The North American medico-chirurgical review . y, and becoming tense,and hard. These attacks were accompanied with extreme pain andprostration; vomiting usually attended them, though never of stercora-ceous matter. The emaciation increased, and the life of the patientwas an agony to which there was seldom a remission. The size ofthe instrument that would pass the constricted position gradually di-minished, until the small rat-tail bougies alone could be admitted ; therewas evidently a great tortuosity of the rectum, and no metallic instrumentcould be introduced. On the 13th inst. he was attack


The North American medico-chirurgical review . y, and becoming tense,and hard. These attacks were accompanied with extreme pain andprostration; vomiting usually attended them, though never of stercora-ceous matter. The emaciation increased, and the life of the patientwas an agony to which there was seldom a remission. The size ofthe instrument that would pass the constricted position gradually di-minished, until the small rat-tail bougies alone could be admitted ; therewas evidently a great tortuosity of the rectum, and no metallic instrumentcould be introduced. On the 13th inst. he was attacked, as previously, with inability to defecate,great distension, and with intense agony, which very soon prostrated usual remedies failed to give relief; the smallest-sized flexible cathetercould not be made to pass the point of constriction. His strength gradu- Pathological Societys Proceedings. 309 ally failed, anodynes in enormous doses produced no alleviation of hismisery, and he sank under it the following morning. Fig. 7. Fig. Autopsy.—The appearance of the body was most striking; the headand both upper and lower extremities were wasted to the bone, while thetrunk presented a resemblance to the old Greek amphora, the thorax be-ing compressed to the size of a childs, and looking like a protuberanceupon the spherical mass of the abdomen, which measured more than fivefeet in circumference. It had the firmness and resonance of a drum-head. An incision was made over the sternum, carried down into theabdominal parietes, where the skin literally cracked before the knife as itwas lightly touched. When the incision had reached about an inchabove the umbilicus there was a sudden explosive report, with theexpulsion of faacal matter and gas, and an immediate subsidence ofthe whole abdomen to about one-half its original dimensions. Exa-mining for the cause of this I discovered that the colon lying acrossthe abdomen had at this point given way, being no longer able to resi


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Keywords: ., bookcentury1800, bookdecade185, booksubjectmedicine, bookyear1859