Medical/Surgical History – Part III, Volume II, p.154
Chapter X – Wounds And Injuries Of The Lower Extremities
Section II – Wounds And Injuries Of The Hip Joint
Amputations At The Hip Joint
The next case is exceptional inasmuch as the amputation and reamputation followed a bayonet stab in the knee instead of shot injury.
FIG 113 – Cicatrix sixteen months after a reamputation at the right hip, succeeding amputation for a bayonet stab through the knee.
CASE 331.–Private Lewis Francis, Co. I, 14th New York Militia, aged 42 years, was wounded July 21, 1861, at the first battle of Bull Run, by a bayonet thrust, which opened the right knee joint. He received not less than fourteen other stabs in different parts of the body, none of them implicating the great cavities. He was taken prisoner, and conveyed to Richmond and placed in hospital. One of his wounds involved the left testis, which was removed on July 24th. On October 28, 1861, his right thigh was amputated at the middle, on account of disease of the knee with abscesses in the thigh. The double-flap method was employed. The stump became inflamed and the femur protruded. An inch of the bone was resected and the flaps were again brought together. In the spring of 1862 the patient was exchanged and sent to Fort Monroe. Thence he was transferred to a Washington hospital, and thence, in March, 1862, to his home in Brooklyn. There was necrosis of the femur, and in May, 1862, its extremity was again resected by a civil surgeon. On October 28, 1863, Francis was admitted to the Ladies’ Home Hospital, New York. Necrosis had apparently involved the remaining portion of the femur. On May 21, 1864, Surgeon A. B. Mott, U. S. V., laid open the flaps and exarticulated the bone. The patient recovered rapidly and had a sound stump. He was discharged August 12, 1864. On October 1, 1865, a photograph, from which the accompanying wood-cut (FIG. 113) was taken, was forwarded by Surgeon A. B. Mott to the Army Medical Museum. Dr. Mott reported that the pathological specimen of the exarticulated femur was stolen from his hospital. For some months after his discharge Francis enjoyed good health; but then the cicatrix became unhealthy, pus was discharged through several sinuses, and there was bleeding from the slightest irritation. In March, 1867, a messenger was sent to his residence, 54 Hamilton Street, Brooklyn, and found him in very poor health. He had been unable to leave the house since November, 1866. On April 12, 1867, he was visited by Dr. E. D. Hudson, who reported him as then confined to his bed. There was a large ulcer at the upper outer angle of the cicatrix, which communicated with extensive sinuses; there was a fistula-in-ano also. The pus from the different fistulous orifices was thin, oily, and ichorous. There could be little doubt that there was disease of some portion of the innomi-natum. The patient was much emaciated, and had a cough with muco-purulent expectoration. His pulse, however, was not frequent, and he had a good appetite. In May, 1867, it was reported that his general condition had somewhat improved. In March, 1868, Pension Examiner J. C. Burdick, of Brooklyn, reported that this pensioner was “permanently helpless and required the constant aid of a nurse.” On May 30, 1874 (Decoration Day), and the day prior, at a preparatory parade of the veterans of his regiment, he was particularly active. The day after this unusual exercise, May 31, 1874, he died suddenly while at table.(2) This statement from the Brooklyn Union, June 1, 1874, is corroborated by the records of the Pension Bureau.
(2) Circular No. 6, S. G. O., 1865, p. 49. Circular No. 7, S. G. O., 1867, pp. 52, 65. HAMILTON (F. H.), Treatise on Military Surgery, 1865, p. 629.