188 PHILOSOPHICAL TRANSACTIONS. [aNNO I746. 



About the 7 th month from its birth the child had an eruption of hard red pimples, 

 (tubercula) on the face, neck, shoulders, breast, and other parts. These pimples, 

 the eruption of which was preceded by fever, were accompanied with a most 

 troublesome itching, and rose gradually into vesicles filled with a thin pellucid 

 serum, after which they dried up and scaled off, leaving behind them dark red 

 marks. One crop of these pimples succeeded another for some time; at length, 

 however, they were entirely removed by the use of mild evacuating medicines. 

 The child was weaned about the beginning of the 10th month from its birth; 

 it seemed not to suffer much from weaning; but on the 6th day after, it was 

 seized with a violent vomiting, which in the course of 24 hours terminated 

 fatally.* 



On opening the abdomen, the liver was found to be large and pallid. The 

 gall-bladder was enlarged and turgid with thick, black bile. All the adjacent 

 parts were tinged of a yellow colour. The ileon was inflamed, and the colon 

 was not in its place. 



On removing the sternum, they were astonished to find that a large portion of 

 the stomach had forced itself into the left cavity of the thorax, concealing from 

 their view the left lobe of the lungs, with the pericardium and heart. The sto- 

 mach being drawn aside to see what was under it, they found that a large portion 

 of the ileum, together with the caecum and its appendage, and a portion of the 

 colon, had been likewise forced up into the same place. On further inspection, 

 they found that this had happened in consequence of a laceration or rupture of 

 the diaphragm, which ruptnre must, from the appearances of the edges of the 

 ruptured part, have taken place a considerable time before the death of the child. 

 It (the rupture) extended from the sternum and cartilages in front, down to the 

 tendinous centre of the diaphragm, so as to form an unequal opening (sinus), wider 

 on the left than on the right side. Through this large opening, the beforementioned 

 viscera had got admission into the left side of the thorax ; and were retained there 

 so securely, as not to slip back again in any posture or under any agitation of 

 the body. Dr. F. imagined that this rupture of the diaphragm, and consequent 

 displacement of the stomach and intestines, happened at the time of the child's 

 birth. 



The heart was exceedingly small, and was forced against the spina dorsi ; and 

 the lungs on the left side were compressed into a very small compass. From the 

 preternatural situation of the lower part of the stomach, the passage of the bile 

 through the ductus communis choledochus was interrupted, whence the high 

 coloured urine, the jaundiced appearance of the skin, &c. are easily accounted for. 



* In addition to the disordered action of the bowels, at one time costive at another time loose, 

 the urine was observed to be bilious, and the skin was sometimes yellow. 



