Civil War Washington

CASE 40.—Pneumonia precedes the febrile attack, which is not characterized by severe symptoms.—Private Elijah Marsh, Co. D, 7th Wis. Vols., was admitted Oct. 30, 1861. Diagnosis—typhoid fever. On October 9 he had pain in the bowels but no diarrhœa, pain in the chest and cough with rusty sputa. On the 27th he had a chill followed by some fever, but without headache or confusion of mind, epistaxis or diarrhœa. On admission the skin was husky, tongue dry and smooth, teeth blackened, pulse 80; there was difficulty of swallowing from soreness of the fauces; he had two thin yellowish stools with acute tenderness in the right iliac region, but no tympanites nor gurgling; he had little appetite and was very weak; some cough was also present. Turpentine emulsion and whiskey-punch were prescribed. Next day he had soreness in the bones, occasional dizziness and mental dulness​. On November 1 the tongue became moist, clean at the tip and edges but covered with a grayish fur at the base; on this day he expectorated some blood. There was some headache on the 2d; but the patient slept well on the 3d, and next day there was moisture and sudamina on the skin, while the tongue had again become dry and brown and there was much abdominal tenderness; two stools were obtained on this day by means of castor oil. The tongue on the 6th became again moist and clean at the tip and edges and the skin dry; two offensive stools were passed; there was some cough and the respirations at this time were increased to 31 per minute; two rose-colored spots were discovered on the chest. The record gives no further details, closing with the statement that the patient was returned to duty on December 1.