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 couch for one or two weeks. Dr. J. then regarded the case as one of chronic ulcer of the stomach. The pain was immediately relieved, and there was no return of it until December. It then came on again, and was rather increas- ing, when, in January, 1859, he fell, and injured his hip. In consequence of this accident he kept his bed for a month, and the house for two months ; and during this time his stomach was much better than it had been before, showing the effect, as Dr. J. supposed, of entire rest, and a rigidly simple and abstemious diet. For some months he continued better, and went on tolerably well, until towards the latter part of the summer of 1860, when he began to have dyspeptic symptoms, with loss of flesh and strength ; the pain returned about midsummer, and in- creased in severity, so that, during the last few weeks, opiates were required. The appetite failed in November, and never returned ; food caused great distress, though he was very cautious as to the quantity, and generally as to its quality. Vomiting came on, and by this the distress was temporarily relieved ; the matters vomited consisting mainly of the food, though, towards the last, mixed with a dark matter, probably the secretions colored by blood. The bowels were sufficiently well, until he began to use the opiates ; and no tumor was ever felt in the epigastrium. Finally, in January, he became limited to very small quan- tities of nutritious liquids and stimulants ; being confined to the house, and mostly to his couch. He sat up, how- ever, more or less, until a week before his death, enjoying his friends, and being able to go up two flights of stairs to bed, every night. An acute pulmonary affection then came on, and under this he sank." (Med. Jour. Vol. LXIV. p. 307.) 1861.

Dr. J. B. S. Jackson.

2191. Ulcer from a man, set. forty years, who had been subject for several years to constipation and nausea ; the latter never severe, and generally relieved by vomiting his food. Died at last from perforation, after an illness of about thirty-six hours. The stomach adhered toward its right extremity, to the under surface of the liver, and the pari- etes there were vere very much thickened to the extent of

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