Civil War Washington

CASE 74.—Dulness​ and drowsiness for a day or two; diarrhœa and dry skin persisting; rose-colored spots and vibices; tongue flabby and coated yellow; moist skin, and convalescence on 38th day.—Private William Morrison, Co. E, 1st Pa. Rifles; age 38; had a chill about Oct. 1, 1861, followed by fever and perspiration, slight headache, anorexia and some cough. He was admitted on the 10th as a case of typhoid fever. Next day he was dull and drowsy, but without any sign of congestion about the face; his pulse was 80 and feeble, skin hot and dry, tongue slightly moist, red at the tip and edges and heavily coated with yellowish fur in the centre; he had intense abdominal tenderness, but only one stool during the previous twenty-four hours. Emulsion of turpentine and tincture of iron were ordered in repeated doses. On the 12th the eruption appeared; the skin was of natural temperature, the tongue slightly moist but coated with yellowish fur, and the appetite good; two stools were passed, and the patient had some abdominal tenderness and cough. He slept well and next day was brighter mentally. From this time till the end of the month his general condition remained unchanged. The tongue was flabby and always more or less yellow-furred; the appetite usually good; the bowels moved from one to seven times daily, with general and occasionally umbilical and left iliac tenderness, and with slight tympanites on the 10th and 29th; the skin, usually hot and dry, showed some vibices on the 19th and 20th; on the 22d rose-colored spots appeared on the face and did not fade until the 29th, when some epistaxis occurred; there was more or less cough with some mucous expectoration; the pulse beat generally about 75 per minute. On the 30th quinine was ordered in three-grain doses every two hours. Next day the pulse was lowered from 80 to 60, and the diarrhœa increased from one to seven stools; otherwise the patient's condition appeared unaltered. Astringents were given, and in the course of four or five days the diarrhœa became lessened to one or two stools daily. On November 4 a boil appeared on the patient's forehead. On the 7th the skin is recorded for the first time as being moist; pulse 75; tongue cleaning; appetite good; bowels tender and moved twice. Cod-liver oil and wine were ordered on the 10th. The daily record of symptoms ceases on the 11th. The patient was transferred to Alexandria, Va., December 20.