On July 6, I first visited Mrs. W. She complained of a severe, dull pain in the hepatic region; pains shooting up behind the left scapula and into the left shoulder; and frontal pain. She had had one slight chill. Her pulse was 110, and full; her temperature 100°; her tongue clad in a dirty, yellowish coat; her bowels constipated; her urine of a reddish hue.
An arterial sedative, an anodyne, and an alterative followed by a saline cathartic gave her such relief that the following day she went about her usual household labors and walked over two miles to do some trading.
On July 8 she applied to my colleague, Dr. Osborne—her symptoms much the same as already recorded. Dr. Osborne's prescription of a vigorous alterative again brought her relief.
On July 14, upon call, I found her suffering from frontal headache and desultory thoracic algias. Her tongue betokened