CASE XI.
GEORGE ENGLISH, æt. 25. For symptoms see page 141.
_Abdomen._ Numerous ragged ulcers in the cæcum, which, having destroyed
the mucous, had laid the muscular coat quite bare; both the muscular and
the peritoneal coats were blackened and in the first stage of
sphacelation; an aperture of about the size of a sixpence had been
formed in them through which a considerable quantity of fæces had
escaped into the peritoneal cavity; in different portions of the mucous
membrane of the other intestines there were slight patches of
inflammation; omentum much thickened, adhering anteriorly to the
abdominal peritoneum and posteriorly to the intestines; the latter were
so agglutinated together, that it was impossible to trace their
convolutions; the peritoneal sac contained four pints and a half of
serum mixed with pus; the peritoneal coat of the liver adhered to the
diaphragm all around, except at one point where a sac was formed which
was filled with serum; substance of liver healthy; other viscera
healthy. _Head._ Dura mater vascular; pia mater highly vascular;
arachnoid healthy; more fluid than natural between the membranes and in
the ventricles; substance of the brain pretty healthy. _Thorax._ [Right
pleura vascular; superior and middle lobes of right lung contained
numerous miliary tubercles; lower lobe, one or two in the first stage of
suppuration; the under surface of this lobe adhered to the diaphragm
with great firmness, shewing that the disease of the abdomen had
extended to the thorax; pleuræ of left side contained two ounces of
bloody serum; substance of left lung healthy; pericardium contained
three ounces and a half of serum; left ventricle of heart full
three-fourths of an inch thick.]
CASE LXXXVI.
WILLIAM BAKER, æt. 26. Admitted on 15th day of fever: no account to be
obtained of previous symptoms: too insensible to give any statement that
can be depended on of his present feelings; points to lower part of
chest and epigastrium as the chief seat of pain; abdomen tender on
pressure; some cough; voice hoarse, husky, and feeble; no pain of head;
pupils contracted; pulse 100, sharp.
16th. Six stools, two passed in bed; hiccup; frequent cough; respiration
laborious; pulse 84.
20th. No perceptible change until to-day, when the stools, six in
number, became mixed with blood; the expectoration is also tinged with
blood; respiration more hurried and difficult; hiccup continues; pulse
120.
23d. Five stools in bed; hiccup gone; no sleep; great restlessness;
pulse the same. Died next morning.
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