was variable and bowels irregular. He gradually grew worse till time of admission. He was then restless, talkative and maniacal, pressed his hand to his head as if in pain. At times he was quiet, would not reply to questions or manifest any consciousness, then had periods of restlessness and incoherence, with spasmodic twitchings of muscles of face and upper extremities. He became more maniacal, threw himself about, attempted to injure himself, refused food, tongue became dry, secretions offensive, evacuations involuntary. He failed rapidly and died in two weeks.

Autopsy-Head.-Dura mater thickened and adherent to frontal and left parietal bones by strong fibrous bands. Some sub-arachnoid effusion. All the vessels were much enlarged and membranes congested. Convolutions of the cerebrum were softened in many places. Some were rust and others violet colored. The cerebellum was of a soft and creamy consistence. Left lateral sinus was filled with a firm, fibrinous clot, some two inches in length. A microscopic examination of the clot presented a laminated appearance, formed by the layers concentrically arranged. The exterior of the clot next the dura mater showed indications of fatty degeneracy. There were also numerous connective tissue elements scattered through the clot where it adhered to membranes of the sinus. Weight of encephalon forty-one ounces.

Thorax.-Whole surface of right lung adherent to pleura. Heart, normal. Abdomen, all the organs were in a normal condition.

Man, age nineteen; good habits. Had epilepsy for nine years prior to admission. Nothing further was known of his history. His mind was feeble; he did not converse or manifest any interest in his condition or surroundings. He con

tinued to have frequent and severe seizures, lost control of the movements of his bowels and bladder, and retained his bed most of the time. After eighteen months he died in a fit.

Autopsy-Head.-Dura mater thickened. Several bony plates were found on inner surface of the membrane, two of which had sharp projections. They were situated near the longitudinal sinus, one on either side. The largest was one and one-quarter inches in length, and one-half inch in width. The longest projection was about three-sixteenths of inch, and impinged on the pia mater, but had not lacerated it. The interior surface of all the plates was roughened and ridged. They were held in position by fibrous bands attached to the dura mater. The pia mater was much engorged, and the vessels were enlarged. Anteriorly there were points of extravasated blood beneath the membranes.

Thorax.-There were several cicatrices, a small abscess, and tuberculous deposits in apex of left lung. Right lung normal, heart enlarged, soft and fatty; abdomen, liver normal, kidneys congested and filled with blood. A large amount of bloody serum escaped from spinal canal, and the whole substance of cord deeply congested.

Man, aged twenty-five, intemperate in his habits. Father and mother had for years kept a low drinking saloon and house of ill-fame, and both had served sentences in state prison as receivers of stolen goods. After their release, the husband obtained a divorce from his wife and lived with another woman, to whom he claimed to be married. With her he resumed his former occupation. The place was well known to the police as a resort of criminals and abandoned characters. The patient had received a common education, and been employed as clerk in various offices, and on the canal. From

his own statement he had led a dissolute life, and had contracted venereal disease, which his condition, on admission, verified. His health having failed, he came home, boarded with his father, and engaged in the insurance business, but without success. He continued his evil associations, and gave himself up largely to drinking and dissipation. During this time he often threatened the life of his father and stepmother, secluded himself in his room, and shortly before admission had symptoms of fever, was described as delirious, out of bed and around the house with only his underclothes on, drank freely of liquor, became abusive, threatening and violent. The police were called in at times to quell the disturbances. One day a boarder in the house hearing a noise in the room occupied by patient, went up stairs and found him seated at the head, with a pistol in his hand. The patient discharged it at him, and the bullet passed through the right forearm. The injured man retired and soon after heard three pistol shots fired in quick succession. The police, summoned by the noise, went into the patient's room and found the stepmother lying dead on the floor. A ball had penetrated the chest, passed through the right lung, removed a portion of the wall of the aorta and lodged in the left lung. The patient was seated upon the side of the bed reloading the pistol. He was removed to the jail, and on the inquest gave a contradictory, confused statement of the affair; said, "the woman was trying to get into the room to kill me; I cocked the pistol when I saw she was going to kill me; I shot the bullet and it went plumb through her heart." He also made other statements giving a different version of the affair. An investigation was made before the county judge; he was declared insane and sent to the asylum. On admission gave a very long history of

his case, justified the shooting on the ground "that his stepmother had attempted to poison him, and that God had ordered him to send her to hell without a moment's warning;" that he had shot the man "because he had brought him bad water to drink." He was then in flesh; conjuctivae pearly, tongue heavily coated, features sharp and skin pale. He had two sinuses opening into palm of left hand, one between ring and fourth finger of right hand, one on left foot near big toe, and one in same position on right foot. For the first few days he was about the ward, talked incessantly, maintained his assertions as to the killing, and its justification, then became more feeble; was complaining, fault-finding, whining in speech and childish, asked for changes in room, in bed, in diet, ate and slept well, though he asserted he did not. After some two weeks there appeared an extensive swelling of left leg and foot, resembling somewhat phlegmonous erysipelas. The skin was raised in large patches, and blood and serum was effused beneath. There were some ten or more sinuses in region of buttocks discharging a purulent serum. The patient grew more feeble, and was evidently failing. Three days afterward, at about midnight, he had an extensive hemorrhage; when physician reached the bedside the bleeding had ceased. He was pale and cold, complained of chilliness, and teeth were chattering. Under the buttocks was a large pool of blood, and the abdomen was swelled and painful. He seemed perfectly conscious that he was sinking, and died at six o'clock in the morning.

Autopsy-External appearances. Abdomen tympanitic. Left leg much swelled by infiltration of serum and large gangrenous ulcer eight by four inches. Another ulcer extended over arch of left foot toward internal malleolus. A deep sinus.

existed near head of left fibula. On the right were two sinuses, one opening between great and second toes, and another more superficial near ankle joint. On right knee was an inflamed spot two inches in diameter, the skin was elevated by dark colored effusion beneath. A deep sinus opened between thumb and index finger of left hand, and another between ring and little finger of same hand. There was also one corresponding to this on the right hand. The sinuses opening in sacral and gluteal region, some ten in number, were found to communicate with each other, and formed a common abscess. Some of them were filled with thick yellow pus, and others with partly disorganized blood-clots.

Head.-Calvarium thin and soft; slight adhesions between dura mater and arachnoid; small amount of serous effusion under arachnoid; more abundant about medulla and base of brain. Brain tissue pale.

Thorax.-Small quantity of serum in pleuritic cavities. Lower lobe of left lung hepatized. Pericardial sac distended with about three ounces of a greenish fluid.

Heart. Substance pale; right ventricle filled with frothy, watery blood; left ventricle empty; valves normal.

Abdomen.-Whole cavity distended with pus and serum, of a greenish color. Omentum firmly bound to intestines, and these to each other by adhesions. On attempting to remove the omentum, the intestines were torn through. The ileum. was gangrenous near cæcal valve, and other portions of it were deeply congested and softened. Transverse colon highly inflamed; mesentery deeply congested, and the gland much enlarged and filled with cheesy material. Peyers' patches enlarged and ulcerated; pelvic cavity filled with a very offensive yellow pus; pancreas soft and of a yellow color; spleen