5. An effusion by rupture, or a congestion of all the component parts of the blood. 6. Gangrene from the death of the blood-vessels. 7. Rupture of blood-vessels, producing hæmorrhage. 8. Redness, phlegmon, pustules, and petechiæ on the skin, and tubercles in the lungs, and on the liver and bowels. 9. Schirrus. 10. Calcareous and other earthy matters. Both these take place only in the feeble and often imperceptible grades of morbid action in the blood-vessels. 11. Death. This arises from the following causes. 1. Sudden destruction of the excitability of the blood-vessels. 2. A disorganization of parts immediately necessary to life. 3. A change in the fluids, so as to render them destructive to what are called the vital organs. 4. Debility, from the exhausted or suspended state of the excitability of the blood-vessels. All these effects of fever are different according to its grade. Dr. Blane says fevers are rarely inflammatory in the West-Indies; that is, they pass rapidly from simple morbid excitement to congestion, hæmorrhage, gangrene, and death. This remark is confirmed by Dr. Dalzelle, who says the pneumony in the negroes, in the French West-India islands, rarely appears in any other form than that of the notha, from the arteries in the lungs being too much stimulated to produce common inflammation; but such is the force of morbid excitement in hot climates, that it sometimes passes suddenly over all its intermediate effects, and discovers itself only in death. This appears to have taken place in the cases at Vera Cruz, mentioned by baron Humboldt. All the different states of fever may be divided, I. Into such as affect the whole arterial system; but with no, or very little local disease. II. Into such as affect the whole arterial system, and are accompanied at the same time with evident local disease. III. Into such as appear to pass by the arterial system, and to fix themselves upon other parts of the body. I shall call these states of fever _misplaced_. I. To the first class of the states of fever belong,