CASE 76.—Record imperfect during first four weeks; delirium;
diarrhœa; rose-spots from 29th to 39th day;
convalescence on 40th day.—Private Peter
Courtwright, Co. B, 1st Pa. Rifles; age 27. This
man stated that he had suffered from some kidney trouble at
the age of 20, and afterwards from both liver and kidney
disease. About Sept. 12, 1861, he had chills followed by
fever and sweating, with epistaxis, pain in the back and
limbs and anorexia. He was admitted October 10, when he seemed
stupid; his eyes were dull; cheeks flushed; pulse 90 and
quick; skin hot and dry; tongue moist, red at the tip and
edges, coated whitish in centre; appetite poor; the bowels
quiet, but with some gurgling and slight tenderness in the
left iliac and umbilical regions; a few rose-spots were
noted. Dover's powder was given. On the 11th and 12th the
general condition remained unaltered; the skin lost its heat
but continued dry. Tincture of iron was ordered to be taken
three times a day. On the l3th the eyes were dull, injected
and suffused and the cheeks slightly flushed; the pulse had
fallen to 60; a few rose-spots appeared on the chest and
abdomen; three stools were passed, and there was pain on
urinating. Profuse perspiration occurred during the night,
and in the morning the patient looked bright but there was
some mental derangement; the pulse was 46, full and firm;
six stools were passed. Astringents were ordered. The
condition on the 15th is not recorded, but on the following
day there were more rose-spots, delirium, tinnitus aurium,
six stools and umbilical tenderness; pulse 68. Tenderness
and tympanites over the tranversetransverse colon accompanied six
stools recorded on the 17th. There was less delirium on the
18th; the face had become pale and the eyes sunken; one
stool was passed. Three stools were reported on the 19th and
six on the 20th, on which day also some rose-spots appeared. On the 21st, after sleeping well, the patient's tongue,
which had heretofore been red at the tip and edges and more
or less coated in the centre, was found to be clean and
natural, his skin of normal temperature, pulse 70 and
appetite good; two stools were passed. After this he
improved, but a diarrhœa, causing about three
stools daily, persisted until November 4, when the bowels
were reported regular. He was able to be up and to walk
about October 3Oth, and was returned to duty November 10.