Civil War Washington

Case from the case-book and medical descriptive lists of the DOUGLAS HOSPITAL, Washington, D. C., Assistant Surgeon William Thomson, U. S. A., in charge from February, 1863, to September, 1864, and after September, 1865:

CASE 303.—Private J. S. Livingston, company K, 7th Wisconsin volunteers; age 32; admitted March 23, 1863. Chronic diarrhœa. Had contracted diarrhœa in September, 1862, but continued on duty until Christmas, when he was sent to the regimental hospital for debility, having lost forty pounds in weight. [The register of the regimental hospital shows that he was admitted December 24th, and transferred to division hospital March 7th.] He was then transferred to field hospital, where he remained until March 22, 1863. [He appears on the register of the hospital of the 1st Division, 1st Army Corps, as admitted March 7th—chronic diarrhœa—sent to Washington, D. C., March 22d.] The diarrhœa had continued unchanged, averaging about three stools daily, except when temporarily aggravated by hard work or exposure. There had been very little pain or abdominal tenderness; the stools were small and light-colored; appetite good. His diet had consisted chiefly of hard bread and fresh or salt beef. When admitted to this hospital his pulse was nearly normal; tongue moist, and in the center covered with a yellowish-white fur; the skin dry; he had about three liquid light-colored stools daily; no abdominal tenderness; moderate appetite; micturition was frequent but not painful. He was very much emaciated. ℞. Nitrate of silver one grain, powdered opium and blue mass each half a grain, ipecacuanha quarter of a grain, every four hours. Water acidulated with nitric acid for drink; whiskey and beef-essence. March 27th: Substituted three grains of subnitrate of bismuth with quarter of a grain of sulphate of morphia every four hours. Diet: Milk, rice, mutton broth, eggs. April 7th: Seems somewhat better, but still haw two or three stools daily; appetite moderate; tongue clean; is able to sit up a little. Discontinue medicine, and give an enema of one drop of creasote in an ounce of mucilage three times daily. April 15th: Two grains of quinine and ten drops of aromatic sulphuric acid three times daily. April 18th: Had five stools during the day, attended with tormina and tenesmus. Continue the quinine; give also bismuth and whiskey. April 20th: Still has five or six stools a day; bilious vomiting has set in, accompanied by loss of appetite. Stop the quinine. April 22d: The vomiting has ceased, but the diarrhœa continues about the same. He has become considerably emaciated; tongue red and dry. ℞. Opium one-third of a grain, acetate of lead two grains, every four hours. April 27th: Continues about the same. ℞. Elixir of opium twenty drops, subnitrate of bismuth four grains, every four hours. Died, May 8th. Autopsy: Old pleuritic adhesions about the lower lobe of the right lung; the posterior part of the upper lobe of the lung was hepatized; left lung normal. The liver was slightly enlarged and of a mahogany color. The intestines were somewhat congested in patches throughout their entire length, the congested patches being of a dark mahogany color, but no ulceration could be detected. Peyer's patches and the mesenteric glands were healthy.—Acting Assistant Surgeon Francis M. Holly.