PHTHISIS PULMONALIS. 
478 
organic disease ; gall bladder healthy; kidneys contained a 
little puriform matter, otherwise healthy , nowhere very pale. 
Peritoneum loaded with albuminous deposition; in one of its 
folds on the right side, near the external ribs was a small 
tumour full of pus. 
The thorax contained an increased amount of serum. A 
tumour (the one I have sent you), containing about a quart 
of very liquid pus, occupied the superior mediastinum, im¬ 
mediately above and anterior to the heart. You will be able 
to estimate the quantity of fluid the tumour would contain. 
The thick white deposition in the inside, mechanically ad¬ 
mixed with the thicker portions of the pus, I presume is 
chalk. It was very abundant, and some portion of it was 
lost; but the majority of the sediment coats the inside of the 
tumour. The gritty feel is very apparent, on feeling a por¬ 
tion of the pus between two fingers. Another, of about the 
same size and of the same character, occupied the normal 
situation of the anterior portion of the right lung. Different 
portions of the lungs, but principally the anterior, presented 
condensation, with a great deposition of calcareous matter in 
their substance , without having become broken up, render¬ 
ing the thoracic viscera adherent, to a great extent, to the 
anterior portion of the sternum and first rib. The solid 
matter weighed 11J lbs.; and the escaped pus, Mr. Barker, 
m.r.c.v.s., who assisted me in making the examination, 
estimated at about 5 lbs. I think with him as to the pro¬ 
bable weight. 
The lining membrane of the left side of the heart, along 
with its valves, was coated with gritty matter, the right side , 
with its valves , being free. The serous membranes of the great 
arteries were healthy also. 
The brain presented a little frothy fluid on its surface. 
Its internal and external membranes were pale, but free 
from all gritty deposit. The fluid in the ventricles, more 
than normal, partook of the same character as that in the 
chest and abdomen, as did likewise a considerable quantity 
which escaped out of the spinal canal. 
Remarks .—The interesting features in the case seem to be, 
the presence of so much thoracic disease, with little or no 
cough, (I saw the patient frequently, and never heard her cough, 
and the owner said, “ only very seldom,”) and the situation 
of the gritty deposit, in preference to the liver, kidneys, &c. 
The passage and consequent oxygenation of the blood, through 
the lungs, must have played some part in this singularity of 
choice. There was always great dulness on percussion of 
