356 MORBID ANATOMY. in. in diameter, and filled with old fibrine ; the sternum being absorbed to the extent of the tumor.
The patient was a woman, aet. twenty-six. In May, 1861, she received a violent blow on the chest, aad shortly afterward had acute pain across the upper part of the chest and shoulders, with slight cough. In September she had a deep-seated "smarting" beneath the upper part of the sternum, with dyspnoea, hoarseness, and dysphagia. In May, 1862, a tumor appeared, and her disease progressed. In December (Hospital, 246, 146) a double pulsation was quite marked over the tumor ; aneurisrnal bruit below the right clavicle, and over the carotid, but not in the tumor. Respiration loudest over right side ; and over the left it was somewhat bronchial. Occasional, hollow, hard, hoarse cough. April, 1863, she raised a few ounces of aerated blood, and died in about ten minutes.
The left primary bronchus was much flattened, and closely adherent to the sac ; an opening having undoubt- edly taken place there, as blood was found in the bronchi upon both sides. The right lung was distended and healthy. The left pleura was adherent, except at the lower part where was a cavity containing about a pint of pus ; and the lung was small, compressed, and contained numerous small purulent cavities. (Med. Jour. Vol. LXVIII. p. 463.) 1864. Museum Fund.
1775. A second and similar cast. The tumor is about in the same situation, but smaller and more diffused than in the above case.
The patient was a man, get. fort3 r -eight. (Hospital, 266, 194.) About a year before, whilst helping to carry a heavy timber, one end was dropped, and he felt his right shoulder severely jarred. Recovered at once, but a month after- ward a pulsating tumor appeared, and increased from that time, with much pain and considerable d3'spno3a. 1866. Mr. J. Collins Warren, one of the house-pupils.
The exciting cause of the disease, in these two last cases, seems,to have been unquestionable, however impossible it may be to explain its operation.
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