Civil War Washington

CASE 112.—Coincidence of remittent fever and typhoid.—Arminius Tyler, attendant; age 21; was admitted Sept. 9, 1861, having been sick since the 1st with headache, pain in the back and fever, aggravated at night, but not preceded by a chill. On admission his face was flushed, pulse 79, tongue white and coated, skin warm and sweating; he had epistaxis and a few rose-colored spots on the abdomen. Next day the tongue was moist, brown-coated in the centre and red at the tip and edges; the bowels were quiet but tender on pressure. Quinine was taken during the day and Dover's powder at night. On the 11th the patient was dull and prostrated, pulse 68 and feeble; but in the evening there was much restlessness with high fever, pulse 90 and strong. Next morning a remission occurred, followed by an exacerbation in the evening; the tongue was pale, flabby and coated brown, and the bowels continued quiet. On the 13th the evening exacerbation was not so marked, but the tongue was heavily coated gray and the skin and conjunctivæ were jaundiced. Blue-mass was given in addition to the quinine. On the 15th two large stools were passed, and in the evening three free, thin and painless stools. Aromatic sulphuric acid was prescribed. On the 16th the pulse was 62, the tongue pale and heavily coated gray, the bowels quiet, the jaundice disappearing; there were rose-colored spots and a profusion of sudamina on the skin, which perspired freely. Rose-colored spots appeared again on the 18th; the bowels continued quiet and the evening accession became less manifest; night-sweats were profuse. On October 1 the patient had so far recovered as to be placed on light duty.