4(>4 A CASE OF INFLAMMATION OF THE UTERUS. 
After four hours, the straining considerably abated; but the pulse 
still frequent and strong. I again bled to 6ifo, and ordered the 
fomentation to be continued. 
25th j 9 o’clock a.m. — Straining abated : she had given about 
a quart of milk just before I arrived. The bowels had been 
acted upon, and every symptom was more favourable. The 
pulse was not so frequent, but still about 120 : the extremities 
were of a natural heat. 
9 o’clock p.m. — Straining occasionally, but not so frequent 
as before: she had taken a little oatmeal gruel : pulse as before. 
She had yielded a small quantity more milk. I ordered the 
fomentations to be persisted in to the loins and external parts 
of the labia pudendi. 
26th. — Every symptom more favourable, with little straining. 
Pulse 115; mouth hot and dry. She had stood considerably 
longer than before ; had eaten a small quantity of hay, and 
taken some oatmeal gruel ; but still evinced very great difficulty 
in voiding her urine : the catheter was introduced, and a large 
quantity of urine was evacuated. 
27th. — Pulse continues frequent, but the surface of the body 
is of a natural temperature. She had eaten a little boiled corn 
in combination with linseed : her milk amounted to three quarts 
a-day. There being yet a considerable difficulty in making 
water, fomentations were used two or three times a-day. The 
labia pudendi were very much swollen. Give six ounces of 
sulphate of magnesia. 
28th. — Pulse about 100. The straining nearly subsided. She 
had taken a fair quantity of bay, boiled oats, and linseed, and 
occasionally some oatmeal gruel. The milk was still increasing in 
quantity ; the catheter was again introduced, and a large quan- 
tity of urine evacuated. On everting the labia pudendi, slough- 
ing could be perceived covering a very considerable surface, and 
a quantity of white and very offensive-smelling fluid was con- 
tinually escaping from the uterus and vagina. 
29th. — The pulse is now about 90 ; all inflammatory symp- 
toms have gradually subsided ; the urine is evacuated without 
difficulty. A large quantity of decomposed substance has now 
detached itself, and which appears to have been the internal 
lining of the uterus and vagina. When folded together, it is about 
the size of a small hand ; smaller quantities having come away 
previously at several times. A discharge of the white opaque 
fluid still continues, of a very offensive smell. The quantity of 
milk is still increasing. She eats boiled oats, and oatmeal gruel, 
hay, &c. in moderate quantities. Let a dose of tonic medicine 
be given on three successive mornings. 
