_Abdomen._ Mucous membrane of pyloric end of stomach and of intestines
in general vascular; that of jejunum and ilium very nearly black,
presenting the appearance of extensive ecchymosis; ilium contained an
infinity of elongated ulcers, many of which had penetrated the muscular
coat; the cæcum and the lower part of the colon in a similar condition;
there was no deposition of adventitious matter; but the ulcers were
formed entirely in the coats of the intestine; other viscera healthy.
_Thorax._ Mucous membrane of both bronchi inflamed; bronchial tubes full
of mucus; mucous membrane of larynx perfectly healthy, and without the
least thickening in any part; [apex of left lung adherent to costal
pleura; adhering part of the substance of the lung contained a mass of
tubercles, some of which were passing into the state of suppuration; the
remainder of the lung more vascular than natural, and some parts of it
hepatized; right lung less consolidated, but still more firm and
vascular than natural.] _Head._ Brain and its membranes tolerably
healthy.
CASE LXXIX.
THOMAS BRYAN, æt. 18, labourer. Admitted on the 8th day of fever: at
present pain of abdomen, much increased on pressure; tongue white and
moist; much thirst; bowels loose; pain in right side on full
inspiration; some cough; pain of head and back, which had been severe,
gone; pulse 90.
9th. A few hours after the visit, the pain in the side became
exceedingly severe and was attended with frequent cough. On account of
these symptoms he was bled to the extent of twenty-four ounces, with
immediate and great relief: the pectoral symptoms have not returned;
abdomen still tender; five stools, dark; no pain of head, but the skin
over the scalp is hot, and there is some intolerance of light; pulse
112. Takes a grain and half of calomel, with two of Dover’s powder,
every six hours.
10th. Pain of abdomen continues; vomiting; two stools; pulse 116.
13th. Gums already affected; throat sore; none of the symptoms relieved;
tongue has become brown and dry; five stools; less sensible; much
moaning; pulse 120.
14th. Abdominal symptoms undiminished; five stools; more insensible;
pulse 112.
16th. Insensibility increased to coma; little change in the other
symptoms.
20th. Severe pain in the abdomen, particularly in the region of the
cæcum; tongue brown and dry and quite hard; four stools; pulse 118.
23d. Vomits food and medicine; coma continues; delirium; pulse 118.
24th. No change, excepting that the vomiting ceased, after having taken
a scruple of calomel at a single dose.
26th. Died.
_Abdomen._ Ilium and cæcum much and extensively ulcerated; other viscera
healthy. _Head._ Membrane of brain natural; substance vascular; more
serum than natural in the ventricles; some at the base; much fluid in
the theca vertebralis. _Thorax._ Posterior part of left lung
tuberculated, and infiltrated with purulent matter; upper part of right
lung still more tuberculated and condensed.
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