Civil War Washington

The notes were forwarded, with the specimens, to the Army Medical Museum from CARVER HOSPITAL, Washington, D. C., Surgeon Oliver A. Judson, U. S. V., in charge:

CASE 425.—Private Granville Vanwagner, company D, 126th Ohio volunteers; admitted from the field hospital, army of the Potomac, July 4, 1864. Typhoid fever. [This man appears on the register of the regimental hospital of the 126th Ohio volunteers, admitted June 25th—fever—sent to depot hospital June 29th. He is borne on the register of the depot hospital of the 6th Corps, City Point, Virginia, admitted—bronchitis—sent to general hospital July 3d.] He was very much emaciated, and was suffering from symptoms resembling typhoid fever. His tongue was covered with a thick, dry, brown fur; teeth with dark sordes; bowels tympanitic. Petechiæ were observed on the chest and the upper portion of the abdomen. There was tenderness on pressure in the right hypochondriac region. The surface of the body was dry, but there was little abnormal heat. The diarrhœa was quite severe, but the stools were feculent, and contained no blood or mucus. After a few days the diarrhœa abated somewhat, the tongue appeared moist, and there seemed to be a decided improvement in the condition of the patient. July 25th: The diarrhœa became aggravated, the tongue again dry and dark colored. The patient became delirious, and died July 30th. The treatment consisted in the free use of turpentine emulsion, together with opium and tannic acid to check the diarrhœa. Brandy and sulphate of quinia was also given freely. The diet consisted of boiled milk, gruel, &c. Autopsy six hours after death: Body greatly emaciated; rigor mortis not marked. There were old pleuritic adhesions on both sides. The lungs were normal, with the exception of some slight congestion at the apex of the right lung. The pericardium contained two ounces of pinkish serum. The heart was normal and contained no clots. The liver was enlarged and pale; the gall-bladder nearly filled with bile. The spleen was dark colored, and measured eight inches by four, but appeared firm. The stomach was dilated and flabby; its mucous membrane thickened and softened. The solitary follicles of the jejunum were slightly enlarged; those of the ileum were enlarged to the size of pin-heads. The mucous membrane of the ileum was thickened and softened, and Peyer's glands were congested but not elevated. The colon was distended and thin; in the ascending colon were a number of ulcers; in the transverse colon, which made a bend downward toward the pubes, large ulcers with ragged edges were seen, some of which extended through the muscular coat; these ulcers increased in size toward the sigmoid flexure.—Acting Assistant Surgeon O. P. Sweet. [Nos. 416, 417, and 418, Medical Section, Army Medical Museum, are from this case. No. 416 is a portion of the ileum taken from just above the ileocæcal valve, with slight enlargement of the solitary follicles. No. 417 is a portion of the transverse colon of the same patient, which is quite thin, and presents a number of irregular oval ulcers. No. 417 is a portion of the descending colon, also quite thin, and presenting numerous ulcers which have coalesced, forming large erosions, which in several places penetrate to the peritoneum.]