VI. _An Instance of the Gut_ Ileum, _cut thro’ by a Knife, successfully treated by Mr._ Peter Travers, _Surgeon, at_ Lisbon. _Communicated by_ John Huxham, _M.D. F.R.S._ [Read Jan. 27, 1757.] Lisbon, August 3d, 1756. ANtonia Josée da Costa, one of the King’s messengers, was attacked by two men, and, after receiving two blows on the head, was stabbed with a knife in the right hypogastric region, about three fingers breadth above the os pubis; the external wound being larger, as the knife was drawn obliquely towards the navel, and might be an inch and half in length, the perforation thro’ the peritonæum about three quarters of an inch; the intestine ileum hanging out about ten or twelve inches, and quite pierced thro’, the wound in the gut being large enough to admit my fore finger. After clearing the grumous blood with warm water and Hungary water, the uninterrupted suture was made on both perforations; then dilating the common integuments of the belly, the intestine was reduced, leaving the ends of the two threads at the superficies of the wound; and the external incision was sewed up by the interrupted suture, and common dressings of lint and bandage applied. A clyster was given him immediately after the above operation, of oil of olives, the yolk of an egg, and warm water. 4th. This day I found he had passed in the most excruciating pains, attended with continual vomitings: his fever very high, pulse full and irregular: he was bled ten ounces this morning, and the like quantity this evening. The clysters were continued thrice a day, with a decoction of wormwood and camomile instead of the warm water, and an anodyne mixture of mint-water, liquid laudanum, and sugar, to be taken occasionally; also three ounces of syrup of rhubarb, with an ounce of the fresh-drawn oil of sweet almonds, to be taken, a common spoonful every two hours. 5th. The bleedings were continued twice this day, three ounces each time, and the clysters were administered as yesterday. His pulse and fever very high; he vomited some excrements; and towards night complained of a singultus. 6th. His bleedings and clysters were continued as before. Finding his singultus and vomiting so very troublesome, I ordered him Dr. Huxham’s tincture of the bark; which was taken, a tea-spoonful, six times a day, in a little mint-water; which indeed greatly relieved him: his singultus and vomiting became less frequent. 7th. I found his skin moist, and pulse softened. I remained with him about an hour, and found a plentiful perspiration throughout the body; on which I omitted his bleedings: the clysters were continued; and towards night he had a proper discharge by stool, very fœtid, and inspissated. 8th. I found, for the first time, he had slept last night, and seemed much in spirits: the symptomatic fever something lessened; and he had purged last night, and this day, eight times.