Civil War Washington

CASE 110.—Mild typhoid grafted on remittent fever.—Private E. S. Elmer, Co. K, 14th N. Y.; age 22; was admitted Sept. 24, 1861, having been taken sick three weeks before with diarrhœa followed by bilious remittent fever. On admission he had severe headache with flushed face, injected eyes and accelerated pulse. He slept little during the following night; in the morning he was covered with sweat, pulse 108, full but weak, tongue slightly yellow, bowels moved once, respiration natural; his appetite was good, but he had much thirst and was somewhat dizzy. Two grains of blue-mass and a half grain of quinine were ordered to be given every two hours. On the 26th he was not so well: his face was flushed, eyes much suffused and countenance anxious; the dizziness was increased and there was delirium; the tongue was heavily coated yellow and the appetite lost; there was also retention of urine, but the skin was moist and profusely covered with sudamina; there had been but one stool, and the patient had no pain nor tenderness. Castor oil and extract of buchu were ordered. In the evening the skin was hot but bathed in perspiration, the pulse 96, strong, the tongue coated and moist, the bowels tender and slightly tympanitic. On the 27th the face was not flushed; the skin was soft and natural, the respiration normal, the tongue moist, yellow in the centre, and the appetite good; two stools were passed and there was some right iliac tenderness; a few rose-colored spots appeared on the abdomen. One drachm of turpentine emulsion was given every three hours, with twelve grains of quinine in the forenoon. In the evening the cheeks were flushed, the eyes suffused, the pulse 96, the skin dry and hot, the tongue moist and heavily coated gray, the appetite good; two stools were passed and tympanites, borborygmus and tenderness were present. Sweet spirit of nitre and Dover's powder were given. No stool was passed on the 28th; the skin was natural, pulse 92, strong, the tongue moist and yellow, the appetite moderate; there was some difficulty in micturition but no abdominal pain nor tenderness. In the evening four or five rose-colored spots appeared on the abdomen and chest. Next day the skin was soft but rather above the natural temperature, the tongue moist and yellow-coated but red at the tip and edges; there were twelve dull red spots on the abdomen, which was slightly tympanitic but not tender. He vomited during the following night and had three stools with some tympanites and left iliac tenderness. Lead, opium and tannin were given. Slight relaxation of the bowels continued up to October 10, when the patient was sent to hospital at Annapolis, Md.