2268. A portion of intestine, showing a perforation about an inch in diameter, and about 2 in. above the caecal valve ; the whole base of an ulcer seeming to have sloughed through. There were only one or two very small ulcers near it, and none of the other patches were distinct. The peritoneum was generally reddened, and there was lymph to the extent of an inch around the large ulcer.
From a healthy young man, who had had well-marked symptoms of typhoid fever for about two weeks. Perfora- tion occurred forty-eight hours before death, but the pain and other symptoms were by no means urgent. (Med. Jour. Vol. LIX. p. 522.) 1859. Dr. 0. G. Putnam.
Five Thibert's models. 1849. Dr. J. Ware.
2269. A very large perforation of the ileum, from ulceration of Peyer's patches ; the others having healed.
2270. Small intestine, seen externally ; and showing peritoni- tis, the result of perforation.
2271. Inflammation of the small intestine.
2272. Numerous ulcerations of the small intestine, giving the appearance of lace-work ; with considerable swelling of the tissues.
2273. Long and narrow ulcerations, transverse to the course of the small intestine, with swelling of ithe mucous mem- brane, thickening of the parietes, etc. ; the result of chronic inflammation. Mesenteric glands swollen, red, etc.
2274. The appendix cseci, from a case of tuphlo-enteritis.
The patient was a lady, set. thirty-seven years, who, having been indisposed for a few days, was attacked sud- denly and violently with pain in the abdomen, and died on the ninth day. There was more or less pain throughout ; some vomiting ; no free dej. ; pulse nearly imperceptible from the first.
On dissection, there was found extensive peritonitis. The first half inch of the appendix was quite healthy ; but the rest was inflamed upon the inner surface, and tending to gangrene. In the cavity were very numerous masses of faecal matter ; and one much larger than the rest, protruded from an opening through the parietes of the appendix, and
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