Great depression frequently accompanies even the first stages of this disease, indicated by a want of tone in the pulse, by an extremely listless manner, and sometimes by a tendency to syncope (Case I). The countenance becomes anxious, the tongue dry and brown in the centre, and red at the edges, or, in other instances, it presents a coating of a pasty yellowish-white colour; a dusky yellow hue frequently pervades the skin, and sometimes the conjunctivæ of the eyes. This may or may not depend upon an accompanying affection of the liver. The pulse varies much in frequency in different cases, and at different times in the same case: generally it is very rapid, especially when accompanied with much heat of skin. The pain is sometimes severe, and may be referred exactly to the spot which subsequent examination shows to have been the seat of secondary inflammation; at other times it is not confined to any particular situation, but consists of general ill-defined feelings of short duration, and recurring at irregular intervals. The peculiarity of such sensations is best expressed by the terms applied to them by the patients themselves. "Catching pains all over", "soreness of the stomach", and "thrilling in the blood", not unfrequently accompany this disease. Vomiting may occur, either as a symptom of constitutional disturbance, or as indicative of inflammation of an abdominal organ (Case XXVI). In the latter case, it is extremely obstinate, and the fluid ejected is generally of a green colour. Diarrhoea is a symptom of frequent occurrence, and appears to exercise a considerable influence on the course of the disease. Its appearance will not unfrequently be accompanied by relief of the other symptoms (Case III); when it occurs, it is generally profuse, and little under the control of medicine, but, if checked, may be followed by a sudden change for the worse in the condition of the patient. The intellect is seldom affected during the first stages of the complaint; but subsequently, in severe cases, restlessness, delirium, and coma, seldom fail to succeed each other. These symptoms are all peculiar, both in regard to the rapidity with which they make their appearance, and also the sudden manner in which they occasionally disappear. The disease may seem, within a few hours, to leave a part which it has first attacked, and to fall upon a different organ in some remote part of the body.