*384 MELANOSIS ‘AND OSSIFICATION. 
1849, when she was sent to my infirmary for advice, on account of 
a swelling which had appeared upon the abdominal parietes, on the 
side the tumour existed, going towards the sternum : this oedema- 
tous swelling, as a matter of course, was more observable on the 
Monday morning, after the day’s rest on the Sunday, than at other 
times. I was thereupon desired to remove the tumour, if I consi- 
dered it advisable. 
I proceeded to examine carefully the tumour and left mamma, 
which was now tense and painful to the touch, as were the adja- 
cent parts. On turning up her tail, I discovered a number, nearly 
a hundred, of distinct detached tumours, varying from the size of a 
marble to a pea in the cellular tissue beneath the skin covering 
and surrounding the anus, labia , and perineum , and extending down 
the hairless surface of the tail; its extremity being for about eight 
inches within its tip much thickened, and in circumference greater 
here than at its sacral articulation. 
I at once told the man who led her to my infirmary that I sus- 
pected these were black or melanotic tumours ; and, to place the 
matter beyond doubt, I selected one from the side of the vulva of 
the size of a large marble, and, cutting through the skin, quickly 
dislodged it : it was quite black, and stained the fingers as ink 
would. 
I formed an unfavourable prognosis, and declined to remove the 
one in the thigh, and desired the man to inform his employers that 
the case would, in all probability, ultimately terminate in death ; 
but that I would visit her in a few days, and explain the matter to 
them. I did so, and informed them that I considered it a constitu- 
tional disorder ; and that I had no doubt but that others existed 
internally, which, coupled with her age and other adverse circum- 
stances, made me look upon an operation as a doubtful means of 
ensuring restoration to health. The wound made by the excision of 
the small tumour had perfectly healed without treatment, leaving 
scarcely a trace of its existence behind. 
In a week or two I visited her again, but declined to adopt any 
course of medical treatment, deeming it useless : I found the ab- 
dominal swelling much in the same state, and directed fomentations 
to be applied to it occasionally. There was little constitutional 
disturbance. The man informed me that she is stiff when at work, 
and does not do it so well as formerly. 
From this time 1 heard nothing of her until early in February 
1850, when I was again consulted. The tumour was fast increas- 
ing, and extending upwards, the mare flagging at her work, and 
the cedematous swelling more diffused : she was wasting, and there 
was considerable constitutional disturbance. Poultices were re- 
sorted to, and she was ordered a fortnight’s rest. 
