FRANCIS' CASES OF MORBID ANATOMY. 507 



of blood. In 1812 he fractured one of the ribs of his left side. In 

 the winter of 1813 — 4, he again laboured under a severe pneumonic 

 affection, but had not recourse to medical advice. His susceptibility 

 to inflammatory diseases of the thoracic viscera being increased, and 

 his professional employment exposing him to sudden changes of heat 

 and cold, he, from this period to the time of his present illness, 

 frequently suffered from attacks of pneumonia, and as often neglected 

 the means of relief. 



The weak condition of his digestive organs, which was first occa- 

 sioned by the yellow fever of 1798, was often made manifest, more 

 particularly for the last ten years of his life. He was frequently reduced 

 to the necessity of rejecting the contents of his stomach immediately 

 after eating either animal or vegetable food ; and fish, though prepared 

 in the most delicate manner, and taken in very small quantity, was so 

 obnoxious to him as to cause excessive vomiting. For the last two 

 years there has been an increase both in the frequency and in the 

 severity of the disorder of his gastric region : the assimilating powers 

 of the stomach being much impaired, he often complained of headach, 

 heart-burn, flatulence, and other symptoms of dyspepsia, with a costive 

 state of his intestinal canal. During the early part of the summer of 

 1814, he at times stated to his friends, that he found considerable diffi- 

 culty in swallowing ; that repeated efforts were necessary, in order to 

 make substances, in any degree hard, pass down into the stomach ; that 

 these efforts produced a sensation of choking, and were attended with 

 some pain ; and that even fluids were not taken in with the same facility 

 as formerly. 



From this period, finding the symptoms of his complaint gradually 

 becoming more alarming, and his constitution evidently more impaired, 

 he judged it expedient to solicit medical advice, and was accordingly 



