214 AGRICULTURAL REPORT, 



tlie skin, kidneys, or bowels, the torpor .and prostration disappear, tlie 

 appetite and strength are increased, and a prompt recovery may be 

 expected. 



In fatal cases the torpor and prostration are augmented; the breath 

 becomes fetid ; the anus more pufl'y, red, and with a greater tendency 

 to remaifi open ; the dung passed often and in small quantities, soft and 

 mixed with glairy reddish or bloody matter. Tlie urine is scanty, high- 

 colored, slimy, sometimes thick and gelatinous, fetid, and even bloody. > 

 The pulse becomes more and more rapid and weak, the eyes sunken, the 

 surface and extremities become cold, the hairs are easily detached, and 

 tlie stupor and debility extreme. 



ComiyJication in the joints, muscles, and connective tissue. — Bheiimatic 

 manifestations. — The stiffness of the body and limbs, and the general 

 soreness in many cases, even at the outset, show how commonly the 

 vvhite fibrons tissues of the joints and muscles are implicated. It is 

 only requisite that these symi^toms should be unusually prominent to 

 make the rheumatic feature of the comi)laint its characteristic one; 

 and this has often been the case to a large extent in the colder latitudes, 

 such as Northern Germany, Denmark, and Scotland. It has been a 

 frequent complication in New York during the iulluenza of 1872. Cases 

 of this Icind mostly begin by showing the symptoms of the simple 

 catarrhal malady, and often after this has made some progress in a 

 regular, and it may be exceptionally mild form, there suddenly appears 

 painful inflamnmtiou, with more or less infiltration and swelling of the 

 fibrous sheaths of the muscles and tendons and of the ligaments of 

 joints. There may be merelj'^ some swelling and tenderness of certain 

 muscles of the face, nock, back, or limbs, or there may be thickening 

 and shortening of , the tendons and ligaments leading to distortion, and 

 knuckling over at the knees and fetlocks, or liquid eifusious may take 

 j)lace into the joint capsules, resulting in pufi'y, elastic swellings in 

 different parts ; the bones even may be involved in the disorder, or, 

 worse still, the fibrous structures and valves of the heart. Dropsical 

 eJiusions take place in some such cases from the impairment of the 

 local nutrition processes, and weakness of the circulation, and even 

 at times from the implication of the heart. Though tbe majority of 

 rheumatic patients will entirely recover with proper care, yet a certain 

 proportion only do so with stiffened limbs and joints, or with incurable 

 disease of the heart, which subjects them to constant danger of faiiiting 

 and sudden death. 



Dropsical complications. — As already noticed, dropsical effusions some- 

 times ensue from preexisting disease of the heart or suppressed secre- 

 tion of the kidneys. In other cases they appear due to extreme weak- 

 ness of the circulation and nutritive processes, and a watery or very 

 impure state of the blood, the result of protracted or severe illness, 

 unwholesome conditions of life, overwork at too early a stage of con- 

 valescence, and the like. Such (edematous swellings of the limbs, 

 beneath the chest and belly, and in the lower part of the head, have 

 repeatedly occurred as a i^romiuent feature of the influenza in England, 

 and notably in 1751, and July, 1815, apparently in connectiou with the 

 extremely variable and unwholesome weather which prevailed. The 

 dropsical cases in 1872 have been virtually unknown in this country, 

 having been confined to Buffalo, Rochester, New "York, Philadelphia, 

 Washington, and other large cities, where the patients were in many 

 cases condemned to draw overloaded street-cars, or other vehicles, as 

 soon as tlie nasal discharge had been freely established and the fever 

 had begun to decline ; or when they were confined to damp, close, reek- 



