184 
CONTRIBUTIONS TO THE PATHOLOGY AND 
a quantity of yeasty-looking matter, the fetor from which was really 
horrible. 
21th.—Nine o'clock, A.M. : Pulse 75, respirations 18 per minute; 
discharge from the nostrils copious, and of the same offensive 
smell. I can easily detect the metallic tinkle in the chest; the 
effusion, I also believe, has greatly increased; mucous rale at 
present subdued. Very little change took place during the day, 
and my treatment consisted of stimulants. I gave port wine and 
Peruvian bark, brandy, spirits of nitre, and, also, a quantity of 
yeast. 
28 th. —Throughout the whole of to-day she has been much the 
same as yesterday: mucous rale at times very loud ; a diffuse 
sibulous sound was present, particularly on the left side; pulse 76 
and respirations 15 per minute; extremities warm. Continue the 
administration of stimulants, and give an ounce of yeast every three 
hours. 
29 th. —This morning she is weaker: the appetite is gone; she 
begins to have a very emaciated appearance; the extremities, ears, 
&c., are very cold ; pulse 89 and respirations 22 per minute : the 
muscles of both shoulders and left hind leg exhibit an involun¬ 
tary jerking kind of motion. During the day the mucous rale was 
sometimes uncommonly loud; when it subsides I can detect a ring¬ 
ing kind of sound : it exactly resembles the sound caused by drops 
of water falling into a deep well. The action of the heart is masked; 
every time it beats a quantity of fluid seems to be forced away 
from it. On the left side, for about ten inches in length, and along 
its medium plane, I can detect the moist crepitus rhonchus. This 
sound, about which many comparisons have been made, exactly 
resembles the frizzling of paint when spread over a board or can¬ 
vass and held before a large fire. Not only is the length over 
which this sound is heard considerable, but its breadth is consider¬ 
able also. The effusion appears to have increased very much 
during the last twelve or fourteen hours; the discharge from the 
nose continues unabated; and the cough exhibits the same pecu¬ 
liarity it has done from the commencement. To continue the use 
of the yeast. 
30^A.—On going this morning I fully expected to find my pa¬ 
tient dead, which, however, was not the case—she was down upon 
the floor : a cold sweat bedewed the skin ; the extremities were 
warm ; and the eye glassy. She lay in this state about two hours, 
and died. 
Examination two hours after death.—State of the Digestive 
Organs: The stomach contained a small portion of food scarcely, 
if at all, acted upon; the mucous membrane of this organ, of the 
