CASE 93.—Stephen McLaughlin, who was
discharged from 2d U. S.
Art'y
August 17,
1865, on account of premature old age, asthma
and general debility from twenty years' service, was
admitted September
11, confused in mind and with tremors of the
limbs and voice; pulse 136; he appeared to have been
drinking to excess. His legs were œdematous; abdomen full,
tense and fluctuating; auscultation disclosed roughness of
the heart-sounds with increased impulse, the sounds being
heard all over the left side; there was absolute dulnessdullness
from a little below the nipple to midway between that point
and the crest of the ileum; the respiratory murmur was
absent at the base of the left lung, puerile at its summit
and on the right side; the left side of the chest was
contracted, the right side enlarged. At 2 P. M. on the day of
admission he experienced a severe chill, for which brandy
and quinine were given and mustard applied. He recovered,
but the chill recurred at 2.30 P. M. on the following day
and he died at 7 P. M. Post-mortem
examination seventeen hours after death: Body bloated; skin
of the head dark and livid; a thick greenish liquid flowing
from the mouth. The brain was normal. The right lung was
healthy. The left pleural cavity was partly obliterated by
adhesions, but contained in its sacculi serum and lymph; the
lung was diminished to half its size, the lower lobe being
very friable and having its air-cells filled with a
prune-juice liquid. The pericardium contained four ounces of
serum. The heart weighed fourteen ounces and a half; the
ventricle was hypertrophied, the middle valve somewhat
thickened and the curved margins of the pulmonary and aortic
valves hardened. The liver was enlarged and softened; the
spleen, weighing twenty-two ounces and a half, was pulpy.
The peritoneum was darkly injected and contained ten ounces
of serum. The stomach and intestines, which were much
distended with gas, had their mucous lining congested. The
kidneys were nodulated on the surface and contained several
cysts somewhat larger than a pea.—Douglas Hospital, Washington, D.
C.