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 379.—Sergeant Benjamin Russell, company I, 13th Massachusetts volunteers; admitted October 24, 1863. Chronic diarrhœa. [This man appears on the register of the regimental hospital of the 13th Massachusetts volunteers, admitted September 24th—acute diarrhœa—sent to division hospital October 15th. He is borne on the register of the hospital of the 2d Division, 1st Corps, admitted October 19th—chronic diarrhœa—sent to general hospital October 24th.] Died, October 25th. Autopsy twenty hours after death: No rigor mortis; body much emaciated; apparent age 34; height five feet eight inches. The brain was healthy, and weighed forty-seven ounces. The mucous membrane of the trachea was readily torn; it was generally pale, but somewhat purplish between the rings. The right lung weighed twenty-nine ounces and a quarter; its upper lobe was hepatized posteriorly and presented at its apex a tubercular deposit about the size of a chestnut, in which there was a cavity partly filled with softened tubercular matter; the middle lobe was in the stage of gray hepatization; it was coated externally with a thick layer of lymph; the lower lobe was in the stage of splenization; a large amount of greenish frothy fluid exuded on pressure; the lobe was covered posteriorly with old adhesions. The left lung weighed twenty-two ounces and a half; its upper lobe contained a number of small vomicæ, the lower lobe was in the stage of gray hepatization. The pericardium contained seven drachms of fluid. The heart weighed six ounces and a half; its valves were healthy; the endocardium was of a dark-purple color; both cavities contained soft whitish clots and a considerable quantity of venous blood; the clot in the left side was larger than that in the right. The liver was healthy; it weighed forty-two ounces and a half; the gall-bladder contained an ounce and a half of dark-brown very viscid bile. The spleen weighed four ounces and a half; it was of a dark-mulberry color and rather friable. The pancreas was healthy, it weighed an ounce and three-quarters. Both kidneys were congested; the right weighed four ounces, the left four and a half. The small intestine was healthy, except that its walls were thin; Peyer's patches were not elevated. The large intestine from the rectum upward was extensively diseased; numerous small punctated ulcers were observed along the tract; the mucous membrane was thickened and irregularly covered by a fine granular exudation which was most abundant near the rectum; the cæcum was of a dull-slate color, the colon congested.—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.