Civil War Washington

CASE 87.—Headache, dizziness, deafness, delirium and muscular twitchings; relaxation, tenderness and tympanites of the bowels; pneumonia; no rose-colored spots.—Private Sidney D. Way, Co. I, 2d Vt.; age 18; was admitted Sept. 27, 1861, having been taken three weeks before with intermittent fever, cough and pain in the breast. The case was diagnosed typhoid fever. The patient was weak, his cheeks flushed, countenance anxious, pulse quick, 120, skin hot and dry; he had some pain in the head and chest, with deafness and muscular twitchings; there was anorexia with a moist white tongue, and relaxed bowels with much tympanites and general abdominal tenderness. Small doses of blue-pill and opium were given on the 28th and turpentine emulsion on the 29th. During the next four days his condition was but little altered; the deafness increased, and delirium, dizziness and aphonia were manifested; three or four passages from the bowels were recorded every twelve hours; the cough occasionally became troublesome, and was accompanied with a mucous expectoration; the respirations were at one time as high as 36 per minute. On the morning of October 2 the patient, having slept well during the previous night, was found with the skin of natural temperature and bathed in perspiration, sudamina on the right side and over the abdomen, the tongue moist and slightly coated yellow, and the pulse 95 but strong and quick; two stools had been passed during the night and a little blood expectorated, after which the cough became less troublesome; respiration 28, with much crepitation anteriorly on the left side and a little on the right side. Next day, however, the pulse was again accelerated, 113, and the skin hot and more or less dry, the other symptoms continuing as already described until the 6th, when with a freely perspiring skin the pulse fell to 90, and the patient had less cough and some improvement in the voice. After this the pulse again rose to 105, the skin becoming hot and dry, but the tongue remaining moist and yellow-coated; the cough and expectoration of mucus and blood continued, with dulness​ over the lower lobe of the right lung posteriorly and mucous and submucous râles above, and with crepitation over the left lung posteriorly; the diarrhœa and abdominal tenderness continued as already reported. By the 11th the pulse had risen to 118, and the patient was quite deaf and complained of headache. On the 12th the tongue, still continuing moist and yellow-coated, became red at the tip and edges; some sordes formed upon the lips, and tormina accompanied the diarrhœal passages. From this time to the end of the month the condition varied little from day to day, but a gradual alleviation of the symptoms of the lung and bowel complaints was observed. A free perspiration which occurred on the 20th was followed by a reduction of the pulse on the 21st and the manifestation of some appetite. The abdominal tenderness became lessened and the passages less frequent until the 31st, when, for the first time, the daily record shows that no stool was passed during the previous twenty-four hours. On November 1 the pulse was 80 and feeble, the skin natural, the tongue pale, the appetite good; the cough was less troublesome and there had been but one stool. His condition had not changed materially on the 9th, when he was discharged from the service on account of debility; the cough persisted with occasional relaxation of the bowels and abdominal tenderness, but with a good appetite and natural skin.