22d. Stupor; mind incoherent; scarcely any sleep; tongue brown and dry; pulse 108; skin hot. 27th. Coma; erysipelas on face; pulse 110. 28th. Coma increased; tongue deeply crusted; erysipelas extending. 29th. Delirium; tongue black; stools passed in bed; erysipelas extending. 30th. Muscular tremor. 35th. Increasing coma and prostration. Died. _Head._ Arachnoid opake; slight serous effusion; substance of brain and spinal cord vascular. _Thorax._ [28][Ten or twelve ounces of serum in bag of pleuræ; pericardium contained twelve ounces of sero-purulent fluid; that part of it which is reflected over the heart highly inflamed and covered with flakes of coagulable lymph.] _Abdomen._ Viscera healthy. CASE XVII. MARGARET GIBBS, æt. 63, widow, admitted on the 43rd day of fever. Pain of head still considerable; sleeps badly; pain of chest on right side; much cough, with purulent expectoration; abdomen tender; tongue loaded, dry; pulse 105. 45th. Pain gone; drowsiness, approaching to coma; no delirium; pulse 100. 48th. Insensibility continues; cough, with bloody sputa; pulse 108. 55th. Prostration; pulse 135, extremely weak; skin cold and clammy. 57th. Died. _Head._ Arachnoid opake, with gelatinous effusion beneath it; adherent to the dura mater along the longitudinal sinus; substance of brain vascular. _Thorax._ [Pleuræ adherent; slight effusion in left side; substance of lower lobes partly gorged, partly hepatized; melanotic deposits in the parenchyma. _Abdomen._ Both ovaria dropsical; partly converted into cartilage; scirrhous tumour in walls of uterus.] CASE XVIII. ELIZABETH RALPH, æt. 65, widow, admitted on the 8th day of fever. From commencement, severe pain of head and abdomen; both continue; mind confused; scarcely any sleep; tongue foul and dry; much thirst; bowels purged; pulse 105. 9th. Pain of head diminished; that of abdomen unrelieved; 8 stools; pulse 108. 10th. Pain of head gone; that of abdomen undiminished; 4 stools. 11th. Pain of head not returned; tenderness of abdomen undiminished; 7 stools; pulse 124. 12th. Tenderness of abdomen unabated; now swollen, hard, and rounded at umbilicus; 7 stools; pulse 125. 14th. Tenderness and purging continue. Died. _Head._ [Falciform process of dura mater ossified;] substance of brain vascular; more fluid than natural in the ventricles. _Thorax._ [Pleuræ adherent; serous effusion into parenchyma of lungs. _Abdomen._ Peritoneal sac contained several ounces of pus and serum; peritoneum covering the liver coated with coagulable lymph; peritoneal coat of the intestines highly inflamed; colon adherent to the omentum all around;] all its coats so softened as to be easily torn; mucous membrane in general healthy. CASE XIX.