"If every effort made by art fails to excite the sinking powers of life, the symptoms of what has been called the second stage are soon succeeded by others, which more certainly announce the approach of death. The pulse again becomes equal, but so weak and quick, that it is almost impossible to count it; a difficulty of breathing, nearly resembling the _stertor apoplecticus_, is often observed; sometimes the eyes are suffused with blood, the flushing of the face is more frequent than before, but of shorter duration, and followed by a deadly paleness; red spots, or blotches, sometimes appear on the body and limbs; deglutition becomes difficult, and convulsions generally close the scene. In one case, I may observe, the jaws of a child of four years of age were so firmly locked for more than a day before death, that it was impossible to introduce either food or medicine into his mouth; and, in another case, a hemiplegia, attended with some remarkable circumstances, occurred during the two days preceding dissolution. "Having thus given as exact a history of _apoplexia hydrocephalica_ as I could compile from the writings of others, and from my own observations, I should think myself guilty of imposition on my readers, if I did not caution them that it must be considered merely as a general outline: the human brain seems to be so extremely capricious (if the expression may be allowed) in the signals it gives to other parts of the system, of the injury it suffers throughout the course of this disease, that although every symptom above-mentioned does occasionally occur, and indeed few cases of the disease are to be met with, which do not exhibit many of them; yet it does not appear to me, that any one of them is constantly and inseparably connected with it." To this history I shall add a few facts, which are the result of observations made by myself, or communicated to me by my medical brethren. These facts will serve to show that there are many deviations from the history of the disease which has been given, and that it is indeed, as Dr. Quin has happily expressed it, of "a truly proteiform" nature. I have not found the dilated and insensible pupil, the puking, the delirium, or the strabismus, to attend universally in this disease. I saw one case in which the appetite was unimpaired from the first to the last stage of the disease. I have met with one case in which the disease was attended by blindness, and another by double vision. I have observed an uncommon acuteness in hearing to attend two cases of this disease. In one of them the noise of the sparks which were discharged from a hiccory fire, produced great pain and startings which threatened convulsions. I have seen three cases in which the disease terminated in hemiplegia. In two of them it proved fatal in a few days; in the third it continued for nearly eighteen months. I have met with one case in which no preternatural slowness or intermission was ever perceived in the pulse.