Civil War Washington

Case from the case-book of the CUMBERLAND HOSPITAL, Maryland, Surgeon John B. Lewis, U. S. V., in charge:

CASE 247.—Private Henry Pierson, company D, 5th Michigan cavalry; age 24; admitted October 29, 1864. Chronic diarrhœa. [It appears from the register of the Lincoln hospital, Washington, D. C., that this man was admitted to that hospital June 16, 1864—chronic diarrhœa—and transferred to another hospital June 27th. He is borne on the register of the Satterlee hospital, Philadelphia, as admitted June 28th—chronic diarrhœa—transferred to Detroit, Michigan, August 2d. He appears on the register of the St. Mary's hospital, Detroit, as admitted August 6th, and sent to duty August 19th. The register of the Cavalry Corps hospital, Winchester, Virginia, shows that he was admitted from the field October 20th—chronic diarrhœa—and sent to another hospital October 28th.] The patient stated that he had suffered from chronic diarrhœa for the last eighteen months. October 30th: He is much emaciated; skin cool, dry, and yellow; tongue red, dry, and fissured; has no appetite; great thirst; pulse 70 and feeble; abdomen tympanitic; had fifteen dejections in the last twenty-four hours. Ordered a turpentine mixture containing nux vomica; also quinine and whiskey. November 3d: seems better; the tongue is moister; the tympanites has disappeared; the dejections are less frequent. Continue the quinine and whiskey. The patient continued to improve till November 20th, when he procured and ate a large quantity of chestnuts. This produced a relapse; the dejections again became very frequent; the abdomen tender and tympanitic; tongue dry. Renewed the mixture of turpentine and nux vomica prescribed October 30th. November 25th: The patient has again improved, but his appetite remains poor. November 30th: The diarrhœa has recurred. ℞. Nitrate of silver six grains, powdered opium three grains; make twelve pills. Take one every six hours. Continue the quinine and whiskey; milk diet. December 15th: The patient continues to emaciate and grow feeble; his abdomen is more tender and swollen. Substitute for the nitrate of silver pills the following: ℞. Sulphate of copper two grains, powdered opium four grains; make eight pills. Take one every four hours. The patient continued to grow worse, and died December 30th. Autopsy ten hours after death: Body extremely emaciated. There were slight pleuritic abscesses. The heart was healthy. The great omentum was contracted, and closely adhered to the transverse colon. The pyloric portion of the stomach was contracted, and there were two ulcers near the pylorus, also one of considerable extent in the greater curvature; several others had existed but were healed. The walls of the stomach were thickened, the rugæ very prominent. The mucous membrane of the small intestine was congested and inflamed in patches. The colon was extensively ulcerated from its arch to the rectum. The ulcers were most numerous in the sigmoid flexure; many were healed, some in process of healing, others still spreading. The liver was congested, bleeding freely on section. The spleen was of normal size, but light-colored and hard. The kidneys were much congested. The mesenteric glands were enlarged, hard, and filled with tubercular deposits. Acting Assistant Surgeon S. B. West.