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IIOL06T LlttAU



T Jrl K



MEDICAL AND SURGICAL HISTORY



OF THE



WAR OF THE REBELLION.

PART II. i LIBRARY

UNIVERSITY Of

VOLUME ii. [CALIFORNIA.
SURGICAL HISTORY.



Prepared, under the direction of JOSEPH K. BARNES, Surgeon General United States Army.
BY GEORGE A. OTIS, ASSISTANT SURGEON UNITED STATES ARMY.



IFIIRST ISSTJE.



WASHINGTON:

GOVERN.MENT PlUNTCXa OFFICE

1876.



,mi06t



A few words m;iy be necessary to explain the relation of this volume to the large work, The Medical and Surgical History of the War ol tin
Rebellion, of which it is a component part.

In October. 18t;.1. the Surgeon General published, under the title of Circular No. (i. " Reports on the Extent and Nature of the Materials available
for the preparation of ft Medical and Surgical History of the Rebellion," that had been accumulated in his Office. The circular comprised a re|M>rt on
Ihe materials relating to military medicine, prepared by Assistant Surgeon .1. .1. WOODWAUD, II. S. A., and one on the! surgical materials, prepared by
the writer >,( this volume. Such elaboration was given to these preliminary reports, that, while subserving the purpose of the Surgeon (ieneral of
calling Ihe attention of Congress to the value of the data in his possession, the inconvenience arose that, in many quarters, they were regarded as an
attempted digest of these materials, and were very frequently quoted as in fact the completed oflicial medico-military report of the War. The recom
mendation of the Surgeon General, sustained by the Secretary of War, was so far Complied with, that, in the " Aft making Appropriations for Sundry
Cii il Expense^, i:tc., approved July L 8, I8(i(i, an item was inserted making provision for the preparation of plale.s and illustrations for a first part of a
.Medical and Surgical History; but it was not until March 3, 18(19. that, by Public Resolution, No. 15, the Government Printing Office was authorized to
print "five thousand copies of the First Part of the Medical and Surgical History of the Rebellion," to " be disposed of as Congress may hereafter
direct." As the labor of designing the illustrations and digesting and arranging the data had long been prosecuted, the work was rapidly pushed
toward completion, and, in the winter of 1870, the First Part appeared, divided into a Jledieal Volume, a Surgical Volume, and an Appendix, the
whole comprising eighteen hundred quarto pages, prefixed by a concise but comprehensive chapter by Surgeon General li.VHNES on the inception,
progress, and scope of the work, and the probable requirements for its completion. The latter, it was thought, would demand two more parts of equal
magnitude, each subdivided into medical and surgical volumes. On June 8, 187:2, was approved "An Act fur the Completion and Publication of Die
Meihfal mid Surgical History of the War in two Parts of eighteen hundred pages each, in addition to the first Part already compiled. With the limited
clerical force at the disposition of the Surgeon General, it was found utterly impracticable to complete this undertaking within the fiscal period of two
years wherein the appropriation for the purpose was available, and accordingly, in the Act making Appropriations far Sundry Civil Expenses, etc.,
approved June :!, 1875, the unexpended balance of the appropriation of June 8, 187:2, was continued, and, moreover, an additional appropriation was
made for a second edition of the six volumes of the entire work.

In the Surgical Volume of the First Part, after the Prefatory paper of the Surgeon General, the Introduction of the editor, and a Chronological
Summary of Losses in Battles and Kngagements, an exposition of the statistics and detailed reports of Special Wounds and Injuries of the Several
Regions was commenced and continued through live Chapters, treating respectively of the Injuries of the Head, Face, Neck, Spine, and Chest. The
nature and results of forty-nine thousand and sixteen cases of injury by war-weapons were set forth. It was aimed to give concise details of as large a
number as possible of individual facts bearing on the practice of military surgery. The space occupied by the detailed reports was so great, that
discussion and comment on the material was to a great extent reserved for a later portion of the work:

In the present, or Surgical Volume of the Second Part of the Medical and Surgical History, the presentation of the facts regarding the Special
Wounds and Injuries is continued, according to regional classification, through four Chapters. In Chapter VI, eighty-five hundred and thirty-eight
cases of Wounds of the Abdomen are tabulated, and detailed abstracts of six hundred and ten of them recorded. In Chapter VII, thirty-one hundred
cases of Wounds of the Pelvis are enumerated, six hundred and ten being detailed. In Chapter VIII, twelve thousand six hundred and eighty-one
cases of shot Flesh Wounds of the Hack are tabulated, with abstracts of two examples. In Chapter IX, eighty-eight thousand seven hundred and
forty-one cases of Wounds of the Upper Extremities are considered fifty five thousand and eighty-six injuries of the soft parts, and thirty-three thousand
six hundred and fifty-five cases of shot fractures. Detailed abstracts are given of eight hundred and seventeen cases ; the principal facts concerning
thirty-seven hundred and twelve excisions and eighty-two hundred and forty-five amputations are concisely recorded in tabular form ; the remainder of
the cases are adverted to in numerical statements.

The Record of the yet more numerous Injuries of the Lower Extremities constitute the subject-matter of Chapter X, with which the Surgical
Volume of the Third Part of the History will begin. A chapter will succeed on Fractures and Luxations from other causes than gunshot injury reported
during the War, to be followed by one on the reported instances of I5urns, Scalds, and Frostbites. This will conclude the review of Special Wounds
and Injuries, and will be followed by a chapter of generalities on shot wounds, their nature, frequency, and fatality, and principal complications, as
pyaemia, secondary haemorrhage, gangrene, and tetanus. Generalities on amputations, excisions, and ligations will also be presented. Chapters on the
Use of Aiuesthetics in field and hospital, with details of the alleged deaths from chloroform, on the Materia Chirurgica, including Artificial Limbs
and Prothetic Apparatus, and on the Transportation of the Wounded by Land and Water, will follow, and a copious Analytical Index of the three
surgical Parts will conclude the Volume.

CrEOKOK A. OTIS.



lit



TABLE OF CONTENTS



VOLUME II OF PART II



MEDICAL AND SURGICAL HISTORY OF THE REBELLION,



SIMUIICAT, VOLUME.



MEMORANDUM



Ill-



CHAPTER VI. INJURIES OF THE ABDOMEN.



SECTION I. Contusions and Wounds of the Abdominal Parietes.

I ll 111 I III I <l mill llllITll KIMIIIll-

Sabre and l.ayonet wounds

Other* Punctured and Incised wounds

l,:i< <-r:il< <i ami < oilliiNed \t >nn<N .. ...

Kiiptm-e of n ii Mfii N...

. Illl-hol I ll ,h WOUnd*

TAliU-r I. I artial numerical statement of shot wounds of

the Abdomen

TAIII.K II. Cases of injuries ,-1 the Abdominal Walls re
turned during tlie War

4 oiii|tlic:itiou of l j ari-lal WIIII|M

Haemorrhage

Foreign bodies

Gangrene

Hernia,

Nervous disorders

Tetanus

SECTION II. Visceral Injuries without External Wounds ..
KupturcH of the Liver. .
Rupture* of (he W|I|TH
It ii pi ii r CM of the Kidney.
It npiui < - of the Nlomneh

K u pi ii res of (he I n i< -l i=i<

PLATE I. Ktipturo of Jejunum, facing

Itaptui-ett oT the Oiiieiiliiui niid JIeenlery
ItnptureN of the RIootl-veNNelM .
KiiptureM of the Diaphragm . ..
TAI:T,K ITT. Xiimerical statement of Visceral Injuries

without external wound

SECTION III. Penetrating Wounds of the Abdomen

Simple Penetration* :iu<l Pcrforntionw

without ViHcvrnl injury

Abstracts of Punetured and Incised wounds. . . .

Abstracts of cases of Gunshot wounds

Wound* of the Mlomnch

Punctured anil Incised wounds

Gunshot wounds

Abstracts of cases of recovery

Fatal complicated cases

Gastric fistulae



Page.

TION in. PENKTRATIKO WOUNDS OP AuuoionfCuoHniwd.
WoundM of the Mmnll l.u. >HM. .

Punctured and Incised wounds. . r til

Gunshot wounds 114

Wounds of the Duodenum 07

Wounds of the Jejunum G8

Wounds of the lleuin 70

Pl.ATK. II. Knterorujihy of Mourn, faring 72

WoiiiidH of the I.nrye liiit.iim. IT,

Punetured and Incised wounds ?t!

Gunshot wounds 7(i

t l.ATK IV. Fa-rail Fistula of Colon, facing 77

Alistr.wts of fifty-nine cases of recovery 77

Pl.ATE V. Shot perforation of Alxloinen. fuc wg 81

Halls voided at stool <>8

Fatal cases . 102



Abnormal \mi-

Suture

Anaplasty

Knterornphy

Pl.ATK III. Suture of Ileum. facing

Palfyn s method

Heybard s mcthixl

I.e Dran s metluHl

Method of the Four Masters and Duvciyer

Method of Donans

Metluvd of Uamdohr . .

Jobert s method

Lemliort s metiMMl

G61.r s meth.Ml

Views of Gross and Heybjird

Kntcroraphy in Shot wounds



109
111
111
112
1K1
114
115
11.1
Hi.
Hi.
117
118
ll .t
II!)
12.1
1 2.1



\VomidM of the I ii r

Punctured and Incised wounds

Gunshot wounds

Memoranda of fifty nine uncomplicated caws .
Memoranda of one hundred ami fourteen compli

cated cases

Pl.ATK VI. Metastatic Foci, faring . .

Recoveries, abstracts of cases



TABLE OF CONTENTS.



CHAPTER VI.



INJURIES OF THE
Page.



SECTION III. wouxns OK AUPOMEN [Continued.

\\ onn.U ol Hi. H |( |i , ii 14!

Punctured and Incised wounds .................... 141)

Ciiinshot wounds .................................. l-~> ()

Tabu lar statement of the recorded operations of Splon-
otomy ......................................... 1 ">-

Wi.iimlx of i In- l :iii< i - :i.
Wound* of Hi. Ivitliii >

C.unshot wounds ................................. lol!

Memoranda of twenty six alleged eases of re
covery ..................................... 1 03

Abstracts of fatal cases ........ - . ............. H>7

Wound* of the S iMi-iii < mil CapMiileM.. ..

\\ on nil- .l III*- Omen IIIIK. Vleoentery. ami



CoiiipliriUioiiu ......

Haemorrhage
Foreign bodies
Visceral protrusions
PLATE X. Hernia of Jejunum. facing
Hernia ..........

Ilerniotomy, abstracts of twelve
Abdominal effusions

ISlood, abstracts of four cases. . .



ABDOMEN CONTINUED.

DION S | Continued.



Page.

SKCTION 111. Al .pnMiVU.

Paracentesis li- l

Bile 192

Urine... 193



L94
LSfi
198



Fa-ees, etc

Pus

A i r or gases

Traumatic peritonitis 19!)

! i < (|ii. n< \ of Won lulu of" i In- \biloiii. ii . . .
.Tlortnlily of Wound* nnd Injuries of the

* iHlom. n

TAIII.K IV. Statement of the eases of Penetrating

wounds of the Abdomen returned during tlio War.

TAIM.I: V. Number of Penetrating shot wounds of

the Abdomen in other wars, with ratio of mortality.

Deadliness of shot wounds of Abdomen

Observations by Kurg. .1. .1. 1!. Wright

Kxamples of Impalement



201
202
202



203
204
204
204



PLATK XI. Rupture of I lenm, facing 205

Concluding obMervntioiiM 205

Laparotomy for traumatism 206

Diagnosis 20G

Treatment 207

P.ibliogniphy 208



CHAPTER VII. INJURIES OF THE PELVIS.



SECTION I Shot Fractures of the Pelvic Bones

*>lil friieliire* of the Ilium -, |-J

PLATK XXXVI. Shot fracture of Ilium, facing 212

Penetiations without visceral injury 213

Abstracts of cases 214

Abstracts of fractures of both Ilia 21")

Illustrated shot fractures. 2IS

TAllLK VI. Indicating the relative liability of the

right and left Ilia to shot injury 221

PLATK XXXIV. Carious shot fracture of Ilium, facing. 221

PLATK XXXV. Fracture of Us Innominatum. lacing... 223;

Caries and Necrosis 225

Pl.ATK XXXVII. 1 Shot perforation of Ilium, facing.... 22.",

Pyaimia and Septiea-mia 22!)

Kxcisions of portions of the Ilium 230

Whol friietiirew of the PII M* .. . 237

Mhot fracture* of the iHehiiiiu : . . . 240

Excisions of portions of the Ischiuni and extraction

<.f foreign bodies 24."

Mhot liiKliii.N of the :i<ium .. . 04,;

Excisions of portions of the Sacrum 2.">0

Nhot fraeliirex of the 4 occyx.... , 52

Mhot fractir*N of the I elvic Itoiie* in >ii-



TAIII.K VII. Numerical return of fourteen hundred
and ninety eases of shot fracture of the Pelvis

F.xeisions of portions of the Pelvic bones

PLATK XLI. Instruments for resection, facing
Injiiriew of the I d vie l.i^ituieiil* . ..
SECTION II. Injuries of the parts contained in the Pelvis., -s,:
Whol peitetriilionN or perform ion* without

\i-i.i.il injury 037

Injiirieo of the If ladder. .. 202

Kuptures of the liladder -. o<;n

Punctured, Incised, and Lacerated wounds 203

Concussions of the P.ladder o (;4

Nhot MOIIIKN of ihe Rlndder (;4

Foreign lio.li. - . in ihr Itluddcr t>(g

Vesical calculi formed about projectiles 20!)

PLATK VII. Vesical calculi, facing 272

Calculi having nuclei of bone or of encrusted bone

splinters .j7g

Calculi consequent on shot wounds of IJludder., 27!)

PLATE VIII. Vesical calculi removed after shot wounds,

facing ... ogo

TAISI K VIII. Descriptive numerical statement of

twenty- one cases of lithotomy 282

VI



SECTION



II. FOKKICX I .OIUF.S IN Tin: RLAnnF.it [Continued.

I /it hot oin y for ordinary vesieal calculi 282

I .xtraiieous bodies escaping by the Urethra 283

Mhot fvoiindN of lilaildi i . olhcr < \:ini|>l< s 283

Itecovery. abstracts of twenty-eight cases 280

Fatal shot wounds 290

Urinary infiltration 2!)G

1!. -marks on shot wounds of the P.ladder 297

U omuls o! Ill* 1 lrosliito 303

Wounds of th<> I{<*eliiui 305

Stercoral fistula- after shot wounds of the Kectum.. 308

Recovery after shot wounds of the Kectum 310

Fatal shot wounds of the Rectum 315

Anal fistulas 321

Anal fissure 321

Ihemorrhoides 322

Foreign bodies 322

Wounds of the If lood- vessels ami Serves 323

Punctured and Incised wounds 323

(iiinshot wounds 324

Wounds of the Internal Pubic artery 324

Wounds and ligations of the Sciatic artery 320

Wounds of the llio-lunibar artery 327

Wounds and ligations of .the (iluteal artery 327

Wounds and ligations of the Internal Iliac or

Hypogastric artery 330

Wounds and ligations of the Common Iliac artery 333

Wounds and ligations of the Spermatic artery. . 337

Wounds of the Veins 338

Wounds of the Nerves 339

III On Injuries cf the Genital Organs 343

Wounds of the I eiiis 343

Incised wounds 343

Ciiinshot wounds 345

Wounds of the I rethra 349

C.unshot wounds 350

Recovery after gunshot wounds of the Urethra..

Traumatic strictures 351

Urethral fistules 3(10

Deep Urethral fistules 304

Urethro-rectal fistules 301>

Fatal shot wounds of the Urethra 372

Urinary infiltration and free incision 373

Injuries not caused by shot 374

Foreign bodies 375

Treatment of wounds of the Urethra and of traumatic

strictures and fistules . 380



TAJ3LJ3 OF CONTENTS.



CHAPTER VII. INJURIES OF THE PEI_VIS-[Cc



SECTION III. WOUXUS OF TUB UUETIIUA [Continued.

Organic Strictures (three abstracts) 380

Dilatation and Divulsion :j8

Urethrotomy ;{<)o

Intonial I rethrotomy :(;)-,>

I LATK XII. Urethra! instruiiients, facing- ;j J5

Kxtcrnal perineal Urethrotomy (seven abstracts) 3!>0

L rethroruphy and L rethroplasty (four abstracts) 401

IIIJIIIK- ;iiul dint-ax * of the TcHtin... . 405

.Shot injuries of the Testis 405

.Shot lacerations of the Testis (twenty abstracts) 400

Kxcisions of the Testis for shot injury 409

Abstracts of thirty-two cases of recovery . . 40!)

Fatal cases (seven abstracts) 411)



SECTION III. IX.Jl-lUKS, KTC., OF TIIK TESTIS [Conttnilc.l.

Kxcisions .if both Testea (three abstracts)

Atrophy of the Testes

Injuries of the Spermatic C,,r<l (live abstracts)

Contusions of the Testis (three abstracts)

Sarcocele (one abstract)



Wonnds <>i :

Ilydroccle

Operations for Ilydmcelo.
Varicocelo. . .



Concluding observat IOIIH

TABLK IX. statement of thirty -one hundred and seventy.

four cases (.f injury to the Pelvis



414

115

117
418



4 -JO
421
122

423
423



CHAPTER VIM. FLESH WOUNDS OF THE BACK.



Page.

Relative frequency of Shot wounds of the Back unat
tended by Fracture 4x>7

TABLE X. Statement of Wounds of the Back and Hips
in the field or primary hospitals 428 ,

T AISLE XI. Statement of twelve thousand six hundred
and eighty-one Gunshot Flesh wounds of the Back. .. 428 ||



1* nurtured nud ln< i-<<! noun, I, of Itiifk. |J!)
(.niinliot woiuidN of Ihc Itiit-k (abstracts of

tw<; eases) .J.MJ

PLATE. IX. Laceration of the Buttocks, facing 4:10

Miiu <; r:il I in;; .. 4;j(

Fatality of Shot wounds of Hack. . . . 432



CHAPTER IX. WOUNDS AND INJURIES OF THE UPPER EXTREMITIES.



Page.

Prolegomena 4;i;3

TABLE XII. Collated return indicating the relative fre
quency of shot wounds of the upper extremity 434

SECTION I Flesh Wounds of the Upper Extremity 435

I ll MI I mi <l mid lin i-<<! \V<iiii<l-. 435

Ligation of the Brachial artery 430

legation of the I lnar artery 430

Ligation of the Hadial artery 436

Wounds of the Palmar arches 437

ol Wounds 438

False Anchylosis 438

Atrophy and Deformity after sloughing 439

Pyaemia 440

Lesion of the large Blood-vessels 440

legations of the Axillary artery 442

Abstracts of fifteen cases 442

legations of the Braehia! artery 440

TABLE XIII. Summary of seventy-six cases 448

legations of L lnar artery 451

Ligations of Kadial artery 452

Ligation of Interosseous, Superficial Palmar

Arch, and other arteries 454

Flesh wounds involving large Blood-vessels treated

without operation 454

Blood-vessels primarily involved, abstracts of

nine cases 454

Sloughing involving the larger Blood-vessels... 450
Haemorrhage from the Subclavian or its

branches 43(i

Haemorrhage from the Axillary or its branches 450

Haemorrhage from the LSrachial orits branches 457

HaDinorrhage from the Ulnar or its branches 458

Haemorrhage from the Radial or its branches 458

Haemorrhage from the Interosseous artery.. 458

Flesh wounds involving the larger nerves 401

Injuries of the Brachial plexus 403

Injuries of the Circumflex, Musculo-cutaneous.

and Musculo-spiral nerves 403

Injuries of the Median nerve 404

Neurotomy *..... 405

Injuries of the I lnar nerve 400

Injuries of the Kadial nerve 407

Amputations consequent on Flesh wounds 408

Amputations at the Shoulder Joint 4G8

TABLE XIV. Summary of fourteen cases.. 408

Amputations of the Upper Arm .. . 409

TABLE XV. Summary of fifty-four cases 409



473



Page.
SECTION 1. FLESH Wor.sus [Continued.

Amputations of the Forearm 471

TABLE XVI. Summary of fourteen cases 471

<< iirral <>!>-< r> :i I ion- oil I li -h- \\ i>u ml ~ of
the Upper E \lri-niif > . 471

SECTION II. Fractures of the Clavicle and Scapula .t: :!

Mnbre nnd Bayonet Mound*

Shot li :i< IIIK of the C lnviclc and Mcapula

TABLE XVII. Statement of twenty-two hundred and

eighty shot fractures of the Clavicle and Scapula. . 474

Shot fractiircM of the Clavicle .. . 475

Excisions of the Clavicle 470

T AISLE XVIII. Summary of twenty-two cases. 480

Shot fracture* of the Ncnpulu . 481

PLATE XLV. Shot fracture of Left Seapula, facing 488

Excisions of portions of the Scapula 492

TABLE XIX. Summary of forty examples 4U5

Partial excisions of Clavicle and Scapula 497

TAISLE XXII. Summary of nine cases 497

SECTION III. Wounds of the Shoulder Joint 501

Wound* treated on the Expectant plan 502

Wounds unattended by Fracture 502

Wounds attended by Fracture of the bones composing

the Shoulder Joint 50:)

Abstracts of thirteen cases of recovery 503

Abstracts of nine fatal eases 510

KxciHioiiN at tin- Shoulder. ..

TABLE XXI. statement of eight hundred and eighty-

five cases of excisions at the Shoulder 500

Excisions of the Head of the Ilumerus with portions

of the Clavicle and Scapula * . - .

PLATE XIII. Kcsults of excisions of the Head of the
Humerus, facing.. .

TABLE XXII. Tabular summary of forty-two

cases

Partial excisions of the Head of the Hnmerus- . .
TABLE XXIII. Tabular summary of four-

cases -"

llcrapimtioii" of Ihc llnmeruN. . .

Primary decapitations of the Head of the Humerus 52!

Successful operations, abstracts of six cases . .
Pi. .\n: XIV. Kesults of excisions of the Head of (he
Ilumerus. facing. - .

TABLE XXIV. Summary of ono hundred

and nineteen cases 531

l. nsuccfssful operations

VII



524
52C



TABLE OF CONTENTS.



CHAPTER IX. WOUNDS AND INJURIES

Page.
SECTION III. Il-i AlTfATlOXS OF THE Hi MEKl ti [Continued.

PLATE XVII. Results of excisions of the Head of the

Humcriis. facing r 36

TAlfLE XXV. Tabular summary of fifty-
six cases >*<>

Intermediary decapitations of the Humerus. .

.Successful cases (two abstracts) 537

TABLE XXVI. Tabular summary of twenty-
one cases - - J 3l>

Unsuccessful eases (two abstracts) .. . 540
TABLE XXVII. Tabular summary of thirty-
four cases 5-H

Secondary decapitations of the Humerus. . .

.Successful eases (three abstracts). .. 543
TAHI.K XXVIII. Tabular summary of thir
teen cases 54:i

PLATE XVII. Results of excisions of the Head of the

Humerus. facing - 544

Unsuccesful cases (two abstracts) . 545

TABLE XIX. Tabular .summary of thirteen

cases 545

Decapitations of the ilumerus of unce/tain date (two

abstracts) 547

TAHI.K XXX. Tabular statement of seventeen

cases 547

I vi i-i.ni- of the Hi-mi and portion* of tin

lini i of iln II iiiui mi 548

Primary excisions of the upper extremity of the Hu
merus 548

.Successful operations (abstracts of twenty -nine

eases) 548

TAUI.E XXXI. Tabular summary of two

hundred and thirteen cases 554

Unsuccessful operations (abstracts of nine cases) 50!
TAHI.K XXXII. Tabular summary of eighty

fatal cases 570

Intermediary excisions of he upper extremity of the

Humerus 57U

Successful operations (abstracts of fourteen cases) 573
TAUI.E XXXIII. Tabular summary of ninety

one crises 570

Unsuccessful operations (abstracts of seven eases) 584
TABLE XXXIV. Tabular summary of sixty-
four cases 585

Secondary excisions of the upper, extremity of the

Humerus 58 J

Successful operations (abstracts of eight cases) . . 589
TAHI.K XXXV. Tabular summary of thirty-
eight cases 591

Unsuccessful operations (abstracts of two eases) 595
TABLE XXXVI. Tabularsummaryof twelve

eases 590

Excisions of the upper extremity of the Ilumerus of

uncertain date 597

TABLE XXXVII. Tabular summary of nineteen

cases 597

!: \ci-ion* of the Mhoiilder, pnrln not defi
nitely determined 597

TABLE XXXVIII. Tabular summary of thirty-nine

cases 598

C onclndini; obnervatiouN on : \< ision. nt

the Nhoiilder lifter -hoi injury 599

TAHI.K XXXIX. Numerical summary of the eight

hundred and eighty-five excisions at the Shoulder 599
TABLE XL. Tabularsummaryof two hundred and

one cases practised in Confederate army (101

TABLE X 1,1. Number of excisions of upper extrem
ity of the Ilumerus in other wars, with ratio of

mortality 007

Ampulnlionx nl the Nhoiilder . .. <ii:t

Scapulo-humeral amputations after shot fracture 013

TABLE XI, II. Numerical statement of eight hun
dred and fifty-two amputations at the Shoulder

Joint after fracture 014

Primary amputations at the Shoulder Joint 614

Successful operations (abstracts of thirteen cases) 615

VTII



OF THE UPPER EXTREMITIES [C

1
SECTION III. AMPUTATIONS AT THE SIIOI:LI>KK [Continued.

TAUI.E X 1.1 1 1. Tabular summary of three hun
dred and sixty-eight cases ..
Unsuccessful operations (two abstracts)..
TABLE XI. IV. Tabular summary of one hun
dred and seventeen ca>es. . .

Operations with unknown results

TAUI.E XI,V. Tabular summary of fourteen



ige.



Intermediary amputations at the Shoulder Joint...
Successful operations (abstracts of three cases) . .
. TAHLE XI, VI. Tabular summary of eighty-five

cases

PLATE XLVI. Shut comminutions of the Humerus,

facing

Unsuccessful cases (abstracts of three cases). . .
TABLE XLYI1. Tabular summary of seventy-
two fatal cases

Secondary amputations at the Shoulder Joint

Successful operations (three abstracts)

TABLE XLVI 1 1. Tabular .summary of forty-



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