Abdomen. Peritoneal coat of intestines vascular; several ulcers in ilium and cæcum; appearance of ulcers peculiar, resembling those of phthisis rather than those of fever; vermiform process externally vascular; internally contained a crop of bodies like tubercles or enlarged glands and so numerous as to form a layer under the mucous membrane. Head. Membranes and substance of brain vascular; more fluid than natural in the ventricles. Thorax. [Pleuræ of left side adherent;] other viscera healthy.
Case LXXVII.
William Waller, æt. 24, barge builder, admitted on 22d day of fever. No tenderness of abdomen on firmest pressure; tongue loaded and dry; thirst; bowels said to be regular; no uneasiness of chest; some cough; pain of head, which had been severe, entirely gone; mind dull and confused; no sleep; face flushed; prostration; great sense of oppression; pulse 114, tremulous and indistinct.
23d. No change, excepting that the tongue has become brown and dry.
24th. Pulse 120, weaker and more tremulous: other symptoms the same.
27th. Tongue has become extremely dry; thirst urgent; three stools, mixed with blood; abdomen not tender; pulse 100.
28th. After yesterday’s visit, seized suddenly with violent delirium, urgent dyspnœa, and copious discharge of blood from the bowels; these symptoms continued until half past eleven, p. m. when he expired.
Abdomen. Mucous membrane of greater part of small intestines much inflamed; that in lower part of ilium quite black and nearly sphacelated, containing several spreading ulcers; colon throughout of darker colour than natural; mucous membrane of rectum highly vascular; spleen enlarged and softened; [bladder thickened and vascular.] Head. Arachnoid opake and milky, covering a large quantity of gelatinous fluid. Thorax. [Pleuræ of left side generally adherent, of right less extensively adherent;] substance of both lungs healthy.
Case LXXVIII.
Margaret Pennifold, æt. 20, servant. Admitted on the 8th day of fever, which, besides the ordinary symptoms, commenced with pain and tenderness of bowels: at present, abdomen tender, especially the epigastrium; tongue very red, sore, and cracked; lips and teeth sordid; much thirst; some uneasiness of chest on full inspiration; slight cough; some pain of head, especially in occiput; scarcely any sleep; mind much confused during the night, scarcely distinct during the day; pulse 105.