Civil War Washington

CASE 111.—Private Charles Lewis, Co. G, 23d U. S. Colored troops; age 21; was admitted Oct. 20, 1865, on which day he had a chill followed by fever. Dover's powder was given in the evening, but the chill recurring next day, quinine in five-grain doses was administered. There was no chill on the following day; but the febrile action continued and increased so that on the 24th his pulse was 120, quick and full, respiration 60, skin hot and dry, tongue furred; and he was weaker, sleepless and slightly delirious. Small doses of eggnog, chlorate of potash and turpentine with Dover's powder were administered. Next day his condition was unchanged; castor oil was given to move the bowels. On the 26th the insomnia and delirium continued; the tongue was dry, brown and coated; the eyes jaundiced; the urine passed involuntarily, staining the linen yellow; the abdomen tender and tympanitic; a thin yellow-colored discharge was procured by the oil. Next day the pulse was not so strong, the tongue continued dry and ` brown, but the skin became somewhat moist and the patient slept a little. One grain of calomel and two of ipecacuanha were given every hour for six hours, with mustard to the back of the neck and chest. He died on the 28th. Post-mortem examination thirty hours after death: The arachnoid over the interpeduncular space was thickened and opaque and there was serous effusion in the cerebral ventricles. The lungs and heart were normal, but there was effusion in the left thoracic cavity. The liver was large, its right lobe honey-combed, full of air and of a very peculiar appearance, and its left lobe normal in texture but of a yellow color. The pancreas was large; the kidneys normal; the spleen large, soft and dark-colored. The colon and rectum were normal; Peyer's patches were enlarged, as were also the mesenteric glands. [Specimen 639, Med. Sect., Army Medical Museum, from this case, shows the honey-combing of the liver by dilated gall-ducts.]—Surg. E. Bentley, U. S. V., Slough Hospital, Alexandria, Va.