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sion. She was ordered opiates, with linseed-meal and laudanumpoultices to the abdomen.

Jan. 16th.—One A.M. (nine hours after admission) : The painwas slightly relieved, but the surface of the body was cold, andcovered with a clammy perspiration ; the pulse was quick andscarcely perceptible. At six A. M. she died.

Autopsy, eight laours after death. —Pleura slightly adherent ;lungs and heart healthy; kidneys small and slightly granular.The peritoneum contained fifty ounces of turbid serum, seem-ingly mixed wih water and other fluids from the stomach.There was a copious deposit of recent lymph over the intestines.The stomach presented an ulcer on its anterior wall, at aboutan inch and a half below the lesser curvature, and near the I,cardiac extremity. The ulcer on the peritoneal surface wasoval in shape, of the size of a fourpenny-piece; on the mucous Isurface it was larger; the membrane was congested at its supe-rior edge, and its lips were thickened. When seen from theinternal surface the ulcer presented a funnel-shaped appearance.

PERFORATING ULCER OF STOMACH; DEATH IN SIXTEEN HOURS.

(Under the care of Dr. H. THOMPSON.)

The following notes were furnished by Mr. M. H. Welby,senior clinical assistant :-John B-, aged twenty-six, shipwright, admitted March

7th, 1863. For two years he suffered from pains in the

epigastrium and between the shoulders, increased after meals.During the last month these pains became more severe. Ateleven A.M. on the day of admission he partook of a wineglassof rum and a glass of ale. In a quarter of an hour afterwardshe was seized, while standing in the street, with acute pain inthe epigastrium, extending to the shoulders. Ten minutesafterwards he was brought to the hospital. He complained ofmost acute pain over the whole abdomen, especially in theepigastrium. The face was pale, expression anxious; skin overthe whole body cold; tongue moist and clean; pulse 100, verysmall and compressible. Ordered a suppository of morphia,and hot fomentations with laudanum to the abdomen.-Atmidnight the pulse was so indistinct that it could not becounted; the surface of body cold. Was quite sensible, and saidhe was much relieved.-At half-past three A.M. he died.

Autopsy, twelve hours after death. - Rigidity universal.Omentum and intestines much injected, and covered with largepatches of yellow lymph. On the anterior surface of stomach,and three-quarters of an inch from the lesser curvature, andan inch and a half from the oesophagus, was a small roundorifice, the size of a threepenny-piece, with thin, sharp edges.The tissues around the orifice were much thickened. Smallpatches of injection in the mucous membrane of the stomach,over which the tissue seemed abraded. The stomach containedsnme thick yellow fliiid- Ofhpr organs Tmrmal.

GUY’S HOSPITAL.

FATAL CASE OF GLANDERS, WITH POST-MORTEMAPPEARANCES.

(Under the care of Dr. GULL.)E. J-, aged forty-eight, was admitted into the clinical

ward on the 3rd of March. He had been employed all his lifein a knacker’s yard breaking up bullocks’ bones; horses’ boneshe had nothing to do with. He also attended to horses. He

was always in good health, and pretty steady. His presentattack commenced three weeks ago with pain in the right side;he took to his bed. and kept it ever after ; the pain got worse,and at night he sweated a good deal.He looked very ill on admission, and was evidently the sub- i

ject of blood-poisoning. The skin had a yellowish tinge. On ’,the upper lip was an unhealthy-looking sore about the size ofa sixpence, the result of a blow from a piece of bullock’s bone ;the surface of the sore was nodular and pustular. On the armswere some nodular swellings, red on the surface. On examin-ing the chest, a distinct pericardial frottement was heard ;rates over the chest, and dulness on percussion at the base ofthe right lung, where also a pleuritic rub could be heard ; skinhot; tongue dry and furred ; pulse 92.March 4th. - Pericardial rub not so loud ; great thirst ;

pulse 108 ; profuse perspiration, but no smell of rheumatism.5th.—Much the same; no pain. Another swelling has ap-

peared on the right forearm, and also a pustule on the shoulder,accompanied with redness. Right eye puffy.

6th.- Looks very ill, but does not complain. More pustules

have appeared on the body ; they have at first the appearanceof a red pimple, and progress somewhat like variola. Skinhot, but moist. Ordered plenty of nourishment, with quinineand brandy.7th.-On this and the following day he became gradually

lower, fresh pustules appearing on the face and body ; eyeswollen and discharging; tongue dry.

9th.-Several pustules collected together on the chest, ofvarious forms and sizes, and in some places running into eachother; no discharge from the nose; a number of nodules onthe arm. He died.

Autopsy, twenty hours after cd,eceth.-Only a partial exami-nation was made. When the skin was reflected on the body,some diffused suppuration was found in the subcutaneous tissue,corresponding to the external swellings. Both lungs were ad-herent by old cellular tissue. Small masses of lobular pneu-

monia on the surface of the lungs ; but no well-marked pyæmicabscesses. The surfaces of the pericardium were covered withlymph. Only a superficial examination was made of the heart;but a few incisions into it did not show any points of suppu-ration. -

PURPURA ARISING FROM SMALL-POX OR OHIER FEVER;QUICKLY FATAL.

This case was involved in obscurity. The boy evidently diedof purpura; but whether this was only one symptom of feverwas not very evident. Scarlatina was prevalent in the neigh-bourhood of his residence, as well as small-pox. Mr. Stocker,the resident apothecary, who saw him alive, rather inclined toits being the latter. There was no proof that the blow hereceived was a severe one, or that it could have given rise tothe purpuric condition. Curiously enough, a few days after-wards a man who lay in the next bed in the ward was seizedwith small-pox.Wm. F-, aged fourteen, was admitted into Job ward on

the 24th of Dec., lS62. He came to the admission-room com-plaining of pain in his back, and saying that he had received ablow there. The boy was consequently taken into a surgicalward. He appeared very ill, and soon an eruption was ob-served, somewhat like that of scarlatina ; but there was nomarked sore-throat. Towards evening the rash became pur-puric in character, in the night he vomited some blood andpassed some by the bowels, and on the following morning hedied.

Autopsy, t7iirty-tivo hours after deaf,7t.--The body was thatof a boy who had died of ?.cute disease. On the chest andupper part of the body a purpuric or petechial rash was pre-sent. The spots were very small, as if corresponding to somerash. The brain was healthy, with the exception of some pur-puric spots in parts of the medullary substance. Spots of

ecchymosis were present on the surface of the lungs, and a fewon the pericardium. They were also observed in various partsof the peritoneum. The stomach was highly congested, orrather of a purple colour, partly from congestion, and in partfrom straining. The stomach still contained some fluid blood ;the small intestine was healthy, large, of a dark colour likethe stomach, and contained blood ; the bladder contained alittle urine, which was not albuminous.

METROPOLITAN FREE HOSPITAL.POLYCYSTIC OVARIAN TUMOUR IN A WOMAN AGED SIXTY-

FIVE ; OVARIOTOMY ; RECOVERY.

(Under the care of Mr. HUTCHINSON.)THE notes of the following case were furnished by Mr.

Warner, house-surgeon :-S. B--, a monthly nurse, aged sixty-five, but looking ten

years younger, had been sent by Dr. Sutton (under whose ob.servationshe had been at times for three years) to Mr. Hutchinsonin order to the performance of ovariotomy. Dr. Suttonfirst discovered the tumour three years before. It was then

very small, and at first it increased slowly, and caused no in-convenience; latterly it had grown much more rapidly. The

woman’s health had also much failed. She was a widow, andhad borne five children. The abdomen measured forty-fiveinches in circumference, and was everywhere dull excepting inthe right loin. The integuments, especially of the hypogas-trium, were cedeuiatous, and the prominence of the tumour wasgreatest in the hypogastric region. Fluctuation could be

elicited, but it was indistinct, and as if transmitted through2 2