Civil War Washington

CASE 70.—Severe diarrhœa and abdominal pain; free perspirations; mental dulness​; rose-spots from 15th to 30th day; tongue flabby and yellow-coated; improvement in 5th week.—Private Byron Steinback, Co. A, 1st Pa. Art.; age 21; became affected on Sept. 25, 1861, with headache, pain in the back and limbs and diarrhœa, on October 2 with chills and fever, and on the 6th with epistaxis and some retention of urine. He was admitted on the 9th, on the evening of which day he was found to be weak, having had ten stools, with general abdominal tenderness and some retention of urine; a few rose-spots were scattered on the chest and abdomen; the face was slightly flushed, the eyes injected and suffused and their lids closed, the skin of natural temperature, pulse 80, tongue moist, red at the tip and edges, coated yellow on the dorsum, appetite deficient; he had some cough and pain in the limbs. On the 10th there was much thirst; the skin was hot and dry; four new rose-spots had appeared; the tongue was moist and flabby, red at the tip and edges and heavily coated yellow in the centre; six stools were passed. Tincture of iron was given three times daily. On the 11th the skin was covered with perspiration, the rose-spots had increased in number, the bowels were moved twice and there was tenderness at the umbilicus and in the iliac regions, markedly on the right side, with some tympanites and borborygmus. Turpentine emulsion was given every three hours. On the 12th the patient was reported as having slept well; he was dull and stupid; his eyes dull and injected; cheeks somewhat flushed; pulse 75, regular; skin hot, dry and profusely covered with rose-colored spots; tongue slightly moist, red at the tip and edges, coated yellow in the centre; lips and teeth covered with sordes; appetite poor; his bowels were moved five times, and there was much abdominal tenderness, notably about the umbilicus. Astringents were given, but the diarrhœa continued. On the 15th, 16th and 17th profuse perspirations were noted, and rose-spots, perceptible to the touch, continued to erupt. A few of these spots appeared on the forehead on the 22d and a few more on the chest two days later. On the 22d the diarrhœa was controlled: one stool only was passed instead of three, four or more, as on previous days; but the general abdominal and extreme umbilical tenderness was not relieved until some days later. Meanwhile the tongue became clean, the skin natural and the appetite good. The cough, which had affected the patient more or less from his admission, now assumed prominence as a symptom, and was accompanied with mucous expectoration. He was transferred November 1 to Annapolis, Md. [whence he was discharged from the service on the 29th because of debility].