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 389.—Sergeant James H. Morse, company D, 8th Pennsylvania cavalry; admitted September 17, 1863. Quotidian intermittent fever and chronic diarrhœa. Died, December 15th. Autopsy seventeen hours after death: Height five feet five inches; no rigor mortis. The posterior parts of the meninges were considerably congested; the brain was firm, and weighed forty-eight ounces and a half; the ventricles contained a drachm of serum. The œsophagus was pale throughout; the larynx and trachea were also pale; at the bifurcation of the trachea there was a quantity of bronchial secretion. The right lung weighed twenty-three ounces; the anterior and superior portions of its upper lobe were healthy, the posterior and inferior portions hepatized; the lower lobe was partly carnified, partly splenified; the left lung was healthy, and weighed sixteen ounces. The pericardium contained five drachms and a half of fluid resembling the white of an egg. The heart weighed eleven ounces and a half; a very small whitish-yellow clot, the size of a horse-chestnut, was found in the right side, one of similar dimensions and appearance in the left side; the valves were healthy. The liver had the nutmeg appearance, was quite fatty, and weighed sixty-three ounces; the gall-bladder contained two ounces and a half of dark-green bile, in which there was considerable sediment of an intense green color. The spleen was somewhat softer than usual, of a dark-purple color, and weighed twelve ounces and a half. The pancreas was firm, white, and weighed three ounces. The kidneys were pale and apparently fatty; the right weighed six ounces, the left six and a half. The intestines were bound together and to the abdominal parietes by fibrinous bands; the mucous membrane of the small intestine was healthy to within two feet of the cæcum; Peyer's patches and the solitary glands were not prominent; the large intestine was ulcerated throughout, most of the ulcers being punctated; they were most marked along the longitudinal bands.—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.