SYMPTOMS. 283 



dence of symptoms may occur oftener than once during the 

 course of the disease. 



In some special instances, where these elevations are parti- 

 cularly well developed over the floor of the abdomen, the 

 skin loses its vitality, and becomes removed by sloughing, 

 leaving an ulcerous, ill-conditioned sore, not much disposed 

 to heal. 



Very early in the course of the disease, or it may bo delayed 

 for some time, is the altered condition of the lining membrane 

 of the nasal cavities. It is at first merely heightened in 

 colour, and studded with petechia?, which gradually extend, 

 chiefly by coalescing, until they cover the greater portion of 

 the septum which is visible, and steadily assume a darker 

 colour ; or they may be observed to alter in colour, as also 

 in extent, with the changes and remissions of the other 

 symptoms. When these blood-spots and submucous blood- 

 extravasations are fairly established in connection with the 

 nasal structures, we observe that a sero-sanguineous fluid, or 

 blood, of a darker colour than natural, and not disposed to 

 coagulate, trickles from the nostrils. This condition of 

 vascular disturbance, when observed in connection with the 

 nasal membranes, is probably very extensively distributed 

 throughout the body in connection with the cutaneous struc- 

 tiu-es and mucous membranes, and is only not a regularly 

 observed symptom because of the pigmented and largely 

 developed epidermic portion of the one and the hidden cha- 

 racter of the other. 



From the infiltration of the subcutaneous tissue of the 

 external, and the submucous of the upper and internal air- 

 passages, and consequent swelling, the breathing becomes em- 

 barrassed or accompanied with a troublesome cough. 



Fever, although rarely absent, is seldom a very prominent 

 feature. The pulse is more frequent than in health, soft, or 

 thready and weak, the respirations accelerated, and the 

 internal temperature increased by 3° or 4° F. 



There is usually impaired appetite all through the course 

 of the disease, sometimes refusal to take anything for days, 

 digestion invariably weak, bowels rather inclined to be 

 confined. 



Occasionally very early in the development of the aftection, 



