Civil War Washington

CASE 64.—Hospital Steward Benjamin Y. Stone, 28th Mich.; age 28; was admitted Feb. 14, 1865, with pneumonia. The patient, of a nervous temperament, was considerably depressed and seemed to be laboring under mental anxiety. He said he had been subject to tertian intermittent fever and diarrhœa, for which he had taken opium and quinine in large quantities. He was not much emaciated, but his pulse was weak and he had no appetite; a slight crepitus was detected in the lower lobes of the lungs; he had headache and some deafness on both sides. He continued to grow weaker and more depressed in mind, so that by the 20th he could not leave his bed. The diarrhœa yielded readily, but the deafness increased; the pulse became thready and rose to 140; restlessness was followed by delirium, during which the patient wanted to sit up or kept picking at the bedclothes. He became drowsy on the 28th, but continued picking at the bedclothes until the coma deepened. He died March 3. Post-mortem examination: The cerebral membranes were opaque and serum was effused beneath them; the brain was quite hard and rather pale; the choroid plexus pale, almost white near the foramen of Monro; the spinal cord was pale. The pericardium contained clear serum. The upper lobe of the right lung was soft, hepatized gray behind and crepitant only in its anterior edge; its bronchial tubes were full of pus; the lower lobe was brown in color and sank in water; its tubes were dark-purple and thickened. A patch of strong adhesion was found on the external surface of the left lung, the upper lobe of which was crepitant but softened and presented a little cicatrix at the posterior part of its apex; the lower lobe was softened and spotted with blackish or brownish-red patches in a gray or pinkish-gray crepitant tissue; the bronchial tubes, dark-purple in color, were filled with pus. The liver was soft, pale-yellow and of good size; the spleen soft and small. The ileum was full of air and slightly injected, but otherwise normal. The kidneys were fatty and injected with dark blood.—Third Division Hospital, Alexandria, Va.