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 541.—Private Michael Swift, company A, 17th Wisconsin volunteers; admitted July 22, 1865. He stated that he had suffered with diarrhœa over six months; is now emaciated to an extreme degree. To take camphor and opium pills; brandy. July 24th: Prescribed enemata of solution of chlorate of potassa. July 25th: The corneas are becoming opaque. To rub the body with cod-liver oil. July 28th: The tongue is glazed, red, and has curdy flakes on its surface; but there has been less diarrhœa during the last forty-eight hours. July 29th: The tongue is less glazed, and the curdy flakes are less abundant. Last night the diarrhœa again became troublesome. To take pills of tannic acid and opium. July 30th: Vibices have made their appearance over the sternum; the hands and arms are cold; the stools are watery, frequent and involuntary. July 31st: The involuntary discharges continue; the patient is unable to swallow. Died, August 1st, at 3 A. M. Autopsy thirteen hours after death: Vibices on arms, legs and breast; slight rigor mortis in the upper extremities. The lungs were collapsed and pale; there were old pleuritic adhesions of the posterior and external portions of the right lung. The heart was normal, except that the foramen ovale was patulous. The lower part of the ileum was darkly injected, its mucous surface coated with whitish pseudomembrane. The colon was thickened, and there were a few ulcers in the caput coli and sigmoid flexure. The liver was normal. The spleen small, hard, its trabeculæ distinct. The kidneys large and fatty.—Acting Assistant Surgeon William C. Miner. [No. 596, Medical Section, Army Medical Museum, is from this case. The specimen is the heart, which is rather small; the foramen ovale is patulous, the opening passing obliquely through the interauricular opening; there is on each side of the passage a valve-like fold of the endocardium, by which the orifice was kept closed during life.]

⃰ 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.