Civil War Washington

CASE 113.—Diagnosis—remittent. Delirium, stupor, deafness; diarrhœa; rose-colored spots and bed-sores.—Private Bennett Pepper, Co. H, 62d N. Y.; age 19; was taken sick early in February, 1862, with headache, nausea, vomiting and pains in the back and limbs, and was admitted on the 27th as a case of remittent fever. On March 5 he was delirious, drowsy and inclined to stupor; he had tinnitus aurium and twitching of the mouth, puffy eyelids, flushed cheeks, rapid and weak pulse, hot and dry skin, moist but much coated tongue, sordes on the teeth, some appetite, much thirst, a diarrhœa of four watery stools daily, which were sometimes passed involuntarily; respiration was hurried and there was some cough. Beef-essence, turpentine emulsion and tincture of opium were prescribed. On the 6th there was profuse perspiration with sudamina. Next day the delirium abated and the patient replied rationally but with difficulty; the tongue was coated but moist, and was permitted to remain protruded indefinitely; the bowels were regular but meteorized and tender and the abdomen showed some rose-colored spots; the breath was very offensive from ozæna. There was much tendency to stupor on the 9th, with occasional delirium. Free perspiration with sudamina occurred again on the 10th, and the urine was excessive in quantity; cough persisted and there was some dulness​ on percussion a little below the clavicle on the right side. The skin became hot and dry on the 12th and the watery stools returned; respiration was hurried and the breath very offensive. The mind became clear on the 14th, and on the following day the skin was natural, the tongue clean, the pulse good, but the bowels continued loose. The diarrhœa, however, subsided on the 16th, on the occurrence of copious sweating with sudamina, and the congh was much relieved; earache, developed on this day, was noted also on the 17th, when the skin again became hot and dry and the tongue somewhat coated. Some sore spots on the back and hips were observed on the 18th, and next day the patient was placed on a water-bed. He became deaf at this time, but his general condition improved, and on the 28th he was able to walk about. He was discharged April 26 because of general debility.