Civil War Washington

CASE 15.—Mental dulness​; delirium; eruption; diarrhœal affection not prominent as a symptom; skin moist; date of onset not defined.—Private Frederick P. Seclor, Co. A, 9th Pa.; age 24; had suffered from fever and ague in June, 1861; but since then had done his duty uninterruptedly until September 19, when he was admitted as a case of typhoid fever. In the evening the patient was weak and had headache; the bowels were quiet, but there was some tenderness in the right iliac region and intestinal gurgling; face flushed; eyes bright; breath offensive; pulse 88; skin hot and moist; head cool and sweating; tongue grayish-yellow in the centre, red and clean at the edges. Ten grains of calomel and jalap were given. Next day, with a continuance of the symptoms stated, the patient became dull and stupid and had muscæ and tinnitus. On the night of the 21st there was delirium, and the characteristic eruption appeared on the 22d, on which day also he had two stools with some tympanites and tenderness; his tongue was black at the base, reddish-white in the centre and red at the tip. Turpentine emulsion and wine were given. Next night he was again delirious, and on the 23d dull, the skin unaltered save by the fading of the eruption from the chest and abdomen, the bowels quiet, slightly tympanitic but free from tenderness, and the tongue cleaning. Dover's powder was given in small doses, with stimulants. An enema was administered on the 24th, with two grains of blue-pill and one of quinine every three hours. By the 26th the eruption had disappeared, but the patient continued dull; the skin was moist, the tongue cleaning. The bowels were moved once on this day and on the 27th, and some tenderness and tympanites remained; but after this the tongue became clean, the appetite good and the bowels natural. The patient was returned to duty October 20.