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shining central radiated portion of this concrete mass is evidently cholesterine. Its brown laminated outer crust, interspersed with particles of crystalline matter, is supposed by Dr. Prout to consist principally of inspissated bile. It was examined by this distinguished physician and chemist, on the request of Dr. Latham, with whom I consulted on the case, at the most critical period of its character. Upon the event of this excretion, all the urgent symptoms gradually and entirely subsided. During their continuance there was no evidence of fever; the tongue was but slightly coated, and the pulse maintained it usual average of from 60 to 65 beats in the minute. The subject of this case, an old gentleman of cheerful temperate habits, resided in the West Indies during the greater part of his early life. For the last five and twenty years he has been much harrassed by a loud, inveterate stomach cough, accompanied by profuse expectoration, and frequent vomiting of a thick tenacious mucus. About ten years ago he voided more than twenty feet of tape worm, after a dose of turpentine, which he took on my prescription.

I have been reminded by this case of another instance of biliary concretion, analogous by its size and extent of pressure, as by the negative character of its symptoms.

On the examination, post mortem, of a female patient, aged 47, who died comatose, with jaundice, while under my care in St. George's Hospital, in October 1833, a round calculus, described in a note

of the same date as enormous and large as a walnut," was found impacted in the ductus communis hepaticus. A smaller concretion of irregular shape was lodged in the duct, where it passes obliquely through the coats of the duodenum. The gall-bladder was small, nearly empty, and contracted to an hour-glass shape by partial adhesion of its inner central surface. It contained a small calculus in the cavity thus formed at its convoluted extremity. The ductus cysticus, the ductus hepaticus, and the bile-ducts generally throughout the liver, were exceedingly dilated by accumulation of their proper fluid behind the obstruction on its current to the bowel. The patient in this case had complained much of weight in the upper abdomen, but never of pain. There is an inference from these cases that may be remembered with advantage in our diagnosis of jaundice and constipation. The progress of gall stones, (even when inordinate in their dimension,) through the ducts, is not disproved by the absence of pain from the epigastrium.

Dr. Bence Jones has since favoured me with the following analysis of the substance in question:

"This calculus was lighter than water, and consisted of two parts, a central white crystalline radiating matter, which cut like wax, and an exter

nal dark brown substance, which was deposited in irregular layers, which were not crystalline, and which broke in dividing.

"The centre, when heated, melted, took fire, burnt with a clear flame, leaving no ash. It was entirely soluble in hot alcohol, and was deposited on cooling in scales.

"The external part was very slightly soluble in water. When heated it did not melt, but after a time took fire, and burnt with a smoky flame, leaving a white ash. 277 grains of calculus gave '024 grains of ash, that is about 8.6 per cent. This ash consisted chiefly of carbonate of soda, with a little phosphate of lime.

"The external substance dissolved with effervescence in nitric acid, giving off nitric oxide gas. The solution was at first deep red, and became, when heated for some time, yellow. It was dissolved by caustic potash, and the solution in the cold was yellow, and when heated became dark green. Treated with hot alcohol, a very small portion of this external substance was dissolved and crystallized on cooling, in scales.

"Hence the centre of this calculus consists of nearly pure cholesterine, and the external part of inspissated and altered bile, with a little cholesterine or fatty matter. The colouring matter of the external part is identical with the cholepyrrhin of Berzelius, which is the same as the colouring matter of the leaves of plants.

"When burnt, dissolved in pure hydrochloric acid, evaporated to dryness, redissolved in water, and tested with ferroprussiate of potash, no Prussian blue was formed: hence none of the colouring matter of the blood is present in this calculus."

ON

FATTY DEGENERATION OF THE

ARTERIES,

WITH A NOTE ON SOME OTHER FATTY

DEGENERATIONS.

BY GEORGE GULLIVER, Esq., F.R.S.

COMMUNICATED BY THOMAS HODGKIN, M.D.

READ FEBRUARY 28TH, 1843.

It has long been known that the arteries are very liable to a disease in which a soft matter of diverse consistency, and usually of a brown, yellowish, or white colour, forms between the internal and middle coats; that this matter, though it has been variously denominated, has often received the epithets atheromatous and steatomatous; that it is sometimes a forerunner of partial thinning and destruction of the internal membrane, a frequent concomitant of thickening and corrugation of this tunic, and of ossification of the vessels. And it is as well known that their inner surface is extremely subject to small opaque white or buff-coloured spots, either isolated, grouped together in irregular patches, arranged in streaks, or so diffused as to present

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