410
THE HONGKONG GOVERNMENT GAZETTE, 13TH APRIL, 1895.
On the 27th quinine pill grs. v. three times a day ordered. Tepid sponging every two hours and liquor morphiæ m. xxx, at 9 p.m. On the 28th morning, pulse slightly intermittent and tendency to delirium; tr. digitalis m. xii., sp. ammou co. m. xxx., tr. cinchon co, m. xxx. ordered every four hours. No sleep during the night. On the 29th delirium marked; pulse still slightly intermittent. Ilyoscin hypodermically gr. O
1 100
On the 30th at 2 a.m, he had another gr. To as he had not slept at all and was continually wanting to get out of bed. At 9 a.m. has had no sleep, pulse very irregular now; pupils widely dilated, (? Hyoscin). 12.30 p.m. had grs. x. bromide of ammouium.
1st July at 3.30 a.m. he had gr. morphine. "He repudiates the ice-bag"-pulse inter- mittent, and anaerotic-no rebound wave by sphygmograph. The morphia had no effect in quieting him and at 4.30 a.m. he had a hypodermic injection of gr. hyosein. After this he slept for over an hour. At 10 a.m. urine was drawn off by catheter, highly coloured, ammoniacal, deposit of mucus, trace of albumen, and deposit of phosphates (by microscope). The digitalis and ammonia mixture continued as before.
At midnight he at last got a good sleep and slept until 5 a.m., morning of the 2nd July; pulse still intermittent-
t-no lung complications; taking his nourishment well; ammonia and digitalis mixture continued and grs. iiss. quinine instead of grs. v. three times a day. No sleep at night. July 4th, situation unchanged.
During the night of the 5th as the pulse had improved though still intermittent, the digitalis was left out of the mixture. No sleep. Until the night of the 7th condition got worse. Low muttering delirium, and his pulse was now very bad, stimulants being given freely. On the evening of the 7th he had a hypodermic injection of hyoscin gr. and slept until about 7 a.m. on the 8th. seemed to be the turning point for on the 8th he was much better and was put upon strychnin and iron, in addition to the cinchona and ammonia.
This
On the 12th the bubo was opened and a large amount of pus evacuated. On the 16th ammonia and cinchona three times a day was the medicine he was getting. His pulse was still somewhat intermittent but otherwise much improved in quality. On the 18th extract of malt three times a day ordered. On the 20th he was ordered tinct, strophanthi m. x. and liq. strychnin m. v. thrice a day under which the condition of the pulse rapidly improved.
On the 5th of August cultivations from and microscopic examination of blood and bubonic discharge showing no bacilli, he was removed to the Civil Hospital. At this time there was some considerable enlargement of the glands along the iliac vessels and as there had been a great amount of sloughing in the upper part of the thigh careful surgical attention was necessary. The mass in the iliac fossa remained large and indurated for over a month and was opened by Surgeon PENNY whilst I was in Japan, whilst several other openings were made afterwards. A long and tedions convalescence terminated by his discharge from Hospital on December 2nd, the most of the swelling having disappeared and the scar being firmly healed.
JULY, 1894.
13 14
15
16 17 18
19 20 21 22 23 24 25 26
.106-
25
105-
104-
103-
102-
101-
100-
на
27 28 29
99.
98-
76 76
190
88
84 72 190 82 92 72 74 38 169 188 172 88 70
Pulse
88
92 100
96
88 94 96 100 98) 96 104 104 104/104) 88 83 86
20
20
22
20
18
16 14 19 15 12/ 12 16 [14 16 116 16 0
Resp. 20 20
201
22
16 12 161 18 16 14 16 14 16 18! 16
10
0
0
0
B.O.
2
0
0
The
Remarks.-This was a most tedious and anxious case up till the end of October. enlarged iliac glands (the induration round which extended to within an inch of the umbilicus) gave rise to considerable atony and obstruction of the bowel, which necessitated urgent manual mea- sures on several occasions. The femoral artery lay bare ou the surface of the callous ulcer for a long time
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