528

Abdomen.—The intestines contain a clearyellowish liquid, which tinges the valvulæconniventis. The mucous membrane through-out is free from injection. The glandulæagminatae et segregate seem free fromchange ; nothing abnormal in the color orrectum. The whole tract of the intestinalcanal is pale ; other abdominal viscerahealthy.M. Guersant considered that this child

was cut off by a kind of choloric affectioii,supervening on pneumonia; but it may be

reasonably asked, whether the subsequentsymptoms were not more or less connectedwith an excessive loss of blood.

P. H. G.

NORTH LONDON HOSPITAL.

DILATATION OF THE AORTA, INTERFERING

WITH THE ACTION OF THE SEMI-LUNAR

VALVES.

HENRY ATKINSON, thirty-five years ofage, a waggoner, was admitted March 14th,under the care of Dr. ELLIOTSON. Tenyears ago had rheumatic fever, and hassince then been subject to pains in hisshoulders, loins, and hips, coming on at dif-ferent times, but more especially after ex-posure to cold or wet. Twelve monthssince, he had rheumatic pains in his loinsand right hip; at this time he had his houserobbed, which produced great distress ofmind, and caused him to use unusual bo-dily exertion, on one occasion running adistance of fourteen miles. A few daysafter this exertion he found that he couldnot make his accustomed exertion withoutproducing palpitation. He had no pain inthe region of the heart. His rheumaticpains were relieved by wearing flannel, buthe has always been subject to dyspnoea andpalpitation at different times, especiallyafter exertion. In the latter end of Decem-

ber last he was attacked with influenza, hadcough, with wheezing respiration, orthop-noea, vertigo, and severe palpitations, buthe continued his employment till the thirdof the present month, when his breathingbecame so difficult that he was incapable ofany exertion. Since then he has been undermedical treatment, has had a mustard poul-tice applied to the left side of his chest ontwo occasions, and he states that his gnmshave been made sore with some pills.

Present syniptoms.—Temperature of thebody natural, skin rather dry. Attemptsto lie in the supine position are attendedwith a choking sensation, wheezing, and afit of coughing. His sleep is often inter-rupted by attacks of dyspnoea and cough.Respiration, 30, with sonorous and sibillantrattle heard all over the chest ; expecto-rates a thick mucus. Complains of no painxcept acroas the cardiac region ; a saw-

sound after the pulse is heard all over thecardiac region, right side of the chest, andfeebly in the interscapular region oil eachside of the spine. It is heard loudest atthe superior alld inferior parts of the ster-num, and is heard double in the carotidsand subclavians. The carotids pulsatestrongly and visibly, and strong pulsationsare felt in different parts of the body.Pulse 92; bowels regular ; tongue ratherwhite. To be bled to ten ounces; twelveminims of the tincture of digitalis in anounce and a half of camphor mixture tlireetimes a day.

15. Breathing more ea;y ; cough lesstroublesome. Can lie in the supine posi-tion. Less palpitation ; no pain ; bloodbuffed.

20. Had pyrexia the night before last,with aching pains all over him. Yesterdaymorning a rash came out, first on the abdo-men, and has been spreading up to the pre-sent time, and now covers the whole trnnh,upper extremities, and inside of the thighs.The rash is of a scarlet colour, becomingwhite on pressure, attended with considerable itching and slight burning. Thefebrile symptoms ceased on the appearanceof the rash. Pulse 94; tongue foul; uothirst; bowels open.

21. Cough and dyspnoea aggravated;could not lie in the supine position lastnight; rash continues out, but itches less.I Thraat red; tongue red at the edges andtip; throat sore on pressure ; twelve leechesto the tliroat ; senna draught.

22. Wished to leave the hospital, not

being used to the confinement. Discharg-ed, recovering from the scarlatina.

TO CORRESPONDENTS.0. 0. The law is at direct variance with

the opinion of that learned person.The letter of Mr. Dawson next week.The statement of Mr. Hardy ought not to

have been printed, as it related to a strictlyprivate trausaction.

j We really do not understand what AnOriginal Unionist" means. Many sen-

tences in his first letter were quite unintelli-gible, and we therefore desired somethingshorter and plainer for pitblicatioit. In his

present note, for instance, whobutthe writer,could interpret the sentence, "the doubtswere generally and oflicially removable"the same day in which, &c.? The insinua-tion respecting motives is as false as the

language which conveys it is nonsensical.ERRATA.—In the 11 leader" of the last

LANCET, on the Irish Medical Charities Bill,at the end of the first paragraph, for "manyclauses," read money clati8es. In the noteto the letter of Dr. EI LIOTSON, liacro 469, forthe first French government," read theh’rench government.

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