Civil War Washington

CASE 88.—Diarrhœa; bilious vomiting; perspirations; no rose-colored spots; dizziness; pulmonary complications on the 15th day; improvement on 28th.—Private Dwight Tousely, Co. E, 3d Mich. Vols.; age 30; was admitted Oct. 10, 1861. Diagnosis—typhoid fever. On the 12th, after undergoing much fatigue, he was taken with headache, weakness and slight diarrhœa. He slept well after admission, and on the morning of the 20th his countenance was natural, pulse 88 and strong, skin perspiring, tongue moist, pale-red at the tip and edges and brownish in the centre; he had some appetite, slight thirst, two thin watery stools, some right iliac tenderness, borborygmus and slight tympanites. Quinine administered in a full dose at noon was vomited along with much phlegm and greenish-watery liquid. On the evening of the 21st he again vomited a greenish mass mixed with the rejected ingesta; he had dizziness and tinnitus aurium. The tongue on the 23d was covered with white scales; on the following day it was raw, red in the centre, pale and slightly coated at the sides; it became scaly again on the 25th, and the pulse close to 91. On the 26th the pulse was 120 and feeble, the patient delirious, his countenance haggard and anxious, skin warm, moist and at times sweating profusely, tongue moist and cleaning from the tip and edges; he had no pain, but there was much tympanites, which was relieved by an enema; râles and creaking sounds were heard in the upper part of the chest, and the respirations were increased to 25. The pulse fell to 96 on the 27th, and on the 28th the patient appeared somewhat better; his mouth and fauces were covered with aphthæ. He had a chill on the afternoon of the 29th, and on the 30th was very nervous, although the tongue was cleaning, appetite good, bowels quiet and respiration normal. His condition did not improve materially until November 8, the tongue being occasionally dry and brown or moist and cleaning, the skin husky and the pulse accelerated. After that date, however, he slept well, had a good appetite, no thirst, soft skin and quiet bowels; some tenderness remained in the right iliac region; he had sore throat, but no cough, and his respiration was normal. He was transferred to Annapolis. Md., on the 18th.