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 368.—Private John A. Poer, company D, 4th Georgia (rebel) infantry; age 23; admitted August 3, 1863. Chronic diarrhœa. Died August 23d. Autopsy twenty-seven hours after death: Body emaciated; rigor mortis slight; height five feet seven inches. The brain was healthy, and weighed forty-eight ounces and a half. The mucous membrane of the œsophagus was of a deep-yellow color throughout, roughened above, smooth below; that of the trachea was pale, slightly purplish between the rings; the trachea contained a brownish fluid. The right lung weighed fifteen ounces and a quarter, the left twelve and a half; the lower lobes of both lungs were deeply congested. The pericardium contained half a drachm of fluid. The heart weighed eight ounces and a half; the right ventricle contained a long fibrinous clot, which extended a short distance into the pulmonary artery; the left cavities were filled with venous blood, part of which formed a soft clot in the ventricle. The liver was healthy, and weighed forty-eight ounces. The spleen was unusually firm, of a dark grayish-red color internally, grayish-green externally; it weighed five ounces. The pancreas was healthy, and weighed two ounces and a half. The right kidney weighed five ounces and a quarter, the left five and a half; in both the cortical substance was pale and slightly injected on the surface, the pyramids purple, the pelves pale; at the upper portion of the right kidney there was a depressed softened spot in which the parenchyma was undergoing some degenerative change. The small intestine was healthy. The large intestine was extensively ulcerated. The ulcers were small, mostly distinct, but occasionally confluent; they had blackish borders and pale bases. In the lower portion of the intestine the mucous membrane was dark colored, and presented a few patches of discolored shreddy exudation.—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.