41
On June the 2nd he continued to take as much nourishment as possible. At 2.30 a.m. as his temperature had not come down with the antipyrin a cold sheet was frequently applied; but with no effect on the temperature until about 8 a.m. when it dropped about two degrees, and as he then shivered slightly it was removed. In the afternoon the amount of haemoglobin was estimated at 60 per cent., cynosis considerable. In the evening vomiting was severe and a mustard plaster was applied to the epigastrium. Iced champagne ordered in addition to the brandy in egg flip.
June 3rd: no more vomiting during the night, had only a few snatches of sleep. Quinine grs. v. three times a day, in addition to digitalis and strychuin mixture-tr. digitalis m. vi., liq. strychninæ m. iii. every hour for three doses. At 6 p.m. hæmoglobin was estimated at 53 per cent. There is now slight dulness and fine crepitations at the left base and at night the digitalis and strychnin mixture was repeated every four hours with ammonia mixture. On the 4th--has had a very bad night, great delirium. There are now a few fiue erepitatious at the right base (hypostatic). The palse occasionally intermits and the hemoglobin is estimated at 40 per cent. As his condition was getting rapidly worse I asked Dr. HORDER who had seen a considerable amount of plague at Pakhoi to see him with us but in spite of frequent stimulation by champagne, æther, and ammonia he rapidly sank and died at 9.45 p.m. During the afternoon he had frequent inhalation of oxygen which improved his pulse and respiration temporarily each time; but on the oxygen being discontinued they very soon got as bad as before. Ice-bags had been almost continuously on his head from the time of the commencement of delirium, in addition to a blister on the back of his neck.
On the 2nd of July from the rapid onset of acute delirium and the increase of respiration along with the marked cyanosis a most unfavourable pragnosis was given. Sleep was unfortunately out of the question that night owing to the hideous noises of a Chiuese procession on shore. Several times the patient dosed off only to be awakened by the sound of an extra hundred crackers blazed off being wafted over the calm waters of the harbour, and which the patient even in his delirium complained bitterly of. The aconite and antimony were left off whenever the pulse began to get dicrotic and stimulation commenced.
219
Case V-English. Æt. 26,
On the 26th of June at 2 p.m. was requested to see this patient, found him suffering from plague and had him removed to the Hygeia at once. History:—On the 23rd June felt quite well. Ou 24th of June at 10 a.m. felt feverish, temperature 102° F., same evening 105° F. Noticed slight swelling in left femoral region. On the 25th knocked off work. Treatment on admission: calomel grs. x. and later on liquor morphiæ m. XL., milk, eggs, brandy, Braud's essence ad lib. Had a fairly good night.
JUNE.
JULY, 1894.
26
106-
27 28 29
30 I 2 3
5 6 7 × 9 10 11 12
105-
104
103-
102-
101-
100-
99.
سورية
98-
Pulse
81
81 80 SO 180 60 80 70 80 80, 80
84
80
82
82
32
88 88 80 80 76 78 80 96
28 40 32 24
90
84
287 20/ 21 24 28 20 18
20
Res Pr
B.O
32 28 20 28 36 28 36 22 92 27 20 22
0
5
3
3
1
2
0
0