a similar nature. Dr. Baillie mentions a bony mass having been sometimes found in the cavity of the uterus; and gives it as his opinion, that the hard fleshy tubercle of the uterus has, in such cases, been converted into bone.

No uterine disease was suspected during the life of this woman, who had had three children; all her complaints being confined to the chest. A reference to the accompanying sketch will give a better idea of the parts than can easily be conveyed by description.

The following is an account of the chemical composition of this tumor, as contained in a note from Dr. PROUT to Mr. COPLAND HUTCHISON" The substance you were kind enough to furnish me with, is more nearly allied to bone than to any thing else that I am acquainted with. When digested in a weak acid for a considerable time, I found that the earthy matter was taken up, and that an animal substance analogous to cartilage was left behind. The earthy matter consisted principally of phosphate of lime. Besides these two principles, there was a portion of fatty matter present. In short, this bony tumor seems to resemble exactly one which was extracted from a wen in the neck, and which is now deposited in the College of Surgeons, together with an account of its composition, &c. as ascertained by myself a few years ago."

No. II.-Case of Enlargement of the Heart.

Thomas Platt, a stout muscular man, thirty-three years of age, by trade a coach-plater, about two years since was attacked with dyspnoea, cough, and pain in the chest, by which he was confined to his room for two or three months. The dyspnoea and pain in the chest gradually subsided, and he followed his usual occupations; but complained very much, at times, of pain in the right hypochondrium, and has constantly been affected with a troublesome cough. About six months ago, the pain in the hypochondrium had left him, and all his complaints at that time were referred to the chest. It was about three months before his death that I first saw him: he then complained (to use his own words,) of great uneasiness in the chest, and breathed with much difficulty, especially in the recumbent position, which produced a sensation of suffocation; the pulsation of the radial artery was upwards of 100, and had a sharp vibratory character; his countenance showed the greatest anxiety, but the expression is not easily described,—it is, I believe, if not peculiar to affections of the heart, always present when this organ is affected; his lower extremities were æde. matous; and his urine had lately diminished in quantity. The action of the heart was felt distinctly in the scrobiculus cordis and right hypochondrium. With regard to the treatment, No. 291.

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purgatives and diuretics appeared to afford the most relief: cupping on the chest relieved the difficulty of breathing for a short time; but neither cupping nor general bleeding removed, in any degree, the vibratory character of the pulse, although it diminished its frequency and fulness. The anasarca of the extremities gradually increased, and soon became general over the whole body. The difficulty of breathing became most distressing; the man expressed a great dread of going to sleep, lest he should be suffocated, which dread continued till the last. A short time before his death, erysipelatous inflammation attacked the scrotum and upper part of the thighs, which quickly terminated in sphacelation; and death soon released him from his sufferings. I examined his body a short time after death, and the following is a description of the appearances:

In each thoracic cavity, nearly a pint of serous effusion had taken place; the lungs were considerably collapsed, from the pressure of the fluid. In the lower portion of the right side of the chest, a large tumor was observed, resembling a second heart covered with its pericardium: this, on examination, was found to be the right lobe of the liver enormously enlarged, which had pressed up the diaphragm, and was nearly on a level with the heart, and in contact with it. This very satisfactorily accounted for the extensive, though very faint, pulsation which was felt in the scrobiculus cordis and right hypochondrium, as every pulsation of the heart must have been communicated, in some degree, to the enlarged lobe of the liver. The heart weighed twenty-eight ounces: its length from the base to the apex was eight inches, and its measurement across, in the widest part, six inches and three quarters. The aorta, at its commencement just above the semilunar valves, was surrounded by scales of osseous matter, forming a complete bony ring; the aortal valves were much thickened, and their corpora secamoidea enlarged to three times their natural size; the left ventricle was nearly twice the size of the right; but the dilatation was more of the passive than of the active kind, as its parietes were not much thickened. The lungs were of a healthy structure. The right lobe of the liver was nearly three times its usual magnitude, but of a firm healthy structure and colour; the spleen was also considerably enlarged. No other diseased appearances were observed, except a small quantity of serous effusion in the cavity of the abdomen.

The symptoms denoting an affection of the heart were so well marked in this case, as to leave no doubt on the minds of those who saw the patient of there being some disease of this organ. The diagnosis, however, is often extremely obscure; and it becomes worthy of consideration, how far the feelings of the patient can be relied upon in assisting us. I have been informed

by a practitioner who has paid much attention to the subject, that persons labouring under disease of the heart very frequently request that they may be opened after death, expressing their. conviction that something extraordinary will be found. In the case just related, the man expressed the same wish, and constantly declared to those around him, that he felt persuaded that the real nature of his complaint was not known. Although I do not mention this circumstance of the patient's own view of his disease as one to be trusted, still, as it has occurred often, I think it worth mentioning; as, taken in combination with other symptoms, it may possibly lead us to form a more correct diagnosis.

ART. VII.-A fatal Case of Paraplegia, from an uncommon Cause; together with an Account of the Dissection, and some Observations thereon. Communicated by EDWARD HARRISON, M.D. MISS R. S. aged eleven years, of a fine complexion, a very delicate form, and in feeble health, complains of great weakness and emaciation. These symptoms have rapidly increased of late. She has scarcely the power of walking or standing alone. Appetite is small, and uncertain. Her bowels are generally constipated. The motions are black, and emit a sulphureous smell. She is frequently called upon to make water, and always suddenly. The disorder was first distinguished by pains in the small of the back, in the lower region of the abdomen, about the hips, the fore-part of the thighs, and legs. She says, that she cannot bear to extend her lower limbs, when in bed, from the pain which the effort produces.

The disorder commenced more than three years ago. She then resided upon the sea-coast; and, till within the last few days, has been under the care of a fashionable physician and an experienced surgeon, who gave it as their opinion that she was suffering from inflammation in the hip-joints.

On examination, I found the twelve dorsal vertebræ rather protuberant; the three upper lumbar vertebræ were also too much raised, especially the middle one: together they formed a small arch. Most of the ribs were a little displaced in front, and projected irregularly forward. The breast was peaked, and unusually narrow. Considering the patient to labour under a decided spinal complaint, a firm bandage was put round her chest and loins; she was then laid horizontally upon a flat mattress, a position which she could not be induced to give up during the remainder of her illness.

April 17th, 1821.-Miss R. S. has had a good night, and feels easier this morning, in consequence, as she believes, of

having adopted the recumbent posture, and the support derived from her bandage. There has been one dark-coloured motion. She has seldom made water, and it is voided with greater freedom. Her legs and feet, which had for a long time past been deadly cold, were this evening warm and moist. She is observed either to keep picking her nose without a moment's cessation, or to thrust and turn her fingers in one nostril or the other, with force enough to make them raw, and frequently discharge a few drops of blood.

18th.-She had two motions yesterday, and five during the night, from having taken some aperient pills. The fæces have a more natural appearance, and her urine continues to be discharged with ease. Appetite is good, and digestion so much improved, that she is less restricted in diet. The lower limbs are warm, and free from pain, except at the top and inside of her thighs, where they are tender, stiff, and contracted.

Fe

28th.-Debility and emaciation continue to increase. verish paroxysms, commencing with slight shiverings, recur daily, at uncertain intervals. They are accompanied with a hot and dry skin, but are seldom followed by any perspiration. Urine is high coloured, and deposits a lateritious sediment. The bowels incline towards costiveness, and the fæces have a natural appearance. Although the pains in the abdomen and thighs have gradually subsided, the febrile symptoms are rather aggravated. The patient, for the last few days, has had a teazing cough, which is imputed to her having caught cold. It is accompanied with increase of fever, and with sharp, darting pains in different parts of the chest. The physician above referred to being consulted for this new attack, delivered it as his opinion that she was probably now suffering from phthisis' pulmonalis.

June 5th.-Though the catarrhal symptoms and pains have entirely left her, the fever still returns, and is even more violent. The weakness and extenuation have also advanced so much within the last few days, as to occasion, in the minds of her friends, the most alarming apprehensions. Under the influence of this impression, another popular physician was applied to, who, having carefully inquired into all the circumstances, was led to imagine the seat of the disorder to be in the mesenteric glands.*

12th. From the date of the last report, the little sufferer had regular attacks of hectic fever, which invaded her generally in the evening. The appetite was nearly lost; and she grew visibly weaker till June 21st, when she expired, about noon. The ir

See Dr. JEBE on Paralysis, &c. Case ix.