Civil War Washington

CASE 63.—Mental dulness​; rose-spots on the 9th day, disappearing on the 16th; bowel affection slightly marked.—Private John Dickerson, Co. A, 4th Mich.; age 21; was taken about Sept. 9, 1861, with pain in the bones, back and head, fever which was said to be worst at noon, and diarrhœa. He was admitted on the 16th. Diagnosis—typhoid fever. In the evening the fever was slight; pulse 71; skin warm and dry; face flushed; tongue red at the edges, coated yellowish at the base and in the middle, moist and with prominent papillæ; a bitter taste was felt in the mouth; one stool was passed during the day, and there was some umbilical tenderness. Two grains each of calomel and jalap were given. Next day the pulse was 70 and small; the skin dry; the tongue dry, heavily coated and brownish; the cheeks flushed; the patient was weak and dull; his bowels had been moved once; a few characteristic rose-spots were seen. Quinine was ordered. During the next week there was little change in the patient's condition; his eyes were injected and half closed and he was dull and drowsy, answering questions in a low tone; the face was flushed and the skin hot, dry, husky and profusely spotted with the rose-colored eruption; the tongue, heavily coated and brown, became moist on the 19th; the bowels quiet and neither tender nor tympanitic; there was some headache with dizziness at this time. On the 22d the patient was dull; his pulse 80 and feeble; face flushed; skin hot, moist and spotted; tongue red at tip and gray in centre; he vomited once during the day and had one stool. Next day the pulse was 82 and weak, the eyes suffused, the skin warm and moist, the tongue gray in the centre and red at the tip, the bowels quiet and not tender. On the 24th the pulse was 78, the skin warm and soft, the tongue moist and slightly coated gray, the appetite good. Wine was occasionally given. He was returned to duty October 24.