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Course.-Prostration increased and diarrhoea continued. She fell
out of bed apparently in a fit, for, when seen soon after, she was un-
conscious, with upturned eyes, shallow and rapid respiration, thready
pulse, and convulsive movements of upper limbs. There was also a
huge purple haematoma on the forehead. Consciousness never returned,
and at 3-15 p.m. she was lying with lower limbs stretched out, pupils
dilated, and inactive to light, arms flexed and stiff, teeth clenched and
body opisthotonous. After two minutes the muscles relaxed and urine
was passed. Three fits followed with gradually diminishing intensity,
death occurring at 3-45 p.m.
Treatment.-Chalk mixture had been given for the diarrhoea and
rum for the prostration and one dose of a mixture containing Quinine
and three minims of Liquor Strychniae.
CASE II.-SECONDARY PNEUMONIA; DEATH.
R. K., Hindu female,aet. 19; admitted 14th March 1898 (afternoon).
History.-Rigors and fever of one day's duration.
Condition on admission.-Temperature 105, pulse 120 (fairly strong
and regular), respiration 37; drowsiness, constipation, thickly furred
tongue, and diffuse tender swelling in the left groin above Poupart's
ligament.
Course.-Constipation continued, slept well with intervals of
excitement and delirium, pyrexia continued, pulse became weaker, tongue
somewhat clearer, drowsiness diminished, bubo extended to femoral
glands, sudden supervention on 19th March 1898 of acute pneumonia
followed by death on 20th March 1898 at 3-5 p.m.
Treatment.-Hypodermic injections of three minim doses of Liq.
Strych. every four hours, and a mixture containing Tinct. Nucis Vomic.,
Spirit Aether, Spirit Ammon., and rum. Constipation was relieved by
Calomel and enemata, and delirium by Pot. Brom. and Caffeine Citrat.
CASE III.- SUPPURATION OF BUBO; RECOVERY.
M. V., Hindu female, aet. 20; admitted 4th March 1898.
History.-Fever of two days' duration.
Condition on Admission.-Temperature 105, pulse 100 (fairly full
and regular), skin hot and dry, and tongue thickly furred.
Course.-Pyrexia continued high for two days and then was brought
down by Phenacetin. The tongue remained thickly coated and the
ocular conjunctiv injected; speech was indistinct and on 5th March