Civil War Washington

CASE 83.—Chills; diarrhœa; umbilical pain; free perspirations; no notable cerebral symptoms.—James Tobin, attendant; age 29; was admitted Sept. 11, 1861, having been taken sick ten days before with headache, constipation, pains in the bones and a chill and fever, for which quinine was administered. On the day after admission he was restless and had an anxious expression; he perspired during sleep, but when awake his skin was hot and dry; pulse 74; tongue pale but red at the tip and edges; four thin stools had been passed during the twenty-four hours, and there was slight pain, chiefly umbilical and during micturition; he had also a stitch in the side and some pain in the breast. Quinine was given. In the evening the pulse was 78, the skin hot but sweating and the tongue pale, flabby and somewhat brown; four stools were passed during the day. Acetate of lead and opium were prescribed. Next morning the pulse had fallen to 56 and the patient was sweating profusely. In the evening there was a slight accession of fever; only one stool was passed during the twenty-four hours. For some days after this the perspiration continued profuse, especially at night, although aromatic sulphuric acid was administered; the bowels remained quiet and the tongue flabby and coated gray or brown at the base. Blue-pill was given three times on the 15th, and in the evening of the 16th ten grains of calomel, which produced three painful stools, but the bowels thereafter became again quiet although tender especially in the right iliac region. The perspirations continued. Morphia was given at night and the patient was sponged with alcohol. On the 18th some pustules appeared on the abdomen. Next day he is reported as looking stout and healthy, with bright eyes and clear mind, although there was some headache and pain in the back and breast, with a slight gray coating on the tongue. Three grains of calomel and a half grain of opium were given three times. The record concludes on the 21st, the patient still perspiring at night and having the umbilical region tender.