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 316.—Private Daniel McDonald, company F, 39th Massachusetts volunteers; admitted from the army of the Potomac September 9, 1864. Chronic dysentery. He stated that he had suffered from frequent attacks of diarrhœa during the summer, and that for the last three weeks he had been in field hospital with a severe attack of dysentery. During the summer he also bad an attack of intermittent fever. [This man appears on the register of the hospital of the 1st Division, 2d Corps, as admitted August 9th—diarrhœa; no disposition is recorded. He is borne on the register of the depot hospital of the same division, City Point, Virginia, as admitted August 13th—intermittent fever—sent to general hospital September 8th.] He is now emaciated and feeble; conjunctivæ tinged with yellow; tongue furred; pulse 80. The abdomen is flat and tender to the touch, especially over the transverse and descending colon; he has also a slight bronchitis. His dysentery was partially controlled by astringents and a proper diet, and he was apparently doing well until September 29th, when he was seized with nausea, vomiting, and increased tenderness in the abdomen. From this time he sank rapidly, his pulse became feeble, his skin cool, and he died September 30th, at 10 A. M. Autopsy four hours after death: Rigor mortis well marked. Both lungs were firmly adherent to the sides of the thorax; their apices presented several dense fibrinous bands resembling cicatrices, and contained a number of cretefied tubercles, some of which were quite hard, others of a more cheesy consistence. The heart was healthy. The external surface of both large and small intestine was covered with a yellow croupous lymph, beneath which the peritoneum was slightly reddened. The recto-vesical cul-de-sac was filled with a thin yellowish-green pus, and there was a patch of lymph of considerable size on the fundus of the bladder. The small intestine was normal, except that a large cul-de-sac projected from the ileum, opposite its mesenteric attachment, about sixteen inches above the ileocæcal valve. The large intestine was much thickened, and presented both follicular ulcers and extensive ragged erosions; the ulcers were very irregular in size and shape, and were most extensive and numerous near the rectum. The liver, spleen, and kidneys were healthy.—Assistant Surgeon William F. Norris, U. S. A.—[No. 400, Medical Section, Army Medical Museum, is from this case. The specimen is a portion of the colon, which presents a few follicular ulcers and a number of somewhat extensive erosions.]