Civil War Washington

Case from the case-book and medical descriptive lists of the DOUGLAS HOSPITAL, Washington, D. C., Assistant Surgeon William Thomson, U. S. A., in charge from February, 1863, to September, 1864, and after September, 1865:

CASE 302.—Private Jacob Mehn, company I, 108th New York volunteers; age 34; admitted February 13, 1863. Typhoid fever. This man was taken sick at Aquia Creek and brought here in a very low and emaciated condition after being sick three weeks. He was very feeble; pulse 110; tongue clean and red; stools liquid and frequent. He was treated with powders of opium and tannin; diet of scalded milk. February 27th: Somewhat better; pulse 95; tongue clean and moist; some appetite; stools less frequent. To take powders containing three grains of quinine and one-twelfth of a grain of morphia three times daily. March 2d: Pulse 85; skin moist tongue clean but rather dry; bowels moved three times during the day; some tenderness in the umbilical and left iliac regions. Continue treatment; two eggs daily. March 12th: Appearance improved, looked much brighter and seems stronger; has moderate appetite; three stools in twenty-four hours; is still very feeble and greatly emaciated, but there is now no abdominal tenderness; tongue slightly red on the edges and inclined to dryness. Since the 6th has had suppositories of opium and tannin after each stool; milk-punch and beef-tea every four hours. March 17th: Is worse again; abdomen tympanitic and tender, the tenderness being greatest over the descending colon; there is no tenesmus; tongue and skin dry. Continue treatment. March 18th: Very weak; pulse 140; tongue and skin dry; considerable thirst; abdomen very tender and tympanitic. He complains of much pain in the epigastric region; had two stools in the last twenty-four hours, they were light-yellow and liquid; there is no tenesmus; micturition painful; the urine normal. The stomach retains stimulants and nourishment very well, but digestion and assimilation are wanting, and emaciation steadily progresses. Died, March 19th.—Acting Assistant Surgeon H. L. W. Burritt. Autopsy: Emaciation extreme. There were recent pleuritic adhesions of the lower lobe of the right lung, which was hepatized; the rest of the right lung and the left lung were normal. The heart was small but normal. The liver presented the nutmeg appearance; it was one-third larger than natural. The spleen was somewhat indurated. The pancreas was firm. The kidneys were natural in size and texture, but the cortical portion was somewhat pale. Stomach much contracted. The lower part of the small intestine was injected in patches. The cæcum contained a number of small superficial ulcers. The mucous membrane of the colon was somewhat thickened, and presented numerous large ulcers, between which the mucous membrane was coated with pseudomembrane. In this case no symptoms observed during life culled attention to the pulmonary lesion.—Acting Assistant Surgeon F. M. Holly. [Nos. 288 and 289, Medical Section, Army Medical Museum, are from this case. The specimens are successive portions of the colon. In No. 288 the mucous membrane is irregularly coated with pseudomembrane; in the lower portion of the piece is a large irregular diphtheritic ulcer which penetrates to the muscular coat. In No. 289 there are several similar ulcers, but the mucous membrane between them presents very little adherent pseudomembrane.]