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 387.—Private Andrew Eckstine, company K, 52d New York volunteers; admitted November 23, 1863. Chronic diarrhœa. Died, December 6th. The immediate cause of death was supposed to have been imprudence in eating oysters. Autopsy: Height five feet one inch; rigor mortis not very well marked; body much emaciated. The brain was firm; its ventricles contained a drachm of fluid. The œsophagus was slightly purplish in its superior portion, of a greenish-ochre at the cardiac extremity. The larynx and trachea were pale. The right lung was congested, especially its lower lobe; it contained an excess of frothy bronchial secretion; the upper lobe of the left lung was in the same condition; the lower lobe was in the stage of gray hepatization. The pericardium contained two ounces of fluid. The heart was healthy; its right cavities were filled by a large venous clot, which extended into the pulmonary artery. The liver was firm, its acini well marked; there were many dark-brown spots on the surface of the organ and disseminated through its substance; the gall-bladder contained three drachms of dark-green very viscid bile. The spleen had a dark sienna-brown color and was quite firm; it measured four inches and a half by three. The pancreas was whitish and moderately firm. The cortical substance of the kidneys was pale, the pyramids injected. The small intestine was pale, anæmic, and had an ironed-out appearance; its solitary glands were conspicuous. The large intestine presented a great number of punctated ulcers, some of which were becoming confluent; the mucous membrane was of a lively red.—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.