Civil War Washington

CASE 77.—Delirium, diarrhœa and involuntary stools; eruption of rose- and dark-colored spots; improvement about end of 4th week, but debility with flabby tongue continuing after defervescence.—Private B. T. Conglin, Co. G, 5th Wis. Vols.; age 22; was taken about Sept. 16, 1861, with epistaxis, headache, pain in the limbs and back and diarrhœa, and was admitted October 1 as a case of typhoid fever. On the 2d his face was congested and he looked dull; his pulse 90, quick and strong, skin normal and tongue moist, brown and with prominent papillæ; he had some pain in the back and anorexia, but no movement from the bowels; the abdomen was covered with dark spots (vibices?) and showed a few rose-spots, which latter disappeared on pressure; he was delirious. Emulsion of turpentine was given every two hours, tincture of iron three times daily and beef-essence as required. Five involuntary stools were passed on the 3d, and astringents were administered. The passages were frequent but passed voluntarily on the 4th; the abdomen and chest were covered with dark-colored spots imperceptible to the touch and disappearing on pressure; the tongue was dry and brown and there was some hoarseness. The stools became again involuntary on the 5th, and the teeth and lips covered with sordes. The patient's face was congested, eyes dull, skin hot and showing the remains of the dark-red spots. He had anorexia, slight tympanites and iliac tenderness; pulse 100. Beef-essence and punch were ordered, with Dover's powder in the evening. Involuntary micturition and defecation, with much tenderness, were noted on the 6th; pulse 112. The tongue was clean, red and dry on the 7th; the appetite improved and there was but one stool. During the three or four days which followed the tongue became moist and flabby, with prominent papillæ; the appetite continued to improve; the bowels were quiet, but there was much umbilical and some iliac tenderness. On the 12th the pulse fell from 110 to 80, the eyes became bright and the delirium ceased. Next day the tongue was moist and clean and the appetite good; but until the end of the month flabbiness and prominent papillæ were reported. The patient was free from diarrhœa, but the abdomen was occasionally tender; at times he had headache. He was transferred to Annapolis, Md., November 1, as a case of debility [and was returned to duty Feb. 3, 1862].