Civil War Washington

CASE 105.—Record given in full. The existing malarial attack appears to have ended on October 7, when the pulse had fallen to 80 and the skin and tongue were in natural condition, leaving the patient, however, with a diarrhœa, suggesting a congested and perhaps ulcerated condition of the bowels, and some pulmonary engorgement. The typhoid fever is unmarked by prominent symptoms; its influence, other than in the appearance of the rose-colored spots, seems only to have prolonged the period needful to a return to health. It is noticeable that on October 16, while the rose-spots were yet fading, the patient was permitted to be out on pass.—Corporal Christopher Beninger, Co. D, 3d Mich.; age 26; had been liable to attacks of intermittent fever since 1858. He was admitted Sept. 28, 1861, as a case of typhoid fever. He had been taken sick three days before with chills, fever and pain in the back, and had taken quinia; face flushed, eyes dull, lids dropped; pulse 104, small, easily compressed; skin moist, slightly above natural temperature; tongue moist, slightly coated white; anorexia and irritability of stomach manifested by unsuccessful efforts at vomiting; tenderness over entire abdomen, slight tympanites in right iliac region, no stool; dull, heavy head-pain; nervous twitchings of muscles; no cough but respiration hurried, 30 per minute. During the examination a violent chill came on; the extremities became cold, the pulse small and at times imperceptible at the wrist, the cheeks cold, the breathing hurried and interrupted, the eyes turned upward; some stupor was also noted. Quinia, opium and calomel were ordered to be given every four hours. 29th, morning: Slept some; face congested; eyes suffused; pulse 120, quick, feeble; some pain in head and limbs; some deafness and stupor; skin of natural temperature; tongue dry, brown, moist at edges; anorexia; epigastric and general abdominal tenderness; tympanites; derangement of liver; no cough. Milk-punch, beef-essence and blue-mass and opium were ordered. Evening: Feeling better; face flushed; eyes suffused; head dull and heavy; pulse 120, full and strong; skin moist; tongue moist at edges, brown and dry in centre; anorexia; slight tenderness in abdomen, particularly in right iliac region; some tympanites and borborygmus; no stool; no cough. Dover's powder was given. 30th, morning: Slept well; cheeks congested; eyes dull; head-pain; pulse 112, quick, small; skin hot and moist; tongue moist at edges, dry in the centre; anorexia; tympanites; slight tenderness in right iliac region, marked in left; much soreness in right hypochondriac region; two stools. Ordered three grains of calomel, one of opium and one-sixth of a grain of antimony every three hours. Evening: Drowsy; face congested; eyes dull; head-pain; pulse 112, strong; skin above the natural temperature, covered with perspiration; tongue slightly moist at tip and edges, dry and brownish in centre; four stools; slight tympanites; tenderness im left iliac region. Ordered astringents. October 1, morning: Head-pain; pulse 112, quick, strong; skin moist, slightly above the natural temperature; tongue moist at edges, dry and white in centre; appetite small; several stools; some cough; pain in right lung; respiration 30. Ordered beef-essence and astringents. Evening: Ordered one grain of quinia and two grains of Dover's powder every three hours. 2d: Slept some; face congested; eyes dull; slight head-pain; pulse 105, quick and strong; skin hot and moist; tongue moist, coated white in patches in centre; some appetite; slight tenderness; no tympanites: paroxysms of coughing; mucous expectoration streaked with blood; respiratory murmur in lower lobes of right lung entirely lost. Veratrum viride and sweet spirit of nitre were ordered to be taken every hour. 3d: Slept some; head-pain and slight delirium; pulse 112, quick, strong; skin somewhat hot; tongue moist, clean but for a few yellowish patches in centre; some appetite; two stools; much cough; viscid mucous expectoration streaked with blood; respiration 35; respiratory murmur absent over lower part of right side; some dulness​ on percussion on both sides. 4th: Slept but little; some head-pain; pulse 108, strong; skin hot; tongue moist, covered with yellowish patches in centre; vomiting; anorexia; three stools; some cough; mucous expectoration streaked with blood; respiration 30 but deeper; dulness​ decreased in left lung, increased in right. Fifteen drops of veratrum viride were given during the day. 5th: Slept well; pulse 85, full; skin soft but rather warm; tongue moist, slightly coated in centre with yellowish patches; some appetite; three stools; but little expectoration; respiration 26. Milk-punch and Dover's powder were given. 6th: Slept well; head-pain; pulse 90, full; skin of natural temperature, covered slightly with perspiration; tongue moist, coated white in centre; appetite good; some tympanites; right iliac tenderness; two stools; slight cough and expectoration; respiration 25. 7th: Slept well; looking better; pulse 80, natural; skin and tongue natural; two stools; slight cough; respiration 25; respiratory murmur absent on left side below third rib. 8th: Not so well; countenance and skin natural; pulse 85, quick; tongue moist and clean; appetite good; three stools; some cough; slight expectoration of mucus slightly tinged with blood; respiration 35; some crepitation and absence of respiratory murmur on left side, lower portion; mucous râles in middle lobe of right lung, vesicular murmur in upper portion. 9th: Slept well; pulse 80, weak; skin natural; appetite improving; two stools; respiration 26. 10th: Restless; eyes more natural, cheeks less congested; pulse 80, quick; skin natural; tongue moist, clean; appetite moderate; cough slight; two stools. Tincture of iron ordered three times daily. 11th: Stronger; slept some; eyes bright; face slightly flushed; pulse 85, quick; skin natural; tongue moist, clean; appetite good; three stools; cough slight. 12th: Slept well; looking better; cheeks congested; pulse 90, strong, wiry; skin of natural temperature, an occasional rose-spot appearing; tongue moist, clean; slight tenderness in right iliac region; two stools; no cough. 13th: Slept well; looking bright; pulse 90, quick; skin a little above the natural temperature; slight pain in right lung; tongue moist and clean; appetite good; six stools; no cough. 14th: Slept well; looking bright; pulse 110, quick, corded; skin of natural temperature, an occasional rose-spot appearing; tongue slightly coated yellowish in centre; appetite moderate; three stools; moderate tenderness in right umbilical and left iliac regions. 15th: Slept some; pulse 80, regular, corded; skin of natural temperature, showing a few rose-spots, disappearing on pressure; tongue moist, coated yellowish-white in centre; appetite good; three stools; some umbilical tenderness; some pain in middle of right side on deep inspiration. 16th: Out on pass. 17th: Slept well; pulse 85, quick; skin of natural temperature; tongue moist, coated slightly white in centre; appetite moderate; two stools. 18th: Wakeful; pulse 86, somewhat irregular; skin covered with perspiration; slight headache; tongue moist, clean; appetite poor; two stools; some epigastric pain and tenderness. 19th: Slept well; pulse 62, regular; skin natural; tongue moist, clean; appetite moderate; three stools; pain on deep inspiration. 20th: Slept well; pulse 86, regular; skin and tongue natural; appetite good; two stools. 21st: Slept well; pulse 90, quick; skin and tongue natural; buzzing in ears; appetite good; two stools. 22d: Slept well; bright; pulse 90, somewhat quick; tongue clean; appetite good; two stools; some abdominal tenderness. 23d: Slept well; pulse 90, natural; still some pain in right side of chest. 24th: Wakeful; pulse 90, quick; skin moist; tongue white; appetite moderate; two stools; less tenderness. 25th: Slept well; pulse 90, quick; skin natural; tongue clean; appetite good; two stools; some general tenderness. 26th: Returned to duty.