DUKE 
 
 HOSPITAL 
 
 LIBRARY 
 
 Greorgia Medical Society 
 Permanent Loan 
 
Digitized by the Internet Archive 
 in 2016 
 
 https://archive.org/details/vademecumofmorbi01mone 
 
A 
 
 VADE-MECUM 
 
 OF 
 
 MORBID ANATOMY, 
 
 MEDICAL AND CHIRURGICAL j 
 
 WITH 
 
 PATHOLOGICAL OBSERVATIONS 
 
 AND 
 
 SYMPTOMS. 
 
 ILLUSTRATED BY UPWARDS OF 
 
 TWO HUNDRED AND FIFTY DRAWINGS. 
 
 LONDON: 
 
 BURGESS AND HILL, GREAT WINDMILL STREET, 
 
 HAYMARKET. 
 
 1830 . 
 
James Bulcock, 
 
 4, Furnivars Inn Court, Holborn. 
 
PREFACE. 
 
 This Vade-mecum is iieither intended nor calcu- 
 lated to supersede any of the standard works on 
 Morbid Anatomy, by which medical science has 
 been enriched during the last thirty years. To fur- 
 nish a concise and faithful transcript of the labours 
 of all the eminent morbid anatomical writers, and 
 to illustrate the productions of his more elaborate 
 predecessors, are objects which the Author has 
 most zealously endeavoured to achieve. He has not, 
 however, confined his task merely to the transcrib- 
 ing and illustrating of what others have seen, and 
 of which others have written ; but he has blended 
 in the work some account of what he has himself 
 observed, during many years of close application 
 to this subject. The work contains. Observations 
 on, with Illustrations of, the Changes of Structure 
 found in the Brain, Thoracic, Abdominal, and Pel- 
 vic Viscera, and of the Organs of Generation in 
 both sexes. It likewise gives the Pathological 
 Symptoms, by which we judge of disease during 
 
 24830 
 
IV 
 
 PREFACE. 
 
 life, and a true Description of the Morbid Changes 
 that are exhibited after death. 
 
 The Sketches are made either from diseased 
 parts in the Author’s Museum, or from recent dis- 
 section ; and it is hoped, the arrangement will 
 render the work convenient, both for occasional 
 reference and regular perusal. 
 
 It has not been deemed necessary to give Cases, 
 nor to introduce all the strange appearances that 
 are occasionally found aft^^d^eath : the Author has 
 preferred a brief Statement of Symptoms and Mor- 
 bid Phenomena in Diseases the most likely to fall 
 under the daily notice of the Practitioner, than to 
 any speculative hypothesis, or rare or doubtful 
 subjects. 
 
 The Author, although his name is not appended 
 to the work, is however happy in having this fa- 
 vourable opportunity of publicly returning his sin- 
 cere thanks for the kindness he has received from 
 his numerous medical friends ; and he cannot con- 
 clude this short Preface without presenting to 
 those who have executed the Sketches, his grateful 
 thanks for the faithfulness and ability with which 
 they are depicted. 
 
 Londoyi, 1830 . 
 
% 
 
 
 V'- 
 
PI . 1 . 
 
 Kg. 2. 
 
EXPLANATION 
 
 OF 
 
 THE PLATES. 
 
 PLATE I. 
 
 This Plate represents simple abrasion of the bones of the 
 
 head, thickening of the pericranium, and mercurial skull. 
 
 Fig. 1. a Thickening and fibro-cartilaginous state of the 
 pericranium. 
 
 h Simple absorption, or erosion of the parietal and 
 frontal bones. 
 
 Fig. 2. Fibro-cartilaginous state of the pericranium. 
 
 a The fibro-cartilaginous matter dipping into, and 
 firmly adhering to the abraded bone. 
 b Outer table of the bone completely destroyed. 
 
 Fig. 3. Spiculse of bone arising from the inner table of 
 the parietal bone. 
 
 4. A portion of mercurial cranium. 
 
 Symp. Dull heavy pain, with soreness of the integuments 
 covering a particular part or parts of the head, ac- 
 companied with a puffiness of the scalp ; pulse small 
 and frequent, tongue moist, and covered with a whitish 
 fur ; sometimes an erysipelatous state of the head 
 and face, sickness, constipation of the bowels, restless 
 nights, coma. ' 
 
 Morbid Anat. The pericranium is generally found thick- 
 ened, and firmly attached to the bones of the head. 
 In some cases it presents quite a cartilaginous texture, 
 
 B 
 
2 
 
 nearly three quarters of an inch in thickness ; when 
 removed from the skull, the bone or bones are found 
 to be very much destroyed by absorption, particularly 
 the outer table, and its texture resembles that of coarse 
 spunge, but very white. 
 
 In such cases you generally find some organic de- 
 rangement within the cranium. 
 
 PLATE II. 
 
 Acute and chronic inflammation of the dura mater are repre- 
 sented in this Plate. 
 
 Fig. 1 . Exhibits at one view acute inflammation and soften- 
 ing of the dura mater, and an enlarged state of 
 the pacchionian glands, situated within the lon- 
 gitudinal sinus. 
 
 a Longitudinal sinus split open. 
 
 b Softening, lesion, and separation of the laminae com- 
 posing the dura mater. 
 
 c Injected and arborescent state of the venous capil- 
 lary vessels of the dura mater. 
 
 Symc. Nausea, thirst, headach ; quick, full, and hard 
 pulse; restlessness, pain, and corded sensation of the 
 head. 
 
 Morbid Anat. The dura mater presents a degree of red- 
 ness more or less intense, and the venous capillary 
 vessels are seen to be dilated and loaded with blood of 
 a vermilion colour. Sometimes lymph is found eft’used 
 on its surface, but more frequently pus, particularly 
 so if an injury has been the exciting cause. 
 
 The dura mater is sometimes found firmly united to 
 the inner table of the cranium, and sometimes to the 
 arachnoid membrane and pia mater. Softening of the 
 dura mater is not a very common aft’ection, although I 
 have met with several cases within the last ten years. 
 
^7r 
 
 PI . 2 
 
3 
 
 Fig. 2. Fibro-cartilaginous state of the cellular tissue be- 
 tween the laminae of the dura mater: 
 
 3. Ossific depositions between the arachnoid and 
 dura mater. 
 
 4. Fungoid tumours arising from the under surface 
 of the dura mater. 
 
 5. Encephaloid tumour arising from the under surface 
 of the tentorium cerebelli. 
 
 Symp. of 2, 3, 4, and 5 are, long and continued headach, 
 accompanied, at times, with the ordinary symptoms of 
 epilepsy or apoplexy. 
 
 Morbid Anat. Deposition of ossific matter is frequently 
 found between the arachnoid membrane and dura 
 mater ; the patches of bone are generally small, scaly, 
 and irregular in their shape ; the falx cerebri and 
 tentorium have been found completely ossified. 
 
 Fungoid tumours are pulpy to the touch, and of a 
 fibrous texture. In some points they become softened, 
 and broken down, with blood effused into their sub- 
 stance. 
 
 The dura mater is also subject to ulceration, and 
 some say gangrene. Scrofulous tumours are found 
 adhering, and sometimes passing through the texture 
 of this membrane ; also small indurated fleshy tumours, 
 of the size of peas, are met with. 
 
 PLATE III. 
 
 ' Represents inflammation of the pia mater, arachnoid mem- 
 brane, and substance of the brain, and also softening of the 
 cortical and medullary substance of the same organ. 
 
 Fig. 1. Shows at one view inflammation of the arachnoid 
 membrane, pia mater, and substance of the brain. 
 a The arachnoid membrane thickened and opaque, 
 and the convolutions of the brain imperfectly seen 
 through it. 
 
 24930 
 
4 
 
 b injected state of the vessels of the pia mater, 
 
 with a deposition of lymph between the convolu- 
 tions of the brain. 
 
 c Bloody points in the substance of the hemisphere. 
 
 Syi\ip. Arachnitis — Headach, sense of constriction over the 
 eyebrows, injected state of the eyes, heat of the scalp, 
 nausea, agitation. 
 
 Pia Alater — Intense throbbing pain in the head, 
 increase of heat, flushing of the face, injected state of 
 the eyes., disturbed functions, want of sleep, delirium. 
 
 Substance of the Brain — Weight and sense of hea- 
 viness in the head, numbness of one or more of the 
 extremities, ringing in the ears, irritability of the retina, 
 deceptive vision, convulsions, paralysis, coma. 
 
 Morbid Anat. Thickening of the arachnoid membrane is 
 generally the consequence of chronic inflammation. It 
 has sometimes acquired the thickness of the pleura, of 
 the pericardium, of the dura mater, and even as thick 
 as the coats of the stomach. 
 
 Inf. of the Pia Mater — The minute capillary ves- 
 sels are much more numerous than in its natural state, 
 are filled with florid blood, and form, by their anasto- 
 mosis, a beautiful network. 
 
 Substance of the Brain — The inflamed portion be- 
 comes of a red colour, although this is seldom very 
 intense ; when cut into, the colour is found to arise 
 from a great many small vessels which are filled with 
 blood. The part which is inflamed has no peculiar 
 hardness, but yields nearly the same sensation to the 
 touch as it would do in a healthy state. 
 
 Fig. 2. Extensive softening of the cortical and medullary 
 substance of the left hemisphere of the brain. 
 
 3. Softening of the medullary matter of the right 
 hemisphere. 
 
 4. Softening of the pons varolii, corpora pyramidalia, 
 olivaria, and medulla oblongata. 
 
 5. Complete destruction of the right hemisphere of 
 the cerebellum by the softening process. 
 

 
Fig. 6. Pulpy state of the cerebral matter within the ser- 
 rated body. 
 
 7. Softening of the corpus olivare. 
 
 Symp. Softening of the brain — Long and severe attacks of 
 headach, occurring at distinct intervals, obscure vision, 
 loss of memory, deafness, rheumatic pains in the limbs, 
 sleepiness, paralysis of some part or parts, coma. 
 
 Morbid Anat. Softening, to a greater or less degree, of the 
 cortical or medullary matter, without any traces of 
 vascularity or perceptible change of colour; the me- 
 dullary portion being of a dull white and homogeneous, 
 whilst the grey substance remains in its natural state, 
 whatever be the de«:ree of softeninof. 
 
 c5 o 
 
 PLATE IV. 
 
 This Plate represents abscess, cyst, ulceration, and scrofulous 
 tubercles. 
 
 Fig. \ . An abscess in the substance of the brain ; it con- 
 tained a small quantity of pus. 
 
 2. A large cyst of a fibro-cellular texture, situated in 
 the medullary substance of the right hemisphere of 
 the brain. 
 
 3. Ulceration of the cortical and medullary substance 
 of the right hemisphere, from long and protracted 
 inflammation of the organ. 
 
 4. Encysted scrofulous tubercles, situated in the 
 substance of the left hemisphere of the cerebrum 
 of an infant who died of tabes mesentericse. The 
 centre of the large tubercle is softened, and pre- 
 sents the curd-like appearance. 
 
 Symp. Violent pains in the head fixed to a particular spot, 
 disturbed sleep, convulsions of the extremities, invo- 
 luntary piercing cries, dejected countenance, accom- 
 panied with a lemon tint of the skin. 
 
G 
 
 Ulceration — Pain and weight in the head, with a 
 sense of tightness, nausea, vomiting, giddiness, twitch- 
 ing, paralysis. 
 
 PLATE V. 
 
 This Plate represents the morbid appearance in Apoplexy, 
 
 Fiff. 1. An extravasation of blood between the dura mater 
 
 O 
 
 and the pia mater, from a rupture of one of the 
 veins. 
 
 a The convolutions of the anterior and lateral part of 
 the right hemisphere, completely covered by a 
 mass of effused blood. 
 
 b Shows the turgescent state of the vessels of the pia 
 mater. 
 
 Fig. 2, An effusion of blood under the pia mater, the 
 patient died of typhus fever (hsemorrhagic brain). 
 
 a The anfractuosities of the brain filled with fluid 
 blood. 
 
 h A large mass of dark blood lying on the centre of 
 the hemisphere. 
 
 (■ Pia mater, dissected and reflected back from the 
 brain. The vessels of the membrane were loaded 
 with blood. 
 
 Fig. 3. Complete destruction of the wall of the left ven- 
 tricle, thalamus, and corpus striatum, by the soften- 
 ing process. 
 
 a An attenuated and softened state of the corpus cal- 
 losum. 
 
 b Corpus striatum. 
 
 c Softening of the crus cerebri and thalamus. The 
 ventricles were filled with blood. 
 
 SvMP. Apoplectic effusion — The pulse is firm and vibrating 
 under the finger; face swollen, and of a brick red 
 colour ; stertorious breathing, with a frothy white fluid 
 issuing from the mouth and nostrils ; paralysis, coma. 
 
► 
 
 PI, 5 , 
 
 Fig 3 . 
 
PL . 6 
 
 Pig. 5. 
 
r 
 
 I 
 
 i 
 
 r 
 
 F 
 
PI. 7 
 
 Tig.l. 
 
7 
 
 Morbid Anat. Between the pia mater and tunica arach- 
 noides there often is to be observed a serous effusion, 
 which in some bodies is colourless, in others turbid, 
 bloody, or even mixed with streaks of coagulable 
 lymph. With respect to the substance of the brain, it 
 is sometimes found unusually firm ; and when cut into, 
 the numerous points of blood show that the divided 
 vessels are enlarged. A considerable quantity of 
 serous fluid is also found in the ventricles. 
 
 For the most part extravasated blood is met with in 
 the cranium ; sometimes between the membranes, some- 
 times in the substance of the brain, and sometimes in 
 the ventricles. 
 
 PLATE VI. 
 
 Fig. 1. A PORTION of apoplectic brain, with a large clot 
 of blood at its base, accompanied with softening of 
 the crura cerebri and cerebelli. 
 
 2. An apoplectic cyst formed in the thalamus, with 
 softening of the corpus striatum. 
 a Curd-like appearance of the softened medullary mat- 
 ter of the thalamus. 
 b Dark brown clots within the cyst. 
 c Softening of the anterior and inferior portions of the 
 corpus striatum. 
 
 Fig. 3. An old apoplectic cyst with a recent coagulum. 
 b The cyst formed by condensed cellular tissue. 
 a The clots of blood or coagula. 
 
 PLATE VII. 
 
 In this Plate tubercles in the substance of the brain, with 
 circumscribed and diffused melenosis, are depicted. 
 
 Fig. 1. An encephaloid tumour, situated in the substance 
 of the right hemisphere of the brain ; it was lobu- 
 
8 
 
 lated, indurated, intersected by bands of cellular 
 tissue, and of a greyish white colour. 
 
 Fig. 2. Cancillated scirrhous tumour, as large as a pigeon’s 
 egg, in the substance of the right hemisphere of the 
 brain. 
 
 3. Scrofulous tumours, situated within the lateral 
 ventricle, and arising from the thalamus and corpus 
 striatum. 
 
 4. Circumscribed melenosis of the cerebral texture. 
 
 5. Diffused melenosis of the substance of the brain. 
 
 Syiaip. Of Tumours within the Cranium — Severe headachs, 
 continued or intermittent, with twitching of one or 
 more of the extremities, pallid countenance, convul- 
 sions, loss of memory, paralysis, epilepsy, coma, hydro- 
 cephalus. 
 
 Moiuud Anat. Scirrhous tubercles and encephaloid tu- 
 mours are found in the form of round irregular masses, 
 varying from the size of a pea to that of a hen’s egg, 
 either of a greyish or reddish colour, and sometimes 
 nodulated on the external surface. The nature of the 
 tumour can be determined only by cutting into it ; the 
 interior is sometimes found softened, and contains some 
 effused blood. The medullary matter surrounding the 
 tumour is generally found softened. 
 
 PLATE VIII. 
 
 Tms Plate represents the encephaloid and scirrhous tumours, 
 also depositions of calcareous and bony matters in the sub- 
 stance of the cerebrum and cerebellum. 
 
 Fig. 1. An encephaloid tumour at the posterior part of 
 the medulla oblongata. Two are softened and 
 have a flocculent appearance ; they are adhering 
 to the pia mater, covering the right lobe of the 
 cerebellum, and receive their vessels from the 
 .same. 
 

T1 . 9 
 
9 
 
 Fig. 2. Section of an indurated enceplialoid tumour, situ- 
 ated on the cortical matter of the left hemisphere 
 of the brain. 
 
 3. An indurated tumour, situated on the crura cerebri 
 and optic nerves. 
 
 4. Appearance of the cancillated scirrhous tumour, 
 taken from the left hemisphere of the brain. 
 
 5. Macerated portion of the above, showing its can- 
 cillated texture when the intervening matter is 
 washed away. 
 
 6. A large calcareous mass taken from the substance 
 of the right hemisphere of the brain of an idiot. 
 
 7. A portion of bone embedded in the substance of 
 the cerebellum. 
 
 PLATE IX. 
 
 Hydatids, cysts, tubercles, and fleshy tumours adhering to 
 the choroid plexus. 
 
 Fig. 1 . Hydatids adhering to the plexus choroides of an 
 infant who died of hydrocephalus. 
 
 2. A large cyst, firmly attached to the plexus of the 
 left ventricle. To the right ventricle were adhering 
 several masses of flesh, somewhat of a fibrous 
 character. 
 
 3. Extensive tuberculated state of the plexus cho- 
 roides. 
 
 Symp. Of Hydatids and Cysts — Dull obscure pain in the 
 head, with a sense of compression, giddiness, tendency 
 to sleep, numbness of the extremities, convulsions. 
 
 Tuberculated state of the P/e.rM5— ^Great emaciation, 
 loss of appetite, vomiting, moaning, ptosis of the upper 
 eyelids, starting in sleep, with a constant inclination 
 to lie down, pallid countenance. 
 
10 
 
 More. Ap. Of Hydrocephalus — On removing the scalp 
 the bones are found to be very thin, and there are 
 frequently broad spots of membrane in them. These 
 appearances are however only to be observed when 
 the disease has been of long continuance. In some 
 cases, where the quantity of water is not great, the 
 substance of the brain appears to be indurated, and 
 in others softened. We frequently find within the 
 cranium the veins, particularly those of the membranes 
 on the surface of the brain and lining of the ventricles, 
 gorged with dark blood ; sometimes considerable ad- 
 hesions and thickening of the membranes and minute 
 and florid vessels upon the pia mater : collections 
 also of a viscid tenacious matter have been disco- 
 vered, in cysts, upon its external surface, and tumours 
 have been found attached to its substance. 
 
 PLATE X. 
 
 Fig. 1 . An extensive deposition of a calcareous matter in 
 the substance of the striated body, and in the 
 thalamus. 
 
 a Chalky concretion embedded in the substance of the 
 thalamus. 
 
 b Irregular and serrated appearance of the earthy 
 matter deposited into and on the surface of the 
 corpus striatum. 
 
 Fig. 2. A deposition of chalky matter in the substance of 
 the quadrigeminal bodies. 
 
 3. A very large hydatid, with a great many smaller 
 ones, situated in the substance of the left hemi- 
 sphere of the cerebrum. 
 
? 1 . 11 
 
 Eg. 5. 
 
 Eg.l. 
 
 Titf 2. 
 
 O 
 
T1 .12 
 
11 
 
 PLATE XI. 
 
 Fracture of the bones of the head and fungus cerebri. 
 
 Fig. 1. Fracture of the skull. 
 
 a Extravasation of blood between the pericranium and 
 bone. 
 
 b Depressed portion of bone. 
 
 Fig. 2. Fungus cerebri, from an injury of the bones of the 
 head. 
 
 3. Fungus cerebri, in consequence of a complete 
 destruction of the bone and membranes of the head 
 from syphilis. 
 
 PLATE XII. 
 
 Fig. 1. Complete destruction of the eye and all its ex- 
 ternal appendages within the socket, by an exten- 
 sive encephaloid tumour. 
 
 a Encephaloid mass removed from the anterior lobes 
 of the brain. 
 
 b External and lobulated appearances of the tumour, 
 as seen when projecting from the socket. 
 
 d Section of the optic nerve compressed and embedded 
 in the substance of the encephaloid mass. 
 
 Fig. 2. Lobulated state of the eye from a deposition of 
 encephaloid matter within the sclerotica ; also a 
 large tumour, situated externally, of the same 
 nature. 
 
 3. The whole cavity of the eye filled up with en- 
 cephaloid matter, but in its centre and on its edges 
 are seen depositions of melenotic matter. 
 
 4. A small encephaloid mass seen arising from the 
 vessels of the retina. 
 
 Symp. Fungus Hcematodes — Diminution of sight, amaurosis, 
 dilatation and immobility of the pupil, deeply seated 
 
12 
 
 and constant pain in the eye, white shining metallic 
 appearance in the fundus of the eye, opacity of lens, 
 eyeball enlarged, deep leaden colour of sclerotica, 
 dilated and varicose state of vessels of the conjunctiva, 
 countenance pallid, bowels torpid, coma. 
 
 Morb. Anat. The eyeball, optic nerve, and in many cases 
 the brain itself, are all involved in the disease. The 
 morbid growth has, in almost every instance, the ap- 
 pearance of medullary matter. It is chiefly composed 
 of an opaque, whitish, homogeneous matter, having the 
 same degree of pulpy softness and tenacity with the 
 brain, mixed with a filamentous substance, resembling 
 the cellular membrane. 
 
 PLATE XIII. 
 
 Sketches of chronic inflammation of the fauces, enlarged, 
 
 indurated, and ulcerated tonsils. 
 
 Fig. 1. Chronic inflammation of the mucous tissue of the 
 palate and fauces. 
 
 2. Enlarged and indurated tonsils. 
 
 3. Extensive ulceration of the tonsils, uvula, and 
 mucous tissue of the fauces. 
 
 Sy.mp. Tickling in the throat, attended with great heat and 
 a peppery taste in the mouth, cough, expectoration of 
 mucus, sometimes blood ; the tonsils are enlarged, and 
 of a dark red colour. The uvula is soft and papulous, 
 as if composed of a clot of blood. The capillary 
 veins are distended, and the soft vascular network 
 spread over the palate gives it the appearance of a 
 well injected tissue of blood vessels. 
 
 Morbid Anat. Cynanche maligna — The fauces are in- 
 flamed, suppurated, and gangrenous; and the trachea 
 and larynx are likewise in a state of inflammation, 
 and lined with a viscid fetid matter. 
 
Piff.l. 
 
 Tl. 13. 
 
Tl, 14. 
 
T1 . lb . 
 
13 
 
 PLATES XIV. XV. 
 
 These Plates represent acute and chronic inflammation of 
 the oesophagus and its effects. 
 
 Plate XIV. 
 
 Fig. 1. Acute inflammation of the mucous tissue of the 
 oesophagus. 
 
 2. Fibrine deposited in the oesophagus; itwas moulded 
 to the calibre of the tube, and slightly adhered to 
 its mucous tissue. 
 
 3. An enlarged state of the mucous glands situated 
 in the oesophagus. 
 
 4. Extensive ulceration of the mucous follicles of the 
 oesophagus. 
 
 Symp. Inflammation of the (Esophagus — Burning sensation 
 on taking food, pain in the neck, particularly so in the 
 side, which is increased on pressure, dryness of the 
 fauces, regurgitation of the food through the nostrils. 
 
 Ulceration — An uneasy sensation in some part of 
 the oesophagus, which is aggravated after eating, or 
 after drinking ardent spirits ; a lancinating or burning 
 sensation in one or more parts of the tube ; slight cough, 
 cardialgia, repeated efforts to clear the throat of a 
 tough dirty-coloured matter. 
 
 Plate XV. 
 
 Fig. 1. Two tumours of a fibro-cartilaginous nature, 
 arising from the mucous tissue of the oesophagus. 
 
 2. A tumour of the encephaloid character, arising 
 from the mucous tissue of the oesophagus. 
 
 3. Stricture of the oesophagus, from chronic inflam- 
 mation of the mucous tissue. 
 
 4. Stricture of the oesophagus, from ulceration of the 
 mucous tissue, produced by the swallowing of 
 sulphuric acid. 
 
14 
 
 Sv!\ip. Stricture of the CEsophagus — Dyspnoea, difficulty in 
 swallowing, nausea, vomiting, eructation, sense of 
 hunger, bowels constipated, dejected and pallid coun- 
 tenance, cramp and spams, both at the seat of stricture 
 and in the stomach. 
 
 Morbid Anat. The mucous membrane is generally found 
 pulpy and red, and its capillary vessels are very dis- 
 tinctly seen loaded with blood ; sometimes it is lined 
 with a false membrane. Ulcers of the oesophagus are 
 generally surrounded with indurated and everted edges ; 
 the erosion sometimes is very deep, sometimes super- 
 ficial. 
 
 PLATE XVI. 
 
 This Plate exhibits the effects of contraction of the chest 
 consequent on pleurisy. 
 
 Fig. 1. Anterior view. 
 
 2. Posterior view. 
 
 PLATE XVII. 
 
 Inflammation and ulceration of the trachea, with deposi- 
 tion of fibrine ; also an enlarged thyroid gland. 
 
 Fig. 1. An extensive inflammation of the mucous tissue of 
 the trachea, with a deposition of fibrine, which is 
 firmly adhering to the inside of the tube. 
 
 2. Fibrine moulded to the shape of the trachea, and 
 bifurcation of the bronchia of an old man who 
 died of laryngitis. 
 
 3. Fibrine expectorated in a severe case of pneumonia. 
 
 4. An enlarged and scirrhous state of the thyroid 
 gland. 
 
n . 1 6 
 

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 \ .-If;;: •:.?*,' 
 
 
 'vr 
 
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 Eg.l 
 
PI . 18 . 
 
 Tig. 2 
 
 
15 
 
 Fig. 5. Section of the thyroid gland, to show its cancillated 
 structure. 
 
 6. Extensive ulceration of the mucous tissue of the 
 larynx and trachea. 
 
 Symp. Croup — Harsh, dry, metallic cough, dyspnoea, shrill 
 voice,^flushed face, veins of the head and neck turgid, 
 and violent action of the muscles of the throat ; asphyxia. 
 
 Trachitis — Heat, pain, soreness in the trachea, dry- 
 ness of the mucous tissue of the windpipe, followed 
 by copious mucal expectoration, cough. 
 
 Bronchocele — At first the swelling is without pain, 
 but as the tumour increases in size it grows hard and 
 irregular, the skin acquires a yellow colour, and the 
 veins of the neck become varicose ; flushing, headach, 
 and lancinating pains in the tumours. 
 
 Ulceration of the Larynx — Fixed pain in the seat 
 of this organ, difficulty of breathing, and the patient 
 can only speak in a whisper. 
 
 More. Anat. In croup there is generally an exudation of 
 lymph, which, becoming concrete at the very moment 
 of its formation, lines the inner surface of the trachea 
 to a greater or less extent. When this false mem- 
 brane is removed, the subjacent tunic is found of a 
 deep, vivid, red colour, occasionally livid and somewhat 
 thickened. 
 
 This colour is commonly uniform over the whole 
 space covered by the false membrane, but is also fre- 
 quently unequal, and occasionally altogether wanting. 
 
 PLATE XVIII. 
 
 This Plate represents the diseases of the bronchial membrane 
 and tubes. 
 
 Fig. 1 . Extensive ulceration of the mucous tissue of the 
 right bronchial tube. 
 
16 
 
 Fig. 2. Dilated bronchia — ramifications, which, in the 
 natural state, would scarcely admit a fine probe, 
 acquire a diameter equal to that of a crow-quill, 
 or a goose-quill, or even of the finger. 
 
 3. A dilated bronchial tube terminating in a cul- 
 de-sac. 
 
 4. Ulceration of the bronchial valve and mucous tis- 
 sue lining the edge of the tube. 
 
 5. Fungoid excrescence arising from the edge of one 
 of the bronchial apertures. 
 
 6. Rupture of the delicate membrane forming the 
 bronchial valve. 
 
 7. A small fleshy excrescence arising from the mucous 
 tissue of the bronchial membrane. 
 
 8. The calibre of the left bronchus and its bifurca- 
 tions diminished from a thickening of the mucous 
 tissue. 
 
 9. A transverse section of the lower end of the trachea, 
 showing its calibre reduced in size from thickening 
 of the mucous membrane. 
 
 10. The calibre of the left bronchus reduced in size 
 by a deposition of a fibro-cartilaginous matter be- 
 tween the laminae of the mucous tissue. 
 
 1 1 . Concretions expectorated from the lungs. 
 
 12. A large chalky concretion expectorated from the 
 pulmonary organ. 
 
 13. Lobulated hydatid taken from the substance of 
 the lungs of a person who died of phthisis. 
 
 Symp. Bronchitis — Dyspnoea, loose, deep, and diffused 
 cough, accompanied with a stuffing noise, copious and 
 loose expectoration, purple, violet, or leaden colour of 
 the lips and cheeks, soft and compressible pulse. 
 
 Dilatation of the Bronchia — Over the seat of the 
 principal dilatations pectoriloquism, more or less per- 
 fect, is perceived, together with a loud mucous rattle, 
 precisely like the cavernous rattle of phthisis. 
 
 More. Anat. The bronchial membrane is generally covered 
 with mucus, and if you wipe that off with a sponge. 
 
17 
 
 you will find the membrane highly injected, and gene- 
 rally of a dark colour, which soon becomes more red 
 on being exposed to the air, when the mucous secretion 
 is removed. The substance of the lung itself is gorged 
 with venous and arterial blood. If you press the end 
 of your finger upon the part most affected, the impres- 
 sion remains. If you slice the lung, and squeeze the 
 divided portions, a mucus or muco-purulent fluid will 
 issue from the cut surfaces, similar to that contained 
 in the bronchial passages. 
 
 Symp. Of Pneumonia — Dyspnoea, accompanied with a weight 
 and sense of oppression in the thoracic cavity, metallic 
 cough, expectoration of a dark yellowish, or yellowish 
 green lymph, which adheres firmly to the sides of the 
 vessel, crepitation in some part or parts of the chest, 
 flushed countenance. 
 
 Morbid Anat. The lung is heavier than in its natural state, 
 and presents on its surface a livid or violet colour, and 
 a degree of firmness much greater. It is, however, still 
 crepitous ; but when pressed between the fingers it is 
 very apparent that it is gorged with a fluid, and that 
 the crepitation is much less than in the healthy state. 
 When cut, its tissue appears of a livid red, and alto- 
 gether filled with a serous fluid, more or less bloody 
 and frothy, which exudes in abundance from the 
 divided surfaces. In the second stage there is no 
 crackling whatever of the lung on its being pressed 
 between the fingers, and it then acquires a degree of 
 firmness and solidity similar to that of the liver. 
 
 In the third stage the pulmonary tissue preserves 
 the same firmness and granular appearance, assumes 
 a pale yellow colour, and pours out, in greater or less 
 abundance, from its divided surfaces, a yellow, opaque, 
 viscid, and evidently puriform matter. 
 
 c 
 
18 
 
 PLATE XIX. 
 
 This Plate represents emphysema and apoplexy of the lungs. 
 
 Fig. 1. General emphysema of the lung. 
 
 2. Dried portion of the same lung. 
 
 3. Diffused apoplexy of the lung. 
 
 4. Circumscribed apoplexy of the lung. 
 
 Symp. Emphysema — Dyspnoea, wheezing inspiration, op- 
 pression and stricture across the chest, cough, mucous 
 expectoration, lassitude, torpor; pulse generally regular, 
 lips violet-coloured, thick, and swollen. 
 
 Apoplexy — Dyspnoea, cough, oppression at the chest, 
 expectoration of a bright and frothy, or black and 
 clotted blood, quite pure, or merely intermixed with 
 saliva, or some bronchial or guttural mucus; pulse fre- 
 quent, full, and vibrating under the finger. 
 
 Morbid Anat. Emphysema — The pulmonary vesicles on 
 the surface of the lungs are distended, their size varies 
 from that of a millet seed to a nut ; the partitions 
 separating them are ruptured, hence the contained air 
 is readily extravasated. The small bronchial ramifica- 
 tions of the affected part are also dilated. 
 
 Apoplexy - — The lung is generally found gorged with 
 dark venous blood ; when sliced, it presents an appear- 
 ance similar to indurated liver, and the minute vessels 
 and bronchial tubes are completely buried in the 
 bloody mass. On the pleura pulmonalis are seen a 
 great many ecchymose spots. Sometimes the blood is 
 found diffused, sometimes circumscribed. 
 
PI . 19 . 
 
 Kg.l. 
 
PI . 2 0 . 
 
 i 
 
 \ 
 
19 
 
 PLATE XX. 
 
 Miliary, indurated, and suppurative tubercles, and vomicae 
 
 of the lungs. 
 
 Fig. 1. A portion of lung loaded with miliary tubercles. 
 
 2. A portion of lung studded with indurated miliary 
 tubercles. 
 
 3. A portion of the. left lung considerably reduced 
 in size, with a large tuberculous excavation in 
 the superior part of it, and other smaller cavities 
 filled with cheese-like matter. 
 
 4. One very large tuberculous excavation, with a 
 fibro-cartilaginous state of the bands crossing it. 
 
 5. Vomicae, with condensation of the intervening 
 tissue of the lung. 
 
 Symp. Incipient Tubercles — Short dry cough, dyspnoea, dull 
 heavy pain at the scrobiculus cordis; fatigued on the 
 slightest motion; venous inactivity around the nasal 
 and ocular portions of the face ; dry skin, with a florid 
 state of the mucous tissue of the lips. 
 
 Suppurative Tubercle — Increased cough, accom- 
 panied with copious expectoration of a muco-purulent 
 matter, suppression of the catamenia, colliquative per- 
 spiration, and diarrhoea ; skin pale, shrivelled, and 
 sometimes dry; intense heat in the soles of the feet 
 and palms of the hand ; nose sharp, cheeks prominent, 
 with a purplish blush ; pearly appearance of the con- 
 junctiva of the eyes ; nails elongated and curved ; 
 tormina. 
 
 Morbid Anat. On the surface and in the substance of 
 the lung are generally found the vesiculated, granular, 
 or indurated cheese-like tubercle ; sometimes all these 
 might be met with in the same lung ; after the vesicu- 
 lated stage is past, they have the appearance of in- 
 durated glands, are of different sizes, and are often 
 found in clusters. Their firmness is usually in pro- 
 portion to their size, and when laid open in this state 
 they are of a white colour, and of a consistence nearly 
 
20 
 
 approaching' to cartilag'e. Although indolent at first, 
 they at length become inflamed, and at last changed 
 into little abscesses or vomicae, which breaking and 
 pouring their contents into the bronchia, give rise to 
 purulent expectoration. 
 
 PLATE XXI. 
 
 Encephaloid, scirrhous, and melenotic state of the lungs, 
 also vomicae. 
 
 Fig. 1 . An extensive vomica, lined with a membrane of a 
 fibro-cartilaginous texture. 
 
 2. A vomica communicating with a dilated bronchial 
 tube. 
 
 3. A fibro-cartilaginous state of the lung, which has 
 destroyed the minute bronchial texture, and pro- 
 duced condensation through compression. 
 
 4. Encephaloid tumours embedded in the parenchy- 
 matous texture of the lung. 
 
 5. An extensive deposition of melenotic matter into 
 the substance of the lung. 
 
 Symp. Dyspnoea, cough, expectoration, with slight oppres- 
 sion at the chest. 
 
 Melenosis of the Lung — Dyspnoea, cough, which is 
 often dry, but sometimes attended by a mucous ex- 
 pectoration, intermixed with some puriform sputa. 
 
 PLATE XXII. 
 
 Hydatids, cysts, bony and chalky concretions in the sub- 
 stance of the lung ; also ossific, calcareous, and scrofulous 
 depositions in and on the surface of the bronchial gland. 
 
 Fig. 1 . Section of a large and an encysted tumour, situated 
 
T1 . . 
 
 Fig, 1 
 
Tig.l , 
 
 PI . 22 . 
 
ng, 1. 
 
 PI . 25 . 
 
 Fig. -i 
 
 Fig. 2. 
 
21 
 
 in the lower portion of the parenchymatous texture 
 of the lung. 
 
 2. Hydatids, situated in the substance of the lung of 
 a youth twelve years old. 
 
 3. A large chalky concretion, embedded in the sub- 
 stance of the lung of an old man who died of 
 phthisis. 
 
 4. Fibro-cartilaginous state of the capsule of an old 
 hydatid, from chronic inflammation. 
 
 5. Bone deposited on the superior and lateral part 
 of a bronchial gland. 
 
 6. Chalky concretion, deposited within the capsule 
 of a bronchial gland. 
 
 7. An enlarged and scrofulous state of a bronchial 
 gland. 
 
 PLATE XXIII. XXIV. 
 
 Represent diseases of the pleura pulmonalis and costalis. 
 
 Plate XXIII. 
 
 Fig. 1. Condensation or compression of the lung by a 
 fluid, in the cavity of the chesty produced by in- 
 flammation of the pleura. 
 
 2. Deposition of ossific matter on the pleura costalis. 
 
 3. Fibro-cartilaginous state of the pleura costalis. 
 
 4. The lung compressed by a tumour of the en- 
 cephaloid character, arising from the pleura cos- 
 talis. 
 
 Symp. Pleuritis — Acute pain in the side or sides, difficulty 
 of breathing, dry cough ; deep inspirations increase the 
 pain and produce a catch in the side ; inability to lie 
 on the side affected. 
 
 Hydr^othorax — Dyspnoea, numbness of one or both 
 arms, sense of suffocation on lying down, frightfid 
 dreams, weight and oppression at the chest, urine high 
 
22 
 
 coloured and scanty, anarsarca of the extremities; the 
 chest sounds dull on percussion, and the respiration is 
 inaudible. 
 
 Morbid Anat. When the pleura is inflamed, it becomes 
 thicker than it is naturally, and in some degree pulpy. 
 There are also interspersed through it a great number 
 of very small vessels containing florid blood, and a 
 layer of coagulable lymph is at the same time formed 
 upon its surface. 
 
 Plate XXIV. 
 
 Fig. 1. Extensive adhesion of the pleura costalis to the 
 pleura pulmonalis by strong cellular bands. 
 
 2. Complete union of the pleura pulmonalis to the 
 pleura costalis. 
 
 3. Small indurated fleshy tubercles arising from the 
 pleura costalis. 
 
 4. Tumours of an albuminous nature arising from 
 the pleura costalis. 
 
 PLATES XXV. XXVI. XXVII. XXVIII. 
 
 Represent the effects of acute and chronic inflammation 
 of the pericardium and substance of the heart. 
 
 Fig. 1 . Pericarditis, with an extensive deposition of lymph 
 on the heart and inner surface of the pericardium. 
 
 2. The surface of the heart firmly fixed to the peri- 
 cardium by strong cellular bands. 
 
 3. Perfect adhesion of the pericardium to the surface 
 of the heart. 
 
 Symp. Acute Pericarditis — Heat and soreness of the integu- 
 ments covering the pericardial region, with acute pain 
 in the anterior mediastinal space, particularly so on 
 taking a deep inspiration ; firm pulse, wiry, and re- 
 
Tag.l. 
 
 PI . 24, 
 
 Tig. 
 
 2 
 
23 
 
 gular, but rendered variable by tbe slightest move- 
 ment of the body. 
 
 Crepitation in the heart’s region : this symptom com- 
 mences with the attack, and subsides in six or ten 
 hours. 
 
 Chronic Pericarditis — ’Dull obscure pain in the 
 cardiac regions, with irregular pulse, palpitation, acute 
 lancinating pains in the chest, sense of tightness, 
 dyspnoea, anxious and pallid countenance, oedema of 
 the lower extremities. 
 
 Morbid Anat. Redness of the membranes, more or less 
 deep, a concrete albuminous exhalation, and a sero- 
 purulent effusion. 
 
 The redness is most generally but slight in the acute 
 disease; when it exists it is for the most part only 
 partially. 
 
 It is commonly punctuated, and looks as if the sur- 
 face of the membrane was covered with little specks 
 of blood, very close to each other. In some cases, 
 wherein, judging by the thickness of the false mem- 
 branes, the inflammation appears to have been very 
 great, no redness whatever can be discovered on the 
 serous membrane on removal of this membranous exu- 
 dation. 
 
 This concrete albuminous exudation commonly in- 
 vests the whole surface of the pericardium, as well on 
 the heart and large vessels as on the sac. It rarely 
 presents the appearance of an equable membranous 
 layer, like the false membranes of pleurisy ; on the 
 contrary, its surface is most frequently marked by a 
 great number of rough and irregular prominences. 
 
 Symp. Tnf. of the Substance of the Heart — Violent palpi- 
 tation and sense of oppression ; at times anxious breath- 
 ing, aggravated by exercise or any bodily motion ; pulse 
 full, sometimes weak and intermittent ; bowels consti- 
 pated, pain in some cases, relieved in others, aggra- 
 vated by the application of heat. 
 
24 
 
 Plate XXVI. 
 
 Fig. ] . Several indurated pearly tubercles arising from the 
 serous membrane of the heart. 
 
 2. Deposition of a cartilaginous matter into the cel- 
 lular tissue, between the laminae of the pericar- 
 dium reflected on the heart. 
 
 3. Ulceration of the reflected portion of pericardium 
 and muscular substance of the heart. 
 
 4. A great many small cysts attached to the pericar- 
 dium ; they contained a small quantity of limpid 
 fluid of a faint straw colour. 
 
 5. Deposition of bony matter betweep the laminae of 
 the pericardium reflected on the heart. 
 
 Sy.aip. of Ulceration — Palpitation, fatigued by the slightest 
 exertion, pulse small but quick, constant weight and 
 sense of burning in the regions of the heart. 
 
 Morbid Anat. Ulceration of the heart is a very rare disease ; 
 I have seen but two cases in twenty years : the subjects 
 were young women, disease asthma. The ulcer was 
 situated in the muscular substance of the ventricle of 
 the heart; it appeared of a dark colour, surrounded 
 by an irregular edge, and bordered with an inflamed 
 areola. One part of the surface of the ulcer had a 
 tough cheese-like matter adhering to it. When first 
 examined, the pericardium contains a quantity of blood- 
 like serum, and very offensive. 
 
 Plate XXVII. 
 
 Fig. 1. Chronic inflammation of the serous membrane 
 1 ining the cavity of the left ventricle, with thicken- 
 ing, and a deposition of cartilaginous matter be- 
 tween its lamime. 
 
 2. Recent effusion of imperfect lymph on the surface 
 of the serous membrane lining the heart (chronic 
 rheumatism). 
 
if 
 
TL 28. 
 
 Tig. 1 
 
 Tig. 5. 
 
25 
 
 3. The cavity of the heart filled with coagulable 
 lymph. 
 
 4. A large abscess situated in the muscular substance 
 of the left ventricle, the effect of acute inffam- 
 mation. 
 
 5. Softening of the muscular fibres of the lower and 
 lateral portion of the right side of the heart. 
 
 6. Softening, attenuation, and rupture of the muscular 
 fibres of the apex of the heart. 
 
 SvMP. Inf. internal Lining — Agonizing pain in the peri- 
 cardial region, dyspnoea, concentration of heat over the 
 site of the organ ; jactitation, with great expression of 
 distress depicted in the countenance ; pulse full, quick, 
 and wiry. 
 
 Softening of the Heart— T>v\\ obscure pain in the 
 region of the heart, pallid countenance, pulse small 
 and soft, and sometimes intermittent; slight exertion 
 at times produces syncope ; the lips are seldom purple, 
 and still more rarely swollen, but on the contrary 
 almost always colourless. 
 
 Polypus — In cases where the heart has been acting 
 regularly, if the pulsations suddenly become anoma- 
 lous, obscure, and confused, so as not to be analyzed, 
 we may suspect the formation of a polypus. If the 
 disordered action exists on one side of the heart only, 
 we may consider the thing as almost certain. 
 
 Morbid Anat. Of Softening — The muscular fibres are soft, 
 and easily torn ; sometimes the softening takes place 
 only on one side of the organ. It is of a dark red or 
 brown colour in the acute stage, pale and yellowish in 
 the chronic. 
 
 Plate XXVIII. 
 
 Fig. 1. Deposition of an earthy matter in the muscular 
 substance of the heart. 
 
 2. A fibro-cartilaginous state of the wall of the left 
 cavity of the heart. 
 
 3. An encephaloid tumour arising from the muscular 
 substance of the left ventricle. 
 
26 
 
 PLATE XXIX. 
 
 Cartilaginous and bony deposition on the valves of the 
 
 heart. 
 
 Fig. 1 . An extensive dilatation of the foramen ovale. 
 
 2. A mulberry-like tumour, the size of a pigeon’s 
 egg, firmly attached to the inner surface of the 
 auricle. 
 
 3. An opening in the septum ventriculorum. 
 
 4. Cartilaginous state of the corpora sesamoidea, and 
 a reticulated state of the semilunar valves. 
 
 a b Reticulated portions. 
 
 Fig. 6. The superior margins of the semilunar valves 
 completely encased in bone. 
 
 6. A deposition of cartilaginous matter between the 
 layers of the serous membrane forming the mitral 
 valve. 
 
 7. Ossific and cartilaginous deposition in the sub- 
 stance of the tricuspid valve. 
 
 Symp. Blue or violet colour of the skin and mucous tissue 
 of the body, dyspnoea, palpitation of the heart, syn- 
 cope. 
 
 Ossif. of Semilunar Valves — Dyspnoea, aggravated 
 on motion, palpitation, intermittent pulse, face gene- 
 rally violet or brick-red colour. 
 
 Ossif. of Mitral and Tricuspid Valves — Dyspnoea, 
 inoreased on the slightest motion, irregular action of 
 the heart at its pericardial region, while the pulse at 
 the wrist is small and feeble ; purplish hue of counte- 
 nance. 
 
 Morbid Anat. Tumours situated in the auricles generally 
 have a proper capsule, besides the envelope they re- 
 ceive from the serous lining of the heart. The proper 
 capsule is smooth externally, but internally it has more 
 the character of loose cellular tissue, and apparently 
 enters into the composition of the tumour. The sub- 
 
PI . 29 . 
 
 Tig . 5 . 
 
 I 
 
PI. 30. 
 
 
27 
 
 stance of the tumour is composed of fibrine, partially- 
 organized, and intersected with patches of coagulated 
 blood, of a purplish red colour ; sometimes there is a 
 matter in its substance similar to the earthy-like mat- 
 ter formed on the external surface of the aorta. 
 
 PLATE XXX. 
 
 Deposition of calcareous and bony matter, and ulceration 
 and tumours on the serous surface of the aorta. 
 
 Fig. 1. Deposition of ossific and cartilaginous matter on 
 the thoracic aorta. 
 
 2. Chronic inflammation of the serous tunic of the 
 thoracic aorta, with a deposition of a cheesy or 
 earthy-like matter. 
 
 3. Ulceration of the serous and muscular tunics of 
 the thoracic aorta. 
 
 4. Several tumours of an indurated fleshy structure, 
 arising from the serous membrane of the abdominal 
 aorta. 
 
 Symp. Inf. of the Serous Memh. of the Aorte— Strong pulsa- 
 tion in the heart’s region, coming on suddenly, dyspnoea, 
 great anxiety, sighing, pulse strong and full, face florid, 
 jactitation. 
 
 Chronic — Sense of weight in the pericardial region, 
 anxiety, and depressed countenance ; dyspnoea, bron- 
 chitis, pulse slow and weak, disposition to syncope on 
 motion. 
 
28 
 
 PLATES XXXI. XXXII. XXXIII. XXXIV. 
 XXXV. XXXVI. 
 
 These plates represent the effects of acute and chronic 
 inflammation of the serous and mucous membrane of the 
 stomach ; xxxv. contains a tuberculated state of the spleen, 
 with a bony and cartilaginous deposition on its capsule. 
 
 Plate XXXI. 
 
 Fig. 1 . This patch represents the vessels in congestion ; 
 the larger vessels are distended to their utmost 
 extent, and the capillary vessels are empty. 
 
 2. This figure represents the arborescent state of 
 vessels in acute inflammation of the serous tunic 
 of the stomach. 
 
 3. Appearance of the capillary vessels in chronic 
 inflammation ; they are enlarged, tortuous, and 
 filled with blood. 
 
 4. Tubercles arising from the serous tunic of the 
 stomach. 
 
 5. Melenotic state of the serous membrane of the 
 stomach. 
 
 SvMP. Ser 0 -Gastritis — Pain in the region of the stomach, 
 anxious and hurried breathing, hot skin, pulse quick 
 and small, tongue covered by a whitish fur, nausea, 
 sometimes actual vomiting. 
 
 Chronic — More or less pain at the scrobiculus cordis, 
 aggravated on pressure and accompanied by a sense 
 of distension and confinement after any food has been 
 taken, emaciation, a yellow, clay-like appearance of 
 the skin, tongue broad and soft, pale tip and edges, 
 and covered with a whitish fur. 
 
 Morbid Anat. The serous membranes of all the organs in 
 acute inflammation, present an arborescent state of the 
 minute serous vessels ; there is also an infiltration of 
 
r 
 

 1 
 
 52 . 
 
29 
 
 lymph between its laminae, and a lai’ger quantity of 
 blood allowed to circulate through the larger capillary 
 vessels ; it also becomes thickened, softer, and less 
 transparent. 
 
 Chronic — The veins are observed to be enlarged, 
 and their capillary vessels dilated and loaded with a 
 red-coloured blood. 
 
 Plate XXXII. 
 
 Fig. 1. A deposition of lymph on the mucous surface of 
 the stomach in acute gastritis. 
 a Lymph firmly adhering to the villi of the stomach. 
 h Lymph removed, shewing a red and pulpy surface. 
 
 Fig. 2. Minute ulceration of the mucous follicles of the 
 stomach. 
 
 a a The ulcerated points. 
 
 Fig. 3. Melenotic state of the mucous tissue of the sto- 
 mach ; those parts unoccupied by the black matter 
 are white and corrugated, and the stomach was 
 very much attenuated. 
 
 Symp. Acute Muco-Gastritis — Nausea, vomiting ; full, hard, 
 and quick, sometimes small and contracted pulse ; 
 tongue white, with red tip and edges ; concentration of 
 heat about the scrobiculus cordis, great prostration 
 of strength, pain increased on pressure, desire for cold 
 fluids. 
 
 Chronic Muco-Gastritis — Sense of heat and pain 
 in the stomach after eating, nausea, constipation of 
 bowels, cardialgia with acid eructation, dejected coun- 
 tenance, dyspnoea, cough, palpitation, emaciation, 
 oedema of the lower extremities, tongue covered with 
 a white varnish and red tip and edges, skin cold and 
 harsh to the touch. 
 
 Morbid Anat. The mucous membrane of the stomach is 
 sometimes studded with red dots, or covered by patches 
 arising from the effusion of blood into the substance of 
 the membrane itself ; at other times a uniform redness 
 
is diffused over its whole extent, being particularly 
 conspicuous, and of a deeper shade, around the cardia 
 and pylorus. 
 
 Plate XXXIII. 
 
 Fig. 1. Thickened and pulpy state of the mucous mem- 
 brane, with a deposition of lymph between it and 
 the muscular fibres of the stomach. 
 
 2. An attenuated state of stomach, from long and 
 protracted inflammation. 
 
 3. An attenuated state of stomach, with the solution 
 of its mucous and muscular parietes. 
 
 Symp. Nausea, vomiting after meals, pain in the region of 
 the stomach, increased on pressure, cardialgia, prostra- 
 tion of strength, pulse small and quick, tongue red tip 
 and edges, skin dry and husky. 
 
 Morbid Anat. The mucous coat softened, varies in colour 
 from white, or grey, to the deepest shade of red ; scraped 
 with a knife it is easily detached in the form of a 
 pulpy matter, occasionally it presents slight erosions. 
 
 Perforation — The edges are thin, soft, fringed, 
 sometimes with a blackish line more or less marked. 
 It presents no appearance of thickening or inflamma- 
 tion. In perforation from caustic poisons, the edges are 
 of the same thickness as the organ; sometimes they 
 are hard and callous. 
 
 Plate XXXIV. 
 
 Fig. 1 . An encephaloid tumour embracing the lower and 
 external portion of the oesophagus. 
 
 2. An encephaloid tumour arising from the mucous 
 membrane of the stomach ; it is partially softened, 
 and the flocculent appearance arises from the ves- 
 sels which formed the tumour. 
 
 3. Encephaloid tumours in the pyloric extremity of 
 the stomach. 
 

 ri . 
 
 0 
 
 » 
 
 to... 
 
Ikr ' • 
 
T1 . 5! 
 
 1 
 
31 
 
 Symp. Tumour at the Cardia — Pain in the epigastric and 
 dorsal regions ; regurgitation of food ; sometimes a small 
 quantity of matter, similar to a solution of arrowroot 
 in water, is ejected. 
 
 Tumours in the Stomach — Vomiting, particularly 
 after eating, and distension of the epigastric region. 
 
 Rupture of the Stomach — Suddenly seized with the 
 most acute and unremitting pain in the stomach, and 
 a rigidness and contraction of the abdominal muscles. 
 
 Plate XXXV. 
 
 Fig. 1. A portion of scaly scirrhous stomach. In this 
 case the villi were matted together and of a fibro- 
 cartilaginous texture. 
 
 2. A deposition of a fibro-cartilaginous matter be- 
 tween the several tunics of the stomach. 
 
 3. A tuberculated state of the spleen, taken from a 
 child who died of tabes mesenteria. 
 
 4. Section of a tuberculated spleen. 
 
 5. A cartilaginous state of the proper capsule of the 
 spleen. 
 
 6. Ossific deposition between the laminae of the cap- 
 sule of the spleen. 
 
 Symp. Fungus and Scii'rhus — Pain after eating, nausea, 
 sometimes vomiting, great emaciation, dull, earthy co- 
 lour of the skin, pulse small and quick, tongue clean 
 at its tip and edges, but the base is generally covered 
 with a dirty, yellowish fur; matter ejected is dark, 
 acrid, and sometimes very offensive. 
 
 Morbid Anat. In the fibro-cartilaginous state, the part is 
 harsh and firm, it feels like bone, and, when cut, pre- 
 sents a light greyish surface, minutely intersected with 
 whitish bands of a cartilaginous texture. If a portion 
 be macerated for some time in water and vinegar, the 
 intervening jelly-like substance is freed from the mass, 
 and the indurated cellular tissue is seen crossing in 
 every direction. 
 
32 
 
 Plate XXXVI. 
 
 Fig. 1. An enlarged state of the mucous glands of the 
 stomach. 
 
 2. Solution of the substance of the mucous glands 
 of the stomach. 
 
 3. Extensive phagedenic ulceration of the mucous 
 tissue of the stomach. 
 
 PLATE XXXVII. 
 
 This Plate represents the effects of acute and chronic in- 
 flammation of the serous membrane, and the parenchyma- 
 tous texture of the. liver. 
 
 Fig. 1. An extensive deposition of lymph on the serous 
 membrane of the liver. 
 
 2. Adhesion of the upper part of the liver and the 
 diaphragm, and laterally to the abdominal muscles. 
 
 3. Thickening of the diaphragm and close adhesion 
 to the liver. 
 
 4. Deposition of bone, the size of a bean, surrounded 
 by a false membrane, which has become organized 
 and attached to the peritoneal surface of the ab- 
 dominal muscles. 
 
 5. A deposition of cartilaginous matter between the 
 laminae of the serous membrane. 
 
 6. An abscess in the substance of the liver. 
 
 7. A portion of indurated liver from acute inflam- 
 mation. 
 
 8. Softened state of the parenchyma of the liver. 
 
 9. Incipient fatty, or light nutmeg-coloured liver. 
 
 10. Dark brown nutmeg-coloured liver. 
 
 1 1 . Melenotic nutmeg liver. 
 
 12. Circumscribed melenosis on the serous surface 
 of the liver. 
 
PI. 3/. 
 
 Tig. 4 
 
 Tig.-5. 
 
 Ti^.6 
 
PI 36. 
 
33 
 
 Symp. Hepatitis. — Pain in the side, increased on pressure ; 
 nausea, vomiting ; hurried respiration ; yellow tint of 
 the skin ; unable to lie on the left side. 
 
 Chronic — An uneasy sensation in the side, sallow 
 countenance, nausea, dyspepsia ; high coloured urine ; 
 tongue covered with a dark yellowish fur. 
 
 Morbid Anat. Acute Inf. — Its size is generally increased, 
 it cuts solid, and its substance is of a bright purple 
 colour. 
 
 Abscesses are sometimes found in the substance of 
 the liver, containing a large quantity of pus. 
 
 Softening — In this state the parenchyma is dis- 
 solved, and a larger quantity of fluid is deposited in 
 the substance of the liver. The veins are also found 
 thickened, and their coats either inflamed or of a 
 pearly white colour. 
 
 Hepatic Apoplexy — The vena porta and hepatic 
 veins are loaded with dark blood, and in different 
 parts of the liver are to be seen circumscribed spots of 
 blood of greater or less size, 
 
 Ossific and calcareous depositions take place on the 
 serous surface, and in the substance of the liver. 
 
 Exsanguinated liver is generally found to exist 
 in subjects who die of marasmus, or long and pro- 
 tracted ascites. The texture of the liver is healthy, 
 but quite bloodless. 
 
 PLATE XXXVIII. 
 
 Fig. 1. Scrofulous tubercles situated in the substance of 
 the liver. 
 
 2. Scirrhous tubercles in the substance of the liver. 
 
 3. Macerated portion of liver, containing scirrhous 
 tubercles. 
 
 4. Light granulated state of liver. 
 
 5. Dark granulated state of liver. 
 
 D 
 
34 
 
 Fig. G. Soft dark brown tubercles, situated in the sub- 
 stance of the liver. 
 
 7. Melenotic state of liver. 
 
 8. An encephaloid tumour situated in the substance 
 of the liver. 
 
 9. The external and internal surface of the liver 
 studded with encephaloid tumours. 
 
 10. Softening of the parenchyma of the liver, with a 
 large cyst in its centre. 
 
 11. Ulceration of the gall-bladder and stomach. — 
 The gall-bladder was firmly united to the small 
 curvature of the stomach ; ulceration and perfora- 
 tion had taken place at the point of union ; the 
 gall-bladder contained several gall-stones. 
 
 12. The proper tunics of the gall-bladder thickened 
 to six times their natural size. 
 
 13. Tuberculated state of the serous membrane of 
 the gall-bladder. 
 
 14. A nest of hydatids taken from the liver. 
 
 15. Dilatation of the ductus communis choledochus. 
 
 16. and 17. Gall-stones. 
 
 Morbid Anat. Granulated liver is very common; but dif- 
 fers from tubercle in many respects. Granules begin 
 in clusters, and seldom increase in size individually, 
 although the liver will become one perfect mass of 
 them. In slicing this state of liver, the knife grates, 
 as if cutting a sandy substance. The cellular connect- 
 ing membrane is more or less of a fibro-aponeurotic 
 structure. 
 
 White or scirrhous Tubercle — The part is hard, and 
 cuts solid ; its colour is of a dirty white, or bluish grey. 
 
 When macerated, the parenchyma can be washed 
 away, and nothing but its beautiful and cancillated 
 structure is to be seen. 
 
 Encephaloid — The colour of the liver, in which 
 these tumours are found, is of ,a purplish brown ; 
 and its texture is generally softer than usual. Some- 
 times they are softened, and of a darker colour than 
 the substance of the liver, in consequence of an effu- 
 sion of blood from some of the veins. 
 
PI . 5':^ . 
 
35 
 
 Mdenosis — Sometimes the liver presents a black 
 lobulated mass, intersected by a dark brown and dirty 
 yellowish substance. At times the liver is found 
 loaded with melenotic matter, and softer than usual. 
 Sometimes the matter is circumscribed in the sub- 
 stance, and on the serous membrane of the viscus, 
 
 PLATE XXXIX. 
 
 This Plate shows the effects of acute and chronic inflamma- 
 tion of the serous membrane of the intestines, also intus- 
 susceptions and hernise. 
 
 Fig. 1. Extensive inflammation of the serous membrane 
 of the ileum, with a deposition of lymph. 
 
 a An injected and arborescent state of the mi- 
 nute capillary veins. 
 
 b Lymph lying on the surface of the intestines. 
 
 Fig. 2. Chronic inflammation of the serous membrane 
 of the ileum, with adhesions of the intestines, by 
 cellular bands. 
 
 a Bands. 
 
 Fig. 3. Ulceration and perforation of the serous membrane 
 of the ileum, close to the caput coli. 
 
 a The perforation. 
 
 Fig. 4. Vesicular, or first stage of tubercle. 
 
 5. Fibro-cartilaginous tubercle, taken from the in- 
 testine of a patient who died of marasmus. 
 
 6. Tuberculated state of the serous membrane of the 
 intestine, and an enlarged state of the mesenteric 
 glands. 
 
 7. Scrofulous tubercle, arising from the serous tunic, 
 with adhesion of the folds of the intestine. 
 
 8. Small fleshy tubercles, arising from the peritoneal 
 surface of the abdominal muscles. 
 
 9. Enlarged and indurated tubercles, arising from 
 the peritoneal surface of the abdominal muscles. 
 
36 
 
 Fig. 10. Scirrhous tumours, embedded in the cellular tissue, 
 between the abdominal muscles and peritoneum, on 
 the left side. 
 
 1 1 . Melenotic matter deposited between the abdomi- 
 nal muscles and reflected peritoneum. 
 
 12. A portion of the ileum, showing two intus-suscep- 
 tions, taken from an infant. 
 
 13. Section of an intus-susception, showing the inva- 
 ginated portion. 
 
 14. Strangulated hernia, exhibiting gangrene of the 
 intestines. 
 
 15. A portion of strangulated intestine : the stricture 
 is seated in the neck of the sac. 
 
 Symp. Acute Sero-enteritis — Extreme prostration of strength ; 
 nasea, vomiting ; intense pain in the abdomen, parti- 
 cularly so about the navel ; concentration of heat in 
 the umbilical region ; tympanitic state of bowels, con- 
 stipation ; tongue flaccid, broad, and white ; urine 
 high coloured. 
 
 Chronic — Pain and distension of the abdomen ; 
 nausea; tongue broad, and covered with a whitish 
 fur ; pulse is jerky, and the face pale and swollen ; 
 emaciation of the body. 
 
 Tubercles in the Peritoneum — Swollen and board- 
 like feel of the abdomen, tender to the touch ; pain 
 increased on pressure ; cough, skin dry and harsh ; 
 blanched conjunctiva ; tongue covered with dirty white 
 varnish, and red tip and edges ; great emaciation. 
 
 Intus-suseeptio — Constipation, irregular and swollen 
 state of the abdomen ; nausea, hiccough, colic pains, 
 great prostration of strength : pain in a particular part 
 of the abdomen ; vomiting of a mucous, bilious, or 
 stercoraceous matter. 
 
 Morbid Anat. Acute Inf. — The peritoneum becomes thick, 
 soft, and of a bright red colour. The veins of the part 
 are also distended with blood ; and the redness of the 
 inflamed part is often increased by an effusion of blood 
 into the cellular substance, under the peritoneum, in 
 the form of streaks or patches. Sometimes it is of a 
 
37 
 
 greenish colour, when its vessels are loaded with venous 
 blood, and an etFusion of lymph has taken place. The 
 thickness of the lymph varies, according to the degree 
 of inflammation, from a line to a quarter of an inch. 
 
 Chronic — The peritoneum is generally found thick- 
 ened, either by a deposition of lymph on its external 
 surface, or an infiltration of lymph between its lami- 
 nae ; it is also white, red, or bluish, with an injected 
 and dilated state of the venous capillaries of the part. 
 There is generally found in the cavity a quantity of 
 fluid, of a light straw colour, or a blood-like serum 
 with patches of lymph floating in it. 
 
 Intus-susceptio — In the infant it is not uncommon to 
 meet with three, four, or even five intus-susceptions, at 
 the same time ; but they are generally unaccompanied 
 with inflammation. 
 
 Inflammatory Stage — The intestines, above the intus- 
 susception, are greatly distended and inflamed ; they 
 are of a brownish red colour : and if the inflamma- 
 tion has continued long, purulent matter is mixed with 
 serum in the belly. When the distended bowels are 
 laid aside, we find a knot of intestines, which may be 
 called the vaginal portion ; these are of a pale yellow, 
 with black spots upon them ; and the track of the 
 canal below the obstruction is pale, compared with 
 the portion above. 
 
 Strangulated Hernia — If the stricture be of recent 
 date, the portion of intestine is of a dark or petechial 
 red colour, and the incarcerated portion is much 
 thicker than natural, from an infiltration of lymph 
 between its laminae. The veins are dilated and mi- 
 nutely injected, and some petechial points are to be 
 seen. When gangrene has actually commenced, the 
 part becomes more of a chocolate colour, or of a 
 reddish purple tint, and an indistinct appearance of 
 the capillary vessels of the part. Complete mortifica- 
 tion of a portion of intestine is demonstrated by the part 
 presenting a dull dark brown colour, with dark patches 
 of a bluish green upon it ; the surface is abraded and 
 softened, and when punctured no fluid appears. 
 
38 
 
 Tubercles — Of the peritoneum are found as small as 
 millet seed, and as large as pigeon’s eggs ; they are 
 generally of a greyish, but sometimes of a yellowish 
 white colour, and of a cheese-like consistence ; their 
 centres, when large, are generally found softened. 
 
 PLATE XL. 
 
 An enlarged and ulcerated state of Brunner’s and Payers 
 glands j perforation, and an encephaloid tumour and stricture 
 of the rectum. 
 
 Fig. 1. Chronic inflammation of the mucous tissue of the 
 ileum, and an enlarged and ulcerated state of 
 Brunner’s glands. 
 
 2. An enlarged state of Payer’s and Brunner’s glands 
 in the ileum. 
 
 3. An enlarged and ulcerated state of Payer’s gland. 
 
 4. Chronic inflammation, with ulceration of the mu- 
 cous texture of the colon. 
 
 5. Extensive ulceration of the mucous and muscular 
 tunics of the ileum, and perforation of the perito- 
 neal coat. 
 
 6. Ulceration of the caput coli, from a phthisical 
 patient. 
 
 7. An encephaloid tumour arising from the serous 
 tunic of the colon. 
 
 8. Hemorrhoids situated in the cellular tissue, be- 
 tween the muscular and mucous tunics. 
 
 9. An encephaloid tumour, arising from the mucous 
 texture of the colon. 
 
 10. Stricture of the rectum, from a puckering and 
 thickening of the mucous and muscular tunics of 
 the gut. 
 
 11. A great deposition of scirrhous matter into the 
 cellular texture of the rectum. 
 
 12. A stricture of the rectum, from a deposition of 
 

39 
 
 a fibro-cartilaginous matter into the cellular tissue 
 of the gut. 
 
 Fig. 13. Specimen of internal piles. 
 
 Symp. Acute Muco-Fnteritis — Compressed state of the ab- 
 domen, pain in the region of the navel ; nausea, vomit- 
 ing, slight tormina ; jelly-like evacuations ; tongue 
 covered with a whitish fur, red tip and edges ; pulse 
 soft and compressible. 
 
 Chronic, with Ulceration — Cough ; rigors with alter- 
 nate flushes of heat ; jelly evacuations, mixed with 
 pus or blood ; tongue covered with a dirty yellowish 
 fur, red tip and edges, pulse soft and compressible, 
 pain on pressure just above the pubis ; belly becomes 
 flatter, the face more sunk, and the cheeks and eyes 
 more hollow. 
 
 Mucous Memh. of the large Intestines~Tioxmm 2 i, 
 tenesmus ; scanty evacuations of feculent matter, 
 blended at times with mucus, pus, or blood ; pulse 
 quick and full, tongue white, with slight red tip and 
 edges. 
 
 Stricture of the Gut — Pain and sense of weight in 
 the loins, which sometimes extends to the rectum and 
 thighs ; obstruction to free evacuation, with a thready 
 and compressed appearance of the feculent matter ; 
 pallid countenance ; if of long standing, great ema- 
 ciation. 
 
 Cancer of the Rectum — Severe pain, darting through 
 the pelvis to the bladder and the groin. The coun- 
 tenance is of a sallow leaden colour. 
 
 Morbid Anat. The parts are redder than usual, and the 
 vessels are seen to course in an arborescent manner ; 
 there is an cedematous and puffy state of the part, 
 which is produced by an infiltration of fluid into the 
 cellular connecting membrane. Lymph is sometimes 
 found adhering to its surface. The redness in acute 
 inflammation has no line of demarcation, but vanishes 
 gradually from a dark red to a faint flesh colour. 
 
 Chronic — The mucous tissue is thickened, attenu- 
 
40 
 
 ated, softened, indurated, or ulcerated ; and the colour 
 of the parts varies considerably, being at times blue, 
 red, green, yellow, white, or black. 
 
 Encephaloid tumours differ in their structure from 
 fungus haematodes, and likewise in their manner of 
 destroying parts. These tumours are found to be of 
 a medullary consistency, and protected by one or more 
 tunics, according to the part affected. The capsules 
 are bountifully supplied with arteries and nerves, and 
 the venous capillary vessels are seen to form complete 
 masses of vessels on their external surface. Some of 
 the vessels enter into the substance of the tumour. 
 Sometimes the medullary matter occupies one cell 
 only ; sometimes six or eight, so as to form one tumour, 
 hence the lobulated appearance. 
 
 The intervening cellular tissue is matted together 
 by chronic inflammation, so as not to be separated 
 without the greatest difficulty. In the substance of 
 these tumours there is most commonly found a small 
 quantity of blood. 
 
 Fungus Hcematodes — has no proper capsule, and 
 possesses the peculiar power of changing every por- 
 tion of the human frame to its own nature ; and 
 this occurs without that thickening or hardening of the 
 cellular tissue which generally accompanies chronic 
 inflammation. 
 
 In ulceration, the capillary vessels of the venous 
 system form a perfect net-work ; and these minute 
 vessels press into larger branches of the venous system : 
 it is to the varicose and partial lesion of these vessels, 
 that the edges and inferior surface of the ulceration 
 owe their dark ruby colour. If the ulceration be ex- 
 tensive, the destruction of veins is very great, and 
 hemorrhage is the consequence. 
 
Eig.l. 
 
 PI . 41 
 

-. 1 . 
 
P1.43 
 
 Tigl. 
 
41 
 
 PLATES XLI. XLII. XLIII. 
 
 Acute and chronic inflammation of the kidney ; calculi in 
 its substance and ureters ; also hydatids, and a deposition of 
 melenotic matter. 
 
 Plate XLI. 
 
 Fig. 1. Inflammation of the membrane lining the pelvic 
 portion of the kidney and its substance. 
 
 2. Extensive destruction of the parenchymatous struc- 
 ture of the kidney, from long and protracted inflam- 
 mation. 
 
 3. External appearance of the scrofulous abscess 
 formed in the kidney. 
 
 4. A section of the scrofulous kidney, showing the 
 destruction of its internal texture. 
 
 Plate XLII. 
 
 Fig. 1. Pelvic portion of ureter loaded with calculi. 
 
 2. Extensive dilatation of the pelvic portion of ureter, 
 from a large calculus. 
 
 3. A very large calculus, situated in the pelvis of 
 the kidney. 
 
 4. 5. Calculi in the ureter, at its upper extremity, 
 and in the middle. 
 
 6. Section of ditto. 
 
 Plate XLIII. 
 
 Fig. 1. Several calculi formed in the substance of the 
 kidney, accompanied with destruction of the me- 
 dullary and cortical part of the kidney. 
 
 2. Hydatids in the substance of the kidney, taken 
 from a patient supposed to be labouring under 
 chronic hepatitis. 
 
 3. Several cysts formed on the surface, and in the 
 parenchymatous texture of the kidney. 
 
 4. Deposition of melenotic matter in the substance 
 and on the surface of the kidney, taken from a pa- 
 tient who liad been affected with chronic inflam- 
 mation of the air passages. 
 
42 
 
 Symp. Nephritis — Pain in the region of the kidney, in- 
 creased on pressure ; micturation, dysuria, nausea, 
 vomiting; urine of deep red colour, constipation, re- 
 traction of the testicles. 
 
 Chronic — All the symptoms milder in character; of 
 several months’ duration. 
 
 Abscess— A\\ the above symptoms increased in vio- 
 lence for a time, accompanied with chilliness and shiv- 
 ering, and a dull deep-seated pain in the loins. 
 
 Calculi in the Kidneys or Uf^eter^s — Dull heavy pain 
 in the loins, accompanied with spasmodic twitches 
 about the superior portions of the ileum and lumbar 
 region internally ; pressure on the abdomen produces 
 pain in the course of the anterior crural nerve ; nausea, 
 vomiting ; pain in the testicles, irritation of the glans 
 penis ; skin pallid ; lithic acid blood, or pus, mixed 
 with the urine ; bent position produces great pain in 
 the loins. 
 
 Hydatids — Dull obscure pain in the loins, with 
 slight irritation of the bladder and glans penis ; a 
 discharge of hydatids from the urethra. 
 
 Morbid Anat. In acute inflammation of the kidney, the 
 surface is covered with dilated minute capillary 
 vessels, beautifully arborescent ; it cuts more solid, 
 and its vessels contain more blood ; yet it is not in- 
 creased much in size, in consequence of the inelastic 
 state of its capsule ; hence the acute pain. Some- 
 times the kidney is found to be of a fibro-cartilaginous 
 texture, and when cut, presents a surface similar to 
 a cut turnip. The scirrhous kidney is of a light 
 greyish, or dirty yellow ochre colour, harder than na- 
 tural ; and when cut, presents a homogeneous appear- 
 ance ; but if macerated for a short time, a quantity of 
 chalky or clay-like fluid can be pressed from it, and 
 it presents a beautiful reticulated appearance. 
 
 Sometimes a quantity of adipose matter is found 
 deposited in the substance of the kidney ; it is gene- 
 rally very soft and flabby. Sometimes there is a de- 
 position of an ochre-coloured matter, of the consistency 
 

 1 ;. 
 
 
 :w ' 
 % .. ■« 
 
 ry^ 
 
 ' 
 
 W 'i§- 
 
 
 % 
 
 t- 
 
 
 
 
 
 

 C 
 
43 
 
 of tallow, between the calices ; and sometimes the 
 posterior half of the organ externally is buried in this 
 substance. 
 
 Ossification — of the substance is a very rare dis- 
 ease ; but bony depositions on its fibrous tunic are not 
 unfrequently found. It is sometimes converted into 
 a cheese-like matter, and enlarged to twice its natural 
 size, its capsule thickened, and of a fibro-cartilaginous 
 texture. 
 
 Hydatids are found adhering to its surface, and 
 embedded in its substance. 
 
 Sacculated Kidney — arises from various causes ; but 
 the most common is from the formation of calculi in 
 the different compartments of the organ ; which, from 
 their pressure and irritation, produce rapid absorption 
 of the medullary and cortical parietes of the viscus, 
 leaving nothing but the capsule filled with calcareous 
 matter, 
 
 Hypertrophia and atrophia of this organ, as well as 
 every organ in the body, is at times found to exist. 
 
 PLATES XLIV. XLV. XLVI. 
 
 Diseases of the prostate gland, vesiculse seminales, bladder, 
 and urethra. 
 
 Plate XLIV. 
 
 Fig. 1. An enlarged state of the prostate gland, from 
 simple infiltration of lymph into its substance, ac- 
 companied with induration. 
 
 2. An enlarged prostate gland, taken from a patient 
 who had been the subject of diseased urinary or- 
 gans upwards of ten years. 
 
 3. Thickened and corrugated state of the bladder, 
 with simple increase in the size of the prostate 
 gland. 
 
44 
 
 Plate XLV. 
 
 Fig, 
 
 1. Extensive ulceration and thickening of the mu- 
 cous and muscular tissue of the bladder. 
 
 2. Calculi in the bladder of a youth, fourteen years 
 old. 
 
 3. Fungi in the bladder, taken from a gentleman 
 aged eighty years. 
 
 4. Abscess of the vesiculae seminales and prostate 
 gland : the latter is divided into two distinct lobes, 
 and filled with a thick curd-like matter. 
 
 5. Ulceration of the vesicula seminales of the right 
 side. 
 
 G. Calculi in the substance of the vesicula seminales. 
 
 7. Hydatids in the substance, and on the surface of 
 the vesicula seminales. 
 
 8. Fibro-cartilaginous state of the vesicula semi- 
 nales, taken from a young man, who was addicted 
 to onanism, and who hung himself. 
 
 Symp. Inf. of the Prostate — Pain and heat in the perineum 
 and rectum ; tenesmus ; constant desire to pass the 
 urine, without the power to do so ; acute pain on 
 pressure of the gland. 
 
 Scirrhus — Lancinating pains darting through the 
 gland ; dysura, tenesmus, and an inability to bring the 
 thighs close to each other ; constipation. 
 
 Ulceration — Frequent desire to pass urine ; mictu- 
 ration, tenesmus, burning sensation in the perineum, 
 with pain of the meatus urinare ; ardor urinae ; dis- 
 charge of matter per urethra ; emaciation ; dejected 
 and pallid countenance ; gland painful to the touch. 
 
 Abscess of the Vesicula Seminales — All the symp- 
 toms of inflammation of the prostate, with increased 
 pain and irritability of the testes ; tenesmus, shivering. 
 
 Ulceration — Pain, deep seated and lancinating ; te- 
 nesmus, ardor urinse, extreme irritability of the testes ; 
 great emaciation. 
 
 Cystitis — Heat and pain in the hypogastrium ; fre- 
 quent attempts to make water, which is evacuated in 
 

45 
 
 small quantity, and with great pain; or there is a 
 total retention of the urine, with a strong desire to 
 void it ; the urine, at first limpid, becomes turbid and 
 reddish. 
 
 Chronic — Dull heavy sensation behind the pubis, 
 with sense of weight in the perineum ; slight tenes- 
 mus ; constipation ; difficulty in passing urine ; it is 
 generally loaded with mucus or pus. 
 
 Ulceration — The discharge is generally mixed with 
 blood, sometimes with a greenish foetid matter ; great 
 emaciation. 
 
 Fungi — Dull pain, with a constant desire to pass 
 urine ; a sensation as if girt with a cord at the hypo- 
 gastric region ; weight and uneasiness about the kid- 
 neys ; aching pain in one or both testicles ; discharge 
 of pure blood, or blood and mucus ; itching at the 
 meatus ; constipation. 
 
 Injiammation of the Corpora Carnosa — Deep seated 
 pain in the pelvis, with a sense of weight, and constant 
 desire to pass urine. 
 
 Ulceration — Pain, deep seated and lancinating; and 
 if the ulceration be extensive, tenesmus, and ardor 
 urinae, with wasting of the body. 
 
 Calculi — Frequent inclination to pass urine, dysu- 
 ria, itching or pain at the meatus urinare externis; 
 nausea, vomiting ; increased pain after discharging the 
 water ; tenesmus ; violent exercise increases the pain, 
 and is generally followed by bloody discharge from 
 the bladder, pulling the prepuce over the glans penis ; 
 muco-purulent discharge. 
 
 Morbid Anat. When the mucous tissue of the bladder is 
 acutely inflamed, there is a suffused redness of the 
 part, with bloody points, more or less mucus adhering 
 to its healthy surface. 
 
 Ulceration sometimes advances so far as to destroy 
 a portion of the bladder entirely, and to form a commu- 
 nication between it and the neighbouring parts, as the 
 abdominal cavity, rectum in the male, and vagina in 
 the female. Sometimes the inner surface of the bladder 
 
46 
 
 is lined with a cheese-like substance, but not uniform 
 on its free surface, but divided into innumerable irre- 
 gularities. 
 
 The mucous, muscular, and peritoneal coats are 
 thickened. 
 
 Corpora Carnosa — Are found at times enlarged, ul- 
 cerated, scirrhous, or ossified. 
 
 Hydatids — have been found adhering to the inner 
 surface of the bladder. 
 
 Fungi — Arise from several parts of the internal 
 membrane at the same time ; the nuclei of these tu- 
 mours are capillary veins, which are enlarged, and 
 intersect each other, so as to form an imperfect lace- 
 work ; from this matting arise thousands of minute 
 pencillated vessels, which are so intimately woven to- 
 gether as to give character to the tumour during 
 life, but which disappears at death, and presents 
 nothing more than macerated cellular membrane. 
 
 Sometimes there are fungoid tumours met with, that 
 are pulpy to the touch but fibrous in texture, and 
 preserve their appearance after death. 
 
 The fibro-cartilaginous, scirrhous, and corrugated 
 state of bladder, are met with ; also hypertrophia and 
 atrophia, melenotic deposition, &c. 
 
 Calculi are found in the bladder. 
 
 Sacculated state of bladder arises from a separation 
 or lesion of some of the muscular fibres, and the mu- 
 cous texture passing through the preternatural aper- 
 ture and carrying before it the peritoneal coat, which 
 forms a perfect sac or pouch. 
 
 Plate XLVI. 
 
 Fig. L Extensive ulceration of the posterior portion of 
 the prostate gland, with an enlarged and indurated 
 state of the vesiculse seminales. 
 
 2. An enlarged and scirrhous state of the prostate 
 gland. 
 
 3. Fibro-cartilaginous state of the cellular tissue, sur- 
 rounding the entrance of the ureter into the bladder. 
 
PI. 46. 
 
 ■Fig' ng. 9. 
 
47 
 
 Fig. 4. Fungoid excrescence, arising from the right side 
 of the corpus carnosum, which entirely obstructed 
 the flow of urine into the bladder, and produced an 
 enlargement of the ureter on that side. 
 
 5. Inflammation of the mucous tissue of the urethra 
 and mucous follicles. 
 
 6. Approximation of the sides of the canal, forming 
 
 stricture. 
 
 7. Irregular stricture, or callous state of the urethra. 
 
 8. The calibre of the urethra diminished, and a fibro- 
 
 . cartilaginous state of the spongy body of the penis. 
 
 9. A false passage made by the improper use of the 
 bougie. 
 
 PLATE XLVII. 
 
 This Plate represents cancer, tubercles, and hydatids of the 
 uterus. 
 
 Fig. 1. Hydatids adhering to the fallopian and ovarian 
 extremities of the uterus ; on the left side a section 
 is made to show its compartments. 
 
 2. Cancerous tumour arising from the cervix uteri. 
 
 3. Tubercles arising from the cervix and fundus 
 uteri. 
 
 4. An encephaloid tumour, arising from the mucous 
 tissue of the uterus. 
 
 5. Scirrhous tumour filling the cavity of the uterus. 
 
 Symp. Inf. Mucous Tissue of the Uterus — Dull heavy 
 pain, referred to the os pubis, with a circumscribed 
 burning heat in the centre of the pelvic and vaginal 
 portion of the uterus ; dryness of the parts. The pubic 
 portion of the abdomen appears as if flattened and 
 sunk towards the back ; and the veins, coursing over 
 the inguinal and hypogastric regions, are swollen ; 
 tense pain in the back, pelvis, and thighs ; constipa- 
 tion, tenesmus, dysura ; pulse full and soft ; examina- 
 tion per vaginam produces pain. 
 
48 
 
 Irritable Uterus — Fulness, and an uneasy feeling- 
 in the centre of the pelvic viscera, accompanied with 
 a degree of heat, and a dull aching pain and sense of 
 weight in the lumbar and sacral regions ; slight dis- 
 charges of mucus ; sometimes the parts are quite dry, 
 as if scorched by heat ; soreness about the pubis, par- 
 ticulai’ly at the insertion of the round ligaments ; swel- 
 ling and puffiness of the labiae, with irritation about 
 the bladder and rectum ; examination per vaginam 
 causes exquisite pain ; the patient becomes very irri- 
 table, and ultimately disagreeable. 
 
 Cancerous Tumours — Dull heavy pain in the loins, 
 accompanied, at times, with acute and lancinating 
 pains in the uterus ; an offensive discharge of sanious 
 matter ; examination per vaginam gives pain ; dysu- 
 ria ; constipation. 
 
 Phagedenic Ulceration — Pressure on the organ 
 gives pain ; discharge of a bloody or greenish yellow 
 matter, which is very offensive, but different in smell 
 to the discharge from true cancer ; dysuria ; constipa- 
 tion ; sickness ; tenderness at various points of the 
 abdomen ; great distress, both of body and mind ; 
 emaciation. 
 
 Hydatids — There are no symptoms which will en- 
 able us to elucidate their first formation. 
 
 Morbid Anat. Acute Inf. Mucous tissue presents a thick- 
 ened and pulpy state ; the veins are dilated, and their 
 inner surface very red, and sometimes obstructed by a 
 coagulum of blood and pus. In very severe cases 
 lymph is found adhering to the mucous texture of the 
 uterus, and its follicles enlarged and very red. 
 
 Ulceration., as far as I have observed, arises mostly 
 in females of strong venereal appetites, or in those 
 who have suffered from the effects of syphilis or mer- 
 cury. 
 
 The ulcers have been situated about the os internum 
 and internal portion of vagina. 
 
 Phagedenic presents a livid or purplish red colour 
 of the part, with an increased state of the venous 
 
49 
 
 capillaries ; vesication of various sizes, and an abra- 
 sion of the part by the ulcerative process. The ulcer 
 is generally very deep. 
 
 Cancerous — The ulceration presents an uneven, 
 ragged, and excavated surface, the edges of which are 
 hard to the touch ; sometimes the surface is covered 
 with bloody patches, or black masses. The discharge 
 from this kind of ulcer is very offensive, it smells like 
 rotten eggs. 
 
 Irritable Uterus — Fulness and varicose state of 
 the veins situated on the lateral portions of the cervix 
 uteri externally, and an oedematous state of the os 
 internum, with a fulness and slight vascularity of the 
 follicles situated between the rugae formed by the 
 folding of the mucous texture within the cervix uteri. 
 Sometimes this portion of the uterus is scirrhous. 
 
 Bleeding Ejicephaloid — It is generally lobulated, and 
 its texture firm and apparently fleshy ; when cut, it 
 presents a bright red, intersected by bluish or pur- 
 plish patches. Its capsule is bountifully supplied 
 with tortuous vessels ; and sudden distension or lesion 
 of these vessels cause the hemorrhage which so often 
 occurs in this disease. 
 
 Placental Polypus — is generally situated at the la- 
 teral or fundal surfaces of the mucous texture of the 
 uterus ; it presents an irregular hemorraghic coagu- 
 lum, with several shreds or patches of a loose mem- 
 branous texture, which lay collapsed on its surface. 
 This substance, when sliced, presents a dark purple 
 or reddish cancillated texture, and its parenchyma 
 bears a great resemblance to the spleen. 
 
 The perfect conception is distinguished from the 
 imperfect or uterine growths, by its not reeeiving its 
 origin from the mucous texture, or fibrous texture of 
 the uterus. 
 
 Scirrhus — The uterus enlarges to nearly six times 
 its natural size ; and when cut, presents a greyish or 
 yellowish white structure, and is intersected by bands 
 of a whiter appearance than its intermediate substance. 
 
 The cavity of the uterus is sometimes found oblite- 
 
 E 
 
50 
 
 rated ; sometimes the os internum only . I have found 
 bone deposited on the fundal surface of the organ. 
 
 The mucous texture of the uterus is occasionally lined 
 with a calcareous matter. Hydatids frequently adhere 
 to the substance of the uterus and its appendages, 
 and large masses of them are sometimes found in the 
 cavity of the uterus. Rupture of the uterus is of rare 
 occurrence. 
 
 PLATE XLVIII. 
 
 Hydatids in the substance of the testicle, encephaloid and 
 scirrhous state of the same organ. 
 
 Fig. 1 . External appearance of the testicle from hydatids 
 in its substance. 
 
 2. Section of the testicle, showing the fibrous texture 
 of the capsules of the hydatids. 
 
 3. Extensive encephaloid tumour, situated in the 
 body of the testicle. 
 
 4. Section of an encephaloid tumour, situated in the 
 body of the testicle. 
 
 5. An enlarged and scirrhous state of the whole body 
 of the testicle. 
 
 6. Section of a scirrhous testicle. 
 
 7. Section of a fibro-cartilaginous state of testicle. 
 
 Symp. Hydatids — The disease is attended with obscure 
 fluctuation ; but it is rather a yielding at the part 
 compressed with the finger, than an extensive fluc- 
 tuation from one extremity of the swelling to the 
 other. If the diseased part be firmly compressed, it 
 gives the sensation of squeezing the testis ; pain in 
 the loins. 
 
 Encephaloid — An enlarged and indurated state of 
 testicle ; the enlargement proceeds generally rapidly ; 
 lancinating pains in the substance of the organ ; want 
 of appetite, emaciation of the body, pains in the 
 
PI 48 
 
 Tigl 
 
 ng.2 
 
51 
 
 thighs and legs; wan and leaden appearance of the 
 countenance. 
 
 Scirrhus — The stony hardness, the imperceptible 
 growth at first, the lancinating pain in this part ex- 
 tending to the loins, and the tuberculated feel of the 
 testicle, form the most distinguishing characters of 
 scirrhus. 
 
 Morbid Anat. The testis in its centre ; is filled with nu- 
 merous cysts, of various sizes, some small as the 
 head of pins, others the size of peas, and the largest 
 about an inch in diameter; as they vary in size, so 
 the fluid they contain differs in appearance. 
 
 Encephaloid — A secretion of a soft pulpy matter, 
 looking something like brain, is found deposited in 
 the midst of the semeniferous tubes, in its early 
 stages ; and, as the disease advances, and the testicle 
 becomes enlarged, the semeniferous tubes are absorbed, 
 and the peculiar secretion of this disease occupies their 
 natural situation. The tumour is partially vascular 
 in some parts ; the vessels are very numerous ; in 
 others, they do not enter the mass. 
 
 Scirrhus — When the testicle is cut open, the tunica 
 vaginalis and tunica albuginea are thickened ; and 
 instead of tubes, which form the secreting structure 
 of the testicle, a hard white mass is found, in lobes 
 or tubercles, which are harder than the other parts ; 
 and in which cartilaginous, and sometimes ossific 
 matter, are deposited. 
 
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INDEX. 
 
 The Morbid Anatomy of each organ follows the Symptoms ; 
 and the references to the Plates are so arranged, that the 
 graphic illustrations of any organ, as. well as the letter-press 
 description of it, may be easily found by referring to the 
 numbers of the Plates in the Index ; for instance, 
 
 PLATE I. to XII. 
 
 Contain the Morbid Appearances of the Brain. 
 
 PLATE XIII. to XV. 
 
 Morbid Appearances of the Fauces and Gullet. 
 
 PLATE XV. to XXIV. 
 
 Morbid Appearances of the Trachea, Lungs, and Pleura. 
 
 PLATE XXV. to XXX. 
 
 Morbid Appearances of the Pericardium, Heart, and Aorta. 
 PLATE XXXI. to XXXVI. 
 
 Morbid Appearances of the Serous and Mucous Texture of the Stomach 
 
 and Spleen. 
 
 PLATE XXXVII. and XXXVIII. 
 
 Morbid Appearances of the Serous and Parenchymatous Texture of the 
 Liver and Gall Bladder. 
 
 PLATE XXXIX. and XL. 
 
 Morbid Appearances of the Serous and Mucous Texture of the Intestines, 
 Intus-susceptio, and Hernia. 
 
 PLATE XLI. to XLIII. 
 
 Abscess, Softening, and Calculi of the Kidneys and Ureters. 
 PLATE XLIV. to XLVI. 
 
 Morbid Appearances of the Bladder, Prostate Gland, and Vesiculm 
 
 Seminalis. 
 
 PLATE XLVII. 
 
 Cancer, Tubercles, and Hydatids of the Uterus ; and its Appendages, 
 PLATE XLVIH. 
 
 Hydatids, Encephaloid, and Scirrhous Testicle. 
 
Si/mptoms of Acute and Chronic Inflammation of the folloioing 
 
 Organs : 
 
 Page 
 
 Aohta 27 
 
 Arachnoid Membrane ... 4 
 
 Brain, Substance .... 4 
 
 Softening .... 5 
 
 Abscess 5 
 
 Ulceration 6 
 
 Apoplexy 6 
 
 Tumours 8 
 
 Hydatids and Cysts . 9 
 
 Tubercles of the Plexus 
 Choroides . . . . 9 
 
 Bronchocele 15 
 
 Bronchitis 16 
 
 Bronchia, dilatation of . . . 16 
 
 Blue disease 26 
 
 Bladder 44 
 
 Calculi 45 
 
 Ulceration .... 45 
 
 Fungi 45 
 
 Corpora Carnosa .... 45 
 
 Ulceration . . .45 
 
 Croup 15 
 
 Dura Mater 2 
 
 Eye, fungus of 11 
 
 Fauces 12 
 
 Hydro thorax 21 
 
 Heart 23 
 
 Softening .... 25 
 
 Internal Lining ... 25 
 
 Ulceration .... 24 
 
 Polypus 25 
 
 Ossification of Valves . 26 
 
 Intestines, Serous Membrane . 36 
 
 Mucous Membrane . 39 
 
 (large) . . 39 
 
 Tubercles 36 
 
 Structure 39 
 
 Ulceration .... 39 
 
 Cancer 39 
 
 Intus-susceptio ... 36 
 
 Page 
 
 Kidney 42 
 
 Abscess 42 
 
 Calculi 42 
 
 Hydatids 42 
 
 Liver 33 
 
 Larynx, ulceration . . . . 15 
 
 Lungs 17 
 
 Incipient Tubercle . . 19 
 
 Suppurative Tubercle . 19 
 
 Apoplexy . . . . 18 
 
 Emphysema . . . . 18 
 
 Melenosis .... 20 
 
 Tumours 20 
 
 (Esophagus 13 
 
 Ulceration . . . . 13 
 
 Stricture 14 
 
 Ossification of the Valves of 
 
 the Heart 26 
 
 Pia Mater 4 
 
 Periosteum 1 
 
 Pleura 21 
 
 Pericardium 22 
 
 Prostate Gland 44 
 
 Scirrhus 44 
 
 Ulceration .... 44 
 
 Stomach, Serous Membrane . 28. 
 
 Mucous Membrane . 29 
 Tumours in the . . .31 
 
 Fungus and Scirrhus . 31 
 
 Rupture of the . . . 31 
 
 Trachea . 15 
 
 Te,sticle, Hydatids .... 50 
 Encephaloid .... 50 
 
 Scirrhous .... 51 
 
 Vesicula Seminales, Abscess . 44 
 
 Ulceration .... 44 
 
 Uterus 47 
 
 Irritable 48 
 
 Cancerous .... 45 
 
 Phagedemi, Ulceration 48 
 Hydatids 48 
 
 I 
 
 James BulcoeU, I'unuval’.s Inn Courl, I-Iolboni. 
 
I 
 
 Money 
 
 1830