Civil War Washington

Case from the medical descriptive lists of the SECOND DIVISION of the ALEXANDRIA HOSPITAL, Virginia, Surgeon T. Rush Spencer, U. S. V., in charge:

CASE 443.—Private Johnson Houghtailing, company E, 19th New York cavalry; age 22; admitted October 13, 1863. Chronic diarrhœa. This man had suffered with diarrhœa since the middle of May last. In June he had typhoid fever. He is now much emaciated and weakened, cannot raise his head from the pillow; tongue coated with a thin brown coat, which is broken off in spots, showing a red dry surface beneath; has fifteen to twenty stools a day, with considerable tormina; there is a good deal of tenderness along the line of the colon; pulse 60 and full; no appetite. To take a pill containing a grain of opium and two grains of tannic acid every four hours; four ounces of cherry-brandy daily. October 15th: Had only seven passages in the last twenty-four hours; appears to be improving; can raise up in bed. To take a drachm of subnitrate of bismuth during the day, in three doses; milk diet; cherry-brandy as before. October 16th: Has a voracious appetite, which needs to be carefully regulated. Continue treatment. Substitute for the brandy two ounces of egg-nog every four hours. October 19th: Has had no movement of the bowels during the last twenty-four hours; pulse 64, full; appetite good; strength increasing rapidly. To take thirty drops of the tincture of the chloride of iron every five hours. October 20th: Bowels have not moved yet. Complains of a sense of fulness​ in the head and dizziness. Prescribed a laxative. October 21st: The medicine has operated on the bowels. The patient says he feels uncommonly well; appetite very good. To take quinine and whiskey as a tonic, with tincture of the chloride of iron; egg-nog; extra diet. October 22d: Sat up some time yesterday; bowels moved once. Continue treatment. October 23d: Said he felt quite well; had but two natural looking movements of the bowels in the last twenty-four hours; was able, with a little help, to get up to use the vessel. About 9.30 A. M. his breathing suddenly became very short and rapid, and he died in a few moments, without a struggle or effort to speak. Autopsy eight hours after death: The brain, lungs and heart appeared to be quite natural, except that perhaps the blood-vessels of the brain were a little fuller of blood than usual. The liver was rather large and excessively congested; otherwise its appearance was healthy. The spleen was also large and in a highly congested state. The stomach was healthy. There was extensive ulceration of the intestines, both large and small, and considerable thickening of the mucous membrane of the colon. The kidneys were healthy. Nothing was found to account for the sudden death of the patient.—Acting Assistant Surgeon A. Walter Tryon.