A report of surgical cases treated in the Army of the United States from 1865 to 1871 / War Department, Surgeon General's Office.
- Date:
- 1871
Licence: Public Domain Mark
Credit: A report of surgical cases treated in the Army of the United States from 1865 to 1871 / War Department, Surgeon General's Office. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![ft 274 REPORT OF SURGICAL CASES IN THE ARMY. e\'cn to tlie loins, and increased pretty steadily to the time of his death. On November 23d began to expectorate blood^^ sputa, somewhat darker than in ordinary pneumonia. At first but little dysi)na?a and almost no pain in chest. On 24th complained of flight stitch in lower right chest. On auscultation considerable coarse rale in both fronts; no fine crepitus; back not examined on account of difficulty of moving in bed. On 28th and 29th dyspnoea much increased. On the 30th, he was evidently moribund at 8 A. M., and died at 1.30 P. M. The treatment during the last four months, in addition to the local means already mentioned, may be briefly summed upas consisting of a generous diet—eggs, milk, fresh meat, &c., ad libitum Avith strong beef-tea, regularly administered when the appetite did not induce him to take sutticient nourishment otherwise; tonics, as quinine, citrate of qniniue, and iron, compound tincture of cin- chonae, &c., brandy or whiskey, from four ounces to twelve ounces daily, and opiates, when needed, to relieve pain and procure sleep. Autopsy nineteen hours after death.—Body greatly emaciated, considerable oedema of lower extremities. Cadaveric rigidity marked. Chest decidedly resonant on percussion in both upper fronts, somewhat less so at sides. Abdomen sunken. Thorax.—Lungs do not fully collapse on opening chest. Left pleura contains about fourteen ounces of straw-colored serum. Recent adhesion at left middle front (region of nipple), where pleura costalis shows patch of arborescent redness and blotches as of ecchymosis, slight old adhe- sions at apex. Left lung, lower lobe completely hepatized. On Incision of lower part of upper lobe, free exudation of muddy, sanguineo-purulent fluids ; upper half of this lobe crepitant. Right pleura, some old adhesions at base (diaphragmatic portion), otherwise normal. Right lung, upper and middle lobes, generally crepitant. On section abundant issue of frothy serum. Lower lobe hepatized, friable, particularly toward base, where it resembles softened spleen. At anterior lower margin apparently a clot of blood effused in pulmonary textures, but its margin not well defined from the splenifled tissues surround. Pericardium normal. Heart not examined. Abdomen.—Peritonteum smooth, moist, no effusion or adhesions, no enlargement of mesenteric glands. Intestines externally pale, glossy; alimentary canal not opened. Liver, spleen, and left kidney normal. Right kidney not examined. A large abscess occupies most of situation of left psoas magiuis communicating with external opening that made on November 2d, and with the denuded bodies of second, third, and fourth lumbar vertebra?. Posterior crest of ilium denuded- On right side a section through pelvic fascia unexpectedly opened a cavity with no apparent open- ing, containing eight or ten ounces of thick, healthy, pus, communicating with space between last lumbar vertebra and sacrum, from which the intervertebral substance had entirely disappeared, the opposing surfaces of bone eroded and separated. Traces were found of another sinus, inde- X)endent of the last named abscess, communicating with the old, opening in right lumbar region. The parts were so degenerated, however, that the anatomical boundaries could not well be made out. [A section showing three lower vertebrae, sacrum, and parts of ilia in situ, -jvas forwarded to the Army Medical Museum with this report, and is numbered 5526 of the Surgical Section,] DCCXXVII.—Report of a Case of Caries of the Ptibis, treated in the Post Hospital at Fort D. A. Eussell, Wyoming Territory. By J. Basil Girard, Assistant Surgeon, U. S. A. John K , buglar Troop F, 2d Cavalry, aged 22 years, reported at sick-call in the latter part of August, 18G8, complaining of pain on pressure and motion about the i^egion of the right groin. Inspection of the part showed no swelling, heat, redness, or other visible pathological change, and the case being considered as a sprain of the adductor muscles, caused by horse-back exercise, the patient was dismissed with some anodyne liniment to rub the painful part. A few days after he came again, stating the pain to be worse, and judging from his sickly and worn-out look that the affection might be serious, he was admitted to the hospital on August 31st. On admission, the symptoms were great pain in the groin, especially over Scarpa's triangle, and emaciation. His appetite was good, pulse regular, and no fever present. The painful part was for a few days painted with iodine, and an anodyne given at night to produce sleep. Ordinary diet with beef tea was prescribed. No effect being produced by the tincture of iodine, it was replaced by warm linseed-meal poultice^ which in their turn were dispensed with, and a lotion of](https://iiif.wellcomecollection.org/image/b21970695_0290.jp2/full/800%2C/0/default.jpg)
