tailed on the different organs, as demonstrated by dissection. This is an interesting part of my subject, and will, I doubt not, open a new field for the speculation of the pathologist. In this part as well as the former, I shall endeavour to point out the viscera most deranged by each form of the disease. It will be recollected that the intermittents and remittents, &c. degenerating or rather assuming the continned or typhoid type, most frequently terminated fatally. Of all the bodies which I dissected, I only find the particulars of 80 cases in my note book, 36 of which were of this form, and were, generally speaking, first in point of time, 26 hydropic and 18 dysenteric.

In these the chief organ affected was the spleen. This viscus was always enlarged, often weighing from three to five pounds. Its substance was extremely soft and easily de ranged. Tubercles were often found on its surface. Inflammation and ulceration, not only of its peritoneal coat, but also of its substance, were frequently observed. These ulcers were found in all their various stages and forms, from the most minute to the almost complete exulceration of the whole lienteric mass. Of this last the following is a remarkable example.

Richard Mullan was readmitted with continued fever, which soon terminated fatally. On opening the abdomen, a large sac was found to occupy all the left hypochondriac region. It was firmly united to the stomach, diaphragni, and all the neighbouring viscera. It contained near two quarts of bloody purulent matter, in the midst of which floated the spleen quite detached, and so much ulcerated and wasted as to appear only a sinall mass of bloody matter without any capsule; for its proper peritoneal coat was found to -have formed the basis of the sac. The lower surface of the diaphragm, which seemed to compose the superior part of this sac, was inflamed and deeply ulcerated. There were many other cases of this ulceration of the spleen, some of which being seated on its superior surface, where it comes in contact with the diaphragm, had corroded and destroyed that muscle, so as to form a communication between the thorax and abdomen, into the former of which they were found sometimes to have discharged their purulent contents.

Hard stony concretions were also frequently found on it, and in one or two instances its capsule had become cartilagi-nous. There was likewise an instance of accidental death from a rupture of this organ. Two of the convalescents disputing in their ward proceeded to blows, and one having fallen, his adversary was observed to have struck him while "down with his foot. He rose, however, of his own accord, (No. 143.)

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and ascended his birth, where he expired in a few minutes. Soon after the abdomen was found to have swelled considerably, and on inspecting the body there were found several pounds of fluid blood diffused in it. The rupture or rather laceration of the spleen was about an inch and half in length, and situated on that part of it which lies in contact with the stomach. It was also much enlarged and very soft.

The liver was the next grand organ on which this disease was found to have made rapid progress towards its destruction. Its most common appearance was preternatural enlargement, flaccidity, and induration or condensation. It was also frequently covered with coagulable, lymph and adhered to the surrounding viscera Inflammation and ulceration, not only of its coat, but also of its substance, were often detected. These were not, however, of so frequent occurrence in this organ as in the spleen. Its substance often exhibited a mottled friable appearance, with a deficiency of the secretion of bile in the biliary ducts, although the gall bladder was, in general, discovered to be quite full, and often distended with dark inspissated bile resembling tar.

Hydatids were also sometimes found in its substance. A bag of this kind was once discovered in the substance of the liver, which contained near a quart of limpid fluid. This was retained in a large sac, the structure of which appeared very white and cartilaginous. Tubercles were likewise sometimes observed in it.

The gall bladder was sometimes found in an inflamed state. In general it was distended with dark green viscid bile; sometimes, however, it was much contracted; gall-stones were often detected in it.

The stomach was for the most part found natural. It was often, however, much contracted from its middle to the pylorus. In many cases it was considerably distended with Batus. In a few instances inflammation and ulceration of its coats were discovered.

These ulcers of the stomach do not exactly resemble those of other parts of the body. In these cases there is little cirGumjacent inflammation. The ulcer appears of a circular form, with smooth edges, and little inflammation. At first view they appear as if cut out with an edged instrument.* In many cases the stomach was considerably corroded by the gastric juice, particularly towards its greater curvature. The peritoneum was in many cases much diseased. Its most frequent appearance was that of inflammation and adhesion. Its surface was often covered with purulent matter. Those duplicatures of the peritoneum which form the omenta, were

* Vide Baillie's Morbid Anatomy.

very frequently nearly absorbed. In many cases nothing of it remained but a plexus of vessels attached to the stomach and colon, of a dark or greenish colour. The intestines were in general natural. The most common discased appearance was that of inflammation and consequent adhesion. Intus-susceptio was also frequently observed.

The kidneys were for the most part healthy, except in those cases of dropsy which shall be hereafter mentioned. Stones were sometimes found in the pelvis of the kidney, as well as in the ureters.

The morbid appearance which the thoracic viscera often exhibited, was also very various and considerable.

Inflammation of the pleura and lungs, with all its consequences, was, however, the most common. In some instances the surface of the lungs was thickly encrusted with a cartilaginous substance, It was very common to find the substance of the lungs anasarcous, and sometimes their struc-, ture was so far changed and condensed as to resemble the liver,

The pericardium was also sometimes found inflamed, and formed adhesions with the heart. It almost always contained a preternatural collection of serous fluid.

The heart itself did not escape the inroads of this destructive disease. Its adipose substance was often dropsical, and it was not unusual to find depositions of coaguable lymph on its surface. In one instance the surface of the right ventricle was found much inflamed and ulcerated, especially towards its superior part which approaches the auricle. On opening the ventricle the tricuspid valves were discovered to be in a complete state of ossification, by which the opening between the auricle and ventricle was nearly obliterated. The symp toms of this patient were so vicarious as to induce his medical attendants to suppose that he was affected with a cancer of the stomach.

Brain. This intricate organ was not so frequently investigated as I could have wished, and principally for this obvious reason, that it required a greater length of time for this purpose than could be obtained. There were, however, sufficient demonstrations of the brain to show its general appearance in this disease. It was for the most part natural; there seemed, however, a great determination of blood to this organ, its vessels being in general found turgid. Adhesions of the dura mater to the surface of the brain, and depositions of lymph were often detected. A superabundant quantity of water was very often discovered in the ventricles.-In one or two cases death suddenly occurred while the patient la boured under salivation. In one of these that inspected, a quantity of blood was effused between the brain and dura mater,

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mater, similar to the appearance observed in cases of apo plexy. The swelling of the neck and throat being so much increased as to impede the blood returning from the head, is generally supposed to be the cause of such unexpected oc

I must not forget to mention that large collections of purulent matter in different parts of the body often proved fatal.

These critical abscesses were in general situated on the lumbar region, the thighs, legs, and shoulders,' &c.

The matter detached the cellular substance and fascia from the muscles, insinuating itself between them, and thus formed sinuses and fistulous openings in distant and different parts. These openings were so numerous, and discharged such quantities daily, that the poor sufferers were rendered horrible spectacles. They often continued in this state for months before death terminated their wretched existence.

With respect to the morbid appearance of the hydropic form of the disease, I have little to add to the above-mentioned organic derangements. Here, however, the kidneys always seeined more flaccid and wasted than natural. The liver appeared always less or more diseased, and the whole of the peritoneum was often found to have formed various and extensive adhesions and indurations of its substance. In one case where the hydropic patient was affected with a cutaneous eruption, the whole of the peritoneum exhibited a similar appearance to that of the surface of the body.

The thorax was most frequently the seat of these 'complaints. Perhaps this may be explained by its being more liable to inflammatory attacks than any other cavity of the body. Adhesions of the lungs, pleura and pericardium were found in almost every instance. The substance of the lungs was very frequently anasarcous, and on pressing them, the water was discharged as from a wet sponge. The pericardium was often much distended with fluid, when no other cavity was found to contain any preternatural quantity, measuring often from two to twelve ounces. This preternatural collection of water in some of the cavities was one of the most frequent occurrences met with, under almost every form of this malady. This was not only contained in the abdominal and thoracic cavities, but was frequently found to exist in the ventricles of the brain itself.

In the dysentery, which was the third and last most common form of this disease, the morbid appearance was mostly confined to the intestines; but as the patients all laboured, in' some degree, under the influence of the original complaint,

the

the other viscera in general, were also found to be much deranged.

The great intestines, especially from the sygmoid flexure to the anus, were always much contracted, thickened, inflamed, and ulcerated. The disease seemed to have commenced near the anus, as from thence it was observed gradually to decrease. The ulcers were so united, that the whole inner surface of the gut appeared in a state of granulation. This often extended to the cæcum, and sometimes to the smaller intestines; they commonly contained little fæcal matter, and for the most part only bloody mucus. Scybala were very seldom detected.

Having now finished these remarks, I presume no one, who will attentively peruse them, can draw any other conclusion, than that this disease was originally of an inflamma tory kind. This alone can explain the direful ravages of the viscera, than which humanity never, perhaps, laboured under a greater multiplicity inflicted in so short a period. W. HAMILTON.

Ipswich, October 17th, 1810.

To the Editors of the Medical and Physical Journal.

GENTLEMEN,

I WILLINGLY present to you the following simple nar

rative of facts, deeming them so unusual and eventually fortunate, considering the adverse circumstances under which they happened, as to deserve a more general publication than could be made, otherwise than by publishing them in your excellent Journal. Medical books are full of instances of extraordinary mortality prevailing in camps, prisons, and ships, whenever a contagious disease has broken out; these dreadful instances of visitation have often occurred in the West-Indies in our own times, and more recently were known to have taken place in the fleet of Sweden in the years 1808-9, as well as in the English ships that brought the army home from Spain after the battle of Corunna in 1809.

In the ensuing relation a disease manifestly and doubtlessly contagious, prevailed in a-fifty-gun ship (arned en flute) in which, besides the ship's company, were embarked 343 soldiers, and upwards of 150 women and children.-Among this large and crowded collection of human beings, dysentery appeared, and gradually spread to an alarming extent, so that at different times, 178 persons came under the care of the surgeon for this complaint alone; and of this vast num

ber