation might effect a radical cure.
Private Edward Capon, of “H” Company, 8th Infantry, aged 31
years, of sanguine temperament, was received into the Hospital on
the 3rd of March. He complained of violent pain, extending
from the precordia, to the back, shoulders, and back of the neck,
and running down the left arm as far as the elbow. There was
considerable dyspnoea ; panting respiration ; fever, and a firm, full,
sharp pulse, beating 115 per minute. The head, neck, and
shoulders, drooped forward, and he was either unable or afraid to
assume a straight position. On examining the lungs by ausculta-
tion and percussion, no morbid symptoms could be detected. Di-
recting him to hold his breath, I applied my ear over the region of
the heart, which I found to be the part affected. A rough grat-
ing, friction sound, could be distinctly heard, synchronous with
the systole of the ventricles. No additional morbid sounds could
be heard. The dulness in the region of the heart, did not appear
to extend over a greater space than is usual in health. As this
man had been affected several times, within the last twelve
months, with acute articular rheumatism—the last attack occurring
in the preceding month—I concluded his present complaint to be
rheumatic.carditis, or pericarditis. Fifteen ounces of blood were
taken from the arm, and a dose of xx. grs. of calomel, with
xv. grs. of Dover’s powder administered. A purgative of senna
and salts was given in the afternoon. At 9 P. M. cups were ap-
plied to the left side of the chest, and between the shoulders, and
twelve ounces of blood procured. Ten grains of calomel, and one
of opium were directed to be taken every six hours. The friction
sound could still be heard on the 4th, but not so distinctly as on
the day previous ; the febrile symptoms, had considerably abated ;
the distressing dyspnoea lessened, and the pain moderated. Cal-
omel and opium continued. On the 6th, there was no fever;
pulse 96, irregular, and devoid of strength, pain slight ; the gums
being touched by the calomel, it was discontinued and the im-
pression kept up, by small doses of blue mass, given night and
morning. On the 6th, a blister was applied over the region of the
heart. On the 12th, he was able to walk about the wards. The
cardiac symptoms, with the exception of the friction sound, recur-
red on the 24th, but in a milder form. He was relieved by cups,
and a few doses of calomel, conjoined with the extract of aconite.
At this date, March 31st, he is free from pain, and the sounds of
the heart appear normal, though somewhat less distinct. I believe
that the pericardium has become adherent to the heart. The patient
is pale, weak, and emaciated, and I do not think will ever be com-
pletely restored to health.
Private Fink, of“ A” Company, 2nd Dragoons, was received
in the Hospital on the 15th of March, with a compound fracture of
the bones of the right leg. The fracture was occasioned by a
kick from a horse, as the man attempted to mount him. In falling
the foot was bent backwards on the calf, and the upper fragment
of the tibia, tore through the soft parts. On the 14th, the day
previous to that on which the accident occurred, I had accompa-
nied a scout into the Camanche Country, and did not return un-
til the 18th; so that I did not see the patient till the 4th day
after the receipt of the injury. The tibia was obliquely fractured,
a little below its middle, and the lower end of the upper fragment
denuded for three-fourths of an inch of the periosteum, protruded
two inches and a half from a lacerated and contused wound in the
soft parts, on the inner and anterior part of the leg; the fibula
was fractured an inch and a half higher up, but did not appear
externally. In consequence of the wound furnishing a ready out-
let for the fluids, but little swelling had ensued ; and the man
being of a strong and robust constitution, I concluded to try and
save the limb. I thought it advisable to remove that portion of
the tibia divested of its investing membrane, and it was therefore
excised, when the remaining portion was drawn within the wound,
which was closed as far as practicable, by means of sutures and
adhesive straps. The patient was placed on his right side, with
the leg partially flexed resting on a pillow, and lint saturated with
cold water, kept applied to the wound. The discharge from the
wound consisted of serum, mixed with blood. Considering the
extent of the injury, there was but little constitutional disturbance ;
the skin was hot; pulse full and strong, and the bowels torpid,
but these symptoms abated after the operation of a brisk cathartic.
On the 20th, the limb was placed in a fracture box, the flexed po-
sition changed to the extended, and the cold applications being
agreeable to the patient, continued. The wound gradually
healed by granulation, and on the 9th of April, the limb was
placed in Dessault’s apparatus for fractured thigh, and extension
and counter extension made. The heel was placed in a padded
ring, and daily bathed with a mixture of whiskey and water, with
the view of preventing, if possible, excoriation, yet a bad slough-
ing sore ensued, which gave the patient considerable pain, and
myself much annoyance ; no other unpleasant symptoms occurred.
The splints were removed on the 20th of May ; the injured ex-
tremity is from a half to three fourths of an inch shorter than the
sound one. The union of the tibia, is by bone, and without de-
formity. In consequence of the overlapping of the fractured ends
of the fibula, firm union of that bone, had not, I think, taken place;
and if it has not, the limb will scarce be of much practical use,
till the fibula is cut down upon, and the overlapping portion ex-
cised. The patient left this post on the 23rd of June to join his
Company at Fort Croghan.
August 16th. I have this day ascertained from the Captain of
his company, that the trip from this post to Fort Croghan, excited
inflammation between the fractured ends of the fibula, resulting in
firm union.