Hoivrah Hospital Report for 1 846. 523 



cessary to employ the active measures of general bleedings 

 leeching., cupping, large doses of tartar emetic, and blisters, 

 in several of these cases. 



One case, age 37, was admitted after active treatment on board-ship 

 for five days, in the last stage of the disease ; with hurried, catching, 

 and most painful breathing, and with severe pain shooting across the 

 left breast and side : in this, high delirium came on the very night of 

 admission, followed by clamminess and sinking, and death the next 

 morning. Signs by auscultation, rale crepitant at the seat of pain 

 on the left side, respiratory murmur indistinct there and tubular, an 

 occasional guggling sound heard beneath left arm. Upon examina- 

 tion 5 hours after death, enormous congestion of the blood vessels 

 of the brain was found, more than a pound of blood escaped during 

 the divisjon of the scalp and sawing through the bones ; the arachnoid 

 milky in places ; effusion of serum to a small extent ; brain of healthy 

 firmness. 



Chest. — The pleura, lining the sternum, was adherent to the pleura, 

 covering the pericardium ; a thin layer of yellowish, soft, false mem- 

 brane interposed between the inflamed and deeply reddened pleurae at 

 the points of adhesion ; the lung on the left side in front adherent 

 to the lining of the ribs ; the whole lung was covered with an almost 

 continuous covering of this false membrane, which dipped also into 

 the sulci between the lungs; the lung on this side externally of 

 a dark-purple colour, more particularly so at the dependent parts ; 

 upon division the substance of the lung of a dark-purple colour 

 pouring forth black blood, its texture, particularly so at the depen- 

 dent parts, softened, giving way beneath the fingers ; drops of healthy 

 pus exuded upon slight pressure out of the cut bronchial ramifica- 

 tions. The pleura costalis was likewise inflamed and smeared with 

 the same kind of false membrane ; about half a pint of yellowish 

 serum was found in the bag of the pleura on this side. The same 

 disease was found on the right side but to a less extent : no internal 

 pericarditis found. 



Scurvy.— Seven cases have been treated besides several 

 others of scorbutic rheumatism, the cases, have not been of a 



