VOL. LX\^r.] PHILOSOPHICAL TRANSACTIONS. 219 



the gut there was almost as unequal as the fasciculated surfaces in the heart; the 

 effect probably of universal ulceration there, which had been a part of, or a 

 companion to, the fistula, of which he had been cured by the operation; for, on 

 that part, the villous coat of the intestine was destroyed. 



To this account, more particularly of the last 2 weeks of Dr. Maty's illness, 

 and of the appearances on opening the body, as drawn up by Dr. Hunter, 

 Mr. W. added the few following remarks. 



The heart and lungs were indeed neither of them essentially diseased; yet 

 there was a whitish spot, about the breadth of a sixpence, on the right ventricle 

 of the heart, near its apex; a rough border on the left side of the diaphragm, 

 as if the lungs had been glued to that part and torn off again; a partial adhesion 

 of the lungs to the pleura; and a little purulent fluid within the pericardium. 

 Certainly these were some signs of a slight inflammation having attacked the 

 membranes investing the contents of the thorax. Neither can we suppose such 

 appearances to have existed v.'ithout occasioning some uneasiness: they were 

 perhaps sufficient to account for that great tenderness and oppressive pain which 

 the doctor felt from the least pressure on the sternum, or on any part of the 

 breast near it. 



The principal seat of the disease which proved so tedious, and in the end so 

 fatal, was doubtless confined to the colon only; and it was entirely within the 

 gut. The part first affected must have been that portion of the canal in which 

 we observed the most mischief. The superficial extent of the disease over so 

 large a surface as the whole arch of the colon, and the more formidable appear- 

 ance of it, in only a few inches of the same gut, distinguished the part where 

 the disease first began, and where it must have had its longest duration. The 

 cause of all this mischief was conjectural with Dr. Maty himself. Had it arisen, 

 as he suspected, from having bruised his side with the hilt of his sword, we then 

 should have found the gut injured from without inwards. But is it not most 

 likely, that a little bit of bone, the stone of fruit, some sharp or hard body, in 

 passing, had injured the gut so much, as to lay a foundation for all the growing 

 complaints ? Nearly the same appearances have been observed in the oesophagus 

 from only a hard crust of bread lodging for a time in the passage ; which, after 

 being forced down, was succeeded by great soreness, inflammation, ulceration, 

 and at length so complete an obstruction, as to occasion the death of the patient; 

 of which Mr. W. once saw a very deplorable instance. 



The ulcerated intestine is a disease generally, as in the case before us, slow in 

 its progress, but certainly fatal. An accumulation of acrid matter, confined air, 

 solid ingesta, in short any thing capable of stretching, irritating, or hardening 

 the gut, will spread and increase the disease. The fasciculated appearance in the 

 rectum is what Mr. W. had once met with in a very sound gut, where the villous 



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