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 349.—Private Addison Bowley, company C, 3d Vermont volunteers; admitted January 2, 1863. Chronic diarrhœa. [This man appears on the register of the regimental hospital of the 3d Vermont volunteers, excused from drill on account of diarrhœa, November 12, 1862, and again December 1st; in hospital with diarrhœa December 10th—sent to general hospital January 2d.] This patient had been suffering from diarrhœa three months. He was of scrofulous diathesis; about 30 years old; had large prominent blue eyes and dark hair. The action of his heart was violent, suggesting hypertrophy of that organ, and he complained of a sense of oppression in the præcordia. Pulse small, at times almost imperceptible; countenance cadaveric. Died, February 27th, at 7 P. M.—Acting Assistant Surgeon Henry F. Condict. Autopsy twenty hours after death: Height six feet; body very rigid; no emaciation. The brain weighed fifty-four ounces and a half; it was light colored and firm; there was an unusual quantity of serum in the subarachnoid space and in the ventricles. The right lung weighed twenty-five ounces, the left twenty-one; six pints of serum were taken from the pleural cavities; all the lobes of both lungs contained miliary tubercles, which were most abundant in their posterior portions; the lower lobes were hypostatically congested. The bronchial glands were tuberculous. The heart was soft, flabby, and weighed ten ounces; it was surrounded by a moderate quantity of adipose tissue; the heart-clots weighed one ounce and a quarter. The pericardium contained eight ounces of serum. The liver weighed eighty-seven ounces; it was of a brownish-purple color, mottled, its acini distinct, and had miliary tubercles on its surface; the gall-bladder was empty. The spleen weighed twelve ounces and a half; it was of a dark-purple color, and had miliary tubercles both on its surface and internally. The pancreas weighed three ounces and a quarter. The suprarenal capsules were large, soft, and coffee-colored. The right kidney weighed nine ounces and three quarters, the left eleven ounces and a half; both of them were light colored, friable, and slightly congested inferiorly. The stomach was large, its rugæ prominent. The mucous membrane of the duodenum was congested and softened. There was irregular congestion of the lower fourth of the jejunum, and the whole of the ileum, alternating with slate-colored patches. The valvulæ conniventes were indistinct; the mucous membrane thin; the solitary follicles enlarged. The large intestine was dilated, its walls thin, its mucous membrane bluish and softened. There were several ulcers, each about the size of a three-cent piece, in the colon and rectum. On the peritoneal surface of the intestines were numerous miliary tubercles, which were particularly conspicuous in positions corresponding to the patches of Peyer.—Assistant Surgeon George M. McGill, U. S. A.