CASE 87.—Headache, dizziness, deafness, delirium and
muscular twitchings; relaxation, tenderness and
tympanites of the bowels; pneumonia; no rose-colored
spots.—Private Sidney D. Way, Co. I, 2d Vt.;
age 18; was admitted Sept. 27, 1861, having been taken three
weeks before with intermittent fever, cough and pain in the
breast. The case was diagnosed typhoid fever. The patient
was weak, his cheeks flushed, countenance anxious, pulse
quick, 120, skin hot and dry; he had some pain in the head
and chest, with deafness and muscular twitchings; there was
anorexia with a moist white tongue, and relaxed bowels with
much tympanites and general abdominal tenderness. Small
doses of blue-pill and opium were given on the 28th and
turpentine emulsion on the 29th. During the next four days
his condition was but little altered; the deafness
increased, and delirium, dizziness and aphonia were
manifested; three or four passages from the bowels were
recorded every twelve hours; the cough occasionally became troublesome, and
was accompanied with a mucous expectoration; the
respirations were at one time as high as 36 per minute. On
the morning of October 2 the patient, having slept well
during the previous night, was found with the skin of natural
temperature and bathed in perspiration, sudamina on the right
side and over the abdomen, the tongue moist and slightly
coated yellow, and the pulse 95 but strong and quick; two
stools had been passed during the night and a little blood
expectorated, after which the cough became less troublesome;
respiration 28, with much crepitation anteriorly on the left
side and a little on the right side. Next day, however, the
pulse was again accelerated, 113, and the skin hot and more
or less dry, the other symptoms continuing as already
described until the 6th, when with a freely perspiring skin
the pulse fell to 90, and the patient had less cough and
some improvement in the voice. After this the pulse again
rose to 105, the skin becoming hot and dry, but the tongue
remaining moist and yellow-coated; the cough and
expectoration of mucus and blood continued, with dulnessdullness
over the lower lobe of the right lung posteriorly and mucous
and submucous râles above, and with crepitation over the
left lung posteriorly; the diarrhœa and abdominal
tenderness continued as already reported. By the 11th the
pulse had risen to 118, and the patient was quite deaf and
complained of headache. On the 12th the tongue, still
continuing moist and yellow-coated, became red at the tip
and edges; some sordes formed upon the lips, and tormina
accompanied the diarrhœal passages. From this time
to the end of the month the condition varied little from day
to day, but a gradual alleviation of the symptoms of the
lung and bowel complaints was observed. A free perspiration
which occurred on the 20th was followed by a reduction of the
pulse on the 21st and the manifestation of some appetite.
The abdominal tenderness became lessened and the passages
less frequent until the 31st, when, for the first time, the
daily record shows that no stool was passed during the
previous twenty-four hours. On November 1 the pulse was 80
and feeble, the skin natural, the tongue pale, the appetite
good; the cough was less troublesome and there had been but
one stool. His condition had not changed materially on
the 9th, when he was discharged from the service
on account of debility; the cough persisted with occasional
relaxation of the bowels and abdominal tenderness, but with
a good appetite and natural skin.