Civil War Washington

Case from the case-book of LINCOLN HOSPITAL, Washington, D. C.; Assistant Surgeon Roberts Bartholow, U. S. A., in charge from August 21st to December, 1863.

CASE 367.—Private Elbridge C. Crane, company D, 1st Maine cavalry; admitted August 18, 1863. Chronic diarrhœa. [This man appears on the hospital register of the Cavalry corps of the army of the Potomac, Warrenton Junction, Virginia, admitted August 15th—diarrhœa—sent to general hospital August 18th.] Died, August 23d. Autopsy seven hours and a half after death: Body well developed; rigor mortis strong; apparent age 20; height five feet six inches. The brain was firm, and weighed fifty-four ounces; the pia mater was injected, particularly on the external side of the left hemisphere. The lateral ventricles contained half a drachm of clear serum slightly tinged with blood. The mucous membrane of the upper portion of the œsophagus was pale, toward the cardiac orifice it was darker colored. The mucous membrane of the upper portion of the trachea was pale, lower down it was purplish between the rings. The bronchial gland at the bifurcation of the trachea contained a calcareous deposit. The right lung weighed twelve ounces and a half, the left ten ounces; both lungs were congested. The pericardium contained a drachm and a half of fluid. The heart weighed eight ounces; its valves were healthy; the right auricle was filled with a soft black clot, which extended into the right ventricle and thence into the pulmonary artery; there were no clots on the left side. The liver was of a light-purple color, its acini well marked, its capsule readily torn; it weighed sixty-seven ounces; the gall-bladder contained eight drachms of dark greenish-brown bile. The spleen was very firm, of a liver-color on section, and weighed five ounces and a half. The pancreas was pale but healthy, and weighed two ounces and a half. The right kidney weighed four ounces; weight of the left not recorded; both were slightly congested, their capsules readily torn, their pelves pale. The suprarenal capsules were lighter externally than internally, and of a brownish-ochre color. The mucous membrane of the stomach was firm and of a grayish color. The small intestine was healthy, except in its lower third, where the mucous membrane was congested. The mucous membrane of the large intestine presented a ragged appearance, due to the irregular distribution of a diphtheritic exudation; this was of a light-greenish color, and lay in a thick layer on the surface; those portions of the membrane which were not covered by the exudation presented an angry inflamed appearance and minute ecchymosed spots.—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.