“During the whole course of the disease, his pulse was rapid, but
his tongue was remarkably soft and florid. He was never delirious.
Latterly, he spit blood once or twice; his lower extremities became
very œdematous, and his back was covered with eschars; but these
dropped off, and the sores suppurated and healed kindly. Two months
before his death, his pains abated considerably. He died without pain,
March 4 1784, which was about two years and nine months from the time
the seton was passed, and a year and four months from the time he
underwent the amputation.
“His body was opened a few hours after his death. The abdominal viscera
appeared to be perfectly sound, and of their natural colour, except the
liver, which had a small steatoma on its convex surface, but was in
other respects healthy. The gall bladder was rather fuller of yellow
bile than it is generally found to be. The left kidney was enlarged,
and on dividing it longitudinally, much red gravel was found in its
pelvis, and the ureter seemed much lessened. The urinary bladder
was contracted, and its coats uncommonly thickened, but no sabulous
concretions were observed in it.
“On each side of the vertebræ lumborum, the lumbar regions were
rendered convex by a large cancerous deposition, which elevated the
psoæ muscles; and when the cellular investitures, which were condensed
into a cyst, were opened, the cancerous matter appeared in a large
quantity, in colour and consistence exactly resembling the fungus of
the hand, and not unlike the substance of the brain. The whole weighed
about five pounds; and when this was removed, the last vertebra of the
back, and the three first of the loins, were found to be in a softened,
eroded, and in some parts a totally dissolved state. There appeared
not the least mark of ichor, sanies, inflammation, or hardness of the
soft parts; nor were the mesenteric glands at all affected. The matter
seemed to have been really a cancerous exudation, and to be formed
chiefly of coagulable lymph. This cancerous mass seemed to possess a
remarkable dissolving power, which was exerted wholly on the bones, and
did not, as usual in cases of this sort, cause any schirrous hardness
of the surrounding soft parts.”
CASE V.
A woman, some time after receiving a blow on the leg, perceived a small
moveable tumor. It was soft, elastic, and seated on the outside of the
leg, about half way betwixt the knee and ankle joint. I made a small
incision through the skin down to the tumor, and dissected it off to
its base. I then dissected the substance off from the facia of the
muscle, and brought the skin together with adhesive plaster. It united
readily, and the patient was cured. The tumor was soft, like brain, of
a greyish colour, and greasy consistence.
DISSERTATION V.
_On the Scrophulous Inflammation._
Public-domain text, read in full here on John Shaqi.
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