Civil War Washington

CASE 27.—Diarrhœa; muttering delirium; coma vigil; sordes; dark-red spots, persisting under pressure, on the l7th day, after which improvement was progressive.—Private Andrew Scriber, Co. C, 14th N. Y.; age 22; was admitted Sept. 20, 1861, having been taken sick two weeks before with chills, pains in the head and bones and great muscular debility. Diagnosis—typhoid fever. His pulse on admission was 118 and soft, face flushed dark-red, countenance anxious, skin hot and dry, tongue thickly coated gray in the centre, red at the tip and sides, gums and teeth covered with sordes; there was some diarrhœa with tenderness of the abdomen and tympanites; the patient lay with his eyes and mouth partly open, muttering incoherently when roused. On the 21st he was dull, stupid and difficult to arouse; pulse 90 and quick, skin hot and moist, tongue brownish-gray. He had six stools during the day, accompanied with gurgling but no tenderness. Turpentine emulsion and enemata of laudanum were ordered. On the 22d he was restless; pulse 112, small; skin hot and dry, with here and there dark-red spots which did not disappear on pressure; tongue brown and dry in middle, moist and red at edges. The diarrhœa was checked by the enemata, but there was some tenderness of the abdomen and intestinal gurgling. Brandy was given. On the 23d the eruption had disappeared; two stools were passed; the sordes persisted about the lips, but the tongue was cleaning from the edges. The sordes disappeared on the 25th. Next day the tongue was clean; there was some appetite, and the patient looked and said he felt well; but he was restless and wanted to go out. He had three stools; pulse 81. In the evening the pulse rose to 100, the face was flushed, the skin hot and dry, and there was borborygmus with right iliac tenderness and one stool. On the morning of the 28th the pulse was 82; the skin warm and moist; the tongue moist, red at the tip and slightly coated. His appetite was good on the 29th. He had four stools on the 30th, but no tenderness; his countenance was natural, his skin warm and soft, and he was gaining strength. On October 20 he was detailed on extra duty.