ON THE EPIDEMIC INFLUENZA OF 1836. 631 
Here was evident determination to the brain, and that to an 
intense degree. I bled him until a sensible effect was produced 
on the pulse : I then gave him a mild dose of physic, five 
drachms of aloes; inserted setons behind the ears, and ordered 
thick gruel to drink, as he refused his food. 
7th . — His bowels mildly acted upon by the physic. He is 
not quite so well as yesterday. Rub in some blistering oint- 
ment behind the ears in the course of the cervical vertebrae, and 
allow him plenty of gruel, and as thick as he can drink it, 
which if he refuses to drink, must be carefully horned down 
while he is lying. 
8th . — Purges briskly, every symptom aggravated; staggers 
more if possible ; pulse seventy; sleeps a great deal. It is with 
difficulty he can get up, and as he cannot command himself it is 
dangerous to be very near him. He cannot stand many minutes, 
but reels backwards and forwards, and falls down. Give him 
gruel as yesterday — keep “under him a good bed, in order that he 
may not bruise himself, &c. 
9th . — Continues to purge ; he is sinking fast : I begin to 
think he is purging too much, but which before had been my 
principal hope. I gave him two scruples of opium, half an 
ounce of gum myrrh, two drachms of ginger, and one ounce of 
prepared chalk in some starch, twice a-day, and ordered him 
some starch in his gruel to-day. 
10th . — Does not purge so much ; in other respects he is about 
the same as yesterday. Continue medicine as yesterday, and 
give him his gruel as before. 
11M. — Purging ceased, but my patient is no better; his 
respiration is more hurried ; pulse accelerated. It is with ex- 
treme difficulty that he can get up, and does not stand many 
minutes; — he lies stretched out, and sleeps a great deal. If he 
is enticed to take a mouthful of food, he falls asleep with it in 
his mouth. No medicine to-day. 
1 2th . — No better; I quite despair of his recovery. I gave 
him two drachms each of ginger and gentian, and half an ounce 
of gum myrrh in some gruel, and the nursing department was 
attended to as before. This plan of treatment was continued 
with very little deviation till the 15th, when he died. 
Examination after death . — Extreme congestion of the mem- 
branes of the brain ; about an ounce of blood had escaped and 
coagulated around the pineal gland, and which was intermingled 
with some small bloodvessels belonging to that part ; the lungs 
were considerably inflamed, but the abdominal viscera were quite 
healthy. 
