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 356.—Private George Shertle, company D, 48th Pennsylvania volunteers; admitted from the hospital at Windmill Point, Aquia Creek, Virginia, February 8, 1863. Chronic diarrhœa. Died, March 21st, at 12.30 A. M. Autopsy thirty-six hours after death: Height five feet seven inches; no rigor mortis; body extremely emaciated; apparent age 20. The brain weighed forty-three ounces and a half; the veins of the pia mater and of the brain were congested; the gray matter was darker colored than usual; the pineal gland was absent. The right lung weighed eleven ounces and three-quarters, the left seven ounces and a quarter; the posterior portion of the upper and middle lobes of the right lung was congested, the rest of the lung normal. There were old pleuritic adhesions on the left side. The left lung was collapsed, and some portions carnified. The larger bronchi contained a quantity of muco-pus. The heart weighed six ounces and a half; its substance was quite firm; there were white fibrinous clots in both sides; that in the left side extended into the aorta. The liver weighed forty-four ounces and a half; it was quite firm, and full of dark-colored blood; the gall-bladder contained six drachms of light-yellow watery bile. The right kidney weighed five ounces and a half, the left six ounces; in the right kidney, which was generally congested, were a number of white points the size of millet-seed, which upon section yielded a puruloid matter; in the upper part of the left kidney was an abscess the size of a hazel-nut, full of bluish-white pus; this kidney also contained small white purulent deposits similar to those in the right kidney, but not so numerous. The spleen weighed four ounces and a quarter; it was firm, of a reddish purple color, its trabeculæ distinct. The suprarenal capsules were dark-yellow and friable; the left capsule was quite large. The pancreas was dark colored, and weighed an ounce and three-quarters. The mucous membrane of the stomach was thin and congested. The duodenum was dilated, its glands large. The valvulæ conniventes of the jejunum were generally of a purplish color, while the rest of the mucous membrane was normal; the middle third of the ileum was intensely congested; in places there were extravasations of blood; Peyer's patches were well developed, most of them dark colored, and presenting a mammillated appearance. The mucous membrane of the cæcum and ascending colon presented a number of dark-purplish congested spots and ulcers of variable size, which were generally small and superficial: in the transverse colon, which was irregularly congested, there were but a few small ulcers; in the descending colon there were none; the ulcers were numerous in the sigmoid flexure and rectum, which were intensely congested.—Assistant Surgeon George M. McGill, U. S. A.