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After breakfasting heartily, she suddenly screamed, fell back, and expired in five minutes. On opening the pericardium a large quantity of coagulated blood was found interposed between it and the heart, which was adherent at several points to the pericardium, evidently the result of a former attack of pericarditis. The heart was hypertrophied. There was a rent about two inches long in the cellular coat of the posterior wall of the ascending aorta. The longer axis of this rent corresponded to that of the artery just where the pericardium is reflected from the aorta on the pulmonary artery. The external and middle coats of the aorta in this situation were separated from each other for a considerable space by a quantity of coagulated blood, which reached superiorly as high as the junction of the transverse with the descending portion of the arch, and inferiorly as low as the base of the heart. The cellular coat having been slit up anteriorly, there was brought into view a large transverse rent in the internal and middle coats, not coinciding with the opening in the external coat. It was about an inch in extent, and was situated in the anterior wall of the ascending aorta, at the distance of an inch and a half above the heart. There was an atheromatous deposit in the mitral and aortic valves, and also between the internal and middle coats of the aorta and of the large vessels arising from the arch. Dr. Lees remarked, that this unusual form of aneurism had been described by Laennec, and that similar cases had been recorded by his friend Mr. R. W. Smith in the 9th volume of the Dublin Journal of Medical Science.

2. Benign Osteosarcoma of the Hand.-Dr. Fleming exhibited a specimen sent by Dr. Cusack, of a disease of the bones, which has been designated spina ventosa by some, by others, benign osteosarcoma. Of this disease several specimens had been communicated to the Society by the Surgeon-General and by Messrs. O'Ferrall and Adams, of whom the latter had particularly described this affection in his article on abnormal conditions of the hand, published in Todd's Cyclopædia. The subject from whom the present specimen had been taken was a young lady of strumous habit, about twenty years of age, and who had glandular enlargements in the neck. The disease of the bone involved the ring and little finger of the right hand. It commenced nine or ten years ago as a small tumour on the dorsum of one of the phalanges, which slowly increased in size up to twelve months ago, when, after a blow accidentally received by a fall, it enlarged very much and became painful. The pain was not confined to the tumour, but darted up the arm to the axilla. The integuments were not discoloured, and were moveable over the tumour, but all the prominent points on its surface became ulcerated. Amputation was found to be necessary, and was performed by Dr. Cusack at the carpal joint. On cutting into the tumour the structure appeared cartilaginous or fibro-cartilaginous within a very thin shell of bone. A section of the tumour showed a cartilaginous material, enclosed in a bony shell, which was remarkably thin. Mr. Fleming

alluded to the cases of this disease described by Mr. Adams, at the ninth meeting of the present session, held January 22nd.

3. Scirrhus of the Pylorus.-Cancerous Deposition in the Mesentery and Intestines. Dr. Greene presented a very wellmarked specimen of scirrhous pylorus from the body of a man who died in the Whitworth Hospital during the last week. The illness of this patient was described to have commenced nine months previously with anorexia, thirst, acid eructations, and constipation. There was no vomiting or nausea. After some time he began, in addition to the preceding symptoms, to feel pain, but not of a violent character. It was felt over the umbilicus and in the epigastric region, and was sometimes like colic. When admitted into the Whitworth Hospital, he was labouring under intense jaundice. There was a fulness in the epigastrium, but no defined tumour could be detected. There was no vomiting. Dr. Greene, on examining the patient, was induced to ascribe the jaundice to a mechanical obstruction. About ten days before the patient's death, coffee-coloured vomiting came on. A week ago he became delirious, aud died in that state. On opening the body the stomach was observed to be dilated, but was not ulcerated. This coincides with what Andral has remarked, and also with a case communicated to this Society by Mr. O'Ferrall, in which there was coffee-coloured vomiting, but no ulceration of the stomach. The pylorus in the present specimen was very hard, thick, and firm. Its calibre was greatly contracted, the stricture being narrowest towards the stomach. The ascending and transverse colon and head of the pancreas were bound down into a cancerous mass, with which the duodenum also was connected; the cystic and hepatic ducts were both obstructed by the cancerous growth; they were both much dilated above the strictured part. There were cancerous masses in the mesentery, in several parts of the small intestines, and between the rectum and the bladder. The coats of the gall bladder were hypertrophied; its mucous lining was ulcerated in several spots, leaving merely the peritoneal coat to prevent the escape of its contents; there were no calculi in it, nor had there been any pain felt in that situation during life.

4. Uterus softened and relaxed.-Doctor Montgomery presented the uterus of a patient that died in Sir Patrick Dun's Hospital during the last week. He regretted that the history of the case was defective, as the patient had been unable to detail it; but he had learned some particulars of it from Dr. Henry Kennedy, amounting generally to this, that she had been delivered five weeks before her admission into Sir P. Dun's; that after her recovery she had been attacked by sudden and very profuse hæmorrhage from the uterus, after which fever set in, and she was brought to the hospital in the last stage of typhus. The uterus, it would be observed, was not so small as it should have been at that period after parturition; and there was a remarkable relaxation and softening of its tissue, the effect of the hæmorrhage. Within the cavity, the placental mark was larger and more prominent than usual. There was a small tu

mour depending from the Fallopian tube of the right side. The entire of the uterus was very vascular, and the veins greatly enlarged. There had been in this patient a peculiar soreness and tenderness of the entire surface after her delivery; this Dr. Montgomery considers indicative of disease within the uterus. The same symp

tom is observable in another patient now in Sir P. Dun's, a female recently delivered, and in whom there is also an extreme quickness of the pulse.

Twenty-second Meeting, 16th of April, 1842.

MR. CARMICHAEL in the Chair.

1. Stricture of cardiac Extremity of Esophagus.-Scirrhus? -Mr. O'Ferrall presented the recent parts and an illustrative coloured drawing of a case, where the oesophagus was strictured at its cardiac end. The subject was a man sixty-five years of age, who had for a long time laboured under dysphagia, which progressively increased. Mr. O'F. had only seen him in the last week before his death. The patient at that time referred the difficulty in swallowing to a point opposite the cricoid cartilage. He never had oesophageal vomiting. Mr. O'F. pointed out in the specimen, how the muscular tunic of the oesophagus became gradually thicker towards the cardiac extremity; at the seat of the stricture all the tissues appeared amalgamated, and many lymphatic glands, some of which were softening, were enveloped in the diseased part, all together forming a very hard tumour. Internally, the stricture was sharp and welldefined, with many small spots of superficial ulceration at the narrowest part. A longitudinal section displayed the thickening of the coats and the glandular bodies included in the morbid part; the texture of the thickened portion was explored, by carefully dissecting of the mucous coat, when it was perceived that the submucous and muscular coats were hypertrophied, and that the muscular had completely lost its natural appearance; at the point of stricture all the tissues were lost and indistinct; the morbid condition might therefore be described as hypertrophy of the tissues, merging into a carcinomatous state at the stricture. From a horizontal section near the stricture, and either above or below it, a creamy or cerebriform fluid exuded, when the thickened parts were pressed firmly. It was for the Society to consider whether this was a specimen of true cancer

or not.

She was

2. Scrofulous Deposit on the Peritoneum.- Communication between the Uterus and Bladder effected by Ulceration. — Mr. R. W. Smith presented several specimens of disease from the body of a female of about thirty years of age, who, in last August, began to complain of pain in the side, in the region of the liver. treated for hepatitis, but without obtaining relief, and at last died of peritoneal inflammation: she had no jaundice. On examining the body after death, the usual results of peritonitis, both acute and chronic, were observed, and also very extensive disease in the pelvis:

there were tubercles developed to a great extent in the false membranes, particularly on the surface of the liver; in the pelvis, the ravages of disease were very remarkable; the posterior wall of the uterus was ulcerated and sloughy, in some parts quite broken down, but no part of it had the hardness of carcinoma; an opening had been effected by the disease from the uterus into the bladder, through which there was a tubercle projecting; the bladder was in a state of inflammation; the orifice of the right ureter was almost completely obstructed, and that of the left in a less degree; the uterus was enlarged, and was infiltrated with purulent matter, which extended into the Fallopian tubes. The intestines and the mesenteric glands were extensively affected with tubercle and scrofulous matter, in several stages of development; there was no ulceration of any portion of the intestinal canal. It was a question whether this disease of the pelvic viscera was malignant or not. Mr. Smith inclined to the opinion that it was rather scrofulous degeneration of the uterus. had all the characters of struma, except that the lungs were unaffected. He had not observed the Fallopian tubes filled with morbid deposition in cases of cancer of the uterus.

The case

3. Morbus Coxæ; luxation of the Head of the Femur.—Mr. Adams said he had been requested by Mr. Shannon, the surgeon of the South Union, to communicate to the Society a specimen of disease of the hip-joint in which luxation was produced, an occurrence unusual in this affection. Besides the parts concerned he had also sent a cast and a drawing. The subject of this case was sixteen years of age; the head of the femur it would be observed was softened and dislocated on the dorsum of the ilium; the limb was shortened and adducted: abscess and suppuration had ensued, and the patient had sunk under the continuance of hectic. The capsular ligament had been completely destroyed.

4. Acute Gastritis.-Mr. Robert W. Smith said he wished to lay before the Society a specimen which was highly interesting in a medico-legal point of view. The subject was a female, æt. 20, who had been admitted into the Hardwick Hospital, in the last stage of peritoneal inflammation; she had been a prostitute, and had given birth to a child about a week before her admission; soon after parturition she was attacked with symptoms of gastritis and peritonitis, which proved fatal within 24 hours after her admission into the hospital. The child had been found dead, concealed under the floor of the room in which the mother had been delivered. Upon examination of the body, the anatomical characters of acute peritonitis were found, lymph had been copiously effused; the stomach was in a state of most intense inflammation: in some places the mucous membrane presented patches of the brightest scarlet, the vessels being distinct and arranged in an arborescent form; in others the membrane was perfectly black, as in case of poisoning by sulphuric acid, but there was no abrasion either in the oesophagus or stomach the most careful chemical analysis (in conducting which, Mr. Smith had the valuable

assistance of Professor Apjohn) failed to detect the presence of any poison. (Museum, Richmond Hospital.)

Twenty-third Meeting, 23rd of April, 1842.

Dr. MONTGOMERY in the Chair.

1. Caries of the Vertebra.-Doctor Lees produced recent specimens illustrative of the pathology of this disease. The first case occurred under his care in the Hospital of the South Union. The subject was a child aged five years, which was brought under his notice for the first time about six months ago, in consequence of having been observed to stand crooked or bent towards one side. On careful examination of the spine a slight projection was discovered at the lower part of the cervical vertebræ. An issue was inserted in the neck, and the usual remedies directed. However the child's health gradually declined, the pulse became greatly accelerated, and during the last week it died, labouring under diarrhoea and lobular pneumonia. It had always complained of pain in the front of the chest, but never of any in the back. There was paralysis of motion of the upper and lower extremities without rigidity of the muscles. The fæces and urine were discharged involuntarily. The body was inspected after death; the bodies of the five upper dorsal vertebræ were completely carious and the intervertebral substance destroyed; the sixth and seventh were quite black and rough; the body of the ninth was very vascular; the intervertebral substance between the seventh and eighth was quite sound. The theca of the medulla spinalis was quite thickened, and very vascular; the medulla itself was quite yellow and softened. It was remarkable that in this case no abscess had been formed, though so many vertebræ were engaged. There was no deposition in the diseased vertebræ, and no tubercles in any of the vis

cera.

The next specimen Dr. Lees had to present was sent to him by his colleague Mr. Shannon. The subject was a man of strumous habit, who had died of phthisis; he was also paralysed; his lungs were found to be loaded with tubercles; the three last of the dorsal and the first of the lumbar vertebræ were diseased; there was a cheesy deposition in the substance of the bone and also between the ligaments and bodies of the vertebræ; the spine in this situation was bent to a considerable angle, and the canal was enlarged at the angle of the curvature. This was a good specimen of the scrofulous form

of the disease.

2. Carcinoma of axillary Glands and Mamma.-Scirrhus of the Head of the Pancreas and Ovaria.-Mr. R. W. Smith said he had to lay before the Society several specimens of carcinomatous disease, taken from a woman thirty years of age. She had first observed a swelling of the glands of the axilla, and this had existed twelve months before she was seen by Mr. S. The disease commencing in the axilla indicates, he observed, a more inveterate affection than when it makes its first appearance in the mammary gland.

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