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 460.—Private Emmanuel Fox, company H, 48th Pennsylvania volunteers; age 20; admitted from City Point, Virginia, November 2, 1864. Chronic diarrhœa. [This man appears on the register of the depot hospital of the 9th Corps, admitted October 26th—acute rheumatism; and on that of the hospital steamer Ben Deford, admitted November 1st; sent to general hospital November 2d.] He was very weak, and had frequent copious liquid evacuations, which were generally preceded by pain and followed by exhaustion; the skin was unusually cool, the pulse irregular. Treatment: Tonics, stimulants, and warm applications to the abdomen; milk and extra diet. The patient's appetite was generally pretty good, but there was a craving for improper food. For some time the glands of the neck were swollen, and there was a thin discharge from the ears. The eyes also seemed to be affected, and for several days before death he complained of pains in the arms. For the last week he could be induced to take but little food. Died, December 5th. Autopsy twenty-seven hours after death: Rigor mortis disappearing; body extremely emaciated; very slight suggillation posteriorly. The cranial sinuses were filled with blood; the subarachnoid space contained an ounce of serum; the vessels of the pia mater were injected; the substance of the brain was normal. Neck and spinal column not examined. There were no pleuritic adhesions. The left lung was normal; the right lung was normal anteriorly, posteriorly several of the lobules in all the lobes were hepatized, some of them having advanced to the stage of gray hepatization. There were small calcareous deposits in several of the bronchial glands. The heart was very small, but otherwise normal. The liver was normal; the gall-bladder contained about an ounce and a half of bile. The spleen and pancreas were normal, as was also the mucous membrane of the stomach, duodenum, and jejunum. The mucous membrane of the ileum presented several patches of dark dirty-red color, but no ulcers could be detected. The mucous membrane of the colon and cæcum was thickened and inflamed in patches; it peeled off easily, and there were one or two spots in which it was abraded. The mucous membrane of the rectum also was very much inflamed, softened, and thickened, peeling off easily, but not ulcerated. The kidneys were pale, but otherwise normal.—Acting Assistant Surgeon Thomas Bowen.