HISTORY OF A CASE, OF INCISTED DROPSY; WITH A DISSECTION OF THE SEVERAL CYSTS: AS COMMUNICATED TO THE AMERICAN ACADEMY OF ARTS AND SCIENCES, JAN, 31, 1787. BY Dr. Abijah Cheever, BOSTON.  DISTRICT OF MASSACHUSETTS. TO WIT. L. S. BE it remembered, that on the eighteenth Day of August, in the nineteenth Year of the Independence of the United States of America, ABIJAH CHEEVER, of the said District, hath deposited in this office the Title of a Book, the Right whereof he claims, as Author, in the Words following, to wit, "History of a Case of incisted Dropsy; with a Dissection "of the several Cysts; as communicated to the Ame- "rican Academy of Arts and Sciences, January 31, "1787. By Dr. ABIJAH CHEEVER, Boston." In Con- formity to the Act of the Congress of the United States, intitled "An Act for the Encouragement of Learning, "by securing the Copies of Maps, Charts and Books, "to the Authors and Proprietors of such Copies, during "the Times therein mentioned." N. GOODALL, Clerk of the District of Massachusetts. A true Copy of Record——Attest, N. GOODALL.  I presented this "HISTORY," &c. to the American Academy of Arts and Sciences, Jan. 31, 1787. Soon after, one of the faculty of this town requested to read a copy thereof, which I lent him for that pur- pose; and, notwithstanding he had never seen the patient or subject, this Copy was published in the second Vol. of the Memoirs of the London Medical Society, fol. 368, Art. 32, and his Name annexed thereto as Author; who has also been honoured by the London Medical Society for this communication. By all of which it appears he has completely arrogated this History to himself; thereby taking from me, not only my Right, but also exposing me to an essential injury, the uncer- tainty who is the author. I am therefore obliged to obtain the first and avoid the latter, to adopt this pro- ceedure effectually to establish these two objects, after having waited with much patience, in vain, in hopes to have had such justice done me as would have made it unnecessary for me to have taken any order upon the subject. A. CHEEVER. Boston, August 19, 1794. This may certify, That there is now on the Files of the American Academy of Arts and Sciences, a Communication by DOCTOR ABIJAH CHEEVER, of Boston, dated Nov. 25, 1786, read before the Academy Jan. 31, 1787. and entitled, "History of a Case of incisted Dropsy, with a Dissection of the several Cysts." Attest, JOHN CLARKE, Recording Secretary. Boston, Aug. 17, 1794.  HISTORY OF A CASE OF INCISTED DROPSY. A YOUNG woman, thirty-four years of age, applied to me, in June, 1786, to be relieved of hydropic swellings of the Abdomen, with which she was first affected in the early part of this year. She informed me, she had been ve- ry intemperate, and extremely imprudent for some years, and had, previous to this indisposi- tion, been cured of the Lues Venerea. AFTER the trial of powerful diuretics, ca- thartics, and deobstruent medicines, without ad- vantage, [8] vantage, I performed the Paracentesis, and up- wards of four gallons of limpid water were dis- charged. After this operation, I immediately administered Tonics and occasional Evacuants. She improved in health, recovered her appetite and digestion, and gradually regained her strength and spirits; and had a return of regula- rity in the whole animal œconomy; the urine, in particular, was discharged in its usual quantity and colour. THIS healthy appearance was of short du- ration: In a few weeks the Abdomen again tu- mefied, the accustomed evacuations were sup- pressed, or irregular; the disease increased with great rapidity, and the operation of tapping was again had recourse to, with similar advan- tages—which lasted much shorter than before. She [9] She filled again with water, and I tapped her the third time; finding this was the only means of procuring her any relief, I necessarily performed the operation the fourth time: Soon after which a fever and diarrhea ensuing, she died the 14th October, 1786. I WAS induced, by some extraordinary ap- pearances, to open the body. THE [10] THE DISSECTION. ON opening the integuments of the Abdo- men, I discovered a collection of purulent mat- ter, lodged between the oblique and tranverse muscles; upon continuing the incision into the cavity of the Abdomen, there gushed out an ex- tremely fœtid fluid, intermixed with pus and coagulable lymph, in which numerous hydatides of the magnitude of an hazel-nut, were floating: After evacuating this collection, of which were several gallons, I was surprised to find, that in- stead of the abdominal Viscera, the whole an- terior surface of the Abdomen was occupied by a [11] a membraneous Cyst, which adhered firmly to the internal lamina of the Pœritoneum, extending from the brim of the Pelvis to the Epigastric re- gion, which had contained the collection just mentioned, and by its weight and magnitude it had pressed the Intestines into the upper region, immediately against the Diaphragm. The supe- rior extremity of this Cyst, with the posterior la- mina of the Omentum, having formed a complete Septum, in a parallel direction with the Dia- phragm, made a distinct cavity, which contained the Abdominal Viscera in a sound state; but the Intestin: Colon escaping out of this cavity, took a direction in a right line close to the Vertebræ of the back, and under the posterior surface of the great Cyst, similar to the passing of the Oeso- phagus through the Thorax; and the inferior extremity of the Cyst; with the contiguous mem- branes, [12] branes, formed another Septum, around the brim of the Pelvis, and made, also, a distinct cavity below; thus was the cavity of the Abdomen converted into several distinct cavities. AFTER removing this great Cyst, the tunic of which was about half an inch in thickness, I discovered another Cyst, of about five inches di- ameter, between the Visica Urinaria and Uterus, full of purulent matter, and a substance of a stea- tomatous appearance, combined with a great quantity of hair, eighteen inches in length. THE Uterus was but little diseased; on re- moving it, I discovered a third Cyst lying between this Viscus and the Intestin: Rectum, of half the size of the second, containing pus and a fatty sub- stance, similar to goose grease, intermixed with hair, also; with the additional peculiarity of having [13] having its internal surface lined throughout with a lamella of bone, adhering firmly to the tunic of the Cyst. THE hair found in each of the Cysts, was of a light, sandy colour; but the hair of the Mons Veneris, and the head of the Patient, was black. The length of it removes any suggestion of its originating from an Extra- uterine Fœtus; and it appears beyond all doubt to have been generated within the body. I HAVE been thus particular, as few facts of this nature have yet appeared; and I con- ceived it might have a tendency to furnish some light upon the subject of the theory of the gene- ration of the hair within the human body. I REMARKED this further extraordinary circumstance— [14] circumstance—notwithstanding the bladder was become almost in a scirrhous state, and in some parts ossified, yet, when the patient was re- lieved by tapping, she discharged urine plen- tifully, and with as much facility as in health. I HAVE herewith sent you the ossified cyst, the hair, and other substance within in; the Vesica Urinaria ossified, as also the substances found in the second cyst, for the inspection and consideration of the members of the Academy. Explanation of the annexed Plate. Figure A. the third Cyst, the hair, and other substances within it. c. in figure A. shews the lamella of bone. Figure B. The substance in the second Cyst. SIR, THE extraordinary phænomena, exhibited in this patient and subject, influenced me to present the above History of the Case to you, as President of the American Academy of Arts and Sciences. I have the honor to be, SIR, With great respect, Your most obedient, humble servant, ABIJAH CHEEVER. To JAMES BOWDOIN, Esq. President of the American Academy of Arts and Sciences. BOSTON, Nov. 25, 1786.