Civil War Washington

CASE 108.—Private Gerald Tiffany, 27th New York Battery, aged 44 years, falling between the platforms of two railway cars, February 6, 1864, was caught and squeezed between the buffers. The compression was antero-posterior and over a space to the left of the umbilicus in front, and between the crest of the ilium and the ribs behind. There was ecchymosis in the lumbar region, but the integuments were intact. The patient was conveyed to Kalorama Hospital. There was profound collapse, from which he slowly rallied. The abdomen was tender and swollen, the urine bloody. Emollient fomentations were applied and opiates were administered, and diluents and a light diet were prescribed. There were symptoms of peritonitis during the first week, but not of an aggravated character. The hæmaturia persisted for three weeks, clots being passed occasionally molded of the form of the ureter. There was dulness​ of percussion over the left flank. The symptoms seemed to indicate rupture of the left kidney, with limited and probably extra-peritoneal urinary extravasation. Balsamic remedies were employed, and the bloody appearance of the urine at last disappeared; an albuminous condition of the secretion persisting. Œdema of the lower extremities supervened. With occasional amendments, the evidence of uræmic infection became more confirmed. The patient had several severe attacks of diarrhœa, and sank and died from the effects of his injuries on April 6, 1864. No autopsy.