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 347.—Private M. H. Wray, company H, 136th Pennsylvania volunteers; age 35; admitted February 19, 1863. Diarrhœa. This patient was sent to field hospital in Virginia several months ago with œdema of the legs; subsequently he had an attack of measles, and this was followed by diarrhœa. When admitted he was extremely emaciated, complained of pain and tenderness over the abdomen; had frequent stools; pulse scarcely perceptible; skin cold and cadaverous; tongue moist and free from any fur; feet cold. Died, February 25th. Treatment: Blue mass and opium, Dover's powder, &c. Diet: Boiled milk, toast and tea, beef-tea, brandy. Autopsy nineteen hours after death: Height five feet nine inches; no rigor mortis. The brain weighed fifty-five ounces and a half; it was full of blood, and the vessels of the pia mater were injected. The right lung weighed twelve ounces and a half, the left eleven ounces; both lungs contained an excess of black pigment, and were congested hypostatically. The heart weighed seven ounces and three-quarters, and contained mixed clots which weighed two ounces. The pericardium contained two ounces of fluid resembling mucilage of acacia. The liver weighed thirty-eight ounces, was full of blood, of a reddish coffee-color and firm consistence, the acini indistinct; the gall-bladder contained two drachms of a very viscid and dark-green bile. The spleen weighed two ounces and three-quarters, was of a dark-red color and normal con-consistence​; it contained a small nodule of cheesy matter. The pancreas weighed two ounces and a half. The suprarenal capsules were very small and tough. The left kidney weighed four ounces and a quarter, the right four ounces; they were both very dark colored and tough. The stomach was slightly congested in the fundus and toward the pyloric orifice; its mucous lining was soft. The duodenal glands were slightly enlarged. The valvulæ conniventes in the duodenum and jejunum were not well developed; the upper part of the jejunum was congested, the lower part of a light slate-color; the solitary glands were enlarged; the mucous membrane of the ileum was soft, and deeply congested, but both the solitary glands and the glands of Peyer appeared to be normal. The mucous membrane of the cæcum was soft and dark colored. Congested patches were noticed at the splenic and sigmoid flexures of the colon; in the latter the mucous membrane was brownish-red. Assistant Surgeon George M. McGill, U. S. A.