JOHN MEREDITH, æt. 23, porter. Admitted on the 22nd day of fever, which
came on, besides the ordinary symptoms, with pain of chest, cough and
hoarseness: states that these symptoms were getting better when, a few
days ago, he was attacked with pain of the abdomen, accompanied with
loose stools: at present the abdomen is exceedingly tender on pressure;
tongue brown and dry in the middle, edges white and moist; bowels
purged; distressing hiccup; pain of head, which was severe in the
commencement, gone; mind dull and heavy, but answers any question
distinctly; countenance anxious; features sunk; pulse 88, feeble; slight
degree of hoarseness and some cough remain.
23d. Tenderness of abdomen undiminished; hiccup continues very
distressing; vomiting; bowels purged; tongue brown and dry; scarcely any
sleep; pectoral symptoms the same; pulse 76.
24th. Tenderness of abdomen, hiccup, vomiting, purging, all increased;
eight stools since last report; much restlessness; pulse 84.
25th. Appeared to be more easy yesterday, but relapsed into his former
state to-day. Died following morning.
_Head._ Membranes vascular; arachnoid thickened and opake; substance of
brain vascular; more fluid than natural in the ventricle. _Thorax._
Mucous membrane of bronchi vascular; other viscera healthy. _Abdomen._
Mucous membranes of small intestines vascular; [peritoneum universally
and greatly inflamed; that covering the intestines coated with a layer
of coagulable lymph, by which their convolutions were united into one
diseased mass; false membranes were formed by this exudation which
extended from the under surface of the liver to the right iliac fossa,
where they formed a cyst, in which eight ounces of purulent matter were
contained; the peritoneum covering the abdominal surface of the
diaphragm inflamed; liver enlarged,] but its substance appeared healthy;
other viscera natural.
CASE CVIII.
ELIZABETH TURNER, æt. 26, servant. Admitted on the 15th day of fever: no
account to be obtained of previous symptoms: at present extremely
restless; much delirium; almost constant talking or moaning; no sleep;
mind quite confused and wandering; when roused to answer a question she
seems sensible for a moment, but immediately lapses into low muttering
incoherence; if asked whether she has any pain in the head she points to
the forehead; says she has no pain in chest or abdomen; no cough;
abdomen not tender.
16th. No sleep; constant restlessness; almost unceasing incoherent
talking; incapable of answering when spoken to; tongue cannot be
protruded; stools in bed; pulse too feeble and indistinct to be counted.
Died in the evening.
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