108 REVIEW —GLANDERS IN THE HUMAN BEING. 
ment of his disease he had had great heaviness and pain of the 
head, diarrhoea, and fever. His countenance was of an unnatu¬ 
rally dark hue. On the face, on the breast, and on the belly, 
several phlyzacious pustules were seen; and a gangrenous spot 
was observed on the glans penis. No petechial or lenticular 
typhoid spots or mdamiiia appeared or any part of him. His 
tongue, dry and chapped, was partly covered with a glutinous 
mucus. The thirst was excessive. He had had several liquid, yel¬ 
low, involuntary stools during the night. The urine was discharged 
involuntarily—it was acid, and destitute of any peculiar smell ; 
in fact, it seemed to differ little from healthy urine. 
The pulse was small and frequent—the skin dry and hot—the 
beatings of the heart could not be heard distinctly on account of 
the noise attending the act of respiration, and which the patient 
could not suspend for a moment. The respiration was more 
frequent and laboured than usual, and the patient, from time to 
time, effected an inspiration unusually lengthened. 
The exploration of the chest was managed as well as it could be 
in the exhausted state of the patient, and nothing could be heard 
but the sibilant rale. On percussion, the resonance of the chest 
was good, and the sick man coughed without expectoration 
(sans cracker). The nostrils, exteriorly, had a healthy appear¬ 
ance, and there was no discharge from them ; the voice was 
changed, and very feeble; and there was no enlargement of the 
parotid or submaxillary glands, or the lymphatic ganglions 
of these regions. 
As he lay on his back, his gaze was fixed on some particular 
point or object. He complained, from time to time, of cramps 
in his lower extremities; but the voluntary muscular action was 
exceedingly feeble. When I requested him to squeeze one of my 
fingers as hardly as he could, he could scarcely manage to bend 
it by the exertion of all his strength. His hearing was good, 
his sight unimpaired, and the common sensibility of the skin not 
perceptibly diminished. When he was pressed with questions, 
he more than once told us that his head ached. On the preced¬ 
ing night he had been exceedingly agitated, and attempted to 
get out of bed. He exhibited less impairment of intellect than 
is observed in the putrid stage of enteritis, attended by ulcera¬ 
tion of the mucous follicles of the intestines (^dothin-enteritis) or 
typhoid fever, but more than is often seen after the absorption of 
animal poison, as in dissection. It was a mental prostration of 
a peculiar form and character. Dr. Rayer is giving his own 
lucid account of the disease. 
Although the rarity of typhoid fever at the age of fifty-eight, 
and the rapidity with which the exhaustion pursued its course, 
and especially the existence of the eruption, ought to have con- 
