Additional Remarks on a New Mode of Hospital Construction
Authors: H. Greenway
Journal: BMJ (1873)

June xith.I removed the second catheter, and introduced No. 8, through which sixteen ounces of the same offensive matter escaped (under the microscope, composed of albumen coagulated, blood-corpuscles, and pus-globules in large quantities).Before the operation on this day, the pulse, from 135, temperature ioo-, fell to 115, and temperature 99g.She asked for some chicken and a glass of wine.By careful manipulation, the last catheter could be introduced the whole length, twelve and a half inches, and seemed to traverse the region of the liver in the direction of the left kidney, so far as I could judge by trials at this time and afterwards, without any pain, except at the opening through which the catheter was passed.-9.30P.M.She was in a calm sleep, and had taken a mutton-chop and glass of wine for supper.On this day, for the first time, she expressed a hope of re- covering, and of once again seeing her children.June 12th.Nine ounces of the same kind of offensive matter escaped.The tongue was clean, and the bowels acting regularly.Pulse I09; temperature 99.The appetite was improving.-gP.M.I withdrew the last catheter, -Which was obstructed, and introduced a No. 12. Sixteen ounces of the most offensive matter passed= twenty-five ounces in the last twenty-four hours.She felt better, and free from pain of any kind.She felt hungry, and wanted her supper, which she wished to be cold roast-beef and bread and butter, with a glass of wine.I almost invariably gave a glass of wine before the withdrawal of the plug from the catheter, both morning and evening.At this date, I noticed that the matter, after it had passed into the utensil, had a more flocculent appearance, as though the internal lininc of the abscess were beginning to detach (under the microscope, it presented all the charac- ters of albumen).Pulse quick, 130; temperature 100.June 13th.She had not had so good a niaht; had slept about four or five hours.I drew off at II A.M. twelve ounces, at 9 P.M. ten ounces.Pulse 120; temperature I00.She took her food and wine with a zest.June 14th.She had had a good night.At II A. l.I drew off ten ounces, in the eveining three ounces, not so purulent, but having a yellowish brown colour, and less offensive.On this day, we measured her waist, and marked a reduction of rather more than eight inches in the circumference.Ier friends were struck with the improvement in her appearance.June 15th.Four ounces and six ounces passed.Pulse I00; tem- perature 99.Slie now looked forward to seeing her husband again, and her children, who were to come and see her one at a time.She continued to improve during the next five days.On the 2Ist, there was so much pain in the bowels, particularly the right side, with dis- position to vomit, accompanied with great prostration and coldness of the lower limbs (no diarrhoea), that I began to fear perforation of the abscess into the peritoneum or intestine.She could not bear the slightest pressure.Only one ounce of yellowish bilious-looking matter passed through the catheter in the morning, and three ounces in the evening, of a like character.I ordered her to take ten minims of Chlorodyne every half-hour, and sparkling Burgundy as freely as she wished during the day.After the fourth dose of the chlorodyne, she expressed herself better, and inclined to sleep.June 22nd.She passed a most offensive greenish yellow motion from the bowels, very much resembling the matter passing from the catheter in her side.She was evidently better, and again inclined to take nourishment.The pulse fell from i44 to 99 during the day, and the temperature was 98. Six ounces and a half only of flocculent yellow matter passed during the last twenty-four hours.June 23rd.Slhe was much the same.June 24th.She had lhad a bad night ; complained of pain in her head, and described it " as though it ran up from her belly".-ioA.M. I drew off eleven ounces and a half of greenish-looking matter (with little if any smell), by which she seemed relieved; five ounces and a half ounces in the evening.