Civil War Washington

CASE 883.—Private Julius Zinke, company G, 98th Pennsylvania veteran volunteers; age 54; was mustered into service March 5, 1864, to serve three years. He had previously served out a three years' enlistment which had just expired. The register of the field hospital of the Second Division, Sixth Army Corps, reports him admitted November 23d; catarrh; returned to duty December 1st. It appears from the company muster-rolls, however. that he was again taken on sick-report and sent to general hospital in Washington, December 14th. It appears from the case-book of the Douglas hospital, Washington, D. C., that he was admitted to that hospital December 16, 1864. suffering with diarrhœa. said to be of a month's standing, and with some cough. The diarrhœa yielded to treatment, and he was furloughed, returning to hospital about April 1, 1865. At that time he stated that his diarrhœa was quite well, but that he suffered much pain in the region of the heart, running back to the angle of the scapula. He was somewhat short of breath, anæmic, and had a dry, hacking cough. The action of the heart was strong and rapid, and a murmur was distinctly heard coincident with the first sound; this murmur was so loud that it could be heard all over the region of the organ, which was evidently enlarged. He stated that he had suffered from trouble in the region of the heart for two years, during which time, however, he had been able to do duty in the field, carrying his knapsack. During the three weeks preceding his death he did not seem to suffer very much, but had a continual slight pain in the region of the heart, a short, dry cough and some dyspnœa; the action of the heart was rapid but regular. He was up and about the ward every day, and did not need to have his head very much elevated in order to sleep. On the morning of May 9th he was suddenly seized with a sort of spasm; his breathing became very short and spasmodic, and the action of the heart intermittent. This lasted for about half an hour, when he quietly expired. Autopsy fifteen hours after death: Rigor mortis well marked. The heart was somewhat enlarged. Just above the semilunar valves of the aorta there was an aneurismal​ sac capable of containing about two ounces of fluid. The sac had burst, the blood making its way between the middle and external coats of the aorta to a point a little above the left auricle, being prevented from communicating with the pericardial sac by a copious deposit of lymph, which, however, was so soft that it was torn during the examination, thus making the communication complete. The mitral valves were somewhat thickened and rough: the aortic valves large but healthy; the aorta slightly atheromatous. The pericardium was firmly adherent to nearly the whole surface of the heart and could be removed with difficulty. The apices of both lungs contained calcareous deposits and other indications of obsolete tubercle. The mucous membrane of the colon was somewhat softened; its solitary follicles all prominent and distinct, with a central spot of black pigment in each; just around each follicle was an areola of black pigment. The other organs were healthy. Acting Assistant Surgeon David L. Haight. The specimens were forwarded to the Museum by Assistant Surgeon Wm. F. Norris, U. S. A.

Nos. 546 and 547, Medical Section, Army Medical Museum, are from this case. No. 546 is the heart and a portion of the aorta, presenting the aneurism​ above described. No. 547 is a portion of the descending colon, in which, by transmitted light, a few of the solitary follicles can still be discerned in the alcoholic preparation as opaque spots; most of them, however, have become invisible to the naked eye.

The chromo-lithograph facing page 308 is from a water-color drawing representing the appearances presented by this piece of colon in the recent state; in the lettering of the plate the word dysentery has been erroneously used. The surface of the mucous membrane is salmon-colored, with greenish streaks due to diffuse pigment deposit. In many places the vessels can be discerned as delicate red arborizations. Each of the solitary glands is marked by a central dot of pigment surrounded by a little pigment ring. Nos. 642 to 650, Microscopical Section, are a series of perpendicular cuts of this colon, and will be described further on.

It will be observed that in this case the diarrhœa from which the patient had suffered had not troubled him for some time before death, so that the specimen represents a period when the inflammatory process was well advanced towards resolution. Doubtless slight anatomical lesions such as these—an undue degree of vascularity, abnormal pigmentation, and a moderate degree of enlargement of the closed glands—remaining behind after an attack of diarrhœa are among the conditions which render those who have suffered from that disease more liable to be again attacked, if exposed anew to the causes of the disease, than healthy persons under similar circumstances.

PLATE VIII. COLON WITH PIGMENT DEPOSITS. In and around the solitary Glands.—Dysentery.