to have been deceptive occasionally, upon post-mortem examinations. Whenever such cases occur in the practice of a physician, and permission can be obtained to institute an examination after death, he cannot, in my opinion, render the profession a greater service tha: faithfully to narrate them for publication in some medical journal. A conviction of this kind has prompted me to relate the following case.

In the spring of 1827, Dr P. Jordan, of this place, was attacked with symptoms unequivocally denoting dyspepsia ; and although every remedial agent had been tried, and every dietetic precaution observed on his part, yet the disease appeared to increase in severity, and to bid defiance to every attempt to arrest its career.

In June last, he suffered much from distention of his abdomen from flatus, which daily came on in paroxysms, and continued but for a short time, during which his respiration was impeded. The distention of the abdomen, it was supposed, occasioned the difficulty of breathing, by lessening the dimensions of the thorax, thereby interrupting the respiratory functions. The hepatic system appeared to be free of disease, and the intestines were generally in a soluble condition. About a week before his death, which happened on the 3d of July, his stomach rejected every thing that was taken into it, and, save the vomiting, there was no other indication of his complaint being gastritis.

In short, it was now believed that it was a scirrhus affection of the pylorus, which was beyond the reach of human skill. The irritability of his stomach was such, that the liquids, food, and even the medicines calculated to allay it, never remained longer with him than an hour at furthest, when they would be rejected. This continued to the hour of his dissolution. Permission being obtained, on a post mortem examination the villous coat of the cardiac portion of the stomach was found to have suffered much by chronic inflammation, the pancreas somewhat indurated, the right lobe of the liver much enlarged and thickened, and nearly a quart of serum in the cavity of the thorax. In the case of Doctor Jordan it was impossible, from the symptoms, to suspect so

many organs to be affected by disease. The almost incessant vomiting would have indicated the existence of inflammation of the stomach, but as the pain of which he complained in the epigastrium was always relieved by pressure; as he was free of fever, and as his prostration of strength was inconsiderable, the disorder with which he was afflicted was confidently supposed to be a scirrhus affection of the pylorus rather than gastritis. He never had any pain in the region of the liver, and he could lie with ease on his left side, so that this organ was believed to be sound, and as his dyspnoea only existed and continued during the distension of the abdomen, it was attributed to the latter circumstance. It may, perhaps, be proper to remark, that his habits of life were correct and exemplary.

CASE II. Disease of the Uterus. By JOHN W. GLONINGER, M.D. of Lebanon, Pennsylvania.

In diseases of an obscure and protracted nature, physicians, upon autopsical examinations, frequently find themselves to have been mistaken in their pathological views. Hence the necessity and importance of such examinations. The salutary tendency resulting from them to humanity ought to be a paramount consideration with relations and friends; but, on the contrary, the practitioner has very often, unfortunately, to contend with their prejudices, which form an insuperable obstacle to the consummation of his desire to discharge his duties for the benefit of the living.

at the

The subject of this communication, Mrs. Btime of her decease, was 44 years of age. Ten years ago in a state of pregnancy, and when advanced a little beyond the fourth month, she received a fall in descending a flight of stairs, which caused an abortion. From this period her health became impaired, and she frequently complained of pain in the hypogastric and lumbar regions. Her abdomen began to increase gradually until the time of her demise, when it really was of a prodigious size. She had frequent

miscarriages; and when not pregnant, her catamenial visitations were very irregular as to time and quantity, and in the interval she was much troubled with a leucorrhoeal discharge, and occasionally with dysuria.

The physicians whom she had consulted, considered it an ovarian affection, and upon an examination per vaginam, it evidently appeared that the ovarium on the left side was very much enlarged by disease. She tried every means that had been suggested by physicians of celebrity, but all appeared to be only palliative, as her situation daily became more alarming and distressing; and her death no doubt was accelerated by her having placed herself under the care of a vile pretender of physic, who purged her every other day for several weeks in succession, and, to cap the climax of his ignorance, prescribed medicines for the expulsion of a tape-worm, with which he confidently asserted she was afflicted. This treatment, as was to be expected, occasioned great debility, and she died hectic in January last.

Upon a post-mortem examination, I found in the abdominal cavity nearly two gallons of pus; the uterus, in a scirrhous state, of an enormous size, extending a little beyond the umbilicus, and occupying chiefly the left iliac and lumbar regions. The cavity of the uterus was entirely obliterated, and its substance very much thickened and indurated, and upon weighing it, a few ounces were only lacking of seven pounds.

Both ovaria participated in the disease, as they were somewhat larger than usual, and the fallopian tubes had a cartilaginous appearance.

ART. IX. Effects of Venesection in Abdominal Dropsy, supervening on a suppression of the Catamenia. By Robert Bayard, M.D. of Nova Scotia. Communicated by Dr. Watts.

MISS ELIZA R, aged 17, of a delicate constitution, and slender form of body, the daughter of a respectable farmer, was for a long time subject to occasional indispositions, which

were referred to irregular menstruation, for which aloetic cathartics and tonics were given, according to the urgency of symptoms.

Nov. 23d, 1820.-I was first called upon to visit her, in consequence of a tumefaction of the abdomen, which was tense and evidently fluctuating. At this period the swelling was uniform, and equal in size to a pregnancy of the fourth month. The patient, however, at times imagined that one s de was more prominent than the other; exciting a suspicion that the collection existed within the ovarium. The bowels were cos

tive-urine scanty-pulse quick and feeble-appetite much impaired-the body emaciated-the countenance palestrength reduced-the breathing somewhat oppressed in the horizontal position-skin dry-the catamenia have not appeared for several months. Her menstruation has always been somewhat irregular, both as respects time and quantity. From the history of the case and symptoms, I immediately resolved on the propriety of treating it as a dropsical affection; although I was not satisfied whether the disease existed in the ovarium, or whether the effusion was within the abdominal cavity. I put my patient under a course of cathartic and diuretic remedies; viz. pulv. jalap, c. sup. tart. potass, 1 oz. pro dosi, repet. mane et vespere ad alv. plen. solut. An emetic was previously given, with a view to rouse the action of the absorbents. After the cathartics had operated freely, a mixture of ether nitros, c. ol. junip. was given, and the bowels kept purged with aloetics, as best calculated to irritate the rectum and uterine system. The abdomen was rubbed with the ung. antimon.; and the acet. scill. was given both as a diuretic and expectorant, to relieve a severe cough, which threatened phthisis pulmonalis.

Dec. 29th.-The symptoms continued to increase, as well as the size of the abdomen-the medicines were continued— the muriated tincture of iron was given as a tonic and diuretic also. An effervescent mixture was given to relieve vomiting, which occurred at times partly from the irritation of the medicines and partly from constitutional derangement.

Jan. 4th. The symptoms began to show some abatement, and the abdomen, which was kept swathed, began to reduce in size-the urine increased in quantity—and there was hope that the case was going on to a favourable termination, when from omission in ta ing the medicines, the symptoms returned more obstinately, accompanied with very violent cough.

Feb. 1st.-The former plan of treatment was resumed as vigorously as the state of the stomach and system would admit; but it appeared to give no relief-the ether nitr. c. ol. junip. was omitted, and the sal. diuretic was given in doses as large as the stomach could bear. The kali ærat. saturated with vinegar, was also given. The cathartics were also given at intervals, as before prescribed—and large doses of nitrous ether, with as much cream of tartar in powder, and gin punch acidulated with the cream of tartar as the stomach could bear. The abdomen still gained in size, until it equalled that of the ninth month of pregnancy. My patient as well as myself, began to despair of success; and as she grew very weak, I discontinued her medicines. I may observe, that during her former treatment she had been several times electrified. On making farther inquiry into her case, I was told, that occasionally a few drops of blood distilled from her nose, notwithstanding the pale, sharp, emaciated appearance of her countenance; and I observed an indolent tumour of a phlegmonous character on her face and hands. I was led to grasp at this as a favourable indication, with reference to the cause of her complaint. I was led to hope, if I could alter the action of the intestinal absorbents, or rather increase it, and check that habit which the exhalents had acquired, I might arrest the further deposition of water, and trust to the vis medicatrix naturæ for the removal of what was present; and bearing in mind that power inherent in the constitution, of supplying its deficiencies from the loss of blood by an increased exertion of the chylopoietic viscera, I determined to put their energies to the test.

April 5th.-Notwithstanding the debility of my patient, I bled her. When the bandage was put on her emaciated arm, the flaccid vessels filled themselves tardily; and indeed the