COMPOUND FRACTURE, ABSCESS, ETC. 31 



asked my advice. I recommended the use of a well-fitting internal splint, to 

 procure greater steadiness of the fragments, and so get rid of the irritation which 

 perpetuated the bleeding. Mr. Cameron, however, on removing the compress, 

 found that all tendency to oozing of blood had ceased. The patient was now 

 sober, but continued very restless. The internal splint was therefore applied, 

 and thirty drops of solution of muriate of morphia were administered. 



During the night he suffered a good deal, and got no sleep at all. Next 

 morning, however, he complained rather of a general sense of weariness and 

 sickness, the consequences of his debauch, than of pain ; the pulse had fallen 

 to 76 ; and he took his breakfast pretty well. The surface of the crust was 

 touched with carbolic acid, and this was repeated in the afternoon, when a hot 

 fomentation was applied to the inner side of the leg, and over this a sheet of 

 stout block-tin, to serve, as in some previous cases, the double purpose of ensur- 

 ing the efficiency of the fomentations, and acting as an internal splint. The 

 limb was now quite easy. At night the pulse was still 76. He had made a 

 pretty hearty supper, and felt only occasional twinges in the limb. The fomenta- 

 tion was changed, and the crust again touched with carbolic acid, and the opiate 

 repeated. 



He passed the following night like the preceding, without getting any sleep 

 whatever ; and in the morning his pulse was 90, although the limb was free 

 from pain or inflammatory blush, and he made a hearty breakfast. Fearing 

 the approach of traumatic delirium, I ordered a larger opiate to be gi\'en at 

 night. Fifty drops of the morphia solution were accordingly administered ; 

 and after this dose he slept for about five hours. Nevertheless, he grew more 

 restless, and was found in the morning with the leg fully extended and resting 

 on the calf instead of on its outer side. His pulse continued at 90 ; and although 

 the state of the limb and his appetite were all that could be wished, he exhibited 

 in the afternoon unmistakable signs of delirium tremens, jerking out his tongue 

 when asked to show it, twitching his hands in an excited manner, and declaring 

 that his bedclothes were creeping away from him, while the restless movements 

 of the limb were continued. I ordered a dose of castor oil, to be followed, as 

 soon as it should have operated, by a drachm of the solution of muriate of 

 morphia, to be repeated if necessar}^ He took the opiate about eight o'clock 

 p.m., and soon afterwards dozed a little ; and at eleven his pulse had fallen 

 to 82. After this he fell into a sound sleep, from wliich he did not wake till 

 six a.m. ; and from this time forth he was perfectly tranquil and rational. 



It is needless to enter into particulars regarding his subsequent progress 

 further than to say that it has been in all respects satisfactory ; and on the 

 tenth day after the accident, when I saw him last, his pulse was 76, his 



