1. May
1877.]
ORIGINAL COMMUNICATIONS.
NOTES ON PATHOLOGY.
Pokteb, M.D., F.R.C.S.I.,
(Continued from
Surgeon,
page
4sth
District,
Madras.
88).
ABDOMINAL CAVITY.
Stomach.
Peritoneal surface of 'visceral General appearance; peritoneum, dark pur- healthy mucous coat present* that in colour; ple covering, small intes- congestion of odd mutine, and pelvic vis- cous follicles, as red almost qu'te depressed spots of the cera, black; some lymphy size of a pin's point. effusion iu parts, but no fluid.
Small
Intestines.
Large Intestines.
Peritoneal coat of claret Peritoneal surface not so uni31 ozs.; surface smooth colour; some folds of ileum formly or so deeply congested and shining, very dark adherent by recent lymph as that of the small intestine ; in colour; organ small; to sigmoid flexure; con- on the free borders there are feels so boggy that an tains thin yello\y fluid; ar- many dark oblong patches evi- abscess is suspected, borescent congestion of dently the bases of ulcers on but is found only soft mucou9 membrane, which is mucous coat seen through the on section and gorged thin and looks pale at a thinned outer coats ; mucous with venous blood; is membrane congested and thick- non-alburaenoid; distance. gall ened, especially along free bladder distended with border of colon; in sigmoid tar-like bile. flexure thickening is all round, and congestion most intense, thickening from interstitial deposit, ulceration in different stages; ulcers from 4 to 5 lines by 2 lines broad, placed transversely along whole length of colon; one large ulcer placed in sigmoid flexure had penetrated to peritoneum and caused the peritonitis; folds of ileum adherent to this part of sigmoid flexure; depressed
melanotic cicatrices
Parietal
mottled; black;
peritoneum visceral
mesentery
omenta and intestines matted together; cavity contains about three pints of light
amber-.coloured fluid.
Distended with darkcoloured fluid; mucous membrane stained state colour; peritoneal coat claret-coloured.
Liver.
Distended like stomach (throughparalysis from peritonitis ;) mucous membrane slate-coloured ; a few aphtha) on valvula; conniventes; Peyer's patches livid thickened, ana at lower end of ileum ulcerated; solitary glands nearileo-ceecal; valve also livid and swollen, and some of them ulcerated; peritoneal coat quite black; adherent to neighbouring parts by recent lymph.
Spleen.
3 and
ozs.
;
Left
Right Kidney.
soft
2 ozs.; capeasi-
flabby; is sule strips quite black and ly ; veins
is very friable.
gested, wise
con-
other-
Kidney.
Pancreas.
Slightly lighter Not noted, than, but otherwise like, right.
Mesenteric Glands.
Not
noted.
seems
healthy.
POKTER,
Peritoneum.
M.D.
No,
numerous.
Peritoneal coat less black ; that 31 ozs.; surface smooth 7 | ozs.; firm; 21 ozs.; small, intestine distended and shinin?, mottled, hypertrophy of but apparently ele- healthy. greenish mud-colour- fatty; gall bladder full fibrous ments. mucous membrane of dark-coloured bile. not thickened, but studded over with small ulcers of the size of a pin's head at of small with thin ed fluid; of colon
A. PATHOLOGY.?BY ON NOTES
A.
2
ozs.
Not
noted.
Much
en-
larged.
about 20 to 25 to the square
inch; thickening in folds in and sigmoid flexure, dark studded with pale and dark based ulcers.
-Q3
By
Peritoneum.
Healthy.
Stomach.
tinged with membrane coated with white mucous, difficult to be removed. Contents
bile;
mucous
congested,
Small
Intestines.
Mucous membrane rosecoloured ; a lumbricus in jejunum; patches of congestion through whole length of two inches long; some inches of ileum above ileoccecal valve congested and covered with a thin white lymphy effusion, not detachable from subjacent
Large, oblong,
brown based
ulcers, with sharp cut edges in caput thinning and coli; pallor of ascending colon; minute pale ulceration of mucous follicles in parts thickening, and ulceration towards upper ends, folds of transverse colon livid and ulcerated ; 'wo or three and very large irregular black based mucous membrane; con- ulcers in this part, and an tents, mucous tinged green. abscess (as big as a large pea) of a closed follicle; lividitv and much thickening of mucous membrane of descending colon, which is closely studded with small ulcers; sigmoid flexure presents black tubercles (thickened transverse folds), with clean punched out like ulcers
between, on
a
livid
peritoneal
Parietal glistening and pearly; visceral slate grey colour to
Healthy.
lengths;
contains
purple, shining.
membrane slate
Mucous green;
congested no
a
ulceration;
little
pultaceous matter.
greenish
48 ozs.; surface smooth and shining; feels and cuts seems firmly; healthy; gall bladder full of dark-coloured bile.
114 Spleen.
Eight Kidney.
Left
Kidney.
6 oz.j 6i ozs.; tur- 4 ozs,; capsule gid ; feels soft, strips easily; right. some mottling healthy. posteriorly, and a
like
Pancreas.
Not noted.
Mesenteric Glands.
Much
larged
en-
and
pigmented.
small urinous on
cyst
verse
con-
border;
vessels of calices injected; substance rather
pale.
ground.
Outer coat black, inner Outer blaci, inner with transDistended with gas; covering pale, former looks blue verse rose-coloured patches of the thinned coats effusion about mucous coat through ; by J-inch and healthy ; pale ; some small white Peyer's glands and patches J-inch apart, extending through and some stellate red shrunken ; contents, a little the whole length of gut, all studded with small round ulcers spots towards the py- green pultaceous matter, omentum and visceral lorus. penetrating no deeper than to mucous membrane through the peritoneum quite effusion ; some of the effusions toand matted black, torn lengthwise in manipulagether by recent adhesions. tion, exposing mucous membrane, latter pale in interspaces
Parietal,rose-colour-
ed, adherent by points of soft pale lymph to all the organs; cavity contains a pint of bloody serum; great
Liver.
Large Intestines.
Peritoneal coat slate grey to purplish black on descending colon ; mucous coat quite black, and ulcerated; thickened, thickening (in transverse folds), predominant in transverse colon,
31 ozs.; convexity adherent to diaphragm by recent lymph ; feels moderately firm; cut surface looks pale and fatty; no reaction with iodine; gall bladder full of thin yellow bile.
5 ozs. ; surface with studded soft lymphy
strips
tion of tubercular substance.
noid.
4 ozs.; veins cut
capsule easily; injected ;
4 ozs. ; very much like right.
Not noted.
Enlarged.
surface points; firm; cut surface presents pale; seems fat a large proporty, non-albumi-
41 ozs.; surface smooth 9 ozs. ; firm ; and shining; cuts firm- cut surface dark is under venous-colourly ; pale, fatty microscope, nou-albumi- ed;; very frinoid; gall bladder half able, full of fluid bile.
3 ozs.; small; capsule slightly adherent;
healthy.
4 ozs.; capsule Not Doted. strips easily, healthy.
Not noted.
ulceration predominant, thence to rectum; ulcers irregularly circular ; size of a powla, with deep jet black bases, and occupy fully one-half of whole mucous surface in sigmoid
flexure.
Healthy.
Healthy.
8mall, healthy.
Healthy.
of mucous membrane and ulceration of Heyer's glands near ileo^ ceecal valve.
Pigmentation
Mucous coat of jejunum stained yellow; Peyer's glands tumid, of ileum congested; livid in lower half with circular different coloured depressions (looking like ulcers).
Mucous membrane dark slate.
30 ozs.; small; veins dark blood;
much thickened, full of coloured, slouahy ulcers in transverse healthy. colon; sloughs firmly adherent.
Caput coli has slate-coloured coat, with two large roundish black based ulcers; colon pigmented, thickened in transverse folds, and studded with round ulcers. mucous
6 ozs.;
17 ozs.; large, 40 ozs.; adherent by of left lobe to great thickenspleen, white marks of ing of peritoon neal organized lymph coat; adconvexity ; cuts firmly ; herent, very seems healthy. flrmly to diaphragm.
tip
4 ozs.;
seems
healthy.
strips
urinous
4 ozs.; capsule easily; right.
like
li
ozs.
Not
noted.
cysts on convex border.
3j ozs.; cyst on
surface
con-
ozs.; no cyst, otherwise like
[ taining pus-like right. fluid ; capsule adherent; sub,
stance
fatty,
Not noted
Consider-
ably
larged.
en-
1877. 1, [Mat
N o.
CAVITY.-(Continued).
GAZETTE. MEDICAL INDIAN THE
ABDOMINAL
tion.
Pearly and shining, bu' transverse mesocolon injected and brittle; cedema of sub-peritoneal tissue of sigmoid flexure and descending colon.
Pearly
Pearly
and
and
Healthy.
Coats thin but
healthy.
White viscid mucus adherent over congested patches of mucous membrane at cardiac end.
Healthy
Pearly shining;
straw-coloured
some
fluid
coat of caput coli with dark cicaascending colon light trices; slate-coloured, granular, and thickened; of transverse and descending colon; dark slaty purple, with livid tubercles on transverse rugse ?nd ulcerated ; of sigmoid flexure, ruea; ulcerated away, and ulcers healed, leaving islands of pale healthy look mucous membrane among rivers of black.
43 ozs. ; fatty; gall bladder full of thin bile.
Healthy
10 ozs.; looks
near
pressure.
us
coat
and of rectum in transverse line.
ileo-cacal valve.
Coats
thin
Tiealthy.
and
pale,
Thinning and pigmentation in spots; a few scattered large ulcers on thickened patches towards lower end of gut, and many cicatrices through to muscular coat.
46 ozs.;
x6 x3 inches:
firm, free from fatty other degeneration.
or
14^
ozs.
; 6x
inches; fri;
3 ozs.;
(under scope.)
healthy.
4x2 able face dark
muc
ozs.
;
right.
quite 1$
s
Mucous coat
Heaithy
slough
rugee,
er
con-
ably
cut
sur-
exudes
pulp
4$
sule
ozs.
fatty
micro-
; cap-
strips easi
ly; healthy.
3 ozs.;
like
Not noted.
right.
50
ozs.;
like
2
ozs.
right
Enlarged.
Enlarged.
on
17 ozs.; large; 3J ozs.; small 3? ozs.; like 7Jx4Jx2? in- capsule; does right. ches ; firm, hy- not strip easipertrophied. ly ; fatty.
Not noted.
Consider-
ably
en-
larged.
Not
noted.
Not
enlarged.
in
pigmented, thick-
34 ozs.;
fatty
as seen
ening and ulceration in trans- under microscope.
verse
bathing pelvic viscera;
Very
id
enlarged.
28 ozs.; small, slightly 5 ozs.; small ; Mucous coat pigmented, con4 ozs.; capsule 3i ozs.; quite Pale; a small round de. granular congested, but seems firm, pigment- slightly adher- like right. pressed pigmented, but not gested, thickened, ent ; veins conpuckered spot on mucous throughwhole length; large oval healthy; gall-bladder ed. membrane near ileo-csecal ulcers on raised bases, and filled with dark bile. gested; healthy. covered with grey transverse colon.
ozs.
most
intense toflexnre, where
firm, healthy.
3| ozs.; fatty.
3$ ozs.; small but healthy under miscroscope.
ozs.; seems
4 ozs.;
fatty.
Not
noted.
Very much enlarged.
noted,
Not much
wards sigmoid there are tuberculoid, pustular ulcers, confluent in rectum, converting rugse into slough like
oedema of mesentery about sigmoid flexure.
masses.
Healthy
Contains some food; coat pink,
mucous
healthy.
Healthy
Coats thin and Dale
Mucous coat
gested
as
slightly
con-
during digestion.
Mucous coat pale, not amyloid; a thin layer of dried faecal matter adherent to surface for two feet above ileo-caical yalve; Peyer's
glands empty.
ulcers on thickened patchat beginning of ascendiug transverse colon ; much general thickening and deep ulceration in descending colon, the ulcers grey in the centre and raw, and bleeding at the edges and occupying half the surface ; sigmoid flexure ; one grey sloughy ulcer.
27i ozs.; compact and firm ; cut surface, nutmeggy, nothing abnormal, detected by microscope; gall bladder full of thin green bile.
3 ozs.; very small and firm; cut surface
quite
Not
and ulceration of rug?e; very marked transverse and descending colon, "where the whole surface looks one butf'-coloured ulcer, with occasional knobby warty islets ; in sigmoid flexure there is much thickening, with lymphy effusion on surface not de-
54 ozs.; lOin. x5f in, x 4 inches ; congested not albuminoid or fatty; gall bladder nearly empty; bile brown.
6 ozs.; small, 3\ ozs.; healthy. 3? ozs.; quite like right. flaccid, blue, friable very
Not
Grey
es
and
Thickening
transverse
in
tachable.
brown, thickly
with studded white spots (cut trabecu-
3^
like
ozs
;
right.
enlarged.
noted.
May
2}
like
a bean near lower end.
52 ozs.; KH X7 x 3J inPigmentation, thickening in parts, thining in others, dark ches; flaccid, dark-copatches; pigmentation of cicatrices of ulcers in colon; loured, but healthy. solitary glands ; grey exuda ulceration and pigmentation of tion on some Peyer's patches mucous coat of sigmoid flexure of
valve.
13
Mucous
slate-coloured,
Thinning of coats ; conges
t.iou
...
Peyer's glands
of
Not noted
shining
shining
Coats thin ; shrunken.
5 ozs.; flaccid, 2$ ozs,; small; tough, a white fatty. desyphiloid posit as big as
1877.] 1,
sigmoid
2P 079. ; Pcnr white of little depth on convexity ; cuts firmly ; a good deal of blood flows from surface; fatty; gall bladder full of brownish green bile.
M.D. PORTER, A. PATHOLOGY.?BY ON NOTES
free border of flexure.
Mucous coat pigmented; Pigmentation and superficial lower part of ileum lividly ulceration of mucous membrane congested arid ulcerated ; of colon; ulcers in various ulcers, grey, of Peyer's stages of healing; also dark patches and near ileo-csecal cicatrices interspersed ; in sig valve, and pigmentation of moid flexure is thickening pigmentation and sloughy ulcerasolitary glands.
Much
enlarged.
H5
dark Mucous coat arboresHealthy; spots beneath surface, cently congested at over ileum, and cardiac end. great intestine, also a livid band along all
m
i
'\
\ 116
s ABDOMINAL CAVITY .-(Continued).
J7
18
Slate prey-coloured shining.
;
Contains
some
food;
digested normal.
Healthy
Coats,
Healthy
Healthy
Liver.
Mucous coat pigmented; a Mucous coat congested, of claret colour near middle of good deal of thickening in transverse colon, in with ulceration color slate of jejunum, ilium, and lined with gelati- transversely; this thickening and ulceration extends to sigmoid nous matter towards ileoflexure ; coats of other parts coecal valve. of colon thinned.
Not noted
Healthy
Large Intestines.
Small Intestines.
Stomach.
thin and
Tin-
coats
Contains rice-water like fluid ;
coats
thin
:
inner
slato-coloured.
pale
...
Coats,
thin and
pale 3
Contents rice-water stools; cnat pigmented ; dark cicatrices in caput coli; transverse ulcers at upper end of ascending colon ; much thickening and congestion wi'h numerous small shallow round ulcers in sigmoid flexure.
mucous
Coats thin j
sloughing of
mu-
36 ozs.;
congested
soft; gall bladder of greenish bile.
and full
33 ozs.; anaemic but
healthy; gall
bladder bile.
20
Healthy ; dark veins ramifying on in-
Contents
Not noted
21
Healthy
Healthy
23
21
25
26
Healthy Healthy
Healthy
Healthy
yellowish green
Contains mous
a
fluid.
little gru-
Contents
dark
green, pultacoat ar-
with
Coats thin ; some venous gestion of mucous coat.
con-
20 ozs.;
small; 7x5x2?
brane coated white mucus.
membrane
rose-coloured.
4 ozs.;
7ozs.; 6x5x1 4$ ozs.; fatty.
47 ozs. ; 13 x 6i x 4J inches ; soft and flabby;
healthy
;
gall-bladder
7i ozs.;
con-
uni-
5 ozs. ; 6 ozs.; intensely congested; cor- right.
like
gested
;
two
small
cysts surface.
7J ozs.; firm healthy.
seems
5 ozs.; 5x3? X 1 inch; flaccid ; small.
5
ozs.;
ozs.;
seems
healthy.
44 ozs.; like right.
on
3 i ozs.; like 3$ ozs.; cortex pale; capsule right. 8 trips easily.
4 ozs. ; quite ozs.; small 4J ozs.; capsule firm. strips easily ; like right.
ly ; fatty.
6 ozs.; firm and rounded ;
3 ozs. ; like 3| ozs.; small; capsule strips right. easilr; anajmic ;
Healthy
52 ozs. ; 11x7x4 in. ches ; flabby; heatthy ; full of gall-bladder green bile.
venous on
64 ozs.; 13 x 6f x 3f inches ; large, soft, but healthy ; gall bladder contains some thin bile.
27$ ozs.; 8 x 5 x 2 inches; large and flaccid; substance brownish
glands empty ; pigmented.
Mucous coat pigmented ; two dark cicatrices in caput coli : congestion in rectum.
Not
noted.
Enlarged
and
black.
substance
Not
enlarged.
Not
noted.
Not noted.
Not
noted.
Quite
healthy.
tex thickened.
32 ozs.; small, flaccid, and pale ; fatty ; gall bladder empty.
coat
enlarged.
formly congested like right.
Peyer's glands prominent; Healthy healthy.
Peyer's
Not much
3 ozs.; capsule 2f ozs.; a small Not noted. strips easily ; abscess at lower conges- end; otherwise tion of surface like right.
able.
mucous
???"?
venous
10! ozs. ; very flaccid and fri-
congested in Healthy
Pancreas.
healthy.
73 ozs ; firm, but friable ; very fatty.
Healthy
Healthy
healthy.
6 and
Mucous coat
with
9. ozs; large and flaccid.
4 ozs.;
40 ozs. ; congested ; cicatrix on convexity of little depth.
parts ; healthy.
mucous mem-
41 ozs.; veins distended with dark fluid blood ; healthy.
full of viscid green bile,
rice-water stools ; Mucous coat rather pale congestion of sub-peritoneal veins ; coats thin.
Empty ; healthy
Mucous
thin, tinged
Contains
Not noted
Empty;
Coats
saffron-coloured contents;
veins of mesentery full of dark blood.
firm,
membrane in patches in inches ; pale yellow; gra- inch; flaccid; descending colon, and ulcera- nular on surface; fatty; tough ; empty. tion on deeply congested spots, gall bladder full. and almost perforation in sigmoid flexure, but no periton-
cous
pultaceousmatter ; mucous ceous matter; mucous coat injected in parts. borescently congested.
seen
testines.
ozs.;
Left Kidney.
and of calices.
Deeply congested and much 41 ozs. ; congestion of thickened of asoending colon, and veins ( intralobular ); ulcer as large as a powla in no degeneration of its caput coli; other parts seem tissue detected; gallbladder full. healthy.
Healthy
7
healthy.
full of dark viscid
itis. 19
Eight Kidney.
Spleen.
Notnoted.
Normal.
Not noted.
Not
noted.
GAZETTE. MEDICAL INDIAN THE
16
Peritoneum.
con-
gested.
seems
11
healthy.
ozs
Xlf
flaccid;
; 7x4
inches; dark
sec-
tion.
red.
5| ozs. ; capsule strips easi-
5 ozs. ; quite like right.
3J
3
ozs.
ozs.
Normal.
Normal.
fatty.
4 ozs. ; cap3$ ozs. ; like sule separates right. easily;substance
Notnoted.
Healthy,
4^ ozs.j like 4$ ozs.; capstrips easi- right. substance ly;
Notnoted.
Healthy.
congested.
sule
congested.
1877. 1, [Mat
No.
Healthy
Healthy
48 ozs.; 12}x6Jx2} inches ; congested; gall
bladder full.
28
Healthy
Healthy
Healthy
Healthy
63
ozs.
; 11 x9 x3 in.
ches; healthy; gallbladempty.
der 29
Healthy
...
Healthy
Healthy
01 ozs.; 11 x7}x3} inches; large ; dark brown
Healthy
on
33
31
35
healthy.
healthy.
ozs.;
13 ozs ; 7x51 Xl inch; pale liver-coloured ; not albuminoid.
5J ozs. ; capsule strips easily ; uniformly congested.
5
36} ozs.; large; 4} ozs.; healthy 4} ozs.; healthy 7} xB x 2 inches ; ?ol't, cut surface
Not noted.
Not noted.
Healthy
62ozs.; 11x7x3} ins.; plump; fatty; gall bladder full.
12 ozs.; 7x6 4| ozs. ; cap4} ozs. ; like X2 ins.; flabby, sule adherent in right. tough and fi- places ; somewhat fatty. brous.
Healthy
Healthy
Healthy
Healthy
54 ozs.;
14 ozs.;
Healthy
Healthy
Healthy
Healthy
64 ozs.; 10x8x3} firm ; healthy.
Healthy
Healthy
Healthy
Healthy
Empty;
Ulceration of eight Peyer's Mucous coat moderately innear caecum; ulcers jected; black round spots (cicablack ; surroundings livid trices of ulcers) in ascending and swollen ; two lumbrici colon. in jejunum.
patches
mucous
slightly congested. Healthy
coat
Healthy;
congested
in
parts.
Healthy
Pigmented ; congested
in
parts.
Thickening and ulceration through whole length; ulcers covering fully one-half of entire surface,
Healthy
Healthy
Healthy
Healthy
Healthy
Healthy
Healthy
Healthy
most extensive and in sigmoid flexure.
44
ozs.
seems
j
quite
soft...
13 ozs.;
pulpy.
soft;
4} ozs.; healthy. 4} ozs,; healthy. Not noted. 4 ozs. ; capsule strips easi-
18 ozs.; firm
4
;
like
3 ozs.; like right.
quite
gested; healthy
4 like
quite
3 ozs.;
ly; congested. 3}
;
ozs.
; cap-
healthy; gall bladder pigmented; not sule strips easidistended with thin albuminoid. ly; ansemic. green
ozs.
right.
Not noted.
3
ozs.
healthy.
bile.
26 ozs. j very 63$ ozs.; large; 12x6} x3} inches; structure friable. normal; gall bladder full.
4 ozs.; under scope.
con-
micro-
35 ozs.; small, 9}x5} X4 ins., ansemic; fatty under microscope.
7} ozs.; 5} x 4} xl in. ; flabby ; tough; pigmented.
3 ozs.;
fatty
66 ozs.; plump 10x8 X2 inches; pigmented.
12 ozs.; 6x4 Xl inch ; cut surface dark; substance of consistence and appearance of black currant
4 ozs.;
fatty
...
ozs.
;
right.
2J
2
fatty.
ozs.
healthy.
ozs.
healthy.
3} ozs.; fatty.
;
Not noted.
jelly. 54 ozs.;
fatty microscope; gall der
Healthy
Injected
Pigmented
Pigmented ; dark cicatrices in sigmoid flexure.
Healthy
Healthy
Healthy
Healthy
Healthy Healthy
Injected Healthy
Contains
fluid.
under blad-
empty.
62 ozs.;
fatty
a
little yellowish
Veins injected
Healthy
51 ozs. ;
fatty ; empty.
Healthy
...
congested ;
gall
bladder
28 ozs.; small; left lobe adherent to anterior surface of stomach;
congested interlobularly ; no degeneration detected.
4} ozs. ; fatty...
5
ozs.
;
4
ozs.; healthy. 4 ozs.; healthy.
; 8x5 flaccid and friable.
4
ozs.
8} ozs.; friable.
4} ozs.; fatty.
15
ozs
xl} in.;
7 ozs.; firm ; seems
healthy.
quite
;
healthy.
3}
con-
gested ; fatty.
firm;
10 ozs.;
54ozs.; small; 10} x 7} inches; healthy.
...
6} ozs.; flaccid ; very friable.
healthy.
x3
Not noted
brown.
Healthy
ins.;
noted.
Not noted.
;
Healthy
healthy
Not
like
ozs.
right.
Healthy
sloughy 36
section ;
11 ozs.; 8x4}x 4} ozs.; healthy. 14 inch ; firm;
healthy.
May
Healthy
1877.] 1,
Healthy
ozs.;
healthy. 2^
ozs.
4 ozs.;
healthy.
Not noted.
6 ozs.;
fatty
3
...
ozs.
Horse shoe, kidney 12 ozs.; Seems capsule strips easily ; is quite mal.
healthy.
nor-
M.D. PORTER, A. PATHOLOGY.?BY ON NOTES
27
218
CAVITY.-(Co?we;/.)
No. Peritoneum.
Stomach.
Pigmented; studded with masses of the size of a pin's head to that of a split pea, apparently of organized lymph, and are
Pigmented; a few small purple spots on mucous coat; healthy.
detachable, the
ing
Large
Small Intestines.
leaving peritoneum shinbeneath; only
about three ounces of st raw-coloured fluid in the cavity.
Intestines.
Pigmented ; thickening with two round ulcers, black base and raised edges, and white cica? with grey tubercle ; latter trices in ascending colon, also and one solitary gland ul- thickening and superficial ulcerated ; larger ulcer size of ceration in transverse and dea two-anna piece, with scending colon ; in sigmoid raised edues ?nd black base ; flexure there is mammillation only jejunum and upper with the thickening and reddish black colouration as if from reend of ileum implicated. cent haemorrhage.
pigmented
Mucous coat ; and some solitary glands one Pe.rer's patch distended
J.iver.
Spleen.
Right Kidney.
52|ozs. ; looks quite black j right lobe firmly adherent by its convexity to the diaphragm; cut surface dark chocolate green, studded with- e rey tubercles as big as No. 1 or No. 2 shot, and with small abscessfes o?. b g as beans containing viscid ocbfrejr pus ; tubercles larger than No. 1
4 ozs. ; firm ; black cut surface studded with pale larue firm corpuscles
4 ozs. ; pale yellow, intense, ly fatty.
shot,
are
Left
Kidney.
4 ozs. ; quite like right.
Pancreas.
ozs. ; seems nor-
Mesenteric Glands.
A few
en-
larged from tubercular
Dial.
deposit.
(tuberculated.)
generally
found with ochrey centres showing incipient left softening ; the lobe is not enlarged, and the tubercles there are small and grey gall bladder distended, with black greenish viscid bile, 43
Adherent to intestines Containing a pint of yellowish red foetid and omentum by recent viscera adherent fluid, lymph ; mucous coat to parietes and to healthy. each other.
Pour large black-based, thickPeyer's patches empty ; at lower end of jejuedged ulcers, one in caput colii
one
num
ulcerated.
one
in
sigmoid flexure,
others
in intervening part about equidistant ; perforation of sigmoid flexure by ulcer.
36 ozs. ; capsule torn off in removal, small; 8^ x 5ji X 2^ inches ; flabby ; congested with venous blood.
Not noted.
T.arge and black.
2i ozs.; like Not noted.
Not noted.
9 ozs. ; firm ; 4J ozs.; quite 4| ozs. ; pale x 3| x 2 yellow; capsule like ri;rht. inches; capsule strips easily. mottled with whito fibroid, spots; yellow shot-like
de-
posit in corpus(tubercu-
cles
lar)
seen
on
section.
Healthy 45
Healthy Healthy
Contains thirteen round worms; mucous coat injected, but not ulcerated.
Healthy
Contains
some
food:
healthy.
in
sigmoid
Healthy
Healthy
Healthy
Mucous coat flexure injected.
Mucous coat thin and pale, covered with tenacious mucus.
28
ozs.
diseased.
j
soft,
not
39? ozs.; small ; 8i x 6x3 inches; healthy; gall bladder empty.
30 ozs.; 12| x 6 x Thickening; congestion,pigmentation, and ulceration of mucons 3 inches ; firm but coat; ulcers shallow, small, anaemic"; gall bladder circular, brown based, occupyins contains some dark bile. one-half the entire surface of flexure; mucli fewer ulcers in ascending and transverse colon, but thickening continues to ca;cum.
6 ozs.; and soft.
small
3 ozs.;
small,
yellow; injec- right. tion of calices.
noted.
; like
Not
noted.
Not
2J ozs.; quite
Not
noted.
Enlarged.
2 ozs ; quite 2? ozs. ; 5 ozs; soft, 21 ozs. ; pale normal. free and anaemic, like right. friable, not fatty. from deposit.
Enlarged,
0$ ozs.; flaccid ; 6| x 4J x 1 inch ; pigmented. 7 ozs ; 5J x 3? X If inch ; firm, liver-coloured on section.
4 ozs.;
strips some
4
capsule
with
difficulty.
right.
3 ozs.;
small, ffimic, healthy. an
ozs
GAZETTE. MEDICAL INDIAN THE
ABDOMINAL
like
right.
Mucous
coat
pale.
rather
Injected
as
indigestion
Transverse and descending colon and sigmoid flexure much
thickened, intensely congested,
but neither ulcerated 48
Healthy
Coats
thin
Mucous coat a-ith bile.
thin, stained
mammillated
nor
Caput coli grey, with several livid ulcerated blotches, transverso colon ; one mass of black puckered scars, other parts
pigmented.
29 ozs.; small, firm and rounded ; slightly fatty under microscope.
27 ozs.; x
fatty.
small; 8| x 31 inches; anaemic;
8
ozs.
5i x inch.
3
;
firm; 3 ozs.; fatty 14
x
3
ozs.
j
fatty
Not noted.
Enlarged.
1877. 1,
Healthy
[May
sigmoid
Healthy
Healthy
Mucous
Healthy
gested,
cost
con-
venous.
Healthy
8 ozs.; small; x G x 3 3| ozs.; fatty; x 4 x 2J capsule adherquite gall bladder inches; capsule ent. full of green bile. pigmented. 42 ozs.; 11
inches; healthy ;
Healthy
Mucous coat of duodenum of a dark claret colour, and of parts jejunum
44 ozs.;
63
Healthy
Inflamed;
Mucous coat
Healthy
great
omentum adherent to parietes and to small intestines; mesbut entery pale bathed in pus-like white fluid, in quantity about two glasses; effusion lymphy adherent to capsules of spleen and liver; no signs of tubercle
congested.
Empty; mucous coat greenish at great curvature.
moderately
Peritoneal coat inflamed and adherent to neighbour-
ing
coat
structures;
mucou?
healthy.
10 ozs.;
healthy
healthy.
firm,
3 ozs.;
healthy.
3i ozs.; like right.
3
ozs.
like
;
Not noted
Not noted.
Not noted
Not noted.
right.
Healthy
51 ozs. 5 healthy ; 12 5 ozs.; congest 7s ozs.; small; 5-4 ozs.; like Not noted. x 7 X 3i inches ; gull 6x3Jx inch; ed ; capfule right. firm ; bladder full. white strips easily. spots on capsule (syphilitic P)
Healthy
GS^ozs.: large, antemic; gall-bladder full.
similar.
62
seems
14J ozs.; large; x x 1^ inch; flaccid, pigmented. 7
6 ozs.; much
to diaphragm, cut surface mot-
40 ozs.; healthy; gall bladder distended with bile.
4J ozs.; firm cut surface
ozs
; much
Not noted.
Healthy.
Not noted.
Swollen.
congested; cap- congested; capsule strips easi- sule adherent. ly.
Healthy, except redness of 34 ozs.; 10 x 6 x 3i 14 ozs. ; large; 2?ozs.; small; inches; adherent to 7 X 5 x 2-j in- healthy. peritoneal coat. diaphragm; on removal, ches ; adherent surface mottled green and pink, coats soft, outer half inch con-
0
2
ozs.
;
like
Normal.
right.
tled,livid or red, gested, pale internally ; but no blood gall bladder full of exudes on section. green bile.
anywhere.
...
Health)
Contains pultaceous matter ; mucous coat tinged with bile; reddish; Peyer's
Empty
glands full.
Pearly and shining
Healthy
...
in folds and effusion of bloot5 inches; together is very slight in this flows from cut surface pigmented.
Congested
which is flesh-coloured ; 14 x 7 X o inches.
case.
Mucous
hue.
coloured.
Mucons coat greyish rosecoloured ; solitary glands prominent, as big as piu's heads.
;
fibro-granular.
coat
of
rosy
Mucous coat pale, with dark srots like old cicatrices of ulcers.
70 ozs.;
12f
X
inches;large :
7j
x
4|
veins con-
10J ozs. ; flaccid; 5? x4J x 1^
inch ; pulpy and pigmented. -?
8 ozs. 6 ozs.: pale yellow, except larged and with scongbulging on conpurple tion surface, opposite v e x like right. central calices.
45 ozs.; gested of ous
5 ozs.;
capsule easily.
5^
conven-
huo.
ozs.
;
livid, strips
con-
gested.
4
ozs.
;
like
Not noted.
Not noted.
5
ozs.
Few and
small.
right.
; like
Not noted.
Not noted.
con-
Not noted.
Not noted.
PORTER,
Healthy
Healthy
Healthy
Healthy
right.
5
ozs.
;
M.D.
64
Mat
Healthy
1877.] 1,
61
Healthy
Healthy
A. PATHOLOGY.?BY OjST NOTES
60
Healthy
gested.
1
Healthy
Healthy
Contains ten large lumContains a pint of ghee and milk ; local brici and three plugs of venous congestion of mucus as big as an egg, mucous coat; other parts with a little greenish grumpale rose-coloured; ous fluid; mucous coat arsenic found on analy- dark chocolate-coloured. sis. Contracted to size of caput
the
coli, empty; mucous coat purple; arsenio on ana-
lysis.
coat Empty ; mucous darkly congested with some matter adherent to surface.
fellow
Looks
quite normal
30
ozs.
;
anceaiic;
flaccid and
gall bladder
full of green bile.
Contains raw
dhall;
coloured.
some mucous
grains coat
of
rose-
55?
ozs.
healthy.
;
seems
quite
3} ozs.; small> livid, pigmented.
2f ozs.; venous congestion con-
3 ozs. ; quite like right.
Not noted.
Of size.
6J ozs.; flrm ;
4 ozs. ; livid from congestion.
quite
Not noted.
like
Large.
cut
brown.
surface
siderable.
3-J
ozs.
;
right.
norma
jjg
49
Peritoneum.
Black marbled with old white lymphy effusions ; intestines and omenta matted
Small
Stomach.
Not noted
Not
Large Intestines.
Intestines.
noted.
Not noted
Contains food mixed with spirituous liquor ; coat congested.
Liver
Spleen.
47 oz9. ; much enlargyellow, train-oillike fluid exudes from cut surface; very fatty; pieces float in water ; gall bladder empty.
ed,
together; cavity contains two gallons bloody serum.
Healthy
CA\WY.-(Continuded.)
Veins engorged
Seems
Healthy
Healthy
healthy-
hepatic veins
50 ozs.;
congested; pigmented.
6? ozs.; feels cut doughy; surface black and exudes a tar-like fluid.
5 ozs.;
looks
healthy.
Right Kidney.
3
ozs.
; looks is under
fatty, and found
so
Left Kidney.
3 ozs.; like right.
quite
Pancreas.
Mesenteric
Glands.
Not
noted.
Not noted.
Not
noted.
Not
Not
noted.
Not noted.
microscope.
4
ozs. ;
livid,
congested.
3| ozs.; like right.
noted.
mucous
Healthy
Distended with gas; coat of cardial
mucous
and
28
ozs.
;
congested
;
3 ozs.;
a
small
3
ozs.
;
con-
3
ozs.
;
quite
;
like
deeply pigmented ; a rent at hilus, gested and pig. like right. with effusion of mented; very on convexity; friable; gall blood between friable. bladder empty. layers of gastro-splenic white scar substance
claret-coloured.
omentum.
Healthy
Healthy
Healthy
Healthy
44 ozs.;
seems
healthy.
7
ozs.
;
seems
healthy. (To be continued.)
firm; quite
4 ozs. 4J ozs.; deeply right. congested.
Not noted.
"Very small.
GAZETTE. MEDICAL INDIAN THE
No.
120
ABDOMINAL
1877.]
ORIGINAL COMMUNICATIONS.
NOTES ON PATHOLOGY.
Pokteb, M.D., F.R.C.S.I.,
(Continued from
Surgeon,
page
4sth
District,
Madras.
88).
ABDOMINAL CAVITY.
Stomach.
Peritoneal surface of 'visceral General appearance; peritoneum, dark pur- healthy mucous coat present* that in colour; ple covering, small intes- congestion of odd mutine, and pelvic vis- cous follicles, as red almost qu'te depressed spots of the cera, black; some lymphy size of a pin's point. effusion iu parts, but no fluid.
Small
Intestines.
Large Intestines.
Peritoneal coat of claret Peritoneal surface not so uni31 ozs.; surface smooth colour; some folds of ileum formly or so deeply congested and shining, very dark adherent by recent lymph as that of the small intestine ; in colour; organ small; to sigmoid flexure; con- on the free borders there are feels so boggy that an tains thin yello\y fluid; ar- many dark oblong patches evi- abscess is suspected, borescent congestion of dently the bases of ulcers on but is found only soft mucou9 membrane, which is mucous coat seen through the on section and gorged thin and looks pale at a thinned outer coats ; mucous with venous blood; is membrane congested and thick- non-alburaenoid; distance. gall ened, especially along free bladder distended with border of colon; in sigmoid tar-like bile. flexure thickening is all round, and congestion most intense, thickening from interstitial deposit, ulceration in different stages; ulcers from 4 to 5 lines by 2 lines broad, placed transversely along whole length of colon; one large ulcer placed in sigmoid flexure had penetrated to peritoneum and caused the peritonitis; folds of ileum adherent to this part of sigmoid flexure; depressed
melanotic cicatrices
Parietal
mottled; black;
peritoneum visceral
mesentery
omenta and intestines matted together; cavity contains about three pints of light
amber-.coloured fluid.
Distended with darkcoloured fluid; mucous membrane stained state colour; peritoneal coat claret-coloured.
Liver.
Distended like stomach (throughparalysis from peritonitis ;) mucous membrane slate-coloured ; a few aphtha) on valvula; conniventes; Peyer's patches livid thickened, ana at lower end of ileum ulcerated; solitary glands nearileo-ceecal; valve also livid and swollen, and some of them ulcerated; peritoneal coat quite black; adherent to neighbouring parts by recent lymph.
Spleen.
3 and
ozs.
;
Left
Right Kidney.
soft
2 ozs.; capeasi-
flabby; is sule strips quite black and ly ; veins
is very friable.
gested, wise
con-
other-
Kidney.
Pancreas.
Slightly lighter Not noted, than, but otherwise like, right.
Mesenteric Glands.
Not
noted.
seems
healthy.
POKTER,
Peritoneum.
M.D.
No,
numerous.
Peritoneal coat less black ; that 31 ozs.; surface smooth 7 | ozs.; firm; 21 ozs.; small, intestine distended and shinin?, mottled, hypertrophy of but apparently ele- healthy. greenish mud-colour- fatty; gall bladder full fibrous ments. mucous membrane of dark-coloured bile. not thickened, but studded over with small ulcers of the size of a pin's head at of small with thin ed fluid; of colon
A. PATHOLOGY.?BY ON NOTES
A.
2
ozs.
Not
noted.
Much
en-
larged.
about 20 to 25 to the square
inch; thickening in folds in and sigmoid flexure, dark studded with pale and dark based ulcers.
-Q3
By
Peritoneum.
Healthy.
Stomach.
tinged with membrane coated with white mucous, difficult to be removed. Contents
bile;
mucous
congested,
Small
Intestines.
Mucous membrane rosecoloured ; a lumbricus in jejunum; patches of congestion through whole length of two inches long; some inches of ileum above ileoccecal valve congested and covered with a thin white lymphy effusion, not detachable from subjacent
Large, oblong,
brown based
ulcers, with sharp cut edges in caput thinning and coli; pallor of ascending colon; minute pale ulceration of mucous follicles in parts thickening, and ulceration towards upper ends, folds of transverse colon livid and ulcerated ; 'wo or three and very large irregular black based mucous membrane; con- ulcers in this part, and an tents, mucous tinged green. abscess (as big as a large pea) of a closed follicle; lividitv and much thickening of mucous membrane of descending colon, which is closely studded with small ulcers; sigmoid flexure presents black tubercles (thickened transverse folds), with clean punched out like ulcers
between, on
a
livid
peritoneal
Parietal glistening and pearly; visceral slate grey colour to
Healthy.
lengths;
contains
purple, shining.
membrane slate
Mucous green;
congested no
a
ulceration;
little
pultaceous matter.
greenish
48 ozs.; surface smooth and shining; feels and cuts seems firmly; healthy; gall bladder full of dark-coloured bile.
114 Spleen.
Eight Kidney.
Left
Kidney.
6 oz.j 6i ozs.; tur- 4 ozs,; capsule gid ; feels soft, strips easily; right. some mottling healthy. posteriorly, and a
like
Pancreas.
Not noted.
Mesenteric Glands.
Much
larged
en-
and
pigmented.
small urinous on
cyst
verse
con-
border;
vessels of calices injected; substance rather
pale.
ground.
Outer coat black, inner Outer blaci, inner with transDistended with gas; covering pale, former looks blue verse rose-coloured patches of the thinned coats effusion about mucous coat through ; by J-inch and healthy ; pale ; some small white Peyer's glands and patches J-inch apart, extending through and some stellate red shrunken ; contents, a little the whole length of gut, all studded with small round ulcers spots towards the py- green pultaceous matter, omentum and visceral lorus. penetrating no deeper than to mucous membrane through the peritoneum quite effusion ; some of the effusions toand matted black, torn lengthwise in manipulagether by recent adhesions. tion, exposing mucous membrane, latter pale in interspaces
Parietal,rose-colour-
ed, adherent by points of soft pale lymph to all the organs; cavity contains a pint of bloody serum; great
Liver.
Large Intestines.
Peritoneal coat slate grey to purplish black on descending colon ; mucous coat quite black, and ulcerated; thickened, thickening (in transverse folds), predominant in transverse colon,
31 ozs.; convexity adherent to diaphragm by recent lymph ; feels moderately firm; cut surface looks pale and fatty; no reaction with iodine; gall bladder full of thin yellow bile.
5 ozs. ; surface with studded soft lymphy
strips
tion of tubercular substance.
noid.
4 ozs.; veins cut
capsule easily; injected ;
4 ozs. ; very much like right.
Not noted.
Enlarged.
surface points; firm; cut surface presents pale; seems fat a large proporty, non-albumi-
41 ozs.; surface smooth 9 ozs. ; firm ; and shining; cuts firm- cut surface dark is under venous-colourly ; pale, fatty microscope, nou-albumi- ed;; very frinoid; gall bladder half able, full of fluid bile.
3 ozs.; small; capsule slightly adherent;
healthy.
4 ozs.; capsule Not Doted. strips easily, healthy.
Not noted.
ulceration predominant, thence to rectum; ulcers irregularly circular ; size of a powla, with deep jet black bases, and occupy fully one-half of whole mucous surface in sigmoid
flexure.
Healthy.
Healthy.
8mall, healthy.
Healthy.
of mucous membrane and ulceration of Heyer's glands near ileo^ ceecal valve.
Pigmentation
Mucous coat of jejunum stained yellow; Peyer's glands tumid, of ileum congested; livid in lower half with circular different coloured depressions (looking like ulcers).
Mucous membrane dark slate.
30 ozs.; small; veins dark blood;
much thickened, full of coloured, slouahy ulcers in transverse healthy. colon; sloughs firmly adherent.
Caput coli has slate-coloured coat, with two large roundish black based ulcers; colon pigmented, thickened in transverse folds, and studded with round ulcers. mucous
6 ozs.;
17 ozs.; large, 40 ozs.; adherent by of left lobe to great thickenspleen, white marks of ing of peritoon neal organized lymph coat; adconvexity ; cuts firmly ; herent, very seems healthy. flrmly to diaphragm.
tip
4 ozs.;
seems
healthy.
strips
urinous
4 ozs.; capsule easily; right.
like
li
ozs.
Not
noted.
cysts on convex border.
3j ozs.; cyst on
surface
con-
ozs.; no cyst, otherwise like
[ taining pus-like right. fluid ; capsule adherent; sub,
stance
fatty,
Not noted
Consider-
ably
larged.
en-
1877. 1, [Mat
N o.
CAVITY.-(Continued).
GAZETTE. MEDICAL INDIAN THE
ABDOMINAL
tion.
Pearly and shining, bu' transverse mesocolon injected and brittle; cedema of sub-peritoneal tissue of sigmoid flexure and descending colon.
Pearly
Pearly
and
and
Healthy.
Coats thin but
healthy.
White viscid mucus adherent over congested patches of mucous membrane at cardiac end.
Healthy
Pearly shining;
straw-coloured
some
fluid
coat of caput coli with dark cicaascending colon light trices; slate-coloured, granular, and thickened; of transverse and descending colon; dark slaty purple, with livid tubercles on transverse rugse ?nd ulcerated ; of sigmoid flexure, ruea; ulcerated away, and ulcers healed, leaving islands of pale healthy look mucous membrane among rivers of black.
43 ozs. ; fatty; gall bladder full of thin bile.
Healthy
10 ozs.; looks
near
pressure.
us
coat
and of rectum in transverse line.
ileo-cacal valve.
Coats
thin
Tiealthy.
and
pale,
Thinning and pigmentation in spots; a few scattered large ulcers on thickened patches towards lower end of gut, and many cicatrices through to muscular coat.
46 ozs.;
x6 x3 inches:
firm, free from fatty other degeneration.
or
14^
ozs.
; 6x
inches; fri;
3 ozs.;
(under scope.)
healthy.
4x2 able face dark
muc
ozs.
;
right.
quite 1$
s
Mucous coat
Heaithy
slough
rugee,
er
con-
ably
cut
sur-
exudes
pulp
4$
sule
ozs.
fatty
micro-
; cap-
strips easi
ly; healthy.
3 ozs.;
like
Not noted.
right.
50
ozs.;
like
2
ozs.
right
Enlarged.
Enlarged.
on
17 ozs.; large; 3J ozs.; small 3? ozs.; like 7Jx4Jx2? in- capsule; does right. ches ; firm, hy- not strip easipertrophied. ly ; fatty.
Not noted.
Consider-
ably
en-
larged.
Not
noted.
Not
enlarged.
in
pigmented, thick-
34 ozs.;
fatty
as seen
ening and ulceration in trans- under microscope.
verse
bathing pelvic viscera;
Very
id
enlarged.
28 ozs.; small, slightly 5 ozs.; small ; Mucous coat pigmented, con4 ozs.; capsule 3i ozs.; quite Pale; a small round de. granular congested, but seems firm, pigment- slightly adher- like right. pressed pigmented, but not gested, thickened, ent ; veins conpuckered spot on mucous throughwhole length; large oval healthy; gall-bladder ed. membrane near ileo-csecal ulcers on raised bases, and filled with dark bile. gested; healthy. covered with grey transverse colon.
ozs.
most
intense toflexnre, where
firm, healthy.
3| ozs.; fatty.
3$ ozs.; small but healthy under miscroscope.
ozs.; seems
4 ozs.;
fatty.
Not
noted.
Very much enlarged.
noted,
Not much
wards sigmoid there are tuberculoid, pustular ulcers, confluent in rectum, converting rugse into slough like
oedema of mesentery about sigmoid flexure.
masses.
Healthy
Contains some food; coat pink,
mucous
healthy.
Healthy
Coats thin and Dale
Mucous coat
gested
as
slightly
con-
during digestion.
Mucous coat pale, not amyloid; a thin layer of dried faecal matter adherent to surface for two feet above ileo-caical yalve; Peyer's
glands empty.
ulcers on thickened patchat beginning of ascendiug transverse colon ; much general thickening and deep ulceration in descending colon, the ulcers grey in the centre and raw, and bleeding at the edges and occupying half the surface ; sigmoid flexure ; one grey sloughy ulcer.
27i ozs.; compact and firm ; cut surface, nutmeggy, nothing abnormal, detected by microscope; gall bladder full of thin green bile.
3 ozs.; very small and firm; cut surface
quite
Not
and ulceration of rug?e; very marked transverse and descending colon, "where the whole surface looks one butf'-coloured ulcer, with occasional knobby warty islets ; in sigmoid flexure there is much thickening, with lymphy effusion on surface not de-
54 ozs.; lOin. x5f in, x 4 inches ; congested not albuminoid or fatty; gall bladder nearly empty; bile brown.
6 ozs.; small, 3\ ozs.; healthy. 3? ozs.; quite like right. flaccid, blue, friable very
Not
Grey
es
and
Thickening
transverse
in
tachable.
brown, thickly
with studded white spots (cut trabecu-
3^
like
ozs
;
right.
enlarged.
noted.
May
2}
like
a bean near lower end.
52 ozs.; KH X7 x 3J inPigmentation, thickening in parts, thining in others, dark ches; flaccid, dark-copatches; pigmentation of cicatrices of ulcers in colon; loured, but healthy. solitary glands ; grey exuda ulceration and pigmentation of tion on some Peyer's patches mucous coat of sigmoid flexure of
valve.
13
Mucous
slate-coloured,
Thinning of coats ; conges
t.iou
...
Peyer's glands
of
Not noted
shining
shining
Coats thin ; shrunken.
5 ozs.; flaccid, 2$ ozs,; small; tough, a white fatty. desyphiloid posit as big as
1877.] 1,
sigmoid
2P 079. ; Pcnr white of little depth on convexity ; cuts firmly ; a good deal of blood flows from surface; fatty; gall bladder full of brownish green bile.
M.D. PORTER, A. PATHOLOGY.?BY ON NOTES
free border of flexure.
Mucous coat pigmented; Pigmentation and superficial lower part of ileum lividly ulceration of mucous membrane congested arid ulcerated ; of colon; ulcers in various ulcers, grey, of Peyer's stages of healing; also dark patches and near ileo-csecal cicatrices interspersed ; in sig valve, and pigmentation of moid flexure is thickening pigmentation and sloughy ulcerasolitary glands.
Much
enlarged.
H5
dark Mucous coat arboresHealthy; spots beneath surface, cently congested at over ileum, and cardiac end. great intestine, also a livid band along all
m
i
'\
\ 116
s ABDOMINAL CAVITY .-(Continued).
J7
18
Slate prey-coloured shining.
;
Contains
some
food;
digested normal.
Healthy
Coats,
Healthy
Healthy
Liver.
Mucous coat pigmented; a Mucous coat congested, of claret colour near middle of good deal of thickening in transverse colon, in with ulceration color slate of jejunum, ilium, and lined with gelati- transversely; this thickening and ulceration extends to sigmoid nous matter towards ileoflexure ; coats of other parts coecal valve. of colon thinned.
Not noted
Healthy
Large Intestines.
Small Intestines.
Stomach.
thin and
Tin-
coats
Contains rice-water like fluid ;
coats
thin
:
inner
slato-coloured.
pale
...
Coats,
thin and
pale 3
Contents rice-water stools; cnat pigmented ; dark cicatrices in caput coli; transverse ulcers at upper end of ascending colon ; much thickening and congestion wi'h numerous small shallow round ulcers in sigmoid flexure.
mucous
Coats thin j
sloughing of
mu-
36 ozs.;
congested
soft; gall bladder of greenish bile.
and full
33 ozs.; anaemic but
healthy; gall
bladder bile.
20
Healthy ; dark veins ramifying on in-
Contents
Not noted
21
Healthy
Healthy
23
21
25
26
Healthy Healthy
Healthy
Healthy
yellowish green
Contains mous
a
fluid.
little gru-
Contents
dark
green, pultacoat ar-
with
Coats thin ; some venous gestion of mucous coat.
con-
20 ozs.;
small; 7x5x2?
brane coated white mucus.
membrane
rose-coloured.
4 ozs.;
7ozs.; 6x5x1 4$ ozs.; fatty.
47 ozs. ; 13 x 6i x 4J inches ; soft and flabby;
healthy
;
gall-bladder
7i ozs.;
con-
uni-
5 ozs. ; 6 ozs.; intensely congested; cor- right.
like
gested
;
two
small
cysts surface.
7J ozs.; firm healthy.
seems
5 ozs.; 5x3? X 1 inch; flaccid ; small.
5
ozs.;
ozs.;
seems
healthy.
44 ozs.; like right.
on
3 i ozs.; like 3$ ozs.; cortex pale; capsule right. 8 trips easily.
4 ozs. ; quite ozs.; small 4J ozs.; capsule firm. strips easily ; like right.
ly ; fatty.
6 ozs.; firm and rounded ;
3 ozs. ; like 3| ozs.; small; capsule strips right. easilr; anajmic ;
Healthy
52 ozs. ; 11x7x4 in. ches ; flabby; heatthy ; full of gall-bladder green bile.
venous on
64 ozs.; 13 x 6f x 3f inches ; large, soft, but healthy ; gall bladder contains some thin bile.
27$ ozs.; 8 x 5 x 2 inches; large and flaccid; substance brownish
glands empty ; pigmented.
Mucous coat pigmented ; two dark cicatrices in caput coli : congestion in rectum.
Not
noted.
Enlarged
and
black.
substance
Not
enlarged.
Not
noted.
Not noted.
Not
noted.
Quite
healthy.
tex thickened.
32 ozs.; small, flaccid, and pale ; fatty ; gall bladder empty.
coat
enlarged.
formly congested like right.
Peyer's glands prominent; Healthy healthy.
Peyer's
Not much
3 ozs.; capsule 2f ozs.; a small Not noted. strips easily ; abscess at lower conges- end; otherwise tion of surface like right.
able.
mucous
???"?
venous
10! ozs. ; very flaccid and fri-
congested in Healthy
Pancreas.
healthy.
73 ozs ; firm, but friable ; very fatty.
Healthy
Healthy
healthy.
6 and
Mucous coat
with
9. ozs; large and flaccid.
4 ozs.;
40 ozs. ; congested ; cicatrix on convexity of little depth.
parts ; healthy.
mucous mem-
41 ozs.; veins distended with dark fluid blood ; healthy.
full of viscid green bile,
rice-water stools ; Mucous coat rather pale congestion of sub-peritoneal veins ; coats thin.
Empty ; healthy
Mucous
thin, tinged
Contains
Not noted
Empty;
Coats
saffron-coloured contents;
veins of mesentery full of dark blood.
firm,
membrane in patches in inches ; pale yellow; gra- inch; flaccid; descending colon, and ulcera- nular on surface; fatty; tough ; empty. tion on deeply congested spots, gall bladder full. and almost perforation in sigmoid flexure, but no periton-
cous
pultaceousmatter ; mucous ceous matter; mucous coat injected in parts. borescently congested.
seen
testines.
ozs.;
Left Kidney.
and of calices.
Deeply congested and much 41 ozs. ; congestion of thickened of asoending colon, and veins ( intralobular ); ulcer as large as a powla in no degeneration of its caput coli; other parts seem tissue detected; gallbladder full. healthy.
Healthy
7
healthy.
full of dark viscid
itis. 19
Eight Kidney.
Spleen.
Notnoted.
Normal.
Not noted.
Not
noted.
GAZETTE. MEDICAL INDIAN THE
16
Peritoneum.
con-
gested.
seems
11
healthy.
ozs
Xlf
flaccid;
; 7x4
inches; dark
sec-
tion.
red.
5| ozs. ; capsule strips easi-
5 ozs. ; quite like right.
3J
3
ozs.
ozs.
Normal.
Normal.
fatty.
4 ozs. ; cap3$ ozs. ; like sule separates right. easily;substance
Notnoted.
Healthy,
4^ ozs.j like 4$ ozs.; capstrips easi- right. substance ly;
Notnoted.
Healthy.
congested.
sule
congested.
1877. 1, [Mat
No.
Healthy
Healthy
48 ozs.; 12}x6Jx2} inches ; congested; gall
bladder full.
28
Healthy
Healthy
Healthy
Healthy
63
ozs.
; 11 x9 x3 in.
ches; healthy; gallbladempty.
der 29
Healthy
...
Healthy
Healthy
01 ozs.; 11 x7}x3} inches; large ; dark brown
Healthy
on
33
31
35
healthy.
healthy.
ozs.;
13 ozs ; 7x51 Xl inch; pale liver-coloured ; not albuminoid.
5J ozs. ; capsule strips easily ; uniformly congested.
5
36} ozs.; large; 4} ozs.; healthy 4} ozs.; healthy 7} xB x 2 inches ; ?ol't, cut surface
Not noted.
Not noted.
Healthy
62ozs.; 11x7x3} ins.; plump; fatty; gall bladder full.
12 ozs.; 7x6 4| ozs. ; cap4} ozs. ; like X2 ins.; flabby, sule adherent in right. tough and fi- places ; somewhat fatty. brous.
Healthy
Healthy
Healthy
Healthy
54 ozs.;
14 ozs.;
Healthy
Healthy
Healthy
Healthy
64 ozs.; 10x8x3} firm ; healthy.
Healthy
Healthy
Healthy
Healthy
Empty;
Ulceration of eight Peyer's Mucous coat moderately innear caecum; ulcers jected; black round spots (cicablack ; surroundings livid trices of ulcers) in ascending and swollen ; two lumbrici colon. in jejunum.
patches
mucous
slightly congested. Healthy
coat
Healthy;
congested
in
parts.
Healthy
Pigmented ; congested
in
parts.
Thickening and ulceration through whole length; ulcers covering fully one-half of entire surface,
Healthy
Healthy
Healthy
Healthy
Healthy
Healthy
Healthy
Healthy
most extensive and in sigmoid flexure.
44
ozs.
seems
j
quite
soft...
13 ozs.;
pulpy.
soft;
4} ozs.; healthy. 4} ozs,; healthy. Not noted. 4 ozs. ; capsule strips easi-
18 ozs.; firm
4
;
like
3 ozs.; like right.
quite
gested; healthy
4 like
quite
3 ozs.;
ly; congested. 3}
;
ozs.
; cap-
healthy; gall bladder pigmented; not sule strips easidistended with thin albuminoid. ly; ansemic. green
ozs.
right.
Not noted.
3
ozs.
healthy.
bile.
26 ozs. j very 63$ ozs.; large; 12x6} x3} inches; structure friable. normal; gall bladder full.
4 ozs.; under scope.
con-
micro-
35 ozs.; small, 9}x5} X4 ins., ansemic; fatty under microscope.
7} ozs.; 5} x 4} xl in. ; flabby ; tough; pigmented.
3 ozs.;
fatty
66 ozs.; plump 10x8 X2 inches; pigmented.
12 ozs.; 6x4 Xl inch ; cut surface dark; substance of consistence and appearance of black currant
4 ozs.;
fatty
...
ozs.
;
right.
2J
2
fatty.
ozs.
healthy.
ozs.
healthy.
3} ozs.; fatty.
;
Not noted.
jelly. 54 ozs.;
fatty microscope; gall der
Healthy
Injected
Pigmented
Pigmented ; dark cicatrices in sigmoid flexure.
Healthy
Healthy
Healthy
Healthy
Healthy Healthy
Injected Healthy
Contains
fluid.
under blad-
empty.
62 ozs.;
fatty
a
little yellowish
Veins injected
Healthy
51 ozs. ;
fatty ; empty.
Healthy
...
congested ;
gall
bladder
28 ozs.; small; left lobe adherent to anterior surface of stomach;
congested interlobularly ; no degeneration detected.
4} ozs. ; fatty...
5
ozs.
;
4
ozs.; healthy. 4 ozs.; healthy.
; 8x5 flaccid and friable.
4
ozs.
8} ozs.; friable.
4} ozs.; fatty.
15
ozs
xl} in.;
7 ozs.; firm ; seems
healthy.
quite
;
healthy.
3}
con-
gested ; fatty.
firm;
10 ozs.;
54ozs.; small; 10} x 7} inches; healthy.
...
6} ozs.; flaccid ; very friable.
healthy.
x3
Not noted
brown.
Healthy
ins.;
noted.
Not noted.
;
Healthy
healthy
Not
like
ozs.
right.
Healthy
sloughy 36
section ;
11 ozs.; 8x4}x 4} ozs.; healthy. 14 inch ; firm;
healthy.
May
Healthy
1877.] 1,
Healthy
ozs.;
healthy. 2^
ozs.
4 ozs.;
healthy.
Not noted.
6 ozs.;
fatty
3
...
ozs.
Horse shoe, kidney 12 ozs.; Seems capsule strips easily ; is quite mal.
healthy.
nor-
M.D. PORTER, A. PATHOLOGY.?BY ON NOTES
27
218
CAVITY.-(Co?we;/.)
No. Peritoneum.
Stomach.
Pigmented; studded with masses of the size of a pin's head to that of a split pea, apparently of organized lymph, and are
Pigmented; a few small purple spots on mucous coat; healthy.
detachable, the
ing
Large
Small Intestines.
leaving peritoneum shinbeneath; only
about three ounces of st raw-coloured fluid in the cavity.
Intestines.
Pigmented ; thickening with two round ulcers, black base and raised edges, and white cica? with grey tubercle ; latter trices in ascending colon, also and one solitary gland ul- thickening and superficial ulcerated ; larger ulcer size of ceration in transverse and dea two-anna piece, with scending colon ; in sigmoid raised edues ?nd black base ; flexure there is mammillation only jejunum and upper with the thickening and reddish black colouration as if from reend of ileum implicated. cent haemorrhage.
pigmented
Mucous coat ; and some solitary glands one Pe.rer's patch distended
J.iver.
Spleen.
Right Kidney.
52|ozs. ; looks quite black j right lobe firmly adherent by its convexity to the diaphragm; cut surface dark chocolate green, studded with- e rey tubercles as big as No. 1 or No. 2 shot, and with small abscessfes o?. b g as beans containing viscid ocbfrejr pus ; tubercles larger than No. 1
4 ozs. ; firm ; black cut surface studded with pale larue firm corpuscles
4 ozs. ; pale yellow, intense, ly fatty.
shot,
are
Left
Kidney.
4 ozs. ; quite like right.
Pancreas.
ozs. ; seems nor-
Mesenteric Glands.
A few
en-
larged from tubercular
Dial.
deposit.
(tuberculated.)
generally
found with ochrey centres showing incipient left softening ; the lobe is not enlarged, and the tubercles there are small and grey gall bladder distended, with black greenish viscid bile, 43
Adherent to intestines Containing a pint of yellowish red foetid and omentum by recent viscera adherent fluid, lymph ; mucous coat to parietes and to healthy. each other.
Pour large black-based, thickPeyer's patches empty ; at lower end of jejuedged ulcers, one in caput colii
one
num
ulcerated.
one
in
sigmoid flexure,
others
in intervening part about equidistant ; perforation of sigmoid flexure by ulcer.
36 ozs. ; capsule torn off in removal, small; 8^ x 5ji X 2^ inches ; flabby ; congested with venous blood.
Not noted.
T.arge and black.
2i ozs.; like Not noted.
Not noted.
9 ozs. ; firm ; 4J ozs.; quite 4| ozs. ; pale x 3| x 2 yellow; capsule like ri;rht. inches; capsule strips easily. mottled with whito fibroid, spots; yellow shot-like
de-
posit in corpus(tubercu-
cles
lar)
seen
on
section.
Healthy 45
Healthy Healthy
Contains thirteen round worms; mucous coat injected, but not ulcerated.
Healthy
Contains
some
food:
healthy.
in
sigmoid
Healthy
Healthy
Healthy
Mucous coat flexure injected.
Mucous coat thin and pale, covered with tenacious mucus.
28
ozs.
diseased.
j
soft,
not
39? ozs.; small ; 8i x 6x3 inches; healthy; gall bladder empty.
30 ozs.; 12| x 6 x Thickening; congestion,pigmentation, and ulceration of mucons 3 inches ; firm but coat; ulcers shallow, small, anaemic"; gall bladder circular, brown based, occupyins contains some dark bile. one-half the entire surface of flexure; mucli fewer ulcers in ascending and transverse colon, but thickening continues to ca;cum.
6 ozs.; and soft.
small
3 ozs.;
small,
yellow; injec- right. tion of calices.
noted.
; like
Not
noted.
Not
2J ozs.; quite
Not
noted.
Enlarged.
2 ozs ; quite 2? ozs. ; 5 ozs; soft, 21 ozs. ; pale normal. free and anaemic, like right. friable, not fatty. from deposit.
Enlarged,
0$ ozs.; flaccid ; 6| x 4J x 1 inch ; pigmented. 7 ozs ; 5J x 3? X If inch ; firm, liver-coloured on section.
4 ozs.;
strips some
4
capsule
with
difficulty.
right.
3 ozs.;
small, ffimic, healthy. an
ozs
GAZETTE. MEDICAL INDIAN THE
ABDOMINAL
like
right.
Mucous
coat
pale.
rather
Injected
as
indigestion
Transverse and descending colon and sigmoid flexure much
thickened, intensely congested,
but neither ulcerated 48
Healthy
Coats
thin
Mucous coat a-ith bile.
thin, stained
mammillated
nor
Caput coli grey, with several livid ulcerated blotches, transverso colon ; one mass of black puckered scars, other parts
pigmented.
29 ozs.; small, firm and rounded ; slightly fatty under microscope.
27 ozs.; x
fatty.
small; 8| x 31 inches; anaemic;
8
ozs.
5i x inch.
3
;
firm; 3 ozs.; fatty 14
x
3
ozs.
j
fatty
Not noted.
Enlarged.
1877. 1,
Healthy
[May
sigmoid
Healthy
Healthy
Mucous
Healthy
gested,
cost
con-
venous.
Healthy
8 ozs.; small; x G x 3 3| ozs.; fatty; x 4 x 2J capsule adherquite gall bladder inches; capsule ent. full of green bile. pigmented. 42 ozs.; 11
inches; healthy ;
Healthy
Mucous coat of duodenum of a dark claret colour, and of parts jejunum
44 ozs.;
63
Healthy
Inflamed;
Mucous coat
Healthy
great
omentum adherent to parietes and to small intestines; mesbut entery pale bathed in pus-like white fluid, in quantity about two glasses; effusion lymphy adherent to capsules of spleen and liver; no signs of tubercle
congested.
Empty; mucous coat greenish at great curvature.
moderately
Peritoneal coat inflamed and adherent to neighbour-
ing
coat
structures;
mucou?
healthy.
10 ozs.;
healthy
healthy.
firm,
3 ozs.;
healthy.
3i ozs.; like right.
3
ozs.
like
;
Not noted
Not noted.
Not noted
Not noted.
right.
Healthy
51 ozs. 5 healthy ; 12 5 ozs.; congest 7s ozs.; small; 5-4 ozs.; like Not noted. x 7 X 3i inches ; gull 6x3Jx inch; ed ; capfule right. firm ; bladder full. white strips easily. spots on capsule (syphilitic P)
Healthy
GS^ozs.: large, antemic; gall-bladder full.
similar.
62
seems
14J ozs.; large; x x 1^ inch; flaccid, pigmented. 7
6 ozs.; much
to diaphragm, cut surface mot-
40 ozs.; healthy; gall bladder distended with bile.
4J ozs.; firm cut surface
ozs
; much
Not noted.
Healthy.
Not noted.
Swollen.
congested; cap- congested; capsule strips easi- sule adherent. ly.
Healthy, except redness of 34 ozs.; 10 x 6 x 3i 14 ozs. ; large; 2?ozs.; small; inches; adherent to 7 X 5 x 2-j in- healthy. peritoneal coat. diaphragm; on removal, ches ; adherent surface mottled green and pink, coats soft, outer half inch con-
0
2
ozs.
;
like
Normal.
right.
tled,livid or red, gested, pale internally ; but no blood gall bladder full of exudes on section. green bile.
anywhere.
...
Health)
Contains pultaceous matter ; mucous coat tinged with bile; reddish; Peyer's
Empty
glands full.
Pearly and shining
Healthy
...
in folds and effusion of bloot5 inches; together is very slight in this flows from cut surface pigmented.
Congested
which is flesh-coloured ; 14 x 7 X o inches.
case.
Mucous
hue.
coloured.
Mucons coat greyish rosecoloured ; solitary glands prominent, as big as piu's heads.
;
fibro-granular.
coat
of
rosy
Mucous coat pale, with dark srots like old cicatrices of ulcers.
70 ozs.;
12f
X
inches;large :
7j
x
4|
veins con-
10J ozs. ; flaccid; 5? x4J x 1^
inch ; pulpy and pigmented. -?
8 ozs. 6 ozs.: pale yellow, except larged and with scongbulging on conpurple tion surface, opposite v e x like right. central calices.
45 ozs.; gested of ous
5 ozs.;
capsule easily.
5^
conven-
huo.
ozs.
;
livid, strips
con-
gested.
4
ozs.
;
like
Not noted.
Not noted.
5
ozs.
Few and
small.
right.
; like
Not noted.
Not noted.
con-
Not noted.
Not noted.
PORTER,
Healthy
Healthy
Healthy
Healthy
right.
5
ozs.
;
M.D.
64
Mat
Healthy
1877.] 1,
61
Healthy
Healthy
A. PATHOLOGY.?BY OjST NOTES
60
Healthy
gested.
1
Healthy
Healthy
Contains ten large lumContains a pint of ghee and milk ; local brici and three plugs of venous congestion of mucus as big as an egg, mucous coat; other parts with a little greenish grumpale rose-coloured; ous fluid; mucous coat arsenic found on analy- dark chocolate-coloured. sis. Contracted to size of caput
the
coli, empty; mucous coat purple; arsenio on ana-
lysis.
coat Empty ; mucous darkly congested with some matter adherent to surface.
fellow
Looks
quite normal
30
ozs.
;
anceaiic;
flaccid and
gall bladder
full of green bile.
Contains raw
dhall;
coloured.
some mucous
grains coat
of
rose-
55?
ozs.
healthy.
;
seems
quite
3} ozs.; small> livid, pigmented.
2f ozs.; venous congestion con-
3 ozs. ; quite like right.
Not noted.
Of size.
6J ozs.; flrm ;
4 ozs. ; livid from congestion.
quite
Not noted.
like
Large.
cut
brown.
surface
siderable.
3-J
ozs.
;
right.
norma
jjg
49
Peritoneum.
Black marbled with old white lymphy effusions ; intestines and omenta matted
Small
Stomach.
Not noted
Not
Large Intestines.
Intestines.
noted.
Not noted
Contains food mixed with spirituous liquor ; coat congested.
Liver
Spleen.
47 oz9. ; much enlargyellow, train-oillike fluid exudes from cut surface; very fatty; pieces float in water ; gall bladder empty.
ed,
together; cavity contains two gallons bloody serum.
Healthy
CA\WY.-(Continuded.)
Veins engorged
Seems
Healthy
Healthy
healthy-
hepatic veins
50 ozs.;
congested; pigmented.
6? ozs.; feels cut doughy; surface black and exudes a tar-like fluid.
5 ozs.;
looks
healthy.
Right Kidney.
3
ozs.
; looks is under
fatty, and found
so
Left Kidney.
3 ozs.; like right.
quite
Pancreas.
Mesenteric
Glands.
Not
noted.
Not noted.
Not
noted.
Not
Not
noted.
Not noted.
microscope.
4
ozs. ;
livid,
congested.
3| ozs.; like right.
noted.
mucous
Healthy
Distended with gas; coat of cardial
mucous
and
28
ozs.
;
congested
;
3 ozs.;
a
small
3
ozs.
;
con-
3
ozs.
;
quite
;
like
deeply pigmented ; a rent at hilus, gested and pig. like right. with effusion of mented; very on convexity; friable; gall blood between friable. bladder empty. layers of gastro-splenic white scar substance
claret-coloured.
omentum.
Healthy
Healthy
Healthy
Healthy
44 ozs.;
seems
healthy.
7
ozs.
;
seems
healthy. (To be continued.)
firm; quite
4 ozs. 4J ozs.; deeply right. congested.
Not noted.
"Very small.
GAZETTE. MEDICAL INDIAN THE
No.
120
ABDOMINAL
