Civil War Washington

CASE 57.—Private James Hight, Co. D, 23d Ohio Vols.; age 23; was admitted January 18, 1865, with tertian intermittent fever. He had chills at irregular intervals succeeded by profuse sweating; his intellect was unnaturally dull; he would not eat nor try to help himself though he appeared strong; he had no pain; pulse regular and compressible. The chills yielded readily to quinine, but he remained without appetite or energy. After the first week he declined gradually, becoming morose in disposition and absent-minded, and affected with cough and diarrhœa. On February 20 he was reported as emaciated and imbecile; he had no diarrhœa but passed his stools in bed. On March 1 he rallied so as to answer simple questions correctly; but he had dyspnœa, much expectoration and extensive crepitus in both lungs. On the 5th he became half comatose with quick short breathing, and died on the evening of that day. Post-mortem examination thirteen hours after death: Much emaciation; blister mark on back of neck. There was effusion under the cerebral membranes, which were not injected but pale; the arachnoid at the foramen of Bichat was thick, opaque and white; the ventricles were distended with serum; there was a cream-colored spot of softening, apparently covered by serous membrane, on the ventricular wall formed by the right corpus striatum; the middle commissure was remarkably firm, as it stretched out to nearly an inch in length and so remained without breaking across; the substance of the cerebrum was hard, that of the cerebellum and cord soft. The anterior mediastinum was emphysematous. The bronchi in the right lung and in the lower lobe of the left lung, especially behind and below, were dilated, of a dark purple color and filled with a pus-like fluid, while the lung-tissue around them was here and there dark and solid, the affected lobes as seen from the surface being sunken and of a dark lead color. The heart contained a fibrinous clot. The liver was large and finely marked with nutmeg foliations; the spleen normal. There were patches of reddening along the ileum, and pigment patches in the sigmoid flexure.—Third Division Hospital, Alexandria, Va.