Case from the case-book of LINCOLN HOSPITAL, Washington, D. C.; Surgeon J. Cooper McKee, U. S. A., in charge.


CASE 409.—Private J. F. Chipman, company E, 36th Wisconsin volunteers; age 36; admitted from the army of the Potomac August 30, 1864. Gunshot wound of the back of the left hand. Died, October 17th, of purpura and exhaustion. Autopsy next day: Height five feet eight inches; no rigor mortis; body very much emaciated. The brain appeared to be normal, and weighed forty-seven ounces and a half. On the left side of the larynx was an ulcer which penetrated through the mucous membrane to the hyoid bone, which was roughened as if carious. The lower lobes of both lungs were very much congested, and on section a large amount of frothy fluid of a rust-color exuded, but no part of the lobes would sink in water; the remaining lobes were normal; the right lung weighed sixteen ounces and a half, the left fifteen and a half. The heart and its valves were normal; it weighed eight ounces and a half; its right cavities were filled with a large dark clot; the left auricle contained a medium-sized black clot, the left ventricle a small vermiform one. The skin of the abdomen was studded with spots about a line in diameter, which resembled those seen when gunpowder has been deposited beneath the integument; there was quite a large amount of straw-colored fluid in the abdominal cavity, and a deposit of lymph on the peritoneum. The liver weighed thirty-eight ounces; it was of a dull slate-color externally, and on section appeared to be anæmic; its acini were not well marked; the gall-bladder contained twelve drachms of bile. The spleen weighed seven ounces. The right kidney was normal and weighed three ounces and a half, the left four ounces; the cortical substance of the left kidney was dark colored. The stomach appeared to be normal. The mucous membrane of the small intestine was very much congested, and in the ileum there were quite a number of old ulcers, many of which penetrated to the muscular coat. The large intestine was studded with ulcers resembling those seen in the ileum.—Acting Assistant Surgeon H. M. Dean.