Civil War Washington

Case from the case-book of LINCOLN HOSPITAL, Washington, D. C.; Surgeon Henry Bryant, U. S. V., in charge to May, 1863.

CASE 332.—Sergeant Daniel W. Lyons, company K, 145th New York volunteers; age 21; admitted January 11, 1863. The first notes were taken January 14th. The diagnosis at that time was typhoid fever; the usual symptoms of that disease were present, and the patient was delirious at times. There was no perceptible change until January 17th, when he complained of a severe pain in his chest. On percussion slight dulness​ was detected over the lower lobe of the left lung, but nothing abnormal was discovered by auscultation. He had a slight cough, with rusty-colored expectoration. The treatment was at first stimulant; on the appearance of pulmonary symptoms an expectorant mixture was ordered, with counter-irritation over the seat of pain. Died, January 19th. Autopsy one hour after death: There was some effusion in the subarachnoid space and in the lateral ventricles. Strong adhesions were found on the anterior surface of the right lung; the right lung weighed eighteen ounces and a quarter, the left thirteen ounces and a half; the lower lobe of the left lung was congested hypostatically and presented a circumscribed region of hepatization; stellate spots of black pigment were scattered through the upper lobe. The heart weighed eight ounces and a half. The spleen weighed seventeen ounces and a half and was of a dark-purple color. The liver was pale and weighed seventy-four ounces. The kidneys weighed five ounces and three-quarters each. Ulcerations were observed on the transverse rugæ of the jejunum. The colon was contracted. The mesenteric glands were greatly enlarged.—Assistant Surgeon George M. McGill, U. S. A.