Prescribed?Fomentation and application of Belladonna perineum, alkaline mixture omitted and Copaiba Mixture resumed, injection into urethra and night draught continued. 23rd.?No discharge from urethra ; less pain over perineum ; slight fever; complains of pain over left scapular region and left knee ; appetite fair ; bowels regular ; sleeps fairly. Mixture and night draught continued, injection and application over
omitted.
25th April.?Much pain joints.
in the left
and elbow
ankle, knee,
of Iodide of Potassium added to mixture. in joints ; some fever. Prescribed?Mixture continued ; Liniment Belladonna for Prescribed grs.
27M.?Pain
x.
more
joints.
1st May, 1884.?The left knee semi-flexed, cannot be moved. 6th May.?Has some fever ; temp. 100*4? 5 swelling over the left thigh, left forearm, and right side of neck appeared. 7th.?Temp. ioi?. Pain severe. Bowels costive. Prescribed?Diaphoretic Mixture and night draught continued. Liniment Belladonna for application, castor oil draught. 8th.?Swellings of thigh, forearm and neck fluctuating. Temp. 102?. Prescribed?
ft,
Acid Salicylici Sodse Bicarbonatis Liquor Arsenic
...
...
...
...
...
...
grs xxx. ,,
xx.
mx.
2iij Mft. Aquae free 122 ; perspiration. The 14th.?Temp. 102*2?, pulse large abscess over the left gluteal region opened and 4 ounces of matter discharged. Poulticed the abscess. Complains of pain and swelling over the left flank of abdomen ; fluctuating swelling is forming over the left interscapular region. 15th.?Temp. ioo*8?, pulse 104. Gluteal abscess dressed, discharged 3 ounces of matter; abscess of right side of neck opened ; appetite fair. Bowels regular j free perspiration. 16th. Temp. ioo?. Abscess of left forearm opened, the gluteal, cervical and forearm abscesses formed with acute symptoms, but the interscapular abscess is the largest, and has formed without any acute symptom and without any cognizance on the part of the patient. 17th.?Temp. 102*2?, pulse 120. All the abscesses discharging thin watery matter. Prescribed?Salicylic Mist., night draught, dressing and ...
...
poultice.
HINABHAI HUTTSING HOSPITAL. PYAEMIA FOLLOWING GONORRHCEA ; RECOVERY.
Reported by Assistant-Surgeon
T. M. Shah.
An Afghan Mussulman, aged about 25, admitted into hospital 6th April 1884, with gonorrhoea, bubo in left groin, swelling 6i~ prepuce, and pain over the perineum. The symptoms of gonorrhoea are not very acute, but has burning pain during micturition and white discharge. He has no marked constitutional symptoms. His general health is good, tongue is moist but furred, countenance is anxious, internal organs normal; sleeps badly; appetite and bowels regular. The history of the disease dates 15 days back, when, after sexual intercourse, he had painful micturition, and then the discharge and bubo followed. He indulges in no excesses, but simply smokes tobacco. Prescribed Copaiba Mist 3 doses lead lotion on
giii,
into urethra, and iodine paint over bubo ; fomentation perineum. On the 10th simple alkaline mixture was substituted for the Copaiba Mist. ; an opiate was ordered for
injection over
procuring sleep
at
night.
from urethra is less, pain during micturition diminished. Bowels moved thrice by a draught of Jalap ; appetite good, sleeps well. But there is much pain over the
14th,?Discharge
perineum.
i&th.?Temp, 103*2?, pulse 120. Bowels moved once ; appetite fair, perspiration proluse, Vesp. Temp. 104*6?. Sulphide of Calcium pills 3 (each containing % gr)20th.?Temp. 100*4?, pulse 104. Vesp. Temp. 102*2?. Sweating ; the scapular abscess discharges copious, 3 or 4 ozs. of matter are discharged daily, the other abscesses discharge scantily. Another abscess is forming on the hind aspect of left thigh. Prescribed?Mixture and night draught, and dressing and pills continued. Injection of Condy's fluid into scapular abscess. 25th.?Temp. 99*4?. Bowels costive, appetite impaired ; copious discharge of foetid pus trom scapular abscess, the other abof thigh opened. scesses have nearly healed up. Second abscess Counter opening was made and perforated drainage tube introduced into scapular abscess. Prescribed? > Cinchona Alkaloid grs- vi. Acid Nitro-Hydroch., Dil. TI|^S? xxx. Tinct. Chiratse
...
???
...
???
???
...
Aqua
-
5
?
"?
i?- Mft.
3 doses.
Vesp. Temp. 103*6?. 30^.?Temp. 99?, pulse 100. Bowels moved once, appetite is Has lost flesh considerably; copious sweating daily. poor. Another third abscess has formed over the left thigh just above its popliteal space. The large hard swelling, which formed over left flank, has now increased and become fluctuating. It is opened, and a large quantity of matter discharged. grs- xii. Quinise Sulph. Acid Nitro-Hydroch., Dil. U[s. xxx. ...
Tinct. Cinchona...
Spirit Chloroform Aqua Camphor
...
...
...
...
g
...
...
g
...
...
Country Liquor'...
.?
...
3 doses. ?iv. 4 doses.
Dress abscesses with carbolic oil.
?
...
2
iss.
ss.
iii. Mft.
November,
.884.]
GONORRHCEIC PYAEMIA
7th June 1884.?Temp. ioo-2?. Scapular abscess discharges but little. The other abscesses are contracting. Popliteal abscess opened. Is improving; appetite is better. Reduce Quinise Sulph. to grs. vi. i2.ih.?No fever; 110 fresh abscess forming, the other abscesses are closing up. Is getting better. Continued Quinine Mist., Liebig's Extract 51' three
times. Brandy 5'ii daily. Remarks. From this day
to the time of discharge on 9th has been gradually improving and gaining flesh ; drainage tube removed and all abscesses closed. No new abscess formed. This was a case primarily of gonorrhoea, with indolent bubo and a swelling in the perineum as its attendants. Both the bubo and perineal swelling subsided without any apparent sign of suppuration. The train of symptoms which followed
July,
he
indicated unequivocal pyaemic poisoning?fever, sweating, pain
in joints, and pyaemic abscesses. The supervention of pyaemia after gonorrhoea is unusual, at least this is the first case that I have observed.
Ahmedabad.
HEPATIC ABSCESS.
329
omitted.
25th April.?Much pain joints.
in the left
and elbow
ankle, knee,
of Iodide of Potassium added to mixture. in joints ; some fever. Prescribed?Mixture continued ; Liniment Belladonna for Prescribed grs.
27M.?Pain
x.
more
joints.
1st May, 1884.?The left knee semi-flexed, cannot be moved. 6th May.?Has some fever ; temp. 100*4? 5 swelling over the left thigh, left forearm, and right side of neck appeared. 7th.?Temp. ioi?. Pain severe. Bowels costive. Prescribed?Diaphoretic Mixture and night draught continued. Liniment Belladonna for application, castor oil draught. 8th.?Swellings of thigh, forearm and neck fluctuating. Temp. 102?. Prescribed?
ft,
Acid Salicylici Sodse Bicarbonatis Liquor Arsenic
...
...
...
...
...
...
grs xxx. ,,
xx.
mx.
2iij Mft. Aquae free 122 ; perspiration. The 14th.?Temp. 102*2?, pulse large abscess over the left gluteal region opened and 4 ounces of matter discharged. Poulticed the abscess. Complains of pain and swelling over the left flank of abdomen ; fluctuating swelling is forming over the left interscapular region. 15th.?Temp. ioo*8?, pulse 104. Gluteal abscess dressed, discharged 3 ounces of matter; abscess of right side of neck opened ; appetite fair. Bowels regular j free perspiration. 16th. Temp. ioo?. Abscess of left forearm opened, the gluteal, cervical and forearm abscesses formed with acute symptoms, but the interscapular abscess is the largest, and has formed without any acute symptom and without any cognizance on the part of the patient. 17th.?Temp. 102*2?, pulse 120. All the abscesses discharging thin watery matter. Prescribed?Salicylic Mist., night draught, dressing and ...
...
poultice.
HINABHAI HUTTSING HOSPITAL. PYAEMIA FOLLOWING GONORRHCEA ; RECOVERY.
Reported by Assistant-Surgeon
T. M. Shah.
An Afghan Mussulman, aged about 25, admitted into hospital 6th April 1884, with gonorrhoea, bubo in left groin, swelling 6i~ prepuce, and pain over the perineum. The symptoms of gonorrhoea are not very acute, but has burning pain during micturition and white discharge. He has no marked constitutional symptoms. His general health is good, tongue is moist but furred, countenance is anxious, internal organs normal; sleeps badly; appetite and bowels regular. The history of the disease dates 15 days back, when, after sexual intercourse, he had painful micturition, and then the discharge and bubo followed. He indulges in no excesses, but simply smokes tobacco. Prescribed Copaiba Mist 3 doses lead lotion on
giii,
into urethra, and iodine paint over bubo ; fomentation perineum. On the 10th simple alkaline mixture was substituted for the Copaiba Mist. ; an opiate was ordered for
injection over
procuring sleep
at
night.
from urethra is less, pain during micturition diminished. Bowels moved thrice by a draught of Jalap ; appetite good, sleeps well. But there is much pain over the
14th,?Discharge
perineum.
i&th.?Temp, 103*2?, pulse 120. Bowels moved once ; appetite fair, perspiration proluse, Vesp. Temp. 104*6?. Sulphide of Calcium pills 3 (each containing % gr)20th.?Temp. 100*4?, pulse 104. Vesp. Temp. 102*2?. Sweating ; the scapular abscess discharges copious, 3 or 4 ozs. of matter are discharged daily, the other abscesses discharge scantily. Another abscess is forming on the hind aspect of left thigh. Prescribed?Mixture and night draught, and dressing and pills continued. Injection of Condy's fluid into scapular abscess. 25th.?Temp. 99*4?. Bowels costive, appetite impaired ; copious discharge of foetid pus trom scapular abscess, the other abof thigh opened. scesses have nearly healed up. Second abscess Counter opening was made and perforated drainage tube introduced into scapular abscess. Prescribed? > Cinchona Alkaloid grs- vi. Acid Nitro-Hydroch., Dil. TI|^S? xxx. Tinct. Chiratse
...
???
...
???
???
...
Aqua
-
5
?
"?
i?- Mft.
3 doses.
Vesp. Temp. 103*6?. 30^.?Temp. 99?, pulse 100. Bowels moved once, appetite is Has lost flesh considerably; copious sweating daily. poor. Another third abscess has formed over the left thigh just above its popliteal space. The large hard swelling, which formed over left flank, has now increased and become fluctuating. It is opened, and a large quantity of matter discharged. grs- xii. Quinise Sulph. Acid Nitro-Hydroch., Dil. U[s. xxx. ...
Tinct. Cinchona...
Spirit Chloroform Aqua Camphor
...
...
...
...
g
...
...
g
...
...
Country Liquor'...
.?
...
3 doses. ?iv. 4 doses.
Dress abscesses with carbolic oil.
?
...
2
iss.
ss.
iii. Mft.
November,
.884.]
GONORRHCEIC PYAEMIA
7th June 1884.?Temp. ioo-2?. Scapular abscess discharges but little. The other abscesses are contracting. Popliteal abscess opened. Is improving; appetite is better. Reduce Quinise Sulph. to grs. vi. i2.ih.?No fever; 110 fresh abscess forming, the other abscesses are closing up. Is getting better. Continued Quinine Mist., Liebig's Extract 51' three
times. Brandy 5'ii daily. Remarks. From this day
to the time of discharge on 9th has been gradually improving and gaining flesh ; drainage tube removed and all abscesses closed. No new abscess formed. This was a case primarily of gonorrhoea, with indolent bubo and a swelling in the perineum as its attendants. Both the bubo and perineal swelling subsided without any apparent sign of suppuration. The train of symptoms which followed
July,
he
indicated unequivocal pyaemic poisoning?fever, sweating, pain
in joints, and pyaemic abscesses. The supervention of pyaemia after gonorrhoea is unusual, at least this is the first case that I have observed.
Ahmedabad.
HEPATIC ABSCESS.
329
