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 375.—Private Edward McCann, company G, 69th Pennsylvania volunteers; age 34; admitted September 12, 1863. Chronic diarrhœa and hepatic abscess. Died, September 27th. Autopsy fourteen hours after death: Height five feet ten inches; some rigor mortis. The brain weighed fifty-two ounces; it was somewhat soft. The mucous membrane of the trachea was generally pale, the spaces between the rings slightly purplish. The right lung weighed nine ounces and a half; it was pale and anæmic except the lower lobe, which was somewhat congested posteriorly; the left lung weighed eight ounces, and presented the same appearances as the right; both lungs were peculiar from the absence of the frothy bronchial secretion usually seen on section. The pericardium contained six drachms of fluid. The heart weighed eight ounces; in the right auricle there was a large fibrinous clot which extended upward into the descending vena cava, downward into the ventricle, and thence into the pulmonary artery; the left side of the heart also contained a fibrinous clot, but of smaller dimensions than that in the right. The liver measured eleven by eight by five inches; it contained a number of purulent deposits; these appeared on the external surface as whitish circular spots, about an inch and a half in diameter, surrounded by a purple areola; some of them had a little fibrinous lymph adhering over them; between them the surface of the liver was mottled with yellow and red; on section the parenchyma was pale except immediately around the deposits, where it was congested. The spleen was firm and dark colored; it weighed five ounces and a half. The right kidney was healthy, and weighed four ounces and a quarter; the left kidney was markedly congested, and weighed four ounces and a half. The small intestine appeared to be perfectly healthy. The large intestine, from the cæcum down, was extensively ulcerated; the mucous membrane between the ulcers was of a dark stone-gray color, and not covered by any exudation; the ulcerated patches, however, had a thin diphtheritic coating on the exposed muscular coat.—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.