Part of a Letter from Sir Charles Holt to the Publisher, concerning a Child Who Had Its Intestines, Mesentery, etc. in the Cavity of the Thorax, and a Further Account of the Person Mentioned to Have Swallowed Stones, in No 253. of these Iransactions

Fire and Ax; Instances of which I will not here give, because I have already exceeded the bounds of a Letter. IV. Part of a Letter from Sir Charles Holt, to the Publisher, concerning a Child who had its Intestines, Mesentery, &c. in the Cavity of the Thorax, and a further account of the person mentioned to have swallowed Stones, in No 253. of these Transactions. Sometime since I was desir'd by a Friend of mine to be present at the opening of a Child of his, of about 2 months old, which dyed (as he told me) after an unusual, and extraordinary manner. I found at the house two Learned Gentlemen and very good Anatomists, invited on the same occasion. We enquired into the Circumstances of the Child's Sickness and Death, and from the Women received the following account. 'That the Child was uneasy and restless from its Birth, and constantly laboured under a difficulty of Breathing. 'That its Illness was like nothing they had seen in other Children; neither could they perceive it relieved by any thing administered to it, tho by the advice of a Learned Physician; but it lay groaning and pining till it dyed. 'That they had always observed, when the Child was undrest an odd sort of working in its Breast, and could perceive a Crawling round the Ribs and Breast, on both sides, as if a Knot of small Eels, or large Earthworms had been penn'd up within the Cavity. This This Relation seemed strange, but upon the dissection we found sufficient reason to believe the account. When we had opened the Abdomen there appeared none of the Viscera belonging to the Belly, except the Liver, the Kidneys, Vesica Urinaria, and Intestinum Rectum. We at first imagined that the other Intestines might be covered by the Liver, which, tho' it be commonly large in Children, in this exceeded the usual size; but upon turning of it up towards the Diaphragm, we only found under its concave part, the Stomach, not lying in its natural posture, for the Pylorus was drawn by the Duodenum cross the Vertebrae of the Back towards the Fundus Ventriculi, and part of the Duodenum passed thro' a Foramen in the Diaphragm, placed on the Left side of that thro' which the Gula descends, which occasion'd the Pylorus to lyse almost sub Fundo Ventriculi. We then resolved to trace the Rectum from the Anus upward, not doubting but that it would lead us to the Mesentery and Intestines. The Rectum, we found, lay in an oblique line from the Anus to this new Foramen, and was received into it with a Portion of the Duodenum. This Foramen seemed to be formed by Nature, a primo Ortu, for transmitting those Guts into the Thorax; for had it been made by any Force, its sides would have appeared wounded, or lacerated; but on the contrary, round this Orifice there was a smooth Verge, as is seen in Foramine Vena Cavae perio, er that, per quod Gula descendit. A Sketch of the Diaphragm with its Perforations I have here attempted, and wish I were able to send you a Draught of the Middle Region (which indeed was very surprizing) it might render this account more intelligible than my description can pretend to. When we took off the Sternum, we saw the Mesentery cum adjunctis Intestinis in the Cavity of the Thorax, and lying upon the Heart and Lungs. There was no Omentum spread over the Intestines; that, as I remem- ber, was wholly missing, as was likewise the Mediasti- num. Most part of the Duodenum lay in the Thorax, and all the rest of the Guts, except the Rectum, which (as is already related) ascended in an oblique line from the Anus, and its upper end was inserted into this Orifice. After we had some time admired this new Situation of the Intestines and Mesentery, we began to enquire how this Child, according to the Common Notions of Nu- trition, could be nourished? That it was Nourish'd seems plain, because it daily receiv'd Food, and regularly void- ed Excrement, as we are assured by those who attended upon it. For salving this Quære, we propos'd to en- quire, what communication there was between that Gland, or Glands, in the middle of the Mesentery (com- monly called Pancreas Aselli) and the Receptaculum Chyli placed between the Internal Lumbar Muscles, called Pso- as; but upon the most accurate Search we were capable of making, there was none to be found; for the whole Meseraick Membrane, and Intestines, lay perfectly loose upon the Heart and Lungs, absolutely disengag'd from any manner of Communication with any other part. That Vermicular Motion, which shewed itself on the Ribs and Breast, we ascribed to the Peristaltick Motion of the Guts; and the Dyspnea, we thought, might be occasioned by Pressure made on the Lungs by the Intesti- nes and Mesentery, which likewise so fill'd the Thorax, that there wanted room for the Lobes of the Lungs to move freely in, and by consequence Inspiration, and Ex- piration would be performed with Difficulty. See the figure where a shews the Foramen thro which the Vena Cava passes, b the Foramen thro which the Gula descends, c the Foramen thro which part of the Rectum and Duode- num went into the Thorax. Gobfill (whose case you were pleased to print in the Transact. for June 1699. Number 253.) came lately to me, and told me the Stones grew very troublesome to him; that he had of late vomited up two of them, which he shewed me, and I caused them to be weighed. One weighed 3ii. and the other 5i. Giijs. He complains, that his Strength is of late much impaired; that he voids great quantities of Blood by Stool, which keeps him very weak. His Stomach is much decay'd, and will retain but few things. His hands are palsied; always extreme cold, and his Fingers contracted; he is not able to open them without help, or keep them so, unless by Force. His Legs are very likely in a small time to be as useless to him as his Hands, for, he says, they begin to fail him, and in the same manner grow cold, and have little sensation in them. But the most remarkable of all his complaints, was, a new Progress the Stones had either found or made. Formerly at night in bed, they us'd to get up (as he express'd it) to his Heart, and upon turning to his Knees, or standing upright on his Feet, they would drop one by one so distinctly, that they might be counted, and in this state they always arose straight up on the right side of his Breast; but now they rise obliquely, and get under his right Arm, inclining towards the Scapula, and when they are in this place, by giving him a Blow with the Fist on his right Shoulder, they will all fall down in a Lump together, and may very plainly be heard to clash on the other Stones, which lye as they did formerly just above the Os Pubis. After he had told me this Story, I made the experiment before Dr Fowke and Dr Davies, and the matter of fact proved true as he related it. The poor Fellow concluded, that he thought he could not live long, and desired, when he dyed, that I would take care his body might be opened. I heartily wish some some ingenious Anatomist were appointed for this service, when it shall happen; for this case, if rightly enquired into, may be of use and satisfaction to the curious. V. A Letter from Dr William Musgrave, F.R.S., to the Publisher, concerning some Experiments made for transmitting a blue coloured Liquor into the Lacteals. Exon, Sept. 24. 1701. SIR, The new Theory of Continual Fevers, lately publish'd, speaking (page 54, 5,) of that considerable experiment of Dr Lister's, made for colouring the Lacteals; and printed, Phil. Trans. N. 143; as if the Dr could never get the experiment done to his satisfaction; and intimating, That People may be deceived with Blue Tinctures; for [that] this is the natural colour of these Lacteals, when they are almost, or altogether empty. I have drawn out of my Adversaria the summ of what was, a little after that Transaction came out, done by me, in this matter. Feb. 168; I injected into the Jejunum of a Dog, that had for a day before but little Meat, about 12 ounces of a solution of Indigo in Fountain water; and after three hours opening the Dog a second time, I observed several of the Lacteals of a Bluish colour; which upon stretching of the Mesentery, did several times disappear; but was most easily discern'd when the Mesentery lay loose; an Argument that the Bluish colour, was not properly of the Vessel; but of the Liquor contained in it.