Civil War Washington

CASE 50.—Lieut. J. W. Lowe, Co. B, 9th N. Y. Cav., was admitted Sept. 21, 1863, with his neck somewhat swollen and stiff, the result of a blow from a rebel musket at Brandy Station, Va., Aug. 1, 1863; his general health was good. On the 30th he went home on leave of absence. He returned November 14 much improved, stating that during his absence he had an attack of diarrhœa which lasted only a few days; the attack was preceded by vomiting, and was attributed by him to some error of diet. He felt well and expressed himself as able to join his regiment. But at midnight of the 18th the officer of the day was called to see him as he had been seized with a violent pain in the testicle, without swelling but with great tenderness. An anodyne lotion relieved him and he fell asleep, but awoke about daylight vomiting a pale-green liquid and with great tenderness over the stomach. The abdomen soon became tympanitic, the pulse sank, the vomiting became constant and the countenance livid and anxious. A blister was applied and laudanum given by injection. At noon the vomiting became less frequent and he was able to swallow small quantities of brandy and water with morphia; the pulse, however, was scarcely perceptible and the face and hands were covered with cold sweat. He died at 3.30 P. M. after vomiting as much of a pea-green liquid as half filled a common tin basin. Post-mortem examination: The thoracic viscera were healthy. The peritoneal cavity contained two ounces of pus. The whole intestinal canal was in a state of acute inflammation; the ileum was perforated in several places, some of the openings being large enough to admit the end of the little finger. The inflammatory condition extended to all the abdominal viscera. "How this state of things existed without symptoms for a longer period than fifteen hours I am at a loss to explain or even conjecture. The man was not emaciated; on the contrary he had gained in flesh during his visit home. I am informed by his brother, who came for his remains, that he had complained at times of a pain in the bowels, but of so slight a character as not to attract much attention and which was usually relieved by a draught of warm ginger-tea." [Specimen 77, Med. Sect., Army Medical Museum, showing typhoid ulceration and perforation, is from this case.]—Surg. H. W. Ducachet, U.S.V., Seminary Hospital, Georgetown, D.C.