Case CVI.
George Bury, æt. 9. Admitted on the 11th day of fever: complaint commenced with nausea, pain of abdomen and severe head-ache; the latter continues; abdomen, especially epigastrium, tender; tongue red; much thirst; bowels constipated; pulse 116.
14th. Pain of head gone; countenance extremely pallid; no sleep; great restlessness; delirium; abdomen still tender; tongue red and dry; eight stools, dark and offensive; pulse 130. Died next day.
Head. Membranes vascular; substance of brain highly vascular; pituitary gland in a state of suppuration; cerebellum vascular; effusion between dura mater and arachnoid; one ounce of serum in ventricles, two at base; pia mater covering the spinal cord highly vascular; substance of cord natural. Thorax. Mucous membrane of bronchi slightly vascular; tubes contained some mucus, mixed with pus; [left pleuræ slightly vascular; lower lobe of left lung hepatized; right pleuræ healthy; lower lobe of right lung also hepatized, and contained several hard tubercles;] other viscera healthy. Abdomen. Mucous membrane of lower end of ilium and entire cæcum thickly studded with ragged ulcers, raised and very foul, with indurated margins and irregular surfaces; longest diameter of ulcers in direction of longitudinal fibres of muscular coats; mesenteric glands very large, many of them being the size of almonds; other viscera healthy.
Case CVII.
John Meredith, æt. 23, porter. Admitted on the 22nd day of fever, which came on, besides the ordinary symptoms, with pain of chest, cough and hoarseness: states that these symptoms were getting better when, a few days ago, he was attacked with pain of the abdomen, accompanied with loose stools: at present the abdomen is exceedingly tender on pressure; tongue brown and dry in the middle, edges white and moist; bowels purged; distressing hiccup; pain of head, which was severe in the commencement, gone; mind dull and heavy, but answers any question distinctly; countenance anxious; features sunk; pulse 88, feeble; slight degree of hoarseness and some cough remain.
23d. Tenderness of abdomen undiminished; hiccup continues very distressing; vomiting; bowels purged; tongue brown and dry; scarcely any sleep; pectoral symptoms the same; pulse 76.
24th. Tenderness of abdomen, hiccup, vomiting, purging, all increased; eight stools since last report; much restlessness; pulse 84.
25th. Appeared to be more easy yesterday, but relapsed into his former state to-day. Died following morning.
Head. Membranes vascular; arachnoid thickened and opake; substance of brain vascular; more fluid than natural in the ventricle. Thorax. Mucous membrane of bronchi vascular; other viscera healthy. Abdomen. Mucous membranes of small intestines vascular; [peritoneum universally and greatly inflamed; that covering the intestines coated with a layer of coagulable lymph, by which their convolutions were united into one diseased mass; false membranes were formed by this exudation which extended from the under surface of the liver to the right iliac fossa, where they formed a cyst, in which eight ounces of purulent matter were contained; the peritoneum covering the abdominal surface of the diaphragm inflamed; liver enlarged,] but its substance appeared healthy; other viscera natural.