19th. Severity of symptoms had diminished; lips, teeth, and tongue had begun to clean; pulse fallen to 96; but the parotid gland to-day painful, enlarged and indurated. 20th. Tumour of parotid increased; all the symptoms greatly aggravated; tongue not to be protruded. 22d. Insensibility amounting to coma. 27th. Insensibility and prostration gradually increased. Died. _Head._ Arachnoid white and opake; firmly adherent along the vertex to the dura mater. Surface and substance of brain highly vascular; gelatinous effusion between the membranes. _Thorax._ Mucous membrane of bronchi vascular; [pleuræ adherent; lower lobe of left lung partly hepatized, and partly consisting of a mass of suppurating tubercles.] _Abdomen._ Small intestines of extremely dark colour; mucous membrane vascular. CASE XXII. MARY SINGLETON, æt. 28, married. Admitted on the 8th day of fever: pain of head slight, confined chiefly to the occiput; pain of left side, with inability to lie on it; no cough; tenderness of abdomen; pulse 111. 9th. After venesection to twelve ounces pain in head, side, and abdomen relieved; blood buffy. 11th. Slight pain of occiput; much pain and tenderness of abdomen; pulse 120. 13th. Cerebral and abdominal symptoms unchanged; tongue brown and dry; eyes yellow. 19th. Pain of head never entirely disappeared, but though always present it was always slight; now respiration hurried; tongue extremely brown and dry; pulse 120; eyes yellow. 20th. Died. _Head._ Membranes of brain vascular with gelatinous effusion beneath them; and slight serous effusion into ventricles: substance both of cerebrum and cerebellum highly vascular; pituitary gland softened and suppurating. _Thorax._ Mucous membrane of bronchi vascular; substance of both lungs gorged with blood; [pleuræ universally adherent.] _Abdomen._ Mucous membrane of intestines not vascular; but the mesentery highly injected: [liver adherent to diaphragm.] CASE XXIII. MARY ANN LAMBERTH, æt. 16, servant. Admitted on 22d day of fever. Pain of head, which has been very severe, is now gone; no tenderness of abdomen on fullest pressure; tongue red, smooth, and chapped; lips and teeth sordid; bowels purged; pulse 108. 30th. Cough with slight expectoration; cheek dusky; no tenderness of abdomen; bowels purged; pulse 120. 35th. Mind confused; much restlessness; no sleep; stools passed in bed; pulse 124, weak. A diffused swelling has appeared about the left wrist, attended with great pain. 36th. Mind more confused; countenance sunk; swelling of wrist increased; pulse not to be counted. 37th. Died. N.B. Probable that the swelling of the wrist arose from the peculiar affection hereafter to be described.[29]