Civil War Washington

CASE 11.—Louis Weder, Co. I, 1st N. Y. Cav., was admitted March 28, 1864, having been affected for six weeks with synovitis of the right knee, the cause of which was unknown. Tincture of iodine was applied daily. On April 3 he had a violent headache, with pain in the back and bowels, some vomiting and diarrhœa, complete anorexia, and jaundiced eyes and skin. Camphor and opium pills were given, with hop fomentations to the abdomen. Next day drowsiness and fever were added to the symptoms; the pain in the abdomen was aggravated, the pulse small and frequent. During the night of the 4th he had fourteen stools and vomited a greenish liquid once or twice. At 5 A. M. of the 5th the pulse was 140, very small, weak and soft, respiration 42, expression anxious. The pain in the abdomen continued; the vomiting, temporarily checked by creasote and morphine, recurred at times with increasing prostration until death occurred, on the morning of the 6th. Post-mortem examination: Body not emaciated; skin tawny; conjunctivæ yellow; mouth and nostrils giving issue to a yellow liquid. The knee-joint contained about two ounces of synovia and a few flakes of lymph; the membrane lining the cartilages of the patella and femur was roughened; the subserous areolar tissue on the ligamentum patellae and other soft parts of the joint was exceedingly vascular. The abdomen was distended with several quarts of serum and lymph,—there was a large quantity of lymph in the pelvis and also above the liver, and the intestines were glued together, but no perforation or other indication of the origin of the peritonitis was discovered. The stomach and intestines were distended with liquid. The liver was fatty; part of the right and left lobes was hob-nailed, showing on section a surface mottled with red, yellow and gray, and knotty to the touch. Heart and lungs healthy.—Ass't Surgeon J. H. Bartholf, U. S. Vols., Hospital, Frederick, Md.