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 359.—Private Charles Butleb, company F, 14th Connecticut volunteers; admitted from Finley Hospital, Washington, D. C., March 18, 1863. Chronic diarrhœa. [This man appears on the register of the regimental hospital of the 14th Connecticut volunteers, admitted January 13th—typhoid fever—sent to general hospital January 25th. He does not, however, appear on the register of the Finley Hospital.] Died, April 3d. Autopsy one hour after death: Height five feet six inches; no post mortem rigidity; apparent age 30 years; there was diffuse suppuration of both parotid glands. The brain was firm, and weighed thirty-eight ounces and a half. The mucous membrane of the trachea was pale. The ramifications of the bronchi were filled with phthisical sputa. Miliary tubercles were disseminated through the right lung, most abundantly in its apex; on the surface of the upper lobe were long streaks of black pigmentary matter following the courses of the ribs; some of the lobules of this lobe were emphysematous, others carnified; the right lung weighed twenty-one ounces; its lobes were united together by recent lymph; the left lung was collapsed and presented nothing abnormal. The heart was pale; weight five ounces and a half; there was a good deal of adipose tissue on its external surface; there were no heart-clots. The aorta was slightly atheromatous just above the semilunar valves. The liver was purple externally, yellowish-purple internally; it weighed thirty-two ounces; the gall-bladder contained four drachms and a half of dark tenacious bile. The right kidney weighed seven ounces and a quarter, the left eight ounces; the cortical substance of both was pale, the pelves injected; the left kidney was rather darker colored than the right. The suprarenal capsules were large and dark colored. The spleen weighed three ounces; it was purple externally, light brownish-red internally, its texture firm. The pancreas weighed two ounces. The stomach was very small, the summits of its rugæ congested. The mucous membrane of the last five feet of the ileum was of a dark-purple color; Peyer's patches were normal, but in the neighborhood of the ileocæcal valve the solitary glands were tumefied. The mucous membrane of the large intestine was firm, generally dark colored, in some places purple; the solitary glands were numerous but healthy; there were no ulcers. The omentum was almost entirely void of fat, and extended to the pubis.—Assistant Surgeon Harrison Allen, U. S. A.⃰

⃰ September 14, 1864, Dr. Allen presented to the Pathological Society of Philadelphia a brief "Synopsis of Autopsies made at Lincoln General Hospital," to which the reader is referred.—(Proceedings of the Pathological Society of Philadelphia, in the American Journal of the Medical Sciences, January, 1865, page 133.) In this paper he analyzes the appearances observed in forty-one cases of diarrhœa and dysentery, thirty-five of fever, twenty-one of pneumonia, and five of diphtheria. The notes of Dr. Allen's autopsies, from which the accounts here presented have been condensed, were not contained in the case-books of Lincoln hospital turned in to the Surgeon General's Office at the close of the war, but have since been copied into them from the originals, loaned for the purpose.