462 On the Epidemics of 1852-3. 
ried off,—killed as it were by the immediate effect of the 
poison,—two or three days after the attack; now and then 
Without the appearance of any rash. In a few of these 
cases the persons were of a darker colour about the hands 
and face, of almost a leaden hue, showing a congested con- 
dition of the superficial vessels. In the cases which died 
within the first three weeks, death arose from affection 
of the head, effects of poisoning, or sinking under the 
primary fever, without exhibiting disease of any particular 
organ—the pulse being very rapid and never hardly yielding 
in frequency, the mind clear, and the vital powers sinking. 
Two young women sank this way within ten days, or from 
irritation being set up in the mucus ‘surfaces of the stomach 
and bowels, and Jow fever carrying them off. Of these I have 
seen fewer examples; the two former being far the most 
common causes of death early in the disease, in the cases I 
have witnessed. While the early stage of the disease carried 
off many victims, it was very fatal also after the twenty-first 
day, when death almost always supervened from diseased 
action in the kidney, producing consecutive morbid effects. 
No writer with whom I am acquainted has so fully entered 
into this subject as Dr. Copeland, who very properly points 
out that it is not only in the more marked cases where ana- 
sarca arises from affection of the kidneys, that the kidney is 
much more early affected than is generally supposed, and that 
this complication must be looked for, if the disease is to be 
properly treated. In the year 1843 I was desirous of ex- 
amining the state of the urine in anasarca after scarlet fever, 
to verify Dr. Christison’s views, that the kidney resumes a 
healthy secretion after albumen has been passed, mixed with 
the urine; the results are contained in the following tables, 
compiled from observations made at the Orphan Schools, 
and it is seen that albumen existed in all cases of anasarca, 
