with offensive sordes and detached lymph and slough : -the edge of the tongue, where it came in contact with the teeth and gums, was in the same state of superficial ulceration as the cheek. The secretion was very offensive, but the ulcers were not painful.

13th. Having been admitted after my visit yesterday, I did not see her till to-day, and the ulcers had spread slightly since the previous day. The mouth was ordered to be washed with a gargle, containing one-twentieth of solution of chloride of lime; a powder consisting of three grains of hydrarg. cum creta and ten of rhubarb was given to her, and she was directed to take a scruple of chlorate of potash thrice daily in pimento water.

15th. The ulcer along the cheek was healed, except a narrow line between the teeth, and the tongue was quite healed, and the gums were much improved in appearance.

17th. Only a small ulcer remains opposite to the last molar tooth.

19th. The gums were again inclined to bleed, and were a little swollen, and the tongue was much loaded; a small vesicle had formed again on the lip. The aperient powder was repeated, and the dose of chlorate increased to half 'a drachm.

22nd. Sore perfectly healed, and the appearance of the gums nearly natural.

The chlorate was continued two or three days more, and the girl left the hospital on the 31st; and I heard a few days ago that she continued well.

The ulceration in this case was in a form that I have often cured by ordinary means, and it never had any tendency to rapid sloughing; my impression is, however, that the very marked improvement effected in two days was greater than I had ever before seen from other plans of treatment, and I am induced to anticipate much from this medicine, in more urgent cases of this serious and troublesome complaint.

I am, &c.

CESAR HAWKINS.

Grosvenor Street, June 21, 1843.

P.S.-The child came to my house on the 5th of July, having a slight return of her complaint, in a small part of the surface previously affected; for this I prescribed the chlorate of potash again, and when she showed herself on the 13th, it was quite healed.

C. H.

CASE

OF

ULCERATION OF THE PULMONARY ARTERY

INTO AN ABSCESS OF THE LUNGS.

WITH REMARKS BY JOHN DALRYMPLE, Esq.

BY WILLIAM CROWFOOT, JUN., Esq., BECCLES.

COMMUNICATED BY JOHN DALRYMPLE, Esq.,

SURGEON TO THE LONDON OPHTHALMIC HOSPITAL.

READ APRIL 11TH, 1843.

Mr. L. B., aged 36, of short stature, strumous diathesis, and the member of a large family, several of whom have died of pulmonary consumption, had from childhood suffered from difficult breathing, the consequence of repeated attacks of inflammation of the respiratory organs, to which he had always been peculiarly subject. In the autumn and winter of 1841 he suffered from cough with mucopurulent expectoration, frequently tinged with blood,

and almost all the symptoms of phthisis; by rest, steadily-continued treatment, and a careful avoidance of exposure to cold, his more urgent symptoms were relieved; and, being naturally energetic, he returned to his usual professional avocations, those of a medical man, in the spring and summer of 1842; but he still continued to cough frequently, and expectorated every morning a considerable quantity of muco-purulent matter, occasionally tinged with blood; in this state he continued till the end of November 1842; when, after some considerable excitement, he was attacked with active hæmorrhage, which recurred almost daily, and sometimes in very considerable quantities, varying from half a pound to two pounds. The blood was always expectorated without effort, and appeared almost to flow of itself into the mouth, producing a slight tickling sensation in the trachea, for the relief of which he made a little cough, which was always followed by the expectoration of more or less blood mixed with a little mucus. The physical signs presented by the chest at this period were as follows:—the ribs on the left side were contracted and flattened when compared with those of the right side; the upper part of the left side of the chest was dull upon percussion, and the respiratory murmur was absent in that situation; the right side presented no abnormal sound. The pulse varied from 60 to 80 pulsations in the minute; the urine not high coloured; the tongue slightly coated, with a shining

unhealthy appearance in the mucous membrane of the pharynx. I need hardly say that residing in the house of a most intelligent medical friend, no remedial means were left untried which either professional ability or the kindest friendship could suggest, but all proved unavailing; increased faintness supervened upon the increasing attacks of hæmorrhage, and at the end of a month he sunk from the exhaustion consequent upon the repeated bleedings.

Post mortem examination of the chest twenty-four hours after death.-Externally the left side presented the same same flattened appearance observed during life. Upon opening the cavity of the thorax, numerous adhesions were found between the pleura pulmonalis and costalis of the left side, and the pleura investing both lungs had that peculiar spotted appearance arising from the deposit of strumous matter which is constantly observed in scrofulous subjects. The upper part of the left lung was entirely occupied by a large cavity containing about half a pound of grumous and coagulated blood; the walls of the cavity were composed of the parenchymatous structure of the lungs, condensed and solidified by pressure. Upon careful examination we found the pulmonary artery opening into the cavity at the distance of two inches from its bifurcation by an aperture as large as a crowquill. The right lung was healthy, with the exception of the strumous spots already alluded to.