Sarah Sharp, æt. 18. Admitted on the 22d day of fever: the pain of the head, which had been severe from the commencement, continues; complains also of much pain in back and limbs; abdomen tender; tongue fiery red; bowels purged; pulse 100, soft.
23d. No change, excepting that the tongue has become brown and dry in the middle, but still remains exceedingly red at the edges; four stools; pulse 108.
32d. Pain of head quite gone; that of abdomen, which had increased, has now also disappeared; no sleep; great restlessness; delirium; eyes dull and heavy; face flushed; tongue red and dry; four stools; pulse 110.
40th. Cerebral symptoms unchanged; no cough or uneasiness of chest; skin dusky, that of the cheek of a deep purple colour; tongue loaded and dry; lips and teeth sordid; stools in bed; pulse quick and very feeble; great prostration.
48th. Coma; discharge from both ears; vomiting; pulse 120, very weak.
50th. Erysipelas of cheek, extending to scalp; much discharge from ears; tenderness of abdomen again returned; tongue again of fiery red colour; pulse extremely quick and feeble.
70th. During the whole of the period since last report there has been occasional vomiting; the erysipelas gradually disappeared; the sensibility returned; the tongue became clean and moist; the stools improved, and there was even some return of appetite: on the other hand, there came on extensive excoriation, and at last sloughing of back and hips; the emaciation became very great, the prostration extreme, and at length, on the 86th day from the commencement of the fever, she sunk exhausted.
Head. Membranes of brain highly vascular; substance natural; upwards of eight ounces of serum in the different cavities. Thorax. Mucous membrane of trachea slightly reddened; bronchi vascular; lungs dark and much gorged with blood. Abdomen. Mucous membrane of intestines slightly vascular, [but the peritoneal coat highly inflamed, and contained on its surface a coating of coagulable lymph, which glued the convolutions of the intestines to each other and to the omentum.]
Case XCIII.
Charles England, æt. 22, servant. Admitted on the 11th day of fever: previous symptoms unknown. At present perfectly insensible; pupils contracted, insensible to light; face and lips of deep purple colour; extremities cold; full pressure induces some uneasiness in abdomen; body of tongue loaded and dry, edges red; deglutition difficult; pulse 100, feeble.