Civil War Washington

CASE 79.—Private Abraham J. Cooper, Co. A, 186th N. Y.; age 20; admitted Nov. 30, 1864; typhoid fever. [The diagnosis at the Ninth Army Corps Field Hospital, on the 24th, was typho-malarial fever, and at the Depot Field Hospital, City Point, Va., on the 26th, remittent fever.] Symptoms on admission: Pulse varying from 90 to 110, feeble and thready; skin hot and dry; tongue dry, extremely red and gashed; teeth, gums and lips incrusted​ with sordes; deafness; stupor; low delirium. When undisturbed he lay with his eyes half closed muttering broken and unconnected sentences; when aroused he had a vacant expression and was unable to answer correctly. During the first twenty-four hours after admission he had four passages from the bowels; the abdomen was tympanitic, very tender over the small intestine and cæcum, and marked with a few petechiæ and sudamina. Turpentine emulsion, laudanum and milk-punch were administered. Next day there was a slight improvement: The pulse became somewhat stronger, the tongue less tremulous and protruded with more ease; the patient was able to answer a few questions correctly, but the abdominal symptoms continued and there was some epistaxis. On December 2 the pulse became somewhat stronger and less frequent, the tongue quite moist, the sordes partially removed and the diarrhœa checked; but at 9 P. M. the diarrhœa returned, several involuntary stools were passed and the patient fell into a stupor from which he never aroused. He died at 3 A. M. of the 3d. Post-mortem examination eight hours after death: Lungs crepitant throughout; liver pale, with well marked nutmeg appearance; spleen of full size and softened; kidneys full of blood, the pyramids of a dark-red color; mesenteric glands enormously enlarged; colon pale and without ulceration; ileum injected.—Act. Ass't Surg. W. C. Minor, Third Division Hospital, Alexandria, Va.