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 346.—Private Ely Olp, company 1, 135th Pennsylvania volunteers; admitted January 27, 1863. Chronic diarrhœa. This patient, when admitted, had ten or twelve evacuations daily; was extremely emaciated; tongue furred; pulse 80; no cough or expectoration noticed. Anodynes and astringents were given, which somewhat diminished the number of evacuations; the strength of the patient was supported by wine and ale; but the stools became very offensive and putrid, the appetite failed, and the patient gradually sank. Died, February 25th. Autopsy six hours after death: Height five feet five inches and a half; apparent age about 38 years; body much emaciated; no rigor mortis. The brain weighed forty-eight ounces and a half; it was of a light color, soft and flabby; there was but a small quantity of subarachnoid fluid. The right lung weighed thirteen ounces and a quarter, the left eleven ounces and a quarter; tuberculous deposits were found in all the lobes of both lungs, but especially in their apices; but little softening of these deposits had taken place; the surfaces of both lungs presented an excess of black pigment. The bronchial glands were large, firm, and black. The heart was firm, and weighed eight ounces; there was a large white clot in its right side, a mixed clot in the left; the clots weighed two ounces and a quarter. The pericardium contained six drachms of straw-colored serum. The mucous membrane of the œsophagus was softened and ulcerated for a space which extended from two inches below its commencement downward four inches; there were several separate ulcers, some of which were coated with a greenish disorganized substance. The liver weighed forty ounces and a half; it was mottled purple and white, the acini distinct; miliary tubercles were found in all parts; the gall-bladder contained two drachms of a watery light-brown bile. The spleen weighed three ounces and three-quarters; it was tough, firm, and light colored. The pancreas weighed three ounces and three-quarters; it was flesh-colored and firm. The suprarenal capsules were rather large, and together weighed a quarter of an ounce; they were of a dark coffee-color and tough; in the upper part of the left capsule there were two small cysts. The stomach was natural. The glands of the duodenum distinct. The mucous membrane of the upper third of the jejunum was black, that of the middle third green, the lower third greenish-red; the upper third of the ileum was congested; the mucous membrane throughout the small intestine was soft; the solitary glands were swollen; Peyer's patches inflamed; within eight inches of the ileocæcal valve were a number of small light-colored ulcers with raised edges; the valve itself was blackened by pigment deposits. There was some congestion in the cæcum, but not much in the ascending colon; in the transverse and upper third of the descending colon there was irregular congestion, with ulceration, and deposits of pseudomembrane.—Assistant Surgeon George M. McGill, U. S. A.