46th. Sloughs have formed on both hips and an abscess in the right groin.
49th. Abdomen has become swollen, tense, and tympanitic; no stool; tongue the same; vomits every thing; a large black eschar on sacrum; much discharge from the ulcer in the groin; cough frequent; pulse 120, feeble; extreme prostration. Died in the evening.
Abdomen. Lower portion of ilium and commencement of cæcum contained several ulcers, some of which were of large size; [peritoneal cavity contained two pints of serum, mixed with pus and flakes of lymph; intestines, liver, and abdominal parietes lined throughout with a coat of lymph, easily removeable with the scalpel; intestines adherent to each other and to the parietes of the abdomen.] Head. Arachnoid opake and of milky colour; pia mater highly vascular; much effusion beneath it and the arachnoid; several drachms of serum in the ventricles, and a large quantity at the base of the skull; substance of the brain highly vascular and much softened. Thorax. [In each cavity of pleura about six ounces of fluid; posterior part of lungs condensed; a few recent adhesions between the pleuræ of the right side;] other viscera healthy.
Case LXXXV.
Mary Baker, æt, 23, servant. Admitted on the 22d day of fever, which, in addition to the ordinary symptoms, came on with nausea, anorexia and purging; at present complains of a sense of heat in the abdomen without pain; but there is uneasiness when firmly pressed; tongue white in middle, red at edges, moist; thirst; bowels stated to be regular; pulse 104; no pain of chest or head.
23d. Abdominal symptoms the same; no sleep; some pain of head; pulse 120, weak; much sense of weakness.
24th. Tongue has become dry; three stools; pain of head gone; some vertigo; delirium; expression of countenance anxious and sunk; pulse 120.
25th. Tongue more moist; three stools; slept better; expression of countenance more natural; but the pulse has risen to 130 and is extremely weak.
26th. More pain of abdomen on pressure; more prostration; delirium continues; pulse 130, extremely weak. Died next day.
Abdomen. Peritoneal coat of small intestines highly vascular; mucous membrane of lower part of ilium and cæcum full of ulcers, some of which had penetrated through the muscular to the peritoneal coat; this latter membrane was very dark and approaching to gangrene; peritoneal cavity contained a considerable quantity of bloody serum; omentum dark and inflamed; cardiac extremity of the stomach vascular; other viscera healthy. Head. Dura mater adherent with more firmness than natural to the skull; other membranes healthy; more fluid than natural in the ventricles; substance of brain and cerebellum vascular. Thorax. Mucous membrane of both bronchi highly inflamed; [left thoracic cavity obliterated by old adhesions; left lung completely hepatized; right lung loaded with blood and serum; right cavity contained a considerable quantity of blood and serum; heart flaccid; both auricular valves very dark.]