Civil War Washington

CASE 5.—Private Eli C. Mattson, Co. H, 9th N. Y. Cav.; age 22; was admitted from Augur hospital, Alexandria, Va., Feb. 11, 1865, suffering from acute pharyngitis and tonsillitis, with exudation and sthenic pyrexia. The disease at first appeared to yield partially to treatment, but later it devoloped​ a distinct diphtheritic character; the local affection increased in severity, the false membrane appearing on the walls of the pharynx and gradually extending. About a week after admission the patient's stomach became irritable, and for the last two days before death nothing was retained except a little water from ice melting in the mouth. The fever continued sthenic in character until two days before death, when the system began to suffer from imperfect æration of the blood. From that time the purple hue of the skin became increasingly marked. Latterly very little urine was voided, but no uræmic effects were observable, the mind being perfectly clear until death, which occurred on the 24th. The case was treated at first with saline laxatives and Dover's powder, with tincture of iron internally in doses of fifteen drops repeated every four hours,—applied locally by sponge and used diluted as a gargle. Nitrate of silver and alum solutions were also employed as topical applications. Afterwards lime-water was given with milk; sinapisms and a blister were applied to the epigastrium and nutrient enemata administered. Post-mortem examination: The tonsils and larynx were much inflamed; the trachea lined throughout with a firm false membrane, which, on the left side, extended into the ramifications of the bronchus; the bronchial tubes of the right lung were greatly inflamed but not lined with membrane; the lungs were healthy. The heart contained a firm washed clot in each ventricle, the right clot being larger and more firmly attached than the other. The stomach, liver, spleen and intestines were normal. [Specimen 515, Med. Sec, Army Medical Museum, from this case, shows the epiglottis much thickened and the larynx lined by a thick pseudomembrane which extends to the tonsils and over the sides of the tongue.]—Ass't Surgeon Harrison Allen, U. S. A., Mount Pleasant Hospital, Washington. D. C.