Civil War Washington

CASE 89.—Date of onset not defined; persisting diarrhœa and vomiting of bilious matter; rose-colored spots; sordes; muttering delirium; involuntary passages; cold perspirations; death on 16th day after admission.—Private Charles Green, Co. C, 1st Long Island; age 18; was admitted Sept. 11, 1861, having been suffering for some time from weakness, pain in the bones, heat of skin, thirst and diarrhœa. On admission his stomach was irritable. He rested well during the night, and next day, although he had a brown and thickly coated tongue and a bad taste in his mouth, his appetite was good, pulse 92 and skin hot and moist. Dover's powder was given. The tongue became dry and red at the tip on the 16th; the bowels were moved six times and were tender; the pulse rose to 108 and there was some deafness. He muttered continually during sleep on the 17th; the diarrhœa and irritability of stomach continued. In the evening rose-colored spots appeared on the chest and abdomen and sordes on the teeth; the lips were livid, and a peculiar odor emanated from the body. The muttering during sleep increased, and on the evening of the 18th the patient was delirious on awaking; nausea returned and he vomited twice. During the night he vomited five times a thin greenish-yellow matter of a highly offensive odor. Mild delirium continued during the 19th, and the urine was passed involuntarily; the matter vomited became of a lighter color; the diarrhœa persisted notwithstanding the administration of astringents, and there was intestinal gurgling with umbilical tenderness. Calomel in one-grain doses was given. Next day the gastric irritability was quieted and the diarrhœa lessened. In the evening he was restless and wakeful, his skin hot and dry, but his face covered with a cold perspiration, pulse 120, weak and tremulous; he had subsultus tendinum and passed one stool involuntarily. A similar stool was passed on the 21st, during which the prostration increased. The right iliac region is noted as having been tender on this day. He died on the 22d.