Civil War Washington

CASE 99.—Typhoid fever following intermittent; intestinal symptoms not marked; death from pneumonic complications.—Private A. W. Armagust, Co. I, 33d Pa. Vols., was admitted Oct. 2, 1861. Diagnosis—typhoid fever. About September 28 he had been taken with headache and chills, which recurred every night. He felt well on the morning after admission, but in the evening the pulse became accelerated and strong, the skin hot and dry and the tongue red, clean at the tip but coated at the base; he had three stools during the day, with some soreness of the abdomen, but no tympanites nor gurgling. Quinine was given. He is reported as having slept well on the 4th and as having had no chill on the 5th; on the 6th his condition is not stated. On the 7th he had headache and was restless; countenance natural; pulse 86, steady; skin hot and dry but soft; tongue moist, red and quite clean; he had pain in the bones, two stools and abdominal tenderness, but no tympanites. He had one stool on the 8th. Small doses of calomel, quinine and opium were given. The headache was worse on the 9th; there was a feeling of pressure on the brain with buzzing in the ears and deafness; four stools were passed; the tongue was dry, red at the tip, furred in the centre and coated gray at the base. Sweet spirit of nitre was prescribed. On the 10th the bowels were quiet and continued so to the end with but little complaint of abdominal tenderness or tympanites. Emulsion of turpentine and Mindererus' spirit were administered. On the 11th the skin was hot but moist; the tongue continued dry and the appetite did not return, although there was marked improvement in the cerebral and abdominal symptoms. On the 15th the patient was restless, and there was some cough for the first time in the progress of the case; the cough grew worse, and on the 17th brown mixture was prescribed. Next day there was anxiety of countenance and much cough, but neither accelerated respiration nor pain. On the 20th the patient was slightly delirious. Whiskey-punch and citrate of iron and quinine were given. On the 22d his face was pale, countenance dull, pulse 82, steady, surface circulation good, skin dry and husky but not hot, tongue slightly brown and dry in the centre, whitish and moist along the sides, red at the tip and edges, teeth and gums clean; he had some appetite, no thirst, and a cough with slight wheezing and gurgling sounds in the lower parts of the lungs; at times also he had some dizziness and tinnitus. On the 23d the respiration became increased to 26; the pulse to 102; the abdomen was soft and natural. He died on the 29th. No eruption was noticed in this case.