INTESTINAL ANASARCA, WITH ASCITES. 
687 
comes much increased and laboured. Pulse quickened — trembles — 
totters — wanders about, and lifts his bead up, and I expect him 
every moment to fall down ; but in a few minutes all subsides, 
and he appears himself again. 
II A.M. — About the same. Give opii et camph. aa 3ss, as his 
bowels rumble much. 
2 P.M. — From last date to the present he gradually got worse, and 
at this hour he died. The fits continued the same every half hour 
or so ; but he never lay down until a short time before he died. 
Examination . — In consequence of tremendous and continuous 
rain, he was not examined until seven o’clock the next morning. The 
abdomen contained about ten or twelve gallons of liquid of a simi- 
lar colour to light port wine. I could only discover a few shreds 
of coagulated blood in the abdomen : about the incised spermatic 
cords there was nearly an ounce of coagulated blood, but whence 
it had escaped I could not discover. There was a quantity of 
serum in the cellular tissue surrounding the kidneys, though they 
appeared sound. The whole of the peritoneum covering the in- 
testines and parietes of the abdomen (except the diaphragm) was 
not the least inflamed, but perfectly natural. The diaphragm was 
considerably inflamed and covered with flocculi. The liver and 
spleen had scarcely any blood in them, and the former was of a 
clayey colour ; the latter was small and of a blueish colour. Sto- 
mach beautifully sound. Lungs tender, and little blood in them. 
Heart sound, and scarcely any blood in its cavities. There was a 
little serous effusion into the thorax and pericardium, but I am 
sorry I cannot say whether it had the tinge of blood or not, like 
that in the abdomen. The small intestines were but little thickened 
or diseased. On looking externally at the large intestines, there 
appeared nothing the matter with them ; but on cutting them open, 
the caecum and colon were throughout found seriously diseased ; 
for between the mucous and muscular coats there was a vast quan- 
tity of serum extravasated within the cellular tissue, and in some 
places two inches thick. There was no effusion within the mus- 
cular coats, between them and the peritoneum, nor was there but 
little effusion underneath the mucous coat of the rectum. On 
taking a general view of the body, there appeared very little blood 
in its textures, it being quite pale, and as if he had been bled to 
death. 
Observations. — At page 430 of this volume will be found 
a similar fatal case to the above one ; and, as far as my practice 
has gone, such cases have been rare with me. In both of them 
the symptoms were very deceptive, and liable to mislead us in 
our treatment ; indeed, there were no symptoms that, for seve- 
ral days, would lead us to believe that there was any thing serious 
