234 PHILOSOPHICAL TRANSACTIONS. [aNNO 1738. 



time to time the expulsion both of the excrements and also of the flatuses, for 

 the ease of the patient, as was practised in this case. 



As to the jaundice, which began to show itself 4 months before his death, 

 and continued increasing, till the external purulent tumour in his side was 

 opened, when it began to decline, and quite disappeared soon after the gall- 

 bladder burst : it is easy to conceive, that so long as the gall, descending from 

 the pori biliarii, could make its way into the cystis fellea, and dilate it, there 

 could be no regurgitation of the bile into the blood, and therefore no jaundice: 

 but as soon as the purulent imposthume began to form itself in the neighbourhood 

 and contact of the distended gall-bladder, it encroached or pressed on the cystis 

 fellea, by the force of a multitude of vessels, pouring pus into the cavity of the 

 imposthume, urged on by the circulation of the blood, which is more forcible in 

 these vessels than in those of the liver: and therefore this purulent tumour in- 

 creasing, will very forcibly encroach on the cystis fellea in contact with it, and 

 not only hinder its further distention, but even force the gall it contains to re- 

 gurgitate, or return again by the pori biliarii upwards, and from thence, by the 

 capillaries of the vena cava, into the blood, and so produce the jaundice ; with- 

 out raising an inflammation or obstruction in the liver itself, whose vessels and 

 passages remain open, though the bile take a retrograde course in its biliary 

 secretory ducts. 



But as soon as this accessory pressure is taken off^ from the cystis fellea, by 

 opening and emptying the purulent tumour or imposthume in its neighbourhood, 

 adjoining and adhering to it, the bile begins again to flow freely into the cystis 

 fellea, and to dilate it as before; therefore the regurgitation of the bile into 

 the blood ceases, and the jaundice begins to decline. 



Then, as soon as the rupture or bursting of the gall-bladder happened, and 

 it began to be emptied, all degrees of resistance being now totally taken off 

 from the pori biliarii, they spew out their contents so copiously, that the hepatic 

 ducts are gradually frustrated by such a strong revulsion ; the bile begins to 

 flow all to the wounded and almost emptied cystis biliaria, and either very little 

 or none to be carried by the ductus hepaticus to the choledochus communis, 

 whose diameter and passage into the duodenum was found larger than usual, but 

 empty. In this state, which was the last stage of his distemper, the peristaltic 

 motion begins ta fail, the expulsion of the excrements to be very tardy, or not 

 at all to succeed without the assistance of purging medicines or clysters, which 

 also had but a very slender effect; the patient ceases to be nourished, though 

 he takes a competent quantity of food, and dies in a week after this costiveness 

 began. 



The degree of perfection of the natural, vital and animal functions in this 



