Civil War Washington

The notes were forwarded, with the specimens, to the Army Medical Museum from CARVER HOSPITAL, Washington, D. C., Surgeon Oliver A. Judson, U. S. V., in charge:

CASE 426.—Private Peter Quackenbush, company E, 111th New York volunteers; age 48; admitted from the depot hospital of the 2d Army Corps, City Point, Virginia, July 5, 1864. Chronic diarrhœa. The patient had a senile look, and was considerably emaciated; pulse about 80; tongue moist but covered with a gray fur; anorexia; severe diarrhœa. He continued about the same until July 10th, when he began to improve, the diarrhœa being somewhat checked and his appetite better. July 26th, he was attacked by a severe pain in the right side, with dulness​ on percussion, and other evidence of pleurisy with effusion. The diarrhœa now became aggravated, the anorexia returned, and the patient died August 1st. Treatment: Opiates and astringents were freely given to relieve the diarrhœa, and stimulants were administered from the first. When pleurisy set in a blister was applied to the right side of the chest. Diet: Milk, beef-essence, &c. Autopsy four hours after death: The left lung was bound firmly to the chest by old pleuritic adhesions; its lower lobe was greatly congested; pleuritic adhesions, which seemed quite recent, existed also on the right side; the posterior portion of the right lung was in a state of hypostatic congestion; the right pleural cavity was about half full of fluid. The heart appeared to be normal; a partially washed clot was found in its right side; the pericardium contained about three ounces of fluid. The liver was enlarged, pale, and apparently fatty; the gall bladder was filled with viscid bile. The spleen was enlarged and very soft. The kidneys were of about the normal size; their cortical substance appeared very pale. The mucous membrane of the stomach was thickened and congested; that of the small intestine was also congested, especially within three feet of the ileocæcal valve, where Peyer's patches were considerably thickened and presented a spongy appearance at their centres. In the ascending colon there were several large ulcers with ragged edges, which contained a quantity of black pigment; the mucous membrane was considerably thickened and softened; in the transverse colon these ulcers were less numerous and smaller; in the descending colon they again became larger.—Acting Assistant Surgeon O. P. Sweet. [Nos. 353 to 355, Medical Section, Army Medical Museum, are from this case. No. 353 is a portion of the ileum taken just above the ileocæcal valve, showing a slightly thickened Peyer's patch and some tumefaction of the solitary follicles. No. 354 is a portion of the ascending colon, presenting a number of oval ulcers with abraded edges, varying from the size of a pin-head to that of a five-cent piece. No. 355 is a portion of the transverse colon, presenting a number of minute follicular ulcers.]