I cannot refrain from inserting the following case at considerable length.
Sept. 4, 1820
. — A very diminutive terrier, weighing not 5 lbs. was sent to my hospital in order to lie in. She was already restless and panting. About eight o'clock at night the labour pains commenced; but until eleven scarcely any progress was made. The
os uteri
would not admit my finger, although I frequently attempted it.
At half-past eleven, the membranes began to protrude; at one the head had descended into the pelvis and the puppy was dead. In a previous labour she had been unable to produce her young, although the ergot of rye had been freely used. I was obliged to use considerable force, and she fought terribly with me throughout the whole process. At half-past one, and after applying considerable force, I brought away a large fœtus, compared with her own size. On passing my finger as high as possible, I felt another fœtus living, but the night passed and the whole of the following day, and she ate and drank, and did not appear to be much injured.
Several times in the day I gave her some strong soup and the ergot. Some slight pains now returned, and by pressing on the belly the nose of the foetus was brought to the superior edge of the pelvis. The pains again ceased, the pudenda began to swell from frequent examination, the bitch began to stagger, and made frequent attempts to void her urine, with extreme difficulty in accomplishing it. I now resorted to the crotchet; and after many unsuccessful attempts, in which the superior part of the vagina must have been considerably bruised, I fixed it sufficiently firmly to draw the head into the cavity of the pelvis. Here for a while the shoulder resisted every attempt which I could make without the danger of detruncating the fœtus. At length by working at the side of the head until my nails were soft and my fingers sore, I extracted one fore leg. The other was soon brought down; another large puppy was produced, but destroyed by the means necessary for its production. This was the fruit of two hours' hard work.
She was completely exhausted, and scarcely able to stand. When placed on the ground she staggered and fell at almost every step. Her efforts to void her urine were frequent and ineffectual.
At four o'clock I again examined her; the external pudenda were sore and swelled, and beginning to assume a black hue. It was with considerable difficulty that I could introduce my finger. A third fœtus irregularly presented was detected. I could just feel one of the hind legs. No time was to be lost. I introduced a small pair of forceps by the side of my finger, and succeeded in laying hold of the leg without much difficulty, and, with two or three weak efforts from the mother, — I could scarcely call them pains, — I brought the leg down until it was in the cavity of the pelvis. I solicited it forward with my finger, and, by forcibly pressing back the
labia pudendi
, I could just grasp it with the finger and thumb of the right hand. Holding it there, I introduced the finger of the right hand, and continued to get down the other leg, and then found little difficulty until the head was brought to the superior edge of the pelvis. After a long interval, and with considerable force, this was brought into the pelvis, and another puppy extracted. This fully occupied two hours.
The bitch now appeared almost lifeless. As she was unable to stand, and seemed unconscious of every thing around her, I concluded that she was lost: I gave her one or two drops of warm brandy and water, covered her up closely, and put her to bed.
To my surprise, on the following morning, she was curled round in her basket; she licked my hands, and ate a bit of bread and butter; but when put on her legs staggered and fell. The pudendum was dreadfully swollen, and literally black. In the afternoon she again took a little food: she came voluntarily from her basket, wagged her tail when spoken to, and on the following day she was taken in her basket a journey of 70 miles, and afterwards did well; no one could be more rejoiced than was her master, who was present at, and superintended the greater part of the proceedings.
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The following case is from the pen of Professor Dick:
On the 10th instant, a pointer bitch produced two puppies; and it was thought by the person having her in charge that she had no more. She was put into a comfortable box, and with a little care was expected to do well. On the next morning, however, she was sick and breathed heavily, and continued rather uneasy all the day.
On the forenoon of the following day I was requested to see her. I found her with her nose dry, breath hot, respiration frequent, mouth hot and parched, coat staring, back roached, pulse 120, and a black fetid discharge from the vagina. Pressure on the abdomen gave pain. A pup could be obscurely felt; the secretion of milk was suppressed, and the skin had lost its natural elasticity.
Tepid water with a little soap dissolved in it was immediately injected into the uterus, which in a considerable degree excited its action; and this injection was repeated two or three times with the same effect.
After waiting for half an hour, the fœtus was not discharged nor brought forward; therefore a scruple of the ergot of rye was then made into an infusion with two ounces of water, and one-third of it given as a dose; in half an hour, another one-third of it; the injections of warm water and soap being also continued. Soon after the second dose of the infusion, a dead puppy was expelled; the bitch rapidly recovered, and, with the exception of deficiency of milk, is now quite well.
This case would seem to prove the great power of the ergot of rye over the uterus; but, until more experiments are made, it is necessary to be cautious in ascribing powers to medicines which have not been much tried in our practice. It is not improbable that the warm water and soap might have roused the uterus into action without the aid of the ergot; and it is therefore necessary that those who repeat this experiment should try the effects of the medicine unaided by the auxiliary.
The Professor adds, that the great power which this drug is said to have on the human being, and the apparent effect in the case just given, suggest the propriety of instituting a further trial of it, and of our extending our observations to cattle, amongst which difficult cases of calving so frequently occur.
Mr
. Simpson thus concludes some remarks on ergot in difficult parturition. This medicine possesses a very great power over the uterus, rousing its dormant or debilitated contractility, and stimulating it to an extra performance of this necessary function after its natural energy has been in some measure destroyed by forcible but useless action. The direct utility of the ergot was manifested in cases where the uterus appeared quite exhausted by its repeated efforts; and certainly it is but fair to ascribe the decidedly augmented power of the organ to the stimulus of the ergot, for no other means were resorted to in order to procure the desired effect. Its action, too, is prompt. Within ten minutes of the administration of a second or third dose, when nature has been nearly exhausted, the parturition has been safely effected.
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Nature, proportions the power and resources of the mother to the wants of her offspring. In her wild undomesticated state she is able to suckle her progeny to the full time; but, in the artificial state in which we have placed her, we shorten the interval between each period of parturition, we increase the number of her young ones at each birth, we diminish her natural powers of affording them nutriment, and we give her a degree of irritability which renders her whole system liable to be excited and deranged by causes that would otherwise be harmless: therefore it happens that, when the petted bitch is permitted to suckle the whole of her litter, her supply of nutriment soon becomes exhausted, and the continued drain upon her produces a great degree of irritability. She gets rapidly thin; she staggers, is half unconscious, neglects her puppies, and suddenly falls into a fit of a very peculiar character. It begins with, and is sometimes confined to, the respiratory apparatus: she lies on her side and pants violently, and the sound of her laboured breathing may be heard at the distance of twenty yards. Sometimes spasms steal over her limbs; at other times the diaphragm and respiratory muscles alone are convulsed. In a few hours she is certainly lost; or, if there are moments of remission, they are speedily succeeded by increased heavings.
The practitioner unaccustomed to this fearful state of excitation, and forgetful or unaware of its cause, proceeds to bleed her, and he seals her fate. Although one system is thus convulsively labouring, it is because others are suddenly and perfectly exhausted; and by abstraction of the vital current he reduces this last hold of life to the helpless condition of the rest. There is not a more common or fatal error than this.
The veterinary practitioner is unable to apply the tepid bath to his larger patients, in order to quiet the erythism of certain parts of the system, and produce an equable diffusion of nervous influence and action; and he often forgets it when he has it in his power to save the smaller ones. Let the bitch in a fit be put into a bath, temperature 96° Fahrenheit, and covered with the water, her head excepted. It will he surprising to see how soon the simple application of this equable temperament will quiet down the erythism of the excited system. In ten minutes, or a quarter of an hour, she may be taken out of the bath evidently relieved, and then, a hasty and not very accurate drying having taken place, she is wrapped in a blanket and placed in some warm situation, a good dose of physic having been previously administered. She soon breaks out in a profuse perspiration. Everything becomes gradually quiet, and she falls into a deep and long sleep, and at length awakes somewhat weak, but to a certain degree restored.
If, then, all her puppies except one or two are taken from her, and her food is, for a day or two, somewhat restricted, and after that given again of its usual quantity and kind, she will live and do well; but a bleeding at the time of her fit, or suffering all her puppies to return to her, will inevitably destroy her.
A bitch that was often brought to my house was suckling a litter of puppies. She was foolishly taken up and thrown into the Serpentine in the month of April. The suppression of milk was immediate and complete. There was also a determination to the head, and attacks resembling epilepsy. The puppies that were suffered to remain with the mother, were very soon as epileptic as she was, and were destroyed. A seton was inserted on each side of her neck. Ipecacuanha was administered; and that having sufficiently worked, a small quantity of diluted sulphuric acid was given. A fortnight afterwards she was perfectly well.
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By M. Cross, M. V., Milan. — In July, 1829, I was desired to attend a small bull bitch six years old, and who had had puppies four times. The uterus was completely inverted, and rested all its weight on the vaginal orifice of the urethra, preventing the discharge of the urine, and thus being the cause of great pain when the animal endeavoured to void it, or the fæcal matter. The uterus was become of almost a black colour, swelled, softened, and exhaling an insupportable odour. Judging from this that the preservation of the uterus was impossible, and reckoning much on the good constitution of the patient, I warned the proprietor of the danger of its reduction, even supposing that it was practicable, and proposed to him the complete extirpation of the uterus as the only means that remained of saving the bitch.
Armed with his consent, I passed a ligature round the neck of the uterus, at the bottom of the vagina, and drew it as tight as I possibly could. On the following day I again tightened the ligature, in order to complete the mortification of the part, and the separation of the womb. On the third day I extirpated the womb entirely, close to the haunch. There was very slight loss of blood, but there ran from the walls of the vagina a small quantity of ichorous fluid, with a strong fetid smell. The operation was scarcely completed ere she voided a considerable quantity of urine, and then searched about for something to eat and to drink.
The portion of the uterus that was removed weighed fourteen ounces. The mucous membrane by which it was lined was in a highly disorganized state. From time to time injections of a slight infusion of aromatic plants were introduced into the vagina, and the animal was nourished with liquid food of easy digestion.
The first day passed without the animal being in the slightest degree affected; but, on the following day, in despite of all our care, an ichorous fluid was discharged, which the dog would lick notwithstanding all our efforts to prevent it. The general health of the animal did not seem to be in the slightest degree affected.
On the fourth day after the operation, the cords that had served as a ligature fell off, and all suppuration from the part gradually ceased.
October 20th.
— Three months have passed since the operation, and she is perfectly well.
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By this singular name is distinguished a prevalent disease now about to come under our consideration, which was first observed on the continent. The rapidity with which it spread, the strange protean appearances which it assumed, and its too frequent fatal termination, surprised and puzzled the veterinary surgeons; and they called it "la maladie des chiens," the disease or distemper in dogs.
It
is comparatively a new disease. It was imported from France about one hundred years since, although some French authors have strangely affirmed that it is of British origin. Having once gained footing among us, it has established itself in our country, to the vexation and loss of the sportsman, and the annoyance of the veterinary surgeon. However keepers, or even men of education, may boast of their specifics, it is a sadly fatal disease, and destroys fully one-third of the canine race.
Dogs of all ages are subject to its attack. Many, nine and ten years old, have died of pure distemper; and I have seen puppies of only three weeks fall victims to it; but it oftenest appears between the sixth and twelfth month of the animal's life. If it occurs at an early period, it proves fatal in the great majority of cases; and, if the dog is more than four years old, it generally goes hard with him. It is undeniably highly contagious, yet it is frequently generated. In this it bears an analogy to mange, and to farcy and glanders in the horse.
One attack of the disease, and even a severe one, is no absolute security against its return; although the dog that has once laboured under distemper possesses a certain degree of immunity; or, if he is attacked a second time, the malady usually assumes a milder type. I have, however, known it occur three times in the same animal, and at last destroy him.
Violent
catarrh will often terminate in distemper; and low and insufficient feeding will produce it. It frequently follows mange, and especially if mercury has been used in the cure of the malady. When we see a puppy with mange, and that peculiar disease in which the skin becomes corrugated, and more especially if it is a spaniel, and pot-bellied or rickety, we generally say that we can cure the mange, but it will not be long before the animal dies of distemper; and so it happens in three cases out of four. Whatever debilitates the constitution predisposes it for the reception or the generation of distemper. It, however, frequently occurs without any apparent exciting cause.
That
it is highly contagious cannot admit of doubt. A healthy dog can seldom, for many days, be kept with another that labours under distemper without becoming affected; and the disease is communicated by the slightest momentary contact. There is, however, a great deal of caprice about this. I have more than once kept a dog in the foul-yard of my hospital for several successive weeks, and he has not become diseased. Inoculation with the matter that flows from the nose, either limpid or purulent, and in an early or advanced stage of the distemper, will, with few exceptions, produce the disease; yet I have failed to communicate it even by this method. Inoculation used to be recommended as producing a milder and less fatal disease. So far as my experience goes, the contrary has been the result.
Distemper
is also epidemic. It occurs more frequently in the spring and autumn than in the winter and summer. If one or two dogs in a certain district are affected, we may be assured that it will soon extensively prevail there; and where the disease could not possibly be communicated by contagion. Sometimes it rages all over the country. At other times it is endemic, and confined to some particular district.
Not
only is the disease epidemic or endemic, but the form which it assumes is so. In one season, almost every dog with distemper has violent fits; at another, in the majority of cases, there will be considerable chest affection, running on to pneumonia; a few months afterwards, a great proportion of the distempered dogs will be worn down by diarrhœa, which no medicine will arrest; and presently it will be scarcely distinguishable from mild catarrh.
It
varies
much with different breeds. The shepherd's dog, generally speaking, cares little about it; he is scarcely ill a day. The cur is not often seriously affected. The terrier has it more severely, especially the white terrier. The hound comes next in the order of severity; and after him the setter. With the small spaniel it is more dangerous; and still more so with the pointer, especially if he has the disease early. Next in the order of fatality comes the pug; and it is most fatal of all with the Newfoundland dog. Should a foreign dog be affected, he almost certainly dies. The greater part of the northern dogs brought by Captain Parry did not survive a twelvemonth; and the delicate Italian greyhound has little chance, when imported from abroad.
Not only does it thus differ in different species of dogs, but in different breeds of the same species. I have known several gentlemen who have laboured in vain for many years, to rear particular and valuable breeds of pointers and greyhounds. The distemper would uniformly carry off five out of six. Other sportsmen laugh at the supposed danger of distemper, and declare that they seldom lose a dog. This hereditary predisposition to certain kinds of disease cannot be denied, and is not sufficiently attended to. When a peculiar fatality has often followed a certain breed, the owner should cross it from another kennel, and especially from the kennel of one who boasts of his success in the treatment of distemper. This has occasionally succeeded far beyond expectation.
It
is time to proceed to the symptoms of this disease; but here there is very considerable difficulty, for it is a truly protean malady, and it is impossible to fix on any symptom that will invariably characterise it.
An early and frequent symptom is a gradual loss of appetite, spirits, and condition: the dog is less obedient to his master, and takes less notice of him. The eyes appear weak and watery; and there will be a very slight limpid discharge from the nose. In the morning there will, perhaps, be a little indurated mucus at the inner corner of the eye. This may continue two or three weeks without serious or scarcely recognizable illness. Then a peculiar husky cough is heard, altogether different from the sonorous cough of catarrh, or the wheezing of asthma. It is an apparent attempt to get something from the fauces or throat. By degrees the discharge from the eyes and nose, and particularly the former, will increase. More mucus will collect in the corners of the eye; and the eye will sometimes be closed in the morning. The conjunctiva and particularly that portion which covers the sclerotica, will be considerably injected, but there will not be the usual intense redness of inflammation. The vessels will be large and turgid rather than numerous, and frequently of a darkish hue. Occasionally, however, the inflammation of the conjunctiva will be exceedingly intense, the membrane vividly red, and the eye impatient of light. An opacity spreads over the cornea, and this is quickly succeeded by ulceration. The first spot of ulceration is generally found precisely in the centre of the cornea, and is perfectly circular; this will distinguish it from a scratch or other injury. The ulcer widens and deepens, and sometimes eats through the cornea, and the aqueous humour escapes. Fungous granulations spring from it, protrude through the lids, and the animal evidently suffers extreme torture.
A remarkable peculiarity attends this affection of the eye. However violent may be the inflammation, and by whatever disorganization it may be accompanied, if we can cure the distemper, the granulations will disappear, the ulcer will heal, the opacity will clear away, and the eye will not eventually suffer in the slightest degree. One-fourth part of the mischief in other cases, unconnected with distemper, would inevitably terminate in blindness; but permanent blindness is rarely the consequence of distemper.
It may not be improper here shortly to revert to the different appearance of the eye in rabies. In the early stage of this malady there is an unnatural and often terrific brightness of the eye; but the cornea in distemper is from the first rather clouded. In rabies there is frequent strabismus, with the axis of the eye distorted outwards. The apparent squinting of the eye in distemper is caused by the probably unequal protrusion of the
membrana nictitans
over a portion of the eye at the inner canthus, in order to protect it from the light. In rabies, the white cloudiness which I have described, and the occasional ulceration with very little cloudiness, and the ulceration, are confined to the cornea; but a dense green opacity comes on, speedily followed by ulceration and disorganization of every part of the eye.
The dog will, at this stage of distemper, be evidently feverish, and will shiver and creep to the fire. He will more evidently and rapidly lose flesh. The huskiness will be more frequent and troublesome, and the discharge from the nose will have greater consistence. It will be often and violently sneezed out, and will gradually become more or less purulent. It will stick about the nostrils and plug them up, and thus afford a considerable mechanical obstruction to the breathing.
The
progress of the disease is now uncertain. Sometimes fits come on, speedily following intense inflammation of the eye; or the inflammation of the nasal cavity appears to be communicated, by proximity, to the membrane of the brain. One fit is a serious thing. If it is followed by a second within a day or two, the chances of cure are diminished; and if they rapidly succeed each other, the dog is almost always lost. These fits seldom appear without warning; and, if their approach is carefully watched, they may possibly be prevented.
However indisposed to eat the dog may previously have been, the appetite returns when the fits are at hand, and the animal becomes absolutely voracious. Nature seems to be providing for the great expenditure of power which epilepsy will soon occasion. The mucus almost entirely disappears from the eyes, although the discharge from the nose may continue unabated; and for an hour or more before the fit there will be a champing of the lower jaw, frothing at the mouth, and discharge of saliva. The champing of the lower jaw will be seen at least twelve hours before the first fit, and will a little while precede every other. There will also be twitchings of some part of the frame, and usually of the mouth, cheek, or eyelid. It is of some consequence to attend to these, as enabling us to distinguish between fits of distemper and those of teething, worms, or unusual excitement. The latter come on suddenly. The dog is apparently well, and racing about full of spirits, and without a moment's warning he falls into violent convulsions.
We
may
here, likewise, be enabled to distinguish between rabies and distemper. When a person, unacquainted with dogs, sees a dog struggling in a fit, or running along unconscious of every surrounding object, or snapping at everything in his way, whether it be a human being or a stone, he raises the cry of "mad dog," and the poor brute is often sacrificed. The very existence of a fit is proof positive that the dog is not mad. No epilepsy accompanies rabies in any stage of that disease.
The inflammation of the membrane of the nose and fauces is sometimes propagated along that of the windpipe, and the dog exhibits unequivocal proofs of chest affection, or decided pneumonia.
At other times the bowels become affected, and a violent purging comes on. The fæces vary from white with a slight tinge of gray, to a dark slate or olive colour. By degrees mucus begins to mingle with the fæcal discharge, and then streaks of blood. The fæcal matter rapidly lessens, and the whole seems to consist of mingled mucus and blood; and, from first to last, the stools are insufferably offensive. When the mingled blood and mucus appear, so much inflammation exists in the intestinal canal that the case is almost hopeless.
The discharge from the nose becomes decidedly purulent. While it is white and without smell, and the dog is not too much emaciated, the termination may be favourable; but when it becomes of a darker colour, and mingled with blood, and offensive, the ethmoid or turbinated bones are becoming carious, and death supervenes. This will particularly be the case if the mouth and lips swell, and ulcers begin to appear on them, and the gums ulcerate, and a sanious and highly offensive discharge proceeds from the mouth. A singular, half-fetid smell arising from the dog, is the almost invariable precursor of death.
When
the disease first visited the continent, it was regarded as a humoral disease. Duhamel, who was one of the earliest to study the character of the malady, contended that the biliary sac contained the cause of the complaint; the bile assumed a concrete form, and its superabundance was the cause of disease. Barrier, one of the earliest writers on the subject, described it as a violent irregular bilious fever. Others regarded it as a mucous discharge, or a depurative; and others, as a salutary crisis, removing from the constitution that which oppressed the different organs. Others had recourse to inoculation, in order to give it a more benign character; and others, and among them Chabert, considered that it possessed a character of peculiar malignity, and he gave it a name expressive of its nature and situation —
nasal catarrh
. It exhibited the ordinary symptoms of
coryza
: it was a catarrhal affection in its early stage; but it afterwards degenerated into a species of palsy. The causes were unknown. By some, they were attributed to the natural voracity of the dog; by others, to his occasional lasciviousness; by others, to his frequent feeding on carrion, or the refuse of fat and soups.
There is no doubt that nasal catarrh is, to a very considerable degree, contagious on the continent. It often spreads over a wide extent of country, and includes numerous animals of various descriptions. It is complicated with various diseases; and particularly, at an early stage, with ophthalmia. It may be interesting to the reader to trace the progress of the disease among our continental neighbours. It commences with a certain depression of spirits; a diminution of appetite; a heaviness of the head; a heat of the mouth; an attempt to get something from the throat; an insatiable thirst; an elevated temperature of the body; a dry and painful suffocating cough; and all these circumstances continue twenty to thirty days, until at length the dog droops and dies.
The
duration of distemper is uncertain. It sometimes runs its course in five or six days; or it may linger on two or three months. In some cases the emaciation is rapid and extreme: danger is then to be apprehended. When the muscles of the loins are much attenuated, or almost wasted, there is little hope; and, although other symptoms may remit, and the dog may be apparently recovering, yet, if he continues to lose flesh, we may be perfectly assured that he will not live. On the other hand, let the discharge from the nose be copious, and the purging violent, and every other symptom threatening, yet if the animal gains a little flesh, we may confidently predict his recovery.
When the dog is much reduced in strength and flesh, a spasmodic affection or twitching of the muscles will sometimes be observed. It is usually confined at first to one limb; but the most decisive treatment is required, or these spasms will spread until the animal is altogether unable to stand; and while he lies every limb will be in motion, travelling, as it were, at the rate of twenty miles an hour, until the animal is worn out, and dies of absolute exhaustion. When these spasms become universal and violent, they are accompanied by constant and dreadful moans and cries.
I
n the pointer and the hound, and particularly when there is little discharge from the eyes or nose, an intense yellowness often suddenly appears all over the dog. He falls away more in twenty-four hours than it would be thought possible; his bowels are obstinately constipated; he will neither eat nor move; and in two or three days he is dead.
In the pointer, hound, and greyhound, there sometimes appears on the whole of the chest and belly a pustular eruption, which peels off in large scales. The result is usually unfavourable. A more general eruption, however, either wearing the usual form of mange, or accompanied by minute pustules, may be regarded as a favourable symptom. The disease is leaving the vital parts, and expending its last energy on the integument.
The
post-mortem
appearances are exceedingly unsatisfactory: they do not correspond with the original character of the disease, but with its strangely varying symptoms. If the dog has died in fits, we have inflammation of the brain or its membranes, and particularly at the base of the brain, with considerable effusion of a serous or bloody fluid. If the prevailing symptoms have led our attention to the lungs, we find inflammation of the bronchial passages, or, in a few instances, of the substance of the lungs, or the submucous tissue of the cells. We rarely have inflammation of the pulmonary pleura, and never to any extent of the intercostal pleura. In a few lingering cases, tubercles and vomicæ of the lungs have been found.
If
the bowels have been chiefly attacked, we have intense inflammation of the mucous membrane, and, generally speaking, the small intestines are almost filled with worms. If the dog has gradually wasted away, which is often the case when purging to any considerable extent has been encouraged or produced, we have contraction of the whole canal, including even the stomach, and sometimes considerable enlargement of the mesenteric glands
1
.
The membrane of the nose will always exhibit marks of inflammation, and particularly in the frontal sinuses and ethmoidal cells; and I have observed the portion of membrane on the septum, or cartilaginous division of the nostrils, between the frontal sinuses and ethmoidal cells, to be studded with small miliary tubercles. In advanced stages of the disease, attended with much defluxion from the nose, the cells of the ethmoidal bone and the frontal sinuses are filled with pus.
Ulceration is sometimes found on the membrane of the nose, oftenest on the spot to which I have referred — occasionally confined to that; and now and then spreading over the whole of the septum, and even corroding and eating through it; generally equal on both sides of the septum; in a few instances extending into the fauces; seldom found in the larynx, but occasionally seen in the bronchial passages. The other viscera rarely present any remarkable morbid appearance.