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conjunctivæ contrasted strongly with the dusky colour of the skin. The pulse was exceedingly feeble; he was breathless on the smallest exertion; had frequent retching and vomiting after food, and complained much of pain in the epigastrium. He was exceedingly weak, and had such a sense of stiffness and weakness in the back that when he sat down he felt almost unable to rise again; in fact, he said that his back felt broken. There was tenderness on pressure, and well-marked pain on percussion, over the lower dorsal and upper lumbar vertebræ, and he complained of a sense of tightness round the abdomen, from the flanks to the groins, and of pain and difficulty in stretching out the legs, when he had been lying for some time on his back with his knees raised. The percussion resonance was somewhat deficient over the front of the thorax, especially over the right clavicle, and the respiration, which was everywhere a little harsh, was distinctly tubular in the apex of the right lung, but no moist sounds nor other evidence of active pulmonary disease were at any time discoverable.
From the time of his admission he very slowly, but steadily, declined. The retching and vomiting continued with brief intermissions. He suffered from vertigo when raised up in bed, became somewhat deaf and dim-sighted, and some days before death fell into a drowsy semi-comatose state, though still perfectly able to answer questions when roused. He sank, and died on 28th of March.
Post-mortem examination.- Body moderately nourished, colour much as during life. Both lungs were firmly attached by old adhesions to the ribs, and at the base of the right side of the thorax a cyst the size of a walnut, filled with putty-like matter, was found in the adhesions, which contained also in several places calcareous deposits. In the apex of each lung was a dense solid mass, consisting chiefly of fibrous tissue, apparently the cicatrix of a former cavity. Embedded in these masses of consolidated lung were several opaque yellow nodules, partly cheesy and partly calcareous. The lungs were everywhere crepitant, but dark-coloured and emphysematous around their free borders. The pericardium contained about an ounce of yellow serum, and presented other traces of slight recent pericarditis. The heart was small and flabby, but its muscular tissue was normal. The right auricle and ventricle were filled by a large partially decolorized fibrinous clot. The left cavities contained a little fluid blood.
The right supra-renal capsule was much enlarged, and embedded in thick fibrous tissue which was firmly adherent to the vena cava and diaphragm. The exterior was nodulated, and on section all distinction