Civil War Washington

CASE 103.—Private James M. Forman, Co. H, 33d Pa.; age 21; was admitted Oct. 2, 1861, having been sick for nine days with pain in the head, back and bones, chills, loss of appetite and strength, diarrhœa, epistaxis, pain in the stomach, nausea and vomiting. A bath was ordered for him with Dover's powder at night. Next morning his face was flushed, eyes injected, pulse 98, full, skin hot, dry and rough, tongue heavily coated, the centre brownish, the tip and edges red; he had anorexia, great thirst, irritability of stomach, diarrhœa, the bowels having been moved four times, tenderness in the right iliac region and four or five characteristic rose-colored spots. The case continued for ten days without much change under treatment by astringents, opiates and whiskey punch. The nausea and vomiting gradually ceased; some degree of deafness was developed; there was occasional tympanites, and blood appeared in the stools for several days and on the 8th in large quantity. But on the 12th the diarrhœa ceased, the abdominal tenderness was lessened, the tongue became moist and there were indications of returning appetite. About the same time, however, the right parotid gland became inflamed and the face much swollen. There was slight delirium on the 14th, and next day the swelling, which had become erysipelatous, extended over the face, nearly closing both eyes and presenting a small gangrenous spot on the ear and another on the cheek. The patient walked about the ward in high delirium, but towards evening became more quiet. At 10 P. M. he sprang up suddenly, knocked the pitcher containing his punch from the attendant's hand and endeavored to get down stairs. He was got back to bed with some difficulty and immediately thereafter began to fail. At midnight his pulse was rapid and almost imperceptible, his extremities cold, eyes fixed and jaws locked; he took no notice when called or shaken and died at 1 A. M. of the 16th. Post-mortem examination: Parotid gland in a state of suppuration; side of face dark-colored and with small patches of gangrene in front of the ear. The mucous membrane of the stomach was congested and softened. The liver and gall-bladder were large but healthy; the spleen congested, enlarged and soft. The ileum was inflamed; its solitary and agminated glands were ulcerated and there was a small perforation in one of the ulcerated patches. The large intestine, from the valve to the rectum, was very much ulcerated. The peritoneum was inflamed; the mesenteric glands enlarged; the kidneys and bladder healthy.—Seminary Hospital, Georgetown, D. C.