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 351.—Private Smith Austin, company H, 33d New York volunteers; admitted February 20, 1863. Chronic diarrhœa. [This man appears on the register of the hospital of the 2d Division, 6th Army Corps, Windmill Point, near Aquia Creek, Virginia, admitted January 18th—diarrhœa; no disposition recorded.] He had been sick for five months. He was feeble, emaciated, his abdomen tender, and he had from six to eight loose passages daily. Ordered tonics and supporting treatment. February 26th: Symptoms of pneumonia in the right lung made their appearance. Died, March 2d, at 6 A. M.—Acting Assistant Surgeon Daniel Weisel. Autopsy eighteen hours after death: Height five feet seven inches; body emaciated; no rigor mortis. The brain weighed fifty-one ounces and a half; it was dark-gray and soft; the third and fourth ventricles contained an unusual quantity of serum; some sand-like granules were found in the pineal gland. The right lung weighed twenty-five ounces and a half, the left twenty-one ounces and a half; there were old pleuritic adhesions on both sides, which were very numerous on the left side; there was some lobular pneumonia in the posterior part of the middle lobe of the right lung, and a patch of red hepatization in the lower lobe; both these lobes were considerably congested, as was also the lower portion of the left lung. The bronchial tubes leading to the lower lobes of both lungs were also congested. The bronchial glands were of normal size but dark colored. The heart weighed nine ounces and a quarter, the clots three-quarters of an ounce; there was but a small amount of adipose tissue on the surface of the heart; there were several fibrous adhesions between the posterior wall of the left ventricle and the pericardium. The liver weighed forty-three ounces and a half; it was reddish-brown, tinged with slate-color, and quite firm; the gall-bladder contained nineteen drachms of yellowish, very viscid bile. The spleen weighed seven ounces; it was firm and of an irregular purplish slate-color, its trabeculæ well marked. The pancreas weighed two ounces and a half; it was firm and of a reddish slate-color. The suprarenal capsules were tough, light colored, and together weighed half an ounce. The kidneys were lobulated, and weighed four ounces and a half each; they were friable, slightly congested, and of a purplish-red color. The stomach was normal. The duodenal glands were large and distinct. The jejunum was quite thin, irregularly congested, and near the ileum dark slate-colored. The mucous membrane of the ileum was also slate-colored, and easily scraped off with the finger-nail. Peyer's patches were distinct and yellowish. There were a few ulcers in the cæcum and ascending colon, and a number of small black spots with whitish centres, which, when pressed, exuded a gelatinous substance; in the transverse colon there were numerous small ulcers with whitish borders, coated over with whitish lymph; there were also several ulcers in the sigmoid flexure and rectum.—Assistant Surgeon George M. McGill, U. S. A.