522 FRANCIS CASES OF MORBID ANATOMY. 



Dr. Latham, of London, points out the diagnostic signs of an in- 

 durated pancreas, and has noticed as such the pain in the region 

 of the scrobiculus cordis and the dyspeptic symptoms.* 



How far the hiccup, which proved so distressing to the patient, de- 

 pended upon the affection of the diaphragm, I shall not venture to 

 conjecture. This important muscle was, however, most materially 

 affected, and yet that violent train of symptoms that designate 

 diaphragmitis, (paraphrenias diaphragmatica,) according to nosolo- 

 gical writers, was at no time present.f 



It is very generally supposed that ulceration of the superior part of 

 the oesophagus, particularly when it has proceeded to any considerable 

 extent, produces an enlarged or hardened condition of the thyroid 

 gland. The case now described, will induce us to limit the application 

 of this pathological doctrine. 



The appearance of the pulmonary organs is a circumstance too sin- 

 gular to pass over without notice. The picture attempted to be 

 sketched of the changes wrought in the lungs, conveys but an imper- 

 fect idea of the morbid anatomy of this part, and none of the symptoms 

 under which the patient laboured, was pathognomonic of such changes 

 existing in the system ; though it must here be stated, that he often- 

 times, long before the affection of the oesophagus, complained of 

 sufferings of an asthmatic kind. The repeated and long continued 

 complaints of an inflammatory nature affecting his chest, the indifference 

 with which he regarded them, and the mechanical pursuit which he 

 steadily, and for many years, followed, are probably the most efficient 



* Medical Transact, of the College of Phye. of London, vol. 4. 

 f Sauvage3, Nosolog. Method. Dc Haen. 



