FRANCIS* CASES OF MORBID ANATOMY. 515 



an inch broad, lying obliquely transverse, seeming sacculated and hard. 

 Upon a closer examination this tubercle was found to contain a material 

 of a cheese-like consistence. A short distance above the tubercle com- 

 menced the ulceration of the oesophagus, presenting an extraordinary 

 mass of disease. The ulcer involved the several coats of the oesopha- 

 gus so as to render it impossible to discriminate between them ; those 

 parts which were not affected by suppuration were augmented in 

 thickness, and were, in many respects, of a scirrhous or gristly nature. 

 About an inch above the tubercle, the ulcerous erosion had created an 

 opening into the trachea. The upper part of the oesophagus, nearest 

 the vertebrae, was deeply excavated by the ulcer which here formed a 

 sinus of some extent. The inferior extremity of the pharynx also 

 partook of this diseased condition of the oesophagus. The aorta was 

 firmly attached to this tube, but in no wise altered in its structure. 



The stomach was considerably contracted : externally, it manifested 

 no marks of disease, and its several coats could be easily traced ; 

 internally, it was supplied with its ordinary mucus, and contained about 

 an ounce of fluid : its rugae were very large and numerous, and 

 increasing in size as they approached the inferior orifice. The duode- 

 num was partially contracted, but in every other respect natural. The 

 other intestines were not particularly examined. The liver was of the 

 ordinary magnitude, and both externally and internally presented a 

 healthy appearance. The gall bladder was full of yellow bile of a thin 

 consistence : its duct, as well as the ducts of the liver, was of the com- 

 mon size, and pervious. The spleen had undergone some slight 

 deviation from its healthy structure : it was rather larger than this viscus 

 commonly is, and its vessels were in a highly turgesced state. The 

 pancreas, though considerably enlarged, did not exhibit to the eye any 

 alteration in its structure ; but upon further inspection, it was discover- 

 ed to be remarkably hard, and partially cartilaginous. Its lobulated 



