30th. She rested ill, her throat was worse, and it now gave her great pain to swallow. She had also been taken with a shivering fit, succeeded by fever. On inspecting the throat I could not perceive one pustule there, but the uvula and tonsils were very much swelled and inflamed. An acidulated gargle was directed, and a lenitive purge, which in the evening had operated thrice; the gargle had been frequently used, but the difficulty of swallowing was greatly increased, insomuch that she could get nothing down; the fever too was rather increased. Further help could not now be expected from internals; for upon making the trial, liquids returned through the nose. I directed a blister to be applied to the throat, and that she should frequently gargle with warm pectoral drink. 31st. She had not slept a minute, being disturbed, whenever she attempted it, with such sudden startings as made her afraid to sleep. The feverish heat was not very great, the pulse extremely quick, and all the liquids she attempted to swallow still came through the nose. She could not lie down in bed, and therefore sat up in an easy chair the greatest part of the night. The pustules, which in the face did not exceed twenty, and very few appeared elsewhere, advanced to maturation kindly, without receiving the least check from this adventitious illness. Her speech was so much affected as scarce to be understood. She informed me, however, that she was subject to an illness of this kind; and had once narrowly escaped with her life, but had never been so bad before. I directed twelve ounces of blood to be taken from the arm, and that the sublingual veins should be pricked. But no relief seemed to be derived from any of these measures; and upon inspecting the throat again, the glands, uvula, and fauces were very much inflamed and distended. The tonsils were then lanced pretty deep, and a good deal of blood being discharged, the swelling of the parts subsided, so as to admit her to swallow, though with difficulty, a little pectoral drink, and afterwards few spoonfuls of milk pottage. June 1st. She had rested but very little, though exceeding drowsy, and worn out for want of sleep; for the sudden startings, upon closing her eyes, still remained, though not in so great a degree as the preceding night; but she had swallowed some liquids, though with great difficulty. The feverish heat was not very great, the pulse quick and more feeble. On inspecting the throat towards noon, the swelling, though somewhat abated, was still considerable enough to prevent much being swallowed.