℞. Ol. ricini, ℥ss; Tinct. opii, gtt. xv; Aq. menth. pip. ℥iss.
M. ft. haust.
Half-past eleven, A. M. Draught retained; sickness has gone
off; complains of heat of bath; let it be removed.
Noon. Has vomited some watery matter, with undigested potatoes
in it, and again a rice-watery fluid with flocculi. He has
now a considerable degree of jactitation; countenance more
sunk, and great desire for cold water. These symptoms went
on increasing in severity in spite of sinapisms to spine,
effervescing draughts, calomel, and Dover’s powder, warm
water, enemeta, &c., and head symptoms were now making their
appearance.
Half-past two P. M. Pulse quite imperceptible, and has been so
for an hour and a half; he lies quiet and drowsy, with eyes
turned upwards; face bedewed with cold perspiration; hands and
feet cold and very blue.
My colleagues, Drs. Combe and Lewins, saw him with me at this
time, and concurred with me in thinking him not only beyond all
hope of recovery, but likely to die _within an hour or two_.
From what I had seen of the resuscitating powers of Dr.
Latta’s treatment on the boy’s mother this morning, by venous
injection, I determined on giving it a trial, though this was
a case rather likely to bring discredit on the remedy than
otherwise. The following solution, at temperature 102° F. was
slowly injected into the median basilic by means of a common
silver blow-pipe attached to Reid’s enema syringe:--
℞. Muriat sodæ, ℨi; Carbon sodæ, gr. x; Aq. calid. ℔vj. solve.
T. 102.
Three P. M. A few minutes after the injection was commenced
the pulse returned to the wrists, the blueness and coldness
of the extremities gradually wore off; the countenance was
much improved; and the whole fluid was injected within twenty
minutes.
Half-past three P. M. He has now a healthy, blooming
appearance; is sitting up in bed, and looking about him as if
awoke out of a dream. Pulse 110, natural; extremities of good
colour and warm; voice much stronger.
Half-past four P. M. Pulse has been gradually falling off since
last report; is getting listless, and dislikes to be troubled
with questions, breathing becoming laborious, and head symptoms
more marked, with squinting to a slight degree superadded.
Seven P. M. Pulse again imperceptible; respiration quick and
laboured; countenance collapsed; tongue and breath cold; says
he is dying.
Let the venous injection be repeated to ℔iij.
Half-past seven P. M. Pulse immediately returned, of natural
strength and fulness, and continues so.
Nine P. M. Lies very quiet; pulse good; breathing more natural;
surface of body covered with warm perspiration.
Ten P. M. Large watery evacuations from the bowels came on soon
after last injection; the quantity cannot easily be guessed,
but must have been considerable, as it is running through the
mattress on the floor. Pulse scarcely perceptible; screams
loudly like a child in hydrocephalus.
Eleven P. M. Pulse quite imperceptible; is sinking fast; venous
injections attempted a third time, but desisted from as it was
not productive of the first good effects. Both pupils much
dilated. Died at two A. M. 14th.
_Dissection fifteen hours after death._--On exposing the
brain and spinal marrow, but before opening their investing
membranes, the least pressure with the fingers on the middle
of the hemispheres of the brain caused a remarkable undulating
down to the middle of the back, showing the existence of a
fluid beneath the membranes, and on opening them about two
drachms of pure serum flowed out.
The surface of the brain was rather vascular, and the blood in
the most minute vessels particularly bright. A few ecchymosed
spots on its surface. All the other viscera were found healthy.
The urinary bladder contained about half an ounce of urine.