Civil War Washington

Case from the case-book of LINCOLN HOSPITAL, Washington, D. C.; Assistant Surgeon Roberts Bartholow, U. S. A., in charge from August 21st to December, 1863.

CASE 374.—Private Mark Colgin, company M, 13th Pennsylvania cavalry; admitted September 17, 1863. Chronic diarrhœa. Died, September 18th. Autopsy four hours after death: Body not much emaciated; rigor mortis well marked; apparent age 20; height five feet five inches. The veins of the pia mater were moderately filled with dark blood; the ventricles contained half a drachm of grayish fluid; the brain was firm and apparently healthy; it weighed forty-seven ounces. In the upper part of the œsophagus there were a number of slightly elevated white maculæ, between which the mucous membrane was of a light-purple color; in the lower part of the œsophagus the membrane was reddish. The trachea was full of thick frothy mucus; the membrane over the rings was pale, between them it was unusually purple. The exterior of the lungs was of a grayish-purple with bluish spots, which were most numerous posteriorly; on incision both lungs were found to be congested posteriorly, and a quantity of frothy mucus exuded; the lobes of the right lung were bound together by old fibrinous bands. The pericardium contained nine drachms of straw-colored fluid. The heart weighed thirteen ounces; its right cavities contained venous clots; the lining membrane of the right auricle was reddened; the left auricle was empty, its lining membrane pale; the left ventricle contained a small venous clot. There was a small quantity of straw-colored serum in the abdominal cavity. The omentum was loaded with fat. The liver was healthy; it weighed fifty-nine ounces; the gall-bladder contained six drachms of orange-yellow bile. The pancreas was normal, and weighed two ounces and a half. The spleen was soft, of a dark-purplish color internally, the Malpighian corpuscles well-marked; it weighed thirteen ounces and a half. The kidneys weighed five ounces each; both were slightly congested, the right most so. The mucous membrane of the stomach was pale, with a few reddish points; that of the small intestine was unusually pale. In the lower part of the ileum Peyer's patches were slightly elevated, and one of them near the cæcum ulcerated; the solitary glands were enlarged, reddened, and slightly ulcerated. The mucous membrane of the large intestine was also generally pale; in its upper portion it presented numerous bright-red spots with ulcers in their centres; these were apparently the solitary glands, which here, as in the small intestine, seemed to be the chief seat of the disease. The mesenteric glands were enlarged.—Assistant Surgeon Harrison Allen, U. S. A.⃰

⃰ September 14, 1864, Dr. Allen presented to the Pathological Society of Philadelphia a brief "Synopsis of Autopsies made at Lincoln General Hospital," to which the reader is referred.—(Proceedings of the Pathological Society of Philadelphia, in the American Journal of the Medical Sciences, January, 1865, page 133.) In this paper he analyzes the appearances observed in forty-one cases of diarrhœa and dysentery, thirty-five of fever, twenty-one of pneumonia, and five of diphtheria. The notes of Dr. Allen's autopsies, from which the accounts here presented have been condensed, were not contained in the case-books of Lincoln hospital turned in to the Surgeon General's Office at the close of the war, but have since been copied into them from the originals, loaned for the purpose.