Civil War Washington

CASE 64.—Onset obscured by presence of tonsillitis; headache, deafness and tinnitus; disease marked chiefly by abdominal symptoms; diarrhœa alternating with perspirations.—Private G. W. Conger, Co. B, 19th Ind.; age 20; was admitted Sept. 4, 1861, with a high grade of inflammatory fever, presenting marked remissions and accompanied with flushed face, bloodshot eyes, hot and moist skin, yellow-coated tongue, regular bowels, anorexia and slight tonsillitis. Quinia and a gargle were ordered. On the 7th the fever lost its remittent character and was accompanied with headache, dry tongue and frequent stools; pulse 80. Turpentine emulsion, beef-essence and milk were substituted for the quinine. On the 11th diarrhœa, tympanites and tinnitus aurium were noted; pulse 88. Dover's powder was given at night. The patient rested well and had some appetite next morning; the bowels were quiet, but the skin was hot and dry and the pulse 108; a slight eruption had appeared on the penis and scrotum. In the evening the pulse was 100, the tongue moist and slightly coated; the patient had two stools and some tympanites during the day. The Dover's powder at night was continued. On the 16th the bowels were regular and there was some appetite; pulse 75 and skin moist. On the 17th the tongue was cleaning, the appetite good, the pulse 80 and the bowels regular. Dover's powder was continued. On the 18th the report is varied by noting abdominal tenderness with one stool, and on the 19th by dryness of skin, the tongue continuing moist, slight deafness, cough, respiration increased to 24 per minute and bowels tympanitic, slightly tender in the right iliac region and moved twice. Twelve grains of quinine were given. Copious sweating occurred during the night and sudamina appeared, the bowels again becoming regular and the respiration natural. On the evening of the 22d pain recurred in the abdomen with two stools, dryness of skin, some headache and increase of the pulse to 100. Next day two stools were again reported, but the skin had recovered its moisture and the tongue was natural. On the 24th there was slight deafness but no cough nor pain; the tongue and skin were in natural condition and the appetite good. Again on the evening of the 26th, with an acceleration of the pulse and dryness of skin, there was abdominal pain with borborygmus, followed by free perspiration during the night. From this date to October 1, when he was transferred to Annapolis, Md., the patient slept well, had a good appetite, moist and clean or yellow-patched tongue and natural skin; but there was more or less abdominal pain with from two to four stools daily.