JAMES MOULDEN, æt. 17, servant. Admitted on the 5th day of fever; left the hospital three months ago cured of a similar attack. Present relapse came on besides the ordinary symptoms, with severe pain of the head; pain still continues, but it is now only slight; expression of countenance dull and heavy; pulse 92, soft; no thoracic symptoms; no tenderness of abdomen; tongue loaded in middle with yellow fur, red around the edges, moist. 6th. Pain of head continues with sense of weight and intolerance of light; scarcely any sleep; pulse 102. 9th. Pain of head and intolerance of light increased; adnatæ glistening; pulse 94. 10th. Pain of head quite gone; sense of weight and intolerance of light continue; face flushed; pulse 84. 11th. Pain of head returned; no sleep; delirium; pulse 96; tongue brown and dry. 13th. Pain of head and dullness and heaviness of eyes increased; pulse 84; abdomen tender. 14th. Nearly insensible; pulse 90; abdomen tender, swollen, and hard. 15th. Last evening coma increased; respiration became hurried and laborious; great prostration; expired this morning. _Head._ Membranes highly vascular; a large quantity of coagulable lymph effused at base of the brain. _Thorax._ Mucous membrane of bronchi highly vascular; substance of lungs gorged with blood. _Abdomen._ On mucous membrane of stomach several patches of a dark red colour; mucous membrane of intestines pretty natural. [Spleen studded with soft tubercles of various sizes, some of which contained a cheesy matter; others a puriform fluid; the liver contained a few tubercles of the same nature but smaller.] CASE XXVIII. CHARLOTTE CLARKE, æt. 18, servant. Admitted on 3d day of scarlet fever; throat sore; deglutition painful; no pain of chest; some cough; pain of head severe; much pain of limbs; mind distinct; tolerable sleep; no tenderness of abdomen; skin warm, covered with scarlet eruption; tongue characteristic; much thirst; no stool for three days; pulse 126, of good power; V. S. ad ℥xvj. 4th. Blood inflamed; throat continues sore; pain of head gone; pulse 130. Hirud. xij. gutt. 5th. Throat unrelieved; deglutition very painful; no pain of head; pulse 110. Rep. Hirud. x. 6th. Throat nearly well; pulse 116. 16th. Had become convalescent; yesterday evening felt scarcely so well; during the night extremely restless, with much noisy delirium; at present quite prostrate; pulse 117, not weak; respiration hurried; abdomen tender; tongue quite dry; four stools of green colour, all passed in bed; erysipelas on right temple. 17th. Lies quite prostrate; insensible; constant delirium with unceasing moaning; muscular tremor; all the stools passed in bed; pulse 126. Died following morning.