Civil War Washington

CASE 1.—Private Walter Fitzgerald, Co. H., 4th V.R. Corps; age 68; was admitted June 14, 1865, with a rheumatic affection, from which he so far recovered as to be able to evade the guard and keep himself supplied with whiskey. On August 6 he had a slight attack of delirium which confined him to bed for some days, and on the 21st a more severe recurrence. At 9.40 P. M. of the 22d it was found that one ounce of laudanum had been administered by mistake: he was insensible, but could be aroused by shaking; pupils much contracted, pulse 150; respiration 10; skin pale and warm; hands like a washerwoman's. Eight grains of extract of belladonna were at once given and the patient was kept aroused by the galvanic battery and friction. At 10.30 the pupils began to dilate; pulse 144; respiration 10 when in repose, 14 when aroused; the skin seemed regaining its color and the face and hands were nearly natural. Half an hour later four grains of the extract of belladonna were administered, under the influence of which the dilatation of the pupils continued and the respiration became more frequent, 17; pulse 144; but the drowsiness increased, and the skin became cooler and assumed a blue color. Whiskey and carbonate of ammonia were given by enema. He lived until 5 P. M. of the next day. Artificial respiration was attempted. Post-mortem examination: Rigor mortis slight. The membranes of the brain contained three ounces and a half of bloody serum and the lateral ventricles half an ounce, the choroid plexus of each being enlarged; the cavernous portion of the right internal carotid contained a long fibrinous clot; the superficial cerebral veins were engorged. The lungs presented some old adhesions,—the right was congested, the left had a small vomica in its apex and miliary tubercles in its upper lobe. The heart was flabby and contracted; it contained fibrinous clots which extended into the great vessels; one of the aortic valves presented a cartilaginous deposit about the size of a small pea, another showed a harder deposit, the third was healthy. The œsophagus was red; the stomach normal; the liver enlarged and fatty; the gall-bladder distended; the spleen shrunken and flabby; the kidneys fatty,—the left of normal size, the right half the usual size and nodulated.—Douglas Hospital, Washington, D. C.