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 327.—Private Arnold Gelhouse, company H, 37th Wisconsin volunteers; age 44; admitted from the field hospital of the 9th Army Corps, July 25, 1865. Chronic dysentery. In this case the most noticeable symptoms were distressing tenesmus and a very rapid pulse from the beginning. Eight grains of subcarbonate of bismuth and one of opium, to be taken every three hours, were ordered at first, but with little benefit. Opium suppositories were next resorted to, which somewhat lessened the pain and tenesmus, but did not check the frequency of the stools. Injections of nitrate of silver, two grains to the ounce of water, four times a day, were next directed, with some relief to the patient; but his strength gradually gave way, the abdomen became tympanitic, breathing labored, and he died, August 7th, at 12.30 A. M. Autopsy twelve hours after death: There were numerous old pleuritic adhesions on both sides. The lungs and heart were healthy. The spleen was of natural size, but quite soft. The small intestine was nearly normal. The large intestine was ulcerated from one end to the other; the mucous membrane of the rectum was almost entirely destroyed, only a few shreds remaining. Just below the sigmoid flexure there was a perforation half an inch in diameter; although there were no signs of fæces having escaped into the abdominal cavity, there was considerable peritonitis around the perforation and in the course of the colon generally.—Acting Assistant Surgeon George P. Hanawalt.