e. The patient raises
his head in bed, gradually adding one pillow after another, till he
can rarely, in some cases never, lie down without danger of
suffocation; he inclines his head and breast forward, and supports
himself upon an attendant, or a bench placed before him. A few hours
before death the muscular power is no longer capable of maintaining
him in that posture, and he sinks backward. The dyspnoea is attended
with cough, sometimes through the whole of the disease, sometimes only
at intervals. The cough varies in frequency. It is always strong, and
commonly attended with copious expectoration of thick mucus, which, as
the disease advances, becomes brown coloured, and often tinged with
blood; a short time before death it frequently consists entirely of
black blood.

The changes in the phoenomena of the circulation are very remarkable.
The sanguiferous system is increased in capacity; the veins,
especially, are swelled with blood; the countenance is high coloured,
except in fits of dyspnoea, when it becomes livid; and it is very
frequently puffed, or turgid. The brightness of the eyes, dizziness,
which is a common, and head-ache, which is a frequent symptom, and in
some cases very distressing, are probably connected with these
changes. The motions of the heart, as has already been stated, are
inordinate, irregular, and tumultuous. The pulse presents many
peculiarities. In some cases, probably where there is no obstruction
in the orifices of the heart, it remains tolerably regular, and is
either hard, full, quick, vibrating and variable, or soft, slow,
compressible and variable. Most commonly, perhaps always, when the
orifices of the heart are obstructed, it is vibrating, very irregular,
very intermittent, sometimes contracted and almost imperceptible, very
variable, often disagreeing with the pulsations of the heart, and
sometimes differing in one of the wrists from the other.

The functions of the brain suffer much disturbance. Melancholy, and a
disposition for reverie, attend the early stages of the complaint; and
there is sometimes an uncommon irritability of mind. The dreams become
frightful, and are interrupted by sudden starting up in terror.
Strange illusions present themselves. The mental faculties are
impaired. The termination of the disease is attended with slight
delirium; sometimes with phrenzy, and with hemiplegia.

The abdominal viscera are locally, as well as generally, affected.
Although the d