11 vomited a large quantity of coffee ground matter, and died in about 12 or 15 hours from the commencement of the attack. The next morning her body was examined in the presence of several highly respectable and experienced physicians, who all coincided in the opinion, that the matter vomited and which continued to be discharged from the nose, was identical with that discharged in yellow fever. The stomach as well as the intestines were found to contain a large quantity of a similar substance. The cavity of the peritoneum being likewise found filled with a large portion of it, we at first suspected the existence of an opening in the intestines, by which an effusion had taken place. After a careful and minute examination, however, no such opening was discovered. Our attention was now directed to the condition of the peritoneum itself, which was highly inflamed. It was, moreover, found, that the substance in question exuded from its surface,--the membrane, in many places, especially the portion of it which covers the liver, being coated so thickly with the grounds, that they could readily be scraped off with the back of a scalpel. These cases show conclusively, that the matter of the black vomit, occurring in yellow fever, should not be regarded as altered bile; and that the supposition of its consisting of a secretion of the mucous membrane of the stomach, does not rest on a much more solid foundation. For bile can hardly be admitted to exude from the skin and serous membranes, and we cannot suppose, that fluids, similar in every respect, can be secreted from two surfaces, so very distinct in their organization, and in the nature of their ordinary products, as those of the mucous and serous membranes. From these facts I am led to regard the black vomit as a true haemorrhage, resulting from a state of previous irritation of the surface which furnishes it. That inflammation may be cause of it, we have a sufficient proof in the fact, that a similar fluid is occasionally vomited in cases of puerperal fever, when the irritation progresses from the serous to the mucous membrane of the intestines; as well as in cases of inflammation from blows on the stomach, and the action of poisons. A case of this kind, arising from a kick of a horse, was attended by myself and two respectable physicians in consultation, a few years ago; and another case arising from a large dose of carbonate of potassa, swallowed by mistake, occurred in my practice not long since. But as it would occupy too much time to give them here in detail, I pass them by without further notice.