Civil War Washington

CASE 96.—Cerebral symptoms strongly marked; intestinal and pulmonary symptoms obscured; death on 19th day.—Corporal S. H. Forsyth, Co. A, 3d Pa. Cav.; age 33; was taken sick Sept. 7, 1861, with chills, nausea and vomiting, which recurred for three days. He was admitted on the 14th. Diagnosis—typhoid fever. He had pain in the head and bones, increased heat of skin, tinnitus aurium, dulness​ of intellect and occasional epistaxis. A bath was ordered for him and Dover's powder at night. He rested well, his bowels remaining quiet although somewhat swollen and tender; the tongue was brown and dry. Turpentine emulsion was given every two hours. On the 16th the pulse was 106 and strong, tongue brown, bowels regular but tympanitic, skin hot and dry, showing some rose-colored spots; there was anorexia and occasional epistaxis. He was restless during the night, and on the 17th became somewhat delirious, dull and drowsy; the pulse was 106 but weaker; the bowels regular but distended. A few rose-colored spots appeared on the 18th, and one dark-colored stool was passed. The tongue was tremulous and protruded with difficulty on the 19th, and the teeth were black with sordes. In the evening the tongue was dry, red at the tip and edges and black in the centre and at the base, beef-essence and whiskey-punch were prescribed. On the 20th the eyes were suffused, pupils contracted, pulse 116, skin hot and dry but soft, teeth and lips covered with sordes, breathing labored, bowels quiet but tympanitic and gurgling on pressure. In the evening the pulse had risen to 126; a slight perspiration bedewed the forehead and arms and a few rose-colored spots appeared on the chest and abdomen; the delirium was accompanied by some deafness and muscular twitchings, but the respiration had become quiet and natural. Two days were passed without material change, but on the 23d the respiration became increased to 35; the skin was moist and hot, hands cold and clammy, pulse 136, small and tremulous, bowels quiet but largely meteorized, urine passed involuntarily. Tincture of capsicum was given and a blister and bandage applied to the abdomen. On the 24th the pulse reached 144 and was very feeble; the face was covered with sweat, the hands cold and damp, the feet warm; the patient was somewhat conscious but very deaf, and he had some difficulty in swallowing. A tube was passed to relieve the tympanites. On the 25th he was unconscious, muttering in his delirium, pulse 148, features pinched, forehead flushed, nose and lips blanched, eyes sunken and injected, cornea dull and partly glazed, extremities pulseless, heart's action feeble, skin of body warm and bedewed with perspiration, hands shrunken, damp and cold, tongue dry, brown and badly fissured, lips and teeth covered with dark-brown sordes; he was very deaf, had violent subsultus, dysphagia, involuntary urination and excessive tympanites, but no movement of the bowels; respiration was slow and labored. He died on this day.