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past year. " This epidemic differs in many respects from those which 

 have prevailed in former years. In many cases the disease was 

 ushered in very suddenly by a chill, pain in the head, back and limbs, 

 and great prostration — these were followed by febrile reaction, 

 vomiting and loss of appetite. An abundant rose-coloured rash ap- 

 peared over the body early in the disease. It occurred in patches, 

 irregular in size and shape, and disappearing on pressure. This rash, 

 so striking and characteristic, appeared abundantly on the trunk, 

 sometimes on the limbs, but was never seen on the face. In some 

 cases livid petechial spots were noticed, but they were rare. Suda- 

 mina were seldom seen. The condition of the tongue, of the brain 

 and nervous system, did not materially differ from that noticed in the 

 fever of former years, except that the prostration was more rapid 

 and marked in many cases. Diarrhoea, unattended with pain, tym- 

 panitis or other abdominal symptoms, was of frequent occurrence. 

 It was readily checked by opium. The duration of the disease was 

 usually from two to three weeks, according to the severity of the 

 attack, convalescence usually sitting in and advancing rapidly. Re- 

 lapses were by no means unfrequent, the cause generally escaped 

 detection. In some cases convalescence has progressed regularly 

 for a week, or even two weeks, when all the symptoms of the fever 

 returned even to the eruption over the body. The disease was much 

 more contagious than in former epidemics. No constant lesion is 

 observed after death, many cases, when carefully examined, pre- 

 senting no traces of any organic disease. Occasionally the glands 

 of Peyer have been found affected, and generally they have been 

 noticed as being more distinct than usual, without, however, being 

 properly diseased. Sometimes inflammatory complications were 

 found to exist. In the autumn, ulceration of the large intestines, 

 with symptoms of dysentery, were noticed. In the early part of 

 winter peritonitis was not unfrequent, and during the spring pleu- 

 risy. Bronchitis was very common, and inflammation of the fauces, 

 tending to oedema of the glottis, was occasionally met with. The 

 treatment of the fever has invariably been tonic and supporting, 

 some patients requiring only nourishing broths and wine-whey, 

 while others, and perhaps the majority, required a much more active 

 stimulation, as brandy punch, carbonate of ammonia, &c. To relieve 

 what appeared to be symptoms of local congestion, dry cupping was 

 often used, and when signs of active inflammation supervened, ab- 

 straction of blood by local means was only resorted to." 



It will be observed that there are several strong points of resem- 



