514 FRANCIS* CASES OF MORBID ANATOMY. 



MORBID APPEARANCES ON DISSECTION. 



The emaciation of the body was extreme ; not a particle of adipose 

 substance was visible, and upon removing the common integuments 

 from the anterior part of the neck and chest, and cutting open the 

 abdominal parietes, the muscles themselves seemed to be completely* 

 wasted. 



Upon raising the sternum, its lower surface and the anterior medi- 

 astinal cavity presented strong marks of disease ; the thyroid gland 

 was apparently neither enlarged, nor in any degree materially affected. 

 The larynx and trachea showed the effects of former inflammation, and 

 a small portion of the posterior part of the trachea was destroyed by 

 ulceration, which formed a communication with the oesophagus. The 

 pharynx had undergone considerable changes from disease ; its inner 

 membrane was ulcerated in various parts, especially at the inferior 

 extremity, and that side of it which is next the trachea. Upon laying 

 open the oesophagus, the following appearances were exhibited. 



The parietes of the oesophagus, throughout their structure were 

 more than ordinarily thick, and. in several, and at distant places, hard 

 and scirrhous in their texture. Somewhat more than an inch from the 

 cardiac orifice of the stomach, there was a stricture which extended 

 upward one and an half inches in length : the substance of the part 

 involved in the stricture, was thicker than elsewhere : its several coats 

 were distinctly observed: the rugae w^ere hard to the feel; the transverse 

 muscular coat was contracted, and the outer one materially altered, as- 

 if from inflammation. The strictured part of the oesophagus was so 

 narrowed in its canal as to be impervious to a common sized probe. 

 Just above the stricture, toward the right side and posterior part of the 

 oesophagus, there was a tubercle two thirds of an inch long, and half 



