Civil War Washington

CASE 82.—Ague; gastric irritation; rose-colored spots; cerebral symptoms slightly marked; perspiration and periodic epistaxis.—Private Fred Shaffer, Co. G, 72d N. Y.; age 23; became affected in July, 1861, with ague which lasted for six weeks, after which he was confined to bed with abdominal pains. He was admitted September 29 as a case of typhoid fever. For some days after admission he rested well at night, but had from two to six stools daily with, but sometimes without, tympanites and abdominal tenderness, chiefly marked in the umbilical and left iliac regions; he had some congestion of the face and headache, and the pulse ranged from 85 to 100, being usually somewhat more rapid at the evening visit; his skin, which was natural or slightly moist with the lower pulse and usually hot and dry with the higher, presented a few rose-spots and a profuse eruption; he was troubled with anorexia and great irritability of the stomach; his tongue was moist and white or yellow-coated, or dry and brown; he had some difficulty in micturition and afterwards retention of urine. He was treated with turpentine emulsion, Dover's powder, astringents and small doses of calomel and opium. On October 5 he was restless at night; his face was congested, eyes dull, pulse 95 and weak, but his skin was cool and covered with perspiration. Next night he slept well and in the morning looked better; pulse 80, regular; skin natural; tongue moist, clean; appetite good; but the stomach continued irritable and much green matter was vomited; four stools were passed. Tincture of iron and astringents were given. From this time forward the record shows the presence of occasional headache with dizziness and tinnitus aurium. The stomach continued irritable, but after the occurrence of epistaxis on the 10th and free perspiration on the 11th, this symptom became less prominent and disappeared. The epistaxis recurred on the 13th, 15h, 17th and 21st. The tongue was always moist and generally clean, but flabby and with prominent papillæ. The bowels were loose, giving two or three passages daily, with decreasing tympanites, gurgling and general abdominal tenderness, sometimes particularly marked in the umbilical and right iliac regions; towards the end of the month the stools became reduced to one daily. On the 25th quinine in two-grain doses was given three times daily. The patient was transferred to Annapolis, Md., November 1 [as affected with typhoid fever, on account of which he was discharged from the service on the 25th].