17th.—Was bled last night to twelve ounces, in consequence of increased pain of abdomen and augmented pyrexia; to-day quiet and easy, and has had several stools.
18th.—Diarrhœa and tenesmus troublesome during the night; ball voided with the feces at six A.M.; it is somewhat flattened, as if from impinging on a stone; has felt easy since. Continue antiphlogistic regimen.
19th.—Diarrhœa abated; but the abdomen is tense and painful on pressure. He is distressed with nausea and vomiting; pulse 100, and sharp; great thirst; tongue dry. Bleeding to sixteen ounces; abdomen fomented.
20th.—Bleeding was repeated last night from persistence of the symptoms of peritonitis. Blood drawn very buffy; has had several loose stools during the night. He is to-day easy; abdomen now scarcely painful. Fomentations continued.
29th.—This morning the abdomen was tense and painful on pressure; he was affected with nausea, and had had vomiting repeatedly during the night; thirst and pyrexia. Fomentations were applied from time to time, and yielded relief. Suspect that he has not observed the prescribed regimen.
May 1st.—Pain of abdomen and bilious vomitings during the night; has had three loose stools. Pulse 110, hard and small; thirst urgent. Blood let to fainting; fomentations continued.
2d.—Last night he was again bled to two ounces, when fainting supervened. He passed a quiet night; had two liquid stools; abdomen not painful, nor is he sick at stomach, nor thirsty. To keep himself warm, particularly the belly.
11th.—Suspect he has been rather irregular in diet. Passed a bad night, partly in delirium; has vomited much; has obviously pain on pressure of the abdomen, but appears studious to conceal it; pulse 112, small and not soft; temperature increased; tongue red; thirsty; three liquid stools. The stomach to be kept warm; ten drops of tincture of digitalis in half an ounce of mist. acaciæ, to be taken three times a day; diet of milk and farinaceous food; for drink, infusion of tea in small quantities. Eight o’clock.—Pulse 120, soft; feels easier, and has not vomited. Ordered a foot-bath.
13th.—Molested by pains, nausea, and vomiting during the night; pulse 110, not soft; skin cool, but is thirsty, and his tongue is of a vermilion color, and arid; confesses that he has hitherto disguised his feelings, as well as other circumstances connected with his case, particularly his manner of living. Digitalis continued; blister to be applied to the epigastric region, and the foot-bath repeated in the evening.
14th.—Bad night; pulse 112; skin hot; pain of abdomen not urgent; no vomiting, but is affected with nausea. Digitalis continued. Four o’clock.—Pulse 100; feels nauseated; no pain of abdomen. Digitalis occasionally.