558 
ULCERATED INTESTINE. 
having little or no appetite for food ; great depression, with 
diarrhoea ; the pulse small, weak, and indistinct. I gave him 
a dose of Ether and Tincture of Opium in thick gruel ; 
ordered a pailful of w T ater to be placed before him, which he 
drank with great avidity. 
On my visit the next day, I saw no improvement whatever, 
and so on my subsequent daily visits. I gave an unfavor 
able opinion as to his recovery, and diagnosed ulceration o 
some portion of the intestinal tube. He continued to get 
weaker; occasionally he turned his head to his side, exhibiting 
pain, but by no means of a violent character. 
On the sixth day from the first date he was too weak to 
stand ; some blood followed the repeated evacuations ; his 
thirst becoming more and more excessive, and his pulse all 
but gone. I recommended the poor fellow being deprived 
of what little life remained in him; but I believe nature 
kindly interposed and did the work herself ; for I received a 
message the next day to say that he w 7 as dead. I had an 
opportunity of making a post-mortem examination, which I, 
of course, did not lose, as well with a view to satisfy myself, 
as to show .my client the correctness of my diagnosis. The 
abdomen was the first cavity laid open. The peritoneal cover- 
ing of the intestines was slightly inflamed, particularly about 
the large ones. The man assisting me first drew my at- 
tention to a small opening, about the size of a quill, just in 
the largest portion of the colon, through w hich a little ex- 
crementitious matter was finding its w r ay. I at once saw it 
w 7 as the seat of the mischief. I had a protion of the gut 
removed and washed, when the internal surface presented an 
ulcer of large extent, full six inches long and four broad, of 
an irregular shape, and just in the centre all the coats were 
penetrated : to some extent, surrounding the ulcer, the parts 
w ere thickened by effused lymph. The liver w r as hardened and 
discoloured, the lungs congested, and the heart flaccid. 
I have not detailed my treatment as I think it unnecessary. 
I used the remedies I thought applicable to the disease ; but, 
after I had made up my mind as to its nature, of course little 
w as done. 
I had before seen a similar case, and a professional friend 
of mine some time since also related one to me. The great 
thirst, the constant diarrhoea, and the depressed pulse, with 
the occasional pain, w r ere the guides to my diagnosis . 
I remain, dear Sir, yours, &c. 
Bideford, North Devon ; August, 1853. 
