Campbell, Ephraima machine readable transcriptionSusan C. LawrenceKenneth M. PriceKenneth J. Winkle2011med.d1e41929Civil War WashingtonUniversity of Nebraska–LincolnCenter for Digital Research in the Humanities319 Love LibraryUniversity of Nebraska–LincolnLincoln, NE 68588-4100cdrh@unlnotes.unl.edu2011
The following are responsible for particular readings or for changes to
this file, as noted:
Kenneth M. PriceAJ HowellMatthew BosleyElizabeth LorangStacey BerryAlyssa OlsonThe Medical and Surgical History of the War of the Rebellion.
(1861-65.)Washington, DCGovernment Printing OfficePart 2Volume 11879517-518Medical and Surgical History of the War of the Rebelliondiarrhœa and dysenteryremarks on the pathology and treatment of diarrhœa and dysenterychronic dysenterypost mortem appearances in chronic dysenterymorbid anatomychronic inflammation of the intestines accompanied by follicular or other ulcersautopsy performedchronic diarrhœafeverdejections mixed with bloodcollapsed right lungright pleural cavity contained one gallon of sero-purulent fluidlarge abscess in upper liver communicated with pleural cavity through opening in
diaphragmfifth, sixth and seventh ribs denuded of periosteum and bathed in pusomentum devoid of fatmesenteric glands enlargedmucous membrane of lower ileum coated with pseudomembrane, presented small follicular
ulcers, Peyer's patches slightly thickenedcæcum and colon studded with follicular ulcers, edges of many covered with
pseudomembranefollicular ulcers of mucous surface of descending colon, smallest rounded and very
minute, larger varying from ⅒th to ¼th of an inch in diameter, edges of most
fringed with curdy yellow pseudomembraneappendix vermiformis and caecum showed similar ulcersflat new-formation of bony tissueblessedadded figure encodingadditional proofing of transcription and encoding, identified
keyword termscase text extracted and transformed from larger fileenrich encoding, proof and editencoding and editing
The chromo plate facing page 520 represents follicular ulcers of the colon fringed with
pseudomembrane. The following is an account of the case:
CASE 902.—Corporal Ephraim
Campbell, company D, 150th Pennsylvania
Volunteers; age 24; was admitted to the field hospital of the first division, fifth army
corps, near Petersburg, Virginia, September 12, 1864. Diarrhœa: for which he had been treated in his regimental
hospital. September 14th, he was transferred to
the hospital of the 3d division, fifth corps, and September 29th, to the depot hospital of the fifth corps, at City
Point, Virginia, where the diagnosis recorded was fever. Thence he was transferred to
Columbian College hospital, Washington, D. C., where he
was admitted, October 30th, suffering from all the
symptoms of chronic diarrhœa. He was extremely emaciated, pulse 110 and small; had five or
six loose dejections daily, and no appetite. Ordered hot fomentations to be applied to the
abdomen, with rest in bed, and a diet of boiled milk and beef tea. November 2d, he reports that
he feels better than on admission, and begins to relish his food a little, but the diarrhœa
continues unabated. ℞. Chalk mixture three ounces, fluid extract of ginger half an ounce,
tincture of cinchona one ounce; take a tablespoonful three times a day; continue the hot
fomentations; extra diet. November 6th: Since the last note the patient has been better, but
to-day is worse again. His bowels are moved every hour, and the dejections are mixed with blood;
pulse 110 and thread like; abdomen tympanitic. His strength is less than yesterday; no appetite.
Continue diet and treatment, with the addition of laudanum enemata. November 7th: The bowels are
moved less frequently. The patient rested well last night, and has some appetite. Continue
treatment. November 9th: Pulse 100; bowels again very loose, the dejections contain mucus and
blood; appetite poor. Continue treatment. November 11th: The symptoms continue with little
change, except that the patient complains of a dry cough at night; there is, however, no pain in
the chest, and the respiration appears to be normal. Continue treatment, with the addition of a
cough mixture containing syrup of senega and paregoric. November 14th: Pulse 96, skin dry and
harsh, respiration 20 per minute, cough not so dry. The bowels were only moved twice since
yesterday morning; appetite very poor. Continue treatment. November 15th: Pulse 108, respiration
32, bowels moved twelve times since yesterday morning; the dejections are bloody, strength
failing, no appetite. ℞. Brandy four ounces, carbonate of ammonia two scruples; take a
tablespoonful every three hours; beef tea. November 16th: Pulse 100, respiration 32, bowels very
loose, strength failing fast. Continue treatment and diet. Died November 18th. Autopsynine hours after death: Body very much emaciated.
The right pleural cavity contained one gallon of sero-purulent fluid. The right lung was
collapsed, coated with lymph and carnified. The left lung was normal. There was a large abscess
in the upper portion of the liver which communicated with the pleural cavity through an opening
in the diaphragm three by four inches in diameter. The fifth, sixth and seventh ribs were
denuded of periosteum and bathed in pus. The omentum was quite devoid of fat. The mesenteric
glands were enlarged. The spleen was normal. The mucous membrane of the lower portion of the
ileum was coated with pseudomembrane and presented a number of small follicular ulcers. Peyer's
patches were slightly thickened. The cæcum and colon were thickly studded with follicular
ulcers, the edges of many of which were covered with pseudomembrane.—Acting Assistant Surgeon A. H. Wilson, U.
S. A. [Nos. 433-437, Medical Section, Army Medical
Museum, are from this case.]
The specimens from this case were brought to the Museum
immediately after the autopsy, and a drawing in water colors representing a portion of the
descending colon was made by Mr. Hermann Faber. The plate
is a reproduction of this drawing. The mucous surface is seen to be generally reddened, with
grayish streaks and patches. There are a considerable number of follicular ulcers, the smallest
of which are rounded and very minute, while the larger ones, varying from ⅒th to ¼th
of an inch in long diameter, are usually oval; the edges of most of these ulcers are fringed
with curdy yellow pseudomembrane. The submucous tissue was considerably thickened, as is well
shown on the left hand of the piece near the bottom where its edge comes into view. This
specimen has been preserved in the Museum, No. 437,
Medical Section. The other specimens from the same case are: No. 436, the appendix vermiformis
and a part of the caecum, showing similar ulcers; No. 433, the collapsed right lung, thickly
coated with pseudomembrane; No. 435, a portion of the liver, showing a large abscess cavity on
its upper surface; and No. 434, the seventh rib, showing the effects of the burrowing of the pus
from the abscess in its efforts to escape; the pulmonary surface of the bone is denuded of
periosteum, and presents several flat new-formations of bony tissue. It would appear that in
this case the large hepatic abscess entirely escaped observation during life, and the remark in
the history of the case, on the 11th of November, only a week before death, that "the
respiration appears to be normal," is worthy of note in connection with the considerable
pleuritic effusion and collapse of the right lung, both of which undoubtedly existed before that
time.