Feb. 27th, 9:30 a.m.,—pulse 115, temp. 99.2. Adhesion is taking place between the walls of the sinus, on the left of the vertebræ.
Feb. 29th, 9:30, a.m.,—pulse 104, temp. 100. The sacks, or sinuses, have been washed out regularly every day, and dressed with vasaline.
This case presents several features of interest. The first is the very large amount of secondary hemorrhage, and its location, there being sixty-eight ounces removed at one time and fifty at another, and perhaps thirty or forty at another, from just beneath the skin and superficial fascia of the lower part of the back. The second point of interest would be to know from what vessel this hemorrhage took place. The third interesting feature of the case is its progress and treatment.
At the time of the aspiration the patient was in a critical condition; temp. 105.4, pulse 120; the tongue and chill denoting danger of pyemia. This danger was avoided by drawing off the decomposing blood, and giving the patient a new lease of life. This was but temporary, for six days afterward the same danger presented itself again. This was also avoided by opening the sinus freely, by an incision two inches long, which could not have been done sooner for fear of adding to the hemorrhage.
At the end of six days from this last critical period, the temperature again went up to 103.5, and the pulse and condition of the patient indicated great danger of death from exhaustion—the result of the formation of so much pus. This was avoided by preventing the excessive formation of pus by washing out the sinus with liquid vasaline. The patient is still under treatment in the hospital now under the care of my esteemed friend, Dr. Benj. Cory.
The patient will probably recover. It will be simply a question of endurance with him. That is, if the supply of nourishment can be kept up, and the waste prevented, which must result from the formation of such a large quantity of pus, there is no reason why he should not recover. [A]
At the time of putting him under the care of Dr. Cory, he was taking nine grains of quinia daily, about six ounces of whisky, beef tea twice a day, and eggs twice, with such other food as he might relish; taking four meals a day.
Thus you see I was carrying out the theory mentioned in the first part of this paper:—that of supplying the system with all the flesh producing food the stomach would digest, and using whisky and quinia to prevent disassimilation or waste; also vasaline locally for a similar reason.
With this case I conclude my report; only adding that perhaps the thought of a poet, who evidently knows much of human nature, is applicable to this hastily written paper. This poet says:
“A fool will pass for such through one mistake,
While a philosopher will pass for such,
Through said mistakes being ventured in the gross
And heaped up to a system.”