ii A M . 49 



strai nable, and (where a description of them could be ob- 

 tained) were said to have been exceedingly offensive and 

 usually of a dark color. Muscular weakness was an early 

 and very remarkable symptom in nearly all the cases, and 

 in many it was so great that the patient could only stand 

 by holding on to something. Headache, sometimes severe, 

 was a common and early symptom ; and in most cases there 

 was thirst, often intense and most distressing. The tongue, 

 when observed, was described usually as thickly coated 

 with a brown, velvety fur, but red at the tip and edges. 

 In the early stage the skin was often cold to the touch, but 

 afterward fever set in, the temperature rising in some 

 cases to 101, 103, and 104 F. In a few severe cases 

 where the skin was actually cold, the patient complained of 

 heat, insisted on throwing off the bedclothes, and was very 

 restless. The pulse in the height of the illness became 

 quick, counting in some cases 100 to 128. The above 

 were the symptoms most frequently noted. Other symp- 

 toms occurred, however, some in a few cases, and some only 

 in solitary cases. These I now proceed to enumerate. 

 Excessive sweating, cramps in the legs, or in both legs and 

 arms, convulsive flexion of the hands or fingers, muscular 

 twitchings of the face, shoulders, or hands, aching pain in 

 the shoulders, joints, or extremities, a sense of stiffness of 

 the joints, prickling or tingling or numbness of the hands 

 lasting far into convalescence in some cases, a sense of 

 general compression of the skin, drowsiness, hallucinations, 

 imperfection of vision, and intolerance of light. In three 

 cases (one, that of a medical man) there was observed yel- 

 lowness of the skin, either general or confined to the face 

 and eyes. In one case, at a late stage of the illness, there 

 was some pulmonary congestion, and an attack of what was 

 regarded as gout. In the fatal cases, death was preceded 

 by collapse like that of cholera, coldness of the surface, 

 pinched, features and blueuess of the fingers and toes and 

 around the sunken eyes. The debility of convalescence 

 was in nearly all cases protracted to several weeks. 



"The mildest cases were characterized usually by little 

 remarkable beyond the following symptoms, vi/., abdominal 



