MEMORANDA. " 109 



as detailed to me by Dr. Wilkinson^ of Manchester, under 

 whose care the patient was placed, and to whose kindness I 

 am indebted for the account. 



E,. L — , aged 52 years, a power-loom weaver, has never 

 been the subject of any ailment until four years ago ; in 

 fact, he does not remember ever having had a day's illness. 

 At that time he suffered slightly from indigestion, felt some 

 uneasiness at the pit of the stomach, with at times, though 

 rarely, actual pain. The food taken frequently returned at 

 intervals, varying from ten minutes to two or even four hours 

 after ingestion. The vomit, if retained for some hours, pre- 

 sented the appearance of butter-milk and treacle. He never 

 vomited except when the stomach contained food ; but he 

 was subject to frequent eructations of a small quantity of 

 clear fluid, intensely acid ; sufficiently so to set the teeth on 

 edge, and to produce even a shudder at the recollection. 

 About this time he perceived a hard body directly below the 

 ensiform cartilage, but somewhat to the right side, lying as 

 it were between the depending point of the cartilage and the 

 right costal cartilages. He judged that the lump he felt 

 was a hard substance about the size of a hen's e^g. He 

 felt this lump pass down along the course of the duodenum 

 and intestines, until it arrived in the left hypochondriac 

 region. A short time after this it was passed by stool, being 

 several weeks after he had first noticed it. The whole of the 

 time he had severe and continued pain ; and after it had 

 passed, per rectum, he suffered for thirteen hours severely. 

 Sixteen days afterwards another concretion was passed ; and 

 at the end of sixteen days more one still larger. There were 

 no other concretions passed for two years, and then another 

 of a smaller size. 



He then felt a hard tumour in the abdomen on the right 

 of the umbilicus which has since gradually increased; con- 

 tinuing hard, moveable, and somewhat changes its position, 

 but does not seem to move along the canal. 



The concretions which have been passed have not varied 

 greatly in appearance being irregularly oval. The one he 

 presents is hexagonal, apparently presenting articular facets 

 of a lightish brown colour. 



He states that he has lived since childhood principally on 

 oatmeal porridge with treacle, has taken little animal food ; 

 and, during the four years he has been unwell, has taken 

 magnesia as a purgative. ^He, however, says that he took no 

 magnesia before the first concretion was passed. 



Such is the case as sent me by my friend with a portion 

 of the concretion for microscopic analysis. Chemistry and 



