Civil War Washington

CASE 40.—Superficial gangrenous patches.—Corp'l J. H. Kourtz, Co. C, 130th Pa.; age 19; was admitted April 20, 1863, having been sick since the 1st. He was considerably emaciated and in bad nervous condition; his pulse 90, appetite poor, tongue white-coated, dry and cracked, and bowels moved five or six times during the twenty-four hours; he had a slight cough with thin gray sputa mixed with semi-solid masses of a dark-brown color, and there was dulness​ and slight crepitus in the right infraclavicular region. Suitable nourishment was ordered with sweet spirit of nitre and Dover's powder at bedtime. On the 24th two small pustules with inflammatory areolæ were observed above the left knee. A two-grain dose of quinine in sherry was given every two hours. By the 29th the centre of these spots had become gangrenous and evolved a very offensive odor; a similar but larger spot had also developed on the right forearm three inches above the wrist. Chloride of zinc solution was used locally. The spots enlarged slowly, and on May 3 a pustule with a large inflammatory base appeared on the mucous membrane of the left side of the lower lip. On the 5th there was low delirium; the left side of the face was swollen and the gangrenous spot on the lip was as large as a penny and increasing rapidly; the diarrhœa meanwhile continued. The patient became unconscious and died on the 8th.—Act. Ass't Surg. O. P. Sweet, U. S. A., Lincoln Hospital, Washington, D. C.