[Undoubtedly this case had advanced to the seventh day when the
description began.]

"In general the severity of the clinical picture had increased,
especially some of the individual symptoms: Severe, markedly febrile
general condition; pulse 120 to 136, moderately full, regular."

[Drugs and food caused the increase in the severity of the symptoms,
for if the increase in pulse and temperature had been due to toxic
infection, there would have been no amelioration of these symptoms,
which we find takes place later.]

"There was insomnia with occasional opium slumber; otherwise the
mind was clear but anxious. The tongue was thickly coated, the lips
were dry, there was tormenting thirst."

[Ice and opium were getting in their work, increasing the
nervousness and of course the fever.]

"The cheeks were red. The patient maintained the dorsal decubitus
with feebly flexed legs and hushed voice; the hands moved but
slightly and trembled."

[Narcotism.]

"Occasionally there were spontaneous attacks of severe, tearing,
abdominal pain, starting posteriorly in the lower right side."

[Why not? Food was being given, stimulating peristalsis.]