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 381.—Corporal Charles P. Stevens, company B, 126th New York volunteers; age 33; admitted September 12, 1863. Chronic diarrhœa. Died, November 5th. Autopsy twenty-four hours after death: Height five feet nine inches; rigor mortis well marked; emaciation extreme; abdomen covered with numerous spots. The brain weighed forty-nine ounces; there was a drachm of fluid in the ventricles. The mucous membrane of the trachea was extremely pale. The right lung weighed twenty-four ounces; there were a few tubercles in the lower part of its upper lobe; the middle lobe was free from them, and they were numerous in the lower lobe, in which they were associated with intercurrent pneumonia, which in some parts had advanced to gray hepatization; the lower lobe of the left lung was in much the same condition; its upper lobe was free from tubercles; bronchitis was present on both sides, especially in the lower lobes. The pericardium contained six drachms of straw-colored serum. The heart and its valves were healthy; there was a small fibrinous clot in the right side, none in the left. The liver presented the nutmeg appearance, and weighed fifty ounces; the gall-bladder contained six drachms of dark reddish-brown bile. The spleen was quite firm, and weighed four ounces. The pancreas weighed two ounces. The kidneys were firm and rather pale; the right weighed four ounces, the left five. The walls of the small intestine were very thin; the mucous membrane was soft, the vessels congested. The mucous membrane of the large intestine was ulcerated; most of the ulcers were irregular in form, and blackish, with rather low abrupt walls; toward the cæcum they were small and punctated; wherever the mucous membrane remained intact, it was whitish and lardaceous in appearance, except near the rectum, where it was uniformly pink.—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.