Report of fatal diseases and morbid appearances observed in the post-mortem examinations made at St. George's Hospital during the year 1843 / [Repr. from Lond. med. Gaz].

  • Lee, Henry, 1817-1898.
Date:
[1844]
Catalogue details

Licence: Public Domain Mark

Credit: Report of fatal diseases and morbid appearances observed in the post-mortem examinations made at St. George's Hospital during the year 1843 / [Repr. from Lond. med. Gaz]. Source: Wellcome Collection.

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    and in one a communication existed in the condensed lung between the pleural cavity and a dilated bronchial tube: the bronchus and trachea were filled with purulent fluid of the same character as that contained in the pleural cavity. In one instance the patient had been violently salivated before his admission, and a very large portion of the lower jaw had perished in consequence. Bronchitis.—Bronchitis was the ap¬ parent cause of death in three cases. In the first the mucous membrane was universally inflamed, unaccompanied by any condensation of the lung ; in the second, in addition to the affection of the mucous membrane, the pleural cavity contained some effused serum ; and in the third case the bronchitis was aneurism of the aorta, this was situated the lung : the last case was also compli¬ cated by the existence of an aneurism immediately in front of the trachea, which by its pressure upon the anterior surface of the tube had diminished its antero-posterior diameter to one half its ordinary size. Disease of the Heart.—Disease of the heart was apparently the immediate cause of death in five instances: the pericardium was in all these cases af¬ fected. In three it was universally ad¬ herent ; in the fourth case, the lymph effused upon its internal surface had assumed a honey-comb appearance, confining separate small collections of serum between its numerous partitions; and in the remaining case the pericar¬ dium contained purulent fluid. A layer of very firm bone had in one instance been developed between the adherent layers of the pericardium. Disease of the mitral valve presented itself in three out of the five cases, and in two of these the aortic valves were also affected: the kidneys were diseased in two and congested in one of the above cases. Disease of the Brain.—In many cases in which the supposed cause of death was found elsewhere the head was not examined, and therefore cerebral dis¬ ease may have existed in some cases unobserved. Besides the cases of malignant disease already mentioned, disease of the brain was the cause of death in four instances; in three of these effusion of blood had occurred to a greater or less extent in the substance of the brain, and in one, where erysi¬ pelas had preceded death, some effusion of lymph had taken place at the base of the brain, and the corpus callosum, fornix, and septum lucidum, were found softened. The remains of three sepa¬ rate extravasations of blood were found in one of the above cases, consisting of a transparent fluid in one cyst, a yellowish fluid in a second, and a brownish red semifluid substance in a third ; in another instance, the cavity containing the effused blood, situated upon the surface of the brain, had be¬ come inflamed, and the secretion from its surface mixed with the extravasated blood. The spinal chord was found in one case, for the extent of an inch at its lower part, converted into a pink soft substance. This was accompanied by a soft and spongy condition of the cancellous structure of the correspond¬ ing vertebrae, and with inflammation of the kidneys and bladder. Disease of the Kidneys.—In the great majority of cases disease of the kidneys occasions death by inducing some other disease more immediately fatal. The cases of this nature which occurred have already been enumerated under different heads: five instances, how¬ ever, occurred in which the kidney was the principal organ diseased, and in which no very evident cause of death was found elsewhere. The brain was examined in two only of these cases, and in both found to contain more fluid than natural, both in its ventricles and in its substance. In all the cases, with one exception, the kidney was reduced in size. Upon one occasion one kidney only was present: it was very small and hard, smooth on its surface, with the capsule remarkably adherent, while on the opposite side, the ureter, which was of its natural diameter, terminated above in a cul de sac; around this was some dense vascular cellular tissue, but no appearance whatever of a kidney.* The kidneys were granular upon their surface in all the remaining cases. A remarkable disease of the bladder accompanied the affection of the kidney in one of these instances. Several large varicose veins were observed in the submucous cellular tissue, near the * The teeth of this person were all loose, sup¬ posed to be the effect of mercury taken before his admission.