Civil War Washington

CASE 26.—Private Jos. McVaugh, Co. D, 147th Pa.; age 45; was admitted July 28, 1863. He was very feeble and delirious, with an inclination to stupor; his tongue very dry and red; skin cool and clammy; pulse 113, small and weak; bowels moved about ten times daily; abdomen hard and tender, especially in the right iliac region. In the progress of the case the stools became less frequent, but all the other symptoms increased in severity; the passages during the night before death were involuntary. He died August 2. Post-mortem examination seven hours after death: The brain weighed forty-five ounces; the pia mater was somewhat congested and the choroid plexuses filled with minute air-bubbles. The trachea was greenish but contained healthy sputa; the mucous membrane of the œsophagus was pale yellow-stained near the cardiac orifice and presented numerous whitish points. The right lung weighed eleven ounces and was slightly engorged in its upper and middle lobes. The left lung weighed fifteen ounces; its upper lobe was much shrunken and contained but little air; towards its apex was a small circular elevation about the size of a chestnut, surrounded by a livid purplish zone about three inches in diameter; on opening this spot a quantity of air escaped and a few drops of bloody fluid; the lower lobe was engorged with venous blood. The heart contained a small fibrinous clot in the right cavities and a mixed clot in the left; the pericardium contained two drachms of bloody fluid. The stomach was unusually firm and its mucous membrane pale-red in color throughout. The liver weighed fifty-three ounces and was slightly congested; the gall-bladder contained ten ounces of bile of a brownish-ochre color, filled with a flaky substance which did not precipitate. The spleen weighed five ounces and was flabby, soft and of a mulberry color. The right kidney weighed five ounces; its external surface was of a bluish color spotted with numerous dark-blue points; an abscess about the size of a horse chestnut, with ecchymosed walls, containing discolored pus, was found on the anterior surface near the outer margin. The left kidney weighed five ounces and a half; it was much congested; a small cyst containing serum was found on its anterior surface. The small intestine was healthy to within three feet of the ileo-cæcal valve, but from this point downward the mucous membrane was of a reddish-purple color, thin and somewhat softened; Peyer's patches were discolored and ulcerated, especially near the valve, where patches of a dark-blue stone color, fully an inch in diameter, were eroded. The large intestine was greenish but free from ulceration; the solitary glands were white and conspicuous.—Ass't Surg. Harrison Allen, U. S. A., Lincoln Hospital, Washington, D. C.