Civil War Washington

CASE 31.—Date of onset unrecorded; rose-colored spots; delirium; chest complications interfere with defervescence about end of 4th week, and prolong the case for two or three weeks.—Private Christian B. Krieger, Co. I, 4th Mich.; age 22; admitted Aug. 31, 1861. Diagnosis—typhoid fever. He was weak and feverish, and had diarrhœa, tympanites and well-marked rose-spots; pulse 110; tongue dry and brown but red at the tip; teeth covered with sordes. Brandy-punch, beef-essence and astringents were given. Next day he was slightly incoherent, and on September 4 delirious. The record does not again state his condition until the 13th, when there was fever with much thirst, delirium, tinnitus aurium, muscæ volitantes, a moist brown tongue and dry hot skin. Dover's powder, beef-essence and brandy were given at this time. On the 15th, the patient's general condition remaining the same, his pulse rose to 106, his tongue became dry, and in the evening his urine was passed involuntarily. On the 16th the presence of bronchitis was reported. Next day his tongue began to clean in patches, and on the 18th was moist, glossy and nearly smooth, the appetite improved and the bowels quiet; but the delirium did not abate until the following day, when in the evening it recurred, accompanied with abdominal tenderness and tympanites, some cough, hurried respiration, 30, and dryness of the tongue, which was protruded with difficulty. On the 21st he rested well; his face was pale and sunken but bright; his tongue remained dry, red and glossy, and was slightly coated in patches; the teeth were covered with sordes; the cough continued; but the hearing was good, the bowels quiet, the urine normal and the appetite good. Next day delirium was again added to these symptoms,and on the 23d some deafness and subsultus tendinum. On this day the tongue again became moist, but dried on the 24th in the centre although remaining red and moist at the edges. Turpentine emulsion was ordered. This condition continued until the 26th, when the delirium became lessened, the face and lips pale, the expression anxious, the eyes clear and bright, the pulse 96, the skin dry and husky but of natural temperature, and the tongue clean, soft and moist, but with some sordes remaining on the teeth. Some perspiration is mentioned on the 27th as occurring on the skin for the first time in the history of the case. Delirium recurred on the 29th, with slight failure of the appetite and cough, the tongue remaining moist and the bowels undisturbed. After this the skin was natural, moist, or occasionally dry, the tongue clean or slightly patched with yellow, the pulse from 72 to 96, the appetite good; but the bowels became relaxed, yielding two, three or four stools daily. While in this condition he was transferred to Annapolis, Md., October 10. [This man ultimately recovered and was returned to duty with his regiment.]