Civil War Washington

CASE 111.—Chill; remitting fever; slight diarrhœa; moist skin; flabby tongue; rose-spots on 15th day; drowsiness; perspirations; sordes; record imperfect; death.—Private Henry Martindale, Co F, 19th Ind. Vols.; age 24; was taken Aug. 28, 1861, with headache, pains in the bones, languor and chill. He took quinia and had no recurrence of the chill; but the fever which followed was generally worse in the morning. He was admitted September 4. Diagnosis—typhoid fever. On the 5th: Pulse 76; skin warm and moist; tongue heavily coated, pale and flabby; slight diarrhœa; pain in the back. Quinine was given. Evening: Skin warm, dry; tongue flabby and coated white; four thin small stools, but no pain or tenderness in the bowels; appetite fair. Dover's powder at night. On the 6th and 7th the symptoms were unchanged. On the 8th the mind was somewhat dull; the patient continued to be up and to walk about occasionally. Sugar of lead and opium were given. No material change took place until the 11th, when the warm and moist skin showed sudamina and some rose-colored spots on the abdomen, the tongue at this time being pale, flabby and coated gray, the bowels but slightly relaxed and the appetite good. Whiskey-punch was prescribed. The patient was drowsy on the 12th, and on the following day the tongue became brown and cracked but remained pale at the tip, the skin hot and dry, the breathing hurried, and the bowels moved eight times but free from pain and distention. On the 14th the tongue was dry and the countenance haggard. Two grains of quinine and one of calomel were prescribed for administration three times daily. Profuse perspirations occurred on the 15th, but the diarrhœa continued and sordes appeared on the teeth. Turpentine emulsion was given. On the evening of the 16th there was some tenderness of the abdomen and the patient kept tossing his head from side to side. On the 18th the pulse was 80, weak and small, tongue heavily coated, brown in the middle and red at tip and edges, skin hot and moist, bowels not tender but quite loose, especially at night. On the 19th there was some tenderness in the right iliac region. Ten stools were passed on the 22d, and on the following day the abdomen was tympanitic. The record closes abruptly with the announcement of death on the 28th.