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 throat has nearly resumed its normal appearance, and a vigorous appetite appears to herald a steady convalescence, there is still a necessity for great watchfulness. In severe cases, as I have before remarked, a long-continued exhaustion of the vital powers not unfrequently shows itself, which will tax all our resources, and which in some instances terminates unexpectedly in fatal syncope. A very distressing instance of this mode of death recently fell under my own observation. In this case I did not witness the early stages of the disease, but according to the report of the surgeon in attendance, the diphtheritic symptoms had entirely subsided, and nothing seemed to interfere with recovery, until rapid sinking suddenly ensued. It is well to bear in mind the possibility of such untoward occurrences, under circumstances apparently encouraging. It will save us the pain of giving too favorable a prognosis to the friends of the patient, as well as of allowing ourselves to be too soon lulled into a security which may prove to be fallacious.

Any observations on Diphtheria or other epidemic disease, would be imperfect without a due consideration of those circumstances which experience teaches us may be preventive of its outbreak and extension. Although, as I have before stated, I cannot subscribe to the opinion that the disease has more than an incidental connexion with bad drainage, impure air, and insufficient food, I should strongly urge the importance of abating these prejudicial conditions, as predisposing those exposed to them to this as to other zymotic invasions, by reducing