DISEASES OF THE HEART. 
138 
into a very dark mass. I gave 3 ij aloes, had her removed to 
an open airy apartment, and ordered merely a little water for 
the night, and warm clothing. 
18^/i, Half past 7 a.m. — No better ; pulse 74, hard and wiry ; 
appetite bad. Bled with a large stream ; four quarts flowed, she 
became faint, and lay down. The blood settled as before. I 
blistered her brisket, and gave 3j digitalis, 3 ss. ant. tartar. — 
2 o’clock p.m. No better. Pulse still hard and wiry, and 78. 
Breathing as bad as ever ; extremities cold ; gave fever medicine 
as in the morning, and bandaged her legs.— 8 p.m. Pulse 78, 
rather softer; hind legs still cold. Breathing rather relieved; 
medicine repeated ; a little hay and white water offered her. 
The blister on the brisket has a slight effect. 
19th. — Worse ; pulse 93, small and hard ; breathing very bad ; 
unequal circulation in the extremities ; appetite bad ; bled to five 
quarts in large stream, which did not affect her as before. Blood 
coagulated with thickness of the buffy coat for the first time. 
Medicine repeated; blistered both sides. — 1 p.m. Much the 
same, excepting the pulse being rather softer ; gave the fever 
medicine as before, with 3 ss aloes, the bowels being rather 
confined. — 8 p.m. Pulse 100, small, and still hard ; extremities 
hot as fire coals ; breathing hurried, but the inspirations and 
expirations much truer, and not so much of that incomplete 
action of the flanks as before. Membrane of the nose still inject- 
ed. Blistering has no effect on the sides, therefore more was 
rubbed in. Gave 3 j digitalis, 3 j emetic tartar, 3 ij nitre. Bowels 
being still confined, an injection was given. 
20th, 8 a.m. — Worse in every respect, pulse 104, small and 
hard, maintaining in its former character ; extremities deathy cold. 
No appetite, spiritless, breathing not quite so much affected. 
Mouth hot, sticky and smells offensively. Membrane of the nose of 
purple hue. Blistering on the sides has no effect. Appears as 
if sinking. Gave 3j digitalis, 3 j emetic tartar, Jss sweet sp. 
nitre in half pint of water. Ordered her to be drenched with gruel, 
and stimulating embrocation, and fresh bandaging for her legs, 
and extra clothing, and an injection given. — 2 p.m. Greatly 
improved. Pulse 86, and softer. Appetite increased, more 
lively. Breathing better. Extremities quite warm. Pituitary 
membrane brighter. The blister on sides and brisket begins to 
take effect. Medicine as in the morning, omitting the sweet sp. 
nitre. — 7 p.m. Much the same, excepting the pulse being rather 
on the rise. Gave 3j digitalis, 5 j aloes, the bowels being con- 
stipated. Ordered gruel, and to be enticed to eat a little. 
21st . — Worse. Pulse 140, small and thready ; respiration 
hurried, but not difficult ; appetite again diminished ; unequal 
