Civil War Washington

CASE 118.—Remittent fever followed by typhoid.—Private A. Whipple, Co. A, 4th Mich. Vols.; age 19; was admitted Oct. 30, 1861, as a case of remittent fever. On October 8 he had chills and fever which continued a week, with weakness, anorexia, nausea and vomiting, and during this period he felt better in the morning than in the evening. He was treated with quinine, rhubarb and capsicum. On admission his cheeks were slightly flushed, countenance calm, eyes bright, conjunctivæ yellow, pulse 99, full and strong, skin yellow, warm, dry, soft and without eruption or sudamina, tongue moist, red at the tip and coated grayish in the centre, appetite deficient; the bowels were moved five times, and there was abdominal tenderness with slight gurgling but no meteorism. Calomel and full doses of quinine were prescribed. During the night the patient was delirious at times, and on the following day he had some deafness and tinnitus aurium. The quinine was continued and the calomel omitted. On November 1 the tongue was moist, pale and coated somewhat in the centre and at the base. Next day two rose-colored spots were noticed and sordes appeared on the teeth. Milk-punch, beef-essence and turpentine emulsion were prescribed. On the 4th the patient's condition was unchanged; he was very delirious, his face much flushed, pulse 98 and strong, skin very hot and showing some rose-colored spots, tongue dry in the centre but moist at the edges; he had no cough, but mucous and sibilant rales were heard in some parts of the chest; the bowels were moved by an enema of castor oil and turpentine and the tympanites which had been present was thereby reduced. He was dull and stupid on the 5th and had subsultus tendinum. Next day some petechial spots appeared. No further details are given. The patient was transferred to Annapolis, Md., on the 18th.