METASTASIS OF INFLAMMATION. 649 
occasional injection of starch and chalk, and a pail of starch gruel 
to be slung in the box. 
2 d day .—The purging has greatly abated; during the night 
the patient ate a bran mash, and drank a pail of gruel: the skin 
and extremities are quite warm; no uneasiness or appearance of 
pain, but still considerable dulness: pulse 44, rowel suppurating 
kindly. R Pulv. digitalis Jj; spt. aeth. nit. 3ij, mane nocteque. 
The starch gruel to be continued. 
3d day .—Continued to improve until about noon to-day, when 
the purging returned as violently as ever. At this time, 3 p.m., 
the faeces are of a very watery nature, and without any appear¬ 
ance of mucus accompanying them. There is great restlessness, 
with violent pain ; pulse at the jaw 47, and extremely weak; 
mucous membranes paler than natural; skin and extremities 
moderately warm : no appetite. I do not like to bleed, in con¬ 
sequence of the weak pulse, &c. R Pulv. opii 3j, pulv. catechu 
3ij, pulv. creta ^j, to be given in gruel immediately : injections 
as before. 
4 tli day .—A total change has taken place in the character of 
the disease since my visit yesterday; the purging has-quite 
ceased, and some faeces of a nearly natural consistence have just 
been expelled : the breathing is increased considerably, both in 
frequency and difficulty ; great anxiety is evinced in the counte¬ 
nance ; pulse 70, and full; extremities quite as warm as natural, 
but the most marked charge is in the action of the heart, which 
for three or four successive beats can be felt in every part of the 
body, shaking the whole frame, and rendering its movements 
visible to the eye, at many yards distance ; and then this power¬ 
ful action subsiding suddenly, and perhaps remaining quiet for 
five minutes or more, to recommence and again subside. The 
pulsation of the submaxillary artery does not in any way betoken 
a difference in the heart’s action, but is just the same during 
its highly excited and comparatively quiescent state. V. S. lb ix, 
when the pulse faltered, and the pony nearly fell. R Pulv. 
digitalis 9ij; antim. tart. 3j; pofassee nitr. 3ij; pulv. simp, et 
ol. palmae q. s. ut ft. bol. exhibend. sextaquaque hora. 
7 p.m. —No alteration in the symptoms, except that the 
powerful beating of the heart is constant instead of being only 
occasional. 
5th day .—The violent action has much decreased, but still it 
exists ; pulse 70 ; legs and ears for the first time cold; more 
lively ; faeces natural, or perhaps rather lax than otherwise ; 
rowel suppurates well; breathing worse ; Schneiderian membrane 
red : on the whole, the symptoms evince that the lungs are now 
participating in the inflammatory action. V. S. lb viii, the 
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