CASE 48.—Probable relapse four months after primary attack.
Diarrhœa; abdominal tenderness; eruptions;
sordes; delirium; death.—Private William
Boardman, Co. D, 1st Pa. Rifles; age 29; was admitted
Oct. 10,
1861. He stated that he had been sick since
June, when he had an attack of enteric fever. On admission
he had headache and was anxious looking, his eyes dull,
cheeks flushed, pulse 90, quick and feeble, skin hot and
dry, tongue slightly moist, red at the tip and edges, black
and fissured in the centre; his appetite was fair. Dover's
powder was prescribed. Next day he was reported as having
had four movements of the bowels; his tongue had become
white in the centre and his skin covered profusely with an eruption the character of which is
not stated. Punch and tincture of iron were given. The
eruption is mentioned on the following day and again on the
21st. During the progress of the case the bowels were
relaxed, two stools being passed daily. The appetite
continued good until the day of death. There was great
tenderness in the abdomen, which was at first especially
marked in the left iliac region, but afterwards became
associated with various regions as the epigastric,
umbilical, the track of the transverse and descending colon
and on one occasion the right side; the tenderness was
usually accompanied by meteorism and gurgling. The skin was
hot and dry throughout except on one or two days, when it was
reported as very dry but not hot. The tongue was dry, red,
fissured and glazed, the lips covered with sordes and the
teeth with tenacious mucus. On the l6th there was some
headache with occasional delirium of a mild character, which
afterwards became more continuous. On the 23d the patient is
reported as having slept well as usual; his countenance was
pale, face pinched, lips parched, skin and tongue dry, pulse
95 and feeble, the abdomen flat. Turpentine emulsion,
cod-liver oil and quinine were prescribed. He died during
the night.