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 355.—Private William Allerdist, company D, 20th New York volunteers; German; admitted January 2, 1863. Chronic diarrhœa and anasarca. Died, March 16th. Autopsy twenty hours after death: Height five feet four inches; body slightly emaciated; apparent age 28. The brain weighed fifty ounces and a quarter; there was some effusion in the subarachnoid space; in other respects the brain was healthy. The heart was small; it had very little adipose tissue about it; the valves were normal; the right side was filled with black clots. The pericardium contained a moderate quantity of fluid. Both lungs contained a considerable number of whitish cheesy tubercles; in the apices of their upper lobes these were surrounded with a considerable quantity of melanic matter; the lower lobes were congested and purplish on section. The bronchial tubes were congested and dilated; the larger tubes filled with a frothy mucoid serum. The right lung weighed twenty-two ounces and a quarter, the left twenty-three ounces and three-quarters. The liver weighed forty six ounces and a half; it was firm, full of blood, very finely mottled and smooth purplish-brown. The spleen weighed three ounces and a half; it was firm, full of blood, its trabeculæ distinct. The left kidney weighed eight ounces and a half, the right seven ounces; the cortical substance of the kidneys was ash-colored, the bases of the pyramids of a deep-blood color, the capsules separated readily. The suprarenal capsules were large, greenish-yellow internally, and very friable. In the interior of the left suprarenal capsule were several loose yellowish bodies of a fibrinous appearance. The pancreas was normal and weighed two ounces and a half. The stomach was large, its fundus congested. The mucous membrane of the duodenum was thin and soft; that of the jejunum was of a yellowish-ash color in its upper portion, purplish lower down; the ileum was dilated, its walls quite thin; all the patches of Peyer except the first were congested and dotted with black points. The cæcum was dilated and congested; the ascending colon at first presented a deep-purple color; farther up it was greatly contracted, of a deep-ash color with purple spots; the solitary glands had dark spots in their centres; the transverse colon was also much contracted; the descending colon, sigmoid flexure, and rectum were ulcerated; in the descending colon the ulcers were chiefly grouped along one of the longitudinal bands; they were of moderate size and had indistinct edges; in the sigmoid flexure they appeared as little pits, with indistinct edges, and were irregularly scattered over the mucous membrane; in the rectum they were of larger size, and quite irregular in shape.—Assistant Surgeon George M. McGill, U. S. A.