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Head Toney

Medical and Report of Death of Alfred Toney, 16th North Carolina.

Private Alfred Toney, Co. A, 16th North Carolina, aged 43 years, a farmer by profession, was wounded June 30, 1863, and admitted to hospital No. 4, Richmond, on the same day. A conoidal musket ball had entered the left buttock and lodged. No particular attention was called to this case for so me time. The patient seemed to be doing well. On August 11th, however, he complained of great pain in the knee and ankle; the slightest touch caused great anguish. The foot was oedematous. Chloroform was administered, and digital examination of the wound was made. The finger could pass but half an inch into the wound until the limb was carried forward; it then could be passed into the cotyloid cavity, and the ball was found in the acetabulum. The round ligament was severed and the head of the femur was ascertained to be slightly fractured and deprived of its cartilage. Excision of the head of the femur was decided upon, and on August 12th, Surgeon James B. Head, P. A. C. S., proceeded to operate. The patient was laid on his face, and his buttocks were brought to the edge of the table. A straight incision was commenced two inches below the anterior superior crest of the ilium and carried downward to one inch below the trochanter major. The muscles were then separated, and the joint exposed. The head was then dislocated by forcibly bringing the leg under the table. The soft parts were protected by a spatula and the head was sawn off. The ball was removed from the cotyloid cavity, which was found to be broken across and the cartilage loosened. The wound was then closed by sutures and the patient was removed to his bed. He suffered no pain, and in twenty-four hours the swelling had subsided. His general condition was very feeble, and he was freely stimulated during the after-treatment. He died August 19, 1863, eight days after the operation, exhausted by hectic fever. There is no account of any abdominal disturbance or pyaemia symptoms resulting from the fracture of the acetabulum.

SOURCE: Medical and Surgical History of the War of the Rebellion. Volume 2, Part 3.

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