in
the centre of which, a spot as large as the thumb nail, looks gangrenous.
The inflammation extends over a surface as large as the two hands. Some
bullae or blebs have formed in the vicinity of the gangrenous spot.
Ordered a large flaxseed poultice applied, expecting an abscess would form
at this place. The cathartic moved the bowels two or three times. I will
here state that the patient, after the withdrawal of the blood on Sunday,
was ordered iron, quinine and whisky; twenty minims of Tr. Ferri Muriat.,
three grs quinia, in a tablespoonful of glycerine and a little whisky. I
afterward had the quinia made into pill and left off the iron, as the
latter seemed to disagree with the stomach.

Saturday, Feb. 14th, 5 P. M.,--pulse 112, temp. 102.4. The inflammation
over the left ilium is much better; but there is now as much inflammation
over the right ilium as there was over the left. The fluid in the sinus
has increased gradually since the evacuation of it with the aspirator. The
inflammation that has now existed for two or three days over these parts
of the sinus, led me to conclude that the blood which was left and that
which had accumulated, had undergone decomposition and was now pus. I used
an exploring needle and found this to be the case. I then introduced a
trocar and canula, and drew off fifty ounces of pus, slightly tinged with
blood. I re-adjusted the compresses and bandage over the sinus, hoping
that a part of it at least would become obliterated before it became
necessary to open it more freely.

Feb. 15th, 5 P. M.,--pulse 112, temp. 102.5. The inflammation over that
part of the sinus to the right of the spine is still about the same as
yesterday; also that over the left ilium. The fluid has increased during
the last twenty-four hours so that there is now nearly as much as was
drawn off through the canula yesterday. I concluded that further delay to
a free opening was useless; consequently with the patient lying on his
right side, and near the edge of the bed, I made an opening one inch long
in the lower portion of the abscess,--for I now considered it one,--near
the spot where the needle of the aspirator and the trocar had been
previously introduced.

After the discharge of about a pint of bloody pus, the stream was checked
by a clot of blood coming into the opening. I enlarged the opening, making
it about two inches long, when a clot the size of a hen's egg came
through, followed by about a pint more of