0s6 PHILOSOPHICAL TKANSACTIONS. [^ANNO 1780. 



fore with great caution, and at such an extent as to take in the vena azygos, and 

 afterwards found, on clearing it at his leisure, that it really was the thoracic duct, 

 entirely plugged up with ossific matter, from immediately above the receptaculum 

 chyli. 



Unfortunately, being much straitened for time 'a hen he opened the body, he 

 was obliged to take out the parts for a more careful examination at home, which 

 deprived him of the opportunity of ascertaining the above circumstances at the 

 time he separated the parts, and consequently of inquiring how much farther up 

 this singular ossification extended, and in what state the duct might be at its 

 entrance into the subclavian vein. The vena azygos, as well as the aorta, was 

 perfectly sound. The vena cava was not so free from disease ; for though it bore 

 externally a natural appearance, when he laid it open from finding a singular feel 

 within, he found that its cavity was above half filled with a firm inelastic sub- 

 stance : this substance originated from its internal surface near the entrance of 

 the emulgent vein, attached to it here and there by small points, till about the 

 projection of the sacrum, where the cavity of the vein was almost filled up svilh 

 a continuation of the same substance. 



The spleen, pancreas, and liver, were perfectly sound : the gall-bladder very 

 ^mall, and quite empty ; its ducts in a natural state. The kidneys were much 

 increased in their substance, externally more livid than usual, and seemingly in 

 a state of inflammation. The ureter on the right side was much enlarged, and 

 contained a considerable quantity of urine, which seemed retained there by the 

 distension of the bladder. The left ureter was of its natural size and appear- 

 ance. The coats o( the bladder were considerably thickened, but preserving 

 externally as well as internally its most healthy appearance. As the bladder could 

 not expand itself laterally, it was extended upwards in an oblong form, not un- 

 like that of a calfs, but did not appear capable of containing more than a quart. 



The tumor which occupied the right iliac region, extended itself irregularly 

 in all directions, and appeared outwardly to have destroyed or brought on ab- 

 sorption of a principal part of the os innominatum, so far as this could be ascer- 

 tained by thrusting a probe into it in different directions. The manner in which 

 a portion of this tumor pressed on the neck of the bladder readily accounts for 

 the difficulty of passing the catheter, though a bougie easily slipped in, and 

 shows the reason why the patient was unable to empty his bladder for so long a 

 time before his death. The degree of injury the os innominatum has sustained 

 could not then be certified, the tumor not being sufficiently reduced by maceration. 

 Where the bone was cleared from the surrounding soft parts, it appeared to have 

 suffered a great loss of substance, and, as the tumor dissolved, a large quantity 

 of bony matter, deprived of its connecting medium, was continually subsiding 

 t() the bottom of the vessel in which the tumor was macerating. 



