210 TUMOUR IN THE ABDOMEN, &C. 
was perceptible, which cheered me a little, and determined me to 
persevere ; and I accordingly gave one drachm more of the 
digitalis. 
Fourth morning. — He is much worse ; the expression of coun- 
tenance is aggravated ; the pulse has increased to 102 ; the 
respiration has become a little hurried, and the nasal discharge 
is green, bloody, and highly offensive. Repeat the medicine. 
Noon. — Much the same. Continue medicine. 
Six o’clock, p.m., no alteration. Still continue the medicine. 
During the fifth day he was much the same as on the preceding 
one. The digitalis was repeated morning, noon, and night. 
Sixth day. — It is evident his sufferings are drawing towards a 
close. The respiration is greatly hurried, and the pulse now 
beats from 120 to 125 ; the mouth is cool and clammy ; the 
breath and nasal discharge very offensive, and the latter still 
tinged with blood. As a matter of experiment I gave 3 iss of 
digitalis, and at noon repeated the dose. 
7 p.m. — He cannot survive long. The pulse falters; the 
mouth is cold, clammy, and filled with foam : he has the cold 
sweats of death upon him, and I leave him until the morning, 
but with no idea of seeing him again alive. 
Upon opening the chest, the most remarkable phenomena 
first presented themselves in the lungs, upon the right lobes of 
which were seven or eight air-bladders, beautifully transparent, 
and the largest of them somewhat exceeding a goose’s egg 
in size. The surface of the lungs was of a very light pink 
colour, and their substance, when cut into, of the same hue. 
The right ventricle of the heart was greatly dilated, but the 
auricle not so much. The left auricle and ventricle not much 
altered. When the abdomen was opened, a large tumour attached 
to the posterior and inferior surface of the diaphragm was first 
seen, which occupied from eighteen to nineteen inches laterally, 
and five or six inches superiorly, and from three to four inches 
in thickness. On cutting into it, it was found to be composed 
of blood, the fibrin lying in clots as large as a hen’s egg, in dif- 
ferent parts of the colouring matter. The fauces did not exhibit 
the slightest inflammation ; but the mucous membrane of the 
trachea betrayed a slight blush of it. The intestines, &c. were 
healthy. 
