Civil War Washington

Case from the case-book of the SECOND DIVISION of the ALEXANDRIA HOSPITAL, Virginia, Surgeon Edwin Bentley, U. S. V., in charge. Autopsy was made and recorded in the case-book by Acting Assistant Surgeon Thomas Bowen:

CASE 455.—Private Thomas W. Martin, company I, 67th Pennsylvania volunteers; age 23; admitted from the field August 10, 1864. Chronic diarrhœa. [This man appears on the register of the regimental hospital of the 67th Pennsylvania volunteers, admitted April 7, 1864—catarrh—sent to general hospital April 20th. He is borne on the register of the Lincoln hospital, Washington, D. C., admitted April 21st—chronic diarrhœa—sent to Philadelphia May 3d. The register of the Mower hospital, Philadelphia, Pennsylvania, reports him admitted May 4th—chronic diarrhœa—returned to duty June 24th. He next appears on the register of the depot hospital of the 6th Corps, City Point, Virginia, admitted July 6th—chronic diarrhœa—sent to general hospital August 9th.] Died, November 16th. Autopsy twenty-four hours after death: Rigor mortis very great; body very much emaciated; slight suggillation posteriorly. Head, neck, and spinal column not examined. There were firm, old pleuritic adhesions on both sides. Both lungs contained extensive deposits of tubercle, which were found in all parts, but most abundantly in the upper lobes, in which there were also two or three cavities the size of small nutmegs. An extensive deposit of miliary tubercles was observed on the surface of the left costal pleura. The bronchial glands were very much enlarged. The pericardium contained about two drachms of serum. The heart and its valves were normal; both auricles were filled with black blood. The great omentum was thickened, contained deposits supposed to be tubercular, and was adherent to the small intestine and parietal peritoneum. Deposits of black pigment were observed on the parietal peritoneum and on the outer surface of the intestines; in the latter case they were associated with a deposit of small tubercles; the knuckles of small intestine were interadherent. The anterior portion of the liver was coated with recent lymph; the organ was normal in size but pale, and under the microscope appeared to be fatty; the gall-bladder was nearly empty. The spleen and pancreas were normal. Both kidneys were slightly congested. The mesenteric glands were enlarged and tuberculous. The mucous membrane of the stomach and duodenum was healthy. Large ulcers were scattered through the whole extent of the jejunum, ileum, and colon; they were most abundant in the lower part of the ileum, were of oval form, and had thickened, ragged, indurated edges; some of them were apparently healing, and the mucous coat around these was puckered up in small folds radiating from the ulcers.—Acting Assistant Surgeon Thomas Bowen.