skin, and similar black patches on the lips. There is angular curvature at the second, and great tenderness on pressure over the upper three lumbar vertebræ; he complains also of pain at this part upon moving in bed. There is no paralysis, but considerable general debility. His bowels are regular, and tongue clean, but the appetite is impaired; the urine is clear, moderate in quantity, and not albuminous. Heart-sounds normal, but the impulse feeble. Pulse 80, small and weak.
Nov. 10th. R

Quinæ Disulph. gr. iss.
Aquæ distill. 3j.
Syr. Rhœdos 3ss.
Acid. Suph. dil. m. v.

Ft. Haustus ter die s.-Vin. Alb. ziv.

With these medicines and middle diet he continued with no appreciable change until the 24th, when he had a kind of fainting fit upon rising to have his bed made, contrary to an order that he should keep in the recumbent posture. This day his diet was changed to milk, at his own request. He has been once or twice sick after taking his food.

28th.- The sickness has continued, and he today has a troublesome hiccough, for which he was ordered

Jul. Ammon. p. r. n.

29th.- He has had little sleep, the hiccough, unrelieved by Julep. Ammon., annoying him much. Dr. Barlow, who now took the ward, ordered him

.Æther. Chlor. m. v.
Vini Opii m. v.
ex Mist. Camph. t. d. s.

30th.- He is today about the same. Has been sick this morning, the vomited matter consisting of food and drink. The hiccough occasionally ceasing.

Dec. 1st.- Hiccough still very harassing.

R

Vini Opii m. x.
Tinct. Castorei m. x.
ex Julep. Pimentæ p. r. n.