der but not enlarged. Blood showed crescents. Recovery.
Case 14. P. E. S., 23, from Port Said in a P. and O. vessel. On 27th July felt seedy, with epigastric pain and tenderness. Went to bed at ship surgeon's orders. Profuse hæmorrhages then commenced from the bowel and stomach. Arrived in dock 30th July 1901, and was at once (2 p.m.) admitted, sent in as acute dysentery. On admission, temperature 102.8°. Pulse 140. Urine 1020. No alb. Liver normal, spleen enlarged. No tympanites. No tenderness anywhere in abdomen. 5 p.m. vomited reddish-brown fluid with small clots, and passed two stools of the same material, but not at all fæcal. 10 p.m. temperature 97.4°. 31st, 8 a.m., temperature 97.6°. Still no abdominal tenderness on palpation. 1.30 p.m. vomited ℥x of fluid as at 5 p.m. on 30th, and passed four stools of same material. Much pain then came on in the abdomen. He lost consciousness and died at 2.15 a.m. The partial p.m. allowed revealed no excess of peritoneal fluid and no hæmorrhage into the cavity of the peritoneum, but there was a blood-stained effusion under the peritoneum around the pancreas. The whole extent of
