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 388.—Private Joseph Harbaugh, company D, 6th Maryland volunteers; admitted November 23, 1863. Chronic diarrhœa and semi-gangrenous feet. [This man appears on the register of the regimental hospital of the 6th Maryland volunteers, then at Brandy Station, Virginia, admitted November 14th—typhoid fever—sent to general hospital November 23d.] Died, December 8th, at 6 P. M. Autopsy twenty-one hours after death: Height five feet eight inches; rigor mortis marked; body emaciated. The brain was healthy, and weighed fifty ounces; the ventricles contained a drachm of fluid. The mucous membrane of the trachea was injected. The right lung weighed twenty-four ounces; the anterior part of its upper and the whole of the middle lobe were somewhat emphysematous; the posterior portion of the upper lobe was filled with an excessive amount of bronchial secretion, and inferiorly was in the stage of red hepatization; the lower lobe was engorged and of a dark-purple color, but crepitated under pressure; the left lung was healthy, but congested hypostatically; it weighed thirteen ounces. The pericardium contained ten ounces of fluid. The heart weighed ten ounces; its valves were healthy; the right cavities contained a large mixed clot. The liver was healthy, and weighed sixty-four ounces; the gall-bladder contained two and a half ounces of bile. The spleen was moderately firm, of a dark-purple color; it weighed eight ounces. The pancreas weighed three ounces. The kidneys were anæmic, their cortical substance unusually pale; the pyramids were also pale, but darker than the cortical substance; the right kidney weighed five ounces, the left six ounces. The large intestine presented the usual appearances of chronic diarrhœa; the ulcers were superficial, not confluent, and tinged with a delicate pink color; this condition extended some distance into the small intestine, the mucous membrane of which was congested, while the solitary glands were conspicuous and of a dark-purplish color; Peyer's patches were of a still darker color, but not elevated or ulcerated. [The condition of the feet is not recorded.]—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.