“Dec. 9th 1821, he was attacked by another fit, having the usual character of epilepsy, which terminated fatally. In the morning he appeared in his usual health, and had remarked to his wife that “he was as well as ever he had been in his life.” He ate largely of pork, with sage and onions, for dinner, about one o’clock. About five he was rather unwell, and a little before six “went off in a fit.” He had frequent convulsions “as rapidly as he could have them,” (his wife’s statement) from the time he was taken ill till he died. There was no sickness—no vomiting. He had lain upon his back for some time; he was turned upon his side and suddenly expired. He never spoke from the time of the attack till his death, A week previously he had complained of head-ache, but not on the day of his illness. He was extremely subject to flatulence. He did not cough at any time during the attack which immediately preceded his death. For some years past he had been unable to lie upon his right side.
“He was largely bled from the arm; cold applications were freely applied to the head, with some temporary mitigation of the convulsions. Some medicines were directed, but as the state of insensibility in which he was, precluded swallowing, it may be doubted whether they ever reached his stomach. His pulse was full and frequent, but he was too unsteady to allow it to be counted. The pupils were contracted to points; but on the recurrence of the convulsions became widely dilated. After the cold affusion over the head, and as the convulsions abated, they gradually contracted.
“The examination of the morbid appearances was made, four days after death, by Mr. Alcock, in the presence of Mr. C. T. Haden, surgeon, and others.
“External appearances, those of a very athletic, muscular subject. No external appearance of injury. Slight shew of putrefaction on the abdominal parietes.
“The head was carefully and minutely examined. The vessels of the brain were distended with blood, but in no degree sufficient to explain the cause of death. The brain was firm and natural in every part. The choroid plexus of the right side was studded with a few small hydatid-like vesicles. The spinal marrow, as far as could be seen through the foramen magnum, was free from disease. The ventricles contained about two fluid drachms of liquid, and about the same quantity was found in the base of the skull when the brain was removed.
“The chest. The right lung adhered universally, but its structure was natural; the left lung was somewhat gorged with blood; no preternatural adhesions. About from four to eight ounces of bloody fluid in the left cavity of the chest. The heart was loaded with fat, and had on the outer surface of the right ventricle a patch of lymph like a thin layer of coagulated albumen. Several smaller spots of the same kind on the right auricle; but none of them penetrated into the substance.
“Abdomen. The liver adhered in numerous parts, and very extensively to the peritoneum. The stomach was enormously large and distended with food and air; the small intestines were also somewhat more distended than usual, but exhibited no appearance of disease sufficient to account for the death of the patient. The spleen was small and unhealthy, having several white patches on its surface.
“Thus far no satisfactory explanation of the cause of death appeared. And here, according to the usual mode of conducting examinations, the investigation would have terminated, but I consider it essential in every case to examine the air-passages. On examining the bronchiæ of the left side, the principal ramifications and some of the smaller were filled with a pultaceous substance of a dirty greenish hue and heterogenous texture, resembling food which had undergone some degree of digestion: it completely filled the left bronchia. The right bronchia and its ramifications were quite filled with similar matter, and the trachea was also completely filled at the lower part, so that breathing in such a state must have been impossible. That the matter filling up the air passages consisted of chyme from the stomach became evident, from its perfect similarity to that which remained in the stomach.”
Since the receipt of the above interesting communication from Mr. Alcock, we have found upon an inquiry amongst the carcase butchers, that the presence of food in the pulmonary passages is by no means a rare occurrence in those animals that have been struck on the head.
[32]. Morbid Anatomy, p. 37.—Med. Observ. vol. iv, p. 380—Memoirs of Med. Soc. vol. i, p. 228.