WITH A RUPTURE OF THE COLON. 
271 
and hot, as also was the tongue: the eyes were sunken, and red¬ 
der than natural; the breathing was accelerated, but not very 
laborious; the extremities were cold, while the surface of the body 
was hot, and painful to the touch. The bowels were constipated, 
and had been so for the last week; some dung, however, was eva¬ 
cuated, but it was hard and dry, and in small quantities. The 
pulse was quick, but full; a slight pain and considerable irritation 
in the rectum. I bled him Jx before the desired effect was pro¬ 
duced, and gave him tinct. opii. gtt. xiv, et spt. ether, nit. gtt. viij, 
cum ol. ricini Jiij, and an opiate enema to allay the irritation of 
the rectum. This was about 8 o’clock A.M. 
10 A.M. —The irritation has almost subsided, but he is dull, will 
not eat, hides himself, and has more pain. 1 ordered him a draught 
composed of mutton broth §jss, et tinct. opii. gtt. xviij. 
11 A.M. —The bowels have not been moved, and the pain is 
more intense. His countenance expresses great anxiety, he fre¬ 
quently lies on his stomach, and the pulse is small but quick. I 
gave him a little more broth, and ordered the abdomen to be 
fomented with hot flannels. 
2 P.M. —Has had distressing sickness, and is extremely anxious 
for water. 1 introduced my finger into the rectum, but could not 
discover any hardened fmces. Enemas, composed of mag. sulph. 
and warm water, were constantly kept up the intestines; as soon as 
one came away, another was thrown up. 
4 P.M.—No better. 1 gave him pulv. aloes 3 ], hyd. chlor. gr. vj, 
et pulv. opii. ^ gr. The fomentations to be continued, and the ab¬ 
domen rubbed with a little lin. tereb. 
5 P.M. —A great change has taken place within the last hour. 
The hind extremities are paralysed; the mouth and ears are be¬ 
come cold ; the pulse is more hurried and irregular, and almost im¬ 
perceptible; the respiration is laborious and irregular as the pulse, 
and is frequently interrupted by sickness. To be kept quiet. 
6 P.M. —Another change. He lies groaning piteously, and 
panting; his limbs bathed in sweat, with convulsive struggles. 
Twenty minutes past six death relieved him of his sufferings. 
Post-mortem examination presented general marks of inflam¬ 
mation. The small intestines were extremely red, while the large 
ones were in a gangrenous state, and most offensive, with a rupture 
of the colon. I did not expect to have met with this rupture, and 
must confess that I am at a loss to account for it. The liver was 
of a pale ashy colour, and very light: I put a part of it into some 
water, and it floated upon the surface. The other contents of the 
abdomen (as far as the light would permit me to see) did not shew 
the slightest appearance of having been diseased. 
I am sorry that 1 could not make a more minute examination, 
hut it was dusk when 1 began. 
