the practice of Dr. Glover, of Newcastle, and is thus described by him.¹

William B___, æt. 39, of middle height, but small in bulk ; temperate ; a furnace-man in chemical works ; father fair ; mother darkish ; brothers fair. The father and one brother died of phthisis, and two or three sisters in infancy. Had been delicate in childhood. The best idea of his appearance and symptoms will be gathered from a few of the notes of his case taken at different times, only premising that about eight years ago he had an awkward fall, which he felt at the time to hurt his back, and that about five years ago he became yellow (his wife’s account,) as to be treated for jaundice, without, however, any improvement in his colour.

June 19th, 1856.- Since about Christmas has had pain in the loins and abdomen, with sensation of great heat. Skin very dark, yellow-brown colour ; since end of January bowels costive ; stools variable in colour, light and dark ; tongue clean ; vomits his food at times ; urine scanty ; is very deaf.

22nd.- Has had pain in the back, on both sides, increased on coughing ; pulse 80, intermitting.

30th.- Colour much the same. The bronzed colour seems to have preceded the pains in the back and belly, &c.

January 3rd, 1857.- Sick last night ; twisting pain in stomach.

7th.- Sick this morning ; lifting sensation at end of stomach.

March 14th.- Very dark ; weak in the back ; complains of something holding him from the umbilicus to the back. Owing to his extreme deafness, of thirty years’ standing, he is very unintelligent and unintelligible in describing his sensations. He was able to work at cleaning bricks in the sitting posture for a little time after this.

March 25th, 1859.- Pulse 96 ; watery expectoration, with a little cough ; sad complaint of pain holding him below and to the right of the umbilicus, and in the right iliac region, causing the right thigh to shake when he attempts to stand, and prevents walking or standing in the erect posture ; thinner ; has been darker, to his sister’s knowledge, fifteen years. About this time, too (April, 1859), there was observed an acute prominence of the spine in the upper lumbar region.

July 7th.- The case evidently closing. Has a hollow cough ; pulse very feeble ; emaciated ; pain in the right hypochondrium ; vomits nearly everything. Died on the 10th.

The principal features of the case were-
1. Darkness of the skin, obvious even to a cursory observer, general over the body, but worse at parts, as around the nipples, a dark patch on the outside of the knee, the hands, the mucous membrane of the lips, and especially the generative organs. The tint was a dark, yellow brown, generally like that of a mulatto, and that of the organs of generation approaching that of the negro. He had always been dark, but more so of late.
2. A sensation of something “holding” him from navel to back ; great weakness in the back ; lately inability to walk or stand, excepting in a bent position, and with great pain and acute curvature of the lower dorsal and upper lumbar vertebræ.
3. Vomiting and waterbrash, more two years ago than lately, until the last few days of life, when vomiting was again troublesome.