Civil War Washington

CASE 100.—Private John F. Risley, Co. B, 50th Ohio; age 24; was admitted Feb. 3, 1865, having been sick for five days. The disease commenced with a chill which lasted an hour and was followed by severe lumbar pain. On admission he had no headache, but pain in the loins was very distressing; he was restless and had a wild expression, a moist and coated tongue, full and rapid pulse, coryza, cough and some oppression of the chest; a dark rash, which disappeared on pressure, was noticed on the surface. Rochelle salt and morphia were administered and dry cups applied, but in the evening he was no better. He was restless during the night. Next day the dark rash covered the whole of the body; the patient was drowsy, his pupils contracted; abdomen tympanitic; respiration difficult. He died comatose before midday. Post-mortem examination: Chest, abdomen and posterior aspect of extremities covered with a dark-purple rash and petechial spots; face presenting purpuric patches but no petechiæ. The blood throughout the body was thin. The veins of the cerebral and spinal membranes were engorged and there was serum beneath the arachnoid; but the substance of the brain and cord was healthy. Ecchymosed spots were found on the parietal pleura and serum tinged with blood in each pleural sac, but the lungs were healthy. The peritoneum, mesentery, stomach and intestines were covered with scarlet and dark-red petechial spots. The liver weighed one hundred and sixteen ounces; the gall-bladder was large and full. The right kidney weighed eleven ounces, the left ten ounces; their capsules and the surrounding connective tissue were ecchymosed.—Douglas Hospital, Washington, D. C.