Civil War Washington

CASE 46.—Diarrhœa; drowsiness and deafness; bronchial and pneumonic accompaniments; rose-colored spots on 17th and vibices on 25th day; otorrhœa; pains in the legs; death on the 122d day.—Private Mark Warner, Co. E, 1st Pa. Art.; age 26; was taken sick Sept. 1, 1861, with pain in the back and bones, headache and chills, and was admitted on the 16th. Diagnosisœtyphoid fever. On admission his pulse was 94; tongue smooth and dry in the middle, moist at the edges; skin hot and moist; cheeks flushed; eyes dusky; bowels loose and tender; he had headache and was dull mentally. Catechu was used. Next day the characteristic rose-colored spots appeared on the chest and abdomen and sibilant and sonorous râles were heard over the chest, especially on the left side. Whiskey-punch and turpentine emulsion were prescribed. On the 18th the patient was drowsy and had acute tenderness in the abdomen and tympanites, although the bowels were quiet. An enema of soap-suds was administered. On the 19th the skin was moist and the mind less obtuse, the bowels loose, the tympanites reduced, but the tenderness was not lessened. The respirations were increased to 30 on the 20th; bronchitic sounds were heard over the whole of the chest, and a part of the lower lobe of the right lung was consolidated. Dover's powder was given. On the 21st the pulse was 108, soft and weak, skin hot and dry, showing a few fresh rose-colored spots; decubitus dorsal with flexed limbs; tongue smooth, glossy, dry; bowels relaxed, tender and tympanitic in the iliac regions; the patient was somewhat deaf, and complained of pains in the limbs. Vibices appeared on the skin on the 25th and 29th, sudamina on the 27th. The tongue became clean on the 26th and the appetite returned on the 30th, the chest symptoms meanwhile gradually becoming relieved; the pulse, however, continued accelerated, 100 to 112. On October 7 a discharge from the ear was treated with a solution of nitrate of silver; but it became more profuse and persisted up to the close of the detailed record. On the 9th the patient suffered much from pain in the legs, which were greatly emaciated; sponging with alcohol gave temporary relief; this pain also continued to the close of the record on October 17. After this date the only entry made was the announcement of death from typhoid fever on December 31.