The constitutional symptoms in this severe form are typhoidal in character. The mind appears at ease, quietly passing into a comatose state. The countenance is pinched and sunken, and the skin is dusky and purplish. The eyes appear bloodshot and listless. The breathing is rapid and superficial. The delirium is of a quiet character, and death comes as a most welcome termination. CASE I.--McD. Admitted to the hospital with a high fever (106.4° F.) and complaining of sore throat. One hour after admission there was noticed a very intense red rash, eyes bloodshot, and patient stupid. Patient isolated for scarlet fever. Hemorrhages came from eyes, nose, and mouth. Vomited blood in large quantities. Purplish spots appeared on the skin and spread rapidly over the whole cutaneous surface. Three hours after admission the patient died. CASE II.--The patient, J. H., attended the funeral of a relative in New Jersey. Ten days afterwards he received a letter stating that the person had died of smallpox, but that they desired the matter to be kept secret. Feeling nervous, he got vaccinated. Three days from the receipt of the letter he did not return to work after his lunch, and complained of feeling weary. Went to bed, telling his wife to call him at four o’clock, as he had an important engagement. At half-past three his wife went to call him, and found him bleeding profusely. She called a neighboring doctor, who notified the Board of Health. The health inspector called at five P.M. Patient unconscious; face dark and dusky; eyeballs bulging and blood oozing from them. Hemorrhage from nose and mouth. Vomited a large quantity of dark, coagulated material. Pulseless at both wrists. Temperature 108° F., by rectum. Diagnosis, hemorrhagic variola. Ordered patient removed. Ambulance arrived at 7.15, just after the patient had died. No autopsy. Through the courtesy of Dr. A. H. Doty, the following cases may be quoted. They were reported to the Health Department of New York City with a diagnosis of malignant hemorrhagic smallpox.