Age: 19
Date Enrolled: 1862/03/27
Where Enrolled: Indianapolis, Indiana
Regiment: 7
Company: K
Discharge Date: 1863/12/14
Notes: Recruit. Died, buried in Military Asylum Cemetery, Washington, DC
Cavalry/ Battery Unit:
Name: David Rapp
"Case 98. — Private D. Rapp, Co. K, 7th Indiana, aged 20 years, was wounded at Robinson's Creek, November 30, 1863. He was admitted to the field hospital of the 1st division, First Corps, where Surgeon G. W. Metcalf, 76th New York, noted: "Gunshot wound of left thigh." On December 6th, the wounded man was transferred to Douglas Hospital, Washington. Three days afterwards he was operated on by Assistant Surgeon W. Thomson, U. S. A., who furnished the following detailed report of the case: He was a well developed and very muscular man and had been apparently in good health. At the moment of injury be was retreating, and was struck by a bullet on the posterior aspect of the left thigh a short distance below the gluteal fold, which passed through the limb to the inside of the bone, divided both femoral artery and vein, and made its exit three and a half inches below Poupart's ligament, at the point of election in ligating the femoral in Scarpa's space. There was profuse haemorrhage at the time of injury, and an immediate want of sensibility in the leg and foot. When examined on the 7th of December, the whole limb was found warm and the collateral circulation had been established; but there was no pulsation in either of the tibial arteries. At the superior margin of the wound of exit there was a small tense swelling, which pulsated synchronously with the systole of the heart. An aneurismal thrill, resembling the loud purring of a cat, was distinctly felt, extending along the course of the vessels into the pelvis, but not communicating laterally. The little finger was introduced into the wound at the time of the operation, and the pulsation and thrill were found to be closely localized and confined to the divided ends of the femoral vessels. There was no extensive effusion of blood into the tissues of the thigh, and hence this was not in the strict surgical sense of the word a traumatic aneurism. It was concluded that the sac was composed only of the sheath, which had been united by inflammation after the division and retraction of its vessels, and had then been somewhat distended after the heart had regained its force. It was also suggested by Surgeon Lidell, who kindly saw the case with me, that there was a free communication between the divided artery and vein in this sac which permitted the arterial blood to return freely by the vein, as evinced by the pulsation communicating with such force backward toward the heart in the line of the vessels. It was unmistakable that there existed a wound of the femoral artery sufficient to cause its obliteration, that an aneurism was being developed at the divided proximal extremity, and that the proper surgical procedure would be to secure the ends of the vessel at the point of the injury. It was determined to emulate the example of Mr. Syme, to lay open boldly the sac by a free incision and search for and secure the bleeding orifices. It was hoped that the profunda had escaped injury, and every precaution was to be used to secure the femoral below its origin. A small haemorrhage on December 9th rendered immediate interference necessary, and the following operation was then done with the assistance of Surgeon Lidell and the medical officers of the hospital. After the patient had been fully etherized and the femoral artery thoroughly compressed on the pubes by the thumb of a reliable assistant, as evinced by the loss of pulsation in the tumor, an incision four inches in length was made through the skin and fascia; immediately over the tumor and including the gunshot wound, in a line parallel with the sartorius. A second incision was now made into the tumor, which was dilated instantly by the finger to the size of the first...The first vessel tied was, therefore, the proximal extremity of the femoral vein near the entrance of the saphena; the second, the femoral artery a short distance below the origin of the profunda, both at the superior angle of the incision; the third, the femoral artery at the lower angle of the incision and two inches from its distal extremity; the fourth, the femoral vein near its distal extremity at the centre of the incision, and to control a flow from an incision through its coats, which may have been made accidentally. The profunda had not been seen, and it was hoped that it would suffice to keep up the circulation. No important arterial channels had been interfered with by the operation, and a successful issue might be expected. The man was stimulated, took morphia, and his leg was covered closely in bed with blankets to preserve the animal warmth. This man had lost blood freely at the time of the injury; he had been subjected to a very long and fatiguing transport in ambulances and cars before reaching the hospital, and for seven days his food had not been as good or sufficient as might have been desired for one about to undergo such an operation. He was pallid and haggard looking, and iron, nutrients, and stimulants were freely ordered. There was great pain and restlessness during the ensuing night, and large quantities of morphia were required to procure sleep. December 10th, no interference with the circulation; leg and foot both warm. The whole limb is swollen, and bloody serum escapes freely at the point of the injury. December 12th, the restlessness has been the most marked symptom, caused seemingly by constant and severe indescribable pain in the limb. The pulse is 120. the countenance pale and haggard, the tongue dry and coated, and the general symptoms indicate great nervous prostration. Large quantities of morphia have been found requisite. The whole limb and foot are much swollen and oedematous. On the evening unmistakable signs of sphacelus appeared, the foot became cold, and a hue of purple discoloration was observed as high up as the ankle. The neuralgic pain and restlessness still continued. On December 13th, all the symptoms were worse. The discoloration, the dark purple hue of gangrene, extended rapidly upward, particularly on the inside of the limb. The whole thigh became crepitant, the pulse more rapid and feeble. He became more and more depressed, and finally died at 12 o'clock at night." -- The Medical and Surgical History of the War of the Rebellion. Part III, Volume II. (3rd Surgical volume) by U. S. Army Surgeon General's Office, 1883.
Age: 19
Date Enrolled: 1862/03/27
Where Enrolled: Indianapolis, Indiana
Regiment: 7
Company: K
Discharge Date: 1863/12/14
Notes: Recruit. Died, buried in Military Asylum Cemetery, Washington, DC
Cavalry/ Battery Unit:
Name: David Rapp
"Case 98. — Private D. Rapp, Co. K, 7th Indiana, aged 20 years, was wounded at Robinson's Creek, November 30, 1863. He was admitted to the field hospital of the 1st division, First Corps, where Surgeon G. W. Metcalf, 76th New York, noted: "Gunshot wound of left thigh." On December 6th, the wounded man was transferred to Douglas Hospital, Washington. Three days afterwards he was operated on by Assistant Surgeon W. Thomson, U. S. A., who furnished the following detailed report of the case: He was a well developed and very muscular man and had been apparently in good health. At the moment of injury be was retreating, and was struck by a bullet on the posterior aspect of the left thigh a short distance below the gluteal fold, which passed through the limb to the inside of the bone, divided both femoral artery and vein, and made its exit three and a half inches below Poupart's ligament, at the point of election in ligating the femoral in Scarpa's space. There was profuse haemorrhage at the time of injury, and an immediate want of sensibility in the leg and foot. When examined on the 7th of December, the whole limb was found warm and the collateral circulation had been established; but there was no pulsation in either of the tibial arteries. At the superior margin of the wound of exit there was a small tense swelling, which pulsated synchronously with the systole of the heart. An aneurismal thrill, resembling the loud purring of a cat, was distinctly felt, extending along the course of the vessels into the pelvis, but not communicating laterally. The little finger was introduced into the wound at the time of the operation, and the pulsation and thrill were found to be closely localized and confined to the divided ends of the femoral vessels. There was no extensive effusion of blood into the tissues of the thigh, and hence this was not in the strict surgical sense of the word a traumatic aneurism. It was concluded that the sac was composed only of the sheath, which had been united by inflammation after the division and retraction of its vessels, and had then been somewhat distended after the heart had regained its force. It was also suggested by Surgeon Lidell, who kindly saw the case with me, that there was a free communication between the divided artery and vein in this sac which permitted the arterial blood to return freely by the vein, as evinced by the pulsation communicating with such force backward toward the heart in the line of the vessels. It was unmistakable that there existed a wound of the femoral artery sufficient to cause its obliteration, that an aneurism was being developed at the divided proximal extremity, and that the proper surgical procedure would be to secure the ends of the vessel at the point of the injury. It was determined to emulate the example of Mr. Syme, to lay open boldly the sac by a free incision and search for and secure the bleeding orifices. It was hoped that the profunda had escaped injury, and every precaution was to be used to secure the femoral below its origin. A small haemorrhage on December 9th rendered immediate interference necessary, and the following operation was then done with the assistance of Surgeon Lidell and the medical officers of the hospital. After the patient had been fully etherized and the femoral artery thoroughly compressed on the pubes by the thumb of a reliable assistant, as evinced by the loss of pulsation in the tumor, an incision four inches in length was made through the skin and fascia; immediately over the tumor and including the gunshot wound, in a line parallel with the sartorius. A second incision was now made into the tumor, which was dilated instantly by the finger to the size of the first...The first vessel tied was, therefore, the proximal extremity of the femoral vein near the entrance of the saphena; the second, the femoral artery a short distance below the origin of the profunda, both at the superior angle of the incision; the third, the femoral artery at the lower angle of the incision and two inches from its distal extremity; the fourth, the femoral vein near its distal extremity at the centre of the incision, and to control a flow from an incision through its coats, which may have been made accidentally. The profunda had not been seen, and it was hoped that it would suffice to keep up the circulation. No important arterial channels had been interfered with by the operation, and a successful issue might be expected. The man was stimulated, took morphia, and his leg was covered closely in bed with blankets to preserve the animal warmth. This man had lost blood freely at the time of the injury; he had been subjected to a very long and fatiguing transport in ambulances and cars before reaching the hospital, and for seven days his food had not been as good or sufficient as might have been desired for one about to undergo such an operation. He was pallid and haggard looking, and iron, nutrients, and stimulants were freely ordered. There was great pain and restlessness during the ensuing night, and large quantities of morphia were required to procure sleep. December 10th, no interference with the circulation; leg and foot both warm. The whole limb is swollen, and bloody serum escapes freely at the point of the injury. December 12th, the restlessness has been the most marked symptom, caused seemingly by constant and severe indescribable pain in the limb. The pulse is 120. the countenance pale and haggard, the tongue dry and coated, and the general symptoms indicate great nervous prostration. Large quantities of morphia have been found requisite. The whole limb and foot are much swollen and oedematous. On the evening unmistakable signs of sphacelus appeared, the foot became cold, and a hue of purple discoloration was observed as high up as the ankle. The neuralgic pain and restlessness still continued. On December 13th, all the symptoms were worse. The discoloration, the dark purple hue of gangrene, extended rapidly upward, particularly on the inside of the limb. The whole thigh became crepitant, the pulse more rapid and feeble. He became more and more depressed, and finally died at 12 o'clock at night." -- The Medical and Surgical History of the War of the Rebellion. Part III, Volume II. (3rd Surgical volume) by U. S. Army Surgeon General's Office, 1883.
Inscription
IND.
Advertisement
Advertisement
