CASE 40.—Superficial gangrenous
patches.—Corp'l J. H. Kourtz, Co. C, 130th
Pa.; age 19; was admitted April 20, 1863, having been
sick since the 1st. He was considerably emaciated and in bad
nervous condition; his pulse 90, appetite poor, tongue
white-coated, dry and cracked, and bowels moved five or six
times during the twenty-four hours; he had a slight cough
with thin gray sputa mixed with semi-solid masses of a
dark-brown color, and there was dulnessdullness
and slight crepitus
in the right infraclavicular region. Suitable nourishment
was ordered with sweet spirit of nitre and Dover's powder at
bedtime. On the 24th two small pustules with inflammatory
areolæ were observed above the left knee. A
two-grain dose of quinine in sherry was given every two
hours. By the 29th the centre of these spots had become
gangrenous and evolved a very offensive odor; a similar but
larger spot had also developed on the right forearm three
inches above the wrist. Chloride of zinc solution was used
locally. The spots enlarged slowly, and on May 3 a pustule
with a large inflammatory base appeared on the mucous
membrane of the left side of the lower lip. On the 5th there
was low delirium; the left side of the face was swollen and
the gangrenous spot on the lip was as large as a penny and
increasing rapidly; the diarrhœa meanwhile
continued. The patient became unconscious and died on
the 8th.—Act. Ass't Surg. O. P. Sweet, U. S. A., Lincoln Hospital, Washington, D. C.