CASE 8.—Private Herbert Vaness, Co. D, 171st
Pa.; age 20; was admitted July 8, 1863, with typhoid
fever of twelve days' duration, which progressed favorably
until the 9th, when diarrhœa set in. On the 15th
there was delirium, with dry and tremulous tongue, sordes on
the teeth and swelling of the abdomen; a troublesome hacking
cough was also present. He died on the 17th. Post-mortem examination ten hours after death:
The brain weighed fifty-eight ounces and a half; its
membranes were considerably congested and its substance
rather soft; a small quantity of fluid was found in its
ventricles. The trachea was much congested, of a
purplish-red color and filled
POST-MORTEM RECORDS OF with bronchial
secretion; the lymphatic glands at its bifurcation were
enlarged, blackened and softened. The upper lobe of the
right lung was highly congested, especially at the apex; the
middle lobe was also somewhat congested and presented
evidences of bronchitis posteriorly; the lower lobe was
intensely engorged, purple in color and in some places
almost black. The left lung was generally congested; there
was a considerable transudation of blood beneath the pleura
at its middle and posterior part; its lower lobe contained
splenified lobules, black in color, and separated from each
other by permeable tissue. The right lung weighed
twenty-four ounces and a half, the left twenty one ounces
and a half. A thin fibrinous clot adhered to the anterior
wall of the right auricle and extended through the ventricle
into the pulmonary artery; the left auricle also contained a
fibrinous clot extending into the ventricle and attached to
the mitral valve. The fundus of the stomach was of a dull
lake-red and the pyloric portion paler; it contained five
lumbricoid worms. The liver was soft but of normal color,
its capsule easily torn. The spleen was of a mulberry color
and moderately firm. The mucous membrane of the jejunum was
rather soft and the villi were easily scraped off. The
lining membrane of the three feet of the ileum nearest to
the ileo-cæcal valve was greatly congested, and
Peyer's patches were ulcerated though not perceptibly
thickened; the first ulcer was small, superficial and of a
darker color than the surrounding membrane; about a foot
above the valve a large patch, softened and very
hyperæmic but not elevated, presented near its
border an ulceration about the size of a pea, with elevated
walls and blackened centre. The kidneys were somewhat
injected, the cortical substance firm and
pale.—Ass't Surg. Harrison
Allen, U. S. A., Lincoln Hospital, Washinigton, D. C.