Civil War Washington

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

CASE 416.—Private Lindsey Morris, company A, 140th Pennsylvania volunteers; age 20; admitted from the depot hospital of the 2d Corps, City Point, Virginia, November 14, 1864. Chronic diarrhœa and debility. This man was taken sick October 20, 1864. At the time of admission he was very much exhausted; extremely emaciated; had no appetite; pulse 110 and weak; urine scanty and light colored; bowels loose. Treatment: Quinine, beef-tea, and brandy. November 19th: He was attacked with vomiting, ejecting a greenish acrid fluid. Applied a blister to the epigastrium, and directed him to take, every four hours, a powder containing two grains of calomel, half a grain of opium, one and a half of quinine, and four of prepared chalk. November 24th: The vomiting still continues. Ordered enemata of quinine and beef-tea three times daily. December 1st: The abdomen is so tender that peritonitis is diagnosticated​, and warm fomentations applied to the abdomen. December 4th: The patient lies constantly on his back; pulse 90 and weak. December 6th: Eight abscesses were recognized on the front of the abdomen, and being opened discharged freely. The discharge was kept up by warm poultices; at the same time the injections of beef-tea and quinine were continued, as the patient was still unable to keep anything on his stomach. December 10th: The discharge from the abscesses is lessening. Continued the warm applications over the abdomen. Died, December 22d. From the time this patient was admitted till his death there was constant nausea and vomiting; during the last few days the injections were not retained.—Acting Assistant Surgeon E. B. Harris. Autopsy sixteen hours after death: Rigor mortis well marked; body very much emaciated. On the surface of the abdomen there were a number of small punctures which led to little abscess cavities, none of which extended beneath the external oblique muscle or its tendon. The brain weighed forty-seven ounces and a half. The larynx, trachea and lungs were normal. The right lung weighed eighteen ounces, the left nine and a half. The heart was normal, weight nine ounces and a half; each ventricle contained a very small fibrinous clot. The spleen was normal. The liver weighed forty-nine ounces and a half; it was very much congested, and on section a large amount of dark blood exuded; the gall bladder contained four ounces of very dark viscid bile. Both kidneys were apparently normal in texture, but large; the right weighed nine ounces and a half, and the left ten ounces. The lining membrane of the œsophagus was slightly congested, but the stomach appeared to be normal. Throughout the whole length of the small intestine the mucous membrane appeared to be inflamed, and in the lower half of the ileum it was studded with ulcers about a line in diameter. The mesenteric glands appeared to be perfectly normal, varying from the size of a pea to that of a very small almond. [The condition of the large intestine is not recorded.]—Acting Assistant Surgeon H. M. Dean.