532 francis' cases of morbid anatomy. 



always aggravated, provided any nourishment had been taken a short 

 time previous; and the pain that gave greatest uneasiness was seated in 

 the right side, directly at the inferior orifice of the stomach, and was al- 

 ways aggravated when she laid down upon that side.* The attacks of 

 vomiting sometimes came on very suddenly ; and, for several weeks be- 

 fore death, she discharged the contents of the stomach with extreme 

 violence. The functions of the intestinal canal were performed with 

 great regularity until within some few months previous to the termina- 

 tion of her disease. 



In the spring of 1813, she suffered from an acute inflammation of the 

 liver ; but this affection seems to have been confounded with the dis- 

 order of her stomach, as nothing was particularly done for her relief. 

 During the autumn of the same year, she again laboured under another 

 violent attack of hepatitis. From this period she was at no time re- 

 lieved from distress in the right hypochondriac region, and other 

 symptoms which pointed out a chronic enlargement of the liver. With 

 the exception of an ineffectual attempt to excite the salivary glands by 

 a few grains of mercury, which attempt was made by one of the several 

 practitioners of medicine under whose care she placed herself at dif- 

 ferent times, the treatment both of the hepatic and of the gastric dis- 

 order was exclusively dietetical. 



* Such was the fact with regard to the patient, the subject of case the second. This symp 

 torn, indeed, seems to be eminently deserving of recollection, though it does not occupy a place 

 in any of the medical histories of cases of this disease heretofore recorded. I am inclined to 

 think it will be found to be one of the most prominent circumstances indicating the forming 

 stage of scirrhus of the pylorus, and in this belief I am strengthened by the opinion of one of 

 the most accurate observers and experienced practitioners of the present day, Dr. Samuel 

 Bard, now President of the College of Physicians and Surgeons in the University of th« 

 State of New-York. 



