CASE 91.—Private John Minisberger, Co. I, 90th Pa.; age 40; convalescing satisfactorily from a resection of the left elbow joint, rose on the morning of July 28, 1864, in his usual good health, dressed himself and went out to the pump for a drink as was his daily habit. About 6 A. M. he was suddenly seized with a severe pain between the shoulder-blades, the feeling being as if some one was pressing a bar of hot iron into his back bone. A mustard plaster gave speedy relief, and after the attack was over he got up and walked about the ward. An hour later the pain returned, but was relieved in ten or fifteen minutes by a reapplication of the mustard. He appeared to be sick at stomach and tried to vomit; he declined food but had no thirst. His strength appeared good, but after the attack he fell into a profuse perspiration and slept an hour or two. At 10 A. M. the pain returned with such increased severity that he cried out in anguish; it also lasted longer. At 11 A. M., on raising him up in bed for the application of cups, he was seized with a fourth paroxysm, and exclaiming "Oh! such pain!" fell over on the shoulder of an attendant and immediately became unconscious as if in syncope, his face deathly pale, eyes fixed, muscular system relaxed, radial pulse fluttering and breathing interrupted by long intervals. In a few minutes the pallor of the face and lips gave place to the lividity of asphyxia; the eyes were open, fixed and glassy, the left pupil contracted, the right dilated; the muscles completely relaxed and the pulse imperceptible at the wrist. He took afterwards only three or four long sighing inspirations, with long intervals between them, although ammonia was applied to the nostrils and Marshall Hall's method of artificial respiration was faithfully tried. He died at 11.30 A. M. There was no thirst or any unnatural warmth of skin during the five and a half hours his sickness lasted; nor were petechial or any other kind of spots visible on the surface. Post-mortem examination: On removing the skull-cap four ounces of blood and serum escaped; the veins and sinuses of the brain were congested with fluid blood; there was a moderate quantity of subarachnoid effusion over the hemispheres and the ventricles contained about an ounce of serum. The spinal cord and its membranes appeared healthy. The lungs were intensely congested with venous blood; the pleural cavities contained eight ounces of serum and the pericardial sac two ounces; the valves of the heart were sufficient. All the abdominal viscera were healthy except the kidneys, which were congested of a bright maroon color; the urine obtained at the autopsy was albuminous. The blood remained fluid everywhere; it was dark in color and flowed freely wherever an incision was made in the body.—Ass't Surg. Geo. A. Mursick, U. S. V., Stanton Hospital, Washington, D. C.

⃰ JOHN A. LIDELL, U. S. V., published this case in an article on Epidemic Cerebro-spinal Meningitis in the American Jour. Med. Sciences, June, 1865.