Chapter VII

PRESERVATION OF SPECIMENS OF MORBID ANATOMY.

Many valuable and interesting pathological specimens are continually being lost, from a want of knowledge, or a careless neglect on the part of the physician. That the fullest benefit may result from a post-mortem examination, any rare or interesting specimen should be carefully preserved. Should the physician feel no interest in forming a cabinet of morbid anatomy for himself, he should then deposit the specimen in the anatomical museum of some medical school, where it may be permanently preserved, and the profession thus benefited.

All specimens of _soft tissues_ designed for preservation, should first be soaked in water which is changed daily, until all blood is removed. If the weather be warm, it will be necessary to add to the water each time, either a small proportion of alcohol, or some antiseptic, as carbolic acid, chloride of zinc, corrosive sublimate, or common salt.

After all blood is removed, the specimen may be put into alcohol of a strength proportionate to the size of the specimen, and then allowed to remain until thoroughly “cured.” Small specimens are dried up, shrunken and nearly spoiled in many cases, by the use of too strong alcohol, while on the other hand, large ones, by diluting the alcohol with the large amount of water contained, would be likely to spoil in a weak preparation. Large specimens, particularly in warm weather, should have deep incisions made at a few points, for the better penetration of the preserving fluid.

Before being permanently put up, the specimen should be carefully trimmed, and everything interfering with the best display of the essential point removed.

While either of the antiseptics mentioned above will answer for “curing” a specimen, for permanent suspension, there is no substitute for alcohol. Other fluids may preserve, but they will also become turbid, throw down a precipitate, and in cold weather are liable to freeze, while from their high specific gravity, many light specimens will float on or near the surface. If the specimen has been thoroughly “cured” before suspension, very dilute alcohol will answer for that purpose: equal parts of pure water and alcohol of ninety-five degrees, in all except the larger specimens, being abundantly strong. Delicate, light specimens will sometimes float in such a dilution, in which case it should be made stronger.

The best form of anatomical jar is made with ground glass stoppers, with a hook on the under side of the latter for suspending the specimen. Although expensive, these jars, by effectually securing the alcohol from evaporation, as well as from the greater facility with which the spirits may be changed, which will sometimes be required, will give better satisfaction than any other.

Where the common jar without a stopper is used, great care will be required in closing up, to prevent loss by evaporation. There should first be prepared a circular plate of thick sheet lead, to rest on the top of the neck of the jar. The specimen having been suspended by a string, carried through by a large needle, and at two different points, is to be fastened to the disk of lead by means of two holes, punched by an awl, about half an inch apart, near the centre. The portion of string above the lead, with the holes also, should now be carefully covered with sealing-wax, otherwise, by capillary attraction, the alcohol will keep the bladder covering continually wet, and finally rot it out. Over the lead is now to be stretched a piece of moistened bladder, and wound with twine around the neck of the jar. When dry, this is to be covered with a coat of black varnish; this again when dry, being followed by a second layer of bladder and varnish.

Wet preparations should be kept where they may have a free exposure to sunlight. If placed in a dark closet, they become damaged in texture, and acquire a dark and unpleasant color; this is particularly the case with the ligamentous and nervous tissues.

Dr. Brunetti of Padua, who has invented a new process for preserving certain kinds of specimen, and who received a gold medal some years ago at the Paris Exposition, gives the following particulars of his method:

“The process comprises four several operations, viz.: 1, the washing of the piece to be preserved; 2, the _degraissage_, or eating away of the fatty matter; 3, the tanning, and 4, the desiccation.

“1. To wash the piece M. Brunetti passes a current of pure water through the blood-vessels and the various excretory canals, and then he washes the water out by a current of alcohol.

“2. For destroying the fat he follows the alcohol with ether, which he pushes, of course, through the same blood-vessels and excretory ducts; this part of the operation lasts some hours. The ether penetrates the interstices of the flesh and dissolves all the fat. The piece, at this point of the process, may be preserved any length of time desired, plunging it in ether, before proceeding to the final operations.

“3. For the tanning process M. Brunetti dissolves tannin in boiling distilled water, and then, after washing the ether out of the vessels with distilled water, he throws this solution in.

“4. For the drying process Dr. Brunetti places the pieces in a vase with a double bottom filled with boiling water, and he fills the places of the preceding liquids with warm, dry air. By the aid of a reservoir, in which air is compressed to about two atmospheres, and which communicates by a stop-cock and a system of tubes, first to a vase containing chloride of calcium, then with another heated, then with the vessels and excretory ducts of the anatomical piece in course of preparation, he establishes a gaseous current which expels in a very little time all the fluids. The operation is now finished.

“The piece remains supple, light, preserves its size, its normal relations, its solid elements, for there are no longer any fluids in it. It may be handled without fear, and will last indefinitely.”

For the preservation and hardening of tissues for microscopic examination—as sections of tumors, glands, membranes, spinal cord or brain, etc.—Müller’s fluid may be employed, which is prepared as follows: bichromate of potassa, 75 grains; sulphate of soda, 35 grains; dissolved in six ounces of water. The specimen should be suspended in this fluid until sufficiently hardened to permit of a satisfactory examination.

Preparation of Bones.

Pathological specimens of bones, may be prepared either by boiling or maceration. The method by boiling should be employed, however, only where the texture of the specimen is firm and solid, as in cases of united fracture, etc.; and in these cases, care will be required to avoid injuring the specimen by too long exposure to the process. Maceration, however, is the better method for all cases, and the only one to be employed in cases where the bone is softened by caries or necroses.

The specimen having been roughly stripped of the soft tissues, is to be thrown into a vessel of water, the latter being changed every day, as long as it becomes colored by the blood. It is now to be left until the putrefactive process has so softened the tissues that they may be easily removed, when, after being thoroughly washed in soda water, it may be dried and mounted. If the weather be cold, it will be absolutely important that the macerating be conducted in a warm room, else the process will be so slow as to convert the tissues into a form of adipocere, quite arresting the putrefactive process, and greatly damaging the specimen in its beauty and value.

In this connection, it may be observed that bones from a subject that has been injected with chloride of zinc, can never be successfully macerated, the zinc having a sort of tanning effect upon the tissues, which enables them to resist the putrefactive process. Boiling is the only method by which such specimens can be cleansed.

Where a bone has been properly macerated and dried, and especially if from a young subject, it will be found white and quite free from grease; but when taken from old subjects, or when prepared by boiling, it may be required to be subjected to a bleaching process for removing the grease and improving the color. By exposure to the sun, with frequent washing in chlorine and soda water, the appearance of the specimen may be greatly improved, or what is still better, by covering the specimen for a few days in sulphuric ether, which will effectually dissolve out all the grease, and then washing and exposing to the sun for a few days, it will be left beautifully white and clean.

For permanent preservation, the specimen should finally be mounted on a block or board, in such a manner as best to expose its interesting points.

INDEX.

PAGE

Abdomen, method of opening, 127

Abdominal dropsy, 135

Alcohol, poisoning by, 299

Anatomical syringe, 323

Anus, diseases of, 157
fistula of, 157
hæmorrhoids, 159
ulcer in, 157

Aorta. (See _Arteries_.)

Apoplexy, cerebral, 41
pulmonary, 115

Arachnoid, examination of, 38

Arsenic, poisoning by, 297

Arthritis, chronic rheumatic, 271
scrofulous, 271

Arteries, aneurism of, 99
calcification of, 99
examination of, 98
fatty degeneration of, 99
inflammation of, 98
ossification of, 99
rupture of, 102

Arteries, cerebral.
atheromatous degeneration of, 60
calcification of, 60
obstruction of, 59
position of clot in obstruction of, 59

Atresia ani, 149
urethræ, 212

Autopsy, medico-legal, method of conducting, 304

Biliary calculi, 188
effects of, 190
position of, 189

Bladder, gall-. (See _Gall-bladder_.)

Bladder, urinary.
contraction of, 210
catarrh of, 210
cancer of, 211
dilatation of, 209
examination of, 208
hypertrophy of, 209
inflammation of, 210
malformations of, 208
parasites in, 212
removal of, 131
tubercles in, 211
tumors in, 211

Bones, abscess of, 259
cancer of, 266
caries of, 260
examination of, 259
inflammation of, 259
morbid growths in, 263
necrosis of, 260
rickets in, 261
suppuration of, 259
tumors in, 263
tubercles in, 265

Brain, appearance of, in health, 48
abscess of, 50
atrophy of, 53
blood cysts in, 59
calcareous deposits in, 56
examination of, 29
hardening of, 51
hypertrophy of, 52
hydatids in, 57
inflammation of, 47
membranes of, 36
removal of, 29
softening of, 48
tumors of, 54

Bright’s disease, 197
cirrhotic or contracting form, 201
inflammatory form, 197
waxy or amyloid form, 200

Bronchial tubes, dilatation of, 125
examination of, 106, 122
inflammation of, 123
narrowing of, 124
obliteration of, 124

Bronchitis, 123

Buccal cavity, examination of, 65

Burning, ante-mortem distinguished from post-mortem, 318

Cancer, of bones, 266
black, 291
colloid, 292
encephaloid, 291
epithelial, 293
of gall-bladder, 188

Cancer, of heart, 84
hard, 290
of intestines, 158
of kidneys, 204
of liver, 177
of lungs, 120
of mammæ, 256, 257
of mediastinum, 126
medullary, 291
melanotic, 291
of ovaries, 250
of œsophagus, 73
of penis, 217
of prostate gland, 228
of pancreas, 161
of peritoneum, 136
of spleen, 165
of suprarenal capsules, 208
of scrotum, 219
of stomach, 146
of scirrhus, 290
of testicles, 224
of tongue, 68
of ureters, 206
of urinary bladder, 211
of urethra, 214
of uterus, 240
of vagina, 234

Calculi, urinary, 214

Calvarium, removal of, 28

Carbonic oxide, poisoning by, 299

Carditis, 76

Cerebral arteries, 59

Cerebritis, 48

Cerebro spinal meningitis, 61

Chest, examination of, 65

Children, new-born, medico-legal question relating to, 307

Chloride of zinc, preservative properties of, 321

Colon, removal of, 128

Corrosive sublimate, poisoning by, 298
preservative properties of, 321

Cystitis, 210

Death, signs of, previous to putrefaction, 312
probable cause of, 317

Diphtheria, false membranes in, 71

Disinfectants for instruments, 24

Dropsy of abdomen, 135
of brain, 40
of chest, 103
of heart, 74
of ovaries, 248
of testes, 222

Drowning, death from, 302, 309

Duodenum, removal of, 129

Dura mater, inflammation of, 36, 61
fibrinous clots in, 37
thickening of, 37
tubercular deposits in, 38
tumors in, 38

Ear, examination of, 31
removal of, 29

Embalming, method of, by ancients, 320
objects of, 321
instruments required, 323
the operation, 324
changes resulting from, 325

Embolism of cerebral arteries, 59

Endocarditis, 77

Enteritis, 149

Epididymitis, 221

Epispadias, 212, 215

Exostoses, 263

Eyes, removal of, 32

Fallopian tubes, anomalies of, 251
inflammation of, 251
morbid growths in, 251

Fistula in ani, 157

Fractures, ante-mortem distinguished from post-mortem, 318

Ganglions, 270

Gall-bladder and ducts, 187
cancer of, 188
dilatation of, 188
gall-stones in, 189
inflammation of, 187
tumors in, 188
tubercles in, 188

Gastritis, 141
catarrhal, 141
croupous, 141
phlegmonous, 141

Gums, examination of, 65

Gunshot wounds, ante-mortem distinguished from post-mortem, 318

Hanging, death from, 301, 319

Hæmatocele, 223

Hæmoptysis, 114

Hæmorrhage, pulmonary, 114
uterine, 237

Hæmorrhoids, 157

Head, caries of bones of, 35
examination of, 27
removal of membranes of brain, 28
removal of calvarium, 28
removal of brain, 29
thickening of bones of, 35
thinning of bones of, 35

Heart, atrophy of, 82
abscess of, 86
aneurism of, 86
cancers in, 84
displacements of, 87
dilatation of, 80
ectopia cordis, 88
examination of, 66, 75
fatty degeneration of, 82
fatty growth of, 82
hydatids in, 86
hypertrophy of, 79
inflammation of, 76
melanosis of, 84
malformations of, 86
morbid condition of, 75
normal size of, 80
ossification of arteries of, 85
rupture of walls of, 87
stenosis of, 79
tumors in, 84
transposition of, 88
valves of, 77

Heart clots, causes of, 91
color of, 89
consistency of, 89
time of formation of, 90
position of, 89

Hepatitis, 168

Hernia, 154

Hydrarthrosis, 268

Hydrothorax, 104

Hydrocele, 222
congenital, 222
diffused, 223
encysted, 222
simple, 222

Hypospadias, 212, 215

Hydrocyanic acid, poisoning by, 298

Instruments, 21
disinfectants for, 24

Intestines, cancer of, 158
contraction of, 153
dilatation of, 153
displacement of, 154
examination of, 149
inflammation of, 150
incarceration of, 155
malformations of, 149
obstructions of, 155, 156
parasites in, 159
rupture of, 157
tubercles in, 158
tumors in, 158
ulceration of, 152
wounds of, 157

Intussusception, 156

Joints, bursæ of, morbid conditions of, 269
cartilage of, morbid conditions of, 270
inflammation of synovial membrane, 268
malformations of, 268
rheumatic inflammation of, 271
scrofulous inflammation of, 271

Kidneys, anomalies of, 194
abscesses of, 196
Bright’s disease of, 197
congestion of, 194
cancer of, 204
cysts in, 204
dislocation of, 203
examination of, 193
fatty degeneration of, 202
hæmorrhage of, 195
inflammation of, 195
inflammation of capsule of, 197
parasites in, 205
removal of, 129
size and weight of, 193
tubercles in, 203

Larynx, abscesses of, 71
examination of, 64, 65, 69
false membranes in, 71
inflammation of, 69
necrosis of cartilages of, 70
œdema of, 70
tumors of, 71
ulceration of, 70

Liver, abscess of, 169, 171
atrophy of, 174
blood-vessels of, 182
congestion of, 166
cancer of, 177
degenerations of, 171
examination of, 130, 165
effusion hæmorrhagic of, 167
fatty, 172
hypertrophy of, 177
inflammation of, 168
parasites in, 183, 186
removal of, 130
size of, 165
tubercles in, 181
tumors in, 182

Lungs, appearance in health, 107
appearance, post-mortem, 118, 120
abscess of, 111
apoplexy of, 115
congestion of, 107
cancer of, 120
examination of, 67, 106
emphysema of, 116
gangrene of, 112
hepatization of, 108
hæmorrhage of, 114
hydatids in, 122
inflammation of, 107, 109
melanosis of, 121
suppuration of, 110
tubercles in, 117
tubercular cavities in, 119
tumors in, 122

Mammæ, anomalies of, 252
atrophy of, 252
abscesses of, 253
cancer of, 256, 257
examination of, 252
inflammation of, 253
tumors in, 254
ulcers in, 254

Medico-legal questions, 304
external inspection of body, 305
internal examination, 306

Mediastinum, abscess of, 126
cancerous growths in, 126
inflammation of, 126
tumors of, 126

Medulla, spinalis, 62
oblongata, effusions in, 43
of bone, disease of, 267

Membranes of the brain.
appearance of, in meningitis, 39
examination of, 36
morbid changes of, in insanity, 40
removal, of 28
serous effusion into, 40
sanguineous effusion into, 41

Membranes, spinal, tuberculous deposits in, 61
tumors in, 61

Meningitis, 39
cerebro-spinal, 61
tubercular, 38

Metritis, 237, 242

Metrophlebitis, 243

Morbus Brightii, 197

Mouth, catarrhal or croupous inflammation of, 72
examination of, 64

Myelitis, 62

Müller’s fluid, 329

Neck, examination of, 64

Nephritis, 195

Nitric acid, poisoning by, 295

Nux vomica, poisoning by, 299

Œsophagus, cancer of, 73
dilatation of, 73
examination of, 72
inflammation of, 72
stricture of, 72
tumors in, 73
ulceration of, 72

Opium, poisoning by, 300

Orchitis, 221

Osseous growths, 263

Osteomalacia, 262

Osteophytes, 263

Ovaries, abscesses in, 247
cysts in, 248
dropsy of, 248
examination of, 247
inflammation of, 247
malignant disease of, 250
tumors, tubercles, etc., of, 251

Oxalic acid, poisoning by, 295

Palate, examination of, 65

Pacchionian bodies, 39
atrophy of, 161

Pancreas, anomalies of, 160
cancer of, 161
dilatation of ducts, 161
examination of, 160
fatty degeneration of, 161
hypertrophy of, 161
inflammation of, 161
removal of, 129

Parasites in bladder, 212
in brain, 57
in heart, 86
in intestines, 159
in kidneys, 205
in liver, 183, 186
in lungs, 122
in spinal cord, 63

Pelvic viscera, removal of, 130

Penis, anomalies of, 215
atrophy of, 215
balanitis of, 216
chancres on, 216
cancer of, 217
examination of, 215
fracture of, 216
hypertrophy of, 215
herpes of, 216
paraphymosis of, 216
psoriasis of prepuce, 216
tumors of, 218
warts on, 217

Pericardium, adhesions in, 74
blood in, 74
examination of, 73
inflammation of, 73
morbid growths in, 75

Peritoneum, blood in result of violence, 135
congestion of, 133
cancer of, 136
dropsical accumulation in, 135
exudation, fibrinous, on, 134
examination of, 133
gangrene of, 135
inflammation of, 133
suppuration of, 135
tubercular deposits in, 136
tumors of, 136

Peritonitis, 133
puerperal, 243

Perihepatitis, 167

Peripractitis, 151

Perityphlitis, 151

Pharynx, examination of, 65, 72
inflammation of, 72
tumors in, 73
ulceration of, 72

Phosphorus, poisoning by, 296

Pia mater, examination of, 38
inflammation of, in spotted fever, 61

Pleura, adhesions in, 103
examination of, 103
effusions into, 103
inflammation of, 103

Pleurisy, 103

Pneumonia, catarrhal, 109
croupous, 110
double, 109
lobular, 110
single, 109

Pneumothorax, 105

Poisoning, death from, 294

Post-mortem examinations, 24
preliminary preparations for, 24
in medico-legal cases, 304

Pregnancy, abdominal, 244
extra-uterine, 244
tubal, 245
utero-tubal, 245

Preparation of bones, 329
by boiling, 329
by maceration, 329
bleaching of, 330

Preservation of specimens of morbid anatomy, 326
process of Dr. Brunetti, 328

Prolapsus of rectum, 157

Prostate gland, anomalies of, 227
atrophy of, 228
cancer of, 228
cysts in, 228
concretions in, 229
examination of, 226
hypertrophy of, 227
tubercles in, 228
tumors in, 228
anomalies of, 230

Pudenda, examination of, 230
elephantiasis of, 232
hypertrophy of, 230
inflammation of, 231
tubercles in, 232
tumors in, 232
warty excrescences on, 231

Putrefaction, process of, 314

Pyelitis, 196

Pyelonephritis, 196

Questions relating to new-born children, 307
was the child mature?, 307
was it born alive?, 308
how long did it live?, 310
what was the cause of death?, 311

Rachitis, 261

Rectum, prolapsus of, 157
removal of, 128

Sclerosis of spinal cord, 62

Scrotum, cancer of, 219
examination of, 218
elephantiasis of, 218
hypertrophy of, 218
inflammation of, 219

Seminal vesicles, anomalies of, 226
examination of, 226
inflammation of, 226
tubercles in, 227

Signs of death, 312

Skull, caries of bones of, 35
examination of, 34
fracture of, 34
thinning of bones of, 35
thickening of bones of, 35

Spinal cord, atrophy of, 63
examination of, 60
inflammation of membranes of, 60
morbid growths in, 63
parasites in, 63
preservation of specimens of, 33
removal of, 33
softening of, 62

Spinal column, disease of, 272

Spinal canal, serous effusions in, 61

Spina bifida, 61

Spleen, anomalies of, 162
atrophy of, 162
cysts in, 165
cancer of, 165
displacements of, 163
degeneration of, 164
examination of, 162
hypertrophy of, 162
inflammation of, 163
removal of, 129
rupture of, 163
size of, normal and abnormal, 162
thickening of capsules of, 164
tubercles in, 164

Spotted fever, inflammation of pia mater in, 61

Stomach, atrophy of, 145
Beaumont’s experiments on, 140
cirrhosis of, 144
cancer of, 146
cancer in, results of, 148
dilatation of, 145
examination of, 137
erosions, hæmorrhagic, of, 143
inflammation of, 140
post-mortem changes in, 137
poisons in, and their effects, 142
softening of, 143
tumors in, 148
ulcers in, 142

Strangling, death from, 301

Strychnia, poisoning by, 299

Suffocation, death from, 300

Sulphuric acid, poisoning by, 294

Suprarenal capsules, 207
cancer of, 208
cysts in, 208
hæmorrhage of, 208
inflammation of, 207
tubercles in, 208

Testicles, atrophy of, 220
anomalies of, 219
cancer of, 224
cystic disease of, 225
dropsy of, 222
examination of, 219
hæmatocele of, 223
hypertrophy of, 220
inflammation of, 221
tubercles in, 225
tumors in, 226
varicocele of, 223

Teeth, examination of, 65

Throttling, death from, 301

Thrombi in sinuses of dura mater, 37

Tongue, cancer of, 68
examination of, 68
hypertrophy of, 69
ranula of, 68
syphilitic ulcers of, 68
tubercles of, 68
tumors of, 68

Tonsils, catarrhal or croupous inflammation of, 72
examination of, 65

Tubercular disease of lungs, 117
tubercular cavities in, 119
meningitis, 38

Tumors, adenoid, 285
benign, 274
in brain, 54
in bones, 263
in bladder, 211
classification of, 274
cystic, 274
cartilaginous, 280
carcinomatous, 288
in dura mater, 38
fatty, 279
fibrous, 279
in Fallopian tubes, 251
in gall-bladder and ducts, 188
hydatid, 277
in heart, 84
in intestines, 158
lipomatous, 279
lymphatic, 285
in larynx, 71
in lungs, 122
in liver, 182
myxomatous, 278
myomatous, 284
malignant, 286
in mediastinum, 126
in mammæ, 254
neuromatous, 284
osseous, 281
in œsophagus, 73
in ovaries, 251
papillary, 282
polypoid, 283
in pharynx, 73
in pericardium, 75
in peritoneum, 136
in pudenda, 232
in prostate gland, 228
in penis, 218
sarcomatous, 286
in spinal cord, 63
in stomach, 148
in tongue, 68
in testicles, 226
in uterus, 238
in vagina, 234
vascular, 284

Ureters, cancer of, 206
cysts in, 207
defects of, 205
dilatation of, 206
inflammation of, 206
tubercles in, 207

Urethra, contraction of, 213
cancer of, 214
dilatation of, 213
inflammation of, 212
malformations of, 212
rupture of, 213
stricture of, 213
tubercles in, 214
warty growths in, 213

Uterus, anomalies of, 235
atrophy of, 236
cysts in, 240
cancer in, 240
examination of, 235
excrescences, cauliflower, etc., 241
hæmatometra, 236
hypertrophy of, 236
hydrometra, 236
hæmorrhages of, 237
inflammation of, 237, 242, 243
malpositions of, 236
removal of, 132
rupture of, 241
tubercles in, 240
tumors in, 230
ulcerations of, 238

Vagina, anomalies of, 232
dilatation of, 232
examination of, 230
gangrene of, 234
inflammation of, 233
laxity of, 232
laceration of, 232
rigidity of, 232
rupture of, 233
stricture of, 232
tumors of, 234

Valves of heart, aneurism of, 79
atrophy of, 78
calcification of, 78
contraction of, 79
thickening of, 77

Volvulus, 156

Vulva. (See _Pudenda_).

White swelling, 271

Wounds, death from, 317
contused, appearance of, 317
post-mortem distinguished from ante-mortem, 317

Zinc, preparation of, for embalming, 322
quantity of, required, 322

ERRATA.

On page 21, last line, for “culvarium,” read calvarium.

„ 25, fifteenth line, for “collodian,” read collodion.

„ 79, last line, for “that organ,” read those organs.

„ 93, thirteenth line, for “affords,” read afford.

-----

Footnote 1:

Toynbee on the Ear.

Footnote 2:

See No. 509, College Museum.

Footnote 3:

Id, 473.

Footnote 4:

See No. 490, College Museum.

Footnote 5:

“Morbid Anatomy of the Brain, in Mania, &c.,” by Andrew Marshall, M.
D.

Footnote 6:

See No. 1386, Case T, College Museum.

Footnote 7:

See No. 1295, Case R, College Museum.

Footnote 8:

See No. 1385, College Museum.

Footnote 9:

See No. 1387, College Museum.

Footnote 10:

Paget’s Pathology, p. 586.

Footnote 11:

Medico-Chirurgical Trans. xvii. p. 507.

Footnote 12:

See Hahnemannian Monthly for May, 1871.

Footnote 13:

In one case, the clot presented a marked resemblance to the abdominal
fat of the goose, both in color and consistency.

Footnote 14:

Meigs’ Treatise on Obstetrics, p. 308.

Footnote 15:

No. 1470, College Museum.

Footnote 16:

No. 1344, College Museum.

Footnote 17:

No. 1385, College Museum.

Footnote 18:

See article on Spontaneous Cure of Aneurism, with cases in New York
Transactions of Homœpathic Medical Society for 1868, page 170.

Footnote 19:

See case of recovery reported by Dr. R. Koch, in American Jour. of
Hom. Mat. Med., Vol. IV., p. 123.

Footnote 20:

See Nos. 1309 and 1351, College Museum.

Footnote 21:

See No. 1506, College Museum.

Footnote 22:

Jones and Sieveking’s Pathological Anatomy.

Footnote 23:

Cirrhosis, as applied to this condition of the liver, has reference to
the yellow color, due to the presence of large quantities of yellow
pigment contained in the secreting cells; hence the application of the
term to diseases of the lungs, kidneys, etc., which resemble cirrhosis
of the liver, not in color, but in density of the tissues, is
obviously inappropriate.

Footnote 24:

See No. 1495, College Museum.

Footnote 25:

See No. 1496½, College Museum.

Footnote 26:

See report of case of “Ossification of Veins,” by James Kitchen, M.
D., in American Journal of Homœopathic Materia Medica for December,
1871, page 143.

Footnote 27:

See No. 1500, College Museum.

Footnote 28:

Specimen No. 1329, College Museum.

Footnote 29:

See No. 1336½, College Museum.

Footnote 30:

See No. 1259, College Museum.

Footnote 31:

Bright’s Disease, by T. Grainger Stewart.

Footnote 32:

See No. 1507, College Museum.

Footnote 33:

Specimen No. 1260, College Museum.

Footnote 34:

See No. 1261, College Museum.

Footnote 35:

See No. 359, College Museum.

Footnote 36:

See No. 329, College Museum.

Footnote 37:

See No. 331, College Museum.

Footnote 38:

See Nos. 335 and 360, College Museum.

Footnote 39:

See Nos. 325 and 326, College Museum.

Footnote 40:

See No. 1476, College Museum.

Footnote 41:

See Nos. 1340 and 1341, College Museum.

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TRANSCRIBER’S NOTES

Page Changed from Changed to

237 defect in the excretion of the defect in the excretion of the
menses, or form a morbidly menses, or from a morbidly

300 oxygen though the lungs. The oxygen through the lungs. The
term is generally restricted term is generally restricted

● Typos fixed; non-standard spelling and dialect retained. ● Enclosed italics font in _underscores_.