Civil War Washington

CASE 8.—Private Herbert Vaness, Co. D, 171st Pa.; age 20; was admitted July 8, 1863, with typhoid fever of twelve days' duration, which progressed favorably until the 9th, when diarrhœa set in. On the 15th there was delirium, with dry and tremulous tongue, sordes on the teeth and swelling of the abdomen; a troublesome hacking cough was also present. He died on the 17th. Post-mortem examination ten hours after death: The brain weighed fifty-eight ounces and a half; its membranes were considerably congested and its substance rather soft; a small quantity of fluid was found in its ventricles. The trachea was much congested, of a purplish-red color and filled with bronchial secretion; the lymphatic glands at its bifurcation were enlarged, blackened and softened. The upper lobe of the right lung was highly congested, especially at the apex; the middle lobe was also somewhat congested and presented evidences of bronchitis posteriorly; the lower lobe was intensely engorged, purple in color and in some places almost black. The left lung was generally congested; there was a considerable transudation of blood beneath the pleura at its middle and posterior part; its lower lobe contained splenified lobules, black in color, and separated from each other by permeable tissue. The right lung weighed twenty-four ounces and a half, the left twenty one ounces and a half. A thin fibrinous clot adhered to the anterior wall of the right auricle and extended through the ventricle into the pulmonary artery; the left auricle also contained a fibrinous clot extending into the ventricle and attached to the mitral valve. The fundus of the stomach was of a dull lake-red and the pyloric portion paler; it contained five lumbricoid worms. The liver was soft but of normal color, its capsule easily torn. The spleen was of a mulberry color and moderately firm. The mucous membrane of the jejunum was rather soft and the villi were easily scraped off. The lining membrane of the three feet of the ileum nearest to the ileo-cæcal valve was greatly congested, and Peyer's patches were ulcerated though not perceptibly thickened; the first ulcer was small, superficial and of a darker color than the surrounding membrane; about a foot above the valve a large patch, softened and very hyperæmic but not elevated, presented near its border an ulceration about the size of a pea, with elevated walls and blackened centre. The kidneys were somewhat injected, the cortical substance firm and pale.—Ass't Surg. Harrison Allen, U. S. A., Lincoln Hospital, Washinigton, D. C.