Civil War Washington

CASE 93.—Stephen McLaughlin, who was discharged from 2d U. S. Art'y August 17, 1865, on account of premature old age, asthma and general debility from twenty years' service, was admitted September 11, confused in mind and with tremors of the limbs and voice; pulse 136; he appeared to have been drinking to excess. His legs were œdematous; abdomen full, tense and fluctuating; auscultation disclosed roughness of the heart-sounds with increased impulse, the sounds being heard all over the left side; there was absolute dulness​ from a little below the nipple to midway between that point and the crest of the ileum; the respiratory murmur was absent at the base of the left lung, puerile at its summit and on the right side; the left side of the chest was contracted, the right side enlarged. At 2 P. M. on the day of admission he experienced a severe chill, for which brandy and quinine were given and mustard applied. He recovered, but the chill recurred at 2.30 P. M. on the following day and he died at 7 P. M. Post-mortem examination seventeen hours after death: Body bloated; skin of the head dark and livid; a thick greenish liquid flowing from the mouth. The brain was normal. The right lung was healthy. The left pleural cavity was partly obliterated by adhesions, but contained in its sacculi serum and lymph; the lung was diminished to half its size, the lower lobe being very friable and having its air-cells filled with a prune-juice liquid. The pericardium contained four ounces of serum. The heart weighed fourteen ounces and a half; the ventricle was hypertrophied, the middle valve somewhat thickened and the curved margins of the pulmonary and aortic valves hardened. The liver was enlarged and softened; the spleen, weighing twenty-two ounces and a half, was pulpy. The peritoneum was darkly injected and contained ten ounces of serum. The stomach and intestines, which were much distended with gas, had their mucous lining congested. The kidneys were nodulated on the surface and contained several cysts somewhat larger than a pea.—Douglas Hospital, Washington, D. C.