on the
back extends from the coccyx to the ribs, and from one ilium to the other.
The skin and fascia of the external wall being so thin that the catheter
can be seen over the entire extent, as I push it from one part to another
for the purpose of washing out all parts of the sack. Patient has been
complaining of pain and want of sleep; had a chill last night. He still
takes beef tea twice a day, and eggs and other food twice a day, making
four meals a day; also, continues the quinine and whisky.

Feb. 21st, 9:30 A. M.,--pulse 98, temp. 101. Feels more comfortable.
Discharge of pus much less than yesterday. Wash out the sinuses and inject
liquid vasaline.

Feb. 23d, 9:30 A. M.,--pulse 98, temp. 101. Complains of being "very
sick." Speaks English but poorly. Considerable discharge of laudable pus,
but not so much as before the use of the liquid vasaline. There is one
point near the left hand side of the large sinus on the back, where the
walls are adherent. I wash them out with a five per cent. solution of
carbolic acid in water, and again inject the liquid vasaline. By gentle
pressure made over the upper part of the pouch, I force everything out of
it at the opening below, bringing the walls of the sack together over the
greater part of the surface. Hoping that the adhesion between the walls,
which has commenced, will continue, and soon obliterate, at least, all the
upper part of the pouch. Put on the usual compresses; this time using
oakum instead of folded cloths.

Feb. 24th, 9:30 A. M.,--pulse 108, temp. 101. Did not wash out the upper
or left hand part of the pouch on the back, for fear of disturbing
adhesions that are taking place. Washed out the lower part and injected
vasaline. A small spot, as large as a ten cent piece, has sloughed, making
a hole into the pouch over the lower lumbar vertebra. Another spot
immediately above this, and about the same size, looks as if it would
slough.

Feb. 25th, 9:30 A. M.,--pulse 100, temp. 100.

Feb. 27th, 9:30 A. M.,--pulse 115, temp. 99.2. Adhesion is taking place
between the walls of the sinus, on the left of the vertebrae.

Feb. 29th, 9:30, A. M.,--pulse 104, temp. 100. The sacks, or sinuses, have
been washed out regularly every day, and dressed with vasaline.

This case presents several features of interest. The first is the very
large amount of secondary hemorrhage, and its location, there being
sixty-eight ounces removed at one time and fifty at another, and perha