Civil War Washington

CASE 98.—Private Charles E. Mariner, Co. A, Purnell Legion, was admitted Aug. 16, 1863, having been affected with slight headache and diarrhœa, two or three evacuations daily, for several days. There was no fever on admission, but his tongue was coated and yellow and his eyes jaundiced. Calomel was given as a purgative and small doses of quinine. On the 18th he vomited bile, and next day his tongue was less coated and the sclerotics white. On the 20th signs of prostration were manifested. Delirium occurred on the night of the 22d, after which he failed rapidly and died on the 24th. Post-mortem examination eighteen hours after death: The mucous coat of the stomach was softened and almost disintegrated, Peyer's patches were ulcerated and in two places nearly perforated; the solitary glands were greatly ulcerated and in some instances broken down; the ileo-cæcal valve was disorganized, its mucous membrane being converted into a pulpy mass. The rectum was ulcerated in three places, each as large as a dime. A number of the mesenteric glands were enlarged to the size of a pigeon's egg. The liver was pale; the spleen congested and twice its normal size. The left side of the neck was emphysematous and its tissues engorged, the result, probably, of an ante-mortem blow.—Act. Ass't Surg. W. H. Letterman, Douglas Hospital, Washington, D. C.