Civil War Washington

Case from the case-book of LINCOLN HOSPITAL, Washington, D. C.; Surgeon Henry Bryant, U. S. V., in charge to May, 1863.

CASE 335.—Private Charles N. Blake, company B, 4th Vermont volunteers; admitted January 2, 1863. Chronic diarrhœa. Died, January 25th, at 8 A. M. Autopsy twenty-nine hours after death: Height five feet five inches; body somewhat emaciated; the abdomen was discolored, and there were purpuric spots on the front of the chest. The brain weighed fifty-two ounces; it was light colored and of normal consistence; the choroid plexuses pale; the pons and medulla congested; the sinuses of the dura mater full of coagulated blood; the subarachnoid space contained a considerable quantity of liquid. Both lungs contained miliary tubercles, and in places masses of cheesy tubercle, especially in the lower lobe of the left lung; in the same lobe there was a large cavity which communicated anteriorly with a bronchial tube of the third magnitude; the right lung weighed thirteen ounces, the left twenty ounces and a quarter. The heart weighed four ounces and a quarter; its muscular tissue had a somewhat gelatinous appearance; the right and left ventricles each contained a small clot; there was very little fat about the heart; the lining membrane of the aorta was reddened as far as its bifurcation; the bronchial glands were much enlarged, white internally, and contained pus in places. The liver weighed forty ounces; scattered throughout its substance were numerous miliary tubercles; the bile was dark colored and viscid; there was a considerable deposit of tuberculous matter upon the under surface of the diaphragm immediately above the right lobe of the liver. The spleen weighed seven ounces; it was of a light reddish-brown color, and contained numerous miliary tubercles. The right kidney weighed five ounces and a quarter, the left kidney five ounces; both kidneys contained tubercles, especially in their lower portions. The pancreas weighed two ounces. The mesenteric glands were slightly enlarged, and some of them were tuberculous. The stomach was large; its mucous membrane soft near the pyloric orifice. Numerous round, hard, small bodies were observed on the mucous membrane of the duodenum; some of them were translucent; the mucous membrane was of a pale purplish color. In the upper part of the jejunum was a small white body a line in diameter, which was surrounded by a reddish areola; other similar white bodies occurred farther down; Peyer's patches were dotted with black pigment; the solitary glands were enlarged and hard; the ileum was red, congested, and presented extravasations of blood into its mucous membrane. In the large intestine the mucous membrane was very thin, and there were several dark congested patches in the rectum.—Assistant Surgeon George M. McGill, U. S. A.