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The temperature rose to 100.8 the following day but it fell after the removal of the drain and con- tinued normal throughout. The wound, which healed completely by first intention. was dressed on the 9th day, the silk sutures removed on the 10th and the gut on the 13th. The antiseptics held throughout and this no doubt contributed to the successful result. Mr. Lockwood's recommendations were carried out thoroughly and minutely. Silk sutures are not satisfactory and gut should always be used in these cases.
HEPATIC ABSCESS-REMOVAL OF A RIB-RECOVERY.
B. J. admitted to hospital on the 5th May, 1900, suffering from vomiting and diarrhoea but no fever. There was a doubtful history of dys ntery at Singapore 6 months previously. The liver dul- ness was normal and the tenderness and pain (which were present before his admittance) were gone. On the 16th of May his temperature rose to 100° and kept up between 100° and 101° when on aspiration pus was found in the liver. The abscess was opened in the usual way and a piece of the rib excised. The temperature fell in 48 hours to norm till the 1st June when it again rose 100o, and on the 10th he had a very severe r for with temperature 103°. There was slight tenderness just below the ribs in the mid-axillary line. His temperature now kept rising to 105° and 104° and on the 13th six punctures failed to detect pus. His condition remained the same with furrel tongue, vomiting, fever and great loss of flesh and occasional refor Quinine, carbolic acid in large doses and antistreptococcus serum were all tried without result. On the 19th July the liver was again explored with negative result- but three ounces of clear serum were drawn off from the right pleural cavity. His condition getting worse he was again put under chloroform on the 22nd July when the whole of the 9th rib was found necrosed and was removed up to inch from the spine. His temperature still continued to rise in the evening to 100 and 101° but he slowly convalesced after a large abscess in the right thigh was opened. The patient's weight fell from 150 lbs. to 122 lbs. Patient was discharged on the I-t September. After a trip to da an returned en route to England. His weight had improved and this very large incision completely healed though he still showed traces of the severe illness he had been through.
RUPTURED SPLEEN-OPERATION--RECOVERY.
1
A Chinese adult male was assaulted by two lukongs early in the morning of the 6th September. He walked to the Chinese hospital (Tung Wa) from No. 2 Police Station and after his dying deposi- tions had been taken was brought to this hospital at p.m. Patient was in much pain and very col- lapsed with dulness in both flanks. The abdomen was rapidly opened in the middle line, blood clots removed, and the spleen ligatured and removed. This organ weighed 16 ounces and was found rup- tured right across fr m anterior to posterior bor ler During the operation Dr. THOMSON and Lieut. RAIT, L.M., transfused, which proceeding contributed in no small way to the success of the case. patient rallied fairly quickly from the shock. On the 3rd day as the wound was gaping owing to the great intestinal detention chloroform was again administered and several more stitches inserted. Free purging removed the distension and th after history of the case was uneventful. Patient attended Court on the 26th October and left hospital apparently perfectly well on the 30th.
RUPTURED SPLEEN-OPERATION-DEATH FROM FRACTURED SKULL.
The
A Chinese adult male was admitted at 10.30 a.m. on the 19th September having been mixed up shortly before in a free fight Patient was not much collapsed but complained of great pain ail over the abdomen. He continued in much the same condition till 8 p.m. when his pulse being worse, and the dulness in left flank markel, it was determined to perform abdominal section. Taking his de, osi- tions unfortunately involved loss of time but at midnight with the assistance of Dr. JORDAN, the abdo- men was opened, blood clot cleared out. and the spleen removed. This organ weighed 18 ounces and the rupture had occurred underneath the capsule which was completely raise from the surface of the organ and had eventually given away near the hilum. Previous to the operation two pints of saline fluid were transfused into the connective tissue over the pectoral muscle At 8 p.m. next day the patient seemed quite out of danger. His pulse had improved, all shock had disappeared and his tein- perature was 100°
The next day, however, cerebral symptoms set in with coma gradually deepening, restlessness and a rising temperature till 8 p.m. on the 21st when he died, temperature 105.8 and pulse
150.
Post mortem.-Examination showed the ligature firm on the stump and the abdomen clean. There was a fracture on the left side extending through the petrous portion of the temporal bone to the base and a large clot pressing on the medulla.
MALIGNANT MALARIA-APHASIA-RECOVERY.
A German engineer from a steamer trading between here and Haiphong was admittel on the 24th December He was in a curious dazed condition unable to speak distinctly and could give no clear account of his illness. Temperature 99°, tongue furred but no vomiting and apparently no pain any- Heart and lungs were normal but pulse slow and very feeble. Pupils normal and no facial
where.