57 angles of the mouth drawn up. The back is arched (opisthotonos), and pain is complained of here. The muscles of the legs and arms, as well as those of the neck and back, are stiff. The breath is fetid ; bowels have been opened ; there is no headache. Pulse 120. Muscular pain of a catching nature, but no spasmodic jerking. The muscles of the back were very rigid, and the glutei firmly contracted. Although the muscles of the thighs are hard, the patient can draw up his legs. When he turns on

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... his face his body is like a rigid rod." On the following day the mouth could not be opened as widely as before ; the opisthotonos was very marked, and the belly-wall hard and knotty. The" risus sardonicus " was feebly marked. There was no difficulty in swallowing liquid food. On the 22nd he had passed a comfortable night. The head was more drawn back, but there were no spasms, except a slight stiffening when he was shaken. Constipation had been continuous since admission, and was relieved by enemata. On the 24th the night nurse reported that during the night the boy had had a seizure " like an epileptic fit," in which he bit his tongue. On the nights of Sept. 26th and 27th he did not sleep much, complaining of pain his back. On Oct. 1st the tenseness and fixation of the jaw still continued, but he slept well, and the pain complained of had left him. He was taking his food well. On the 3rd the Abdomen seemed rather harder, and the symptoms altogether retrograde, so bromide of potassium was ordered in doses of half a drachm every six hours. Up to the 9th he bore the bromide well, and said he felt better ; but on the 10th, although the facial muscles were less affected, so that he ,could smile easily, the heart's action was seriously depressed, being slow (44) and irregular, and the pulse very compressible. This drug was therefore discontinued, and carbonate of ammonia and bark were substituted. Under these the pulse gradually improved. By the 16th there was a marked improvement in all his symptoms, although the pulse was still compressible, and from this date there was a rapid recovery. By the end of October the patient could easily walk about, and did not complain of any stiffness, nor could any be detected by manipulation. He still retained the dsus sardonicus, which was at times marked, the features ;being especially distorted when he attempted to smile. Remarks.-It will be seen that chloral was given for two days only, the symptoms becoming worse during its exhibition. The bromide was given at the rate of two drachms a day for seven days, and during this time the symptoms did not abate nearly so quickly as they did subsequently ; but the heart's action was greatly interfered with, and the patient much prostrated. Then, on the substitution of a slight stimulant for the latter drug, the improvement was very rapid.