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474 Hyperpyrexia is an occasional though rare occurrence in cholera. In such the axillary temperature may rise to 107° F., the rectal temperature perhaps to 109° F. These cases also are almost invariably fatal. Sequelœ.— Cholera is apt to be followed by a variety of more or less important sequelæ, such as anæmia, mental and physical debility, insomnia, pyretic conditions, chronic enterocolitis, nephritis, different forms of pulmonary inflammation, parotitis apt to end in abscess, ulceraticn of the corneæ, bedsores, and gangrene of different parts of the body. Jaundice occurs at times, and is said to be of the gravest import. Pregnant women almost invariably miscarry, the fœtus showing evidences of cholera.

Morbid anatomy and pathology.— Rigor mortis occurs early and persists for a considerable time. Curious movements of the limbs may take place in consequence of post-mortem muscular contractions. On dissection the most characteristic pathological appearances in cholera are those connected with the circulation and with the intestinal tract.

If death have occurred during the algide stage, the surface presents the shrunken and livid appearance already described. On opening the body all the tissues are found to be abnormally dry. The muscles are dark and firm; sometimes one or more of them are discovered to be ruptured— evidently from the violence of the cramps during life. The right side of the heart and systemic veins are full of dark, thick, and imperfectly coagulated blood, which tends to cling to the inner surface of the vessels. Fibrinous clots, extending into the vessels, may be found in the right heart. The lungs are usually anæmic, dry, and shrunken; occasionally they may be congested and œdematous. The pulmonary arteries are distended with blood, the pulmonary veins empty. The liver is generally loaded with blood; the gall-bladder full of bile; the spleen small. Like all the other serous cavities, the peritoneum contains no fluid, its surface being dry and sticky. The outer surface of the bowel has generally a diffuse rosy red. occasionally