CASE LXXVI. MARY M’GOWAN, æt. 18, servant. Admitted on the 8th day of fever; attack commenced with usual symptoms; at present, abdomen tender; tongue thickly coated and dry; lips and teeth sordid; much thirst; bowels purged; stools dark and offensive; pain of head which has been severe from the beginning continues, and is most severe over the fore-part; pulse 116, weak. 9th. Abdomen and tongue the same; pain of head unabated; eyes dull and heavy; right cheek deeply flushed; pulse 110. C. C. ad ℥x. temporibus. 10th. Abdominal symptoms unchanged; pain of head relieved, but not gone; pulse 132, weak. 11th. Tongue cleaning; quite moist; three stools; very slight pain of head; delirium; pulse 120, weak. 12th. Pain of head quite gone; but there is no other change. 13th. No sleep; great restlessness; noisy delirium; pulse 126, weak; swelling, redness and pain of left parotid. 15th. Tongue has become brown and dry; and respiration difficult and rattling; face flushed; colour dusky; lies on back quite prostrate; pulse 136, weak; inflammation of left parotid subsided, but it has now attacked the right. 16th. Respiration hurried and noisy; skin in general dusky; cheeks extremely flushed and of deep purple colour; pulse scarcely to be counted; prostration extreme. Died next day. _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.