654 ABDOMINAL TUMOUR, WITH ASCITES. 
got rapidly worse to the end of the month, and on the 1st of De¬ 
cember, while being taken to exercise, fell with her head and 
shoulders down a declivity, where syncope shortly supervened, fol¬ 
lowed by death. 
Post-mortem appearances .—On opening the abdomen, about 
fifteen or sixteen gallons of reddish liquid flowed out, having no 
ill smell nor any flaky matter in it, as is commonly seen in cases 
of peritoneal inflammation. The tumour was sought for, and found 
in situ , attached to the side and covered by a strong capsule of 
peretoneum, the irregular outline of its lower edge, alread}^ men¬ 
tioned, being due to a number of small tumours adherent there, 
each by a pedicle of the same serous membrane. On detaching 
the mass, it was found to weigh 35 lbs. imperial, and on cutting it 
up, it presented two different kinds of structure internally: the 
one appearing, however, to be only a more advanced stage of the 
other. The outside portion, for about two inches in depth, con¬ 
sisted of brainy looking matter, (encephaloid substance of human 
pathologists), white on the cut surface, with here and there a faint 
reddish blush, or a few distinct red points, apparently the cut ends 
of bloodvessels, a few of which could be traced into it, from its 
serous covering. This substance gradually merged towards the 
centre of the tumour, into a sort of reddish grey fibrous matter, 
disposed in generally parallel flakes, not unlike fibrine ill prepared 
from blood, and containing between and among the flakes a con¬ 
siderable quantity of serum, resembling in smell and colour the 
fluid in the abdomen. The disposition of the bloodvessels upon 
the surface, and the semi-organised condition of the centre of the 
tumour, evidently shewed that it must have been nourished by a 
diseased secretion from the peritoneal surface, upon the external 
aspect of which its accretion had commenced. And that this mem¬ 
brane had enlarged with the growth of the encephaloid matter to 
its ultimate enormous size, while, after a certain stage of its growth, 
the matter in the centre had begun to undergo a process of disor¬ 
ganisation. Still, however, so long as the serous envelope remained 
entire no evil seemed to arise from its presence. 
On examining still farther the abdomen, the omentum, and peri¬ 
toneal covering of the kidneys, liver, ribs, and diaphragm, were 
found studded with growths similarly disposed, though of smaller 
size, varying from that of a pea or marble to that of an apple or 
small turnip; and their entire substance being brain-like matter 
confined in a capsule and attached by a pedicle of peritoneum. 
Still there was no appearance of irritation in any of these to ac¬ 
count for the ascites and other causes of death. But to the supra- 
posterior part of the diaphragm adhered a mass of fibrous frag¬ 
ments, like matter of the same'structure as already described, occu- 
