Civil War Washington

Case was forwarded, with specimens, to the Army Medical Museum from the JUDICIARY SQUARE HOSPITAL, Washington, D. C., Assistant Surgeon Elias J. Marsh, U. S. A., in charge.

CASE 266.—Private J. G. Beals, company F, 37th Massachusetts volunteers; admitted February 15, 1863. Chronic diarrhœa. [The register of the hospital of the 1st Division, 6th Corps, shows that this man was admitted to that hospital January 19th, and sent to Washington February 14th; the diagnosis recorded is typhoid fever.] He stated that he had suffered for some months with a slight diarrhœa, when, December 27, 1862, he was attacked with measles, followed by a severe cough. During this attack the diarrhœa ceased. While convalescing he suffered two relapses from exposure, and when admitted to this hospital was quite weak, had some cough, and a diarrhœa which had recently come on. His appetite was fair, tongue clean and moist, and pulse 114. There was no special change until February 20th, when he said he felt better, but was much weaker, and died February 22d. Autopsy twenty-seven hours after death: Body emaciated; rigor mortis slightly marked; abdomen collapsed; muscles pale. The right lung exhibited scattered yellow tubercles in the upper and middle lobes, with muco-pus in the bronchial tubes; the left lung presented one cavity in the upper lobe as large as a hen's egg, with a number of smaller ones from the size of a pea to that of a hazel-nut; these cavities had yellow opaque walls about one line in thickness; there were some yellow tubercles in this lung, and its lower edge was œdematous. The bronchial glands were hard, enlarged, and filled with black pigment. The heart was small, flabby, pale, and remarkably free from external adipose tissue. The spleen was apparently healthy. The liver showed a marked differentiation between the red and yellow portions, the latter being comparatively large and pale. The mesenteric glands small and pale. The stomach contained a thin mucus mixed with bile, but its mucous membrane and that of the duodenum and jejunum was normal. Peyer's glands were normal. The small intestine was smeared over with thick adhesive mucus, stained with greenish-yellow bile, which was darker in the lower part of the jejunum but lighter through the ileum. There were one or two small ulcers near the ileocæcal valve. The colon contained thin yellow fæces; throughout its whole length the mucous membrane was greatly thickened and coated with pseudomembrane. The descending colon and rectum presented numerous ulcers of various sizes from a quarter of an inch to two inches in diameter, the membrane being softened, thickened, and undermined for some distance around the margins of the large ulcers.—Assistant Surgeon E. J. Marsh, U. S. A. [Nos. 223 to 225, Medical Section, Army Medical Museum, are from this case. The specimens are three successive portions of the greatly thickened colon, the mucous membrane of which is coated with a pseudomembranous layer. In Nos. 224 and 225 there are many follicular ulcers, which in three or four patches have extended into eroding excavations, the largest of which is an inch and a half long by an inch wide.]