Case XCIX.
Ann Levitt, æt. 24, married. Admitted on the 16th day of fever, which came on with severe pain of the head and epigastrium; pain of head is now gone, giddiness remains; much pain of limbs; scarcely any sleep; mind confused; eyes dull and heavy; face flushed; no uneasiness of chest; abdomen extremely tender on pressure; tongue red, parched, and cracked; lips and teeth sordid; bowels purged; pulse 123.
17th. After the application of ten leeches to the abdomen the tenderness is much diminished; the pulse fallen to 96; vomiting.
18th. Eight leeches again applied; abdomen now free from pain; vomiting continues; tongue unchanged; pulse 106.
19th. Vomiting undiminished; eight stools; abdomen again tender.
20th. Vomiting; five stools; pulse 108; slight pain of abdomen on full pressure.
22d. Abdomen tender, swollen, and tympanitic; eight stools; pulse 96; great prostration.
24th. Abdomen less tender and tense; still more prostrate.
25th. Stools in bed; pulse scarcely perceptible; features collapsed. Died in the night.
Head. Membranes of brain vascular; substance natural; effusion into the ventricles and at base; pituitary gland suppurated. Thorax. Mucous membrane of bronchi inflamed; tubes full of mucus, mixed with pus; [superior lobe of right lung a mass of tubercular disease; one of the tubercles the size of a pigeon’s egg, in a state of suppuration; effusion of serum into the left pleural cavity.] Abdomen. Mucous membrane of jejunum and ilium much inflamed; caput coli firmly adherent to the abdominal peritoneum; large quantity of serum effused into the hepatic region; substance of liver soft; gall-bladder in a state of suppuration; contained three large biliary calculi; omentum inflamed; [two large hydatids attached to the left ovarium.]