Civil War Washington

CASE 12.—Private Edwin M. Dudley, 5th Mass. Bat'y; age 20; was admitted Oct. 5, 1864, with organic disease of the heart. His comrades reported that he had a short time before suffered from an attack of articular rheumatism. He was anæmic and had anasarca, dyspnœa and a rapid and tumultuous action of the heart unaccompanied by any decided bellows murmur; his pulse was rapid and irregular; tongue covered with a thin gray coat; face turgid and expression anxious; he preferred the sitting posture. The symptoms became aggravated, the heart's action more tumultuous and irregular and the dyspnœa greatly increased; he complained of imperfect vision and roaring sounds in his ears. He died on the 7th. Post-mortem examination: There were adhesions and a small quantity of liquid in the right pleura; both lungs were congested. The pericardium contained two ounces of liquid; the heart was greatly dilated, but there was no marked thickening of its walls; the right side and the great veins were filled with venous blood; the left side contained dark blood with large flakes of lymph entangled among the muscular columns; small, firm, wart-like excrescences were found on the mitral valve and large ones on the aortic valves,—[Specimen 472, Med. Sec., Army Medical Museum]; the endocardium was red and injected. The liver presented a fine nutmeg appearance; the gall-bladder was nearly filled with viscid bile; the spleen was healthy, although bound down in the left hypochondrium by recent adhesions. The kidneys, stomach, small and large intestines were congested.—Act. Ass't Surgeon O. P. Sweet, Carver Hospital, Washington, D. C.