siderably enlarged, owing to its distention by fluid, the aperture having been for some days closed; the new formed skin was changed into a white and fibrous substance, which adhered with great firmness. The pain in the tumour was at this time so particularly violent, from the integuments being so much distended, that I felt inclined to make a small puncture to afford him temporary relief; but on the evening of this day, the integuments gave way, and a considerable quantity of bloody serum was discharged, which occasioned immediate ease; but fluid still seemed contained in the several parts of the tumour.

March 10.-The difficulty of breathing increased, and he had coughed up blood. The integuments at the most convex part of the tumour were beginning to ulcerate, and there were several apertures, through which a probe might be passed into it. The discharge was still considerable, thought it did not tend to the diminution of the swelling.

The pain, difficulty of breathing, and other symptoms grew more and more distressing, and diarrhea came on, with excruciating pain in the bowels. The tumour assumed an appearance of sphacelation at one part, and the discharge became very offensive.

Although the powers of the constitution were reduced to the lowest ebb, a disposition to form these tumours still remained, as one made its appearance on the right side of the neck, and another on the back, and the former became considerably enlarged. Violent sickness, accompanied with tormina and tenesmus, and other dysenteric symptoms, continued till the 16th of March, when death took place.

After insulating the integuments from the base of the tumour, and dissecting back those covering the chest and posterior part of the arm, the superficies of the diseased mass was found to be formed of a congeries of various-sized dark purple-coloured tumours, which had extended between the pectoralis major and minor muscles, as far as the origins of the

latter, and backwards two inches beneath the latissimus dorsi, but had not produced any alteration in their structure.

The axillary absorbent glands were larger than natural; and although the tumour adhered to the capsular ligament, the conquence was only slight thickening of that part.

The vessels and nerves of the axilla were closely imbedded in the upper part of the disease, but except the musculo-cutaneus, or perforans Casserii, which was completely impacted, and lost in the tumour, they were not compressed to such a degree as to impede their functions, or produce any morbid appearance.

The morbid growth weighed four pounds avoirdupois weight, and when the integuments and cellular substance, covering the various-sized tumours which formed the whole, were removed, and the axillary nerves and blood vessels cleaned, it bore much resemblance to an enormous bunch of black Muscadine grapes.

All the tumours situated on the external part of the large one, had that spongy elastic feel peculiar to it, which so singularly characterizes this horrid disease, and which has been described by those who have written on fungus hæmatodes, but particularly by Mr. Burns, Mr. Hey, and Mr. Wardrop.

Several of the tumours were cut through, to examine their internal structure and contents; some were found to be composed of a soft medullary substance, like brain mixed with coagulated blood; others with a dark gray-coloured substance in consistence similar to the former; a few were of a blackish colour, but had the same arrangement of structure as the former, and the fluid expressed from them was exactly like the pigmentum nigrum on the choroid membrane of the eye, or the inky fluid in the bronchial glands, and when their contents were pressed out, the condensed cellular cysts only remained, with a loose fibrous reticulated arrangement of their internal parts, with the ramifications of several minute blood vessels.

The main bulk of the disease was next divided; it presented an irregular union or blended appearance, similar to what

composed the other tumours, and the contents were confined by strata of apparently fibrous reticulated condensed cellular substance; but there were three cavities, each of which contained about an ounce of loose coagulated blood.

The sloughing process on the anterior part of the tumour had not penetrated beyond the integuments, but had changed that part of it beneath them into a white sloughy looking substance.

The blood vessels were numerous, but very small.

There was a tumour in the sternum, under the periosteum, about the size of a walnut, of a brownish red colour, and a pulpy structure. It had caused the absorbents to remove the bone, to allow of its projecting inwards and outwards, and was only held by the ligamentous membrane which covers both sides of that bone; the sternum was softened, and its cancelli filled with the same kind of matter through one half of it; several of the ribs on both sides had similar tumours in them, not far from their cartilages, and under the periosteum. The liver was of a paleish red colour, rather soft in texture, and bestudded throughout its substance with various sized tumours, contained by capsules; some of them consisting of medullary matter mixed with blood, others possessing exactly the same consistence, but of a cineritious colour, and intersected with cellular septa.

There was a small tumour similar to those in the liver, between the layers of peritoneum which form the ligamentum suspensorium hepatis; and two on the front of the pancreas, one about the magnitude of a pidgeon's egg, the other the size of an hazel nut, but connected only by cellular substance to that viscus, which was perfectly healthy.

The stomach, duodenum, and jejunum, presented a healthy appearance, but the mucous coat of the ilium was considerably thickened, and seemed covered with a layer of coagulable lymph of a greenish colour: and I was led to suppose this idea correct, as the valvulæ conniventes were firmly agglutinated, and their extremities thickly coated with the same substance. VOL. V. No. 19.

2 S

The cœcum with its appendage and a great part of the colon, exhibited the same diseased appearance, only in a greater degree, and in some parts of those intestines there was an increased state of vascularity.

The iliac and lumbar absorbent glands were enlarged, but did not partake of the primary disease, as in the cases of medullary sarcoma, related by Mr. Abernethy.

The pericardium and heart were healthy; the lungs were studded in their substance with small tumours, similar to those in the liver, and there were many immediately beneath the pleura pulmonalis; and one of the lobes on the left side was loaded with blood and mucus.

On reflecting the integuments of the cranium, another tumour was perceived on its vertex, beneath the pericranium, which had never been noticed during the patient's life; it had affected the bone only in a slight degree.

On removing the skull-cap, a similar tumour was found on the dura mater, under the occipital bone; it had caused absorption of the surface of the bone, so as to expose the diploe. No deviation from the natural appearances was noticed in the brain, except that the ventricles continued rather more fluid than usual.

The testicles were perfectly healthy.

History of a Case of Remitting Ophthalmia, and its successful Treatment by Opium. By JAMES CURRY, M. D. F. A. S. &c. and senior physician to Guy's hospital.

[From the London Medico-Chirurgical Transactions for 1812.]

In the earlier period of life, my eyes were remarkably strong; and the power of vision very complete, both as to distant and to minute objects. The first injury they sustained, was during my stay at Edinburgh, and that owing to the practice of reading to very late hours in the night, without using the protection of a shade to keep off the direct light of

the candles, or a screen to intercept the cons ant glare of a blazing coal-fire. Still, the only effect of this, was simply fatigue of the eyes; from which they would probably have r. covered entirely, by mere rest. But having imprudently exposed myself upon one occasion, by getting out of bed, and standing for some minutes subjected to theight air at an open window, in consequence of a quarrel in the street, I was attacked, in a day or two after, with acute ophthalmia in the left eye; which, however, was in a great measure removed, in about a week, by the application of leeches, and the use of saline purgatives. A slight degree of obscure vision remained from turgescence of the vessels in the fore part of the cornea; but this gradually lessened, so as, in a year after, to be scarcely perceptible to myself, and not at all to the examination of another. A subsequent residence of eight months in Bengal, during which I suffered no less than five attacks of severe illness, in the different endemic forms of intermitting and remitting fevers, &c. not only radically impaired my general constitution, but laid the foundation of that particular weakened state of eyes, which I have ever since laboured under; every general febrile attack at that time, being followed by a recurrence of ophthalmia: and even a slight relapse of intermittent, which I sustained during the short prevalence of a westerly wind immediately after doubling the Cape of Good Hope on the voyage home, was attended by the same sequela.* From the period of my return in September, 1787, my eyes gradually gained strength; and would probably have continued to do so, had it not been for an unlucky accident. During the very severe weather in January, 1789, at which time the Thames was so completely frozen as to have booths erected upon it, a heavy fall of snow was immediately succeeded by a rapid thaw; and the pipes belonging to the house in which I resided, being all choaked with ice, the snow water

The chief mate of the ship had also a relapse of ague, but in both it was slight, and stopped after the second paroxysm by a remedy much used by the natives of India, for the cure of recent intermitting fevers.