Civil War Washington

Case from the case-book of LINCOLN HOSPITAL, Washington, D. C.; Surgeon Henry Bryant, U. S. V., in charge to May, 1863.

CASE 338.—Private C. R. Johnson, company B, 36th Massachusetts volunteers; admitted February 8, 1863. Chronic diarrhœa. [This man appears on the register of the regimental hospital of the 38th Massachusetts volunteers as admitted December 2, 1862—dysentery—returned to duty December 16th. He subsequently appears on the same register as admitted January 22, 1863—typhoid fever—sent to general hospital January 24th.] He walked into the ward carrying his knapsack, but appeared somewhat exhausted by the fatigue of the journey. During the afternoon he had several loose dejections, and one at midnight. He received ten grains of Dover's powder, and rested tolerably during the night. Next morning he complained of pain and soreness in the abdomen. The diarrhœa still continued. In the evening his symptoms were more urgent, the abdomen being somewhat tense and tender. Pills of blue mass and opium were prescribed. Died, February 10th, having just previously been out of bed to evacuate his bowels. Autopsy twelve hours after death: Height five feet seven inches; body not much emaciated; age apparently about 35 years; rigor mortis marked. The brain weighed forty-six ounces; it was of light color and normal consistence. The right lung weighed twenty-three ounces, the left eighteen ounces and a half; both lungs were congested and marked with pigment in bands corresponding to the ribs; a calcareous concretion was found at the apex of the left lung. The bronchial tubes were congested. The heart was firm and red; it weighed nine ounces and a half. The semi-lunar valves of the aorta were thickened and their adjacent edges adherent to each other. There was a large fibrinous clot in the right side of the heart, none in the left. The peritoneum was extensively inflamed. The liver weighed fifty ounces and a half; it was light colored, flabby, its acini distinct; the gall-bladder contained six drachms of very thick black bile. The spleen weighed three ounces and a half; it was soft, flabby, and of a dark-red color. The pancreas weighed two ounces and three-quarters; it was very light colored and firm. The right kidney weighed five ounces and a half, the left four ounces and a half; both kidneys were light colored and tough. The stomach was large. The valvulæ conniventes became indistinct in the lower portion of the jejunum, and the mucous membrane acquired a light slate color. The ileum was slate-colored and contracted. The colon was very much thickened and extensively ulcerated; one of the ulcers near the cæcum had perforated. The rectum was thick, soft, and readily torn, but not ulcerated. The bladder was hypertrophied.—Assistant Surgeon George M. McGill, U. S. A.