Civil War Washington

CASE 24.—Presenting delirium, unconsciousness, floccitatio​, subsultus, slight diarrhœa, rose-spots, sudamina, bed-sores and vibices. Improvement manifested about 35th day.—Private William E. Thompson, Co. C, 9th Pa. Vols.; age 19; was taken about August 22, 1861, with pain in the head and back, epistaxis, chill, fever and diarrhœa, and was admitted September 12 as a case of typhoid fever; pulse 100, quick; skin hot and dry; tongue dry at the tip and coated gray at the base; the patient was dull-looking and had subsultus, relaxed bowels, right iliac tenderness and intestinal gurgling. Dover's powder was given. On the 13th the skin was hot but moist with perspiration; rose-colored spots appeared. Next day the skin was again hot and dry, but covered with profuse sudamina; the cheeks were flushed, the tongue dry, smooth, cracked and protruded with difficulty, and the patient stupid but restless. Toward evening on the 15th a few more rose-spots came out; sordes appeared on the teeth; the bowels continued slightly relaxed and there was right iliac tenderness; the patient was haggard; he turned his head from side to side, muttered, and had subsultus tendinum. No change occurred on the 16th, but on the 17th more rose-spots made their appearance and the patient became drowsy. On the 19th his pupils were dilated and he was unable to articulate. Next day the pulse was 112, irritable and full; the skin dry and husky; the rose-spots and sudamina had disappeared; the tongue was rough, dry and brown; the gums and teeth covered with sordes; right iliac tenderness, meteorism, gurgling and relaxation of the bowels continued, and the patient muttered and groaned, but had no subsultus. He was greatly emaciated and prostrated, and for some days lay on his back with his eyes half-closed; sometimes partly delirious, picking at the bed-clothes, and at other times unconscious. Meanwhile the pulse became more rapid, rising to 128 on the 23d, and the circulation of the skin languid. He vomited on the evening of the 22d, and after this his bowels became more quiet. Bed-sores appeared over the sacrum. Turpentine, Dover's powder, astringents and stimulants had been used in the treatment. On the 25th the pulse was 114 and stronger, the tongue cleaning and the mind clearer, but the skin continued hot and dry, and vibices appeared profusely on the chest; the bowels remained quiet. The patient was sponged with alcohol and turpentine; warm bottles were applied to the feet and soft pads to the sacrum over the sores. In the evening the eyes became brighter and the skin moist, the pulse having meanwhile fallen to 100. Next day the patient was tranquil, the tongue moist and cleaning at the edges; the bowels were moved by an enema. A purulent discharge came from the right ear. The left ear became similarly affected on the 28th. The appetite returned on the 29th, and after this improvement continued. The patient was furloughed October 31.