Civil War Washington

CASE 68.—Private Charles Bangson, Co. I, 14th Conn.; age 27; was admitted Oct. 19, 1863, with typho-malarial fever. He had been sick for twelve days and on admission was in a semi-comatose condition; tongue dry, glazed and red at the tip and edges; pulse 120, full, bounding and incompressible. On the 27th the pulse was 108 and scarcely perceptible at the wrist; the patient had some cough with thick, tenacious yellowish sputa​. The ileo-cæcal region was tender, but no eruption was observed. Death occurred on the 29th. At first tincture of aconite was given, for which, on the 25th, quinine, carbonate of ammonia and whiskey were substituted. Post-mortem examination ">four hours after death: The trachea was palish but mottled at its bifurcation; several ecchymotic spots were observed on its posterior surface. The œsophagus was pale and its mucous membrane firm. The right lung was perfectly healthy; the left lung weighed thirty-one ounces and a half, its upper lobe being congested generally and solidified in its central parts and its lower lobe mottled with dark-brown spots about the size of a pea. The heart contained fibrinous clots in its right chambers. The liver was congested and weighed seventy-two ounces; the spleen firm, fourteen ounces and a half; the pancreas normal; the kidneys congested. The small intestine near the ileo-cæcal valve was of a darker color than elsewhere; its mucous membrane was healthy to within ten feet of the valve, at which point it became unusually vascular and softened, Peyer's patches and the solitary glands being of a deep pink color; lower down Peyer's glands became enlarged, whitish and hard, with abrupt edges; still lower down they were ulcerated, which condition frequently existed in the centre of a patch while its margins remained enlarged and hard; the glands near the valve were ulcerated in their whole superfices, some of them looking not unlike Hunterian chancres; the ulceration did not extend deeper than the mucous membrane; the solitary glands were enlarged and of a dark-purple color in the lower part of the ileum, and some near its termination were ulcerated. The mucous membrane of the cæcum and ascending colon was of a dark-bluish color; lower down it was pale and in some places pink; the solitary glands were conspicuous but not elevated, appearing as whitish spots with pigmented centres.—Ass't Surg. Harrison Allen, U. S. A., Lincoln Hospital, Washington, D. C.