a child that was said to be in "a fit" and violently convulsed. On arrival, I found that the child had been drowsy and unwell for two days; and that, on being called to rise on the third morning, he could not be roused. There was a peculiar dull, almost bronzed appearance of the skin; deep coma, but frequent convulsive movements and cough. The pupils were dilated and fixed. I did what I could, very blind at the moment as to the exact nature of the case; however, I ordered a hot bath, leeches to the temples, and a purge; but it was of no avail: the coma terminated in death after thirty-six hours. A little urine was passed once in that time, and it was intensely albuminous.

While this child was still alive, another child, a sister, was seized; and this time, seeing the child early, I detected a scarlatinal eruption. The redness lapsed into the bronzed tinge in a very few hours, and the same symptoms of uræmia were manifested, with, I regret to say, the same fatal result.

We now gathered, on inquiry, the fact that scarlet fever had been directly imported into the house; two remaining children suffered from it in a less malignant form, and recovered, but not without subsequent albuminuria.

In 1850 I attended a boy, J. S., at Barnes, seven years old, through a severe attack of scarlet fever. The disease was epidemic at the time in the village. About sixteen days after the disease commenced, symptoms of albuminuria presented themselves, and ended in

dropsy; they seemed to have followed an accidental exposure to a cold damp air. Under treatment the child recovered; and when I ceased attendance, a specimen of urine was tested, and found to be not albuminous.

I heard nothing more of this child until January 21st, of the year 1851, when I was summoned in haste, at 10 P. M. I learned that the child, two days before, had been exposed to cold and wet, and that this exposure had been followed by suppression of urine. A little of the urine last passed had been saved for me, and was found to be albuminous. The symptoms were not alarming until the 21st; but when I arrived they were serious enough. The body was cold; the pulse small the convulsions extreme; the consciousness quite lost. The convulsions were general, involving the muscles of the neck, the face, and the extremities. The pupils were widely dilated and fixed; the breathing was catching and irregular. I at once tied up an arm, and opened a vein freely. The blood at first flowed very feebly, but by-and-bye gave a full stream. It is the fact, that under this depletion the pulse rose and the convulsions ceased. I took not less than sixteen ounces of blood from this little patient without any sign of syncope, and I left him composed and conscious. A purge was afterwards given, and an occasional warm bath. On the 24th the patient sat up, the only noticeable symptom being a slight irregularity of the pulse. On the 1st February there appeared to be no serious mischief remaining; the urine was again passed freely, and was clear of albumen.

On February 24th the child, having, from my last visit on the 1st, been healthy, playing with his fellows merrily, and eating, drinking, and sleeping naturally, was seized, after a hearty meal, with a repetition of his former symptoms, at seven in the evening. I was once more summoned, and regret much that I was induced not again to draw blood from the arm, but to be content with the application of leeches to the temples, and the administration of a scammony purge, with a hot bath. The remedies failed: at one o'clock on the morning of the 25th, the convulsions lapsed into a kind of jactitation, very short and very feeble; and at two o'clock death took the lad.

Twelve hours after the death I made a post mortem examination. There was very slight congestion of the cerebral substance, but no engorgement of the sinuses. The lungs were inflated, and quite healthy. The heart was firmly contracted and healthy: the abdominal organs were all healthy, except the kidneys, which were pale and rather large; but I was surprised, on microscopical examination, to discover that they presented no evidence of degeneration nor of disease of vessel or tubule, sufficient to account for the albuminuria and uræmia on the ground of mechanical obstruction commencing in their structure.

I was called in the summer of 1853 to see two children, a boy and a girl, who were taken with convulsions on going to bed. The one was seven, the other eight years old. I found that they had been near to Kew in their play, one of them having told this to

their mother before becoming seriously ill. Both children were now insensible and violently convulsed their skins were slightly discoloured to a light copper hue all over the surface. The pupils were fixed and dilated. Scarlet fever was present at this time in the neighbourhood; and my mind was perplexed with the doubt whether these children were suffering from uræmia, or from some poison taken by the mouth. After a little time I observed that in one child there was, with the convulsions, a distinct attempt at vomiting. I at once acted on the suggestion supplied, gave a dose of sulphate of zinc, tickled the fauces, and produced in this child free emesis; there were brought up portions of leaves of some plant and small seeds. I turned to the other child, and treated it in the same way with similar results. After the vomiting both children rallied, and next day were well. They recorded plainly enough the cause of their symptoms; they had gathered and eaten the leaves and fruit of the atropa belladonna. I went with them to the place where they had gathered the poison, and saw the plant from which they had eaten.

This case is not irrelevant to the present essay. It indicates the analogy which exists between the symptoms of scarlatinal uræmia and those of poisoning by belladonna, and the possible mistake that may be made in the diagnosis.

I have yet a record of another case where an aged man, suffering from albuminuria, was subjected fre

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quently to attacks of diarrhoea, attacks which were, in truth, compensatory in their natural intentions. During one of these diarrhoeal periods, he had a few repeated doses of grey powder combined with Dover's powder, with the effect of intense and rapid salivation. He recovered from this condition slowly. Twelve months later, having been exposed to wet in superintending the repairs of some house properties, he took what he considered to be a cold, and suffered again from copious diarrhoea. Once more the grey powder and Dover's powder were administered, this time on the prescription of a physician, who, having no cognisance of the condition of the patient's urine, treated him simply for diarrhoea. Once more, but with greater rapidity, the mercurial ptyalism was developed, attended with profound coma and frequent convulsive attacks. On the third evening of the illness of this gentleman, I saw him with his own medical adviser, and passed the night in attendance. The symptoms were unmistakable and most severe; the body was generally warm, and at times hot; the coma was profound and the breathing heavy; the pupils were slightly dilated, and fixed. The effects of the mercury were such that the gums were enlarged throughout the whole of their surface, the lips were swollen, the teeth were loose, and saliva was constantly exuding from the mouth. About every two hours, the scene of deep repose was changed by the occurrence of a violent convulsive paroxysm. The convulsion commenced in the muscles of the face, then extended to those of the neck