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 429.—Private William H. Brookhall, company I, 26th Michigan volunteers; admitted from the depot hospital of the 2d Corps, City Point, Virginia, August 30, 1864. Acute dysentery. At the date of admission the patient was not greatly emaciated. He had been ill but a few days. His pulse was rapid; tongue covered with a dark dry fur. He had anorexia, frequent alvine dejections, which consisted chiefly of mucus and blood, and almost constant tenesmus. The disease progressed unchecked, and, September 5th, great gastric uneasiness set in; the stools were about ten or fifteen during the twenty-four hours, and contained large quantities of mucus and blood, which emitted a very offensive odor; there was severe pain in the abdomen, and continual tenesmus. September 8th: All the symptoms are aggravated; there are involuntary discharges of large quantities of bloody mucus; raving delirium has set in; the pulse is very feeble. The treatment consisted in the free administration of alcoholic stimulants, astringent and opiate enemata, with full doses of opium given at bed-time, &c. The diet consisted of milk, beef-tea, &c. He died September 9th. Autopsy eight hours after death: Emaciation slight; rigor mortis well marked. The right lung was slightly bound to the walls of the chest posteriorly by old adhesions; both lungs appeared to be normal. The pericardium contained two ounces of fluid. The right side of the heart contained a large fibrinous clot, the left side was empty; the valves appeared to be healthy. The liver was enlarged, soft and pale; the gall-bladder distended with bile. The spleen was enlarged, firm and of a dark slate-color. Both the cortical and medullary portions of the kidneys were pale, but the organs were normal in size. The mesenteric glands were enlarged. The stomach was dilated and flabby; its mucous membrane thickened and softened. The jejunum was healthy; in the ileum the mucous membrane was congested and dark colored, and its solitary follicles were enlarged, especially near the ileocæcal valve. In the large intestine the mucous membrane and the sub-mucous cellular tissue were gangrenous; in the ascending colon the sloughs, of dark color and fetid odor, were separating, or had already separated, leaving the circular fibres of the muscular coat in view; in the transverse and descending colon the mucous membrane had nearly all sloughed away, and in places the sloughs appeared to extend nearly or quite through the muscular coat.—Acting Assistant Surgeon O. P. Sweet. [No. 409, Medical Section, Army Medical Museum, is from this case. It is a portion of the descending colon, showing large irregular diphtheritic ulcers which expose the muscular coat; the sloughing pseudomembrane hangs in shreds from the edges of the ulcers.]