francis' cases of morbid anatomy. 521 



posture, he suffered extreme distress in the loins, abdomen, &c. In 

 noting the most serious consequences arising from affections of the 

 pancreas, among others Tulpius enumerates vomiting and great rest- 

 lessness.* Indeed, it seems necessary to advert to the indurated state 

 of this gland, in order to account, in some degree, for the great 

 sickness and remarkable irritability of the stomach, and particularly for 

 that obtuse, circumscribed, and constant pain in the epigastric region, 

 of which the patient, the subject of the present case, so long and so 

 loudly complained. These symptoms, and particularly the latter, have 

 been observed almost always, I believe, to be attendants upon an in- 

 durated and enlarged pancreas. They are prominent among the 

 features of this disease, as we find in Bonetus,f and Morgagni : % Rive- 

 rius did not omit to specify them,£ nor was Stoll ignorant of them :|| 

 they are noticed in the case which fell under the care of Dr. Clossy, 

 formerly professor of Anatomy in King's College in this city ;1T they 

 are described by Baillie,** and are considered among the most certain, 

 indications of an enlarged and scirrhous state of this viscus, by Dr. 

 Sewall, of Boston, as ascertained by him in two striking instances- 

 upon examination after death.ft In a late communication on tumours*, 

 which have occasionally been mistaken for diseases of the liver. 



* Observationes Medicae, lib. iv. cap. 33. 

 f Sepulchretum Anatom. 

 t De Sedibus et Causis.Morbor. Epist. xxx, 

 6 Opera Riverii, Praxeos Medicae, lib. xii. 

 jj Ratio Medendi, vol. 1. 



IF Observations on some of the Diseases of the Parts of the Human Body, chiefly taken 

 from the Dissection of Morbid bodies, p. 81. 

 ** Morbid Anatomy, third ed. p. 270. 

 ff New England Journal of Med. and Surg. vol. 2. p. 21. 



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