the lungs collapsed. They were spongy and elastic throughout; but on the external surface of the superior lobe of the right lung, as also on the middle lobe, were three remarkable emphysematous resications, the largest equalling in size a hen's egg, the two smaller being about that of a pigeon's. They collapsed instantly on being punctured, and exhibited internally a loose and very expanded cellular structure. The bronchial mucous membrane was pale and of a healthy aspect, but the longitudinal fibres in the secondary divisions were developed in a high degree. It has been said that the lungs were spongy throughout, but two points were exceptions to this, for at the apex of the right lung, and posteriorly on the surface, or within the eighth of an inch of the surface, of the middle lobe, two spots declared themselves to the touch, dense, firm, and carnified, and also distinctly circumscribed. Neither of them exceeded in dimension a moderatesized filbert. When cut into, these masses appeared encysted, and were bounded by firm cellular tissue; the contents resembled both in colour and consistence, a black carbonaceous pigment. Upon examining a portion under the microscope, the appearance was that of black amorphous grains, like carbon in a state of minute subdivision; bands of cellular tissue seemed to pass through this carbonaceous deposit. The bronchial glands were of ordinary appearance. The remaining viscera presented nothing worthy of note, except that the kidneys were much lobulated, and both were encysted, the left contained a serous cyst, the capacity of which was equal to ten ounces.

There are several circumstances and conditions in this post-mortem record of considerable interest to the student as well as to the more experienced practitioner. First, the state of the brain as expressive of the apoplectic condition; secondly, the existence of fracture through the temporal bone, presenting a complication of much medico-legal interest; and, thirdly, the state of the lungs as indicative of interlobular emphysema, with the extreme development of the longitu. dinal fibres in the bronchii, expressive of the asthmatic paroxysms during life, together with the presence of two encysted deposits of carbonaceous matter in a state of minute division, and a question raised thereon, whether the circumstances under which he may have been placed as a Sapper and Miner could in any way explain the existence of these unusual appearances in the pulmonary tissue,-whether working oftentimes in an atmosphere loaded with particles of carbon suspended in the air, (as would be the case in many mining operations in military works,) could in any way have tended to the development of these deposits.

Let me first direct your attention to the state of the head, the scalp, and brain. In the former we have evidence of external local injury; in the latter proofs of an apoplectic cyst are unquestionable. I am anxious to point out to you the limit of the indications by which these two conditions are proved. The extravasation of blood beneath the scalp under the temporal fascia must have arisen from external injury, and when we find on minute examination that the temporal bone is fractured, the fact is established beyond doubt. On

examining the state of the brain and its meninges we observe blood extravasated beneath the dura mater, between it and the arachnoid, not upon the dura mater, between it and the bone. Blood has also effused between the pia mater and arachnoid, and at the most inferior point of the middle lobe of the left hemisphere, at the concavity of this lobe lying in the temporal fossa, and close adjoining to the line of fracture; "the cerebral substance is observed discoloured, of a purplish brown, and the spot being opened, displays a clot of blood, surrounded by medullary matter-soft, pulpy, and of a brown-ochrey hue, presenting the condition usually recognised as ramollissement. These appearances are evidences of the apoplectic seizure. The presence of an apoplectic clot or cyst, without accompanying effusion of blood between the meninges or into the ventricles, is not incompatible with life. The cicatrices of many such cysts have been frequently observed in the brains of apoplectics. In a case examined by me two years since no less than five such cicatrices or remains of apoplectic cysts were observed, two in the left hemisphere, one in the thalamus, one in the corpus striatum of the opposite side, and one in the cerebellum. These were severally in various stages of obliteration, and corresponded in number and appearance to five distinct apoplectic fits that this individual had suffered from during the preceding three years. An apoplectic cyst, or sanguinolent clot, even though surrounded by a limited amount of softening, does not necessarily involve the cessation of the vital processes; but in the case before us the apoplectic condition of the cerebral substance was accompanied by effusion of blood between the pia mater and arachnoid, and between the arachnoid and dura mater. It is this transudation of blood beyond the cerebral mass and upon the surface, or into the cavities, of the brain that constitutes for the

most part the fatal lesion in apoplexy; for experience proves that so long as the effusion remains encysted and confined to the cerebral mass, although paralysis usually supervenes, yet the organic functions still continue, those of sensation and motion being impaired. But when the blood escapes beyond the cerebral substance, and is transuded between the meninges, or into the ventricles, the functions of organic life appear to be incompatible with such lesions, and death speedily between the pia mater and arachnoid, or between the

ensues. It follows from this that transudation of blood

latter and the dura mater, must be accepted as a more fatal lesion than the existence of a clot in the medullary mass ; in other words, a simple sanguinolent cyst in the cerebral substance is of less vital moment than one occurring in the superficies of the convolutions, and accompanied by escape of blood between the vascular and serous investments of the hemispheres.

I directed your attention to the soft ochrey-brown pulpy state of the medullary substance that surrounded the clot. This softened condition of the cortical portion must not be viewed as the result or effect of the sanguineous clot, but rather as a condition preceding, and predisposing, if not accessary, to the formation of the apoplectic cyst. There could be little doubt but that the brain had been undergoing some morbid

changes at this spot for some time previous. The mental symptoms spoken of by his wife indicate this. The frequent giddiness and uncertainty of gait, hesitation of manner, and a dread when walking of being run over, spoke of some changes going on in the encephalon inimical to its continued integrity. The opinion of the best pathologists is, moreover, in favour of this view,that the ramollissement surrounding an apoplectic cyst must be admitted as a condition preceding, not following, the formation of the clot.

The coincidence of fracture of the temporal bone imparts to this case an additional interest; and had the circumstances under which he received this injury | been less public, or had any mystery existed, as to the manner in which the accident happened, some questions of great medico-legal moment would have arisen, and would have embraced these considerations,-whether the apoplectic effusion, or the extravasation from the fracture, was the cause of death; and the question would comprehend the equally important one,-whether a blow, or any external violence sufficient to fracture a bone, could possibly induce such an apoplectic cyst as existed in this case, or whether it was not more probable, that the apoplectic fit first supervening, gave rise to insensibility and sudden loss of muscular power, under which the body might fall heavily, and thus account for the external injuries. In the case before us, the facts and circumstances under which the patient was found are sufficiently public and satisfactory, and preclude any speculation as to the probable origin or relation of any of the pathological appearances; but if this man had been found insensible and alone, and robbed, or any doubt had hung over the origin of the accident, then such questions as I have propounded would necessarily suggest themselves, and would imperatively demand a clear and explicit solution to satisfy the demands of public justice. In a medicolegal enquiry, the first point to be determined would be the nature and extent of the external injuries. Contusion of the scalp, with extravasation of blood beneath the temporal fascia and fracture of the temporal bone are present, all of which might equally result from a blow or a fall. These local injuries are unquestionably of themselves sufficient to cause death; but on examining the state of the brain, an apoplectic cyst is found, with transudation of blood between the pia mater and arachnoid, a lesion also incompatible with life. An important point thence arises, to which of these two competent causes are we to attribute the death of the person. I quote the following passage from a note in Beck's Medical Jurisprudence, p. 330. Article wounds :

"If effusion of blood be found between the dura mater and the skull, and if a bruise on the scalp corresponds to the part, we may conclude that it has been caused by the blow; but if blood has been found between the dura mater and the brain, though we should discover the marks of blows, or even fracture of the skull, still the question may be, might not the patient have been attacked with apoplexy during a struggle?'" A case is then quoted from Dr. Cheyne in illustration.

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The unequivocal proofs of apoplexy, therefore, in this case would be accepted as satisfactory evidence,— that death was more likely to have been promoted by this cause than by the local injury; and this inference would be further established by detailing the condition of the brain surrounding the apoplectic spot. For it has been already shown that this softened discoloured condition of the cortical substance must have existed antecedently and could not in any way have been caused by the apoplectic effusion, still less by the local injury. The entire medico-legal question thus turns on the nature and extent of the cerebral complication in conjunction with the local injury. If the cerebral lesions are sufficient to cause death, and capable of being produced independently of external injuries, then we are bound to suppose that death ensued from causes originating in the brain, constitutionally produced, If, on the contrary, the cerebral conditions are such, that it is more likely they were caused by the external injury, such as simple effusion of blood, unaccompanied by any express circumstances proving a spontaneous origin in the system itself, we must then declare the external wound to have been the immediate cause of death, and death by violence, not from natural causes, would then be recorded.

The state of the lungs in this case were an excellent illustration of the conditions of interlobular emphysema, and the hypertrophied condition of the longitudinal fibres of the bronchi, even down to the smaller subdivisions, spoke of the exister.ce of asthma during life, which was verified by the wife's account of the paroxysms of cough, to which he was subject. But there was one other condition of these lungs, or rather of the right lung, of peculiar pathological interest. In examining the lung of this side to determine its spongy crepitating condition throughout, the sense of touch was arrested at two spots, which felt hard and circumscribed. Their situation has been already noted: they appeared encysted, being surrounded by cellular tissue of a dense structure, and when cut into developed a black carbonaceous pigment, which, when examined under the microscope appeared to consist of amorphous granules of carbon, in a state of minute division. This deposit was not affected either by hydro-chloric acid, nitric acid, nor by liquor potassæ; but I much regret now that I did not submit it to more minute chemical

analysis, with a view of determining its positive chemical properties. It was miscible with water, stained the fingers black temporarily, and the negative action of the acids and alkalies on it testify to its being similar to carbon, and if carbon, then in all probability, a deposit of carbonaceous matters inhaled by the respiratory function; for it had not the appearance of a matter deposited by secretion, nor any similarity to melanotic disease. Laennec has distinguished black pulmonary matter from true melanosis, one of the characteristics of the former being its isolated situation in the pulmonary tissue or bronchial glands, and its distinct carbonaceous character when chemically treated, while the latter is seldom or never found confined to one organ, but is distributed through several, and possesses distinct chemical characteristics of organic origin. Laennec also referred

iv.; Pulv. Ipecac., Comp., gr. vj., statim; with fever draughts every four hours..

The next day the pulse was 140; skin intensely hot; pupils insensible, being much dilated; the respiration much accelerated; stares vacantly about; answers no questions; protrudes the tongue when desired, which is clean and moist; face much flushed; eye-balls sensitive; skin bedewed with a copious perspiration; pulse 136, soft, but incompressible; the urine and fæces have been passed unconsciously, the latter have the ordinary aspect. The head was shaved; cold lotion applied. Antim. Potassio-Tart., gr. ; Opii Pulv., gr. ss., quartis horis.

The report on the 28th states that she passed a quiet night, but did not sleep; answers no questions; some little incoherence and muttering to herself; bowels have not acted, and the bladder was relieved by the catheter. Enemata were administered. At night on the 26th she appeared better, and was temporarily sensible, answering one or two questions in mono. syllables. The night was passed quietly, and in the morning she was reported as much better; she even sat up in bed, and took a little arrowroot in the morning of the 27th, but soon after she suddenly became pale and death-like. There was no convulsion; but the pulse was small and rapid, and then imperceptible; the surface was bedewed with a copious deathsmelling sudoresis. She gradually sank and died an hour after the change that appeared at 10 a.m.

Sectio cadaveris thirty hours after death. The body was well formed; no emaciation; on the contrary, the limbs were rounded and plump from subcutaneous fat. The cavity of the cranium exhibited well-marked indications of acute hyperemia in all its parts; the vessels of the dura mater were much injected; the arachnoid was diaphonous and natural; the pia mater was highly injected, so much so as to present the appearance of a dusky-purple; the substance of the brain was natural, except the presence of innumerable red spots from the divided vessels, and the cortical part assumed a dark almost madder hue; the ventricles contained no more serum than could result from cadaveric exosmosis. The lungs and heart were healthy; the stomach and intestines distended with flatus; the lining membrane of the stomach was pale and natural in appearance, but easily detached and peeled off; the duodenum and jejunum was also remarkably pale and exsanguineous. The lower eighteen inches, however, of the ileum was studded with many warty ulcerations, this appearance arising probably from the enlargement of the follicular glands in the first instance and their subsequent ulceration; one ulcered surface wae more than an inch in extent, was oval-shaped, its margins considerably elevated above the surrounding membrane, and its cavity containing a dirty spongy matter, like gangrenous cellular tissue; the surrounding portions of mucous membrane were injected. The entire space of the cæcum was involved in one large, jagged, irregular, wart-like ulcer, its surface being wrinkled and covered with the same conditioned substance attached to the ulcers of the ileum. A nail's breadth beyond, the cæcum and the mucous membrane of the colon presented the

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same pale state of the mucous membrane that marked the stomach and duodenum. The fimbriated extremities of the Fallopian tubes were both intensely congested; the ovaries contained minute serous cysts; the liver, kidneys, spleen, and pancreas, had a healthy appearance.

It is remarkable that inflammation and ulceration of the intestines are oftentimes accompanied by indeterminate and most obscure symptoms. From our knowledge of the functions of the intestines, and of the important part they perform in the animal economy, we might almost infer that the slightest deviation from healthy action would be expressed by some unequivocal symptom, which would emphatically declare the seat of the derangement; but such is not so. Of all the organs of the body under the influence of disease, the intestines exhibit the least expressive and most variable symptoms. This arises from the wide-spread influence exercised by the intestinal function over other and distinct organs, and the powerful sympathy excited in them by intestinal derangement; hence it is that certain portions of the intestinal tube, whether in a state of simple congestion, or even passing into ulcerative disorganization, may almost be said to possess no true pathognomonic characters, oftentimes giving rise to symptoms simulative of other diseases, and thereby masking the real though latent disorder.

The case before us is a well-marked example of the disguise under which intestinal mischief may present itself, and proceed to a fatal termination without developing any prominent abdominal indications. Except some trifling tympanitis of the abdomen all the symp. toms declared for cerebral rather than abdominal disease.

It is commonly asserted in books that inflammation of the intestines in adults is easily determined and recognised in every part of their extent; but that in infants, and in the earlier periods of life, it is admitted that much obscurity often hangs over the symptoms. In children acute enteritis is frequently expressed by cerebral symptoms, but in adults, on the contrary, the greatest variety of sympathetic irritations develope themselves, and as a general rule it may be stated that the enteritis of children is more frequently expressed by cerebral irritation than in the adult; yet enteric disease in the latter not unfrequently declares itself by symptoms chiefly cerebral. It is usually asserted, and practically it is true, that inflammation and disease of certain distinct portions of the intestinal canal are sufficiently well-marked by specific pathognomonic sympoms. Thus, in inflammation of the duodenum, or as the stomach is usually involved in gastro-duodenitis, this condition is declared by the presence of more or less jaundice, pain and fullness over the region of the duodenum, irritable stomach, loaded urine, and clay-coloured dejections. If the stomach be alone the seat of inflammation, vomiting (obstinate and constant,) of a green bilious fluid, is the most prominent symptom. If diarrhoea, long-continued and exhausting, present itself, experience justifies us in fixing on the colon as the seat of the disease. Thus, when these isolated portions of the alimentary canal are involved in inflammatory or dis