Civil War Washington

Case from the case-book of the THIRD DIVISION of the ALEXANDRIA HOSPITAL, Surgeon Edwin Bentley, U. S. V., in charge:⃰

CASE 482.— Private John Wyatt, company B, 75th Ohio volunteers; admitted from the hospital of the 11th Corps, Fairfax Court-House, Virginia, January 22, 1863. Chronic diarrhœa of long standing. The patient was at first able to sit up and walk around a little, but soon grew feeble, and was confined to bed. He was somewhat emaciated. At the date of admission the discharges from the bowels were watery, more or less yellowish, and varied in frequency from half a dozen to a dozen in the twenty-four hours; they were attended with some little pain and tenesmus; there was more or less abdominal tenderness, and occasional colicky pains, which, however, were not severe; the stomach was irritable, and there was considerable nausea, especially after taking food, drink, or medicine; he had but little appetite for food, and complained of constant thirst; the pulse was small, frequent and feeble; the respiration unembarrassed. Treatment: Various astringents, especially acetate of lead, sulphate of copper, and tannic acid, were successively employed in combination with opium; occasionally a small dose of castor oil was administered; cod-liver oil in moderate doses was given as an analeptic; it was administered in peppermint-water, and was tolerated by the stomach better than any other medicine tried; rubefacients were applied to the abdomen. Milk, eggs, and farinaceous articles were mainly employed as food, and gum-water, toast-water, and tea for drink; but there seemed to be no power to assimilate nutriment, and the patient gradually sank, his intellect remaining clear to the last. Died, February 13th. Autopsy ninety hours after death: Body extremely emaciated. The thoracic viscera were normal. The stomach was healthy. There were patches of inflammation in the ileum, but no enlargement or ulceration of the glands of Peyer; there was a well-marked intussusception about an inch long in the lower part of the ileum. The omentum was atrophied, its bloodvessels​ injected. The mesenteric glands were enlarged. The liver was healthy. [There is no record of the condition of the large intestine.]

⃰ It is to be regretted that, in most instances, the records of this hospital do not show by whom the autopsies were made. It is known that many of them were made by Surgeon Bentley himself, or under his immediate supervision, but it is only possible to distinguish these from the others in a few cases.