Page:Transactions of the Provincial Medical and Surgical Association, volume 1.djvu/112

 comatose, and died; on its neck, there had long been a cluster of gangliform tumours, of different sizes, some of which were red, others somewhat softened; the right hypochondrium was tumid, and the liver greatly enlarged; the inferior extremities became œdematous, the rest of the body bloated, the skin squamous and dry. Serum, in considerable quantity, had been effused into the cerebral ventricles, between the cranium and dura mater, and into the vertebral canal; the en cephalic textures were unchanged; the lungs and heart healthy, but the liver was exceedingly voluminous, indurated, and covered with tubercles, some of which contained a dense substance, resembling coagulated white of egg; they were soft and greyish; the mesenteric glands were distended, and full of similar tubercles; and there was an infinite number of concrete bodies, of the size of a small pea, interspersed between the coats of the stomach and intestinal canal. In this case we have, in a very young child, an assemblage of morbid changes, appearing in the encephalic textures, in the hepatic enlargement, in the fluid effused into the vertebral canal, and in the mesenteric disease; any one of which would be sufficient to account for the fatal result of the case. Nor can it be doubted that scrofulous disorganization, in each of these parts, is a more frequent occurrence than is usually imagined. In how many cases of hydrocephalus, do we find extensive tubercular derangement in different viscera? Nay, even in the brain itself such morbid appearances are detected. In one instance, the particulars of which are now before me, where death occurred, such a combination was remarkably illustrated.