A CONTRIBUTION 
TO THE HISTORY OF THE 
HIP-JOINT OPERATIONS PERFORMED DURING THE 
LATE CIVIL WAR: 
BEING THE 
STATISTICS OF TWENTY CASES OF AMPUTATIONS AND THIRTEEN 
OF RESECTIONS AT THIS ARTICULATION IN THE 
SOUTHERN SERVICE. 
BY 
PAUL F. EYE, M. D., 
PROFESSOR OF SURGERY IN THE UNIVERSITY OF NASHVILLE, TENN. 
EXTRACTED FROM THE 
TRANSACTIONS OF THE AMERICAN MEDICAL ASSOCIATION. 
PHILADELPHIA: 
OLLINS, PRINTER, 705 JAYNE STREET. 
1867. A CONTRIBUTION 
TO THE HISTORY OF THE 
V 
HIP-JOINT OPERATIONS PERFORMED DURING THE 
LATE CIVIL WAR: 
BEING THE 
STATISTICS OF TWENTY CASES OF AMPUTATIONS AND THIRTEEN 
OF RESECTIONS AT THIS ARTICULATION IN THE 
. SOUTHERN SERVICE. » 
BY 
PAUL F. EYE, M. D., 
PROFESSOR OF SURGERY IN THE UNIVERSITY OF NASHVILLE, TENN. 
EXTRACTED FROM THE 
TRANSACTIONS OF THE AMERICAN MEDICAL ASSOCIATION 
PHILADELPHIA: 
COLLINS, PRINTER, 705. JAYNE STREET. 
1867. A CONTRIBUTION TO THE HISTORY OF THE HIP-JOINT OPERATIONS 
PERFORMED DURING THE LATE CIVIL WAR. 
The middle of February last I was notified by Dr. Geo. A. Otis, 
Brevet Lieut.-Col. and Surgeon U. S. Vols., in charge of the Divi- 
sion of Surgical Records, S. G. O., and Curator of the Army Medical 
Museum, that, by the direction of the Surgeon-General, he was 
engaged in preparing a monograph on amputations at the hip-joint 
in military surgery, in which it was proposed to give full reports 
of all such operations performed during the late war in the United 
States Army; and, moreover, that he was anxious to include an 
account of similar cases which had occurred in the Southern Ser- 
vice. He further stated, that up to that date he had been able to 
collect only three such examples, one of which I had sent him. 
Accompanying this notice was a circular issued to the medical 
officers of the regular army asking for information on the subject, 
the plan of which was, of course, adopted in my efforts to comply 
with the request to carry out his wishes by the 15th of April, 
though the time of publication has since been extended to June. 
In less than eight weeks, thirteen cases of coxo-femoral amputations 
were forwarded to the Surgeon-General’s Office, in Washington 
City; and up to this date my statistics embrace twenty such exam- 
ples, with the addition of thirteen of resection at this joint, making 
a total of thirty-three of these operations performed at this articu- 
lation in the Southern army. 
Knowing the importance of comparing these two kindred opera- 
tions at this large joint, I have volunteered to do what I could in 
the brief space of the last month in collecting them, and the shorter 
period allowed for the work may account for their number being 
less than the amputations. 
The labor of obtaining material for this report has been much 
diminished by the kind aid and co-operation of the profession to 
whom I am greatly indebted. The particulars of each case have 
been derived, as far as practicable, from the operator himself, and 4 
CONTRIBUTION TO HIP-JOINT OPERATIONS. 
Lis own language preserved. Aiming to present the whole truth, 
every available means were employed, and, in several instances, 
the full history has been secured. To many professional gentle- 
men I have been placed under peculiar obligations, some of them 
personally unknown to me, and to all named is due this public 
acknowledgment; but to Dr. Charles II. Mastin, of Mobile, in par- 
ticular, I cannot withhold my sincere thanks for much of the reli- 
able information in this paper. 
To the 1st of February, 1864, there had been reported to the 
office of the Surgeon-General, S. P. Moore, of the late Confederate 
Army, three cases of primary amputations at the hip-joint, with 
one recovery, and two of resections, both secondary, one died and 
one recovered. The two successful cases were, probably, Dr. Gil- 
more’s amputation and Dr. Read’s resection, detailed hereafter. 
My statistics embrace the report of thirty-three such cases col- 
lected during the months of March and April of this year. 
Table I. contains the cases of amputations and Table II. those 
of resections at the coxo-femoral articulation, performed during 
the late civil war in the Southern service. And to enhance the 
value of this collection will be appended all the facts obtained in 
regard to each one, thus making their history as near complete as 
it was possible under the circumstances. CONTRIBUTION TO HIP-JOINT OPERATIONS. 
5 
No. 
Name of operator. 
Name and rank 
of patient. 
Nature and date of 
inj ury. 
Date of operation. 
Result. 
Authority. 
Remarks. 
1 
J R. Buist, M. D., 
Brigade Surgeon, 
Mauey’s Brigade, 
Cheatham’s I)iv., 
C. S. A. 
Private. 
August 30, 1864; cannon- 
ball lacerating upper 
outer third of thigh, 
and comminuting femur 
through trochanters and 
neck. 
Three hours after 
being shot. 
Death 13 hours 
after operation. 
Dr. Buist, now in 
Nashville, Tenn. 
Cold water dressings and stimulants were 
used. Patient remained sensible for 6 or 
8 hours after being removed from table. 
(See full history of Case No. 1, at foot of 
these tables.) 
2 
D. W. Yandell, M. 
D., Med. Director, 
Gen. A. S. John- 
ston’s Staff, C.S.A. 
Private. 
Crushing of left thigh by 
a shell at Shiloh, April 
7, 1862. 
April 7, 1S62. 
Death in 7 hours. 
Dr. Yandell, now 
in Louisville, 
Ky. 
The femur was shattered into the joint, 
and the soft parts torn to shreds into the 
upper part of thigh. Patient wounded in 
morning, and reaction was deemed suffi- 
cient by evening for the amputation. 
3 
Surgeon St George 
Peachy, assisted 
by Surgeon Chas. 
Bell Gibson, C.S.A. 
Private in U. S. 
army. 
After first battle 
of Manassas, Ju- 
ly 21, 1861. 
Death suddenly 
in a few days 
after operation. 
Prof. T. G. Rich- 
ardson, M.D , of 
N. Orleaus; also 
Surg. E. T. Sabal, 
M. D , of Jack- 
sonville, Fla. 
“The patient was an inmate of the Alms- 
house Hospital.’’ Both Surgeons Peachy 
and Gibson died during the war, in Rich- 
mond, Va. 
4 
Dr. Felton, Surgeon 
to Col. Dockery’s 
Arkansas Regim’t, 
Cabell’s Brigade, 
Maury's Division, 
C. S. A. 
Private. 
Gunshot fracture of thigh. 
Atluka, a month 
after he had been 
wouuded in the 
attack on Co- 
rinth by Gens. 
Price and Van 
Dorn, Oct. 1862. 
Death on the ta- 
ble within an 
hour. 
S. L. Nidelet, M. 
D., late Chief 
Surgeon of Gen. 
Maury’s Divis. ; 
now in Mobile, 
Ala. 
Dr. Felton died of fever in Mississippi, 1863. 
5 
W. A. East, M. D., 
of San Antonio, 
Texas. 
A negro man, 
a refugee with 
his master 
from Ark’sas. 
Latter part of 1S64; head 
of os femoris crushed by 
a rifle-ball. 
Ten hours after 
he was shot. 
Rapid recovery. 
Dr. East, in the 
Aug. No., 1866, 
of the Southern 
Journal of Med. 
Sciences, N. Or- 
leans, La. 
Larrey’s method was adopted ; the arteries 
were tied as divided. Fifteen or twenty 
days after the operation, the patient suf- 
fered intensely in the stump, and thence 
up the spinal column. A tumor was de- 
tected over the last lumbar vertebra, which 
suppurated freely, was opened, and a ball 
flattened about one-half extracted. The 
patient complained no more after the ab- 
scess healed, and has fully recovered. 
Vide journal referred to in which this 
case is published. 
6 
Benjamin D. Lay, 
M. D., now of Cin- 
cinnati, Ohio. 
Shell wound of thigh. 
Death on table in 
about an hour 
and a half. 
S. L. Nidelet, M. 
D , late Ch. Sur- 
geon, Gen Mau- 
ry’s Div., now 
of Mobile, Ala. 
Have written to Dr. Lay several times. 
Ascertained recently that he now resides 
in Cincinnati, Ohio. 
Table I.—Amputations at the Hip-Joint. 6 
CONTRIBUTION TO HIP-JOINT OPERATIONS. 
No. 
Name of operator. 
Name and rank 
of patieut. 
Nature and date of 
injury. 
Date of operation. 
Result. 
Authority. 
Remarks. 
7 
J. T. Gilmore, M D., 
Surg. C. S. A , now 
of Mobile, Ala. 
Private (Wil- 
liamson, he 
thinks), 13th 
Miss. Regiin’t. 
A few days after battle of 
Seven Pines, while on 
picket : femur badly 
shattered. 
Within 3 hours, 
after receipt of 
wound. 
Fully recovered ; 
furloughed and 
returned home. 
Dr. Gilmore. 
At the battle of Cedar Creek, Oct. 19, 1864. 
Dr. G. lost his record of cases. In this 
patient he thinks the recovery was due to 
extra care and being near to Richmond, 
where excellent supplies could then be ob- 
tained. (See further particulars of this case 
and the two next, following these tables.) 
8 
J.T. Gilmore, M.D., 
Surg C. S. A., now 
of Mobile, Ala. 
Member of Gen. 
Barksdale’s 
Miss. Brigade. 
At Malvern Hill. 
Death in a few 
hours after ope- 
ration. 
Dr. Gilmore. 
Dr. Gilmore had all his papers captured in 
Oct. 1864, containing notes of these cases. 
He served nearly the entire war in the 
field, and his ample experience teaches 
him that primary amputation at the hip- 
9 
J T. Gilmore, M. D., 
Surg. C. S. A., now 
of Mobile, Ala. 
Member of Gen. 
Barksdale’s 
Miss. Brigade. 
At Malvern Hill. 
Death in about 48 
hours. 
Dr. Gilmore. 
. 
joint is not a good operation. Neither does 
he favor resection at this articulation. He 
prefers leaving the patients, requiring, as 
is generally supposed, one or the other of 
these operations, to the efforts of nature. 
10 
J. F Grant, M. D , 
Surg. P. A. 0. 8., 
now of Pulaski, 
Teun. 
Private in Maj. 
Douglass’ Bal- 
timore Caval- 
ry- 
Sliot-gnn charged with 
buck and ball cartridge, 
received at four inches; 
extensive comminution 
of femur; near Lavergne, 
Tenn., fall of 1S62. 
Eight hours after 
being shot. 
Fell into enemy’s 
hands; was do- 
ing well 11 days 
after operation ; 
result doubtful. 
Dr. Grant. 
Patient was shot accidentally by a com- 
rade. Lisfranc’s operation was performed. 
We can learn nothing further of this pa- 
tient. (See Dr. G’s own account of this 
and his case of resection, appended to 
these tables.) 
11 
A. M. Fanntleroy, 
M. D., Staunton, 
Va., Surg. C. S. A. 
Private, Co. E, 
43d N. Caro- 
lina Infantry. 
Admitted into hospital 
Dec. 1864, with ampu- 
tated thigh for gunshot 
wound received at Cedar 
Creek ; performed Oct. 
1S64. 
March 11, 186."); 
the b8ne, being 
diseased, was re- 
moved from the 
acetabulum by 
incisions. 
Stump entirely 
healed by 24tli 
April; fully re- 
covered. 
Dr. Fanntleroy, 
in Richm'd Me- 
dical Journal, 
Jan. No., 1866. 
12 
Prof. Edward War- 
ren, M 1)., Surgeon 
C. S. A., now of 
Baltimore, Md. 
Private J. H 
Wolf, Co. D, 
4th Va. Keg’t. 
July 21, 1861, at Manas- 
sas ; ball striking three 
or four inches below tro- 
chanters, resnlting in 
comminution to neck. 
August 22, 1861. 
Death in 30 hours. 
Prof. J. S Davis, 
M. D., of the 
Univ’ty of Vir- 
ginia, at Char- 
lottesville. 
Case was very unfavorable. Patient had 
colliquative diarrhoea. 
13 
W. M Compton, M. 
D., Surg. C. S A., 
2d Tex. Reg , now 
of Holly Springs, 
Miss. 
Private Roberts 
or Robiuson, 
set. about 35. 
March, 1863, at Fort Pem- 
berton,Mississippi; shell 
wound just below left 
hip-joint. 
Immediate. 
Successful, reco- 
vering in a short 
time without an 
unpleasant 
symptom. 
Dr. Compton. 
A year afterwards, his surgeon in charge 
reported the patient in fine health aud 
spirits. (See full account of this case by 
Dr. C., and Nos. 14 and 15, following the 
tables.) 
Table I.—Amputations at the Hip-Joint—Continued. CONTRIBUTION TO HIP JOINT OPERATIONS. 
7 
No. 
Name of operator. 
Name and rank 
of patient. 
Nature and date of 
injury. 
Date of operation. 
Result. 
Authority. 
Remarks. 
14 
W. M. Compton, M. 
D., Surg. C. S. A., 
2d Tex. Reg., now 
of Holly Springs, 
Miss. 
Lieutenant, set. 
about 28 or 30; 
an Arkansas 
regiment, Ca- 
bell’s Brigade. 
At Corinth, Oct. 3, 1862; 
solid shot tearing away 
soft parts and shivering 
femur into acetabulum. 
On the field; right 
hip. 
Did well for 7 or 8 
days, when ery- 
sipelas seized 
the wound, and 
he died in 36 hrs. 
Dr. Compton. 
The notes of these cases were lost before 
the close of the war. 
15 
W. M. Compton, M. 
D., Surg. C. S. A., 
2d Tex Reg., now 
of Holly Springs, 
Miss. 
Private Cooper, 
set. about 20; 
an Alabama 
regiment. 
At Vicksburg ; terrible 
shell wound of right 
hip, comminuting upper 
third of femur, &c. 
Death; no reac- 
tion took place; 
this was a des- 
perate case. 
Dr. Compton. 
See account of these cases from letter of 
Dr. C., Nos. 
16 
Surg Itich’d Potts, 
A young man 
At Belmont : gunshot 
Operation by an- 
Death 10 hours 
Prof. D. D. Saun- 
Dr. Potts, lately deceased. From four dif- 
M. D., late P. A. 
C. S., formerly of 
U. S. Army. 
named Jack- 
son, set. about 
21 years. 
wound fracturing femur 
badly. 
tero - posterior 
flaps, some time 
after injury, at 
least 6 or 8 days. 
after operation. 
ders, M. D., of 
Memphis, Tenn. 
ferent sources I have received the npiuion 
that this was an untimely operation. (See 
what Dr. S. says in reference to it, in let- 
ter following the tables.) 
17 
R. A. Kinlock, M. 
D., Surg. P.A.C.S., 
now in Charles- 
ton, S. C. 
Private, 56tli 
Mass. Colored 
Regiment. 
Wounded at Battery Wag 
ner, Charleston; shell 
striking, head of femur 
and brim of acetabulum. 
July 13, 1863. 
Died in about 20 
hours. 
Dr. Kinlock. 
Manec’s operation was performed in this 
case. 
18 
R. P. Bateman, M. 
D., Surg. C. S. A., 
now of Memphis, 
Tenn. 
John Chamber- 
lain, private 
in U. S. army. 
Minie ball through neck 
of femur, comminuting 
bone extensively. 
September, 186.3, 
24 hours after 
injury. 
Death in 36 hours. 
Dr. Bateman. 
y These men were left on the field of Chicka- 
mauga. 
19 
R. P. Bateman, M. 
D., Surg. C. S A., 
now of Memphis, 
Tenn. 
James Carden, 
private in U.S. 
army. 
Shell wound, producing 
extensive laceration with 
comminution of femur. 
September, 1863, 
24 hours after 
injury. 
Death on the 6th 
day. 
Dr. Bateman. 
20 
A. C. Crymes, M.D., 
late Assist. Surg. 
39th Ala. Infantry, 
now of Eufaula, 
Ala. 
Death. 
Dr. C.Toxey, late 
Surg. 19th Ala. 
Inf’y; through 
Dr. C. H. Mastin, 
of Mobile, Ala. 
V 8 
CONTRIBUTION TO HIP-JOINT OPERATIONS. 
No. 
Name of operator. 
Name and rank 
of patient. 
Nature and date of 
injury. 
Date of operation. 
Result. 
Authority. 
Remarks. 
1 
Prof. Jas. B. Read, 
M. D., then Surg. 
C. S. A., now of 
Savannah, Ga. 
J. M. Jarrett, 
Lieut., Co. C, 
15th N. Caro- 
lina Infantry, 
set. 28. 
At Bristow, October 14, 
1863 ; struck by Minie 
ball two inches below 
Poupart’s ligament, 
fracturing and commi- 
nuting the left femur. 
Entered Hospital No. 4, 
Richmond, Va., Octo- 
ber 20; operation per- 
formed under chloro- 
form, Nov. 9. 
Successful; Dec. 9, the 
limb is shortened 5 
inches, and the wound 
nearly healed ; patient 
cheerful ; can move 
himself with ease and 
facility in bed. 
Dr. Read, in the 
Jan. No , 1864, 
Confed. States 
Med. and Sur- 
gical Journal. 
2 
Prof. Jas. B. Head, 
M. D., then Surg. 
C. S. A , now of 
Savannah, Ga. 
Alfred Tonoy, 
private, 16th 
North Caroli- 
na Infantry. 
Wounded 30th June, 
1863, in left buttock; 
ball lodged ; thought 
to be doing well. 
Aug. 11, under chloro- 
form ; the finger en- 
tered acetabulum ; 
found round ligament 
severed, head of femur 
fractured, and ball in 
the joint; cotyloid ca- 
vity broken across. 
Died eighth day, from 
hectic fever; had much 
improved in 24 hours 
after operation. 
Dr. Read, in the 
Jan. No., 1864, 
Confed. States 
Med. and Sur- 
gical Journal. 
3 
Prof. Miltenburger 
W. F. Hum- 
Wounded four times at 
At Frederick, Md., five 
weeks after being 
Successful; after nine 
Editor Confed. 
If only an inch shortening of the 
performed a sec- 
phreys, Co. H, 
South Mountain, one 
mouths this patient re- 
States Medical 
limb, the recovery with so little 
ond resection up- 
on shaft of bone. 
1st Va. Reg’t. 
ball fracturing neck of 
femur 
wounded. 
covered, with a short- 
ening less than an inch. 
and Surgical 
Journal, 1864. 
deformity is quite remarkable. 
4 
Surg. Ladd, M. D., 
of Ransom’s Bri- 
gade and Ca. 
Private in a N. 
Carolina regi- 
ment. 
Summer of 1864, during 
bombardment of Pe- 
tersburg ; gunshot 
wound, and comminu- 
tion of head of femur. 
Performed a few hours 
after the patient was 
brought from field. 
Considered successful, 
for patient lived over 
60 days, and then died 
for want of proper 
nourishment. 
Dr. J. D. Jack- 
son, then in the 
service, who 
witnessed the 
operation; he 
is now of Dan- 
ville, Ky. 
See letter from Dr. Chas. J. O’Hagan. 
5 
Surg. J. F. Grant, 
M.D., C.S.A., now 
of Pulaski, Tenn. 
T. J. Hobson, 
private, Co. H, 
32d Tenn. Re- 
giment, set. 23. 
Battle Kennesaw Moun- 
tain, June 24, 1864; 
compound commiuut- 
ed fracture of femur, 
extending into the 
joint. 
Operation 12 hours af- 
ter receipt of injury, 
under chloroform. 
Died 3 days after ope- 
ration, having never 
fully reacted. 
Dr. Grant. 
6 
Surg. B. W. Avent, 
M. D., Medical Di- 
rector in C. S. A. 
An officer. 
Gunshot fracture of 
neck of femur; two fin- 
gers at entrance and 
exit fully explored the 
wound. 
Wound dilated at en- 
trance, and spiculae 
removed with saw and 
forceps. 
Lingered for months, 
but finally recovered 
with a limb 4 inches 
short, but able to walk 
with assistance of a 
cane. 
Dr. Avent. 
Table II.—Resections at the Hip-Joint. CONTRIBUTION TO HIP-JOINT OPERATIONS. 
9 
—* 
No. 
> 
Name of operator. 
Name and rank 
of patient. 
Nature and date of 
injury. 
Date of operation. 
Result. 
Authority. 
Remarks. 
7 
Surg. Cullen, M.D., 
of General Long- 
street’s Staff. 
Private in a 
Michigan re- 
giment. 
Wounded and captured 
in front of Knoxville, 
Tenn. 
Kdoxville, Tenn., when 
invested by the Con- 
federates. 
Was recaptured 6 days 
after the operation; 
probably died, as the 
case was unpromising. 
Dr. J. T. Gil-' 
more. 
Notes captured in the valley of 
8 
J. T. Gilmore, M.D. 
.... 
.... 
Death. 
Dr. J. T. Gil- 
more. 
Virginia. 
9 
J. T. Gilmore, M.D. 
DeatJj. 
Dr. J. T. Gil- 
more. 
10 
Dr. M. J. Ash, U. S. 
Army, of Philadel- 
phia, Pa. 
At Gettysburg; head, 
neck, and trochanters 
of femur comminuted 
by a grape-shot. 
28 days after receipt of 
wound ; about inch- 
es were sawed off with 
head. 
Successful. 
I). D. Saunders,' 
M.D., late Sur- 
geon C. S. A., 
now of Mem- 
phis, Tenn. 
Patient was a healthy man, set. 23. 
Eighteen months after operation, 
could walk with a stick. Limb 
shortened three inches. Had some 
motion at the joint. 
11 
None mentioned. 
.... 
Primary. 
Death 23 days after ope- 
ration. 
D. D. Saunders, 
M. D., etc. 
D. D. Saunders, 
M. D., etc. 
’These three cases are reported in 
the April No., 1866, Memphis Med. 
and Surg. Monthly. The fatal 
cases resulted from exhausting 
suppuration. 
12 
None mentioned. 
.... 
Primary. 
Death 25 days after ope- 
ration. 
13 
J. Dickson Bruns, 
Surg. C. S. A., now 
Professor in New 
Orleans School of 
Medicine. 
Private. 
Gunshot wound of hip- 
joint ; Minie ball. 
Resection through site 
of injury. 
Death from excessive 
suppuration. 
Dr. Bruns. 
This is all the account I have re- 
ceived of this case from the ope- 
rator. 10 
CONTRIBUTION TO HIP JOINT OPERATIONS. 
History of Case No. 1. Surgeon Buist.—A. B., a private in 27tli 
Tennessee Regiment, Maney’s Brigade, Cheatham’s Division, re- 
ceived a wound from a solid shot at battle of Jonesboro’, Georgia, 
August 30, 1864. Two hours after receipt of wound was brought 
to field hospital in the following condition: The shot had struck the 
upper third of right thigh, carrying away a large portion of soft 
tissue on the outer and posterior section of the limb, reaching nearly 
to the lower border of the gluteal region and exposing the femur, 
which was terribly comminuted and apparently fissured through 
trochanters and neck at least. The general condition of the patient 
was remarkably good, considering the character of the wound. 
His pulse was strong enough to send out the blood in jets from the 
arteries when the compression was removed. The skin was quite 
natural and warm, he was quiet and self-composed, but, of course, 
somewhat depressed. 
Upon consultation with the medical staff of Cheatham’s Division 
present at the hospital, it was decided to amputate at the hip, as 
such a procedure afforded the only chance of life to the patient. 
He was placed on the table, stimulants and chloroform given, and 
the limb removed in the following manner: A large amputating 
knife was passed in just above and close to the trochanter, carried 
over the neck of the femur, and brought out at the inner surface of 
the thigh some two inches below the pubes, and a long anterior flap 
thus formed. While an assistant compressed the artery at the brim 
of the pelvis with both thumbs, another followed the track of the 
knife with his fingers grasping the flap as soon as formed. The 
hemorrhage was well controlled. With a scalpel the remaining soft 
parts were divided, and the limb removed. The vessels were at 
once tied, the flap drawn up, while the operator proceeded to remove 
the head of the femur. The bone was seized with a stout pair of 
tooth-forceps, and the ligaments divided with the scalpel. An inch 
or two of tissue was then trimmed off’the upper margin of the wound 
so as to smooth off and fashion a posterior short flap. Some ten or 
twelve ligatures were required; the flaps brought together half an 
hour after the operation, and with some difficulty pretty fair appo- 
sition was effected. The loss of blood during the operation was not 
great, but he was more depressed than previous to it. Cold water 
dressings were applied to the wound and stimulants given at proper 
intervals. He remained sensible for six or eight hours after being 
removed from the table, though constantly growing weaker. He CONTRIBUTION TO HIP JOINT OPERATIONS. 
11 
died sixteen hours after being wounded and thirteen hours after 
the operation. 
Cases Nos. 7, 8, and 9.—Dr. J. T. Gilmore, now a practitioner of 
Mobile, Alabama, writes to me March 28, that he operated by ampu- 
tation three times at the coxo-femoral articulation. 
Case 1. A private in 13th Miss. Regiment, wounded on picket a 
few days after the battle of Seven Pines. The femur was so badly 
shattered that amputation was resorted to. He remained in the 
country several weeks after the operation, and was then removed to 
Richmond. I heard from his friends that he recovered entirely, and 
went home. I lost my record of cases at the battle of Cedar Creek, 
October 19,1864, and am, therefore, unable to give the name of this 
patient, but I think it was Williamson. He was a young man, about 
20 years of age, of fine constitution, and was operated on within three 
hours after receipt of the injury. In order to give him every possi- 
ble chance for recovery, I kept him under my own care, and sent to 
Richmond from time to time for such supplies as were necessary to 
sustain him under the great shock and excessive suppuration that 
usually follow this operation. I am convinced that he would have 
died, had he been treated as the wounded usually are after a battle. 
I, therefore, regard this case, though successful, as not a fair crite- 
rion by which to judge of amputation at the hip-joint, especially a 
primary operation, in military surgery. 
The other two cases were members of General Barksdale’s Miss. 
Brigade, wounded at the battle of Malvern Hill. One of them sur- 
vived the operation only a few hours* the other about 48 hours. I 
had a full record of the above cases, and intended to publish them 
on the first opportunity, but the defeat of our army under General 
Early, in the valley, enabled the enemy to capture all my papers. 
I had notes of about 50 cases of resection of the shoulder-joint, and 
about 40 of the elbow, with three cases of resection of the hip-joint, 
all of which I lost on the above occasion. 
Two of the cases of resection of the hip died. The other, a case 
operated on by surgeon Cullen, of General Longstreet’s Staff, at 
Knoxville, Tenn., when our forces invested that place, was living 
at the time our army withdrew, some six days after the opera- 
tion. His condition was not promising the last time I saw him. 
He was a private in a Michigan Cavalry Regiment, wounded and 
captured a few days after our arrival in front of Knoxville. I was 
in the field nearly the entire war, and my experience teaches me 12 
CONTRIBUTION TO HIP JOINT OPERATIONS. 
that amputation of the hip-joint is not a good operation in gunshot 
wounds. 
I recollect some six cases, that would have required amputation 
at this joint, which recovered without an unpleasant symptom. One 
case wounded at the battle of Fredericksburg, a Mississippian; two 
cases wounded at Chancellorsville, Georgians, and the remaining 
cases wounded at Gettysburg, two of them of Kershaw’s South 
Carolina Brigade, and the other of a Georgia Brigade. 
I believe that one third of the cases of gunshot wounds of the 
femur, usually supposed to require amputation at the hip-joint, will 
recover if left entirely to the efforts of nature; and I am confident 
that a much larger percentage will die if subjected to either ampu- 
tation or resection. 
Dr. Grant's Cases of Amputation and Resection.—No. 10, Ampu- 
tation, and No. 5, Resection. The letter is dated Pulaski, Tenn., 
March 30, 1867. • 
The only case of amputation of the hip-joint, that I have any 
personal knowledge of was performed by myself in 1862, upon a 
private soldier of Major Douglas’s Battery Cavalry, whose name I 
do not recollect. The wound was inflicted by a double-barrelled 
shotgun, charged with buck and ball cartridge. The muzzle was 
within a few inches of the patient, the charge passed directly 
through the thigh, just below the trochanters, fracturing and com- 
minuting the bone, with extensive laceration of soft parts. 
The operation was performed about eight hours after receipt of 
the wound, and chloroform was given to complete anaesthesia. Lis- 
franc’s method was selected; by transfixing the parts with a twelve 
inch knife, entering an inch below the anterior superior spinous 
process of the ilium, passing it out near the tuberosity of the ischium, 
a flap about five inches long was made; then another one internal, 
and the head of the bone disarticulated. 
I saw the man three days after the operation, when he had 
thoroughly reacted, and seemed to be doing well. He fell into the 
hands of the Federals the same day. I never saw him afterwards, 
but received a message from him on the eleventh day after the 
operation, stating that he was doing well; this was my last intelli- 
gence from him, I do not, therefore, know whether he lived or 
died. 
The patient was left at a private house on the Murfreesboro’ turn- 
pike, between Lavergne and Nashville; the name of the family CONTRIBUTION TO HIE JOINT OPERATIONS. 
13 
does not occur to me, but I think it was the house of a widow lady. 
You may have an opportunity of learning something of it yourself. 
It was in the fall of 1862. 
I know of but one case of resection at the hip-joint; that I per- 
formed at the battle of Kennesaw Mountain. I will give you the 
case as recorded upon my note book. 
T. J. Hobson, private Co. H. 32d Tenn. Regiment; compound 
comminuted fracture of the femur near the trochanter major, ex- 
tending into the joint. Operation; linear incision ten inches long 
over the prominence of this trochanter; muscles dissected down to 
bone, the head removed, lower fragment turned, and the end sawed 
off below the fractured part with a straight saw; very slight hemor- 
rhage ; chloroform was administered to total anaesthesia. Opera- 
tion performed twelve hours after receipt of wound. Amputation 
was not at all practicable, except at the hip-joint. I chose resec- 
tion as giving in my judgment the best chance for recovery. His 
age was 23 years; health good. Never fully reacted from shock 
of injury and operation, but died on 27th day of June, 1864, three 
days after it. 
Account of Drs. Felton's and Lay's Cases, Nos. 11 and 12, in a 
letter from Dr. Charles H. Mastin, of Mobile, Alabama. 
My friend Or. S. L. Nidelet, of this city, who was surgeon ot 
General D. H. Maury’s Division, at the battle of Corinth, under 
Generals Van Dorn and Price, in 1863, gave me the statement ot 
two cases of hip-joint amputation, as follows:— 
Case 1. A man sent to Iuka, after that battle, had his hip-joint 
disarticulated by surgeon Felton of Colonel Dockery’s Regiment, 
Arkansas Volunteers, think it was the 19th, wound of right thigh 
from conical ball, April, 1863. 
Result of case: patient died on the table. The operation was 
performed at least a month after reception of the wound. Surgeon 
Felton himself died of a congestive fever, at Jackson, Miss., in 
June, 1863. 
Case 2. A soldier who was wounded at Vicksburg, June, 1863.. 
Operated on immediately at Marine hospital, by surgeon B. D. Lay, 
then in charge of that hospital. Result: death in an hour, before 
being removed from table. Dr. Nidelet is a gentleman upon whose 
statements I can fully rely. 14 
CONTRIBUTION TO HIP-JOINT OPERATIONS. 
Dr. Compton’s Cases, Nos. 13, 14, and 15. 
I comply with your request with reluctance, because my neces- 
sary want of accuracy in the detail of the cases of hip-joint ampu- 
tation, performed by me during the war, will add very little, if 
anything, to the value of the proposed statistics. As I stated in 
my letter to you, all my notes and memoranda were lost. But 
since you insist upon it, I will give you such of the particulars as 
occur to my recollection now, and from this you can select such 
items as will suit your purpose. 
Case 1. Lieut. , set. about 28 or 30 years, of an Arkansas 
Regiment, Cabell’s Brigade, was wounded by a supposed solid shot 
at the battle of Corinth, Oct. 3, 1862. The ball struck the right 
hip, making a terrible wound about the buttock, tearing up the 
attachments of the gluteal muscles, and struck the femur about the 
trochanter major. The bone was shivered for four or six inches of 
its body. The head was split, and lay exposed in the acetabulum. 
The operation consisted in paring the edges of the wound; then 
with a long knife, I commenced the incision just in front of the 
upper end of the lower fragment of bone, bringing it down to, 
perhaps, a little lower than the middle of the thigh, and thus made 
a flap of the anterior portion of the thigh, which I adjusted with 
tolerable accuracy to the wound above after removing the head 
from the cavity and securing the arteries. The patitnt had a dif- 
ficult recovery from the shock. For seven or eight days, he seemed 
to do well, and the inflammation did not run high. His appetite 
was becoming good, and I began to have strong hopes of his reco- 
very. At about the end of this period, erysipelas seized the wound 
and extended rapidly in spite of tincture of iron and such other 
treatment as I thought proper to institute, and the poor fellow died 
in less than thirty-six hours. 
Case 2. Private Roberts or Robinson, aet. about 35, of a Louisi- 
ana Regiment, wounded in March, 1863, at Fort Pemberton, on the 
Yazoo River, by a fragment of shell from a gun-boat. I was stand- 
ing within a few fee#t of him, and seeing him fall, I ran to his assist- 
ance. Ripping open his pants, I found that one-half of a twenty-four 
pounder, after entering on the left or outside, had imbedded itself 
in the centre of the upper portion of the left thigh, driving out a 
section of the bone just below and wounding the femoral artery. 
An assistant controlled the hemorrhage, while I made an irregular 
circular incision around the limb at the upper margin of the wound, 
dissected out the head of the bone, trimmed away a considerable CONTRIBUTION- TO HIP JOINT OPERATIONS. 
15 
quantity of lacerated tissue, tied the arteries, and, finally, adjusted 
the parts quite accurately. This was all done and the patient in 
bed in less than an hour after receipt of the wound. Strange to say, 
the shock appeared not to have affected him much. The decline 
of the pulse was insignificant. After recovering from the anaesthetic, 
he was cheerful, and even jocular. Subsequently his symptomatic 
fever was slight, and his appetite never failed him. I treated him 
for three or four days, and then sent him to the hospital at Yazoo 
City. A year after I met Surgeon Green (who was in charge of 
it) at Marion, Alabama; he told me that my patient had recovered 
and gone home, in a short time after his admission, in fine health. 
Since which I have not heard from him. 
Case 3. Private Cooper, set. about 30, Alabama Regiment, 
wounded at siege of Vicksburg by a shell, producing fearful lacera- 
tion of the right hip. The upper third of the femur was commi- 
nuted, tuberosity of the ischium fractured, with the wound extend- 
ing into the rectum. I only operated because the poor fellow 
begged me to do so. The hemorrhage had been great. I operated 
mainly as in Case 2, making a flap of the anterior aspect of the 
thigh; dressed the wound, stimulated as actively as I could, but he 
never recovered from the shock; and thus ended my third, and, I 
trust, my last case of amputation at the hip-joint. 
Case 4, of Resections.—Dr. Chas. Jas. O’Hagan, of Glenville, 
N. C., writes:— 
I assisted Dr. Ladd in the operation, and know more, perhaps, 
of the after-treatment of the case than he does. But I am unable 
to give the name or company of the patient because he did not 
belong to my command, and I kept no notes of the case. 
Private , 56th North Carolina Regiment, Ransom’s Brig- 
ade, was wounded on the night of the 17th of June, 1864, in front 
of Petersburg, by a rifle ball, conical, I presume, in the right thigh. 
It entered on the inner aspect of the limb and passed obliquely 
upwards and outwards, producing a comminuted fracture of the 
neck of the femur and driving the fragments of bone into the sur- 
rounding tissues. The shaft of the bone was not shattered, and as 
the man was very much worn and exhausted, as most of our troops 
were at that time, it was considered advisable to perform resection 
of the head and neck of the femur, as offering a better chance of re- 
covery than amputation. 
The operation was performed on the 18th, twelve hours after the 16 
CONTRIBUTION TO HIP-JOINT OPERATIONS. 
reception of the wound, and the bone removed at the trochanter 
major. He bore the operation well, and, although weak, was hope- 
ful. He was sent to the Fair Ground Hospital, from which he was 
removed in a few days, placed in a tent, and attended by Dr. Ladd 
and myself. 
He survived the operation two months, and succumbed at last to 
suppuration, caused, as I verily believe, by the want of proper food 
and stimulants, and the general prevalence of pyemic poison, which 
attacked nearly all our cases which were in the neighborhood of 
that hospital. 
Statement of Dr. Potts' Case, No. 16 (in a letter from Dr. Saun- 
ders, of Memphis, Tenn.):— 
The case operated upon by Dr. Potts was on a young man named 
Jackson, set. about 21 years, and in fine health. The injury was a 
gunshot wound, the ball entering, as well as I remember, about the 
trochanter major, fracturing the bone badly. I am not positive 
whether the fracture extended into the capsular ligament. The 
amputation was by antero-posterior flaps. The patient lived some 
eight or ten hours afterwards. This was an intermediate operation. 
I now know positively that these twenty cases are not all that 
were operated upon during the war in the Southern States. 
Dr. Josiah C. Nott, now moved to Baltimore, Md., wrote me, in 
March last, that he knew personally of no case worth reporting, 
but says he performed the operation of amputation at the hip-joint 
while attached to General Bragg’s Army. In every instance he 
had to abandon the cases in consequence of constant movements of 
the troops in the field, and had neither time nor opportunity to take 
notes. 
The late Dr. Hargrove Ilinkley, who recently died in Demopolis, 
Alabama, is reported to have operated twice in the battles before 
Jackson, Mississippi, in 1863; one said to have been successful. I 
have failed as yet to obtain the particulars of these cases. 
I also learn that Dr. Cowan, late Surgeon on General Forrest’s 
staff, operated three or four times by amputation and resection. I 
have received no reply to my applications to him. 
I learn through Dr. Mastin, that Dr. Crymes, of Eufaula, Ala 
bama, had another amputation at the hip-joint besides the one 
registered in my tabular statement. 
I think it probable, however, that the above statistics embrace a CONTRIBUTION TO HIP-JOINT OPERATIONS. 
17 
pretty accurate account of these operations performed in the service 
on the Southern side; probably, at least, of all the successful cases, 
since they naturally would be first reported. 
In the analysis of this collection I do not think a question can 
arise as to the success of four in the twenty cases, and one is marked 
doubtful. Dr. East’s is published a success in one of our journals, 
and a member of this Association now present, Dr. Heard, of Gal- 
veston, told me this very week that he was consulted himself in the 
case, and knows it to be authentic. He, moreover,- states that the 
operator was at the time, or had been, in the Southern army. Dr. 
Gilmore’s was furloughed home; Dr. Compton’s was well a year 
afterwards; and Dr. Fauntleroy’s has been published to the world 
in a medical journal. 
This gives a success of four in twenty cases of amputations, or 
one in five. Three of these recovered after primary amputation, 
and one after secondary. 
Of the thirteen cases of resections, five may be considered suc- 
cessful, or one in two and a half. Two after primary, two after 
secondary, and one intermediate (six hours) recovered. 
A comparison now of these two operations at the hip-joint gives 
this result. Resection doubly as favorable as amputation. 
In Circular No. 6, Oct. 1865, War Department, Surgeon-General’s 
Office, Washington City, is given a table of twenty-one hip-joint 
amputations with three successful results. One of these is proved 
to have been erroneous, which reduces the cases of recovery to one 
in ten, being precisely double the mortality that my statistics make 
it to have been in the Southern service; and of thirty-two cases of 
resection or excision of the head of the femur only four recovered, 
being a recovery of only one in eight, a fatality nearly four times 
greater than on the Southern side. 
Thus has the investigation of this interesting subject during the 
past two months, by the request issued from the office of the Sur- 
geon-General, led the searcher unwittingly to a most favorable 
result on the side least expected when we consider the destitute 
and isolated condition of the South during the war.