406 PtTEPTJEA H^MOEEHAGICA. 



swellings are hard, lumpy, and somewhat tender; and their 

 terminations are exceedingly abrupt, and they do not readily 

 pit upon pressure. The nasal membrane is, or speedily does 

 become, covered with large purple-coloured, or blood patches. 

 The respirations are generally disturbed ; and the pulse, in the 

 less severe forms of the malady, will beat at sixty or sixty-five : 

 while in the more severe types, from eighty to ninety, or even 

 one hundred beats per minute, are common. As the disease 

 proceeds, other symptoms of a peculiar character are presented. 

 The head, if not aflTected at the commencement, will swell, and, 

 in the course of a few hours, reach such a size as to present a 

 truly hideous appearance ; the lips and nostrils become so hard, 

 and distended with effused blood, that the patient loses all 

 power to partake of food. Sometimes the swellings of the 

 head will for a time be limited to the eyelids of one eye ; or 

 the tongue may swell, and ultimately attain such a size as to 

 gag the mouth open. When the nostrils are distended, or 

 their mucous membranes covered with blood-patches, the 

 breathing becomes snuffling and harsh in sound ; and when the 

 eyelids are rapidly distended, bloody serum is exuded, which 

 runs down the cheeks, and the patient appears as though 

 weeping blood. Kot unfrequently the dung is dtiated with 

 blood ; and the urine may also contain it, in consequence 

 of blood being exuded from the internal surface of the 

 bladder. 



Pathognomonic Symptoms. — The Pathognomonic Symp- 

 toms are — sudden swelling of tlie lody and limls, which fre- 

 quently appears in association with Scarlatina, lut which may 

 appear independent of the latter ; the swelling terminates 

 abruptly, and -patches of effused Hood are also present upon 

 the nasal membrane of the nostrils. 



