Civil War Washington

CASE 43.—Delirium; diarrhœa; iliac tenderness; no rose-colored spots; coma; death on 29th day.—Private William Etzel, Co. C, 2d Pa. Cav.; age 29; was admitted Nov. 5, 1861. Diagnosis—typhoid fever. He had been in good health until October 22, when he was seized with chills followed by fever, epistaxis, pains in the back and limbs, lassitude, anorexia and thirst. On the 6th his countenance was anxious, eyes dull and suffused, face congested, pulse 95, skin hot, tongue slightly moist, red at the tip and edges, coated white in the centre, appetite good, thirst considerable; he was somewhat deaf and spoke in a whisper; one stool was passed during the previous twenty-four hours, and there was much iliac tenderness with some tympanites; the respirations were 20 per minute and there was some cough. One drachm of emulsion of turpentine was prescribed, to be taken every four hours. On the 8th the tongue was dry and yellow in the centre and the teeth covered with sordes; he slept well and had a good appetite. He became dull and stupid on the 10th and had three stools with much tenderness and tympanites, but no cough. On the 16th he was delirious and constantly picking at the bed-clothes. The diarrhœa continued, the tongue being moist and yellow-coated, pulse 90, skin hot; coma supervened, followed by death on the 19th.