Civil War Washington

CASE 1.—Private Patrick Fletcher, Co. H, 4th U. S. Cav.; age 42; died suddenly while in camp, Dec. 9, 1863. He had not been at surgeon's call during his service of over ten months in this regiment, but a comrade stated that he would occasionally place his hand to his side, complain of pain, and remark that he would die of disease of the heart. He had previously served five years in the 3d Art'y and five years in the 2d Inf. On the day before his death he marched with his regiment a distance of twenty-five miles. It rained all day and was very cold, nearly freezing. He, like every one else, had to sleep on the ground in wet clothes. Next morning a march of five miles was made and the regiment went into camp. Fletcher, while assisting to pitch a tent, fell down and, gasping once or twice, died. Post-mortem examination: Neck swollen as though the bloodvessels​ were engorged. The pericardium was smooth and healthy, but was enormously distended with twenty-six ounces of blood-clot and serum. The heart was of natural size, but the walls of the left ventricle were thicker while those of the right appeared somewhat thinner than usual; the endocardium and valves were healthy. In the aorta, about an inch and a half above the valves, was an aperture a quarter of an inch in diameter, opening into an aneurism​ the size of an egg, the walls of which adhered firmly to the superior cava and pericardium and were as thick as those of the aorta itself except at a point where rupture had taken place into the pericardial sac,—[Specimen 965, Med. Sec., Army Medical Museum]. The left pleura was adherent and the lung engorged with venous blood; the right lung was healthy, although much compressed by the liver, which was so engorged as to reach the lower border of the third rib. The spleen was enlarged; the kidneys healthy.—Act. Ass' t Surgeon Thomas Bowen, 4th U. S. Cav.