275 
IN AKTICULO MOETIS. 
Br BENJAMIN W. KICHARDSON, M.D., F.E.S. 
I HAVE recently read, in Hammond’s Journal of Psychological 
Science for January of the present year, an essay of more 
than ordinary interest by Dr. La Roche, of Philadelphia, on the 
subject of the. Resumption of the Mental Faculties at the 
Approach of Death.” The intention of the learned author of 
this essay is to show that, in cases whare a sick person has for 
some hours or days been lying in delirium, he may suddenly 
become conscious, may speak with wisdom, mth power of 
memor}^, it may be with pleasure, and yet speak thus as but a 
presage to the death which quickly follows. The clearest evi- 
dence is given of this fact, and the frequency of the occurrence 
of the phenomenon in the course of the acute fevers endemic in 
hot climates is forcibly dwelt on. In yellow fever the stage of 
inflammatory reaction continues, says La Roche, with little or 
no mitigation from some hours to two or three or more days — 
generally from sixty to seventy-two hours, and is succeeded by 
the state of remission (the metoptosis of Mosley or the stadium 
of Lining) without fever. The pulse loses its excitement, be- 
comes almost natural or slower than in health, or rapid, feeble, 
and nearly imperceptible ; the skin regains its natural tempera- 
ture, then is colder and colder, and bedewed with cold perspira- 
tion; the pain of the head, back, and limbs disappears, or is 
greatly diminished. The redness and glistening appearances 
are no longer apparent, but the redness is replaced by a yellow 
tinge. These signs in the general course of the disease portend 
approaching death, yet are the}^ accompanied with ‘other signs 
marvellously singular : the wandering or violent delirium, the 
seeming sensibility, or deep sleep (coma), subside more or 
less completely. The patient, who some moments before 
raved, like a maniac, or talked irrationall}^, or could not be 
aroused, regains his natural condition of mind ; thinks, or en- 
deavours to represent himself; converses rationally on all sub- 
jects; is cheerful; sits up in or gets out of bed ; walks with a 
firm step ; expresses an appetite for food and relishes what he 
