Civil War Washington

CASE 103.—Recurring chills; diarrhœal tendency; mental dulness​; rose-spots on 14th day, immediately followed by convalescence.—Private Samuel Bissinette, Co. A, 4th Mich.; age 22; was seized about Sept. 9, 1861, with daily chills accompanied by headache, pain in the back and legs, anorexia and costiveness. He was admitted on the 16th. Diagnosis—typhoid fever. In the evening the patient was weak and had no appetite; the pulse was 80; skin hot and moist; tongue coated white, but red at the tip and edges; one stool was passed; the right iliac region was tender, and complaint was made of pain in the back and legs. Ten grains of calomel and jalap were given. Eight dejections occurred during the night, and next morning the skin and eyes were jaundiced. Quinine was given. In the evening the pulse was 74, the skin warm and moist, the tongue coated gray but red at the tip, the bowels quiet; there was acute right iliac tenderness and mental dulness​ with tinnitus aurium. Next day the bowels remained quiet and the tenderness ceased; but pain in the head and in the back was noted. The abdominal tenderness returned on the 19th, when, also, the tongue was nearly clean but dry, the cheeks flushed and the pain in the back so acute as to require sinapisms. The bowels were quiet on the 20th and without pain or tympanites; the tongue coated gray; the skin moist. Two stools were passed on the 21st; the tongue was white, the skin hot and dry, and there was some thirst and cough, but the appetite was good. A few rose-spots appeared on the 22d, the tongue being pale and moist, the pulse 80. In the evening of this day he was dull; pulse 61. He perspired during the night, and next day the skin was warm and moist, the tongue pale and clean and there was no tenderness, tympanites nor eruption. A few dark spots were found next day on the abdomen and chest. After this improvement was steady. The patient was walking about on the 29th and was transferred to Annapolis, Md., October 1.