Civil War Washington

Case from the case-book and medical descriptive lists of the DOUGLAS HOSPITAL, Washington, D. C., Assistant Surgeon William F. Norris in charge from October, 1864, to September, 1865:

CASE 322.—Sergeant-major George Nichols, 5th United States cavalry; admitted from Winchester, Virginia, January 18, 1865. Chronic diarrhœa. This patient had suffered from diarrhœa for a year. At times the symptoms were very severe, at other times he had but three or four stools in the twenty-four hours. At present the stools are bloody, and accompanied by tormina and tenesmus. He is greatly debilitated, and had upward of thirty-six scanty stools in the last twenty-four hours. An aperient of castor oil was prescribed, to be followed by quarter of a grain of nitrate of silver and one grain of sulphate of quinia every four hours; also an injection of twenty drops of laudanum in thin starch-water three times a day. Stimulants were also prescribed. January 21st: The stools have diminished to eight or nine daily. The patient complains of a cough, which he says he has had for some time; the sputa are thin and yellow. An expectorant mixture was prescribed. January 22d: He complained of external piles; applied an ointment containing tannic acid. January 24th: Complained of weakness in the back; applied a pitch plaster. January 26th: Ordered tincture of the chloride of iron three times daily. February 5th: Has eight or nine passages in the twenty-four hours; is still much debilitated. ℞. Persulphate of iron fifty grains, peppermint water one ounce. Take thirty drops four times a day. February 10th: There is slight fever and headache, for which a diaphoretic was prescribed. February 12th: Symptoms of acute pleurisy set in. Died, February 14th. Autopsy twelve hours after death: Body emaciated; rigor mortis well developed. The left lung was collapsed, but connected to the thoracic parietes, and especially to the diaphragm, by pleuritic adhesions; the left pleural sac contained upward of thirty-two ounces of thin yellow serum in which clots of coagulated lymph floated; the superior lobe of the left lung was healthy, its inferior lobe somewhat hepatized; there were slight recent pleuritic adhesions on the right side. The apex of the upper lobe of the right lung contained tubercular deposits; the rest of the lung was healthy. The colon was ulcerated. The other organs were not examined.—Acting Assistant Surgeon Carlos Carvallo.