296 MORBID ANATOMY.
with a disease of the dura mater, that was probably malig- nant.
From a young man, aet. twenty, who applied to Dr. W. for exophthalmos of the left eye, on the 19th of June ; vision then perfect, and no cause found for the disease. On the 5th of July he went out in the evening to see the fireworks, and from that time his disease progressed until his death, which occurred on the 8th of August. Discomfort about the eye, with great dimness of vision, followed the expos- ure ; and on the 8th the ophthalmoscope showed haziness of " outline of disc, with slight hemorrhagic effusions near macula lutea ; " the right eye being also somewhat affected. On the 10th there was some deafness upon the left side. The eye protruded so that it could not be covered by the lids ; the hemorrhage greatly increased ; the pain in the eye and head was such as to require morphine ; and during the last week there was a wandering of the mind.
On dissection, by Dr. J. Homans, nothing was found in the orbit to explain the exophthalmos, but behind the left eye there was a rather soft growth from the dura mater, about the size of an English walnut. Toward the vertex the dura mater was very greatly thickened to the extent of 2 or 3 in. ; and a vascular, flocculent growth upon the external surface penetrated the diseased bone. Otherwise the membrane was healthy, as was the brain. Externally there were also flattened morbid growths between the fascia and the pericranium, and that penetrated the bone. Micro- scopically, all of these growths presented appearances that much resembled those of malignant disease.
The calvaria, having been removed in the usual way, was found to be diseased throughout the greater part of its extent, internally and externally, but mostly upon the internal surface. A growth of bone arose from this last, in thin laminae, from a line to a line and a half in height, compact in structure, of a pink color, and very finely con- voluted so as to give a somewhat coralloid appearance ; the disease being for the most part defined, and commenc- ing with a roughness of the surface. There were also innumerable foramina, and many of them were quite large ; but otherwise they resembled those usually seen in chronic
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