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 339.—Private David Fenstermaker, company K, 48th Pennsylvania volunteers; age 26; admitted from the hospital of the 2d Division, 9th Corps, Windmill Point, Aquia Creek, Virginia, February 8, 1863. Chronic diarrhœa, contracted at Fredericksburg. He had been sick a month, was emaciated, and had twelve to fifteen evacuations daily. His tongue was dry and brown, his features shrunken, and there was slight tenderness over the abdomen. ℞. Mercury with chalk, ten grains, tannic acid two grains, quinine six grains; make eight pills. Take one every two hours. Half an ounce of brandy every hour. February 9th: Much the same; diarrhœa slightly less. February 10th: diarrhœa worse again; stools involuntary. Died, February 11th. In this case the use of beef-tea seemed to aggravate the diarrhœa.—Acting Assistant Surgeon Daniel Weisel. Autopsy two hours after death: Height five feet ten inches; no rigor mortis; body somewhat emaciated. The brain weighed forty-eight ounces and a half; it was light-colored and soft; the pia mater was somewhat congested. The right lung weighed thirty-five ounces and a quarter, the left forty-eight ounces and a half; the right lung was congested throughout and presented a number of isolated hepatized lobules; the central portion of the upper lobe of the left lung and an irregular area in the lower lobe were also in the state of red hepatization; the rest of the lung was congested; the bronchial tubes on both sides were inflamed, the bronchial glands large and black. The heart weighed eight ounces and a quarter; its muscular tissue was firm and red; there was but little surrounding adipose tissue; the right cavities contained black clots which weighed an ounce and a quarter. The pericardium contained an ounce of serum. The liver weighed fifty-nine ounces and a half; it was firm, finely mottled, and generally congested; the gall-bladder contained a small quantity of light-yellow viscid bile. The spleen weighed eleven ounces and a quarter; it was of a dark-purple color, very firm and congested, its trabeculæ indistinct, The pancreas weighed two ounces and three-quarters; it was light-red and firm. The suprarenal capsules were normal. The right kidney weighed nine ounces, the left nine ounces and a half; the cortical substance of both kidneys had a peculiar light flesh color; their capsules were very readily torn off. The stomach was rather large, its mucous membrane soft. The mucous membrane of the small intestine was reddened; the valvulæ conniventes very distinct. The ascending colon was dark colored; its mucous membrane soft; its glands distinct and slightly enlarged; the transverse colon was contracted; its mucous membrane slate-colored, thin, soft, and presented a number of small ulcers; the descending colon was dilated; but, with this exception presented the same appearances as the transverse colon. In the sigmoid flexure and rectum the ulcers were still larger and more numerous.—Assistant Surgeon George M. McGill, U. S. A.