Civil War Washington

One of eight cases observed at the FREEDMAN'S HOSPITAL, Washington, D. C., during 1865, 1866, and 1867.⃰ In none of them were the patients soldiers. Five are of interest as examples of tubercular ulceration of the intestines. Besides the specimens from these cases, several other examples of tubercular ulceration of the intestines are preserved at the Museum, which were obtained from autopsies of colored women who died at the same hospital during the period mentioned. . . . In all of them extensive tubercular deposits were found in the lungs and other organs. Most of the specimens are portions of the ileum with tubercular ulcers of the mucous membrane and miliary tubercles on the peritoneal surface opposite:

CASE 863.—Frank Williams; dark mulatto; age 14; admitted May 24, 1865, suffering from scrofulous ophthalmia. Symptoms of phthisis pulmonalis were first noticed about the middle of October. There was marked dulness​ on percussion on the left side beneath the clavicle and over the second, third and fourth ribs; expectoration very copious during the last four weeks; hæmorrhage occurred very profusely for the first time, February 4, 1866, about 5 P. M. The boy died in three or four minutes. Treatment: Cod-liver oil, whiskey, nourishing diet, milk-punch, etc. His diarrhœa was not troublesome except during the two or three days preceding death. Autopsy twenty-two hours after death: Body well formed; height four feet nine inches; some emaciation; rigor mortis well marked; weight about 80 pounds. The brain weighed forty-four ounces; its membranes were congested, its substance firm; there were two ounces of fluid in the posterior fossæ of the cranium. The right lung was firmly adherent to the pleura costalis, filled with crude tubercles and vomicæ, and weighed fifteen ounces; there were three ounces of fluid in the right pleural cavity; the left lung was firmly adherent at all points, its lobes interadherent; it weighed twenty-three ounces; in the upper lobe of the left lung was a large vomica the size of a goose egg, which was filled with coagulated blood; tubercles and smaller vomicæ were scattered throughout the lungs. The left pleural cavity contained an ounce of fluid. The bronchial glands were very much enlarged. The heart was small, slightly fatty, and weighed five ounces; all its valves were thickened. The pericardium contained eight ounces of fluid. The liver weighed forty-one ounces, was adherent at all points, its anterior surface coated with lymph; on section it was found to be very fatty and congested, presenting the nutmeg appearance, and contained some tubercles. The spleen weighed four ounces, was adherent at all points, and filled with tubercles. The pancreas and kidneys were normal; the latter weighed three ounces each. The mesenteric glands were very much enlarged. The stomach was normal. Two large tubercular ulcers were found in the ileum near the ileocæcal valve. The rest of the small intestine was normal. In the cæcum a few of the solitary follicles were enlarged. A large tubercular ulcer, involving the mucous and muscular coats, was found in the ascending colon; on the peritoneal surface opposite this ulcer there were numerous minute tubercles; a similar but much larger ulcer was found in the transverse colon; with these exceptions the large intestine was normal. The abdominal cavity was filled with serum, and the intestines were slightly adherent to the abdominal peritoneum. The large intestine was three feet and a half long, the small intestine nineteen feet. The urino-genital​ organs appeared healthy.—Hospital Steward Samuel S. Bond. [Nos. 720 and 721, Medical Section, Army Medical Museum, are from this case. No. 720 is a portion of the transverse colon, showing a number of minute follicular ulcers; near the middle of the piece is a large tubercular ulcer running obliquely to the axis of the gut. On the peritoneal surface opposite the ulcer are a considerable number of minute tubercles; a few others are scattered on other portions of the peritoneal surface. No. 721 is a portion of the omentum containing a large number of minute tubercles.]

⃰ During this period two of the hospital stewards on duty in the Museum, D. S. Lamb and S. S. Bond, were frequently sent to the Freedman's Hospital for the purpose of making autopsies. A considerable number of specimens illustrative of the diseases of the freedmen were thus obtained.