5 1 APPENDIX 



as did the breath at a more advanced stage of the disease ; 

 the pulse was quick, and when the collapse was fairly set in, 

 hardly perceptible ; the patients were quite sensible ; and 

 during the cessation of the cramps, generally calm. The 

 greatest number of deaths took place in this stage. 



" In those cases in which dissolution did not ensue during 

 collapse, the patients either recovered by a remission of the 

 symptoms, or a subsequent stage manifested itself, marked 

 by great febrile reaction, severe headaches, delirium, dryness 

 of the tongue, and pain at the pit of the stomach, which 

 proved fatal^in many instances. 



" The morbid appearances after death, were : congestion 

 of the blood-vessels in the brain, the sinuses being in all 

 cases literally gorged with blood in a fluid state ; in many 

 instances exudation of limpid serum into the arachnoid 

 membrane, and between that and the pia mater ; the lungs, 

 particularly at the back, congested ; the heart flaccid ; fluid 

 blood in the right cavities, the left empty ; the stomach and 

 intestines pale, containing fluid resembling the alvine excre- 

 tions. In all cases the gall-bladder was distended almost 

 to bursting with concentrated bile. No bile observed in 

 the duodenum. The bladder contained scarcely any fluid. 

 The secretion of urine seemed to be suppressed in almost 

 all patients. 



" Those that came under medical treatment at an early 

 stage, with diarrhoea, and other premonitory symptoms, were, 

 with few exceptions, cured. The remedies consisted of an 

 emetic ; if the tongue was foul, a dose of castor-oil was given, 

 and afterwards rhubarb, with some bitter or aromatic infusion, 

 and small doses of laudanum. The diet was reduced to 

 farinaceous food. 



