Civil War Washington

CASE 6.—William Lewis; civilian; colored; age 28; was admitted May 19, 1864, with pneumonia. On August 13, when the record first shows his condition, he was suffering from ascites, which caused a sense of fulness​ in the abdomen but gave no pain; he had also some œdema of the feet and legs. His appetite was good, but he was unable to walk much, though he occasionally went out for air. Diuretics were tried for several days, but failed to give relief. Mercurials seemed for a time to do good, but the benefit was not permanent and the patient gradually failed. He was seized on October 4 with intense abdominal pain, which by midnight became excruciating. In the absence of a trochar an incision large enough to introduce a female catheter was made just below the umbilicus, and twenty pints of liquid were drawn off with temporary relief to the patient. He died early next morning. Post-mortem examination: The liver was much enlarged, grayish-yellow in color, and contained several small abscesses filled with thin yellow liquid; the spleen was large and soft and presented in its upper portion a cavity filled with pus. The mesenteric glands were enlarged.—Act. Ass't Surgeon W. K. Fletcher, L'Ouverture Hospital, Alexandria, Va.