CASES BY MR. TOMBS. 
436 
the abdomen; pulse 60, and hard. I was informed that he 
was taken unwell in the morning, and had refused his food; 
and after that was taken a journey to Leamington and 
back, a distance of twenty miles. On his way home lie 
dunged twice. I administered an anodyne draught, and 
bled copiously at 10, p.m. Gave Barb. Aloes, 3yj in solu¬ 
tion, and an enema. 
]QtA. At 4, a.m., I ordered him Barb. Aloes, ^iij. At 6, 
а. m., symptoms—pulse 70; great distension of the belly; 
tunica conjunctiva reddened; walks round the box; looks 
back; paws the litter; lies down with his head stretched 
out; drinks warm water, and eats a little bran mash. R Aloes 
Barb., 5iv; Hyd. Submur., 3j ; and Opii, 5j, in solution; 
back-raked, and an enema; bled profusely; mustard embro¬ 
cation applied to the abdomen. At 10, a.m., in statu quo. 
No evacuation. Gave 01. Ricini. At p.m. ordered an 
opiate. At 3, p.m., no improvement. Administered Ol. 
Ricini, and a tobacco enema, which caused no action on 
the bowels. Legs to be well rubbed and bandaged. Drinks 
warm water. At 8, p.m., much worse ; pulse 90, up and 
down; often looks back and paws the litter; belly frightfully 
swollen; countenance dejected. Bled largely. Gave Aloes, 
5iv; Hyd. Sub. and Pulv. Opii, aa ^j; ordered frequent 
enemas, and mustard application during the night. 
20 th. 4, a.m. R Aloes Barb., ^ij; Opii and Calomel, aa 5j. 
б, a.m., pulse 80; in less pain. Extremities and ears warm. 
Easier, and apparently somewhat relieved, although he has 
had no motion since he has been under treatment. Gave 
Aloes Barb., 3iij. At 10, a.m., stooled freely, and evacuated 
a large quantity of partially digested vetches. At 4, p.m., 
pains alleviated; pulse 85; has had several not particu¬ 
larly hard faecal evacuations since morning; eats sparingly, 
and drinks largely. My hopes even now are still faint as to 
his recovery. Gave Aloes, jiij, and Pulv. Zingiberis, 5ij, at 
8, p.m. Not so often down. Abdomen too much distended. 
Gave gruel. 
21 st. 6, a.m. Pulse 80. Ears and extremities warm; 
more lively; is fairly purged. I11 consequence of flatus in 
bowels I administered a dose of Spts. Nit. ^Ether. At 6, p.m., 
a great change for the worse ; dejected countenance ; abdomen 
enormously distended; pulse 100; the last faecal evacuation 
is hard. Abstracted a small quantity of blood, which was 
very black0the coagulable lymph much darker in colour than 
at the previous bloodletting, and it crumbled to pieces when 
handled. 1 now gave up my patient as lost. Administered 
Ol. Ricini, 3 v j? and Pulv. Opii, t ~j. 
