Here’s a sad case of a soldier from the 37th US Colored troops who had a horrible case of tuberculosis that was everywhere but in his lungs.
Post Hospital, Fort McHenry
Baltimore, Md. April 25, 1866
Bvt Major & Asst Surgeon
DeWitt C. Peters, U.S.A., Post Surgeon
Fort McHenry, Md.
I have the honor to transmit herewith the Ante & Post Mortem History of Private James Turpins Co. F, 37 U.S. C Troops, Age 23 Years, who died in this hospital April 109, 1866, of tubercular caries of spine, the pathological specimens of which was forwarded to the Army Medical Museum, Washington, D.C., April 20, 1866.
This patient was admitted into this hospital Feby 20, 1866 from the Hicks U.S.A. General Hospital suffering at that time with a severe pain, much increased upon pressure over the region of the Lumbar Vertebrae, attended with loss of motive power in lower extremities, with which was associated great constitutional debility and scrofulous cachexia. He stated that he had first contracted his sickness while in Hospital at Fortress Monroe, Va. With Frostbitten feet; that it had commenced with pain in the back which increased from day to day until he was unable to use his lower extremities, an abscess had formed and had been opened by the attending Surgeon shortly after his admittance into this Hospital. This opening continued to discharge profusely a quantity of very fetid and cloudy pus; at times he was considerably troubled by incontinence of urine. About three weeks before his death another larger Abscess formed lower down over the Junction of last lumbar vertebra with sacrum which being laid open discharged about a pint and a half of fetid cloudy pus followed by a quantity of yellow inspirated matter in which little specks of necrosed bone could be seen, carious bone could be felt through both of these openings. He continued to grow weaker from day to day, and was found dead in his bed by the night nurse early in the morning of April 10, 1866 after having eaten his supper as usual the night before and without having any convulsions or other symptoms of nervous irritation except the paraplegia.
The treatment consisted essentially in the administration of alturatives and tonics calculated to support the vital energies together with a good nourishing diet.
On Post Mortem examination the body was found much emaciated; rigor mortis not well marked.
The dura-mater normal; pacchionian bodies much larger than normal. About three ounces of purulent fluid escaped from subarachnoid space upon opening the dura mater. Vessels of the piamater somewhat congested, the surfaces of the arachnoid and piamater in surarachnoid space were covered with a thick layer of yellowish pus, which was especially marked in the situations of the so-called anterior and posterior subarachnoid spaces and between certain convolution on the uppers surface of the hemispheres in these last situations little leaks had formed in some cases in the sulci which were filled with a thick cloudy pus. This matter on microscopical examination was found to contain a large quantity of half disintegrated tubercular matter. The anterior horn of the left [illegible] ventricle contained about two drachmas of pus of the same character as that found in other parts of the brain. The third ventricle also contained a small quantity of purulent matter. The fourth ventricle was found full of pus which seemed to have effected an entrance by breaking down the membranes forming the inferior boundary of the ventricle. The fifth ventricle was unusually large. The choroid plexuses of all the ventricles was much engorged with blood. No tubercular masses could be discovered in the brain substance or in any of its membranes. The substance of the brain was of normal consistence; the entire surface of the spinal covered was covered with pus. Brain weighs 39 ounces.
The pleural surfaces were absent upon the left side of their upper part; both lungs were every where crepitant [ie made a crackling sound] except a portion of about 2 inches in width along the anterior edge of the upper and middle lobes of right lung. This portion was of a leaden color, tough, fibrous, non-crepitant and of a greater specific gravity than water. No tubercules could be found in either lung but the surface of these organs was every where speckled over with melanotic matter. The bronchial glands were of normal size but infiltrated with pigmentary matter. Right lung weighed 11 ½ ounces. Left lung weighted 9 ½ ounces.
This organ was somewhat enlarged, its muscular substance being hypertrophied; valves normal, cavities filled with whitish fibrous clots, the upper surface of that occupying the right auricle was distinctly grooved by the passage over it of the blood from the venae cavae. Heart weighed with clots 17 ounces.
Had a yellowish brown color. Under the microscope numerous fat granules were found in the cells of this organ; weighed four pounds and one ounce.
Gall Bladder. Filled with bile of a greenish yellow color.
Spleen was of normal appearance, weighed 5 ½ ounces.
Kidneys, somewhat congested, right weighed 6 ounces, left 4 ½ ounces.
Suprarenal capsules normal, weighed each 2 drams.
Pancreas. Natural. Weighed 3 ½ ounces.
Intestines and Stomach.
The mucus membrane slightly infected in some portions, mesenteric glands were enlarged and contained in some cases deposits of tubercular matter. About 8 ounces of yellowish serum was found in the peritoneal cavity.
The lower dorsal, lumbar, sacral, coccyxal vertebrae were all diseased and in some places extensively destroyed by caries; in the lumbar region the ulceration of the vertebrae had proceeded to such an extent as to have eaten its way into the spinal canal and through the theca and forcing its way up the canal, as the man lay on his face, accounted for the presence of pus in such large quantities over the whole surface of the spinal cord and brain and throughout the ventricles of the latter organ and also offered an explanation of the patients sudden death. The lymphatic glands in the inguinal and pelvic regions were infiltrated with cloudy pus.
Pus was also found beneath the sheaths of both psoas major muscles having destroyed the greater portion of their muscular substance. Carious abscesses were found of the fifth rib on the right sight and of the second and forth of the left side at the point of junction with their respective cartilages. The end of the sternum was also carious as far up its junction with the cartilage of the fifth rib. The pelvic bones were studded with spots of caries.
I am, Major, Very Respectfully,
Your Obedient Servant,
A.A. Surg. U.S. Army