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 380.—Private Samuel Ryckman, company C, 6th Michigan cavalry; admitted July 30, 1863. Chronic diarrhœa. Died, October 27th. Autopsy sixteen hours after death: Height five feet ten inches; no rigor mortis; emaciation extreme. The brain was somewhat soft; it weighed forty-seven ounces and a half. The mucous membrane of the trachea was pale. The right lung weighed fifteen ounces and three-quarters; its upper lobes were healthy, the lower lobe somewhat congested, and a tenacious mucus exuded from the bronchial tubes on pressure. The left lung weighed fourteen ounces and a half; in its apex was a mass of tubercle the size of a walnut, which was just beginning to soften; the lower lobe was in a state of venous congestion, the mucous membrane of its bronchial tubes inflamed; the bronchial glands were large, soft and black. The pericardium contained two drachms of fluid. The heart was healthy; it weighed seven ounces and a quarter. The liver was of firm consistence, pale-yellow color, and fatty; it weighed fifty-seven ounces and three-quarters; the gall-bladder contained ten drachms of bile. The spleen was firm, of a dark-mulberry color on section, and weighed ten ounces and a half. The pancreas weighed two ounces and three-quarters. The kidneys were slightly congested; the right weighed five ounces and a quarter, the left three and three-quarters. The upper portion of the small intestine was healthy; in the lower part of the ileum the mucous membrane was thin, soft, and congested; the valvulæ conniventes were almost obliterated; Peyer's patches were of a dull-slate color, but not prominent or ulcerated. The large intestine was extensively ulcerated from the cæcum to the anus; some of the ulcers were very deep, their outlines exceedingly irregular, their bases of a dark blue-stone color; no solitary glands were visible, and no diphtheritic membrane was present. In the transverse colon the ulceration was very superficial.—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.