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 390.—Private Peleg Mitchell, company D, 16th Maine volunteers; age 61; admitted October 19, 1863. Diarrhœa and erysipelas. This man was taken sick with diarrhœa near Fairfax Court-House, Virginia, October 16th. His bowels were moved from ten to fifteen times daily; his stomach was irritable. October 23d: The patient vomits continually; tongue coated with thick white fur; pulse 108 and scarcely perceptible; extremities cold. November 3d: Is much better; the vomiting has ceased and the diarrhœa is nearly checked. November 13th: The bowels have been quite regular for a day or so, but are loose again. He had rheumatic pains when admitted, which have now disappeared. December 14th: Facial erysipelas has set in and the diarrhœa has returned; the discharges are frequent; the abdomen is tender; pulse 110 and feeble. December 16th: The erysipelatous symptoms are better, but the patient is much prostrated; the diarrhœa continues. December 18th: The erysipelas has nearly subsided; the prostration continues; there is no pain, and the evacuations are involuntary but not very frequent. Died, December 19th. This patient had from six to eight ounces of milk-punch per day. Autopsy next day: Body not emaciated; adipose tissue quite abundant. Brain not examined. The lower lobes of both lungs were congested; the lungs otherwise were healthy. The heart was paler than natural. The liver had the nutmeg appearance to a slight degree. The pancreas was white and firm. The spleen was firm, very dark, and filled with black blood. The kidneys were congested. The mucous membrane of the ileum was perfectly healthy, and there was no enlargement of the closed glands. [The condition of the large intestine 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.