tended; the left pleura was firmly adherent; the lower lobe of the lung was in a state of red hepatization; it was soft, heavier than water. The right pleura and lung were healthy. The cavities of the heart contained fibrin; the heart itself was healthy and tolerably firm; its weight was 8 oz.

The absence of pain in this case, although there was extensive injury to the stomach, was very remarkable. The symptoms were exceedingly slight, vomiting shortly after food being the only prominent effect of the poison; the patient was, however, depressed, and the pulse was very feeble; she then became perfectly prostrate, and her death appeared to result from asthenia. The pneumonia which took place on the left side. was, perhaps, set up by the abscess on the opposite side of the diaphragm, or it was the result of the absorption of decomposing material into the blood.

The effect produced on the stomach a considerable time after nitric acid had been taken, is well shown in case No. IX, related with diseases of the oesophagus, in which a young person lingered for three months, and suffered at last from the ordinary symptoms of obstructed pylorus; that part had become thickened and contracted, so as to lead to fatal obstruction, and the stomach was enormously distended.

CASE XLII.-Poisoning by Corrosive Sublimate. Death on the sixth day.— William P-, æt. 25, was brought to Guy's Hospital on October 16th, 1861, about 7 a.m., having swallowed 3iij of corrosive sublimate, dissolved in vinegar, about one hour previously. Vomiting came on in half an hour, and became very severe, the stomach at once rejecting everything. The stomachpump was used, and eggs were given freely. At 11 a.m., he had an anxious expression; there was no whiteness of the gums nor of the mouth; the tongue was clean; saliva was abundant, and the vomiting was frequent. Ile had been purged, and the evacuations were of a dysenteric character, but no urine had been passed; there was no pain at the stomach, nor in the abdomen, but he complained of pain at the back of the mouth and at the upper part of the gullet, and the pain was greatly increased by pressure on the cervical spine. The pulse was small, soft, feeble, and very compressible, 80; the vomited matters consisted of mucus in large quantities.

On the 17th he had passed a restless night, sleeping for a few minutes at a time; he had passed bloody mucus, and suffered from tenesmus; there was a total suppression of urine. He complained of a sense of coldness, the pulse was 70, and he had tenderness about the umbilicus, and in the evening had a good deal of pain in the abdomen, especially in the right side, over the descending colon. There was no vomiting, and the mouth was parched.

On the 18th the stools consisted of blood and mucus, but the urine was still

sagreessed; the pulse was 72; he had had a restless night. On the lui be seemed better; he had siege at intervals, and had passe urine. There wis less tenderness of the ablommen, and the pulse is will as the countenance were .ce zitu On the 2007 he had had a little sleep. Three or fr midions were evacuated but no arine: there was soreness of the throat 2) kuld i swallow; the face and the neck were somewhat swollen, and there was salvation; there was also ten derness over the ubil-2 He had had a ball night; the bowels were moved several times, the stools were of a dysenteric character. He complained of the throat, which was smiler, and be expectorated a small quantity of blood. His strength was evidently falling, and he died the following day st 2 am.

Inspection-The body was well developed; the muscles were very prominent from post-mortem rigidity. Bloody mucus flowed from the mouth; the brain was healthy. The amphoras was affected throughout; a fine layer of lymph covered the mucous membrane, and at the lower part the longitu dinal ridges were covered with adherent granular lymph. The Fronchial tubes were filled with bloody and frothy macas. The 2 were extremely congested, and were in a state of early inflammation; the posterior parts of the lower lobes were especially affected; they were red, solidified, and devoid of air, but some fluid eculd be squeered from them ; other portions were in an earlier stage of pneumonia, and in some parts blood was extravasated. The pericardiam was healthy; the right side of the heart was distended with dark blood and soft coagulum, but the ordinary tough, white fibrin was not present. The left ventricle contained a small quantity of semiduid blood. Abdomen.-The peritoneum was healthy. The stomach was of a pirkish colour, but the colon and the rectum were the portions of the intestine which were especially affected. The duodenum was healthy, it was filled with bilious matter. In the jejunum here and there, were patches of congestion, especially affecting the valvula conniventes. In the ileum there were some dark, congested parts; and at the lower part the mucous membrane was swollen; here and there were patches of granular lymph, and in the mucous membrane there were numerous dark spots of extravasated blood, the distribution and size of which corresponded to those of the solitary glands. The cæcum itself had escaped, but where the ileum joined the colon at the upper limit of the cæcum the congestion was extreme. The ascending colon was the part most severely affected; the mucous membrane there was swollen and of a dark-purple colour, and patches of lymph were adherent, especially on the longitudinal bands. Granular lymph was closely adherent, and the mucous membrane was superficially ulcerated, but no extensive ulceration was observed. The transverse and descending colon were congested in parts; but the reef was in a similar condition to the ascending colon, being of a dark-purple colour, and covered with lymph. The liver was apparently healthy, but full of blood; so also was the spleen. The kidneys w swollen, injected, rather soft and coarse; the uriniferous tubes wer creting cells and with cells filled with granules; observed. The mucous membrane of the bladder

In the following case of poisoning by alcohol, the appearance of the stomach resulted from the irritant action of the poison, but the morbid change was of such a character, that unless especial attention had been drawn to the part, it might very easily have been overlooked. The stomach was minutely injected with arborescent vessels, and the congestion was apparently the remains of an acute erythematous inflammation.

CASE XXXIX-Poisoning by Brandy.-Timothy B-, æt. 27, a vagrant, on January 28th, 1837, was following a man who carried a gallon bottle of brandy. The bottle was accidentally broken, and the spirit spilled in the road. The patient drank the spirit from the ground, by putting his mouth to the earth. A short time afterwards he was observed to lean against a lamp-post, and gradually became insensible: he was taken to the stationhouse, and, since it was thought to be ordinary intoxication, he was left for several hours; he was then brought to Guy's Hospital about two in the morning; the stomach-pump was used, and some dirty fluid brought up, which appeared to be muddy water. Some coffee was afterwards given to him. He spoke once, asking for water, but died about twelve hours after admission.

The mucous membrane of the stomach presented considerable injection, giving a patchy appearance of rose-coloured spots to the surface; and in the cavity of the stomach was some muddy fluid: the duodenum and upper part of the jejunum contained similar fluid.

The oesophagus was healthy; the liver and kidneys congested. The heart contained a moderate amount of blood in both auricles and ventricles; but it was not distended on the right side as in death from apnoea; the lungs The membranes and substance of the brain were much congested; but there was no smell of alcohol.

were congested in patches.

Absence of pain was shown in a marked degree in the case of poisoning by chloride of zinc, from Burnett's disinfecting fluid. Case XLI.

In another case, in which a woman had taken some oxalic acid, the quantity of which, however, was not known, vomiting and prostration were the only symptoms, and the patient gradually recovered.

The following case of poisoning by sulphuric acid is exceedingly interesting in the same respect; but here the absence of complaint of pain can only be partially depended upon, on account of the mental condition of the patient.

CASE XL.-Poisoning by Sulphuric Acid. Death on the eleventh day. Destruction of the Mucous Membrane of the Lesser Curvature and Pyloric extremity

of the Stomach. Acute Inflammation of the Colon and small Intestines.-Charlotte D—, æt. 55, was admitted into Guy's Hospital Oct. 5th, and died Oct. 16th, at 11-30; she had been in Bethlehem Lunatic Asylum three times; and several members of the family had been affected with insanity; about seven o'clock on the morning of the 5th, she drank a wine-glassful of sulphuric acid before breakfast, when the stomach was empty. She was brought to Guy's two hours afterwards in a state of collapse, almost pulseless, and her extremities cold; there was no stain in the mouth, and she could not swallow magnesia mixture, which was administered to her; in two hours she became warm, and vomited some grumous, dark-coloured matter. She continued to vomit blood, and to pass blood by stool; and the vomited matter contained sulphuric acid. In the evening she was able to swallow a little milk and arrow-root, and was decidedly better. For the next three days she was very low, but there were no very urgent symptoms, although she continued to pass blood, and occasionally vomited grumous matter. October 9th, four days after taking the acid, she swallowed without difficulty. She continued in a low condition, able to take a small quantity of food, but suffered from a kind of dysenteric diarrhoea; no blood was passed, but rather pale loose motions, with shreds of mucus. On the day of her death she spoke as usual, got out of bed, but in the evening died unexpectedly, without any one being present at the time.

On

Inspection seventeen hours after death.-The body was wasted, the eyes were sunken. The calvarium was exceedingly light and thin; the depressions for some of the Pacchionian bodies were so deep that only the external layer of bone appeared to remain. The Pacchionian bodies were large; the brain was atrophied. The mouth and throat were of a whitish colour; and at the posterior part of the throat there was considerable injection, and the mucous membrane of the anterior part of the tongue was whitened. On the posterior pillars of the fauces were white, loose, and irregular patches, which consisted of elongated cells and epithelium. Similar tissue was found adhering to the membrane, at the lower part of the œsophagus. The posterior part of the tongue was covered with ordinary squamous epithelium. The edge of the epiglottis was irregular, minutely serrate, as if it had been injured by the acid and ulcerated. The membrane of the œsophagus was pale, and filled with yellow membranous flakes. The cardiac extremity of the stomach was moderately distended; three inches from the pylorus the muscular coat was contracted. The peritoneal surface was not covered by false membrane, nor particularly injected. On opening the stomach it was found to contain about zij of yellow grumous fluid, and a large, thin, yellow membranous mass, which was attached by one extremity to the walls of the stomach; this mass was 4 to 5 inches in length, and as many in breadth; other smaller patches of similar membrane were observed to be partially detached; the surface of the stomach beneath this membrane presented whitish gray tissue, in some parts slightly flocculent. The mucous membrane along the lesser curvature, and for several superficial inches near the pylorus, was destroyed, and the surface was irregularly flocculent. On examining the yellow membranous membrane, it was found to consist of minute particles which highly refracted the light (fat from degenerating

4

tissue); some indistinct markings resembling gastric follicles were observed, and small blood-vessels were seen filled with altered blood. At the cardiac extremity the mucous membrane was thin and granular; but at the centre of the greater curvature the lining membrane presented numerous nodules, about of an inch in height, the intervening depression being of a dull gray colour. In some of these depressions were adherent yellow tissue, consisting of semi-detached mucous membrane. The raised isolated nodules consisted of mucous membrane, which had not been acted upon by the acid; and showed very distinctly the distended gastric follicles; the follicles were also evident at the cardiac extremity of the greater sac. Along the lesser curvature, and at the pyloric extremity, the section presented involuntary muscular fibre; this was covered over by fibrous tissue, in some parts thin and irregularly flocculent, but near the pylorus forming a thicker layer; this tissue dipped down between the bundles of muscular fibre. At the pylorus were several nodules of undestroyed membrane; but for more than an inch and a half in the duodenum the membrane was destroyed, as at the pyloric extremity of the stomach. The intestine then became gray, and was covered over by a delicate adherent tissue in irregular patches, which were contiguous the one to the other, and generally placed transversely. The jejunum was very much congested, the ileum still more so, and at the lower part of the latter, the mucous membrane was covered by adherent diphtheritic membrane. The whole of the colon was acutely inflamed from the cæcum to the rectum; the mucous membrane was covered by adherent diphtheritic membrane; the submucous cellular tissue was white and thickened (œdematous), and the muscular coat distinct; the diphtheritic layer consisted of imperfect cells, mucus, granules, and highly refracting particles. The rectum was less affected. There was a small ecchymosed spot beneath the endocardium below the left semilunar valve of the aorta. The heart was flaccid, but its cavities contained fluid blood. The liver was healthy, but small. The spleen also was small. The pancreas, supra-renal capsules, and kidneys were healthy.

The symptoms usually following the administration of a large poisonous dose of sulphuric acid, are discoloration and destruction of the mucous membrane of the lips and mouth, intense pain, difficulty in respiration and deglutition, vomiting of bloody grumous fluid, and collapse; and death generally follows in a few hours. The appearances after death vary, according to the strength of the acid; if concentrated, the mucous membrane of the mouth, œsophagus, and stomach, are charred, sometimes even every layer destroyed, and the adjoining structures acted upon.

The case detailed presents many points of interest, in a general as well as in a medico-legal point of view. The acid was taken not by accident, but by a melancholic woman, and the exact