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 363.—Private John A. Hopper, company E, 22d New Jersey volunteers; admitted April 19, 1863. Diarrhœa and pneumonia. [This man appears on the register of the regimental hospital of the 22d New Jersey volunteers, then near Belle Plain, Virginia, as admitted April 8th—typhoid-remittent fever—sent to general hospital April 18th.] Died, May 25th. Autopsy forty-seven hours after death: Height five feet eleven inches; some rigor mortis; skin dry and furfuraceous. The brain weighed forty-seven ounces and a quarter. The œsophageal mucous membrane was pale and soft; that of the trachea highly congested and soft. The upper and middle lobes of the right lung appeared on section of a deep reddish-purple color, and exuded a large amount of frothy bronchial secretion; they floated in water; the lower lobe was of a blackish-purple color, and presented emphysematous patches on its surface; it exuded a dark venous fluid, but little or no bronchial secretion; the left lung was similar in appearance to the right. The two pleural sacs contained six ounces and three-quarters of bloody serum. The heart weighed eleven ounces and a quarter; its right side contained a soft venous clot, the left ventricle a small white clot. The spleen was soft, pultaceous, and of a dark-lake color; it weighed twelve ounces and three-quarters. The liver was pale, its acini distinct; it weighed fifty-eight ounces; the gall-bladder contained seven drachms of bile. The pancreas weighed two ounces and a quarter. The right kidney weighed four ounces and a half, the left four and a quarter. The stomach was distended with gas; its mucous membrane blackish near the pylorus, the rest natural. The duodenum was much discolored by dark-purplish patches; the rest of the small intestine, except near the ileocæcal valve, was healthy; Peyer's patches were pale, not ulcerated or elevated; near the ileocæcal valve were numerous circular superficial ulcers penetrating to the submucous tissue; the solitary glands were prominent, but their contents were not blackish; those of the vermiform appendix were prominent. The large intestine was pale; a superficial ulcer of some size, with a blackish base, was found in the ascending colon; about eighteen inches from this was a smaller ulcer with ragged edges, and a short distance from this a third ulcer, not unlike the first, but more ragged. The intestines were distended with gas, especially the colon. The omentum contained very little fat.—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.