Page:Harlow BMSJ1848 Passage of an Iron Rod through the Head.pdf/3

Rh wound in the face was left patulous, covered only by a simple dressing. The hands and fore arms were both deeply burned nearly to the elbows, which were dressed, and the patient was left with the head elevated, and the attendants requested to keep him in that position.

10, P.M., same evening.—The dressings are saturated with blood, but the hemorrhage appears to be abating. Has vomited twice only since being dressed. Sensorial powers remain as yet unimpaired. Says he does not wish to see his friends, as he shall be at work in a day or two. Tells where they live, their names, &c. Pulse 65; constant agitation of the lower extremities.

14th, 7, A.M.—Has slept some; appears to be in pain; speaks with difficulty; tumefaction of face considerable, and increasing; pulse 70; knows his friends, and is rational. Asks who is foreman in his pit. Hemorrhage internally continues slightly. Has not vomited since 12, M.

15th, 9, A.M.—Has slept well half the night. Sees objects indistinctly with the left eye, when the lids are separated. Hemorrhage has ceased. Pulse 75.

8, P.M., same day.—Restless and delirious; talks much, but disconnected and incoherent. Pulse 84, and full. Prescribed vin. colchicum, [½ dram (∼2 ml)] every six hours, until it purges him. Removed the night-cap.

16th, 8, A.M.—Patient appears more quiet. Pulse 70. Dressed the wounds, which in the head have a fœtid sero-purulent discharge, with particles of brain intermingled. No discharge from bowels. Ordered sulph. magnesia, [1 ounce (∼31 g)], repeated every four hours until it operates. Iced water to the head and eye. A fungus appears at the external canthus of the left eye. Says "the left side of his head is banked up."

17th, 8, A.M.—Pulse 84. Purged freely. Rational, and knows his friends. Discharge from the brain profuse, very fœtid and sanious. Wound in face healing.

18th, 9, A.M.—Slept well all night, and lies upon his right side. Pulse 72; tongue red and dry; breath fœtid. Removed the dressings, and passed a probe to the base of the cranium, without giving pain. Ordered a cathartic, which operated freely. Cold to the head. Patient says he shall recover. He is delirious, with lucid intervals.

19th, 8, P.M.—Has been very restless during the day; skin hot and dry; tongue red; excessive thirst; delirious, talking incoherently with himself, and directing his men.

20th and 21st.—Has remained much the same.

22d, 8, A.M.—Patient has had a very restless night. Throws his hand and feet about, and tries to get out of bed. Head hot. Says "he shall not live long so." Ordered a cathartic of calomel and rhubarb, to be followed by castor oil, if it does not operate in six hours.

4, P.M., same day—Purged freely twice, and inclines to sleep.

23d.—Rested well most of the night, and appears stronger and more rational. Pulse 80. Shaved the scalp a second time, and brought the edges of the wound in position, the previous edges having sloughed away. Discharge less in quantity and less fœtid. Loss of vision of left eye.