43d. Delirium continues; prostration increases; lips and teeth covered with dark-coloured sordes; affected leg darker in colour, and colder to the touch; pulse 120; no tenderness of the abdomen, nor has it been tender through the whole course of the disease.
44th. Died.
Abdomen. Mucous membrane of ilium, cæcum, and commencement of colon extensively ulcerated; viscera of head and thorax healthy; slight swelling of the whole left extremity; ankle œdematous; the cellular tissue along the entire course of the saphena major and femoral vein exceedingly condensed and hard; on opening the saphena vein there was found a layer of coagulable lymph lining its whole internal surface, which was universally vascular and rough; in many places, especially about the knee, the coats of the vein were very much thickened, so that the calibre of the vessel was diminished at least one-half its size; the lower part of the femoral vein was in a similar state, but its superior portion and the external iliac were little, if at all affected.
Case LXXXI.
Mary Ford, æt. 30, married. Admitted on the 8th day of fever, which in addition to the ordinary symptoms, was attended at the commencement with pain in the abdomen, which continued for some time, but which is now entirely gone: states that the bowels have been very loose for upwards of a month past; tongue loaded and red; thirst; no uneasiness of chest; some cough; pain of head, which was severe in the commencement, quite gone; pulse 90; great prostration.
9th. No pain in any organ; tongue unchanged; two stools, light and offensive; delirium.
10th. Four stools in bed; delirium; lies on back quite prostrate; pulse 105, weak.
11th. Tongue not to be protruded; perfectly insensible; pulse 125.
Abdomen. Peritoneal coat of small intestines vascular; mucous membrane of ileum and cæcum contained several large ulcers; in other places the membrane was entire, but irregularly raised by submucous deposit so as to present the appearance of large ulcers. Head. Arachnoid highly vascular; effusion beneath all the membranes; more fluid than natural in the lateral ventricles. Thorax. Viscera healthy.
Case LXXXII.