“In about fifteen minutes the after-birth was detached, and taken away. Not even the usual amount of hemorrhage occurred. A bandage was applied to the abdomen, as the patient expressed a wish for it; and after resting awhile, a little panada was given her as nourishment.
“Mrs. S. continued very comfortable through the evening; no excess of the natural discharge; complained only of exhaustion, and slight difficulty of passing urine. As there was some heat of the surface—the pulse being from 90 to 100—tepid sponging was resorted to, which proved very grateful to the patient.
“Second Day (Friday), Seven, A. M.—Found the patient had obtained considerable sleep at intervals during the night; felt very comfortable, though occasionally had slight pains in the abdomen; tongue moist; pulse 81; had passed a little water during the night, but with difficulty; had a strong desire for a cup of coffee, but persuaded her to take a little panada in its place; had not much appetite; was permitted to sit up for a few minutes while her bed was made.
“Half-past Eleven, A. M.—Mrs. S. still very comfortable; found her sitting up in the rocking-chair, the very picture of convalescence. Sponging enjoined, if any feverishness should arise.
“Three, P. M.—Dr. S. sent for, as the patient had been seized a few minutes before, rather suddenly, with a sharp pain in the left side. Had been drinking a tumbler of cold lemonade. Had a natural movement of the bowels that morning, and passed a little water. The tepid sponging of the surface had been neglected. Pain fixed, severe, pretty constant, remitting only for a moment or so. No corresponding contractions of the uterine tumor observed. Some pain also complained of in the hip, with which she had, on a former occasion, been troubled. Up to that time had had no chill. Warm fomentations were applied, but with little relief.
“Half-past Four, P. M.—A chilliness felt, then shivering, prolonged, with increase of the fixed pain of the side; pulse 112, weak; patient restless, anxious, desponding; knitting of the brows, involuntary weeping. A bottle of warm water was applied to the feet, and soon after, the chills ceased.
“A large warm enema was now administered; this brought away considerable fecal matter; and fomentations were applied to the abdomen. Next, the patient was seated in the hip-bath, at a temperature of 95°, for fifteen minutes, when water was passed more freely than before, and a slight nausea experienced. The result of this was complete abatement, for the time, of the pain in the uterine region, the diminution of the frequency of the pulse to 90, and great comfort. The bandage to the abdomen having been removed, to allow of the bath, was not replaced. If need be, fomentations to be kept up.
“At 7 P. M. found the patient in a profuse perspiration; pain in the abdomen had lost its acuteness; soreness there was all now complained of—soreness in the head, ‘in the bones, and all over.’ Abdomen swollen, and tender on pressure; breathing shallow; pulse 110–12; discharge from the womb (the lochial discharge) arrested. Patient is to be kept quiet; to take no nourishment; no fire to be in the room.
“At 9¼ P. M., the perspiration still continues; complains of pain in the hip, but chiefly in the left side, as before, and shooting across the abdomen; pain now very severe, increased by coughing; breathing thoracic (shallow), and 28 in the minute; pulse 98; is thirsty; tongue moistish, with a slight milky coat. Fomentations as usual.
“Half-past Ten, P. M.—Pain increasing in the abdomen and hip; tenderness increasing; can scarce bear slight pressure on the abdomen; knees drawn up; restless, discouraged; pulse 100, though not very full or strong; skin still slightly moist.