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 352.—Private Peter W. Homer, company F, 1st New Jersey cavalry; age 26; admitted January 2, 1863. Typhoid fever, contracted a month previously at Fredericksburg. The patient was very much reduced, emaciated, had an exhausting diarrhœa, from ten to twelve thin watery evacuations daily, and much abdominal tenderness. Was ordered tonics, stimulants, and nourishing diet. January 15th: Some slight improvement is noticed; there are but six evacuations in the twenty-four hours. January 20th: diarrhœa still better. The abdominal tenderness is subsiding, but erysipelas has set in. The eruption extended over the face and a portion of the scalp, but disappeared in the course of a few days, after which the diarrhœa grew worse again, there being about ten evacuations daily. The patient became exceedingly weak, could be aroused with difficulty, and his death was almost hourly expected till February 2d, when he began again slowly to improve. By the 15th the evacuations were reduced to one or two daily; they were of greater consistence, and he began to gain appetite and strength. February 24th: Is not so well; ate no breakfast; the diarrhœa is again troublesome; tongue furred. February 25th: Pneumonia was recognized: there was much cough, pain in the chest, and rusty sputa. Died, March 2d, at 10 P. M.—Acting Assistant Surgeon Daniel Weisel. Autopsy twenty-six hours and a half after death: Height five feet five inches and a half; body rigid and emaciated. The brain weighed forty-eight ounces; it was very firm, of a grayish color, its blood-vessels injected. The right lung weighed twenty ounces, the left seventeen and a half; there was but little pigment in either; the lower lobe of the right lung was hepatized; the middle lobe and the lower lobe of the left lung were affected by lobular pneumonia. The bronchial glands were of normal size and dark color. The heart weighed nine ounces and a quarter; was quite firm; there was but little adipose tissue about its base; there was a white fibrinous clot in the right auricle and ventricle, which extended into the pulmonary artery; in the left cavities there was a similar clot, which extended into the aorta; these clots weighed eight ounces and three-quarters. The pericardium contained five drachms and three-quarters of serum. The liver weighed fifty-two ounces; it was firm, irregularly mottled, its acini indistinct; the gall-bladder contained six drachms of greenish-brown viscid bile. The spleen weighed five ounces and a half; it was moderately firm, of a dark-red color; its trabeculæ were distinct. The pancreas weighed two ounces and a half; it was flesh-colored and firm. The suprarenal capsules were large, yellowish, and rather friable. The right kidney weighed six ounces and a quarter, the left eight ounces and a half; both were light colored but firm. The mucous membrane of the fundus of the stomach was red; near the pylorus slate-colored; its rugæ were distinct. The duodenum was slate-colored and stained with bile; the jejunum slate-colored and slightly congested; the ileum was dark-yellow and congested in places; its lower portion had a smooth ironed look. The large intestine was of a dark slate-color and congested; the fæcal matter in it had a peculiarly offensive odor.—Assistant Surgeon George M. McGill, U. S. A.