yy J / Vf //
/
4
<
■\
i ■
MEDICAL FACTS
AND
OBSERVATIONS.
VOL. L
Digitized by the Internet Archive
in 2016
https://archive.org/details/b28042499_0001
medical facts
/
AN©
OBSERVATIONS.
VOLUME THE FIRST.
LONDON:
/«i7;tkd i)?-r j. JOHNSON, N* 72, ST. Paul’s church yard.
\
i:
\
>-
. • ■ . * ' ^
k
1 ‘ ■ ■''
i'
■'■■ '.,, t
■■•4
V. •-;
•N
i
r
PREFACE.
THE prefent Colledlion of Fa£ls and
Obfervations is intended as a fev^jiiel to the
London Medical Journal. I'hc indulgent
manner in which that work was received
by the Public, and the numerous and va-
luable Communications with which the
Editor was favoured by his Correfpondents,
induced him to perfevere in bringing it out,
at ftated quarterly periods, much longer
than well fuited his other avocations. But
that mode of publication having at length,
been attended with great inconvenience,
both to his profeffional engagements and to
A 3 the
[ ]
the deliberaite management of the work, he
became dehrous of condinfling his future
labours in a way more convenient and fa-
tisfadtory to himfelf.
He was aware, that, by making fuch an
alteration in the plan of the Journal as
might enable him to continue it at his
leifure, he fhould retain the advantages
which an ellablilhed work might be ex-
pedled to have over a new undertaking ;
but the refpedl he owed to his readers (many
of whom might, perhaps, have confidered
any farther change in the mode of publica-
tion as too great a deviation frgm his ori-
ginal plan) induced him rather to bring the
London Medical Journal to a conclufion,
and to begin a new Colledlion, the arrange-
ment of which, fo far as fhould relate td
the periods of publication, might be better
adapted to his other avocations.
thd
t vii ]
The London Medical Journal accoM-
ingly ended with the eleventh volume;
and the prefent Collcdlion of Medical
Facts and Observations is offered to
the Public in its Head. The objedl of this
new workj like that of the Journal, will
be to contribute to the improvement and
diffufion of rnedical knowledge ; and, like
0
that, it will con fill: of papers communi-
cated by CorrefpondentSj and of liiaterials
Golledled from the Tranfadlions of learned
Societies and other printed works*
This method of blending original obfer-
vations with tnaterials collected from books
feems to be the moft proper for a work of
this kind, which, while it ferves to excite
a fpirit of inquiry, and records interefling
fa£ls, is Intended to comprife accounts of
every Important difeovery and improvement
that fhall be made in medical fcience.
The
t Viii ] ■
The great Lord Bacon, who complained,
with too much reafon, of the few additions
made to their art by the medical writers of
his time*, recommended Colledions of
Fads and Obfervations as the beft means of
improving the pradice of phyhc + ; and it
is to the method of invedigating philofo-
phical truth, by indudion from accurate
experiments, which he fo admirably incul-
cated, that we are, in a great meafure, in-
debted for that attention to fads by which
medical fcience, in common with every
other branch of natural knowledge, hath,
fince the days of that truly illuftrious phi-
lofopher, been fo much improved.
' There is, perhaps, hardly any well-in-
formed perfon, engaged in the pradice of
phyhc or furgery, to whom opportunities do
not now and then occur of adding fome-
^ De dignitate et augm. Sclent, lib. iv. cap. 2.
t Ibid.
thing,
■ [ k ]
thing to our knowledge of difeafes ; of
whofe mind, from attentive obfervation,
may not lead him to fuggeft fome improve-
ment in the* modes of treating them : and
when it is confidered that many ingenious
men may be willingto communicate the re-
fult of their experience, in a concife and
familiar form, who have not leifure or in-
clination tocompofe a more elaborate, work,
the utility of a Colledion, like the prefent,
which is open to detached fadts and obferva-
dons, on any medical fubjedt, will, it is pre-
fumed, be fufficiently obvious.
The Editor flatters himfelf alfo, that by
continuing, as in the Journal, to colledl a
part of his materials from books he thall
fender an acceptable fervice to the reader.
The channels of medical information arc
now fo numerous, and in fo many diffe-
rent languages, that many important obfer-
vations
[ ^ ]
Vations probably remain for a long time
unknown to perfons who arc bufily em-
ployed in the pradiee of phyfic, and to
whom, of courfe, they would be the moft
interefting, but who have not fufficient
time or opportunity to confult the fcveral
works in which they are to be found.
This remark feems to be more particu-
larly applicable to the Tranfadions of learn-
ed Societies, which, on account of their
,bulk and price, or the variety of fubjeds'^
not immediately conneded with phyfic, of
which they treat, are, comparatively fpeak-
ing, in the hands of few medical readers,
although they frequently contain papers
with which this clafs of readers cannot but
wifh to be acquainted. To colled froni
fuch publications, either entire or in an
abridged form, the more important obfer-
vations, relative to the pradice of phyfic and
[ }
to medical philolophy, which they contain'^
feems likely, therefore, to be of coiifidera-
ble utility ; and for the reafons, juft now
given, the Editor intends alfo to have re-
coiirfe, occaftonally, to other printed works,
but without profefftng to give a general re-
view of new medical books. Of thefe,
however, a catalogue will be inferted at
the end of each volume.
The Editor propofes to bring out a part
of this Colledlion as often as he fhall have
got together materials fufficient to fill about
fifteen fheets in odtavo ; a volume of this
fize, as it will enable him to make the pe-
riods of publication more frequent, fecming
to be better calculated for the purpofes of
the work than one of greater bulk.
Communications for this work may be
addrefled to Dr. Simmons, Poland Street,
London <
CONTENTS.
[ ]
c O N T E N T s'.
Pagt
I. ^ Cafe of Hydrophobia ; with the Ap-
pearances on DifJeBion. By John
Ferriar, AT. D. Bhyfician to the Infirmary
at Alanchefier. — — — i
II. Some Obfervatioris on the Prevention and
Treatment of Hydrophobia. By ATr. Wil-
liam Loftie, Surgeon at Canterbury, 1 1
\\\, An Account of an uncommon Inflammation
of the Epiglottis. By Mr.Thomas Main-
waring, Apothecary in London. — 40
IV. Cafes of the ExtraSiion of the CataraSl ;
zvith pralHcal Remarks. By Afr. Richard
Sparrow, one of the Surgeons to the Cha-
ritable Infirmary f Dublin ; and AAember
of the Royal College of Surgeons in Ire-
land. — — — — 43
V. Account of an Extra Uterine Conception,
By iV/r.William Ba^Miham, Member of the
Corporation of Surgeons of London > and
Surieon in Effex County in Virginia. 73
3 VI. A
•S ■
C xiii ]
Page
76
90
VI. A Cafe of Spontaneous Evolution of the
Foetus. By Mr. Richard Simmons, one
of the Surgeons of the Britifo Lying-in
Hofpital in London. — —
VW.ACafe of Petechia fne Febre. By Sa-
muel Ferris, M. D. F. A. S. Phyfeian
in London. — — —
VIII. / fiance of a Difeafe, to vohich Sauvages
has given the Name of Meteorifmus Ventri-
culi; zvitb Remarks. Roberi Graves,
M. D Phxfi ian at Shr borne., in Pjorfet-
fjire and EKiV a Luenliale of the College
Oj Ply fician., London. — —
IX. Cafe of a Catheter., left in the Bladder ^
in drawing cf the Urine, for a r e trover ~
fion of the Uterus. By Mr. E iward
Ford, Surgeon of the JV fiminftcr General
Difpenfary.- — — — —
X. Cafe of an Imperforate ReFium. By the
XI. Palls reldfive to Pemphigus. By Mr.
R. B. Blagden, Surgeon at Petworth in
Suffex. — — — — 105
XII. Account of a Fall relative to Menftrua-
tion, not hitherto deferibed. By 'i no.uas
Denmun, M.D. Licentiate in Midwife y
96
— 1C2
\
[ xiv ]
Page
of the Royal College of PhyficianSy Lon- '
XIII. VraBical Obfervations on the Treat-
ment and Caujes of the Dropfy of the
Brain. By Thomas Percival, M. D,
F. R. S. and S. A. Bond. ; F. R. S. and
R. M. S. Edinb.i Prefident of^jhe Lite-
rary and Bhilofophical Society of Manche-
fer ; Member of the Royal M?dical So-
ciety at Paris ; of the Royal Society of
Agriculture at Lyons ; of the Medical So- ■
ciety of Aix in Provence ; of the Philo-
fopbical Society at Philadelphia ; and of
the American A.cademy of ylrts and Sci-
ences, &C. III
XIV. An Account- of the Preparation, Mode
of Application, and EffeSis, of a Liniment
recommended by Roncalli in the Treat-
ment of fcrgphulous Tumours. By Henry
Strcict, Profejbr of Chirurgical Pathology
in ike Imperial and Royal Medico-Chirur-
gical Academy at Vienna. From the Tranf-
. aSilons of the Academy. — — 134
XV. An Account of the Tabafheer. By Pa-
trick Rullcll, M. D. F. R. S. From the
don.
108
PhilofcphicLil T ra-ifaSlions.
XVIe Account of the Nardus Indlca, or Spike-^
nard. By Gilbert Blane, PL D. B. R. S,
From the fame IVork, 153
XVII. An Acccunt of a Child with a double
Head. By Everard Home, Rjq. F. R. S.
From the fame Work. — — 164
XVIIL Cafe of a Gun-JJoot Wound in the
APouth ; in which, oh aci ount of impeded
Deglutition, a flexible Catheter was intro-
duced through the Nofe into the Oefopha-
gus, and uffered to remain there during
the Space of a Month. By M. Manoury,
Surgeon of the Hotel Dieu at Paris. From
the Journal de Chirurgie. — 176
XIX. Account of an extraordinary Change,'
not hithert) defcribed, which, under cer-
tain Circumflance , takes place in the hu-
man Body after Death. From a Work by
M. Thouret, entitled ‘ Rappon fur les
‘ Exhumations du Cimetiere et de VRglife
‘ des Saints Innocensd — — 1S6
Catalogue of Books. — — — 201
Index. — — — — 217
DIREC-
DIRECTIONS TO THE BINDER.
Plate the Firft, the fubjedls of which are de-^
fcribed in pages loo and 104, may be placed
at page 100; and Plate the Second, at page
164.
medical
25S
MEDICAL FACTS
AND
OBSERVATIONS.
~'y~ •• ■■ i '
I. Cafe of Hydrophobia ; with the Appearances
on DiJfeEiion. Communicated in a better to
Samuel Foart Simmons, Af. D. F. R. S. by
John Ferriar, M. D. Fhyfician to the Infir-
mary at Manchefier.
ON Friday morning, December 3, 1790, I
was defired to vifit John Johnfon, recom-
mended as a home patient of the Infirmary,
who was faid to have been bitten by a mad dog.
I found him in a tremulous, irritable (late,
with a weak, irregular pulfe, and a white
tongue. His eyes looked wildly ; he was fear-
ful of every unexpected noife, and feemed to
be continually on the watch againfl: furprifes.
When interrogated refpeCting his complaints,
VoL. I. B he
[ * ]
he gave a long detail of pains in his cheft,
cough, and difficulty of breathing; but was
unwilling to mention his dread of water. He
owned that, a confiderable time before, he had
been bitten in’the left cheek by a ftrange dog,
which leaped at his face in paffing while he was
at work in the ftreet. The accident affedled
him fo little, that the precife date of it had
efcaped his memory. He guefled it to have
happened more than three months ago. Since
that time he had been twice afflidted with com^
plaints fuppofed to be pleuritic, which were re-
moved by bleeding, bliftering, and other reme--
dies, of which he could ^ve no account. He
had been bled twice within the laft week, and
had a blifter on the left fide of the chefl when I
faw him.
On Monday, November the '’29th, in the
evening, his wife had obf^rved, for the firft
time, that he fwallowed fome gin and water
■with reludlance and difficulty ; the uneafinefs
in fwallowing liquids foon became his principal
complaint, but the bite was not recolledled till
Thurfday evening ; when a medical gentleman,
who was applied to, inquired whether he had
ever been bitten by a dog. Even then he recol-
ledled the circumftances but imperfedly, He
got
[ 3 ]
got down folids with great eafe during the
whole complaint.
When I delired him to drink a little water,
he fliewed ftrong marks of difguft, but, recol-
lecting himfelf, faid he would try ; that he did
not believe the dog to have been mad, (a,n idea
in which I encouraged him), and that he was
not afraid of water. As foon as he touched the
cup, I perceived fome fpafmodic contractions
of the mufcles of deglutition, and when he
raifed it towards his ni'ourh the mufcles of the
cheeks were ftrongly contracted, and a fort of
convulfive gulping was very frequently re-
peated. - 4ffct one or tw'o unluccefsful at-
tempts, he fwal lowed a fmall quantity of water,
but with a violent ftruggle, fucceeded by uni-
verfal tenfion ; and he would not be perfuaded
to make another trial.
He complained that cold air alfeCted his
throat with a fimilar uneafinefs ; and when alked
where the impreffion was felt, pointed to his
throat, immediately under the thyrpid carti-
lage. The opening of the door always made
him complain.
His difeourfe was fomewhat incoherent, and
he frequently referred, with fome degree of
terror, to the circumftance of the bite.
B2,
By
[•4 ]
By his wife’s account, he had been a fober,
induftrious man ; abftemious with refpedt to
food ; and addidted to no pradiccs likely to
pervert his imagination. His age was thirty-
nine ; his evacuations were in a natural Itate.
The fear on his cheek, which was between
, the ear and the angle of the jaw, but rather
more advanced, was hardly difcernible : his
wife remembered to have feen it bloody. 1
had him removed to the Hofpital as foon as
poffible, that he might enjoy every advantage
of attendance; and till 1 could have the fatif-
fadtion of confulting with my brethren, ordered
him to take a bolus, contairiing a fcruple of
bark, fix grains of mulk^ and half a grain of
opium : he was immerfed in the cold bath, and
was diredfed to fwaliow, as often as poffible, a
portion of a mixture of vinegar and water.
After his removal, as his wife had informed
me that the found of water diftrefied him, I di-
redfed fome to be poured out in the pafiTage ad-
joining to his room. He ftarted at the noife,
looked wildly round, begged to be fent home,
and faid he was not afraid of water.
At five o’clock in the afternoon we met in
confultation, when the horror of water, and dif-
ficulty
[ 5 ]
ficuky of fwallowing it, were afcertained in
prefence of all the phyficians to the houfe.
We agreed to fcarify the cicatrix on the
cheek deeply, and to apply a blifter over the
incilions : a bolus, containing a fcruple of bark,
fifteen grains of mulk, and two grains of
opium, was diredfed to be given every four
hours ; two drachms of ftrong mercurial oint-
ment were applied to the throat, arms, and
groins; a mixture of eight ounces of diftilled
vinegar, and twelve ounces of decodtion of
bark, was ordered, of which three or four ta-
ble-fpoonfuls were to be given as frequently as
poffible ; and a poultice, confining of three
drachms of galbanum, tw'o fcruples of opium,
and one drachm of camphor, was applied, after
the mercurial fridtion, to the throat.
About nine o’clock the fame evening I faw
him again. He had fwallowed his medicines
without much reludtance, but was more inco-
herent, and complained greatly of cold.
During the night his delirium increafed : he
was very reftlefs, impatient, and intradtable.
He threw himfelf out of bed repeatedly, and
with his nails fcratched the hand of one of the
keepers who attempted to replace him. How-
ever, he took four bolufes, and fwallowed more
B 3 than
/
[ « ]
than a pint of his mixture. He had one fi:ool
before morning.
At nine o’clock on Saturday morning, De-
cember 4th, we met again in confultatlon.
We found that his difficulty in fwallowing li-
quids was lefs : he had taken fome very thin
porridge, the ufual breakfaft of the houfe ; and
he drank feveral draughts of his mixture, with-
out any ftriking appearance of difguft, in our
prefence ; but his eyes were heavy, and inclined
to fix, his pulfe much funk, and there was a
conftant tendency to low delirium. We, there-
fore, concluded that the termination of the dif-
eafe approached ; but diredfed that the plan we
had agreed on ffiould be purfued as long as he
fliould be capable of fwallowing. Before I left
him he retched feveral times, and brought off
fome wind : half a grain of emetic tartar was
'directed to be added to his next bolus, but he
did not live to take it. At a quarter paff ten
he fwallowed fome of his mixture, and imme-
diately after threw up a part of it again. He
then fell into convulfions, and died in the
courfe of a few minutes.
I was very defirous of examining the body as
early as poffible, that the appearances attending
this dreadful diforder might be fairly afcef-
‘ taincd ;
[ 7 ]
.tained ; the inflammation of the fiomach, de*
fcribed in former difTedtions, having been often
attributed to the adtion of the gaftric juice.
Accordingly, the body was. opened by Mr.
Simmons, at a quarter before three o*clock on
Saturday afternoon, in prefence of moft of the
phyficians and furgeons of the hofpital.
In the brain, which was the part firft exami-
ned, the only preternatural appearance was a dif-
tention of the pia mater, on both hemifpheres,
with a limpid fluid* The quantity of water in
the lateral ventricles, at the bafis of the brain and
round the fpinal marrow, appeared to be fome-
what unufual. The lungs were uncommonly
found, excepting one flight adhefion at the pofte-
rior part of the left lobe* The trachea was per-
fedtly found. The pericardium adhered pretty
firmly to the heart in its whole compafs. The
ftomach and inteflines feemed, externally, found;
but on opening the oefophagus a morbid appea-
rance prefented itfelf. About two inches above
the cardia the epidermis of the oefophagus was
abraded in irregular points, and expofed an in-
flamed furface of a dark red colour : ftill lower,
the abrafions became linear, and extended into
the ftomach itfelf. The edges of the epider-
mis, furrounding the abrafions, were unequal,
B 4 and
I
[ 8 ]
• and elevated. A fimilar affection was traced
along the lefler curvature of .the ftomach, but
. fainter in its progrefs. to the pylorus, where it
was leaft difcernible, and about which it feem’ed
. to -terminate. , The whole of the inflamed parts
bore a ftriated appearance, darkefl; in the cefo-
phagusi, and lightefl; and more indiftin6t to-
• wards the pylorus. The ftomach was half full
. cif a dark-coloured fluid, which fmelt ftrongly
•of muflc. The other vifcera were in a natural
j ftate*
. As no more than four hours and a half elapfed
betw'een the patient’s death and the difledlion, I
’ believe the abrafion obferved may be fairly con-
. fidered as the effe6t of the difeafe, efpecially
- as the ftomach contained a confiderable quan-
tity of fluid; but although the preternatural
irritability, produced by this fpecific inflamma-
tion, completely explains the peculiar fenfibi-
lity to cold water and cold air, yet the dread of
water^ though conftituting the diagnofis, can
only be regarded as the fymptom of a fymptom.
The local inflammation, eyen when confldered
in connexion with the flight eftufion vifible in
the brain, is very inadequate to the explanation
. , of the patient’s death.
The
The relief from the difficulty of fwallowing
liquids, obfervable towards the clofe of this
cafe, is not a folitary inftance ; the difeafe has
even been faid to exift without any horror of
water, or difficulty of receiving it into the
ftomach
The eafe with which folids were fwallowed
by our patient admits an obvious explanation.
In the irritable ftate of the cefophagus, the com-
paratively fmall degree of contradtion neceflary
for the defeent of folid food, is performed
without difficulty. For the deglutition of li-
quids a very ftridf contradtion is required,
- which drains and irritates the inflamed parts,
and confequently occafions great didrefs.
Little information refpedling the pradlice in
hydrophobia can be drawn from this cafe ; yet
if other obfervations fhould confirm the opi-
nion, that a peculiar inflammation exids in the
domach and cefophagus, in all indances of this
difeafe, 1 conceive that fome meafures fhould
be taken to counteradt it, though it appears to
be only a fymptom of the general diford er.
' Bliders applied to the throat, or between the
* Sec Mead’s works ; Licutaud, Precis de la Med. prat, j
and fome late articles in the newfpapers.
llioulders,
r lo ]
fhoulders, might be ufeful ; and if another
fimilar cafe fhould unhappily occur to me, I
ihould certainly employ them. Our patient
had a recent blifter on'his fide.
Lieutaud* enumerates very extenfive appea-
rances of inflarrimation and fuppuration in the
'ftomach and bowels of hydrophobic patients
clifeovered on diire<5tion, and other writers have
mentioned infl?mmation of the llomach, in fuch
cafes, in general 'terms; but perhaps ours is
the moft fatisfatfory examination yet obtained,
on account of its nearnefs to the death of the
patient. Lieutaud mentions the adhefion of
the pericardium to the heart, among other ap-
pearances.
I fiiould conceive blood-letting to be a very
ambiguous remedy in this complaint : with us
it was prohibited by the ftate of the pulfe, the
advanced period of the dlfeafe, and the free ufe
made of it a few days before by the patient.
The large ufe of mercurial friilions is faid
to have been fuccefsful in ‘ hydrophobia. It
has perhaps been fuggefted by the determina-
tion to the falivary glands, fo remarkable in
the courfe of the difeafe. I own I have fome
# Precis de la Medcclne pratique, Tome II. p. 92. Sver,
Paris, I777» ,
s
[ ■■ ]
doubts refpedting the propriety of ufing a re-
medy which produces fo great a degree of irri-
tability in the ftate of high irritation attending
hydrophobia. The appearance of the inflamed
parts approaches to the eryfipelatous flate ; and
the whole train of fymptoms feems to require
the aid of the cold bath, and the free ufe of
bark and opium.
Manchejiir,
December 12, 1 790.
II. Some Obfervations on the Prevention and P’reat-
ment of Hydrophobia. Communicated in a Let-
ter to Dr. Simmons by Mr. William Loftie,
Surgeon at Canterbury ,
BOUT two years fince a poor man ap plied
to me who had been bitten, both o n the
leg and arm, the day before, by a dog that, died
mad, after having bit two other dogs which
were immediately killed.
The wounds were fm.all ; that on the arm was
about two inches above the wrift, and only one
of the dog’s teeth had penetrated ; the ot her,
on the tibia, was more confiderable ; here \ ?ere
the marks of two teeth.
In
[ 12 ]
In this cafe nothing was done till the time^of
his application to me, (twenty hours after the
accident) when I diffedted out the bitten parts,
taking off a piece of the integuments, of about
the fize of halt a crown, and removing every
part that had been even touched by the teeth.
Lint, dipped in a ftrong folution of corrofive
fublimate, was applied to the parts, which were
moiftened at times with the fame.
The next day, the arm and leg being much
inflamed, an emollient cataplafm was applied
over the dretlings, and the patient was dire<fted
to take fome Glauber’s fait.
On the third day the dreflings were removed,
a laree efehar was then formed, and there was
O
a confiderable difeharge from the wound.
From this time the flough came off daily,
and the wound difeharged a laudable pus.
On the eighth day the patient complained that
his mouth and gums were fwelled ; which mufl:
have been owing to abforption of the corrofive
fublimate, as no mercurials were given, inter-
nally.
The purging fait was occafionally repeated,
and the wounds were kept open for feven or
eight weeks, w'hen they were fuffered to heal ;
and the patient has continued well ever fince.
From
C 13 ]
' From every circumftance I have no doubt
that ihe dog by which this perfon was bit was
mad; and 1 cannot help thinking that the pa-
tient’s efcape was entirely owing to the removal
of the parts bitten, and keeping the wounds
open fo long.
Since that time another cafe of the fame kind
has fallen under my care, which I treated irf a
fimilar manner and with equal fuccefs ; but in
this the certainty of the animal being mad was
not fo clear.
Two cafes are related by Mr. Foot* of ex^*
cifiQn being attended with fuccefs, in one of
which the diftance of time, between the bit©
of the dog and the extirpation of the part, was
from thirty- two to thirty-five hours ; and in the
other, fixty-eight hours. Such inilances as
thefc, and the firfl; of thofe which I have re-
lated from my own experience, evidently prove
the ufefulnefs and neceffity of extirpation ; and
indeed I have long been of opinion, from all I
have heard and read on the fubjedl, that no-
thing lefs than the complete excifion of the
^larts bitten can be relied on, with any degree
* An ElTay on the Bite of a Mad Dog, 8vo. London,
„8S.
1
of
C '4 ]
of certainty, as a means of prevention in thefc
tinfortunate cafes.
In too many inftances, however, either from
the number and fituation of the wounds, or
from the fears of the patient, we fhall be obliged,
perhaps, to content ourfelves with deftroying
the parts bitten by cauftic, which is certainly
the beft fubftitute for extirpation, though it has
fometimes failed of fuccefs even in the ableft
hands
The cafes, by M. Sabatier, you have favoured
me with from the Memoirs of the Royal Aca-
demy of Sciences at Paris for the year 1784,
are ftrongly in point, and confirm the neceffity'
of deftroying the wounded parts. With your
leave I will copy them. — On the 27th of
“ February, 1784, a dog, kept by way of fafe-
“ guard in a lone houfe, bit the gardener be-
“ longing to the houfe in the upper lip. The
wound was d refled in the common way, and
nothing more was done. The next day the
* See the cafe of Matter Rowley, as communicated by
John Hunter, Efq., to Dr. Hamilton, and inferted by the
latter in his Remarks on the Means of obviating the fatal
EfFefts of the Bite of a Mad Dog, &c. 8vo. London, 1785,
page 211.
“ fame
C 15 ]
^ fame dog, which had been fhut up, but wlth-
out being fuppofed; to be mad, flew at a
“ young, man, who went to carry it fome vic-
‘‘ tuals, and bit and fcratched him in feveral
places. The dog was immediately killed.
Twenty-eight hours after the accident M.
“ Sabatier applied liquid butter of antimony to
the wounds, which w'ere more or lefs confi-
“ derable, and twenty-five in number, and to
the fcratches, of which he reckoned fifty.
The moft confiderable w^ere in each hand
and fore arm, in the right flioulder, and in
‘‘ the left leg. Thefe were kept open a confi-
“ derable time, and the patient did well ; but
the gardener, who thought himfelf fafe, and
“ would not believe the dog had been mad,
began, on the 14th of April, fifty-five days
after the accident, to lole his appetite ; the
day following he complained of a pain in
the wound, of a fevere oppreffion at his fto-
mach, and of a defire to vomit. The fymp-
toms of hydrophobia came on the fame day.
“ He was carried to the Hotel Dicu at Paris,
and died on the i6th.
“ M. Sabatier relates another cafe, which
happened in 1775, of a foldier, bit alfo by a
mad dog, where ihc cauftic was applied
“ with
1
C 16 ]
“ with fuccefs; while another man, who had
been bitten by the fame dog, was feized
with hydrophobia on the fifty-fecond day,
“ and died in twenty-four hours.”
The method propofed by Dr. Haygarth,
“ of wafhing the wound with cold water, not
nightly and fuperficially, but abundantly,
and with the; moft perfevering attention; in
“ bad cafes for hours ; and .after a plentiful
“ affufion of cold water, but not fooner, apply-
“ ing warm water*,” is highly commendable
for its fimplicit)'^, and cannot be too much
known and inculcated, as it promotes the wiilx-
cd-for defign, and gives time for medical af-
fiftance..
The method you have been fo good as to
communicate to me, as propofed by Profeflbr
Mederer, of Fribourg, and which confiils in
wafhing the wound thoroughly, firft with a di-
lute folution of lunar cauftic in water, (in the
proportion of thirty grains of the cauflic to a
pint of water) and afterwards with warm water,
feems alfo to be highly deferving of notice.
At the end of the ProfefTor’s paper I obferve
fome points of theory -concerning the fuppofed
adtion of fea water, in thefe cafes, from its al-
* Sec London Medical Journal, Vcl. X. page 396.
k aline
C 17 ^
kaline contents, which may probably by fome
be deemed too fanciful ; but this is a circum-
f^ance of no great confequence ; and if you
give the prefent remarks a place in the Medical
Faffs and Obfervations, I lhall requell you to
add Profeflbr Meddrer’s letter and other pa-
pers* on this fubjeff, by way of note, or in
any
* Cel. SiMMOTrt, Med. Londin. S- D. M. DE Mederer,
Profe/Tor Fribur^enfis.
De efficacia lixivii matricalis dilutifiimi, ideo non amplius
cau(iici, fed reagentis remedii contra hjdrophobiam prophi-
laftici perfuafus nuper in litteris ad te datis rogavi, qui, (i
quis a beftia rabida demorfus fe curandum lifterer, ilium me-
thodo in fyntagmate de rabie canica a_me defcnpta traftare ve-
ils ut fic & ufu confirmaretur, quod ratione demonftratum eft;
nam cum id rogarem, propriis experimentis certis, quibus
theoriam meam comprobarem, adhuc deftitutus fui.' Veruiri
non diu poft accidit, ut dus a fele rabida demorfa; sncillae, &
nuper denuo, ut tres a cane rabido admorOe perfon® prjefata
mea methodo curarentur, & onines fcliciter confervai entur ;
quorum faftoruni fpeciem fimulque lafionis & fanat.onis hiflo-
riam ex teftimoniis authenticis in hunc finem annexis colli-
gere licet.
Cum verba tantum moveant, exempla vero tr ha t, jam
nunc futurum cxiftimo, ut Philiatrorum nemo amplius dubi-
tet, data quavis occafione pharmacum non caufticum (nam
lapidis cauftici grana triginta in aquae libra una lolma non
amplius adurunt) nihilominus tamen contia hydiophobiam
prophila£licum adhibere, cujus efficacia non folum a priori,
VoL. I. C fcilicct
■[ ]
any other form you pleafe, as I am perfuaded
there are many readers who, like myfelf, will
‘be glad to have a copy of them.
That
fcUicet ratione & analogia dcmonflrata, fed & a pofteriori ipfa
nempe experientia confirmata fuit. Qnod ut omnes ac finguli
quacunque artis faluberrimae praxi occupati faciant, valde
exopto, quo multiplicato demum experimentorum numero
omne dubium evanefeere, atquc fic tandem fieri polfit, ut non
folum calamitas hac a miferis repellatur, fed & ceteri ea
moleftia liberentur, quam aliena miferia affert. Nullus pra!^
terea dubito, quemquam fore, qui aeque opportunam quain
certam hanc curandi methodum non omni alii magis profefto
ambiguae & incommodae praeferat. Nullum enim aliud reme-
dium prophilafticum certius hucufque inventum elfe, ex eo
facile arguitur, quod non ita pridem adhuc a beftiis rabidis ad-
morfi rabie implicarentur, & ea oppredi, licet a peritillimis
in arte viris ^ juxta normas noviifime praeferiptas curarentur,
nihilominus tamen infelicilTime perierint^plurimi ; mea veto
rtiethodo tra£lati confervati fuerint omnes.
* Cum tefte Celfo & omnibus, qui miferos fitire & rabire vi-
dcrunt, hydrophobia cum rabie non folum miferrimum mor-
borum genus, fed etiam eo oppreffi in maximo diferimine fint,
ab hac calamitate & periculo homines confervando hominibus
maximum &: diftinftiffimum officium praflari, & ideo nemi-
. nem, qui officium hoc praeftitit, maxima voluptate non affici
neceffe eft, quare omnes, quibus fortuna, aliquem hac mea
methodo ab ifta calamitate confervare contigit, ut mihi earn
fignificare, & fic Voluptatem fuam ob hominem confervatum
communicare non graventur, etiam atque etiam rogo. Vale.
Dabam Friburgi Bxifgovix die ima Sept. 1789.
Copla
[ >9 ]
That perfons fometimes efcape the effedis of
the bite of rabid animals, without any prophy-
ladic
Copia Auejlati fuprcmee prafeSttra Weren't JJimi S. R. I. Prln‘
dph a Fiirftenberg in ‘■ualle Kinzingana.
In ditione Sereniffimi Principis a Fiirftenberg & qujdeni in
fupremae prsefe6turae vallis Kinzinganae dynaftia Wolfachdifta,
rufticus Andreas Ehle, fubditus in Rankach i3tia Septembris
hujus anni denunciavit, duas prsedii fui ancillas Agatham
Miillerin unam, & Mariam Annam Borhoin alteram a fele
rabiofa demorfas fuiffe.
Mandabatur illico provinciae phyfico & chirurgo, ut necef-
faria interim remedia adhiherent, fed & eodem tempore ad D.
Profeflbrem Mederer Friburgum tabellarius milTus eft, qui
eundem rogaret, ut fuum contra hydrophobiam laudatum re-
medium mittere, modumque applicandi edicere, vel fi non
gravaretur, ipfus venire vellet.
Veoit ipfe ea, qua ob longam diftantiam licuit, celcKitate;
ancillas morfu oSenfas comitante Domino Confiliario intimo &
fupremo Pr^fefto, pone infequentibus D. dynafliai Confiliario,
D. Phyfico &, Chirurgo invifit, vulnera infpexit, fuo reroedio
lavit, dcligavit, addito fimul mandato, ut hzec curandi me-
thodus iterato repetatur, nullum prajter hex aliud remedium
applicetur, poftea vero vulnera confuetis fanandi regulis cu-
rentur.
Per longius deinde tempus banc ob cauffani hie loci commo-
fatus praediftus D. Profdfor de Ijefarum aiicillarum circum-
ftantiis a loci chirurgo indies ecloftf s, 'eafdemque cum ante
abitum adhuc vifitaret, l^natas fere reliquit, domumque fuam
repetit.
C a
Nos
[ 20 ]
la(5lic means being employed, is certain, and
muft be accounted for from fome particular
ftate
Nos nunc ex integro fanatas curatafque efle cernimus, quod
unice fanandi^methodo pra:di£l:i D. Profcflbris in acceptis re»
ferendum effe putainus.
In ciijus rei teftimonium patemes hafee litteras majori fu-
prema; Praefedurae noftrae ligillo munitas dedimus.
Wolf ac hi die Sva Deceinbris 1/83.
Cancellaria fupremae PrsfefVurae Sere-
(L. S.) niffimi Frincipis a Fiirftenbcrg in
valle Kiazingana.
Copia Attejlatl D. provincics Phyfici D. Wegbecher.
Infra feriptus a fupremo huiate Pia'fe6io die ijtia Septem'.
brish. a. mandatum accepi, ut me cum chirurgo Rankachiuin
dynaftiae Wolfacenfis vallem conferrem, ibidemque duarum a
fele rabida demorfarum ancillarum curam gererem. Verum
cum mihi notum eflet, D. Mederer ProfelTorem Fribu'rgenferu
centum contra rabiem habere remedium prophiia£licum, roga-
bam ampliliimam Praefecturam fupremam, ut praefato D, Pro*
feffori cafum hunc nuntiarct, fimulque ab eo requireret, ut vel
ipfe venire, vel remedium fuum cum inftruflione, quomodq
applicari debeat, mittere velit.
Adveniens in Rankach intellexi, felem, quas apibas ancilla?
momorderat, tribus diebus abfentem fuiffe, nempe non, ut>
huciifque folebat, mane & vefpeie, dum vacae mulgebantur,
ad ftabulum veniffe, ubi ab ancillis pra?di£lis femper la£le
pafeebatur. Quanta autem die mane iterum ante domun?
cornparuilTe, & in ibi confiftentes ancillas irruiffe, unius pe-
dem
[ 21 ]
llate of the habit at the time. We daily fee
inftances where inoculation fails, though the
infertion
dem laedens ; inde verberibus deterrlta alteram petiit, pedem
primo, ab hoc vi depulfa ejufdem ancillae manum mordens j
tandem in terram depreflam felem a ruftico ad ancillarum cla-
morem advolante furca interfcflam fuifle.
His in adventu meo auditls jufll, ut fells necata aperiretur,
apertamque infpiciens inveni, linguam arldam, tumidam
ufquequaque nigram, oefophagum vero & afperam arteriam
cum maxima parte pulmonum Inflammatum.
Ex his & ex faftis prsemiffis judicabam, felem revera ra-
biofam fuifle, ideoque morfuum vulnera dilatari, murialavari
&: unguento digeftivo obligari jufli, quod & illico faftum
fuit.
Quamprimum D. ProfeflTor Medercr advenit, ego & ipfe
cum fupremo Praefefto D. Schwab, cum praefeflurte Confi»
liario D. Battie & Chirurgo D. SchrofiF invifebamus admorfas,
quae de fato fuo follicitae & trifles, clavi S. Hubert! in vola
manus aduftae, a D. Profeflbre bono animo elTe jabebantur,
auxilium ipfis infallibile promittendo, — Fidebant miferae pro-
nilflis eo certius quod anno vix dum praeterito undecim per-
fonas morfu rabiofi canis laefas ab eodem D. Profeflbre fanatas
fuifle atteflabamur.
Aperiebantur earum vulnera obligata, lixivio, quod ex
granis triginta lapidis cauflici chirurgorum ,& libra una aquae
communis paratum fuit, diligenter eluebantur, & carpto mox
di6lo lixiviae madefaflo denuo obligabantur, quae operatic ut
una aheravc vice repeteretur, julfit, aliud quod vis remedium
C 5 applicari
[ 22 ]
infertion of the variolous matter is carefully
done, and other patients inoculated at the fame
time,
applicari prohibuit, vulnera vero tnethodo vulgar! curanda
praecepit, quod accurate faftum fuit.
Vigefima tertia Septembris denuo invifebatirus ego, D. Pro-
feffor Mederer, D. Dr. Metzler Comitis Biffing Medicus Sc
Confiliarius, D. Confiliarius Battle & D. Chirurgus SchrofF
(Jemorfas, & illas fortis fuse certiores folatii plenas invenimus.
• — Vulnera erant moderate inflammata, optimam fuppurationis
fpeciem prodentia ; in manu vero ancillse alterius detegeba-
mus, morfum, quern prius tantum fuperficialem credcbamus,
per cutera penetrafle j dilatari itaque & hoc vulnus — prae-
difto lixivio elui, & eo, quo prius mocfo obligari praecep-
tum eft. ,
Nunc poft feptimanas circiter quinque vulnera omnia fine
ullo malo fymptomate fanata, & ancillae fanae & alacrcs cffe
deprehenduntur, quod nvethodo rational! D. Profeffbris attri-
buo. In cujus teftimonium hafce litteras proprio figillo mu-
nitas fcripfi. r
Wolfachi 6ta Decembris 1783.
Wegrecher Medicinas Doclor, Sere-
(L. S.) niffimi Princip?s a Furftenberg Con-,
filiarius, & dynaftiarum Wolfach A:
Haflach Phyficus.
Praepofitum atteftatum j^ropria manu fereniffimi Principis a
Furftenberg Confiliarii — Med. Doftoris Sc fupremas prsefec-
turae iirvalle Kinzingana Phyfici oidinarii, D. Jacobi Weg-
becher
I
C ^3 ]
time, with the fame matter, and the fame lan-i
cet, have the diforder* May not the fame thing
happen
becher hie Wolfachi feriptum fuiffe appreffo cancellariae mi«
nori figillo atteftatur
Wolfachi 8va Decembris 1783.
Cancellaria fupremae praefefVurae Sere-
(L. S. ) niffimi Priiicipis a Fiirflenberg ih
valle Kinzingana.
Copid Attejlaii Chirurgi jurat! D, SchrofF.
Infra feriptus per fupremam pracfefturam cum D. Phyficof
t). Wegbecher ad duas illas a fele rabiofa in Rankach dembr-
fas ancillas mifTus fui, qOas Ijefas inveni, ut fequitur.
Agatha Mlillerin i8annorum, in crure dextro, parte me-
dia anterior! duplicem cxcoriationem, parte exteriori veto &
fuperiori morfum duplicem per cutem profunde in carnem
furae penetrantem palTa eft.
Maria Anna Borhoin zz annorum in parte pofteriori & me-
dia furae finiftrae morfum unum duplicem per cutem profunde
in carnem penetrantem — in parte exteriori brachii liniftri
proxima ad carpum tnorfum alium duplicem per cutem pro-
funde penetrantem accepit ; praeterea in carpo ipfo morfus#
qui primum excoriatio tantum videbatur, poll fuppurationem
vero profunde fub cute penetraffe inventus eft.
Singula cutem penetrantia vulnera a me dilatabantur, mor-
fus duplices penitus confeindebantur — prima vice tantum fe-
cundnm ordinationem D. Doftoris Wegbecher, poftea verb
femper fecundum raethodum D. Profefforis Mederer cura-
bantur, cui foil adferibo, quod demorfae feptimana quintaj fine
C 4 ullo
C ^4 ]
happen in the bite of a mad dog ? — I remem-
ber a cafe of a child at the bread being for a
fortnight
ullo malo fymptomate fanatas fuerint, & adhuc omnimodc
fanae Ik. alacres fint.
Quod propria manu figilloquc atteftor Wolfachi 6ta Decem-
bris 1 7 S3.
CoNRADUS ScHROFF, chirurgus juratus.
(L.S.)
Praepofitum Atteftatum propria manu huiatis chirurgi Jurat!
Conradi SchrofF fcriptum efle, appreffo minori figillo teftatur
Wolfachi 8va Decembris 1783.
Cancellaria fupremae praefcfturz Sere-
(L. S.) niflimi Principis a Furftenberg in
Valle Kinzingana.
Nos ad fupremam praefcfluram vallis Kinzinganae confiituti
fweniflirni Principis a Fiirflenberg Confiliarius intimus & Prae-
fe£lus fupremus nec non Conliliarii & officiales atteftamur
praefentibus, duas illas ancillas in ruftici Andreae Ehle Domu
in valle Rankach praefefturae Obervvolfach decima tenia Sep-
tembris 1783, a fele rabida demorfas, fdlicet Annam Ma-
riam Borhoin ex praefeftura Oberwolfach & Agatham Mlil-
lerin ex valle imperiali Hammerfpach methodo a FriburgenG
D. Doftore & Profeffore Mederer propofita feliciter fanatas,
hucufquc Temper fanas & alacres fuilTc, & adhuc optimc
valere.
Copia
Wolfachi die zp Decembris 1784.
(L. S.)
[ 25 ]
fortnight or more in a room where four or five
children had the fmall pox, and forae of them
the
Copta Attrjlati D- D. Conjtliar. aullc. Mcdle. D. Pofeb
Chirurgi Panck.
David Mayer murarius triginta triura annorum, Bubfliemii
in czef reg. A. A. dynaftia Hochenberg natus, 24ta Julii anni
currentis in via Hufinga Donefehingam ducente a cane rabido
per togam ex cannabe textam & indufium in cubitum dextrum
ita admorfus fuit, ut vulnus rotundum quadrantem pollicis
latum & profundum in mufculum extenforem brevem cubiti
prope flexuram furfum verfus penetraret.
' Francifeus Xaverius Hefler undecim annorum & trium men-
fium filius civis Donefehingenfis ab eodem cane, a quo David
Mayer vulneiatus fuit, admordebatur in pede dextro duos pol-
ices fupra condilum externum. Hoc morfu duo infligebantur
vulnera, primum aeque cotundum quadrantem pollicis latum,
medium veto profundum intrabat fupra condilum externum
inter mufculum peroneum anteriorem & pofteriorem, os ta-
men peroftio fuo adhuc teftum fuit. Sccuadum vero duos
pollices a priori diftans fuper tibiam in tibiaro antico ejufdem
latitudinis, non vero tantae profunditatis erat.
Ab hoc puero canis rabidus inflicbat in puellam gf anno-
rum, hujatis militis filiam, Francifeam Roefch, & profter-
nebat illam rctrorfum in terram. Canis banc puellam admor-
debat in brachio dextro ad articulum biaclni anterioris cum
fuperiore, duoque vulnera infligebat, unum fuper cubitum in
mufculum extenforem brevem, alterum fub cubito introrfuia
■V
in mufculum cubitaeum internum, utrumque quadrantem pol-
Heis latum & profundum. Simul in ejufdem brachii media
&
[ 26 1
the confluent fort, without catching the difeafe,
though, in general, it is fo eafily contracted.
When
& interna parte, ubi caro mufculi radisi intern! in pattern
fuam tendinofam definit, per cutcm nudam fauciabatur vul^
nere fabai italicaj n\agnitudine, & i pollicis profunditate.
Prajterea eidem puells! idem canis rabiofus morfu inferebat
vulnus in labium oris fuperius verfus finiftram lentis vulgaris
magnitudine.
Poll hate fa5la nos, ut in rei veritatem accuratifiime inqui-
riremus, & nnferis auxilium efficaciffimum afFeremus, illico
appellati fuimus.
Inveniebamus tunc has tres admorfas perfonas fine ullo ad-
verfo fymptomate. — Vulnera igitur illico dilatabantur, & poft-
Ijuam fanguis ad fufficientem quantitatem efluxilTet, ilia lixi--
vio,quod ex lapide cauftico gr.'XXX & fufficienti aquae quan-
titate libr. I. paratum fuit, fuadente D. Matthaeode Mederer,
See. Sec. eluebantur, nec non carpto eodem lixivio madefafto
deligabantur, & fecundum artis principia curabantur. Vul-
nera hoc lixivio per Menfem in fuppuratione confiervabanius,
& toto hoc curationis tempore nullum adverfum fymptema ob-
fervabamus.
Elapfo menfe vulneisa jam penitus erant fanata, & hae tres
perfonae hucufque adhuc optime valent. Quamobrem hujus
beneficii nunquam non memores Domino Inventori pratftan-
tilfimi hujus remedii ob ejus divulgationem gratias referimus
debitas, & hifee fa£la haec palam contellamur,
Atteftatum prspofitum ab huiate Serenilfimi Principis Con-
filiario aulico & medico D. Pofch & ab huiate SerenifiTimi
Piineipib Chirurgo de Panck manu propria fubferiptum &
Confueto
3
[ 27 ]
When the means of prevention have been
neglefted, or have failedj and hydrophobia has
actually
Confueto illorum figillo munitum, fimilibus vero ab his exhi*
bitis Atteftatis omnimode crcdendum efle, fub figillo majori
Cancellaris Regiminis Sereniffimi Principis a Flirftenbcrg &
ejufdem Secretarii Nomine manu propria fubfcripto hil'ce in
optima forma affirmatur.
Donefchingce 11 Decembris
Sereniflimi Principis a Fdrftenberg
(L. S.) Regimen hujas.
Frey Confil. & Secrctar.
Copia Attejlati Regiminis Serenijfwii Priticipis a Flirflenberg,
Nos ad Regimen Sereniflimi Principis a Flirflenberg confti-
tuti Prsefes, Cancellarius, Conflliarii intimi aulici attefla-
mur hifce — die 2 3tia Julii anni currentis nobis durante feflionc
a politiae miniftris annunciatum fuifle, quod canis rabidus in
oppidum irruilTet, & homines & pecora lajflflet, nec non quod
jam difpbfitio neceflaria fatla eflet partim, ut homines laefl
convenienter curarentur, partim ut canis rabidus deprehende^
retur & interficeretur, nec non ut pecora laefa majoris fecuri-
tatis caufla illico necarentur, & terra abfconderentur.
Ex continue fafta inveftigatione fcquentia inventa fuerc.'
Canis pra:di£tus erat alienus, hie loci ignotus, fufeus, viilg-
fus, venaticus, armilla coreacea aurichalco prsefixa cin6lus ;
yeniebat fuper viam publicam Huffinga ad oppidum noftrum
hora media undecima ante meridiem. Adbuc in diftantia 200
pafluum ante oppidum infperato & non irritatus irruebat in
fuper viam mox diftam ambulantem Davi.dem Mayer mura-
rium
(; z8 ]
adtually taken place, what are the moil; proper
remedies to be adopted ? The antifpafmodic
and
rium ex Bublheim atquc inferebat ipfi vulnus in cubitum dex-
trum. Ab hoc fecum portato tigni frufto repulfus canis prae-
diftns capite femper demiflb, lingua exferta, ore fpumante, Sc
cauda rctra£l:a direfte fe in oppidum noftrum conferebat,
ftatim ad primamdomum canem ad earn in platea ambulantem
©pprimebat. In oppidum ingrelTus lacerabat gallinam ipii
©bviam, & intrabac in domum apertam & ejus conclave infe-
rius, in quo bona fortuna neminem inveniebat. Ex hat fe in
partem extcriorem hujus loci recipiebat, & adgrediebatur
Francifcum Hefler, puerum undecim annorum fub foribus pa-
ternae domus nudis pedibus llantein, & in ejus pedem finiftrum
dentes adeo defigebai, ut affixus pedi a puero ultra tres paiTus
in domum retraheretur, ubi a patre & fratre majore advolanti- '
bus fuftibus dejiciebatur.
Vix vero 50 paffus abhinc invadcbat a tergo Francifcara
Roefchin, puellam novem annorum in platea exiftentem, piof-
lernebatque earn in terram, & morfu fauciabat brachium ejus
dextrum, & labium oris fuperius.
Tunc prxcife fubulcus gregeni fuam domum cogebat. Prae-
diftus canis rabidus iterate in earn penetrabat, & tres porcos
vulnerabat. Poftea ex loco fupra viam Schweningam ducen-
tem pedes efFerebat ; ante ultimam domum vero adhuc canem
Sc felem per plateam incedentem aggrediebatur & vulnerabat.
Tandem extra oppidum circiter 150 palTus procumbebat ad
\'iam publicam in folTa ficca Sc cefpite obdu£la, ubi a PrincipiS'
chirurgo D. de Panck glande in maxillam inferiorem iftus
fUit,
£
Hoc
C ^9 J
and nervous medicines, which are fo generally
had recourfe to in thefe cafes, have fo often
failed
Hoc i6tu vulneratus canis alia via fe denuo in oppidum re«
cipiebat, & ftatim primo ingreffu allata agrelTus, gallum Sc
gallinam fauciabat. — Ultro in locum irrupturus, a venatore
Carolo Goenner fecundum glandis iftum in ventrem accipie*
bar, accepto fe in (labulum ex adverfo apertum, & per hoc
in domum ipfam recipiebar, ubi rcclufus a Celf. Regimini*
feriba Scheidegg primo pon£l;ibus vulnerabatur, & tanders.
glandis i£lu trajiciebatur. Canis hie nunquam, nec verbera^
tus, nec punflus aut iflus vocem edidit.
De perfonis vero fauciatis referebat Conllliarius aulicus Sc
principis medicus ordinarius D. Pofeh, nec non principis chi-
rurgus D. de Panck, quorurn curse traditae fuerae, quod prae-
dicta; perfonse methodo D. ProfelToris Friburgenfis de Mede-
rer tam fortunato fuccelTu traftatae fuerint, ut non folum tem-
pore curse Temper alacres, fed etiam quatuor poll feptimanat
jam penitus fanacae, & hac cura ab omni periculo rabiei im-
munes redditae fuerint.
Sicut & hae perfonae poll dccurfum 5 menfium adhuc optim«
valent. '
Ad tuendam veritatem & majorem confirmationem praedic-
torum hoc Atteftatum majori nobis commilTo Regiminis In-
figni corrobari, & confueto more per Secretarium nolTrum
Pubferibi julfimus. Quod faftum eft Denefchingce die 23 De-
cembris 1784.
Sereniflimi Principis a FUrftenberg
S-) Regimen hujas.
Frey Confil. & Secretar.
Meihodus
[ 3° ]
failed of fuccefs, that I have long determined,,
in my own mind, Ihould any inftance of this
dreadful
Methodus facillima certijjlnta Homines Animalia cunBa a
Bejliis rabiofis admorfa conjernjandi, ne quoque in rabiem ^
deveniant.
§. 1. In curatione hominis a beftia rablda (cane aut felle)
dcmorfi id imprimis agendum eft, ut virus vulneri immilTum
deftruatur, priufquam abforptuin atque univerfze humorum
inaffae commixtum fuerit. Hoc virus per feptimanas, menfes
loco, cui adplicatum fuit, iners bona fortuna haeret.
§. 2. Quo fine exfciffio aut inuflio yulneris probatiflimum
eft & princeps remedium a Celfo jam recommendatum ; quo^
modo hsec illave inftitui debeat, cuilibet Chirurgum notum,
erit.
§.3. Verum, cum hsec medendi methodus, quia crudelis
adparet, firpe repudietur, impoflibilis fiepe fit, his in cafibus
fecuturad rabiei periculum perfiftit, nifi a,lia ifthaec ratione
avertatur.
§. 4. Cum experientia certo conflet, ex remediis omnibus
liactenus eo fcopo laud?tis nullum infallibile fuifle, alioruin
auxiliorum tentamen nemini abfonum videbitur, praifertim fi
eorum efficacia praevideri polfit, & obfervationibus jam com-
perta fides fit. Quale remedium efte videtur illud a ProfelTore
Friburgenfi de Mederer nuper publici juris fa£lum, lixivium
nempe matricale ita dilutum, ut non amplius adurat. Me-
thodus illud adhibendi fequens eft.
S. 5. Quodlibet vulnus ab animali rabido aut de rabie tan-
tum iufpefto admorfum omnium primo, fi anguftum & pro-
fundum fimul fuerit, lege artis dilatetur, turn lixivio fupra-
difto’
C 31 ]
dreadful diforder fall under niy care, to change
the method of treatment, and try the effedts of
tonics.
The
difto (§. 4) eluatur, (ex granis triginta lapidis cauftici Chi»
rurgorum & libra una aqus ex tempore parato, ) fi locus non
nimis fenfilis illud permittat, carptis eodem ebriis deligetur,
fi vero locus admodum fenfilis elTet, lixivio mox di6to probe
abftergatur, dein aqua communi tepida rurfus eluatur, ac de-
nique ligaminibus ficcis obligctur.
§ 6. Deterfio lixivii ope aliquoties per diem iteretur, tam
diu, quam per inflammationem licuerlt.
§. 7. Si vulnere jam inflammato vocaretur Chirurgus, ex-
fpeftanda ei 'Tuppuratio eft, atque turn methodo fupra de-
feripta (§■ 5) ulcus traftandum.
§. 8. Si ferius adliuc, vulnere nimirum pro parte, aut in-
tegrum jam fanaio accerferetur, illud lapide cauftico denuo
exulcerare, atque ulcus poll dcciduam Efcaram lixivio fccpius,
memorato eluere & deligare debet. Non perinde eft hie, la-
pis caufticus aliudve caufticum recipiatur, ille enim partes
animales & cum his virus rabiofum multb certius deftruit,
quam qu'odcumque aliud caufticum ex vitriolorum profapia.
§,9. ^uloera quaecumque ex diftis (§. 3 vel 5) methodis
traflata caiterum juxta gcnerales artis leges fanantur.
§. 10. Cum hac ratione virus rabiofum admorfo in loco de-
leatur, atque ideo nil de eo reforberi poffit, omnia remedia in-
terna, externaque ad veneni reforptionem impediendam, illu-
dve jam reforptum deftruendum haftenus laudata plane fuper-
fiua funt.
§• ri*
■ . [ 3^ ]
The plan I have propofcd to myfclf would
be, (after luch previous evacuation as might
feeni
§. 1 1 Omnes (§. 3 vel e,) di£Hs methodis tra^ati rabie
ccrripi omnino nequeunt. Quod fi vero omilbonis caufa acci»
den.t, in horum inforrunatorum hominum cura nullum phr-
lantropise officium prastermittatur. hoc eo inagis' fieri pottfi,
cum convifli mode fimus, ejufmndi inforrunatos homines non
mordere, &: falivam fine morfu non inficcre.
§. 12,. \’Vrum non quilihet admorfus, qui ex angore, ne
rabidis moriatur, moeflus eft ^ mericulofus, eadem ex caufa
varii generis fymprorhatibus, hydrophobi«e analogis urgetur,
pro rabido ftatim declaiandus eft. Inde accidit, quod tarn
diverfis faepe fibi contiariis remediis adco multi a rabie fanati
legantur. Anxiis his folatium praibeatur, & fi diifta (§, 5 —
8) mtthodo nondum traOati funt, eadem traflentur.
§. 13. Vera rabies communiter inter tres feptimanas toti-
demque menfes erumpit ; quod de multo citiore vel multo tar.
diore ejus eruptione fcrifitum habetur, id incertum eft.
§.14. A praegrefto veliementi corporis, animive motu ut
plurimum excitatur, vulnus adhuc apertum vei jam claufum
de novo dolere incipir, dolores centrum corporis gradatim pe*
tunt, plerofque alternum frigus adontur cum lafiitudine, fe-
bris fymptomatibus confuetis plus minu'fve ftipara, his fe ad-
fociat deglutiendi Impotentia (unde perpetua ilia fputatio) ac
infuperabilis demque horror non ab omni folum liquido, vc»
rum Si CO omni, quod illius ideam excitare valet.
§. 15. Utrumque hoc fymptoma Difphagia & Hydrophobia
cftentiales rabiei charaCieres conftituunt, ejus prasfentiam ilia
unice definiunt.
§. 16.
[ 33 ] ' '
leem necelTary) to diredt my patient to be kept
as much from the light as poffible ; the bark,
in fubftance, to be given in large quantities,
and Port wine plentifully ; but that every thing
liquid Ihould be given from a dark-coloured,
unglazed tea pot, that nothing might appear
to the patient; that bark clyfters, with opium,
liiould be frequently thrown up ; oil of amber
§. 16. Miferrimum hoc morhorum genus avtl medicjc indo-
Uiabileadhuc eft, & cum in mox diftis (§. 15) fympromatibus
principaliter illud confiftar, interna medicamenta incalTum
haec quaerit. Externa quaerenda^funt remedia, inunftio mer-
curialis haftenus laudata in rabie jam praefente manifefto no-
civa fuic*; balneum ex aqua marina Temper profuiflc legitur-j-;
profuifle poteft, quia ex aqua balneo adhibita reforberi quid &:
lymphaj, proprio virus rabioft vehicuTo admifceri poteft.
§. 17. Si balneum maris hoc in cafu femel jui'it, id alcalL
ex aqua marina reforpto certe debetur ; an lixivium diluium
huic fini non imprimis utile foret ? In virus fcrophulofum
potenter agit, veneno rabiofo plus quam venereum adfine, quo-
cum pofteriore Sauvageus tantam veneni rabidi analogiam re-
f eriit.
§.18. Hinc a£tu rabidi hydrophobia non obftante in bal-
neum lixiviofum provide demittendi, atque in eo tamdiu deti-
nendi effent, quam fieri poteft j in defperatis'anceps remc'
dium expertri melius ejfty quam nullum, Ccifus jam profelTus
eft.
• Moreau.
VOL.I.
D
•f- Tcipius.
rubbed
L 34 ]
Tabbed on the vertebra of the neck and back,
and veficatories, as ftimulants^ applied to the
throat; and that, as foon as poffible, the cold
bath, or, what may be more eafily ufed, the
fhower bath, lliould be had recourfe to.
I have faid norhing of the ufe of mercury,
which has been fo often recommended, and
found inefficacious in thefe melancholy cafes,
becaufe the adlion of it, if there be time for
it to enter the circulation, feems likely to coun-
teradt the bark and the other tonic remedies I
fliould wiffi fo employ.'
I have been confirmed in my opinion of the
propriety of at leaft making trial of the mode
of treatment I have ventured to fugged, by
reading fome obfervations on the caufe and cure
of the tetanus, lately publifhed by Dr; Rulh,
of Philadelphia *, in which he gives an account
of the fuccefs of the bark and wine, taken in
large quantities, in that difeafe. To thefe, in
one cafe, he added a blifter between the flioul-
ders, and, in another, the oil of amber in large
dofesy when he fufpedted the bark and wine
began to lofe their effect.
* Set the London Medical Journal, Vol. VII. page 424.'
After
[ 35 ]
After affigning his reafons for throwing afide
opium and nervous medicines, he proceeds to
bbferve, that, having had nO opportunity of
feeing the hydrophobia fince he had adopted
thefe principles, he is unable to determine how
far his reafoning with refpeift to tetanus may
be applicable to the hydrophobia | but frbm
the fpafmodic nature of the latter diforder,
from the feafon of the year in which it gene-
rally occurs, and, above all, from a cafe related
by the late Dr. Fothergill, of a young woman
having efcaped the effedts of a mad cat by
mean^ Of the wound being kept open, (and
ivhich, from its feverity. Dr. Rulh thinks was
probably connedted with fome degree of in-
flammation) he alks whether it is not ptobable
that the fame remedies, w'hich have been em-
ployed with fuccefs in the tetanus, may be ufed
with advantage in the hydrophobia?
At the cbnclufion of his paper he very pro-
perly remarks, (and the obfervation may fervc
as an excufe for the hints which I myfelf have
Ventured to throw out on the fubjedt) that in a
difeafe fo deplorable^ and hitherto fo unfuc-
tefsfully treated, even a conjedfure may lead to
ufeful experiments and inquiries.
D 2 Althougli
[ 36 ]
Although the caufe of tetanus, and of hy-*
drophobia, may have a different origin, yet the
effedt in both leems, in fome manner, to agree,
a fpafmodic affedtion of the mufcles, and par-
ticularly of thofe belonging to deglutition, being
brought on. I am willing to allow that the
nervous fyftem is likewife affedfed, as the dif-
eafe is always increafed upon even the approach
of liquids, without attempting to drink, or by
any thing of a fhining nature.
Before I conclude this letter I (ball take the
libetty of offering a few more remarks relative
to this fubjedf, which have been fuggefted by
a perufal of Dr. Percival’s hints towards invef-
tigating the nature, caufes, &c. of the rabies
canina, addreffed to Dr. Haygarth, and inferred
in the tenth volume of the London Medical
Joutnal. The learned author fays he does not
perceive any ftridt analogy between the adlioii
of the canine virus and that of lues venerea,
fmall pox, or of the viper; as thefe evidently
affedl the lymphatic fyftem, and their progreft
into the courfe of circulation may be readily
traced, which is not the cafe with the bite of a
mad dog.--^“ Are we theh,” he afks, funda-
“ mentally right in the idea, that the bite of a
“ rabid animal operates by abforption ? and
mi?:ht
[ 37 ]
“ might not its effefts be, at leaft as well, if not
better, explained, by aferibing them to local
nervous irritation, propagated at different per
“ riods of time, according to the varying cir^
cumftances of fenfibility and irritability to
the brain, and from thence to the fauces,
“ gullet, and ftomach ?” — This dodtrine is in-
genious, but not fo clear, I apprehend, as that
of abforption. It is true there is a great diffe-
rence between the virus of rabid animals and of
tKofe diforders which the Dodlor mentions, but
yet the affedion may be eafily accounted for by
abforption, if we allow that a greater length of
time is required for the adion of the one thai>
is neceffary for the other. We know that in
the fmall pox and lues venerea the infedion is
found to have taken place in a few days, and in
fome cafes in a few hours ; in the more adive
contagion of diforders, from putrid affedlon
by infertion, in a very Ihort time indeed.
About thirty years fince I accidentally wounded
my finger with the point of my knife in open-
ing a woman who died of a dropfy of the ova-
rium, where the contained fluid was very pu-
trid. In a very fliort time I felt a flight unea-
flnefs or irritation in the part, and in the courfe
of the night it might be traced to the glands
D 3 above
[ 38 ]
\ •
above the elbow, and from thpncc to the as-
ilia, where a collection of matter formed^
which I am inclined to think faved my life
and the morning following the accident a ripe
puftule wds obfervcd on the puncfturcd part.
The virus of rabid anitiijals will certainly lie
dormant for weeks, till fonie change takes place
in the habit, when it becomes aClive. — Dr.
Hamilton, in his remarks on this fubjeCt, (pages
99 and io8) fays, that the time required for
the virus to become aClivc is rather uncertain ;
but he thinks from four weeks to three months
are by mpeh the mod frequent, and that the
firft fymptom is generally a pain in the part
where the bite has been received, dretching
in the cqurfe of the lyrnphatics towards the
heart, or where they unite with the fanguife-
rous fydem. ^ '
Mr. Jeffe Foot* thinks tjia|; “ forty days is
“ about the general average from the bite to
the time of the coming on of hydrophobic
fymptoms;” though there are cafes on re-
cord where the morbid affeCtion has not fhewn
itfelf forfpme months, even to the eleventh, and^
4s
• X
* Effay on the Ejte of Mad Dog,
in the cafe related by Mr. Nourfe-f-, to the
nineteenth. Still, however, in general, the ap-
pearances take place in the bitten part firft, and
from thence are conveyed by the lymphatics,
or fome other ferits of veffels, to the circula-
tion. It is uncertain what flimulates the virus
to action, but the effedt feems to me to be the
fame as that caufed by inoculation, &c. ; a
local irritation is brought on, and thence com-
municated to the habit.
Dr. Percival, in the paper already referred
to, fays, “ the acceflion of canine madnefs is
“ uncertain as to the diilance of time from the
bite, and the fymptoms by which it firljc
manifells itfelf ; but frequently the cicatrL's
becomes hard and elevated ; pains fhoot from
“ it towards the head ; it is furrounded with
“ livid or red ftreak*s, and the wound breaks
“ out afrefh.” This is coming very near the
action of the venereal difeafe or fmall pox,
though the time is fo uncertain. It is particu-
+ Philofophical Tranfaftions, Vol. XL. page 5. See alfo
a cafe of hydrophobia related by Mr. Dundas in the London
Medical Journal, Vol. VIII. page 156, where eighteen
months intervened between the bite and the acceflion of hy-
drophobia.
D4
larly
[ 40 ]
larly happy for mankind that the virus of rabid
animals requires fo much time to vegetate, (if
I may be allowed the expreffion) as it admits of
preventives to be made ufe of, and none, as I
have already remarked, feems fo likely to fuc-
ceed as excifion.
I
Canterbury ^
January 24, 1791.
Ill, An Account of an Uncommon Inflammation of
the Epiglottis. By Air. Thomas Mainwaring,
Apothecary in London. Communicated in a.
Letter to Everard Home, Efq. F. R. S., and
hy him to Dr. Simmons.
Gentleman, about forty years of age, who
had been expofed to the influence of cold,
on the 17th of December, 1790, was attacked,
in the night, with a violent pain in his throat,
and a total inability to fwallow.
In the morning of the 18th the fymptoms
were a good deal increafed. The pain was not
in the fituation ufual in fimilar aflcdtions, but
lower down, and felt more anteriorly. When
he attempted to fwallow fluids, they paffed rea-
dily
[ 4' ]
dily to the root of the tongue, where they were
not allowed to remain for a moment, but were
immediately forced out of the mouth with con-
fiderable violence.
Uoon examining; the throat, the tonfils were
in a natural llate, as well as the palatum molle
and uvula, having no tumefaction, nor were
they even materially redder than common, fo
that in this view of the parts there was no ap-
pearance of dilcafe ; but upon pulling the
tongue forwards, and looking down into the
throat, the epiglottis was immediately brought
into view, in a very unnatural ftate, and with a
very extraordinary appearance : it was much^
fwelled, extremely red, and looked by no means
unlike the glans penis when diftended with
blood in its ereCfed flare. It flood direClly up,
fo that nothing could pafs over it, and there
was very little room laterally between it and
the fides of the pharynx. All the other parts
were apparently free from difeafe.
A blifler was applied externally to the throat;
leeches were alfo made ufe of ; but there did
not appear to be any abatement from either of
thefe modes of treatment : the complaint con-,
linued, with little or no diminution, till the'“
20th,
[ 4^ ]
20th, when the fwelling, or, more propcrl3r^
the fenfibility of the epiglottis, was fo far gone
off as to allow the patient to fwallow fmall
quantities of fluids, and by the 23d he could,
with fon^e pain and a little difficulty, take folid
food.
As it is intended by the narration of this cafe
principally to point out the uncornmon circum-
ftance of an alfedtlon of the epiglottis, and- that
entirely independent of the other parts, the
mode of ^treatment, particularly as it did not
appear very efficacious, has been, ii^ a great
meafure, pafled over.
Strand,
Fctiruary g,th, 1791.,
IV. Cajes
I
[ 43 3
iV, Cafes of the ExtraEHon of the CataraB ; with
pi'aStical Remarks^ By Mr. Richard Spariow,
me of the Surgeons to the Charitable Infirmary ^
Dublin ; and Member of the Royal College of
Surgeons in Ireland. Commiunicated in a Letter
■ to William Lifter, M. D. Phyfician to Saint
Thomas’s Hofpital in London^ and by him to
' ' f ■
Dr, Simmons.
] t t
CASE I.
}N the month of October, 1788, I was con-
fulted by the Rev. Mr. Johnfon, Curate of
Longford, for a complaint in his eyes, which
he informed me had, for upwards of three
years, impaired his fight fo much as to difqua-
iify him for performing divine fervice.
The account he gave me of his difeafe was,
that, in the fummer of 1785, after working
ip his garden till he was rather warm, he took
off his wig, and laid a w’et napkin on his head,
(which it feems was a frequent cuftom of his);
that fome Ihort time after he was attacked with
fevere pain in his head, which in four days was
fucceeded by fo great a dimnefs of his fight,
that he could not diftinguilh a letter in a book.
Having
[ 44 ]
Having applied to fome country praditioners,
whofe prefcriptions afforded him no relief, he
came to Dublin, and there, at different times,
put himfelf under the care of a phyfician and
an oculift, both of whom miftaking his cafe for
an affedion of the optic nerve tending to gutta
ferena, put him under various courfes of medi-
cine, ordered him fometimes warm, fometimes
cold bathing, large and frequent topical bleed-
ings, blifters, fetons, &c., which had no other
effedthan that of impairing his general health.
It was not for a year and a half after the firft
attack that the real nature of his complaint was
difcovered by two phyficians of eminence in this
city : they told him he had catarads, and judi-
cioufly advifed him to lay afide all farther ufe of
medicine ; but, from his advanced age, were,
I believe, little inclined to recommend a furgi-
cal operation. Tired, at length, with his dif-
treffed fituation, he determined on feeking re-
lief at the only fource from which it could pof-
fibiy be obtained — the hand of the furgeon,
and with this intention he called upon me.
I examined his eyes, and perceived a catarad
in each ; that in the right eye perfedly opaque,
the left not quite fo, but permitting very little
vfeful
I
[ 4i ]
ufeful vifion. There was a remarkable relaxa-*
tion of the tunica conjundliva in both eyes, fold-
ing up near one half of the cornea, and look-
ing like a tear in each eye. In other refpeCts
his eyes had that appearance which experience
teaches us is favourable to the fuccefs of an
operation, viz. the ball of the eye of the natu-
ral fhape and fulnefs ; the cornea tranfparent,
and free from all opacity ; the pupil of the na-
tural fize and lhape, dilating and contradtlng
freely ; but, above all, the power of diftin-
guilhing any opaque body placed betw'een the
eye and the light, the only certain tell of the
found ftate of the optic nerve.
His general health was now redored, nor w'as
he fubjedt to pain in any part of his head. M}/
chief objedtion, therefore, was 'his advanced
age, he being turned of fixty-hve years. At
my’ requeft a confultation was held, in which,
-every objedtion to operation was laid befoie
him; but fuch was his impatience to obtain a
chance of relloration of fight, that he paid lit-
tle attention to our objedlions, and declared his
fixed determination to fubmit to an operation as
foon as it could with propriety be attempted.
He then went to the country, and returning in
November, called again on me. The only pre-
paration
[ 46 ]
paration I thought neceflary was a gradual di-
minution of the u(e of animal food for a fort^^
night; and for about a week previoufly to the
operation he was ordered to bathe his feet in
\varm water every night at bed lime. It was
his wifh to have Only the right eye operated on^
keeping the other in referve in cafe of failure
of the firfb.
As the extraction of the eataraft is an opera-
tion confejfTedly one of the niceft in its execu-
tion, and the mofl important in its effedts, that
the chirurgical art can boaft of, I flatter myfelf
that a detail of the different fleps of it will not
be thought tedious in a cafe like the prefent,'
which has been attended with the mofl com-
plete fuccefs.
Method of Operating^
For the operation a chamber was chdfen into
which only a moderate degree of light was ad-
mitted ; as a bright light irritates the eye,’
Itiakes it unfleady, and forces the pupil to con-^
tradt too much.
On the..20th of November, 1788, I pro-
ceeded to operate in prefence of Dr. Clarke and
fome other medical gentlemen of this city.
Having placed the patient on a low chair, with
his
C 47 ]
his right eye obliquely to the light, and being
feared oppolite to him, the upper eyelid
raifed by my affiftant and friend^ Mr. Richards,
and wHilft I depreffed the lower one with my
right hand, I with my left paffed a knife, ha-
ving a Idng and narrow pdint, through that
part of the cornea next the external angle of
the eye, within half a line of its junAion wkSi
the fclerotica, and a little higher than the center
of the pupil, and pufhing it forwards to th^
bppohte fide, made nearly a horizontal fedfionof
full one half of the cornea. The aqueous hu-
mour immediately flowing out, the lids tverc
clofed, and the eye fuffered to reft for a minute
or two : the patient was then deflrcd to open
the eye, when, having introduced the inftru-
ment recommended by De Wenzel to divide
the capfule, the opaque cry flal line was puflied.
out of the eye by the contradlion of its mufcles^
without the neceflity of any external preflurr
whatever on the globe. After gentle friciioi^
on the cornea to collect any fragments of the
cataradf in the pupil j nothing appearing, and
the pupil feerning perfectly clear and round,
the eye was clofed.
Having been in the habit of applying fomc
fedative application to the eye after this opera*
tion.
tion, which, frorn the neceffity of frequent re-
newal, I had foupd. ^veyy inconvenient to the
patient, in this cafe. I njpde pfe of nothing more
than a bit of fine foft, lint,, fecured with ^ light
comprels and roller, and the patient was laid in
bed on his back, with his head inclined to the
left fide.' During the fliort time the eye was
luffert'd to remain open, after the operation,
the patient could difiinguifh the panes of glafs
in the oppofite window.
Upon examination of the cryftalline, it was
found of the natural fize ; its center of a very
firm confiftence, and of a dark topaz colour,
while the circumference, which was of a whi-
tlfli colour, w’as foftened to the confidence of
jelly.
On the day of the operation, and the two
fucceeding ones, he was quite free from pain or
uneafinefs in the eye.
On the fourth day he could didingulfh,
through the bandage, v\hen the window fliut-
ters of the chamber were opened or clofed.
On the fifth day, the eye became more fenfi-
ble, and watered a good deal; the lids duck toge-
ther, and gave fome uneafinefs ; this probably
arofe from a fevere change in the weather. He
was advifed to. apply his faliva on the end of his
[ +9 ]
finger to the edges of the eyelids when they
adhered ; and this fimple application he always
found removed the adhefion, and gave him
eafe.
On the ninth day^ the irritation having fubfi-
ded, 1 removed the bandage, and opened the eye.
Some inflammation appeared on the lower part
of the conjundtiva ; the w^ound of the cornea
was perfedtly united; the eye naturally full;
the pupil of the natural fhape, fize, and clear-
nefs : he could diftinguifli the different objects
round the chamber, and could even fee the
hands on my Watch. The eye was clofed, and
covered as before. He was allowed a more
generous diet.
On the eleventh day, he could tell the .hour
by my watch.
On the feventeenth day I removed his ban-
dage, and pinned a bit of green filk to his night-
cap. The dilatation and contradlion of the pupil
were now nearly natural. He was ordered to
bathe the eye with cold water.
On the twentyrfourth day, with the afliftance
of a proper glafs, he; could read a newfpaper,
and in a week more returned to the country, his
eye and vifion being then in the following
ftate :
VoL. T. ■ E ' The
[ 50 ]
The eye of the natural fize and fhape ; the
cicatrix of the cornea fcarcely perceptible, and
fo clofe to the fclerotica as to give no impedi-
ment whatever to vifion ; the pupil a little
fmaller than natural, but ifs fliape, dilatation,
and contraftion perfeft. With the affiftance of
a convex glafs-he could fee to read the fmalleft
print as well as he ever did in his life. The tu-
nica conjunctiva, which had been fo much re-
laxed previoudy to the operation, had now re-
covered its tone, probably from the degree of
inflammation neceflfarily attending the opera-
tion. . '
In the courfe of two years, which have now
clapfed linee the operation, I have had many
letters from this gentleman, and have often feen
him in town. His fight is as perfecft, when af-
fifted by a proper glafs, as it was af the age of
twenty ; and fince a month after the operation
he has conftantly gone through the whole of
his'duty as a curate with as much eafe to him-
felf as if his fight had never been affedted.
I
CASE IL
In the month of September, 1789, I w^as
conftflted by Mr. Pollen, of Carlow, for a com-
plaint in his eyes, which deprived him of all
-) . ufeful
[ ]
ufeful fight. Upon examination I found he
had catara£ls, which had been preceded by the
ordinary fymptoins, gradually increafing from
the firft attack, two years before, to that time,
when he was fo blind as to be able to diftinguifli
litrie more than light from darknefs. The ap-
pearance of his eyes and the colour of the ca-
taradls were favourable for operation ; but he
was turned of fixty years of age, was very
rheumaticj and, from a habit of drinking freely
after dinner fince his fight became impaired, he
had got a fulnefs and rednefs in his face which
lliovved a confiderable determination to the head*
Thefe circumftances, however, were by no
means fufficient to forbid the operation where
the appearance of the eyes was fo favourable ;
I therefore gave it as my opinion that his chance
of reftoration to fight was confiderable. He
immediately determined on the operation.
To obviate any inflammatory tendency he
was put on a Arid; antiphlogiflic regimen for
about ten days. I then extradted the opaque
lens from the left eye by making an horizontal
fediion of the inferior half of the cornea,
through which the catarad inflantly ruflied,
accompanied, as nearly as I could guefs, by
about half a tea-fpoonful of the vitreous hu-
E 2
mour.
L 52 ]
tnour. This accident was, I believe, occa^
fioiied by a violent involuntary motion of the
I
mufcles of the eye, for my affiftant, Mr. Ri-
chards, made ho preflure whatever on the
globe : the eye Was clofed, and fufFered to reft,
to preveht any farther flow of the vitreous hu-
mour, which, notwithftanding this precaution,
took place in fome degree. On opening the
lids, the pupil appeared much dilated, but pef-
fedlly clear. 1 then clofed the eye, and cover-
ing it with a bit of dry lint, a thin comprefs^
and roller, laid the patient in bed, with his head
inclined to the right fide.
The cataraft was the largefl; I had feen ; it
was of a dark brown colour, the edges, as
ufual, being lighter in chlour, and fofter in
confiftence.
' Imrriediately after the operation, while I was
taking fome blood from him, he alTured me
that the wound of his arm gave him more
pain than that of his eye.
On the day of the operation he had a fenfa-
tion in the: eye as if it wanted to open, a kind
of vibratory feel, and, as he exprefled it, fre-
quent bright flaflies of light feemed to come
from his eye, fo that he imagined candles were '
lighted in his chamber : he had alfo a flow of
tears,
[ 53 ]
tears, but unattended with heat or pain. Not?
withftanding thefe fenfations, he flept perfectly
well, and next day found his eye quite eafy.
The fenfation of flafhes of light returned at in-
tervals. ,
On the third day he complained of no uneafi-
nefs, but ftill perceived the flafhes of light. I
removed the, bandage to try if any thing was
amifs, The eye, through the lids, appeared
nearly as full as the other, and without operpng
it he could readily diftinguifh the different de^
grees of light adrnitted into his chamber for
the purpofe.
On the fourth and fifth days he was ordered
to apply his faliva to the eyelids when they ad-
hered or were uneafy, which always gave him
relief.
On the fixth day he was permitted to get
out of bed.
On the eighth day I opened the eye. The
wound of the cornea was perfedfly united ; the
eye feemed naturally full; the pupil clear, fome-
what dilated, and of an oval form obliquely
from fide to fide, the diredlion, I fuppofe, in
which the cryflalline had paffed through it;
with confiderable turgefcence of the veffels of
the tunica conjunftiva. He knew his wife and
E 3 friends.
r 54 ]
friends, and could tell the colour of different
objedts. The eye was clofed, and covered as
before. Encouraged by thefe favourable cir-
cumftances, he, without my knowledge, in-
dulged himfelf freely in the ufe of animal food
and port wine, which, in a habit like his, kept
up a degree of inflammation in the eye for
fome time, that made the application of a blif-
ter neceffary. This foon removed all uneafi-
ncfs, and his light gradually became flronger.
On the twenty-fifth day from the operation,
having got a glafs which enabled him to read
moderate-fized print, he returned to the coun-
try. I have had different letters from him
fince, and lafl: fummer I had an opportunity of
examining his eye, as he came to town for
fome days. The pupil was a good deal di-
lated, flill of rather an oval form, with very
little power of contradtion or dilatation, and
that only at its fuperior part ; but, notwith-
ftanding this circumftance, his fight was fo
perfedf, when affifled by a proper glafs, as to
'enable him to read, write, and do all his ufual
tiufinefs.
CASE
C 55 ]
CASE III.
In the month of Oftober, 1789, James
Kell}'^, a poor man, by trade a hatter, requefted
my affiftance for a con;iplaint in his eyes, which
rendered him incapable of earning his bread,
He attributed his blindefs to the influenza, ha-
ving been feverely attacked with that epidemic
in the fummer of 1788; irpmediately after
which he found his fight gradually diminifliing
till about a month before he applied to me,
when he became unable to diftinguifh objedls.
The fymptoms were the ordinary ones of cata-
radt, and on examination I perceived one in
each eye ^ the left completely opaque, and of
a white colour, the other not quite fo, he being
able to fee bright colours with it.
From the whitenefs of the left cataradl I ap-
prehended it was of a milky nature, being, I
fuppofed, diflblved in the capfule ; and from
fome irregularity in the colour, at different
points of it, I judged the capfule to be opaque.
From this latter circumftance, notwithftanding
the favourable appearance of the eye in other
refpedts, I had many doubts of the fuccefs of
an operation ; but he entreated me to give him
E 4 ^ even
[ s6 3
even the chance that remained, as he could
not be worfe than in his prefent fituation.
After the ufual preparation, I proceeded to
extrad; the left catarad, and having pafled the
knife through one fide of the cornea, and ap-
proached the other, the eye turned towards the
internal angle. This obliged me to pierce the
o})pofite fide as quickly as poffible, which im-
mediately gave me fuch command, that I turned
the eye to the pofition I wiflied, and finilhed the
fedion of the cornea. The aqueous humour
flowed out, and from the extreme irritability of
the eye the pupil inftantly contraded to the fixe
of a large pin’s head, enclofingthe catarad. I
turned his back to the light, and, clofing the
eyelids, fuffered him to reft for fome minutes,
but the pupil was fo clearly contraded, that I
had much difficulty in introducing the inftru-
ment recommended by De Wenzel to divide
the capfule of the cryftalline. After waiting,
however, fome minutes longer, the irritation
fubfided in fome meafure, and I effeded it ;
the pupil became a little more dilated, and, by
cautious prelTure, I extraded a large portion of
the cryflalline in a broken and partly diffolved
ftatc ; the remainder of it came away partly by
preflurc
[ 57 ]
preffure and partly by the affiftance of a fmall
hook.
I now was convinced of what I had before a
fufpicion, that the capfule was partly opaque ;
but it feemed confined to a fmall portion of it,
at the external part, which left full four-fifths
of the pupil perfectly clear. From this cir-
'cumftance, and the unavoidable lofs of fome
of the vitreous humour during the operation,
I thought it moft prudent not to attempt to ex-
tradl the opaque capfule from an eye fo ex-
tremely irritable; I therefore clofed it, and ha-
ving bled the patient freely from the arm,
laid him in bed in the proper pofition, viz. on
the oppofite fide to the eye operated on. This
is a very necefiary precaution, as it tends to
prevent ftaphyloma, or any dangerous flow of
the vitreous humour.
From the great irritability of this patient’s
eye, I am perfuaded, that, had I made ufe of a
fpeculum to fix it during the operation, the
moft probable confequence would have been a
fatal difeharge of the vitreous humour.
On the firrt and fecond days after the opera-
tion he had a fenfation of flaflies of light before
the eye, but without heat or pain. He took an
opiate at night.
On
[ 58 ]
On the third day, the roller becoming loofe, I
removed it ; there appeared no inflammation of
the eyelids : he could diflinguilh through them
when I placed my hand between the eye and a
candle. The eye was covered as before. From
this to the eighth day he continued free from
pain, and was allowed a more generous diet.
On the eighth day, having bathed the eye-
lids with warm water, I opened them. The
eye appeared fomewhat inflamed, but naturally
full. The pupil was clear, except a very fmall
portion of it next the external angle of the eye,
which was obftrudted by the opacity of the cap-
fule at that parr. The Ihape of the pupil was
fomewhat irregular, and larger than natural.
He knew his wife’s face, and thofe of feme
friends who were in the chamber. The eye
was covered as before.
On the fourteenth day I obferved a fubflance
like mucus on the inferior part of the cornea
near the cicatrix of the wound. I had feen this
on the eighth dav, but did not then take much
notice of it. This day I examined it more at-
tentively, and found it to be a fubflance like a
very fine membrane in afloughy ftate, taking its
rife from the cicatrix of the cornea. It was re-
rnov’ed with a pair of fmall forceps, and its tena-
city
[ 59 ]
city was found to be confiderable : his fight was
immediately improved by this little operation.
The eye having watered freely for fome days
beforcj he had been ordered a faturnine colly-
rium, but, as ufual in thefe cafes, with no effedt.
As fome degree of inflammation was ^ill pre-
fent, which might be increafcd by the applica-
tion of the inftrument to remove this opaque
fubftance, it was thought advifable to order a
bltfter to the back of the patient’s neck, which
in fome days had the defired effed;.
On the twenty third day from the operation
he could fee objeds very diftindly ; knew per-
fedly all his friends with the naked eye ; and as
he walked through the ftreets he could readily
read the names. See. of the fliopkecpcrs written
over their doors.
I intended purchafiiig a proper glafs for this
man ; but he fpon relapfed into a habit of
drinking fpirituous liquors, to which he had
formerly been much addided, and knowing
that I highly difapproved of this condud, he
was, I believe, afliamed to let me fee him.
I have at different times fince, and fo lately
as a week ago, endeavoured to find him out,
but without fuccefs : I have learned, however,
from his friends that his fight is fo good as to
enal^le
[ 6o ]
enable him to work at his trade without the af-
fiftance of a glafs, but that he has led, and ftill
leads, a very profligate life.
- It may be alked what was the nature of the
fubftance enclofed in the cicatrix of the cornea?
•As it had neither the appearance, nor the con-
fiftence of a fragment of the cryftalline lens,
but rather that of a membrane, as already de-
fcribed, I fufpedt it to have been a portion of
the membrane of the aqueous humour, fre-
quently defcribed by De Wenzel as forming one
fpecies of ftapbyloma after this operation ; in
•which cafe it appears like a drop of limpid
water refling on the cicatrix of the cornea ;
but that it has Tome kind of covering v/e know
from its not being removed by the motion of
the eyelids. A cafe of this kind 1 have feen ;
the little fac was removed by a fnip of a pair of
fcilTars, but returned again next day. Its ra-
dical cure was effefted by the natural motion of
the eyelids.
In the prefent cafe, this membrane, inflead
of forming a little hernia containing aqueous
humour, protruded between the edges of the
divided cornea, and thefe fell into a floughy
ftate, giving the appearance already defcribed. -
CASE
[ ]
CASE IV.
In the month of July, 1790, John Hannatij
a poor fchoolmafter from Kilkenny, aged forty-
three years, applied to me for relief for blind-
nefs occafioned by cataradls. Fifteen years be-
fore, an oculift, in this city, attempted to de-
prefs that of the left eye, in which he failed,
and the man remained blind of it.
The catarad of the right eye had been gra-
dually affcfted in the ufual rhanner for near fix
years, and at the time he came under my care
all ufeful fight had been lofl: for two years. It
was of an iron colour, and from a certain ftreak-
ed appearance on its furface I judged the cap-
fule of the lens to be opaque. In other refpedts
the eye looked well ; the dilatation and contrac-
tion of the pupil were perfeft, and I had reafon
to believe the optic nerve to be in a found date ;
I, however, acquainted him with my doubts of
fuccefs from the opacity of the capfule ; but
his fituation was fo miferably dependent, that
h6 begged I would give him whatever chance
remained.
When I undertook this operation I intended
to have removed, with a pair of fine forceps,
the
[ 62 J
the anterior part of the capfule, fliould it be
found in a ftate of opacity, a thing very prac-
ticable in many cafes ; but from the circum-
itance I am about to mention I was obliged to
alter my intentions. My affiftant, Mr. Richards^
lecured the upper eyelid without making any
preffure on the globe : Lintroduced the knife
into the cornea at the ufual place ; but fcarce
had I done fo when the eye (which was ex-
tremely irritable) fuddenly- turned in towards
the nole : this obliged me to ufe all poffible
difpatch in piercing the cornea at the oppofite
fide, and finifliing the incifion, to avoid being
engaged in the iris, and which with confidera-
ble difficulty I effedted ; for fo rapid and vio-
lent were the motions of the eye, that the blade
of the knife^ while paffing through the cornea,
w'as fo much bent, that on refuming its ffiape it
made a noife that could be heard at the farthefi
part of the chamber. The confequence of all
this was, too finall an incifion of the cornea,
the great, and, I believe, moft frequent caufe of
the failure of this operation in the hands of
pradlltioners in general.
The pupil contradted over the cataradf, and
I had to wait full a quarter of an hour before I
could introduce an inftruinent to divide the
capfule.
[ 63 ]
capfule, which appeared very opaque, and gave
fome refinance to the needle; at length, how-
ever, it was effected, and by the cautious pref-
fure of my affiftant I was enabled to feize the
cataraft with a fmali hook, and extra(ft it fafely
and entirely. It was large, of a brown colour,
and hard confidence. The capfule now ap-
peared obftrudiing more than half the pupil ;
but the quantity of vitreous humour loft during
the operation, the extreme irritability of the
eye, and, above all, the fmallnefs of the wound
of the cornea, made itftmpoflible for me to at-
tempt the extraction of this opaque fubftance
without incurring the greateft hazard of de-
ftroying the e}^e. Having, therefore, puflied
the capfule as much to one fide the pupil as I
could with a fmali blunt inftrument, I clofed
the eye, and trufted to nature for the reft,
I took fome blood from his arm, and laid
him in bed in the ufual pofiiion. At night he
had an opiate. Next day he was free from- all
pain or uneafinefs, feeling nothing more than a
degree of warmth in the eye.
On the night of the fecond day his bandage
loofened and came off, and fo little forenefs had
he in the eye, that, forgetting his fituation, he
rubbed and opened it. When I faw him next
day
[ 64 ]
f^ay I found the eyelids without inflammation^
and curiofity induced me to open them and
examine the eye at this early period. The
wound of the cornea feemed to be perfedtly
united, and the eye naturally full ; but there
appeared to be a good deal of inflammation
and intolerance of light ; the pupil was almofl;
entirely obftrudS^d by the opaque capfule, and
the interftices had a muddy appearance. As
the eye watered much from the irritation of
the light, I clofed it, with little hope indeed
of his getting fight.
From this early opening of the eye it was for
fome fucceeding days in a ftate of confiderable
irritability, giving fome uneafinefs, and watering
freely, but unattended with pain. I laid a blif-
ter on the back of his neck, and kept up a dif-
charge for fome time, which had the defired
cffed;.
I did not open the eye again till the fourteenth
day. There was ftill fome degree of inflamma-
tion and turgefcence of the veflels of the tu-
nica conjundfiva ; the pupil had fome clear
points towards the inferior and internal parts ;
he could diftinguiih my features tolerably well,,
the colours of a painted chair, &c. The wound
of the cornea was flightly opaque. He had
been
[ 6$ ]
been out of bed every day for a week paft. His
room was darkened.
On the 24th day, his fight was improving
fall:. Though more than 4-5ths of the pupil
were obftrudledby thecapfule, he could, through
the clear points, diftinguifh colours accurately J
knew his daughter’s face, and. with the aflif-
tance of a glafs of confiderable magnifying
powers, he could read very large print. He
had that imperfedtion of vifion, however, which
is common after this operation for a fliort time,
viz. of feeing a cancfle and other objedfs double*
For fome days paft he had walked out and
waflaed the eye with cold water.
At the end of five weeks two of the clear
points of the pupil were obftrudted by the cap-^
fule becoming opaque. The one next the in-
ternal angle of the eye flill remained clear, and
though it did not exceed in fize the head of a
large pin, yet through it, with the aflaftance of
a proper glafs, he could fee to read print of the
ordinary fize, to know his friends perfedlly,
and to do all the common offices of life with
eafe. He returned in this fiate^ to Kilkenny*
I have twice feen him in town fince, and
examined the ftate of his eye. The clear point
had increafed fomewhat in fize, and his vifion
was confiderably improved.
VoL. L F From
I
[ 66 ]
From the event of this cafe we learn
very fmall a portion of the pupil will admit a
fufficient number of the rays of light to afford
tolerable vifion j but I am aware that many
may be of opinion that the involuntary motions
of the eye during the operation, and the confe-
quent difficulties, might have been prevented
by the ufe of a proper fpeculum oculi. To this
I can only fay, that from my own experience,
as well as from that of others, I am inclined to
believe thafit would not have had that effedt;
and that when the eye is, either naturally, or
from any other caufes, in a very irritable Hate,
the ufe of an inlfrument of that nature only
ferves to increafe the danger of an operation, as
it evidently tends, by its preffure on the vitre-
ous humour, to render the iris more convex,
and to throw it more in the way of the knifes
But at the fame time that it increafes the hazard
in this particular, it deprives the operator of the
only means of obviating it ; for it is a curious
fadt mentioned by De Wenzelj and of the truth
of which I am convinced by my own experience,
and that of others, that when the knife becomes
engaged in the iris, the only fafe method of ex-
tricating it is by making gentle fridtlon on the
cornea with a finger of the hand employed to
deprefs the lower eyelid, by which means the
iri-9
C 6? ]
I
iris is found to retradt fufficiently to give the
operator an opportunity of finifhing the fec-
tion of the cornea. Now if the hand be eril-
ployed in holding a fpeculuitii it is evident that'
this very important aid cannot be obtained.
Butlhould even this accident be avoided by the
dexterity of the operator, ftill there will be,
from the fame preffure, great hazard of a fud-
den and deftrudliive flow of the vitreous hu-
mour as foon as the incifion of the cornea is
finillied ; at leaft It will require more dexte-
rity to avoid it than falls to the fliare of opera-
tors in general. I am, therefore, of opinion,
that, in difagreeable cafes of this nature, the fuc-
cefsof the operation mufl; always depend chiefly
upon the dexterity of the operator, and that
the ufe of a fpeculum will only ferve to increafe
his embarraflfment and the patient’s danger.
Pra5Hcal Remarks.
Having now finifhed a faithful, though per-
haps tedious, detail of thefe cafes, I fliall, from
them, and fome others which have fallen under
my obfervation, beg leave to fuggeft the fol-
lowing practical remarks :
Firft, That the fafeft and befl method of fe-
curing the eye, during the operation, is to have
the upper eyelid drawn up by an afilftant, while
the operator himfelf deprefl'es the lower one,
F 2 without
C 68 ]
without making any preflTure whatever on th^
globe of the eye. In ordinary cafes I have fhewn
that a fpeculum oculi is at beft unneceflary ; and
in the cafe of an irritable eye I have fliewn that
its ufe would be attended with embarraflment to
the operator and hazard to the patient.
Secondly, That a knife, with the" point long
and narrow, traverfes the anterior chamber of
the eye with more eafe than that in common
ufe, (by which the eye becomes fixed) and from
the increafing breadth of the blade towards the
handle the operator is enabled, by limply pufli-
ing it forwards, to make a fedtion of full one
half of the cornea, a leading ftep in the opera-
tion, and which always renders the fubfequent
one of extradiion more fafe and eafy.
Thirdly, Thar, after fuch a fediion of the
cornea as is above deferibed, the various fedative
and other applications commonly made ufe of to
the eye, with a view to prevent Inflammation,
are altogether unneceffary ; and that the adhe-
fion of the eyelids, which often takes place, is
molt eafily and effedtually removed by the fa-
liva of the patient applied on the end of his fim-
ger, which can be done without removing the
bandage, or- danger of hurting the eye, as the
patient’s feelings will teach him to avoid giving
pain by any degree of preflurc.
Fourthly,
t 69 ]
Fourthl)^, That the lofs of any of the vitre-
ous humour, during the operation, lliould, if
poffible, be avoided, as its prefervation haftens
the recovery of vifion, (fee Cafe I.) ; but that
even a large portion of it may elcape without
material injury. It appears to me that the re-
covery of vilion is flow in proportion to the
quantity of this humour that efcapes, but that
the lofs of it has generally the effedt of pre-
venting after pain and inflammation.
Fifthly, That the opacity of the capfule of
the cryftalline humour is alv/ays to be feared,
as leflening the chance of fuccefs from opera-
tion ; yet that even under circumftances forbid-
ding its removal the patient may be reftored to
fight, as it appears that a very fmall portion of
the pupil remaining clear is fuflicient tor this
purpofe — (fee Cafe IV.)
Sixthly, That a fenfation of flafhes of light
coming from the eye the firfl; days after the ope-
ration, when unattended with pain, is not an un-
favourable fymptom — (fee Cafes II. and III.)
Seventhly, That a preternatural dilatation,
irregularity, and lofs of power of motion in the
pupil, after this operation, are no material im-
pediments to vifion — (fee Cafes II. and III.)
Eighthly, That though a temperate feafon of
the year is moft deflrable for a patient under-
F 3 going
[ 70 3
going this operation, yet that with proper pre-
cautions, neither the rigours of winter, nor the
heats of fummer, prevent its fuccefs.
And ninthly, That when the conftitution In
general, and all parts of the eye, except the
cryftalline and its capfule, arc in a found ftate,
even an advanced age is no bar to the fuccefs
of this operation ; but that a very vitiated ha-
bit, even in youth, will prevent fuccefs I know
from difagreeable experience : having a few
' years ago extrafted cataradfs from a young wo-
man, who was extremely emaciated from ame-
norrhoea and other caufes, the confequence was^
that the wounds of the cornea did not unite for
many weeks, and not till after one eye had fup-
purated, though unattended with pain. I was in-
duced to operate in this cafe from the very favou-
rable appearance of the eyes, and as no accident
occurred during the operation, and it was not
fucceeded by pain^ or other circumftanccs mark*
ing local injury, I think I may fairly attribute
its failure to the badnefs of the patient’s habiq
It may not be amifs here to mention the pre-
fent date of Ab'gail Cremor’s eyes, (the woman
whofe cafe is given in Vol. IX. Part II. of the
London Medical JoLiynal;, and who had a cata-,
raft extrafted fronf one eye, and depreflcd in
3 ' '
[ 71 ]
the other, In the month of Odlober, 1787.) 1
have feen her very lately, and her eyes and vi-
fion are now in the following ftate ; — The pupil
of the couched eye has its fliape, dilatation, and
contradlion, perfedl : it is, however, fomewhat
fmaller, than natural ; and though there is no ap-
parent impediment to vifion, yet ihe does not
fee objects fo diftindlly with that eye as with
the other, in which the pupil is larger than na-
tural, in fome degree irregular, and without
any power of motion, but vifion is as perfedt
as it is ever found to be after the removal of
the cryftalline from its natural fituatipn.
I had long obferved a circumftance in this
woman^s cafe which puzzled me exceedingly;
it was, that ihe could not diftinguifh a letter in
a book, even when affifted by the bell glaffes,
though her fight was fuch as to enable her,
with the naked eye, to few and make all her
own cloaths, to know the hour by a clock, and,
in fhort, to do moft of the offices of life with
perfedteafe, I had often exprelTed my furprife
at this peculiarity; but it was not till laft fum-
mer that, with much feeming rcludtance and
mortification, ffie confelfed that fire had never
learned to read, and that flie was unacquainted
even with the letters of the alphabet : thus had
1 an explanation of a circumftance which, from
F 4 the
[ 7^ ]'
the appearance of this woman’s e}^es, and Iici*
power of vifion in other refpedts, had led me to
form various conjectures relative to her peculia-
rity. of vifion ; but which, from my ignorance of
the real caufe, appeared altogether inexplicable.
Having in the hiftory of the preceding cafes
fometimes mentioned the name of De Wenzel, I
think it neceffary to add, that his method of ope-
radno;, cosether with a number of curious and
inrercfting particulars relative to the extraction
of the cataraCt, are to be found in a.moft excel-
lent practical treatife, entitled 'Traite de la Qa-
tar atJe, avec des Obfervations, &c., publifhed by
his fon at Paris in 1786, in one volume, oCtavo.
His inftruments are delineated in a plate at the
beginning of the book. A good deal of expe-
rience in this branch of furgery had confirmed
me in my favourable opinion of that work, and
it appeared to me to contain information of
fuch public utility, that I had determined on
an Enslilh tranfiation of it, with cafes and rc-
marks, illullrating the juftnefs of the obferva-
tions in general ; but at the fame time pointing
out fome particulars in which experience had
taught me that implicit faith was not to be
yielded even to fuch authority. On making
the necelTary inquiries previous to this underta-
king, 1 found I had been anticipated in the
ttanflation by Mr. Ware, of London, who had
already
[ 73 ]
already made confiderable progrefs in it; and
from the profeflional character ot this gentleman
it is not to be doubted that every juftice will be
done both to the Author and the Public.
Dublin,
March Sth, 1791.
V. Account of an Extra-uterine Conception. Com-
municated in a Letter to Dr. Simmons hy Mr.
William Baynham, Member of the Corpora-
tion of Surgeons of London, and Surgeon in
EJfex County in Virginia.
BOUT ten years ago Mrs. Cock, the wife
of a refpedtable planter in this Bate, be-
came pregnant a third time, and at the proper
time was feized with labour pains, which conti-
nued for a day or two, and then left her. She
remained in a weak and declining Bate for fome
months after; during which time fhe was vifited
and attended by feveral medical pradfltioners,
two of whom declared her difeafe to be a dropfy
of the uterus. At length, however, flie regained
her health, flefli, and ftrength, and fulfered only
a trilling inconvenience from her increafed fize,
which was equal, when 1 firll faw her, to that of
a woman in the feventh month of pregnancy. In
this ftate I found her foon after my return to this
my native country ; and at my firll interview
with her I told her I was firmly perfuaded that
flte
L 74 ]
fhe had actually been with child, but that the
child had never been in the womb ; in which
opinion I was more and more confirmed in every
fubfequent converfation with her.
Some months ago, after a fevere attack of
the influenza, which has for the lafi two years
raged here with very great, and, during the
lafi; fall, with fatal violence, the abdominal tUT
mour began to be painful, and was accompa-
nied with a flight rednefs and inflammation of
the fkin, near to, and a little on the left of the
navel. After attending her for fome confider-
able time, during vvhich 1 made one attempt,
but failed, to relieve her by extracting the
child, I was induced, by circumftances, to un-
dertake the operation a fecond time ; which I
accordingly performed on Saturday laft.
I made an incifion in the belly, beginning
oppofite to, and a little on the left of the na-
vel, and carrying it a finger’s breadth or two
obliquely downwards, and to the right towards
the linea alba, I continued it afterwards in a
feraight direction, clofe to the left of the linea
alba, about half way to the os pubis. Through
this I, with fome difiicnlry, oaraCted the child
by pieces ; from the appearances of which I
judge it to have been equal in fize (when whole)
to a full-grown foetus of nine months.
Some degree of putrefaClion had taken place
in
[ 75 ]
in the child, fo as to denude the greater part of
the bones of the periolleum and other cover-
ings ; but fome of the foft parts ftill retained
their colour and texture, particularly the heart
and lungs, which were perfectly frefh and found,
and are in my pofleffion, preferved in ipirits.
I could find no remains of a navel firing or
placenta, although both muft have exifted ;
but they had probably rotted, and come away
in the difeharge of matter which had come on,
and continued a few weeks previoufly to the ope-
ration, through a fmall opening that remained
after my firfl attempt. Although the foetus
could not have been fupported without the in-
tervention of a navel firing and a vafcular cho-
rion, yet it will perhaps admit of a doubt whcr
ther or not the fpongy fubflance, as in a com-
mon placenta, had an exiflence.
The particulars of the cafe at large I mean
to draw up at my leifure, with the addition of
fome obfervations, which I will tranfmit to \ou,
together with a fpecimen of the bones. Mean
time I flatter myfelf you will not be forry at re-
ceiving this abridged account of fo very un-
common a cafe.
I left my patient yeflerday, being the fourth
day after the operation, as well as could be ex-
pelled ; and my horfe is now waiting at the
^oor to carry me thirty miles to fee h.t again
to-day
[ 76 ]
to-day — which latter circumftancc I offer as an
apology for the haftc in which I write; as be-
fore my return home the fhip will have failed
by which you will receive this letter.
EJfex County.,
Rappahannock Riwr,
Virginia,
January i 8, 1791.
VI. A Cafe of fpontaneous Evolution of t^e Fcetus.
Communicated in a Letter to Dr. Simmons,
F. R. S. by Mr. Richard Simmons, one of the
Surgeons of the Britijh Lying-in Hofpital in
London,
VERY one who is much engaged in the
practice of midwifery muff have expe-
rienced the difficulty, and even danger, with
which the operation of turning a child is fome-
times attended ; and in cafes where the arm
prefents, and fiom the ftrong adtion of the
uterus, it may be hazardous, or even impoffible
to deliver by the feet, it muff be a pleafing -
circu'mftance to know that nature, unaffifted, is
capable of effefting the delivery by bringing
about a fpontaneous evolution of the fcetus.
This curious and valuable fadl, for which we
are indebted to Dr. Denman'^', is more particu-
larly applicable to thofe cafes of arm prefenta-
Sec London Medical Journal, Vol.V. pages 64 and 301.
tion
[ 77 ]
tion where the child is known to be dead be-
caufe in fuch cafes our foie objed; mull be to
bring away the foetus in fuch a way as fhall be
the eafieft and fafeft for the mother ; and we
lliall be more difpofed to wait with patience for
the fpontaneous operations of nature, when we
are certain there is no longer any profped of
faving the life of the child.
The number of indances of this fpontaneous
evolution, hitherto publiflied, being fmall, and
there appearing to be no inconfiderable variety,
both as to the length of time and the manner
in. which the evolution takes place, I am in-
duced to communicate to you the following
fhort account of a cafe which occurred to me
lately in the Britifli Lying-in Hofpital, and
which fully corroborates the ingenious obferva-
tlons of Dr, Denman on this fubjed.
Ann Collins, thirty-fix years of age, and of a
middle flature, was taken in labour of her fixth
child about ten o’clock on Tuefday evening,
December the aifi:, 1790. She had flight pains
till about two o’clock the following morning.
The labour pains began then to grow flronger,
and continued to do fo till about four o’clock ;
when the midwife, upon examination, found
that the left arm of the child had made its way
into the vagina. I was now fent for, and by the
time
[ 78 i
time I reached the patient the arm had advainced
as low down as the llioulder, and was hanging
entirely out of the os externum.
The rtiidwife being unable to give me any
account at wdiat time the membranes had bro-'
ken, I was defirous, during the interval of the
pains, of introducing my hand into the uterus,
in order to effedl the delivery by turning ; but
this, from the frequency and violence of the
pains, I found imprafticable, without uling
more force than I was then willing to do.
In a fliort time the left breaft of the child was
forced out of the os externum ; and as in this
cafe nature feemed likely to do fo much, I was
now in expeftation that a fpontaneous evolution
of the foetus would take place : and in this f
was not deceived for in about 'half an hour
from the time I came to the patient, and not
more than two hours from the firft appearance
of the arm in the vagina, the child was com-
pletely turned by the mere aftlon of the uterus,-
and was expelled as if the breech had originally
prefented. The child was rather a large one;
the placenta came away very properly ; and the
woman recovered without any thing particular
happening to her.
Newman Street ^
March 27, ivV**
VII. J
J
I
[ 79
1
j
Vli. Cafe of Peiechict fine Fehre. Commurii'
cated in a Letter to Dr, Simmons hy Samuel
Ferris, M. D. F. A. S. Phyfician in London i
Dear Sir,
GREEABLY to rliy promife, I commu-
nicate to you the hiftory of a cafe which
fell under my obfervation in January lull;: a cafe
of Petechia fine Fehre. This is either a difeafe
of fo rare occurrence, that but few pradlitio-'
nets have had an opportunity of feeing it ; or
if many have feen it, but few of the many have
given any clefcription of it to the Public. .Two
or three only of my medical friends know any
thing of the complaint from their own expe-
rience. From one of them, Mr. Rumfe\', a
very afiiduous and obferving practitioner at
Amerlham in Buckinghamfhire, I have received
notes of feveral cafes, which occurred to him
in practice, in his own neighbourhood. As lor
myfelf, I never law but two inftances of it be-
fore that, the hiftory of which you now receive,
and thofe I faw at Edinburgh about eight
years ago.
Fo Dr. Simmons.
Dr.
[ So ]
Dr. Graff publlfhed an Inaugural DlfTcrtatlon
on this difeafe, at Gottingen, in 1775 ; and he
is confidered as the firfl who wrote expreflly on
the fubjedl, although Lazarus Riverius is re-
ferred to as having alluded to this difeafe in his
chapter de febre pejlllenti — (fee ‘‘ Lazari Ri-
“ verii praxeos medicse Lugduni editie, 1653,”
p. 348.)
Since the publication of Dr. Graff’s Thefts,
the hiflory of a fimilar cafe has been publifhed
in the Tranfadlions of the Medical Society of
Copenhagen, and Dr. Duncan, of Edinburgh,
has publiflted fome account of this difeafe in a
volume of medical cafes and obfervations ;
and two years ago Dr. Adair, jun. from having
obferved feveral cafes of it, likewife in Edin-
burgh, made it the fubjedt of his very ingeni-
ous Inaugural Thefts.
Riverius affixed no particular appellation
to this difeafe to diftinguifh it from thofe pe-
techial complaints which have fever as ef-
fential to their exiftence. Dr. Graff diflin-
guiffied it by the petechia Jine febre ; this,
name conveys no idea of the effufion of blood,
which, from fome fource or other, generally
accompanies an appearance of petechias with-
out fever, and therefore Dr. Duncan propofed
to
3
[ 8i ]
to call t\n% petechianojos vel aimorrhaa;
and in order to connedt the idea of both occur-
rences, Dr. Adair calls it hamorrh(sapetechialis:
But neither the names propofed by Dr. Duncan,
nor that adopted by Dr. Adair, are expreffive
of the abfence of fever; and I, on that ac-
count, prefer the name, under which. Dr.
Graff firft defcribed the difeafe : for the ab-
fence of fever is one of its moft linking pecu-
liarities.
CASE.
M. C. daughter of J. C. a publican, in Hart-
llreet, Bloomlbury, was brought to me, Ja-
nuary 2oth laft ; Ihe was feven years old in De-
cember, 1790; Ihe had always appeared to be a
healthy, and Ihe was always an adive child. She
had never been fubjed to any particular com-
plaints, nor had Ihe been in theleall indifpofedfor
three years prior to the appearance of the dif-
eafe which was the occafion of my feeing her:
and three years before, Ihe had only a flight
remittent fever, which the apothecary, who ac-
companied the child to my houfe, informed
me, was not of very long continuance. Her
food had ever been as good, and her clothing
VoL. I. O
[ 8^ ]
and habits fuch as the children of people in the
fituation of her father and mother are ufually
accuftomed to, and. they are refpedable people,
in their line of life.
During the night of the- 17th of January laft,
fome bright red fpots appeared on her left foot,
and on both of her legs ; from that night to
the 20th, when I firft faw her, many more
made their appearance on different parts of her
body, gradually increafing in number from
the legs upwards, and on the 20th there were
feveral on her arms, neck, and face ; thofe on
the thighs were the largefl, and many of them
were livid, likebruifes; fome likewife on the
neck and cheek were livid, and there was one
larger than a fhilling on the inftep of the left
leg, livid, hard, and fomewhat prominent, as
if blood had been effufed into the cellular mem-
brane, and had coagulated there.
On the morning of the i8th, her mother,
when fhe went to the child’s bedfide, obferved
that her nofe had bled a little during the night,
and that fome dark-coloured clotted blood came
from her mouth. Her mother then firfl no-
ticed the fpots on her legs. During the night
of the i8th, when the child fellafleep, her mo-
ther faw her nofe bleed, and, as it appeared to her,
I more
D
[ 83 ]
I
more than it had bled the night before, and fonic
blood, partlv clotted, and partly fluid, came like-
wife from her mouth, of a dark colour. The child
herfelf did nor feem refllefs ; but her motherj
from apprehenfion, left the blood fliould fufFo-
cate her, awakened her repeatedly, and imme-
diately as fhe was awakened, the blood ceafed
to flow.
No hsemorrhage occurred through the day
of the 1 8 th nor of the 19th, nor in the night of
the 19th did the nofe bleed, as it had done be-
fore ; but fo foon as flie was afleep, blood be-
ean to flow, and fome clots likewife came from
the mouth, as in the preceding night, but in
greater quantity, and always flopping imme-
diately, whenever flie was awakened. She had a
Very trifling cough on the morning of the 20th,
but had not any before, nor even the leafl fen-
fible indifpofition of any kind prior to the de-
fcribed affedlions obferved on the morning of the
1 8 th. Her appetite had been uniformly good,
and her bowels regular, and were fo on the 20th ;
nor had her water been obferved to change in
the leafl from its ufual appearance. She had
flept well, had been confcious of no increafe of
heat, and her fldn had been, and was, when 1
faw her, foft and natural to the touch.
G 2
On
[ 84 ]
On the 2oth, when fhe was brought to me fof
my advice, fhe feemed perfedlly alert, not in the
lead; debilitated ; her pulfe was calm and regular,
and by no means weak ; but her tongue was a very
little white, and, as her mother informed me,
it had been more fo during the night, and in the
morning before I faw her. She was not in the
lead: unufually thii dy ; her fauces were tumefied,
and the fwoln amygdala were livid, and feem-
ingly ruptured, for there was the appearance
of coagulated blood, of a dark colour, hanging
about the furface of them, as on the furface of
an ill-conditioned ulcer i her breath was excef-
fively oftenfive, but was never noticed to have
been fo before the morning of the iSth. Her
gums were clean and found. She felt no un-
eafinefs from fwallovving, nor did fhe complain
of the lead pain in any part of herd)ody.
My prefcription on the 20th was the following :
I>i Decodi Corticis Peruviani |j
Pulveris ejufdem, gran. x.
Syrupi Papaveris albi,
Tindiurze Radicis Serpentaris Virginienfis-,
ana sj.
Mifce fiat haudus quater inter horas xxiv.
fumendus. Let her eat oranges ad libitum.
The
[ 85 ]
The notes which I took of her fituation, and
the directions I gave afterwards, were as follow :
January 21ft. The fpots are nearly as yef-
terday, but fome are now obfervable on the
edge of the tongue, on the gums, and one on
the tunica fclerotica of the right eye. She had
no bleeding from the nofe, and lefs from the
mouth laft night; her appetite is not fo good
as yefterday; Ihe complains of pain in the right
hypogaftric region. She has dill a little cough;
her urine of laft night was whitilh, that of this
morning is of a deep red colour, as if ftrongly
tinged with blood. Her pulfe is quicker and
rather lower; her tongue fomewhat white.
The draughts and oranges to be continued,
and let her drink wine and water as her common
beverage.
22. She ftept well laft night, and but little
blood came from her mouth. Her nofe did not
bleed ; her appetite is not fo good ; the fpots
feem to diminifh; the pain in the hypogaftric
region continues ; her urine is ftill red, but
her mother fays it is of a lighter tinge. Her
pulfe is not very quick, but low; her tongue
as before.
Let ten drops of the acid elixir of vitriol
be added to each draught.
G 3 23d
L 86 ]
a3d. The fymptoms are nearly as yefter-
day ; more vihices appear on the thighs, legs,
and other parts of the body ; and very flight
preflure on the arms occafions them. No blood
flowed from the mouth laft night ; her urine
in confiderable quantity, and a little tinged,
with blood. Her tongue is whitifli ; Ihe had
two ftools yefterday. — The fame medicines to
be continued.
24. The fmall petechial fpots are dimi-
niflied ; and feveral are entirely gone; the vibices..
remain as yefterday; the urine of laft night is
of a bright florid’ blood colour; that of this
morning darker, with light red fediment, but
nothing like coagulum, nor has fhe made fo
much water during the laft twenty-four hours, as
flie made in the twenty-four preceding. She
ilept well, and but very little blood came from
the mouth; the fauces are ftill tumefied, but
the amygdalte are lefs livid. The pain of the
bypogaftric region continues; flie fometiraes
refers it to the feat of the right kidney. She
had no motion yefterday; herpulfeis quick and
low; her tongue a little furred, butmoift; Ihe
was fomewhat more than ufually thirfty yef-
terday, but was not fenfible of the feaft extra-
ordinary heat or drynefsof the fkin.
Five
[ 8; ]
Five grains of the Powder of Bark to be added
to each draught,
25th. She llept well laft night ; no blood has
flowed from the mouth ; her breath is lefs offen-
five; the petechial fpots are on the decline,
but the vibices remain’on the legs and arms ; her
urine has been in lefs quantity than before, and
lefs tinged with blood. She had one motion
yeflerday; her pulfe is nearly as yeflerday; her
tongue and mouth clean; her appetite mended,
and fhe is in good fpirits.
2^th. Every fymptom is abating; her urine
is returning to its natural appearance.
29th. She is ftill better than on the 27th ;
the petechial fpots are gone; her urine is nearly
natural.
gift. She feems in ev^ry refpeft v/ell. The
urine of the 29th, has depofited a little fediment,
with fome few particles of the colour of blood.
Yeflerday and to-day her urine has been natural;
but th^re are ftill very flight traces of vibices re-
maining ; her appetite and fpirits are exceed-
ingly good; her throat is well ; her breath not
the leaft offenfive ; and her bowels are re-
gular.
Her draughts to be continued morning and
evening for a few days.
G 4 There
4
[ 88 ]
There is nothing more ufual chan for phyli-
cians to attempt to explain the fource and caufes
of the different phenomena of difeafes. But the
theoretical opinions of different phyficians, con-
cerning thefe circumflances, are frequently fo
various and contradictory, that we need re-
quire no clearer elucidation to prove the general
inutility of fuch attempts.
Under fuch a conviCtion, it would be incon-
fiftent in me to enter into a long difeuffion of the
Ratio Symptomatum of Petechia fine Febre.
It can' fcarcely be denied that the blood cir-
culating through the veffels of the living body,
is thinner in its texture at one time than at ano-
ther. Riverius, Dr. Duncan, and others, have
confidered a preternatural thinnefs of the blood as
the immediate fource of petechia 2Si^vihices ap-
parent in the difeafe above deferibe'd. It has been
fuppofed alfo by fome phyfiologifls that it is pof-
fible for fuch a partial laxity of the vafcular fyflem
to exifl, as to occafion an eafy rupture of the
finer veffels, from any very flightly applied force,
or to admit of the blood’s paffage through parts
not permeable by the blood when fuch parts are
in their natural ftate, and that without any per-
ceptible diminution of vital energy, or at leaf!
fufficient to interrupt the full exertion of muf-
2 cular
[ 89 ]
cular aftion. Such a ftate of laxity has been
likewife confidered as the fource of the petechia
and vibicesm the difeafe juft now defcribed ; and
the remarkable circumftance of the blood ceafing
to flow, as mentioned in the above cafe,’ when
the child was awakened, is a ftrong prefump-
tive proof of the juftnefs of fuch an inference.
For as there is lefs occafion for mufcular exer-
tion, during fleep, there is confequently lefs
energy excited, and all the aflfumed confe-
quences of fuch a fuppofed laxity might be ex-
pected to happen, whenever the vital energy
fliould diminifh as it does in fleep, and to be fub-
verted whenever that energy flaould be roufed
, for the due performance of mufcular motion.
But perhaps the fad is, that both the af-
cribed caufes of thinnefs of blood, and partial
laxity of veflTcls, may afllft in tlie production
of petechia fine febre ; a difeafe feemingly very
much allied in its nature to the true fcurvy.
I have the honour to be, &c.
Samuel Ferris.
John Street^ Bedford R 01V,
April 6, 1791.
VIII.
[ 9Q ]
VIII. Ivjlance of a Bifeafe, to which Sauvages has
given the Name of Met eorifmus Ventriculii with
Remarks. By Robert Graves, M. D. Phy-
fician at Sherborne^ in Dorfetjhire ; and Extra
Licentiate of the College of PhyfcianSi London.
ON the 2d of February 1791, Ann Hunt,
who had juft entered into her fifteenth year,
was afFedted with an uncommon, large, hard, unir
form, prominent tumour or fwelling in the epi-
gaftric region, extending from the fternum to
fome diftance below the umbilicus. It was of
n circular form, accompanied with very little
or no pain, excepting upon its being prefifed
and even in that cafe, the pain excited was but
inconfiderable. She perceived forne flight diffi-
culty of breathing, upon ufing any bodily exer-
tion, particularly that of walking ; flie had
much thirft, yet her appetite for food remained
tolerably good, no way depraved, and her belly
regular, with but little apparent lofs of flefh.
No obfervable change in her countenance could
be difcovered, except that it had become fome-
what of a paler colour than ufual.
The appearance of this extraordinary fweHing
was firft; perceived in the region of the ftomach,
fomc
)
[ 91 ]
fome time in the month of June 179°’ ^
lize not larger than that of a hen’s egg. From
this time it continued gradually to increafe, till
about the commencement of the enfuing Au^
guft, when the enlargement which it had re-
ceived in the courfe of this interval was fuch,,
that the whole fpace between the fternum and
umbilicus became completely occupied by it.
Afterwards it remained with little variation to the
period of its removal. Shortly after the appear-
ance of this fwelling, fame medicines were
given her with a view to its difcuffion ; but from
their feeming inefficacy, joined to her parents’
ilender ability to procure them, on account of
their expence, they were foon difcontinued.
As I was ftrongly perfuaded^ from the age of
the patient, and other circumftances, accompa-
nying the cafe, that it was to be confidered as
falling under the denomination of meteorifmus, as
defcribed bySauvages, I refolved to fupply her
with fuch medicines as the nature of the cafe
feemed to me to indicate, in order to learn with
greater certainty from the event, whether I was
right in the judgement I had thus formed of it.
Accordingly on the 2d of February, when lire
came to me, I gave her fome powders, confift-
ing of about eighteen grains of prepared fteel,
and
[ 9^ ]
and directed one of them to be taken twice a
da)\ She had likewife a purgative medicine,
which was ordered to be taken early the next
morning' compofed of a fcruple of rhubarb,
and of about three grains of calomel. This
powder operated brilkly and well j her ftools
were of a blackilh colour, and dightly otfenfive.
From this operation the lize of the tumour
feemed no way diminilhed or affedted. But
after a continuance of the chalybeate powders
only for the Ihort fpace of three or four days, her
fwelling was found leflened to a confiderable
degree ; and in a day or two afterwards w'as to-
tally removed, fo that the parts, which before
had been fo exceedingly hard and protuberant,
became enabled to refume their natural form,
fituation, and foftnefs. It is naw upwards of
two months fince flie was happily relieved; nor
has fhe experienced, as yet, the fmalleft alarm
from any fign or appearance which the com-
plaint has at all fliewn of returning again. It
may not be improper here to obferve that,
though the quantity of eighteen grains of char
lybs makes a pretty large dofe to begin with,
and would in mod: tender habits be produftive
of fome degree of ficknefs, it had no fuch flimu-
lant effedt in the cafe before us. The only fenfible
operation
[ 93 ]
operation attendant on its exhibition was, its
occafioning violent and frequent erudations of
wind ; and it is fomewhat remarkable, that this
effed took place very foon after the firft dofe of
It had been fwallowed, and before the period at
which the fecond was taken.
That the cafe above mentioned affords a per-
fed, though uncommon example of the meteo-
rifmus ventriculi, as defcribed by Sauvages, the
fymptoms accompanying it, together with the
means employed in its cure, bear ample and
unequivocal evidence. Although this is a dif-
eafe, which has been faid by fome authors not
to be of infrequent appearance in chlorotic fe-
males, and others labouring under a fuppreffion
of the menfes, yet it is prefumed that the pre-
fent inftance, on account of the peculiarities dif-
played by it, cannot be deemed altogether un-
worthy of regard. The flow and gradual man-
ner in which the fwelling acquired its increafe
of bulk; the enormous and extenfive fize it at-
tained ; its long continuance afterwards with-
out any very obfervable change ; and laflly its
yielding fo fpeedily to the remedies made ufe of,
are all of them circumflances that may render
it perhaps highly acceptable to the curious and
intelligent reader.
Of
C 94 ]
Of the feveral particulars here mentioned the
two firft are certainly of very rare occurrence,
feldom to be obferved in cafes of a like nature.
Whether in the ftomach or inteftines, when
any fwelling arifes folely in confequence of a
collcflion of air, its rife and progrefs are for
the moft part fudden, and as it were inftanta-
neous ; and there are but few examples of its
appearing firft of a diminutive fize, and then
receiving a flow and gradual enlargement for
any long continued portion of time. It is from
a knowledge of this and other well-afcertained
fadts, that we are enabled to diflinguifli, with
fufficient accuracy, between dropfical fwellingS
and others, of the abdomen, that have nothing
but an accumulation of confined air for the im-
mediate caufe of their diftention. As to the
enormous fize the fwelling exhibited, I believe
it may be fafely afferted, that fuch another in-
flance has fcarce ever fallen within the eye and
obfervation of the oldeft and moft experienced
medical pradtitioners. In general the fwelling
in thefe cafes amounts to little more than to fill
up the hollow or depreflion between the fter-
num and the umbilicus, obfervable in thofe ,
who are altogether exempt from any difeafe of
thofe
r 95 ]
thofe parts ; “ ita ut nulla fit cavltas ab fieri
no ad umbilicum quails in fanis
The late Dr. Cullen, who has fo defervedly
acquired the thanks and praifesof all thofe that
are engaged in medical purfuits, for the many
important fervices which have been rendered by
him in almofl: every branch of our fcience,
comprehends this and the three other remaining
fpecies of the genus, meteorifmus, of Sauvages,
under the general title of T ympanites. Though
there are undoubtedly obvious advantages re-
fulting from his careful and judicious reduc-
tion of the difeafes to which mankind is liable,
to a lefs number than what had been before, by
rendering the fludy and knowledge of them
more eafy and expeditious ; yet it is doubtful,
whether in confequence thereof, fome ambi-
guity alfo be not incurred often in practice. No
one from a perufal of the account which Dr.
Cullen has given us of tympanic affedlions,
would have fuppofed without the aid of fome
additional information, that the above cafe
ought to have been referred to this head of dif-
eafes. It is much more probable that its caufe,
under fuch circumftances, would have been at-
tributed to fome morbid obftrud:ion and enlarge-
• Sauvages Nofol. method.
ment
%
[ 96 ]
ment of the liver, or of fome other adjoining vif-
cus contained within the cavity of the abdomen.
From the event of the foregoing cafe we
have likewife an excellent example of the fu-
perior power of fleel as a tonic medicine; lince
the generation of the diftending air cannot but
be ultimately refolved into a laxity of the fibres
of theflomach. In cafes even where the com-
plaint is confined folely to the inteflines, its
life feems from hence to be particularly pointed
out. The flatulent nature of thefe cafes has al-
fo led to the employment of medicines of the
carminative clafs; but though the milder kinds
may be adminiftered without any fufpicion of
danger, their poflTefling any real efficacy is ex-
tremely doubtful, and particularly where the
inteftinal canal becomes the feat of the difeafe.
IX. Cafe of a Catheter, left in the Bladder, in
drawing off the Urine, for a retroverfion of the
Uterus. By Mr. Edward Ford, Surgeon of
the IVefiminfier General Difpenfary.
Mary wilding, a thin delicate
w'oman, about twenty-five years of age»
was admitted in January laft, as a patient at the
Weflminfter General Difpenfary. Sh? com-
[ 97 ]
plained of a painful and involuntary difcharge of
urine, mixed with blood and matter, from the
urethra ; andalfo of a difcharge of purulent urine,
which was continually flowing from a fiftulous
fore, lituated in the buttock, near the middle
of the glutffius mufcle. She was in a weak and
emaciated ftate, and had been confined to her
bed for feveral months; every attempt to move
from thence being attended with moft fevere
pains, both in the neck of the bladder, and at
the fiftulous wound in the nates.
Upon introducing a found into the bladder, an
extraneous fubftancc was eafily felt within its ca-
vity; and froniitshardnefs, Ijudgedthatitmlght
be a calculous concretion. At the patient’s defire,
I then proceeded to examine the fiftulous fore
on the buttock, and flie told me there was
a loofe bit of bone In the wound, which
frequently made its w^ay outwards beyond the
Ikin, but as often feemcd to be retradled with
confiderable force. I found by examining it
with the probe that it lay loofe in the finus,
and I endeavoured to remove it with the forceps,
gradually drawing it outwards. This procefs
was not attended with much pain ; but when
the extraneous fubftance was brought forward
about half an inch beyond the integuments, a
VoL. I. H further
[ 98 ]
further removal of it feemed inipradicable^, as'ifi
was ftrongly held back by the contracUon of the
mufcles. Whilfl it was retained externallyby the
forceps, I viewed it clofely to afeertain whether it
was an exfoliation of carious bone, or a calculous
concretion that had made its way outwards from
the bladder, but was much aftonifhed to find that
the fubftance protruded from the wound, was evi-
dently the bulbous end of a filver catheter.
This difeovery infiantly induced me to fuf-
pend any further operation, as it was clear that
an attempt to remove the catheter by extra6Urig
it forcibly through the wound, mufl: occafion at
confiderable laceratioti of the fundus of the
bladder ; and I was anxious to colled; from the
patient, fuch circumftances, as might explain
her unfortunate fituation. She profelFed her-
felf totally ignorant by what means the cathe-
ter had been lodged in her bladder, and could
with difficulty believe the information I gave
her. The narrative ffie furnifhed me with was,
that fire had been brought to bed four months ;
that in the third month of her laft pregnancy,
file had been felled with a difficulty of voiding
her urine, which had been feveral tirties drawn
off'^y means of a catheter ; that Ihe had experi-
enced great relief from this operation,- but that
2 the
i 99 ]
the iaii time it was performed Ihe had felt great!
pain, and had ever fince been unable to remove
from her bed without great diftrefs ; that Ihe
had been fafely delivered at the expiration of
the ninth month; and that the had fince fuckled
her infant, though in the mofi: wretched and
debilitated ftate. It was obvious from this ac-
count, that the catheter had efcaped from the
hands of the operator the lafi; time the urine
had been drawn off; that it had flipped into the
bladder, and had been fuffered to remain there;
and that the only method of relieving her was
to extract it through the meatus urinarius.
From the weak ftate in which Ihe lay, ex-
haufted by fuckling her infant, by pain, and
by the difcharge from the wound, I declined
perforrhing the operation till her health fliould
be a little invigorated by weaning the child,
and by a more nourifhing diet. When this was
accomplifhed, I was favoured with the affiftance
of Dr. Jackfon, Dr. Bland, and Dr. Combe, - all
of whom were anxious to fee fo Angular a cafe.
The patient was laid upon a table and fecured
in the manner ufually adopted in the operation
of Lithotomy. The urethra was dilated by the
blunt gorget introduced upon a female ftaff,
and the catheter was then attempted to be taken
H 2 out
[ 100 ]
out by the forceps. This part of the operation
was attended with much difficulty, as the cathe-
ter lay tranfverfely in the bladder, the handle of
it refling on the arch of the pubis, and its other
extremity on the crura ifchii. It was dlflodged
from its fituation by drawing the blunt end out-
wards through the poflerior wound, fo that the
handle of the inflrument being detached from
the pubes, was more eafily brought forward
through the opening in the urethra, and ex-
tracted. The catheter, which is now in my
poffeffion, was found covered with a flight incruf-
tration, as reprefented in the annexed drawing
The operation was finiffied by extracting a few
fm’all calculi from the bladder. The patient
was then put to bed, and the fame regimen
purfued as after cutting for the flone. A flight
fever came on, but was apparently more owing
to the flate of her breafls, as fhe had juft weaned
her child, than to the operation. The fiftulous
opening on the buttock healed in a few days,
the urine paffing entirely through the natural
paflage ; and in one month ffie was perfeClly
well. She now retains her urine, and fuffers
no inconvenience from this extraordinary ca-
lamity.
The foregoing cafe is, I believe, un-
* Sceplatf I., fij. I.
precedented
Jfe/^iral Fact) and obd: Tbl:I. F/are
/
[ lOI ]
precedented in medical hiftory. It affords a-
lingular example of an accident occurring from
an operation in furgery, which has ufually been
deemed eafy to perform, and free from hazard.
The natural ftrudture and fituation of the fe-
male urethra warrants the general opinion of
the fafety of this operation ; but when an al-
teration takes place in thefe parts, either from
pregnancy or other caufes, the operation of
drawing off the urine may become liable to dif-
ficulty.
In cafes of retroverted uterus, we find,
Ty the teftimony of Dr. Hunter, and other prac-
titioners, that this operation is not always to be
done with facility, and that in fome cafes it has
been impradticable. The poor woman who is
the fubjedt of this paper had been liable to a
retroverfion of the womb, both in this and in
a former pregnancy. Her urine had been drawn
off a few days before this accident by a man-
midwife of eminence; but being fuddenly taken
ill, Ihe applied to a perfon in her neighbour-
hood, from whom this accident happened.
His bufinefs obl'ging him inftantly to leave Lon-
don, he heard no more of his patient, and ima-
gined, I fuppofe, that the catheter had been ex>
})clled by the efforts of the bladder.
Golden Square,
May 1 6, 1791.
H 3
X, Cafe
[ 102 3
X. Cafe of an Imperforate Return. By the fame,
March 6th, 1791, 1 was defired to fee
a male infant, two days old, who was
fuppofed to have an imperforate redlum. He
appeared to be a flrong healthy child, well
formed in every other refpcft, had taken nou-
rifliment the day before, and as he exhibited ex-
ternally no marks of mal-conformation, when
examined at his birth, it was not fuppofed that
he laboured under this defedt till it was found
that no evacuation had taken place throujgh the
inteflines, that he rejedted his food, and vo-
mited up every thing he had taken.
When I faw the child he w'as continually vo-
miting; the matter thrown up was of a dark
yellow colour, and foetid, and the abdomen was
tenfe and fwelled : in other refpedls he looked
healthy, had voided his urine properly, and
the anus was naturally formed as far as re-
garded its external appearance.
I endeavoured to introduce my little finger
through the fphindler ani into the redtum, but
found an uncommon refiftance in the firfi; at-
tempt, the parts not admitting of being dilated
as ufual ; and when this difficulty was with fome
force
\ I V
[ 103 ]
force overcome, at the diftance of an inch
from the external parts, there was an ob-
ftrudlion to be felt, which relifted every effort
I made to penetrate it, firft with the nail of
my finger, and afterwards with the blunt end
of a probe.
The firft confideration which offered to my
mind, was to perforate the obftrudltion with a
fmall trocar; and in order to do this as fafely
as poffible, a fmall catheter was introduced
through the urethra into the bladdey, which
ferved as a direction to avoid wounding thofe
parts in the operation. Thccanula of the tro-
car was then introduced into the anus, under
my finger, which defended the urethra, and
was fixed as well as I could againft the obftruc-
ted part of the canal,
The ftilet was then carried up through the
canula, and pulhed through the obftrudtion
in a direction rather backwards towards the os
factum. On withdrawing the ftilet it w-as fol-
lowed by a difcharge of faeces, through the ca-
nula, which continued for an hour fo as to
form rather a copious ftool. Upon taking out
the canula, a bougie was attempted to be In-
troduced through the artificial opening, but
without effedt.
H 4
The
[ ]
The child was now left an hour, and on my
return I found his belly more tenfe, and that
his vomiting continued, I therefore dirccfted
feveral clyfters of oil and water to be thrown up
by means of a fmall pipe which was fortunately
conveyed through the artificial opening into
the gut. Thefc clyfters brought off a confi-
derable quantity of fteces, but did not feem
thoroughly to empty the inteftinal canal ; fo
that I deemed it expedient to attempt an en-
largement of the opening, by means of the
point of a blunt gorget carried up in the groove
of a common director. A farther difcharge of
fcBces enfued ; and the child was then put into
a warm bath, and caflor oil was afterwards ad-
mini ftered by the mouth. Nothwithflanding
thefe remedies, the vomiting continued, the
child becarne convulfed, and died'^in the courfc
of the following night.
Upon opening the body the next morning, I
found marks of confiderable inflammation in the
inttflines, principally in the larger ones, which
wne inflated to a great degree. There was no
obft iicf on, however, tq be found in any part of
the in efti.nl .ao i) except that in the redtum.
Tiie drawing which accompanies this paper
will |how the manner in which the intefline
terminated
[ 105 ]
terminated in a blind poucb, at the diflance of
an inch from the anus, in the hollow of the os
facrum*. The fpace between the inteftine and
the anus was lined with an inelaftic ligamen-
tous fubftance, which would probably have
produced much inconvenience to the patient
in retaining his flools, had the operation per-
formed protraded his exiftence.
Golden Square,
May 20, I "9 1*
XL FaSls relative to Pemphigus, Communicated
in a Letter to Dr. Simmons by Mr. R. B.
Blagden, Surgeon at Petzvorth in Sujfex.
'I' WAS, in January, 1790, defired to fee a
X girl, two years and ‘a half old, who had
been obferved to droop the preceding day.
The child looked heavy, and was feverilh. A
neutral mixture with tartarifed antimonial wine
was direded for her. The next day the child
was more feverilh, and had flight delirium : an
enema was then injeded, and a blifter put be-
* See Plate I. fig. 2, in which a refers to the inteftine, h
t» the ligamentous fubflance above dcfcribcd, and c to the
anus.
tween
C ]
tween the Ihoulders. Late in the evening of
that day puftules were obferved on the waift,
and before the morning on the other parts of
the body, and on the extremities,' but chiefly
on the forehead and fcalp, Within three days
the puftules became complete little bladders,
being grown turgid with a yellowilh fluid.
The general fize of the veficles was that of
an almond, but the fize of thofe on the fore-
head and waift approached nearly to that of a
nutmeg.
The larger ones were pierced, the fmaller
ones were fuflcred to burft of themfelves, and
not a veficle filled again.
The untruentum ceras was made ufe of as
O
drefling. The veficles on the extremities and
on the head were healed in about ten days. It
was very evident that the child Tuffered ex-
tremely from the forenefs of thofe on the waift,
which were not complete-ly healed in lefs than
two months. The veftiges of five of the largeft;
of thefe, and of two on the forehead, will ever
remain.
All the hair, which grew underneath the ve-
ficles on the fcalp, came off with the plafters.
Many very minute veficles were obferved in
the mouth, and the child fliowed a repugnance
to
t 1°7 3
^0 fwallovv. As the fever and delirium went off
on the appe'arance of the eruption, the medi-
,cine was laid alide. No frefli puftule appeared
after the fourth day.
Five days after the appearance of the erup-
tion on this child, an infant, fourteen weeks
pld, belonging to the fame parents, grew fe-
verifh, and, within the next three days, had an
eruption exactly refembling the above, except
in the fize of the veficles, which, in this cafe,
were no larger than peafe ; they burft, and the
parts were well in about a week.
This child was not ill enough to require any
medicine internally.
And now may 1 be permitted to draw the fol-
lowing conclufions ; — -7
That the difeafe is contagious;
That new velicles do not, in every cafe, arife
after the end of the fourth day ;
That the fluid they contain does not, even in
every cafe of pemphigus fimplex, appear to be
of a bland nature ; and
That, in fome Inftances, no apparent abforp-
tion of it takes place ?
fet'oiorth,
M?/ 5.
XII. Ac-
[ Jo8 ]
XII. Account of a Fa6i relative to JAenfiruationy
not hitherto defcribed. Communicated in a Let-
ter to Dr. Simmons by Thomas Denman,
M. D. Licentiate in Midwifery of the Royal
College of Phyficians, London.
Dear Sir,
LL the common circumftanccs attending
menftruation have been well defcribed by-
various authors; but having frequently feen a
fubftance expelled with the menftrual dif-
charge, which had efcaped obfervation, I beg
leave, by your favour, to give a Ihort account
In the examination of that difcharge, for
the purpofe of inveftigating the ftate of the
uterus, a membranoqs fubftance had been ob-
ferved, which pafled, without any particular
notice, as theftoken of an early conception, or
as the cafual form of coagulated blood. Exa-
mining this fubftance with greater attention, I
conftantly found that one furiace had a flocky
To Dr. Simmons.
of it.
appearance,
C 109 ]
appearance, and the other ^ a perfectly fmooth
one ; that it had, in all refpeds, the refeni-
blance of that membrane which Ruyfch had
called the villous, and which the late Dr. Hun-
ter, fpeaking of abortions, had defcribed with
great precifion, and called the decidua. To
put the matter out of doubt, about two years
ago I requefted the favour of Dr. Baillie to ex-
amine fome portions of it, and he agreed with
me in thinking it fimilar to the decidua.
Having never obferved this membrane dif-
charged by unmarried women, a doubt arofe
whether it was not really a confequence of an
early conception ; but I have the moft un-
doubted proofs that it may be formed without
connubial communication, and that the uterus,
in tome women, has the property of forming it
in the interval between, or at each period of
the menftrual difcharges. It feems particu-
larly necedary to eftablifti this fact, as the ap-
pearance of the membrane might give rife to
erroneous opinions and unjuft refledtions.
In every cafe, in which this membrane has
been obferved, the w'omen have menftruated
with pain, and the difcharge has flowed flowl3q
and apparently with difficulty, till the mem-
brane
[ ho ]
brane has come away, which in Tome cafes has-
been in fmall flakes, and in others in pieces equat
to half the extent of the cavity of the uterus, of
which they retained the fliape. But whether this
membrane be expelled in every cafe of painfut
menftruation, my experience does not enable
me to decide.
No woman, in the habit of expelling this*
membrane, has been known to conceive; and
this obfervation leads me to fpeak of the treat-
ment which has been advifed for making fuch
a change in the ftate of the uterus, that it
fliould be divefled of the property of forming
this membrane at the time of menftruation.
There does not appear to be any external pecu-
liarity of conftitution, or difpofition to any other
complaint in thofe who have been Hable to the
formation of this membrane, which feems to be^
a proper office performed at an improper time.
Recourfe has been generally had to mercurial
medicines in one form or other, -fometimes as’
adtive purges, and fometimes carried fo far as
to occafion a flight falivation ; but the fafeft'
method, and, as far as I know, the moft effec-
tual, is, lo give fmall dofes of calomel every
r.ight at bed tirhe for feveral weeks together.
I
C ]
and twice, in the courfe of the day, a large
dofe of the volatile tindure of bark.
I remain, dear Sir,
Your very humble Servant,
Thomas Denman.
'Qld Burlington Street,
May s, 1 79-1 •
XIII. Tragical Obfervations on the Treatment
. and Caujes of the Dropjy of the Brain, By
Thomas Percival, M. D. F. R. S, and S, A.
Lond, ; F. R. S. and R, M. S. Fdinb. ; Freft-
dent of the Literary and Fhilofophical Society of
Manchejler ; Member of the Royal Medical
Society at Baris ; of the Royal Society of
Agriculture at Lyons ; of the Medical Society of
Aix in Provence ; of the Fhilofophical Society
at Philadelphia , and of the American Academy
of Arts and Sciences, &c.
The fafety and efficacy of mercury in the
hydrocephalus internus has been fully
eftabliffiedi by the experience of various medi-
cal praditioners, in this and other countries
firy«e
[ ]
fince the year 1777, when the public was firft
informed of its fuccefsful adminiftration * ; and
though it is far from being a certain remedy,
yet the almoft condant fatality of this diforder,
under every antecedent method of cure, ren-
ders it a valuable and important acquifition to
the healing art. But in the recital of one of
the earlieft cafes in v/hich it was employed I
have perhaps too much difparaged former modes
of treatment, and too haftily declared my foie
• and exclufive truft in the internal and external
ufe of mercury ; for there are feveral medici-
nal aids, which, however infufficient in them-
felves to conquer this formidable difeafe, may
contribute to fo happy an event, by mitigating
pain and fpafm, by promoting abforption, and
by increafing the ferous difcharges of the body.
With thefe views I now generally prefcribe
either opium, muik, fait of hartfhorn, flowers
of zinc, fquills, or blifbers, in conjundtion with
the mercurial courfe, with which they perfedlly
coincide. The preference to be given to one
or other of thefe remedies the circumftances of
* See Medical and Philof. Commentaries, Vol.V. p. 174,
Vol. VI. p. 219 ; Medical Obfervations and Inquiries, Vol.
VI. art, yi. by Dr. Dobfon, art. viii. by Dr. Haygarth.
the
' [ ]
I \ , . ;
tile cafe will fufficicntly indicate ; and it would
be a falfe and unjuftifiable facrifice to limplicity
of practice not to avail ourfelves, in the treat-
ment 'of fo dreadful a malady, of fubordinate
means, which may pfoVe auxiliary, and cannot
counteract, the falutary pow'ers of what merits
our chief reliance. In purfuing this enlarged
plan, I have experienced fewer difappointments
than formerly, and have derived fatisfaCtion
under it, froni the confeioufnefs of no neg-
ledt or omiffion. When the pains arc very
acute, opiates, in large and repeated dofes, are
elTential to the cure ; but if the patient be in a
ftate of coma, they are obvioufly improper, and
fnuik, combined with fait of hartfliorn, Ihould
be freely adminiftered. Under every circum-
Itance of the difeafe blifters are expedient;
and the application of them Ihould be renewed
as often as can be done without exciting ftran-
gury. I have tried fox glove in but few cafes
of hydrocephalus.' In one, which was of long
continuance, and terminated fatally', this re-
medy produced extreme debility, various difr
treffing nervous fymptoms, and was attended
with no beneficial operation. Mercurials, and
Other active means, had alfo been tried in vain;
and all hopes of relief being given up, the
Von.L I child
[ J
child was fent into the country, where, though
totally blind, he was not without enjoyment;
and retained his faculties in a perfeft ftate till
death, notwithftanding it was found, on open-
ing the head, that the right hemifphere of the
brain was entirely difiblved, the corpora ftriata
deftroyed, and the left lateral ventricle con-
tained twelve ounces of water. In another
cafe, which lately occurred, fox glove was ad-
miniftered, with opium and calomel, accord-
ing to the following formula ;
II, Pulv. digital, purpur.
Opii colati.
Calomel. pp‘b aa g' j. M.
F. Pilula; ij. 4“* horis fumend^.
After the fecond dofe of thefe- pills, the pa-
tient, wvho was about twelve years of age, fell
into a found fleep, which continued fix or eight
hours. She awaked, in a great meafure, free
from pain, highly refrefhed, and capable of
viewing the light. Her head had fweated pro-
fufely, a large flow of urine had taken place,
and from this period the commencement of re-
covery was clearly to be dated. But 1 am in-
clined to aferibe the falutary change rather to
the
[ *15 ]
the opium than to the fox glove, and to the
opium only as auxiliary to the powerful aftion
of the mercury, which had been previoufly and
very largely adminiftered in the way of uncftion;
and I am ftrengthened in this conclufion by the
antecedent effedts of mercury in the fame pa-
tient, under the diredtion of Mr. Henry, before
I was confulted ; for confidcrable relief had been
obtained by it, though afterwards flie fuffered a
relapfe ; and the courfe was renewed by my ad-
vice, with the additional remedies above men-
tioned.
I have examined various hiftories of hydro-
cephalus, related in different medical journals,
fince the adoption of mercury in the treatment
of it, and of twenty-fix cafes, noted indiferi-
minately in the courfe of my inquiries, I find
that eleven recovered, and fifteen died. Of
the recoveries, mercury was employed in feven
of the inflances, and other remedies in the re-
maining four. Of the deaths, mercurials were
employed in four cafes, and other remedies in
eleven. Thefe fa6ts, drawn from authentic re-
cords ■*, afford a ftriking proof of the fuperior
advan-
* Medical Obfervations and Inquiries ; Dr. Duncan’s Me-
dical Commentaries ; London Medical Journal j Memoirs
la of
[ 116 ]'
advantages of the prefent method of practice id
a difeafe heretofore deemed fo fatal, and my
own experience confirms the conclufion ; for in
the above references no cafes are included which
fell under my own infpedlion.
A profufe perfpiration of the head is not an
unfrequent effedt of the exhibition of mercury 5
and it fliould be encouraged by wrapping the
head in flannel, for it fometimes affords fpeedy
relief, of which I fhall relate, from my notes,
the following inflance : — October 23, 1784, 1
vifited Mafler E., a child of eighteen months
old, who laboured under the hydrocephalus
internus : his eyes were diftorted, and in every
pofition, witliout the power of feeing : his pulfe
beat one hundred and fixty ftrokes in a minute ;
he fliewed figns of great pain iri his head, and
frequently rocked it on the pillow. The right
arm and leg were motionlefs. The bregma was
fofc and enlarged. I directed a blifter, the un-
guent. hydrarg. fort., and fmall dofes of mer-
cury internally. In twenty-four hours a rtiofl:
profufe fweating of the head came on. The
pain and diftortion of the eyes were confidera-
of the Medical Society of London j Dr. Donald Monro’s’
Letters and EiTayt.
bly
[ ”7 ]
bly abated. Little Inflammation or ferous dif-
charge had been produced by the blifter, —
Odtober 25th, the power of motion was rcr
flored to his paralytic arm and leg, and he faw
objedfs diftlndtly, as appeared by his catching
at my watch when held before him. — On the
27th he relapfed into his former flate. — Oc-
tober the 30th he died ; but permiflion to ex^-
prine the head could not be obtained.
The good effecfls of mercury In hydrocepha-
lus Internus are independent of fallvation ; and
it is truly aflonifliing that very large quantities
of the unguent, hydrarg. may be ufed in in-
fancy and childhood withoyt affedfing the gums,
notwithftanding the predifpofition to a flux of
faliva at a period of life incident to dentition.
Between the 8th of February and the 7th of
April, 1786, a child, under one year of age,
received, by facceflive fridllons, four ounces,
flx drachms, and two fcruples of the ftronger
mercurial ointment. One fcruple was adminif-
tered each time ; the operation took up more
than half an hour, and the part to which the
ointment was applied was always previoufly
bathed with warm water, precautions adapted
to fecure the full abforption of the mercury.
Thirty-feven grains of calomel were alfo given
[ ”8 ]
at proper intervals, and in fixteen dofes, during
the fame period. The child recovered without
fymptoms of fallvation, and has ever lince re-
mained free from any painful affedtion of the
head.
In the profecution of the mercurial courfe it
is neceffary to guard againft laxity in the bowels,
or this remedy will be carried out of the h ftem,
and produce no falutary effed:. Coftivenefs,
however, is not to be permitted, left it increafe
ficknefs, fever, and pain : clyfters, therefore,
of milk, oil and fait, fhould be injedted as of-
ten as they may be deemed expedient.
An acceleration of growth, to an extraordi-
nary degree, is frequently obferved after the
dropfy of the brain has been fubdued by mer-
cury. In one cafe, which fell under my own
diredlon in 1784, a young lady, nine or ten
years of age, of a noble family in this county,
increafed two inches in ftature within the fpace
of four months fucceeding her recover}%
The comparative frequency of the hydroce-
phalus at different periods of life, the predif-
pofition of each fex to it, and the duration of
the difeafe, as deducible from the records of
the twenty-fix cafes to which I have already re»
ferred, are noted in the following table ;
[ ”9 ]
J^e.
From birth to one year
one to two years
t;wo to five
: — five to ten
ten to twenty —
p ■ ■ twenty to thirty
26
Sex. Event.
Males — 14 Died — 15
Females — • 12 Recovered — n
Duration
Two weeks and under — — y
From two weeks to three, inclufive, — 6
three weeks to four, , — 4
one month to fix weeks, , ~ i
Three months, with intermifiion, — i
This table is not fufficiently comprehenfive
to furnilh any decifive conclufions ; and jt was
my intention to have enlarged it, if leifure had
* The duration, I believe, is only ftated in nineteen of the
twenty-fix cafes.
I4
permitted.
[ 120 3
permitted, by a review of the numerous cafe^
which have occurred in my own practice. Se-
veral a^ this inftant prefent' themfelves to my
fecolledtion, which were of very long dmation.
'I'hc child mentioned above, to whom fox glove
was given with injurious efFeft, fubfifted under
the difeafe fixteen months. The malady came
on by almoft infenfible degrees, and was at-
tended with very little pain : his head was
large, but neither the bregma nor the futures
were open : his cyefight failed, and a complete
amaurofis' fucceeded. The left fide became pa-
ralytic; and in this melancholy fituation he
continued till a fliort and flight attack of fever
put an end to his cxiftence. — Another cafe,
about which I was confulted, I lhall relate more
‘at length, as it was attended with many curious
and interefting circumftances. A lady, aged,
twenty-five years, of a healthy conflitution,
and of a florid complexion, was delivered of
her third child in July, 1786. During the
latter months of pregnancy fhe was fubjeft to
frequent head-achs, attended with great cold-
nefs' of the legs and feet. The head-achs
abated after delivery ; but in the fucceeding
month of Oftober they recurred periodically
every morning, and were generally alleviated
■ ' ‘ during
t 121 ]
^qring the courfe of the day. At this time Oie
fuffered extremely from habitual coftivenefs*
In December her oldeft child, whilft fitting on
her knee, was feized with a oonvulfion, which
occafioned fuch terror and agitation in the mind
of the mother as to aggravate, to a very great
degree, the pains of her head. Blifters, ai>
emetic, and other means w'erc directed, without
any material or lading relief. In February,
1787, a flight fliaking of the head came on;
and a phyfician in London, defervedly held in
high eftimation, was confulted, who delivered
it as his opinion that the dlfeafe was an extrava-
fation of water in the brain. At this period
the pupils of the eyes were greatly dilated, and
the fight fo much affeded, that fhe was inca^
pable of reading. Her fpeech alfo wasfcarcely
intelligible. In April application was made to
another very eminent phyfician, who direded
an iffue between the fiioulders capable of hold-
ing twenty-four peas, and afterwards -advifed
the mercurial ointment, which was employed in
the quantity of one drachm every night during
the fpace of a month. A profufe falivation
fucceeded, but with little or no benefit. Elec-
tricity, the Bath waters, frequent emetics, Hi-
^ulating cataplafms to the head, &c. were
’equally
[ ]
equally inefficacious. February the 14th, 178S,
I received a ftatement of the cafe. The lady
had then for fome time declined all medical afr
iiftance ; but fhe fuffercd under an almoft gene-
ral paralyfis, and was incapable either of dref-
fing or of feeding herfelf. Her head was fome-
times totally free from pain during the fpacc of
a day or two, but always in fo fhaking a flate,
that file was obliged to ufe a fleel fupporter.
The mufcles of the jaws were likewife fo re-.-
laxed, that manducation was performed with
great difficulty. In this long-protrafted cafe
there is reafon to fuppofe that a ferous effufion
fubfifled both in the ventricles and between the
membranes of the brain ; and it is not un-
likely that the fpinal marrow alfo was affedted
by a fimilar compreffion. Under fuch circum-
ftances, and after the trial of fo many adtive re-
medies in vain, diredted by phyficians of dif-
tinguiffied fkill and judgment, I felt a peculiar
diffidence in offering any encouragement for
the ufe of farther means. But when a great
and good end is in view, the poffibility of at-
tainment is not only a juftifying motive of ex-
ertion, but even renders it a duty ; and expe-
rience evinces that fuccefs fometimes crowns
our endeavours when there are no probable
<7 grounds
C 123 ]
grounds of expedlation of it. I therefore re-
commended that the ftrengrh of the patient
Ihould be fupported by a cordial and nutritive
diet ; by refidence in a dry and temperate at-
mofphere ; and by gentle cxercife, either na-
tural or artificial. Of the latter kind, fridtion
of the abdomen and of the fpine, with new
flannel, every night and morning, was particu-
larly advifed. As the ilTue in the back ap-
peared to be too wafting a drain in fo advanced
a period of the diforder, I hinted the pro-
priety either of healing it or of dreffingit only
with one pea. The vapour bath was propofed
to the lady, which, by warming the whole
habit, might give energy to the nervous and
lymphatic fyftems. As the mercurial courfe
had been tried without benefit, it could not be
deemed expedient to renew it to any extent :
but I conceived that fmall quantities of the un-
guent. hydrargyri might be rubbed, with ad-
vantage, into the fpine every night at bed time.
If this were objedfed to, I mentioned the ufe of
a volatile embrocation as a fubftitute. Sternu-
tatories having fometimes proved beneficial in
hydrocephalic affedtions,^ I therefore fuggefted
ihe ufe of them in the prefent cafe ; and recora-
pnended the trial of mulk, aether, and the calx
of
\
C 124 ]
Qf zinc. If an adequate degree of ftrength
to bear the fatigues of a fea voyage were reco-
vered by thefe or other means, 1 urged the at-
tempt of it, at a proper feafon of the year, as
likely to produce a falutary revolution in the
whole fyftem.
Such was the advice I gave in this interefting
and affedling cafe ; and I regret that no other-
information has been communicated to me, of
the refult of it, than that the lady received con-
folation and benefit from the plan propofed to,
her trial.
Our imperfedl knowledge of the ftrufture of
,the brain, and of the diverfified energy of the
nerves in their origin, progrefs, and termina-
tion, neceffarily involves the diforders of the
head in a peculiar degree of uncertainty j and
it is often extremely difficult to diferiminate
even between the fympathetic and idiopathic af-
fedlions of that important organ. It cannot,
therefore, be furprifing that the caufes of hy-
drocephalus have not hitherto been afeertained
with any degree of accuracy or precifion. The
light which diffedtions afford is, obtained only
at the clofe of the malady ; and the ftate of the
encephalon may have undergone confiderable,
changes, either by the operation of nature, or
hX
t ]
by the a6lion of the medicines employed. A
medical friend informs me that he lately af-
fifted at the dilTedtion of a child whofe death
was the confequence of a convulfive. fit. The
child had been indifpofed about two months
with frequent pains of the head. Worms had.
been fufpedted; but anthelmintic remedies af-
forded no relief. The velfels of the brain were
found to be uncommonly turgid, and the ven-
tricles contained about double or treble the or-
dinary quantity of ferum. In this cafe I ap-
prehend the turgefcence of the veffels was the
efFedt, and not the caufe, of the cohvulfions j
for the reflux of the blood from the head to
the heart being obflrudted during the fit, in
which I believe the patient expired, the vafeu-
iar diftention mufl; have been permanent. The
rednefs and even blacknefs of the face, which
takes place in convulfions, affords fuflicient
proof of fanguineous accumulation.
That the diforder under enquiry originates
fometimes in inflammation, I can entertain no
doubt, from feveral cafes which have occurred
within the circle of my obfervation ; one of
which I fhall here briefly relate. Mifs , a
robuft young lady, at a boarding- fchool in
Manchefler, after dancing very violently, went
I out
[ 126 ]
out to the pump for a glafs of cold water, which
Ihe eagerly and haftily drank. In a few mi*
nutes fhe ran towards the wall, and leaning a-
gainfl: it, cried our, oh my head ! From this
inftant the pain never ceafed ; and becoming
more and more acute, was fucceeded by all the
train of afflidive fymptoms which characterize
the hydrocephalus. At the end of three weeks
Ihe died, and I was prefent at the opening of
the head. The brain was found to be in a ftate
of inflammation ; the veflels were extremely
turgid ; and the venticles contained at leafl; fe-
ven ounces of water.
But I have reafon to believe that hydroce-
phalus molt frequently arifes from glandular
.obftruCtion, and either local or general pleni-
tude. A family, with which I have been long
and intimately conneded, has repeatedly fuf-
fered from this formidable difeafe, as diflee-
tions have manifefted. But in the following in-
fiance, the fatal event took place before the ex-
travafation of water, which, from the ftate of
the brain, and the conftitutional predifpofition,
would probably have fucceeded, if the difeafe
had been of longer continuance. Mafter ,
a fine healthy boy, aged fifteen weeks, who fed
iheamiy and grew very fall after he was weaned;
though
r 127 ]
though regular in his ftools and well exercifed,
was feized with convulhons. May nth, 17721
He had been obferved, a day or two preceding
this attack, to be averfe to motion, and as there
appeared to be no fpecific fymptoms of fmall-pox
or dentition, the difeafe was aferibed to general
plenitude. Gentle evacuations were therefore
directed; blifters applied; and anodyne and
antifpafmodic remedies adminifkered. By thefe
means the fits gradually abated in frequency and
violence. May 13th, the convulfions entirely
ceafed, and every fymptom feemed to be fa-
vourable : but in the evening, his pulfe inter-
mitted, his refpiration became laborious, and
fometimes fufpended, and his countenance was
funk and ghaftly. By finapifms, blifiers, and
cordials, the vital powers were again roufed :
but the next evening he relapfed, and died early
the fucceeding morning. His body was opened.
The vifeera of the abdomen and thorax were
found, the mefentery excepted, the glands of
which were much obfirufted and enlarged.
The veflTels of the brain were turgid, but
not inflamed ; and no water was yet effufed,
either between the membranes or into the ven-
tricles.
In a chronic afFettion of the head, of many
years
[ 128 ]
years continuance, the patient Informed
that to hide certain marks left by glandular tu-»
mours in his neck, he ufed, for a long time, a
flrong and broad ftifFening under his neckcloth;
and frequently tied it fo tight, as to occafion
pains of the head, iluflaings of the face, and gid-
dinefs. This practice he purfued till the. com-
mencement of the melancholy diforder, about
which he confultedme; and wasperfuaded that
it greatly contributed to bring it on. The
fymptoms of the cafe were acute pains of the
head ; a vertigo in (looping; afenfe of fainting;
when the head was fuddenly thrown back; a
flrabifmus, and protrufion of one of the eyes ;
a paralytic debility of the whole frame ; and a
conliderable diminution of mental energy. By
the continued ufe of tonics and ftimulants; by
a cordial regimen; and by drinking goats-whey
on the mountains in Wales, this gentleman’s
health is, in a tolerable degree, reftored. A-
mongd the ftimulants employed, the-mezereon
root, mercury, and blifters are comprehended.
In this ftngular cafe, the internal veftels of the
‘ head were probably at firft over diftended ; and
fomc degree of ferous extravafation permanently
enfued. But the complaint was fo graduallypro*
duced, that the vital adions fuftained a lading
injury
[ 129 ]
injury from turgefceiice of the brain, without
any concomitant inflammation*
In reviewing fome notes on Hydrocephalus^
which I made many years ago, I find fhat of
twenty-two cafes enumerated, eleven were
known to be ftrumous ; three were fufpefted to
be fuch ; and four were accompanied with ail
enlargement of the head, probably from a
rickety conftitutjon. So that in eighteen of
thefe cafes, the inflammatory diathefis was not
likely to prevail- But filch fubjedls, from the
laxity of their fibres, muft have been incidental
to general or partial plenitude • to glandular
bbflrudtiorts, and to a feeble adlion of the lym-
phatic fyftem. And thefe circumftances pecu-
liarly difpofe to an effufion of water in the brain *
becaufe that organ is fo copioufly fupplied with
veflels of every order’. For anatomifls have
eftimated that one tenth of the whole mafs of
blood circulates within it, although the weight
bf the entephalon does not exceed one fortieth
part of the whole body. The following cafe
affords fome confirmation of this reafoning.
Mafter -, the fort of a flrumous parent, w'a^
born with a large head. Being , a lufty child
and growing well, the difproportion became
lefs obfervable within the fpace of two years.
VdL. I. K He
[ ]
*
He was then attacked with a maliotlant Itch*
the cure of which proved very obftinatc ; and
when the eruption gaVe way, its icceffion was
too fudden. The child’s appetite abated, and
his flelh, ftrength, and fpirics were much im-
paired. He was fent into the country, where
he feemed to be recruited. But about the end
of May, he fickened, grew languid, averfe to
food, dull, watchful and yet drowfy. His
countenance had that peculiar caft, which led
tne td fufpedl an eff'nfion of water in the brain,
though his pulfe was not much changed, nor
his eyes otherwife affedted than by the lofs of
their ufual brightnefsi June 2d. The pupils
became dilated, and the pulfe was fometimes
flow and fometimes quick. The child feemed
to feel uneafinefs in the head, but gave nbfigns
of acute pain* June 3d. A complete amau-
rofis took place, with occallonal fquinting and
frequent convulfive ftretchings of the limbs*
The pulfe continued to be irregular, atld the
urine was voided in large quantities. No fymp-
tom of acute pain occurring, I examined the
head attentively, hut did not perceive either
any opening of the futures, or foftnefs of the-
bregma. The mother informed me that the
child’s head had been gradually augmenting in
fize.
[ I3I ]
fize, during the laft three months, without a
proportionate growth of the reft of the body,
infomuch that Ihe had been obliged to make for
him new and large night-caps.
Pradtical writers have related many cafes of
dropfical metaftafts. I have feen an affedtion of
the brain, which appeared to be hydrocephalic,
and probably originated in inflammation, fud-
denly and cornplctely relieved by the attack of
an acute pain in the lide, which terminated 'in
a fatal abfcefs and hydrothorax. When an in-
cifion was tnade through the cartilage of the
third rib, a quantity of water flowed out of the
cheft. The fternum being removed, evident
marks of inflammation were difcovered ; the
lungs adhered ftrongly on every fide to the
pleuraj and were covered with a purulent mat-
ter. An open abfcefs was found in the pofterior
lobe of the left fide, the rupture of which, in
all likelihood, occafioned the fudden death of
the patient. Not being prefent at this diflec-
tion, I had afterwards to regret that the furgeon
omitted to examine the ftate of the brain.
Whether the following cafe, with which I
(hall conclude thefe obfervations, is to be af-
cribed to metaftajis^ I leave to the decifion of
the reader. Mr.,C.’s daughter, aged nine years,
a after
■jff
[ 13^ ]
after labouring under the fymptoms of phthifis
pulmonalis four months, was affedted with un-
ufual pains in her head, which inereafed rapidly
to fuch a degree, as to occafion frequent fcream-
ings. The cough, that had before been ex-
tremely violent, and attended with flitches in
the breafli now abated ; and in a few days ceafed
almofl intirely. The pupils of the eyes became
dilated ; a flrablfmus enfued and in about a
week, death put a period to her agonies.
P. Si The foregoing pradtical obfervations
have been drawn up from my notes, or from
refiedlion, wdthout confulting, at the firne^
any books on the fubjedl. But firice thefe were
written, I have perufed, with attention, a va-
luable and very interefting work, lately pub-
lifhed by Dr. Quin, on the dropfy of the brain.
The view which he has given of this difeafe ap-
pears to be, in general, judicious and accurate i
yeti am inclined to afcribe lefs than he does to
inflammation ; and confequently fhould recom-
mend much caution in the ufe of blood letting,
even in the firft flage. For the vefl'ds of the
brain fcem quickly to lofe their tone by diften-
tion; and great torpor and debility of the whole
fyftem fucceed. If depletion, therefore, be in-
dicated
[ I3S ]
dicated, k will be beft accompliflied by a ki- '
mulating mercurial purgative, and by the ap-
plication of a large blifter to the head. For
Dr. Quin is miftaken in fuppofing, that the
mercurial undtion was ever difedfed to that part
of the body, either by Dr. Dobfon or myfeif.
He has fallen likewife into another error, in
bating that the firft patient cured by Dr. Dob-
fon, of Hydrocephalus, was his own child, and
that the fortunate event depended on the op-
portunity that this afforded of the mqft early
attention. This, indeed, was the cafe, with
refpe<3: to one of the early hiiljlories, which 3
have related ; and I acknowledge the julfice of
the Dodtor’s conclufion concerning it.
ManchjfieTf
May 20,
xw.
/
[ 134 ]
XIV. An Account of the Preparation, Mode of
Application, and Effedls, of a Liniment recom-
mended ^Roncalli in the treatment of fcrophu-
lous Tumours. By Henry Streitt, Profejfor of
Chirurgical Pathology in the Imperial and Royal
Medico-Chirurgical Academy at Vienna. Vide
Abhandlungen der K. K. Jofephinifchen Medi-
%in. Qhixurg. Akademie zu Wien. Vol, I.
H E remedy here recommended for the
cure of fcrophulous tumours was made
public fo long ago as the year 1741, by Ron-
calli, who obtained it from a furgeon at Mot
dena ; and the author of the paper before U5
claims only the merit of bringing it again into
notice.
Roncallidefcribes the preparation and manner
of ufing it in thefe words :
‘‘ Felli bovino in fua cyfti integro addantur
“ tria cochlearia falis communis & olei nucum;
cyfti deinde aliquo temporis intervallo, aut
foli, aut levillimo calori, expofita. Stupp^
‘‘ ichore illo humedlatas, bis in die fcrophulofis
tumoribus aptentur.” *
* Hift. Mprbprum. Folio, Brixis, 1741, p. 41.
Profellbr
[ 135 ]
f
Profeflbr Streltt obferves of this liniment^
that repeated trials have convinced him, firft,
that whenever . a fcrophuloiis tumour is capable
of being difperfed, fuch an effed: may in gcr
neral be expeded from the ufe of this applica-
tion ; fecondly, that when the tumour cannot
be difperfed, the ufe of the liniment ferves to
promote fuppuration ; and thirdly, that in thofe
inveterate fwellings, or fpecies of feirrhus^
which neither difperfe nor come to fuppuration,
a long-continued ufe of it has been found to
lelTen the bulk of the tumour to a confiderab’p
degree, fo as to leave only, as it werg, a very
fmall nucleus.
Ten cafes are related in which this appHca?
tion was tried, but in the greater number of
thefe, as the author very candidly informs us,
internal remedies were occafionally adminiftered
during its ufe.
The fubjed of tke firft cafe was a foldier,
nineteen years qld, who had large glandular
fwellings in the neck and under the lower jaw.
In this cafe the ufe of the liniment was be-
gun on the 9th of July,
On the 17th the furface of the tumour was
inflamed and covered with veficles, which made
it neceflary to fufpend the ufe of the liniment
K 4 till
I
C ^36 ]
dll the 2ift, when it was again had recourfe to.
The fwellings had now fomewhat diminilhed ;
but on the 9th of Auguft frefh veficles ap-
peared, and the ufe of the liniment was obliged
to be again fufpended till the iSth.
At this period of the cafe the fwellings were
diminilhed to half their former bulk. The ufe
of the liniment was continued without inter-
ruption fi-qm the i8th of Auguft till the 13th
of September, when it was again neceftarily
fufpended, during fix days, on account of the
appearance of frefti veficles.
On the 30th of September the fwellings were
entirely difperfed, and the patient was dif-
charged cured.
The internal remedies given in this cafe were,
a purgative medicine, compofed of jalap and
cream of tartar, at the beginning of the treat-
ment; and afterwards a decodfion of the roots of
bardana and polypodium, with pills compofed
’ of foap, gum ammoniac, ar\d rhubarb.
The fecond patient was a foldier, aged twen-
ty-three years, who was admitted under our
author’s care on the 20th of June, 1786, with
a fwelling of the fubmaxillary glands of the
right fide as large as a hen’s egg, and feveral '
other
[ >37 !3
pther confiderable fwellings of the glands of
the neck on the fame fide.
The life of the liniment was begun in this
cafe on the 9th of July, and on the 14th the
fwellings were evidently beginning to leffen and
to become fofter, fo that by the end of the
month they were reduced to half their former
fize.
The life of the liniment was diligently con-
tinued during all this time, excepting, that in
order to prevent vefications, it was fometimes
omitted, or more fparingly applied ; as the
ftate of the Ikin, from the greater or lefs degree
of rednefs, Teemed to require.
Before the end of Augufl: all the fwellings
were difperfed except two which were ftill large
though of a fofter confiftence, and thefe were
entirely removed about the middle of Septem-
ber, on the 23d of which month the patient was
difeharged cured.
The fame internal remedies were given in this
as in the firft cafe.
The third patient was a foldier, aged twenty
years, who had a large fwelling of the fub-
inaxillary gland.
He began the life of the liniment on the
?3d of January 1787. The tumour was well
■rubbed
[ 138 ]
rubbed with it and a pledgit previoully moift-
ened with it was alfo applied to the part, and re-
newed twice a day ; care being taken, however,
to watch the date of the fkin, and to omit the li-
niment, or to leffen the quantity of it, as occa-
lion required.
In the fpace of a month, without any affif-
tance from internal remedies the tumour was
entirely difpcrled, and on the 2^th of February
the patient was difeharged cured.
The fubjedt of the fourth cafe was a young
prince, fifteen years old, who had a large fero-
phulous fwelling of the glands of the neck un-
der his right ear, of five years ftanding, which
deformed his whole face. The furface of the
Ikin was not difcoloured, and the tumour itfelf
was indolent and moveable.
In this cafe there was alfo an enlargement of
the thvroid pland.
J O
The tumours were rubbed gently every night
for a quarter of an hour with the liniment, and
fomc of it was applied to them on pledgits and
kept on all night. When it excited vefication,
the ufe of it, as in the former cafes, was occa-
fionally fufpended. In this manner the treat-
ment was continued during three months, at
the end of which time we are told the fwelling
[ 139 ]
of the glands under the ear was almoft entirely
jdifpen'ed, and that of the thyroid gland was
much lelTened.
In the fifth, cafe, as in that lafi: related, a tu-
mour of the parotid and fubmaxillary glands was
only partially difperfed.
In the fixth, which was alfo a cafe of glandu-
lar fwdling of the neck, the tumour fuppurated.
In the feventh, which was a fwelling of the
right parotid and fubmaxillary glands, of three
years Handing, the ufe of the liniment was per-
severed in during the Space of five months, but
at the end of that time although the fwelling
of the parotid gland is Said to have been al-
mofl; entirely difperfed, the fubmaxillary glands
were ftill large and indurated.
In the eighth cafe the fuccefs of the liniment
wvas alfo incomplete ; a large fcrophulous fwel-
ling of the parotid and fubmaxillary glands
having been only partially leflened by its ap-
plication.
The fubjedt of the ninth cafe was a foldier,
aged twenty-five years, who had a white fwel-
ling of his left knee, which had been coming
on flowly about two years, but in which there
was as yet no appearance of fludtuation. Different
topical applications were tried, and among
others
[ 140 3
others the Hungarian remedy compofed of
gum ammoniac and vinegar. By means of
this la£t the tumour feemed to be fomewhat di-
minifhed, but an intolerable itching made k ne-
cefikry to fufpend its ufe on the eighteertth day
©f the treatment. Recourfe was now had to
the tiniment three or four times a day, and in
about fix weeks, without the affiftance of any other
mternal remedy than a Angle purgative medicine
the fwelling was removed, and the patient, at
the end of two months, was difmiffed cured.
In another patient, a man aged thirty five
ycarSs. who had a fimllar complaint, which had
alfdbeen llowly coming on, a cure was effefled by
the fame means in a hill fhorter time; for at the
end of five days the tumo-ur began fenfibly to
diminifh, and before another week hadelapfed he
was almoft entirely cured : this man took a mer^
©urial purge twice during the treatment.
Roncatli, as we have feen, direfts the llni-
nment to be nfed only twice a day ; but we find
©ur author fometimes applying k more fre-
quently ; though he acknowledges that by fo
doing the cure is not always aeeelerated; its
* For aa account of this remedy fee tbe ficC volorac' ©>f tiia
^adon. Midical Journal,, page 1.54.
opcr.aiiicaa
t ]
operation on the fkin when it is often repeated,
rendering it neceffary to fufpend its ufe frofm
time to time, fothat its efFefts in this refpc-iS;
will, of courfe, require to be particularly at'-
tended to.
XV. An Account of the I'abafheer. In a hettsT
from Patrick Ruffell, M. D. F. R. S. to Sir
Jofeph Banks, Bart.P.R. S. — Vide Phihjofhicd
F’ranJaPiions of the Royal Society of London^
VoL LXXX. for the Tear 1790. Part. H,
4to. London, 1791.
^ ’'HE drug, which is the fubjedt of the pa-
per before us, has long been a medicine
of high repute in the Eafl:, and is mentioned
by all the Arabian Medical writers, as an im-
jportant article of their materia medica.
To the Arabs and Turks it is known under
the name of Tabalheer only ; and under that
name alfo it is mentioned in the vwitings of the
Arabian phyficians.
In the Gentoo language it is called Vedroct-
paloo, Bamboo milk ; in the Malabar, Miingei
Upoo, fait of Bamboo; and in the Warriar^
Vedroo Carpooram, Bamboo Camphor,
I
Our
[ 142 ]
Our author obfcrves, that Garcias ab litorfo
long ago pointed out a dangerous error, com-
mon to the old tranflacors of the Arabian wri-
ters, refped;ing this drug ; Tabafheer, in the
Latin verfions of Rhazis and Avicenna, being
conftantly rendered Jpodiumy and this interpre-
tation having been adopted by molt cf the fub-
fequent tranflators of other Arabian medical
writers.
The late Mr. Clianning^ when engaged in the'
tranflatiort of Rhazis on the fmall-pox, ap-
plied, it feems, to our author, then in Syria,
for fuch information as he might be able to coi-
led: on the fubjedt of Tabafheer at Aleppo^
Dr. Ruflell, accordingly tranfmitted to him va-
rious fpecimens of the drug, together with fe-
veral extrads relative to it, from books found
in the Aleppo libraries ; but he is now con-
vinced, he tells us, that much of the drug
commonly vended in Turkey is fiditious or
adulterated.
The Arabian medical writers generally agree
in fuppoling the Tabafheer to be a produdioh
of the Indian raed ; more efpecially of fuch as
have fuffered from fire, kindled b}/’ the fridion
of the reeds one againfttheother, an accidentthat
is faid to happen frequently in the dry feafon.
Our
[ 14^ 3
Our author has been affured, he tells us, byfe->-
Veral mountaineers, with whom he has converfed
on the fubjeft, that the bamboo is not the only
tree fubjedt to accidental ignition by fridtion ;
but thefe people added that they never looked for
Tabaflieer in the half-burnt fragments of the
bamboo, though they doubted not it might
fometimes be found there as well as in others.
Dr. RulTell is convinced that the genuine
Tabafheer is a produdtion of the Arundo Bamhos
Linn, the lly of the Hortus Malabaricus, and
the Arundo Indica arbor ea maxima^ cortice Jpinofo,
of Herman ; but he thinks it no lefs certain that
fire is not a necefliiry agent in its produdtlon.
He obferves that the bamboo, in which the
Tabaflieer is found, is vulgarly called the Fe-
male Bamboo, and is dillinguifhed by the large-
nefs of its cavity from the male. They arc
even faid, it feems, to be feparate trees; but this
fadl he has not been able to afcertaln.
Of the feven pieces of bamboo which accom-
panied the paper before us, four, we are told, were
from the mountains near Vellore, and three from
a fpot diftant about twenty miles from Viza-
gapatam, the place from which the author
dates * his letter. The former were perfedtly
* Not. 36, 1788.
green
r 144 ]
green on their arrival at Madras ; and the othe'ri
were ftill fo when they came to his hands;
Thefe, he obferves, were all feleded on a con-
jedture of their containing Tabafheer, from a
certain rattling perceived upon fhaking the
fcamboo, as if fmall ftones were contained in the
cavity. This, by the natives, is confidered as an
indication of Tabaflaeer being contained in one
or more joints of the bamboo, and, it feems,
they are feldom difappointed ; but it does not
always follow that there is no Taballrcer where
a rattling is not perceptible ; for upon fplitting
a number of reeds, it was fometimes remarked,
that where the quantity of the drug was incon-
fiderable, itwas^found adhering fo clofelp .to
the fides of the cavity, as to prevent any rat-
tling from being perceived upon fliaking. In
general, however, our author hTas found the
rule of the natives, for choofing the bamboo, «
cood one.
On examining one of the bamboos, confifting
of fix joints, from Vellore, Dr. Ruflell found
Tabaiheer only in two of the joints, and in thefe
the quantity was various, amounting in the
whole to about twenty-feven grains.
The quality alfo, he obferves, was various*
^he particles reckoned of the firll; quality, and
which
[ H5 ]
which did not exceed four grains in weighty
were of a bluilli white colour, refembllng fmall
fragments of IheDs. They were harder than the
others ; and when rubbed between the fingers
eafily crumbled into a gritty powder, which
had a flight faline teftaceous tafte. ‘The reft
were of a cineritious colour, rough on the fur-
•fade, and more friable ; and intermixed with
thefe were fome larger, light, fpoligy, particles,
fomewhat refembling pumice ftones. Dr. Ruf-
fell thinks it probable, that the Arabs, from
thefe appearances of the drug, were led into
the opinion already mentioned of its produdfion.
The two middle joints, he obferves, w'ere of
a pure white colour within, and lined with a
thin film , and it was in thefe chiefly the Ta-
baflieer w^as found. The others, particularly the
two upper joints, were difcoloured within, and
in fome parts of the cavity was found a blackifh
fubftance in grains, or iii powder, adhering to
the lides, the film being thefe obliterated.
Thirty-feven green bamboos, brought from
the hills fifty miles diftant from Vizagapatam,
being carefully fplit and examined, the refult
we are told, was as follows.
In nine out of the thirty-ieven there were no
Vefliges of Tabafhcer. In twenty-eight fome
VoL. I. L,
were
were found In one,' two, or three joints of each^
but never in more than three joints of the fame
bamboo. The quantity varied, but in all was
inconfiderable; and the empty joints were fome-
times contiguous, fometimes Interrupted, indif-
ferently.
Dr. Ruflell obferves that the whiter, fmooth,
harder particles, when not loofe together with
the others in the cavity, were moftly found ad-
hering to the feptum that divides the joints,
and to the ^d'es contiguous but never to the
lides about the middle of the joints ; and that
inilead of being, chiefly found at the lower ex-
tremity of the joint, as' might be exped:ed from
the j.ulee fettling there, they were found adher-
cnt indlflerently to either extremity, and fome-
times to both. In this fituation they formed a
fmooth lining, which ufually was cracked in
feveral places, and might eafily be detached
with a blunt knife.-
. In fome joints, the Tabafheer was found- thus
eollefted at one or both extremities only, and
in fuch no rattling was perceived upon Ihaklng
the bamboo; but in general, we are told, while
fome adhered to the extremities of the joint,
other detached pieces were intermixed with the
coarfer loofe particles in the cavity.
The
I i47 3 .
The quantity found in each bambdo is faid
to have been very incohfiderable ; the produce
bf the whole twenty-eight reeds, from five to
feven feet long, not having much exceeded two
drachrris; The author therefore thinks it very
probable that the Tabafheer, though not ab-
folutely confined to certain regions, may be
produced in greater abundance in feme foils than
in others ; but that in all regions where the
bamboo grows favourably^ fbme proportion of
it will be foiindj however it may Vary in quality
Or quantity^
Rumphius, who very candidly acknowledges
that he hirtlfelf had not had opportunities of
making enquiries bn this fubjedt, refers his read-
ers to Garcias, whohaS remarked that theTaba-
Iheer is not found in all bariiboos, nor iii all the
branches ihdifcfiminately j blit only in thofe
growing about Bifnagur^ Batecala, and on^ part
of the Malabar coaft;
With refpedl to BifnagUr our author has been
informed in a letter from one of his medical
friends at Hydrabadj That though Taba-
fheer be in great requeft at Hydrabad, and
“ bears a high price, it is never brought
thither from Bifnagur ; that fome of what is
found in the Bazars is brought from the Ar-
L 2 cour
i 148 ]
“ cour pafs in Canoul, and feme from Emna'^
bad, at the diftanc(5 of about eighty miles to
“ the N. W, ; but that the greateft part comes
“ from Mafulipatam. -
“ That there are two forts fold in the Bazars;
one at the rate of a rupee a drachm ; the
other, of inferior quality, at half the price ;
but that this is faid to be chiefly compofed of
’ burnt tedth and bones.
That he was informed by a Perfee, who
had been in Bengal, that the Tabalheer was
*•' produced in great quantities at Sylhet, where
it fold by the pound from one rupee to one
and a half, and formed a confiderable article
of trade from Bengal to Perfia and Arabia.”
Dr. Ruflbll has procured fomeofthe prime fort
of Tabafheer from Hydrabad, and found it to
differ materially from his own fpecimens, not
only in its fuperior whitenefs, and in its being
lefs mixed with impure particles, but alfo in
being much harder and heavier, and fcarcely in
any degree friable to the finger.
With refpedt to the fuppofed formation of
Tabafheer from the juice of the recent bamboo
Dr. Ruflbllfirft quotes Rumphius, who remarks
that in Amboina ‘‘ Juniores arundines plerumr
que in inferioribus fuis nodis femi-repletse'
I utcunquo'
[ H9 ]
utpunquc funt lympida aqua pptabili, qu^
“ hifce in terris fenfim evanefcit, in aliis vero
resionibus exficcatur iri fubftantian albam
“ et calceam qua? 'Tabaxir vpcatur.”
Garcias, as pur author obferves, gives an ac-
count fomewhat different from this, Inter
fingula internodia liquor quidam dulcis ge-
neratur, craffus veluti amylum congeflum,
et'fimili candore, interdum multus, nonnun-
“ quam vero perpaucus. Sed non omnes arun-
dines five rami pum humorem continent. . . ,
“ .... Hie autem liquor concretus, interdum
nigricans et cinereus invenitur, fed non ideo
“ improbatur. Nam aut ob nimiam humidi-
tatem, aut quod diutius ligno inclufus
‘‘ permanferit, hunc fibi colorem conciliat ;
“ non autem ob arborum incendium, veluti
nonnulli putarunt. Siquidpm in multis
“ ramis, ques non contigit ignis, niger etiam
invenitur *.
The exiftence of this fluid in the bamboo is
known by fliaking the joint. In a confiderable
number of bamboos Dr.Ruffell never found wa-
» ^
ter in more than two joints, and generally not
more than two or three drachms in each. The
Cap. 12.
L 3
largcft
[ >50 ]
largeft quantity procured by him at one tim$
was one ounce and a half; very few joints, in
proportion, being found to contain any.
The fluid, he obferves, was always tranfpa-
rent, but varied in confiftenpe; when thicker
it had a whiter colour than ufual ; when more
dilute it differed little to the eye from commop
water, except that fometimes it had a pale
greenifli cafti Applied to the topgue it had a
flight faline, fub-aftringent tafte, more or lef^
perceptible in proportion to the confiftence of
the fluid. After evaporation in the fun, the
reliduum had a pretty ftrong faline tafte, with
lefs aftringency. Some of the fluid, of a darkifh
(Colour, thickened in the reed to the confiftence
of honey ; while fome, in another part of the
feed, was perfedtly white and almoft dry; both,
we are told, had the lharp fait tafle, which the
Tabafhcer itfelf lofes in a great degree by kcep-
ing.
From an ounce of fluid of a greenifli caft, and
flight faline tafte, procured from green bamboos,
our author obtained by flow eyaporatipn fmall
particles of a whitifli colour refembling the
inferior fort of Tabafheer.
As a further proof that this fubftance is
formed in the cavity of the bamboo, we learn,
from
[ ]
from our author’s obfervations, that recent greet^i
bamboos, which, upon fliaking, appeared to
contain water in their cavity, loft this appear-
ance after Handing a few days ; and that when
fplit, after they had ceafed to give any found
by fhaking, fometimes no fluid was found in
the cavity. The interior thin pellicle, how-
ever, was difcoloured, as if by recent moift
ture; and in general fome of the fluid, in a
mucilaginous ftate, remained at the lower part
of the joint.
In the latter end of Odlober, a green bamboo
of five joints was brought to him, wTich ap-
peared to contain both water and Tabaflicer.
After three days, the found of water, upon
flmking the reed, could hardly be perceived ;
and on the fifth day it w'as iniirely impercep-
tible. Upon fplitting the bamboo about half a
drachm of fhe fluid, now thickened into a mu-
cilage, was found at the bottom of the upper
joint. The fecond joint contained fome perfed:
Tabafhcer loofe in the cavicyp The third joint
was empty, excepting a few particles of Taba-
flieer which adhered to the fides near the bottom.
The fourth joint, at the bottom, contained
above a drachm of a brov/nifli pulpy fubftance
adherent. The laft joint, in Ijke manner, con-
T 4 tained
[ 152 ]
taiaed half a drachm of a fubaance thicker and
harder in confiftence, and nearly of the colour
of white wax. • ' ‘
This fpecimen, as the author obferves, ex-
hibited at one view the progrefs of the Taba-
ih eer through its fcveral hages.
In a poafeript to this letter, dated Wey-
mouth Street, July i6th, 1790, we are in-
f^ormed that four of the green reeds prefented
to the focicty on the night’ the preceding ac-
<^ount was read, having been carefully fplit, the
contents, upon comparing them with the fpe-
cimens fent from India, then on the table, were
found to agree in all refpetfts, as well as with
the defeription of the more recent ones given in
this paper. * ' ”
^ t
* In addition to the above account of the T^abaflieer, from
the Philofophical Tranfa£fions, the following extrafi of a let-
ter, on the fame fubjeft, addrelTed to the Editor of this Avork, .
will it is prefumed not be unacceptable to the reader j and
more efpecially as it ferv’es to confirm the opinion of Dr. Ruf-
fell with refpeft to the formation of this fubftance. It is Avrif-
ten by Mr. J. L. Williams, an ingenious Surgeon in the
fervicc of the Hon. Eaft India Company, in Bengal, and h
i
dated at Benares, October 23, i79°-
‘ I have lately procured from the hills in this neighbourhood,
‘ a drug, fpecimens of which I lhall fend, by the Ihips of this
*• leafon, for your infpeflian.
‘ It
t
[ 153 ]
XVL Account of the Nardus Indica, or Spike-
■ nard. By Gilbert Blanc, M. I). F, R> S. —
Vide Bhilofophical Franfaciions of the Royal
Society of London^ VoL LXXX. for the Fear
ly^o. Part II.
IN fome very judicious refledtions, with which
this account of the Nardus Indica is pre-
faced, Dr. Blane exprefles his regret that the
records of antiquity afford fuch imperfedt de-
feriptions of natural objefts, particularly of
thofe of the vegetable kingdom. Moft of the
vhitings of the ancients, he obferves, have
come down to us cither mutilated by the acci-
‘ dents
t It is called in PeiTian, 'tabajhecr \ in Hindoo, Bum-lochun
‘ or fait of the Bamboo. It has a peculiar qualit}'' of ftrongly
‘ adhering to the tongue, and is held in great efteem by the
‘ natives in a variety of difeafes ; but 1 have not yet been able
‘ to afeertain its virtues from my own experience.
‘ a Perfian work (the Tofut ul-Monein of Mahomed
‘ Monein Hofeiny) I have found the following obfervations
‘ on this fubitance, and its fuppofed medicinal properties, viz.
“ It (i. e. the Tabaflteer or Buns-lochun) is procured
from the cavity of the Indian reed or Bamboo j and itisfaid
“ that when, from the violence of the winds, fire takes hold of
thofe reed thickets, the Tabalhccr is formed of the joints of
“ the reeds, which are feparated from the aflies thereof. The
“ bell kind is of a white colour, and of a roundifli fliape
having to the palate a fmall degree of a rough and biting
tafie. - - - - There is a faftitious kind made of burnt bones ;
‘ kut
[ 154 ]
dents of time, or corrupted by unfaithful and
ignorant tranfcribers ; and he feems to think
that the learned works upon profefilonal fubjedts
have been more unfortunate in thefe refpedts
than works of imagination and general fcience.
But even fuppofing the works of Theophraftus,
DIofcorides, and the other ancient phyficians
and natuialiftsj to be extant in their utmoff
completenefs and purity, ftill their method of
defcribing plants and other natural bodies was
fo defedtive, that very few of them, he ob^
ferves, could now be recognized; for we have
not only to contend with the obfeurity belong-
“ but this has but a fmall degree of bitternefs to the tafle, and
“ pofieffes no ftrength The Tabalheer will not diflblve
“ in water. - - . - It puts a flop to bilious vomitings and t*
“ the bloody flux. It is alfo of fervice in cafes of palpitation
“ of the heart, in faintings, and for ftrengthening thofe mem-
bers of the body tiiat are weakened by heat. It is ufeful alfp,
“ for the piles, and for acute or burning fevers, and for puftules
“ in the mouth (thrulli) ; and, given with oxymel is of fervice
“ againft reftlelTnefs, melancholy, and hypochondriacal afFec-
“ tions. ---- The habitual internal ufe of it is prejudicial to
“ the virile powers. It is all’o faid to be prejudicial to the lungs.
“ Its correftives are the gum of the pi;ic and honey. The dofe
“ of it is to the weight of two d’herems or feven ipafhas’.”
• With the fpccimcns of this drug, I fliall alfo fend you a
' piece of the Bamboo unopened, with fome of the fait, or fu-
' gar, in it ; from which you will be convinced that the Ta-
' bafliecr is not formed by the burning of the bamboo, as the
^ author juft now q^uoicd, and others, have fuppofed,’
ino
t
C 155 ]
|ng to a dead language, in fo far as the name
merely is concerned, but it would be impoffi-
ble, as he juftly remarks, even in a living lan-
guage, to perpetuate the knowledge of any ob*
jeft in nature, fuch as a plant, without fome
defeription to diferiminate it from all others.
For want of fuch defeription the knowledge
contained in the writings of the ancient natu-
ralifts could, he thinks, be of ufe only to their
contemporaries and countrynaen, who were al-
ready acquainted with the objedts of it, but
could afford no certain information to the igno-
rant in diftant countries and future ages. Of
all the ancient medicines, he obferves, there is
perhaps none but opium of which the identity
can be unqueftionably afeertained ; of moft of
them little more being faid than merely giving
their names : fo that the fruits of the inge-
nuity and labour of one age have, in a great
meafure, in confequence of this ambiguity, been
loft to another. Pofterity will, therefore, he
adds, be greatly indebted to thofe induftrious
naturalifts of the prefent times, who are carry-
ing the defeription of nature to an unexampled
height of improvement.
Dr. Blane has been led, he tells us, to his re-
flexions on this fubjedf by an account fent to
him.
[ 156 ]
him, fome time ago, by his brother in India,
of the Spikenard, or Nardus Indica, a name
familiar in the works of the ancient phyficians,
naturalilfs, and poets ; but the identity of which
has not hitherto been fatisfattorily afcertained.
He fays, in a letter dated Lucknow, Decem-
ber, 1786, that travelling with the Nabob
“ Vifer, upon one of his hunting excurfions,
towards the northern mountains, I was fur-
“ prifed one day, after eroding the river Rapty,
“ about twenty miles from the foot of the hills,
‘‘ to perceive the air perfumed wdth an aroma-
tic fmell ; and, upon afking the caufe, I was
told it proceeded from the roots of the grafs
“ that were bruifed or trodden out of the ground
by the feet of the elephants and horfes of the
Nabob’s retinue. The country was wild and
uncultivated, and this u’as the common grafs
which covered the furface of it, growing in
“ large tufts clofe to each other, very rank,
and in general from three to four feet in
length. As it was the winter feafon, there
was none of it in flower. Indeed the greateft
“ part of it had been burnt down on the road
we went, in order that it might be no impe-
“ diment to the Nabob’s encampments.
“I col-
c >57
I collefted a quantity of the roots to be
dried for ufe, and carefully dug up fome
it, which I fent to be planted in my gardeil
“ at Lucknow. It there throve exceedingl}^
and in the rainy feafon it Iliot up fpikcs about
hx feet high. Accompanying this I fend
)'ou a drawing of the plant in flower, and of
the dried roots, in which the natural appea-
ranee is tolerably preferved.
“ It is called by the natives T^rankus, which
means literally, in the Hindoo language,
fever-reftrainer, from the virtues they attri-
bute to it in that difeafe. They infufe about
“ a drachm of it in half a pint of hot water,
“ with a fmall quantity of black pepper.
“ This infuflon ferves for one dofe, and is re-
peated three times a day. It is efceemcd a
“ powerful medicine in all kinds of fevers,
“ whether continued or intermittent. I have
“ not made any trial of it myfelf; but fliall
certainly take the firfl: opportunity of doing
fo.
“ The whole plant has a ftrong aromatic
odour ; but both the fmell and the virtues
** reflde principally in the bulky roots, which
in chewing have a bitter, warm, pungent
tafte, accompanied with fome degree of that
‘‘ kind
/
[ ]
“ kind of glow in the mouth which cardi*
“ moms occafion.”
Befides the drawing, d dried fpedmen, wc
are told, has been fenr, which was in fuch good
prefervation as to enable Sir Jofeph Banks,
P. R. S. to afcercain it by the botanical charac-
ters to be a fpecies of Andropogofi^ different from
any plant that has ufually been imported under
the name of Nardus, and different from any of
that genus hithtrto d^fcribcd in botanical fyB
tems.
Our author is of opinion, however, that
there is great reafon to fuppofe it to be the true
Nardus Indie a of the ancients ; for firft the
eircumftance, in the account above recited, of
its being difeovered in an unfrequented coun-
try from the odour it exhaled by being trod
upon by the elephants and horfes, correfpondsj
be obferves, in a flriking manner, with an oc-
currence related by Arrian, in his Hiftory of
the Expedition of Alexander the Great into
India. It is there mentioned, lib. vi. cap. 22*
that during his march through the deferts of
Gadrofia the air was perfumed by the Spike-
nard, which w'as trampled under foot by the
army. Secondly, though the accounts of the
ancients conicerning this plant are obfeure and
defe^five^
t 159 ]
i^efeftlve, it Is evident, he thinks, that It was
a plant of the order of gramina, as the term
arijla, fo often applied to it, was appropriated
by them to the frudfification of grains and
graffcs* The term fpica, he farther obferves,
is applied to plants of the natural order verli^
fillat^e, in which there are many fpecies of fra-
grant plants, and the lavender, which being an
indigenous one, affording a grateful perfume,
was called N'ardus Italica by the Romans ; but
-We never find the term arijia applied to thefe.
The poets, as well as the naturalifis, conftantly
apply this term to the true Nardus. In proof
of this our author refers to Statius, who calls
the Spikenard odorata arijla ; to Ovid, who, in
mentioning it as one of the materials of the
phoenix’s neft, calls it Nardl le-vis arijia ; and to
a poem on the fame fubjedt, afcribed to Lac-
tantius, where the epithet ■pubenils in the ex-
preffion of his addit teneras Nardi pubentis ary'
tasy feems even to point out that it belonged to
the genus andropogon, a name given to It by
Llnnsus from this circumftance Galen, it
feems, fays, that though there are various forts
of Nardus, the term or Spike-
nard, fhould be applied only to the Nardus
Indif.a. It would appear, our author obferves,
that
t ]
that the NayiiUS Celtic^ was a plant of a difte-
rent habit, and is luppofed to be a fp^cies df
Valeriana. He is aware that Pliny’s defeription
of the Nardus Indica docs not correfpond with
the fpecimen which is the fubjedt of the prefect
account, for he fays it is frutex radice pingui et
crnjfa, whereas this has fmall fibrous roots*
But as Italy is ver-y remote from the native
country of tins' plant. Dr. Blane thinks it rea-
fonable to fuppofe, that others, more eafily pro-
curable, ufed to be fubftituted for it; and the
more fo, as,, according to the author lafi; men-
tioned, there were r.ine different plants by which
it could be imitated and adulterated. Our au^
thor finds a Nardus yfflyrm mentioned by Ho-
race, and a Nardus Syriaca by Diofeorides, as a
fpecies different from the Ind'ica ; and both Di-
ofcoridcs and Galen, he adds, by \Vay of fixing
more precifely the country from whence it
comes, call it alfo Nardus Gaugites. Thirdly^
Garcias ab Horto, the only writer perhaps,
Dr. Plane remarks, who appears to have fpoken
of it in its recent fiate, from his own obferva-
tions, has given a figure of the roots, or rather
the lower part of the ftalks, which correfponds
with our author’s fpecimen. Fourthly, the
fenfible qualities of this fpecimen are fuperior,
we
t >8i ]
\vc are told, to what commonly palTes for it ill
the Ihops, being poflefled both • of more fra-
grancy and pungency, which feems to account
for the preference given to it by the ancients.
It has been a fubjedt of inquiry with Ma-
tliiolus, whether the roots or ftalks of this plant
were the parts moft efteemed by the ancients;
The roots of Dr. Blane’s fpecimen, it feems,
are very fmall, and poflefs fenfib'le qualities in-
ferior to the reft of the plant ; yet it is men-
tioned, in the account above recited, that the
virtues refide principally in the hujky roots. It
is evident, he obferves, that by the bulky roots
muft be meant the lower parts of the ftalks and
leaves where they unite to the roots; and he
thinks it probable that to a flight inaccuracy of
this kind is owing the ambiguity on this point
that occurs in the ancient accounts.
With regard to the virtues of this plant. Dr;
Blanc obferves, that it was highly valued an-
ciently as an article of luxury as well as a me-
dicine. He finds the ungiientum nardinum fpo-
ken of as a favourite perfume at the ancient
baths and feafts ; and he learns from a paflage
in Horace, that it was fo valuable, that as much
of it as could be contained in a fmall box of
precious ftone was confidered as an equivalent
V OL. I. JVi foe
[ i62 ]
for a large veffel of wine, and a handfome quota
for a gueft to contribute at an entertainment,
•ccording to the cuftom of antiquity :
Nardo v'lnum merebere
Nardi parvus onyx eliciet cadum.
Its fenfible qualities, we are told, do not de-
pend on a principle fo volatile as effential oil ;
and this, our author thinks, would be a great
recommendation of it to the ancients, as its
virtues would thereby be more durable, and
they were not acquainted with the method of
colledfing ellential oils, being ignorant of the
art of diflillation. He finds the fragrance and
aromatic warmth of the Nardus to depend on a
fixed principle, like that of cardamoms, ginger,
and fome other fpices; He has tried to extract
its virtues by boiling water, bj maceration in
wine and in proof fpirits ; but to all thefe men-
flrua it yielded them but fparingly and with
difficulty.
As a remedy, both external and internal, it
had a high character among the ancients. Dr^
Blane finds it one in the lift of ingredients in all
the antidotes, from thofe of Hippocrates, as.,
given on the authority of Myrepfus and Nico-
laus Alexandrinus, to the officihals which have
kept their ground till modern times under the
3. !»ame.9
i ]
*
hames of Mithridate and Venice Treacle. He
obferves that it is recommended by Galeri and
Alexander Trallian in the dropfy and gravel
that Celfus and Galen employed it both exter-
nally and internally in pains 6f the ftomach and
bowels ; and that the latter of thefe phyficianS
having been called to attend Marcus Aurelius^
when that Emperor was feverely afflidted with
an acute complaint in the bowels, the firft re-
hiedy he applied was warm oleum nardlhuni
on wool to the flomach.
It appears that the natives of India confidef
it as an efficacious remedy in fevers ; and Dr.
Blane obferves, that its fenfible qualities pro-
mife virtues limllar to thofe of other fimples
now In ufe among uS in fuch cafes. Befides a
ftrong aromatic flavour, it pofTefTeS, we arc
told, a pungency to the tafte little inferior to
the ferpentaria, and much more conliderable
than the contrayerva. Our author finds it men-
tioned In a work attributed to Galen, that a
medicine, compofcd of this and fome other
aromatics, was found ufeful in long-protradted
fevers, which are the cafes, he obferves, in
which medicines of this clafs are employed in
modern practice.
Mz
The
[ i<54 ]
The paper is accompanied with an engraved
figure of the plant, for which we mull refer
our readers to the work itfelf*
XVII. Account of a Child with a double Head.
In a Letter from Everard Home, Efq. F. R. S.
to John Hunter, Efq. F. R. S. — Vide Philo-
fophtcal ‘TranJaElions of the Royal Society of
London, Vol. LXXX. for the Tear 1790,
Part IL
The fpecies of lufus nature, which is thtf
fubjedt of the curious and interefting
paper before us, is fo extraordinary and unac-.
countable, thatj 'although the fadfs are fuffi-
ciently eftablllhed by the teftimonies of the-
molt refpedfable witnefles, the author would
fhill, as he very candidly alTures us, have been
diffident in bringing them before the Royal
Society, had he not been enabled at the fame
time to produce the double Ikull itfelf, in which
the appearances illuftrate fo clearly the different
parts of the hiftory, that it muft be rendered
perfedlly fatisfadfory to the minds of the moft
ineredulous.
The
///////Zi
3fed: T£Lcl3 and Oha: rdl.I.F/atr lT.
[ i65 ]
The following account of the child, when
fix months old, he was favoured with by Sir
Jofeph 'Banks, who, it feems, from the hand-
writing and other circumftances, believes that
it was written by the late Colonel Pierce. Mr.
Home has, however, he tells us, been lefs fe-
licitous to afeertain the author, as the obferva-
tions contained in this account agree fo en-
tirely with the remarks that were afterwards
made, and with the appearances of the Ikull,
that they require no name being annexed to
them in confirmation of their having been made
with accuracy and fidelity, *
The child was horn In May, 1783, of
“ poor parents; the mother was thirty years
old, and named Nooki ; the father was called
‘‘ Hannai, a farmer at Mandalgent, near Bar-
dawan, in Bengal, and aged thirty-five.
“ At the time of the child’s birth, the wo-
‘‘ man who adted as midwife, terrified at the
firange appearance of the double head, en-
deavoured to deftroy the infant by throwing
“ it upon the fire, \vhere it lay a fufficient time,
“ before it was removed, to have one of the
eyes and ears confiderably burnt.
“ The body of the child was naturally form-
?d, but the head appeared double, there be-
M 3 ' « ing,
I
[ i66 ]
ing, befidcs the proper head of the child,
another of the fame fize, and to appearance
almoft equally perfedt, attached to its upper
part. This upper head was inverted, fo that
they feemed to be two feparate heads united
‘f together by a firm adhefion between their
‘‘ crowns, but w,khout any indentation at their
union, there being a fmooth continued fur-
face from the one to the other. The face of
the upper head was not over that of the
lower, but had an oblique pofitioh, the cenr
ter of it being immediately above the right
e;ye.
“ When the child was fix months old, both
of the heads were covered with black hair
in nearly the fame quantity. At this period
“ the Ikulls feemed to have been completely
offified, except a fmall fpace between the olTa
frontis of the upper one, like a fontanelle.
“ Obfervations on the fuperior or inverted Head.
No pulfation could be felt in the fituation
of the temporal arteries y but the fuperficial
veins were very evident.
The neck was about two inches long, and
“ the upper part of it terminated in a rounded^
foft tumor, like a fmall peach.
One
/
[ -67 ]
‘‘ One of the eyes had been eonfiderably
“■ hurt by the fire, but the other appeared per-
“ fedt, having its full quantity of motion ;
but the eyelids vvere not thrown into adtion
‘‘ by any thing fuddenly approaching the eye \
nor was the iris at thofe times in the leaft af-
“ fedled, but, when fuddenly expofed to a
ftrong light, it contradted, although not fo
much as it ufually does. The eyes did not
correfpond in their motions with thofe of
‘‘ the lower head ; but appeared often to be
“ open when the child was afieep, and fliut
when it was awake.
“ The external ears were very imperfedt,
being only loofe folds of fkin, and one of
them mutilated by having been burnt. There
did not appear to be any palTage leading into
“ the bone which contains thp organ of hear-
ing.
“ The lower jaw was rather fmaller than it
“ naturally fhould be, but was capable of mo-
“ tion. The tongue was fmall, flat, and ad-r
hered firmly to the lower jaw, except for
“ about half an inch at the tip, which was
“ loofe. The gums in both jaws had the na^
“ tural appearance ; but no teeth were to be
feen either in this head or the other.
M4
‘‘ The
. [ i68 ]
’ The internal fnrfaces of the nofe and
mouth were lubricated by the natural fecre-
tions, a conliderable quantity of mucus and
faliva being occafionally difcharged from
5* them.
“ The mufcles of the face were evidently
poffeffed of powers of adtion, and the whole
head had a good deal of fenfibility, fince
violence to the Ikin produced the diftortion
expreffive of crying, and thrufting the fin-
‘‘ ger into the mouth mqde it Ihevv ftrong
marks of pain. When the mother’s nipple
was applied to the mouth, the lips attempted
tQ fuck,
“ The natural head had nothing uncommon
in its appearance ; the eyes were attentive to
‘‘ objedts, and its mouth fucked the breafl; vi-
‘‘ goroufly. Its, body was emaciated,
“ The parents of the child were poor, and
carried it about the ftreets of Calcutta' as a
curiofity to be feen for money • and to pre-*
vent its being expofed to the populace, they
“ kept it conflantly covered up, which was
confidered as the caufe of its being emaciated
“ and unhealthy.”
The attention of the curious could not fail
to be attfadled by fo uncommon a fpecies of
deformity ;
I
[ 1^9 ]
deformity ; and Mr. Stark, who was then refi-:
dent in Bengal, paid, we are told, particular
attention to the appearances of the different
parts of the double head, and endeavoured tq
afeertain the mode in which the two Ikulls were
united, as well as to difcover the fympathies
which exifted between the two brains. Th/S
gentleman, on his return to England, finding
that Mr. Home was in poffeffion of the fkull,
and propofed drawing up an account of the
child, very obligingly favoured him with the
refult of his obfervations, and at the fiime time
permitted him to have a fketch taken from a
very exadt painting, made under his own in-
fpedtion, from the child while alive, by Mr.
Smith, a portrait painter then in India. From
this figure *, and two others -j~, which accom-
pany
^ See Plate I [. Fig. i.
t See Plate II. Fig. 2 and 3. In fig. 2 the double head is
reprefented exaflly half the natural fize. One of the eyes of
the upper face appears fmaller or more contrafted than the
other; this is faid to be in confequcnce of the injury it re-
ceived when the child was thrown upon the fire. In this figure
the'fuperficial veins upon the forehead of the upper head are
very diftinflly feen. — Fig. 3 is an exa£l reprefentation of the
double (hull, which is now in Mr. Hunter’s colleaion, upon
^ ,.^he fame fcab as fig. 2. Mr. Home obfervej of it, that it
Ihow*
C '7° ]
pany Mr. Home’s account, and which we have
taken the liberty to copy for the gratification
of our readers, a very accurate idea is given of
the child’s apj)earance.
At the time Mr. Stark faw the child it mufl
have been, our author thinks, nearly two years
old *, as it was fome months before its death,
which he has every reafon to believe happened
in the year 1785. At this period the appea-
rances, we are informed, differed in many re-
fpedts from thofe taken notice of when the
child was only fix months old.
The burnt ear had fo much recovered itfelf
as only to have loft about one fourth part of the
loofe pendulous flap. The openings leading
from the external ear appeared as diftindl as
In thofe of the other head. The fkin furround-
ing the injured eye, which was on the fame fide
fliowt the curious manner in which the t%yo Ikulls are united
together, and the number of teeth formed before the child’s
death ; which circumftance, he adds, afeertains with tolerable
accuracy its age,
* Mr. Home remarks, in a note, that the dentes molares,
which ufually appear at twenty months or two years of age,
were through the gums ; and there was no reafon, he adds,
tp expeft them very early in this child.
with
r 171 ]
with the mutilated ear, vva,s in a flight degree
afFedted, and the external canthus much con-
tradied, but the eye itfelf was perfedt.
The eyelids of the fuperior head were never
completely Ihut, remaining a little open, eVen
when the child was afleep, and the eyeballs
moved at random. When the child was roufed,
the eyes of both heads moved at the fame time;
but thofe of the fuperior head did not appear to
be diredted to the fame objedt, but wandered
in different diredlions. The tears flowed from
the eyes of the fuperior head almofl; eonftantly,
but never from the eyes of the other, except
when crying.
The termination of the upper neck was very
irregular, a good deal refembling the cicatrix
pf an old fore.
The fuperior head feemed to fympathize with
the child in its natural adtions. When the child
cried, the features of this head were affedted ip
a fimilar manner, and the tears flowed plenti-
fully. When it fucked the mother, fatisfadtion
was exprefied by the mouth of the fuperior head,
and the faliva flowed more copioufly than at any
other time; for it always flowed a little from it.
When the child fmiled, the features of the fu-
perior
[ 17^ ]
perlor head fympathifed in that acllon. When
the ikin of the fuperior head was pinched, the
child feemed to feel little or no pain, at leafl
not in the fame proportion as was felt from a
hmilar violence being committed on its own
head or body.
When the child was about two years old, and
in perfed; health, the mother, we are told, w'ent
out to fetch fome water, and upon her return,
found it dead, from the bite of a Cobra de Capeh.
The body was buried near the banks of theBoop-
norain river, but was afterwards dug up by Mr.
Dent, the honourable Eaftindia Company’s Agent
for fait at Tumloch, on whofe grounds the pa-,
rents of the child then lived. By Mr. Dent it was
given td Captain Buchanan, late Commander of
the Ranger Packet, in the fervice of the ho-
nourable the Eaft India Compafiy, who, being
ftruck with the uncommon appearance of the
double fcull, had expreifed a wifli that he might
be permitted to bring.it to Europe and prefent
it to our author, to whom he well knew it would
be highly acceptable. This requeft, we are inr
formed, was no fooner communicated to Mr,
Dent, than it was complied with; and Mr.
Home obferves that he Ihould do both thele
gentlemen,
r >73 ]
gentlemen injuftlce, were he not to attribut’d
their readinefs upon the prefent occafion to
oblige him, in a great meafure to their knowing
that the double Ikull would be depofited in Mr,
Hunter’s Collection, which muft now be con-
fidered more as a national and public repofitorj
than a private cabinet.
Mr. Home remarks that the two fkulls which
compofe this monftrous head appear to be nearly
of the fame fize, and equally complete in their
oflification, except a fmall fpace at the upper
edge of the ofla frontis of the fuperior fkull,
fimilar to a fontanelle. The mode, he tells us,
in which the two were united is curious, as no
portion of bone is either added or diminifhed
for that purpofe ; but the frontal and parietal
bones of each Ikull, inftead of being bent in-
wards, fo as to form the top of the head, are
continued on ; and, from the oblique pofition
of the two heads, the bones of the one pafs a
little way into the natural futures of the, other,
forming a zig-zag line, or circular future, uni-
ting them together.
The two fkulls are faid to be almoft e-
qually perfeCt at their union ; but the fupe-
rior fkull, as it recedes from the other, is de-
fcribed as becoming more imperfeCt and de-
I ficient
[ <74 ]
ficient in many of its parts. Mr. Home oId^
ferves, for inftance, that the meatu$ auditorius
in the temporal bone is altogether wanting;
and that the balls of the Ikull is imperfedl in
feveral refpeds, particularly in fuch parts as
are to connedt the Ikhlll with a body, the
foramen magnum occipitale being only a
fmall irregular hole, very Infufficient to give
palfage to a medulla fplnalis, and there being
.no condyles with articulating furfaces round
its margin, as there were no vertebrse of the
neck to be attached to it. He farther remarks
that the foramen laccrum in the balls of the
cranium is only to be feen on one fide, and even
there is too fmall for the jugular vein td have
palled through ; that the ofia palati are defici-
ent at their pollerlor part; that the lower javv
is too fmall for the upper ; and that the condyle
and coronold procefs of one fide are wholly
wanting.
. In moli other refpedts, the two fl^ullsj v\<e
are told, are alike; the number of teeth in both
being the fame, viz. fixteen.
From an examination of the internal ftrudfurd
^ of the double Ikull, the two brains, our author '
obferves, have certainly been inclofed in one
bony cafe, there being no feptum of bone be-
tween
C 175 ]
tween them. How far they were intlrely dif*
tindt, and furrounded by their proper mem-
branes cannot now be afcertained; but from the
fympathies which were taken notice of by Mr.
Stark, between the two heads, more particu-
larly thofe of the fuperior with the lower, or
more perfed:, Mr. Home is inclined to be-
lieve, that there was a more intimate connex-
ion between them than limply by means ^of
nerves, and therefore that the fubftance of the
brains was continued into one another.
Had the child, he obferves, lived to a more ad-
vanced age, and given men of oblervation op-
portunities of attending to the effects of this
double brain, its influence upon the intellecflual
principle muft have afforded a curious and ufeful
fource of inquiry ; but unfortunately, he adds,
the child only liVed long enough to complete
the oflification of the Ikull fo as to retain its
fliape, by which means he has been enabled to
afcertain and regifter the fadt,, without having
enjoyed the fatisfadion that would have refulted
from an examination of the brain itfelf, and a
more mature inveffigatfon of the effeds it would
have produced,-
I 17^ 3
XVIII. Cafe of a Gun- foot Wound in the Mouth *
in which, on account of impeded Deglutition, a
flexible Catheter was introduced through the
Nofe into the Oefophagus, and fuflfered to re-
main there during the Space of a Month. By
M. Manoury, Surgeon of the Hotel Dieu at
Paris. Vide Journal de Chirurgie, par M.
Default, Chirurgien en Chef de H Hotel Dieti
de Paris. Tome I. 8vo, P^ris, 1791.
very curious cafe,' though defcribcd
by M. Manoury, appears to have been
chiefly under the diredtion of M. Default. It
relates to a young man, who on the i8th of
December, 1789, about midnight, difcharged
• a loaded piftol Into his mouth. M. Default,
w’ho favv him within an hour after the accident,-
found him bleeding profufely at the mouth,
with his face already confiderably fwelled the
infide of his mouth blackened by the powder 5
the rieht half of his tongue much torn and
burnt; his lo'vver ja'w fradtured on the right
fide ; and a lofs of fubflance in the back part of
the bony palate, on the fame fide, large enough
to admit his thumb ; together with a laceration
of the velum pendulum palati.
Ih
[. ^77 ]
In order to afcertain the extent of the wound
M. Default, we are told, introduced a female
catheter through the opening in the palate.
From this examination there did not feem to be
any communication with the cavity of the fleuil ;
and that the brain was not injured appeared fhill
more cleaily from the rational date of the pa-
tient ; but M. Default was unable to difeovef
either of the three balls, with which the patient
by figns made him to underftand the piftol
had been loaded. They were not to be found
in the blood which had been difeharged, and
the patleht was certain that he had not fwal-
iowed them 5 it was therefore thought likely
that thfey might be concealed in the cells of the
os ethmoid'es or in the fphenoidal finufes.
With a view to fupprd's the haemorrhage the
flexible filver wire of a catheter was introduced
through theright nodril intothefauces, and itsex-
tremity, by the affiftance of a finger, was brought
out at the mouth ; which was an operation
'of fome difficulty on account of the fwelling of
the parts. To.this extremity were tied the ends
of two pieces, or ribands, as the author calls
them,- of waxed thread, between which w'as
faflened a doffil of lint, large enough to fill that
part of the,phdynx which correfponds with
VoL. T. N the
[■ .78 ]
the pofterlor noflrils. By withdrawing the wire
and threads through the nofe, the doffil was
carried into the fauces, and, by the affiftance of
a finger, applied againfl: the pofierior opening of ■
the noftrils. The two portions of thread which
came out through the nofe being then feparated,
one of them was pulled tow'ards the feptum
narium and the other to the oppofite fide. The
noftril was now filled with fmall doffils of lint,
over the lafi. of which, larger than the refi, were
tied the two ends of the waxed threads.
After having thus put a flop to the hasmorr-
hage, Default attempted to reduce the two
fragments of the lower jaw, one of which had
been forced more than half an inch above the
other ; but the fwelling of the foft parts ren-
dered this attempt fruitlefs. He therefore, we
are told, contented himfelf with applying to
the cheeks, chin, and upper part of the neck,
compreffes moiflened with vegeto-mineral wa-
ter. But notwithftanding the frequent renewal
of this appplication, and the ufe of a fuitable
gargle, the tumefadion went on increafing, fo
that the next day deglutition was become ex--
tremely painful and difficult, and on the fccond
was altogether impoffible.
In this alarming ftate of the cafe, M. Default
I was
s
was Induced to remove the doffils of lint froni
the noftrils and fauces, as they were no longer
neccffary, and to introduce through the left
f)oftril a large catheter made of elaftic gum, and
properly curved, which he had before employed
with fuccefs, in a fimilar manner. Having car-
ried this as far as the middle and poflerior part
bf the pharynx, he with one hand drew but the
wire of the catheter, while with the other he
fupported and fixed the catheter itfelf, which
he endeavoured to introduce into the cefopha^
gus, inftead of which it paffed, it feems, at fir ft
into the larynx. This was immediately knowm
by a kind of guggling noife, and by the agita-
tion of the flame of a candle brought clofe to the
mouth of the catheter. Such a deviation, the
author obferves, in an attempt to introduce
flexible catheter in this nianrier Into the oefo-
phagus is frequent, as the furgeon feldom fuc-
beeds at once in getting it into that channel!
The Inconvenience, however, arifing from fucli
a deviation, is, he adds, not great ; it being
eafy to difeover it, not by the acute pain and
convulfive cough, as hath been fuppofed (for in
general neither of thefe, he remarks, takes'
place, and the patients appear to be but little
incommoded by it) but by the trial with the
i flame
'[ i8o ■]
flame of a candle, in the wa}'- juft now dc-
fcribed.
M. Default having inftantl}^ withdrawn the
catheter from the larynx, made a frefh attempt
to get it into the ccfophagus and fucceeded.
It was fccured by means of two waxed threads
fixed to its outer extremity, and tvvifted round
■ a pin in each fide of the patient’s night cap.
• About four ounces of broth wei'e now injedled
through the catheter into the ftomach, and an
attendant was inftrudled in the manner of re-
peating this operation oecafionally. In this way,
it feems, fuitable medicines and nourifliment
were introduced into the ftomach with great
facility and without exciting the leaft ficknefs or
uneafinefs. The patient, we are told, was ap-
prized of the neceffity of repeating them, not
by the ufual fymptoms-of hunger'and thirft, but
■ by a peculiar fenfation of weaknefs and gnawing
in the epigaftric region which ceafed as foon as
the injedion was repeated.
On the third day there vvas a confiderable de-
gree of fever, and the infide of the mouth was
filled with fmall portions of Houghs, v^hich, on
the fourth day, wh^n a fuppuration began to
•take place, were more eafily detached and
brought away by means of a gargle of barley
water
1
\ ;
/
[ ]
water and honey of rofes, of which the patient
was djredled to make frequent ufe. Hitherto
the fwelling of the parts had gone on increafing,
and was now, w^e are told, fo conliderable that
the fauces appeared, as it were, entirely clofed.
It would therefore have been impoffible, our
author obferves, to have got down the lead;
fubftance either liquid or folid in the ufual way
of fwallowing, and without the affiftance of the
catheter, which continued to remain in the oefo-
phagus wdthout any inconvenience to the pa-
tient.
On the feventh day the fwelling appeared to
be a little diminiflied ; the fever alfo was lef-
fened ; and the fuppuration on the infide of the
mouth was confiderable, and furnifhed a copious
difeharge of a grayifh and foetid pus, which
rendered a frequent ufe of the gargl. neceffary.
On the fifteenth, the tumefa6lion of the cheeks
and mouth being almofi: entirely diflipated, M.
Default made a frefli but unfuccefsful attempt
to reduce the fradlure of the lower jaw. The
catheter was ftill kept in the oefopnagus, and
the patient feemed to mend daily.
From the fifteenth to the twentieth day, nothing
remarkable, we are told, occurred. The mouth,
at this period, was pretty free from fioughs,
N 3 and
[ i8z ]
^ f
and feverai parts of it which had been in a ftatc
of ulceration were already healed, as was ’'alfo
the velum pendulum pafati; but there Was ftill
a Me In the roof of the mouth. The cathetet
■appearing to be no longer neceffary, was now, it
feems, withdrawn, and the patient attempted to
fwallow a little broth ; but the lofs of one half
of his tongue;' the cicatrices 'on the Ihfide of his
tnouth and the confiriftiori they occafioned, to-
gether with the opening in 'the bony palate and
his having been fo long unaccuftomed "to fwal-
lowlng, all concurred in rendering deglutition
fo difficult, that he ’entreated to have the^ufe of
the catheter continued fome days longer. It
was accordingly again introduced and fuffered
to remdn- till the thirtieth day, when it was
finally withdrawn. '
At firft, and for feverai days after its removal,
deglutition was performed, it feems, with dif-
ficulty ; but by degrees became more eafy;
The patient’s ' pronunciation likewife, we are
told, was for fome time difficult and indiftind:.
Th e two fragments of the lower jaw were
not yet united.' One of them was ftill,. it feems,
Gonfiderably higher than theother^ though not fo
much fo as at firft ,* and their redudion was again
attempted, but with as little fuccefs as before.
■ The
L 1^3 J
The patient remained at Paris a month after
the removal of the catheter, and at the end of
that time went into the country to.his relations.
The fraftured portions of the lower jaw were
even then not confolidated, but were reduced
nearly to a level with each other, aqd it was
thought likely that by removing one of the
dentes molares, which by its projedfion feemed
now to be the chief obftacle to the complete rer
dudtion of the fradture, every difficulty with
regard to it wovild gradually give way,
Inftead of a hole in the bony palate, there was
now, we are told, only a fmall fiffiure to be per-
ceived, which there was rcafon to expedt would
foon be completely clofed. The patient had
recovered, in fome meaftire, the fenfe of tafte,
and although he Hill mafticated with difficulty,
was able to take folid food, and could ev^n
chew a cruft of bread. He articulated, howr
ever, with difficulty, and fpoke through his nofe,
except when he wore fpedlacles fo as to com-
prefs his noftrils to a certain degree.
In fome refledtions on this cafe M. Manoury
points out the great advantages the patient de-.
rived from the ufe of theflexible catheter, which
by conveying fuitable food and medicines into,
the ftomach, feemed to have been the chief
N 4
means
[ 1^4 }
means of prcferving his Hfc. The utillry- of
fuch an inflrnmcnt fo applied, he obfcrvcs, is
not confined to cafes fmiilar to the prefent, but
niay be extended to a variety of other difeafcs,
fuch as tetanus, hydrophobia, fpafmodic coiit
traction' of the pharynx, paralyfis of its muf-r
cles or of thofe of the tongue, and tumours
lituated along the oefophagus or in. its coats,
even within the thorax. Nor are the advan--
tages of -thefe catheters, he contends, limitccl
to difeafes that prevent deglutition, as they are
capable of being employed with fuccefs in thofe
which alFedt the channels of refp.iration, when-
ever the obflacle is feated above the bronchia,
as, for example, in cafes of abfeefs or ulcera-
tion of the inner furface of the larynx, with
difeafe of the cartilages ; in certain fillulas of
the trachea or larynx ; in wounds"tf thofe parts,
&c. He even goes fo far as to query, whether
in cafes where both refpiration and deglutition
are impeded at the fame time, as in fome fpecies
of angina, in wounds of the neck where both
the larynx and cefophagus are divided, it may
not be advifable to introduce a flexible catheter
through each noftril, and to pafs one into the
cefophagus, and the other into the larynx, fix-
ing them to the patient’s cap, as in the preced-
[ 1^5 ]
ing cafe, and taking care to dillinguifli them by
feme obvious mark, fo that the injection may
not by miftake be forced into the lungs inftead
of the ttomach. M. Default, he obferves, has
as yet made no trial of this method in affedtions
of the larynx, but propofes to have recourfe to
it In the firft favourable cafe that fliail prefent
itfelf; and he forefees, we are told, nothing that
can prevent it from fucceeding.
The facility with which thefe catheters may
be introduced into the larynx, the little incon-
venience fome perfons have experienced who
have had them in that paffage for feveral mi-
nutes, and the effedts of canulas which have
been worn by patients in the trachea, feveral
days after the operation of bronchotomy, all
tend, bethinks, to obviate the objedtions which
may be made to fuch a mode of treatment on
account of the difficulty of executing it, or the
fiippofed impoffibility of a }')atient’s fupporting
fuch an inflrument in a part thought to be fo
irritable as the larynx.
XIX.
[ >86 ]
XI K. Account of an extraordinary- Change, not
hitherto defcribed, which, under certain Cir-
cumftances, takes place in the human Body after
Death. — Vide Rapport fur les Exhumations du
Cimeiiere et de I'Eglife des Saints Innocens ;
lit dans la Seance de la Societe Royale de Mede-
cine tenue au Louvre le 3 Mars, 1789. Par
M. Thouret. 4to. Paris, 1790-
¥N this report, relative to the removal of the
A bodies from the church and church-yard of
the Holy Innocents, M. Thouret, who is a very
refpedtable phyfician at Paris, and already well
known to the Public by his writings, gives an
account of a very extraordinary change to
which the human body, under certain circum-
llances, is fubjedt after death.
The fituation of the burial place In quefbon,
in the center of the city of Paris, has for a
great length of time pointed it out as a nuifance
to the Public. Its fuppofed unhealthinefs oc-
cafioned it to be a fubjedt of inquiry fo long
ago as the year 1557, when two phyficians,
Fernelius and Houllier, were diredled by Go-
vernment to examine it; and in 1737 ^ Com-
mittee of the Academy of Sciences was ap-
C is? ]
pointed fgr the fame purpofe. On both thefe
bccafions the removal of it was earneftly re-
commended ; but it does not appear that any
fteps were taken to remedy the inconv eniencc
complained of till the year iy8o, when aii
order was iffued to prevent any more burials
'in this fpot. This regulation, however, M.
Thouret obferves, which might have been fuf-
ficicnt in the generality of places of this kind,
where the bodies, being but thinly interfperfed
in the earth, are fpeedily deftroyed, was alto-
gether inadequate to the evil in the prefent
inftance, the foil being here fo faturated with
animal matter as to be no longer capable of any
adtion on the more recent bodies accumulated
within it.
M. Thouret obferves, that fince the year
ii86 this place has ferved as a common burial
place for the greater part of the city of Paris,
and that for a great number of years paft from
two thoufand five hundred to three thoufand
bodies ‘ have been interred in it annually.
He has been affured, it feems, that in a fome-
w'hat lefs fpace of time than thirty years up-
wards of eighty thoufand bodies were interred
in it by the laft fexton. This immenfe collec-
tion of dead bodies occupied, we are told, a
furface
[ i8S ]
lurface of more than ten thoufand fquarc feet.
They were accumulated, for the moll part, in
common graves, or pits, from twenty five to
thirty feet deep, each of which was large enough
to contain from twelve to fifteen hundred cof-
fins ; and as a proof how few bodies were buried
in feparate graves, we are told that the number
of fuch interments feldom exceeded two hundred
annuallv.
At length, Government having determined
to remove this nuifance, the Royal Medical
Society were called upon to point out the bed
mode of doing it ; and our author, W'ho was
one of the Committee appointed by the Society
for that purpofe, and who fuperintended the
whole of the undertaking, now communicates
the refult of his obfervations on4:his fubjeft to
the Public. The operations lafted npw'ards of
two years, and during that period, it feems, a
layer of earth from eight to ten feet deep was
removed from the furface of the burial ground
to. the extent of twelve thpufand fquare feet,
and, befides great number of feparate graves,
between forty and fifty of the common recep-
taeles were opened to the depth ol eight or ten
feet, and fome of them -to their very bottom,
and
[ ‘S9 ]
and about twenty tboufand bodies, buried at dif-
ferent periods, were removed with their coffins.
Amidft a great variety of appearances which
fo many bodies exhibited, from their having
been interred a greater or lefs fpace of time, in
feparate graves or in the common receptacles,
there was one extraordinary circumdance wdiich
foon ftruck our author’s attention. This was
the date of the coffins and bodies in the com-
mon pits. The coffins in thcfe w'ere, in gene-
ral, firm and in good prefervation ; and the earth
that furrounded them was of a deep black co-
lour; but, excepting this blacknefs which had
tinged the coffins externally, they retained their
fredinefs, and withinfide the natural colour of
the wood was eafiiy didinguidiable. The
fhrouds were obferved to be in the fame date
of prefervation, and the bodies themfelves ap-
peared to be undiminidied in bulk. Upon
removing the fliroud the fleffiy parts of
the bodies feemcd to be preferved ; the only
change that was perceived confided in their be-
ing converted, as it were, into a fubdance, the
whitenefs of which was heightened by the black-
nefs of the furrounding foil. ,
The author tells us that at fird fight of this
curious phenomenon he was inclined to con-
ifider
t
t 190 ]
iider it as the efFccl of lime fpread over thefc'
bodies ; but upon examining them more
attentively he was foon convinced that he was
wrong in this fuppoiition, and he found that
all the foft parts were converted into a white
mafs, more or lefs firm, and jilready known
among the gravediggers by the name of fat,'
(gras.) This mafs, which exhibited no ap-
pearance of a fibrous texture, felt undluous or
foapy when rubbed between the fingers, and in
a. dry air grew harder, and even acquited a
flaining polilh and a fort of metallic luftre, but
became loiter when expofed to a moifi: air.
In general thefe malTes, the author obfervesy
preferve the entire fiiape of the limbs. Among
the bodies which he found the mofi completely
transformed into this fubftance, and which form
a part of the colle(51;ion he has "made to illuf-
t.ate the hiflory of this phenomenon, fevcral,*
he tells us, retain their natural lhape, together
with the features of the face, the eyes, eye-
brows, and eyelids. The tranfmutation, he
obferves, is not confined to the furfacc of the
bodypbut may be traced through every part of
the mufcles, ligaments, and tendons, and like-
wife through the different cavities, where all or
the greater part of the vifeera are found con-'
verted'
[ 191 3
Verted into the fame fubftance, which is alfo
to be feen in the cavities of the bones, even
in the cells of the diploe; It is found to afted:
the texture of the cartilages, but the bones
themfelves, it fcerils, remain unaltered, as do
likewife the hair and nails. There are likewifcj
we are told, certain colouring principles, fuch
as the bile, the fluid of the bronchial glands,
the pigmentiim of the choroid, the red parti-
cles of the blood, and the fibrous part of the
iliufcles, which remain for a long time diftin-
guifliable in the mafs that furrounds them.
The parts that have appeared to our author
to be the rnofi; fufceptible of this change have
been the adipofe and membranous. Some
parts, he obferves, evidently acquire it much
fooner than others, and he has found the blood
vefiels of different vifeera, particularly thofe of
the liver, transformed into this mafs, while the
’furrounding fubftance of the vifeUs itfeif had
as yet undergone no fuch change.
He obferves that, in general, the parts pre-
ferve their natural configuration in proportion
to the quantity of adipofe and lymphatic juices
they contain, and in proportion to the denfity
of their texture. Thus the brain, the heart,
the liver, and fome other vifeera, it feems,
change
C ]
change completely into this fubftance, and re-
tain their original figure, while of the inteflines
and the fpongy and .veficular texture of the
lungs only flight veftiges remain after this
change, and in thefe the fatty fubflance into
which they are converted is of a much thinner
confiftence than in' the other parts.
From a chemical analyfis of this fubflance j
for which our author acknowledges himfelf in-
debted to M. Fourcroy, it appears to confift of
an oily principle combined with volatile alkali
fo as to form a foap. The oily bafis of this
ammoniacal foap, feparated by acids, is de-
feribed as a concrete fubflance, of a grayifll
yellow colour, and fomewhat more fufible thari
wax •, combined with fixed or volatile alkali it
' forms, we are told, a firm foap;,-
M. Thouret remarks, that it is^ not dudfile
under the fingers like wax, but that it crum-
bles into fmall, foft, and untfluous fragments
like fpermaceti, the fubflance with which he
confiders it as having the greateft analogy.
Thus he obferves that it chryflaliifes like fper-
maceti, and diflblves even in a greater propor*
tion than that does in heated alcohol ; part of
it feparating again as the folution cools, ih the
form of fmall fliining laminae.
From
I^rom thefe data our author is led to attempt
i theory of the formation of this fubftance.
He afcrihes it t6 a peculiar modification of the
putrid change that bodies undergo in the earth,
^nd thinks that the origin of all the pbenomend
is to be fought for in the decompofition of wa-
ter. It has been fuppofed, he obferves, that
from a combination of phlogifticated with in-
flammable air there refults, during putrefac-
tion, volatile dkali '; and the fixation of a larger
proportion of inflammable air, and perhaps alfo
of a certain quantity of dephlogifticated air,
may^ he thinks, give rife to a fat or oily fub-
ftancc, which, ;by uniting with the volatile al-
kali, forms a foa^,
M. Thouret obferves, that a concretion ana-
logous to this fubftance is not foreign to the
living animal oeconomy ; that it exifls, as is
well known, -in large malTes in the cavities of^
tl>c brain of the whale, and is diftributed by
numerous veflels through all the parts of that
animal ; and that it is alfo to be found in the
bile, where till of late it has been taken for a
fefin. It has fometimes, he adds, been found
cxtravafated in the liver when dried in the air^
as was proved by the late M. Poulletier de la
^alle, of Paris, who, having expofed a humaii
VoLili O liver
[ 194 3
liver to the air for a confiderable number of*
years, found k changed, at lengthy into a rv hi-
tilli rnafs, in its appearance not unlike agaric,
and which, on expofure to a gentle heat, yield- '
ed a fubftance fimilar to fpermaceti. M. Thou-
ret aifures us his experiments have taught him
that a fubftance of the fame kind may be ex-
tradfed in abundance from the brain of man
and other animals. May it not, therefore, he
alks, be latent in the living body, and in-
tended to anfwer fome purpofe in the animal
oeconomy with which we are as yet unac-
quainted ?
This lingular tranfmutation, he obferves^
though it is found to affedt bodies of both
fexes, and of all age's, is fubjedt, however, to •
fome differences which have not efcaped the
notice of the gravediggers, who have remarked
that bodies which are the fattell and molt com-
padt jraf^ the foonelt into this Hate ; that very
dry and lean ones acquire more of the appea-
rance of dry mummies ; and that lax and hu-
mid ones melt into waters
The tranfmutation, whatever may be its na-
ture, takes place, v\’e are told, indilfercntly in
different kinds of earth. It likewife appears
to be completed in a Ihort fpace of time. The
, laft-
[ >95 ]
lafl great pits of the burial place had been
clofed, it feems, only five years, and from the
furface to the bottom all the bodies they con-
tained, a very fmall number excepted, were
found by our author transformed into the fub-
ftance in queftion.
In general, however, the manner in which
this tranfmutation,' when once begun, goes on
and is completed, appears to be not altogether
uniform. In the pits where it feemed to be the
moft completely effedted, the greater number of
bodies, we are told, were entirely transformed ;
but, on the other hand, in fome the change ap-
peared to be only juft beginning to take place,
while in others the decompofition was com-
plete. In the fmall number that afforded no
marks of it the bones only remained, and thefc
exhibited the common appearance. Were thefe,
the author alks, the remains of bodies that had
paffed through this ftate, and had afterwards
been totally deftroyed ? There was nothing,
he obferves, in the fituation of thefe laft that
could explain the difference. They were found
at all depths, and clofe to others in which the
change was complete. In general, however,
it feems, it was in the bodies at the greateft
depth that the change appeared to take place
O 2 the
[ '96 ]
the fooneft/ and thefe alfo feemed to be the lad;
in which this fatty fubftance was deftroyed.
Our author found this fa£t cohfirmed by what
he faw in two other burial grounds at Paris.
It appears from M. Thouret’s obfervations,
that the Ikin is the part in which this change
firft begins to take place, and that after this
follow the fat, the mufcles, and the vifcera.
In the early ftage of the tranfmutaticn the tex-
ture of the Ikin, we are told, is ftill diftin-
guifhable, as is alfo thfe colour of the fat and*
of the mufcles, and it is not till the fibrous
texture of the latter has entirely difappeared
that the change can be faid to be complete.
When this is accompliflied, a decompofition
begins to take place. This is firft obfervable
in the cavities of the body, and as it advances
the bones become difunited, the fatty fubftance
is gradually dilTolved, and at length there re-
main only flight appearances of it adhering to
the furface of the bones ; but in this ftate it has
the confiftence and colour of clay, or becomes'
dry and friable and of a darker colour* M.
Thouret fuppofes this to be the remains of the .
"colouring principle, or of the earthy principle
ftill combined with a little of the fatty fub-
ftanee. i
The
[ ‘97 3
The brain, according to our author, is the
part that is the laft deftroyed.
As it is to the extrication of aeriform fluids
from the dead body during putrefadtion, and
to the re-adtion of thofe fluids on the body
itfelf, that our author thinks we are to alcribe
the formation of this fubftance, fo he obferves
that it is not till ;he furrounding earth is fatu-
rated with thefe fluids that the change begins to
take place. This faturation of the earth he
thinks is proved by its black colour. Expofed
to the air, it foon, he obferves, lofes this ap-
pearance, and becomes capable of diflblving the
fatty fubftance in queftion. He has found this
fubftance only in the common pits where the fur-
rounding earth has acquired this black colour ;
he has never been able to difeover any traces of
it in Angle graves ; he therefore concludes that
an accumulation of animal bodies in larse
mafles is requifite for its formation, andalfo that
thefe mafles muft be fufliciently covered with earth
o prevent the evaporation of the aeriform fluids
that are extricated, becaufe in proportion as
thefe efcape, the faturation of the furrounding
earth becomes lefs complete.
But befides the evaporation of thefe fluids
which takes place fooner or later, another caufe
is mentioned by our author as contributing
O 3 very
I
\
[ >98 ]
very powerfully to the deftruftion of the bo-
dies imis transformed, and that is the moifture
of the foil, which by rcafon of the foapy nature
of the fubftance in qucftion is found to diflblvc
it very completely. Theftate of the earth, in
this refpedt, is, therefore, one of the principal
circumftances on which the duration of this
fubftance depends. Our author accordingly
obferved that in the pits the leaft expofed to
the fun, and which, from their lituarion in
other refpedts, were moft liable to moifture,
the bodies were the moft fpeedily decompofed.
He has even feen coffins in an inclined pofition,
in one part of which, expofed to the aftion of
moifture, the fubftance in queftion was com-
pletely diftblved, while in the dry part it had
undergone no change.
Of this curious phenomenon, which feems
hitherto to have efcaped obfervation, M. Thou-
ret remarks that it adds new fadts to the hiftory
of the decompofition of animal bodies in the
earth, and may be confidered as a particular
fpecies of mummyficarion, which, compared
with that which produces the dry and fibrous
mummy, fhews us in this way a new procefs of
nature. Both thefe fpecies of mummy, he ob-
feryes, depend on the adtion of aeriform fluids.
j Thu«
C 199 ]
Thus the deflrudtlon of the body takes place if
thefe evaporate; the fpecies of mummy, which
is more immediately the fubjedt of this paper, is
produced if thefe fluids when difengaged are re-
flected on the foft parts of the body or retained
in their texture ; and, on the other hand, the
dry and fibrous mummy is formed whenever
thefe fame fluic^s are not at all or imperfectly dif-
engaged.
On fimilar principles, he thinks, maybe ex-
plained the different circumftances obferved ia
the decompofition of bodies in burial grounds,
whether in feparate or in common graves; thofe
eircumftances more efpecially w'hich may beaf-
cribed to the nature of the foil. In general, he
obferves, they will depend on the facility with
which it abforbs or tranfmits the different fpe-
cies of air extricated from bodies by putrefac-
tion, and hence, dry fand is, he thinks, the
moft favorable to the decompofition of bodies.
This decompofition will alfo, he adds, be ac-
celerated by calcareous earths, wdtich are known
to be very porous and permeable, and for this
reafon have been called putrid or feptic earths.
On the other hand, compaCt a'^gillaceous earths,
he obferves, are found to retard tb’s dcccriiipo-
fition, as was mentioned by MefTieurs Lemcry,
O 4 jeoffroy,
r 2.00 j
Geoffrey, and Hunauld, in their report la the
jf^cademy of Sciences in 1738.
Thefe farfts, the author farther remarks, ferve
to ffiow how little foundation there is for th?.
opinion commonly entertained relative to the
cpnverfion of the dead body into earth, no fuch
appearance having been obfetved in ^ny of- the.
coffins that were intire; neither, he adds, is what
is ufually imagined true that the body is, in
general, deftroyed by worms, as thefe are found
only near the furface of the earth, or in bodies
that have been e:q)ofed to the air. His obfer-
vations have convinced hinl that human bodies
configned to the earth infenQbiy exhale and
evaporate in volatile principles; and for this
rcafon it is, he thinks, that the foil of burbf
places docs not perceptibly accumulate.
M* Thouret preferves in his cojlcftipn (peer-
mens procured in thefe refearches, and which
ferve to confirm and illuftrate all the fadts he has
related in the report before us ; and he propofes
in fubfequent papers to deferibe the different
parts of the fubjedt more fully, and to give
engravings of the appearance of different parts
of the bodies he h^s examined,^
C ATA-
[ aoi 3
CATALOGUE gf BOOK So
JL. A NEW Tranllation of the Pharma*
XA. copoeia of the Royal College ot Phy-
ficians of London, of the Year ij8j ; with
Notes critical and explartatory ; Dofes of the
feveral Preparations ; lil5.ewife a Table of the
quantities of Opium and Quicldilver in the
9ompound Medicines which contain them ; and
a Lift of the new Names, together with Latin
apd Englifh Indexes. By an Apothecary.
3 VO. Johnfon, London, 1789.
Obfervations on the Duties of a Phyftcian,
^nd the Methods of improving Medicine; ac-
comodated to the prefent State of Society and
Manners in the United States ; delivered in the
yniverfity of Pennsylvania on the 7th of Feb,-
ruary, 1789, at the Conclufion of a Courfe of
Leftures upon Chemiftry and the Practice of
Phyfic. Benjamin RuJh,'M.,'D. 8vo. Phila-
delphia, 1789.
3. Practical Hints on Opium confidered as
a Poifon. By R. Hamilton, M. D. 8vo. Ip^
wich, 1790.
4. Thoughts Phyfiological, Pathological, and
Pradlical, with fome Cafes, and Anatopaico-prac-
ticai
[ ]
tical Obfervations. By Allen Swain Jlon, M. 13.
at York. 8vo, York, 1790.
5. A Letter to Sir John Sinclair, Bart, con-
cerning the Virtues of the Muriatic Acid, or
Spirit of Sea Salt, in the Cure of Putrid Dif-
eafes.. By Sir William Fordyce, M. D. F. R. S.
8vo. Cadell, London, 1790. ’
6. An EfFay on Fevers ; wherein their theore-
tic Genera, Species and various Denominations,
are, from Obfervation and Experience for thirty
Years, In Europe, Africa, and America, and
the intermediate Seas, reduced under their Cha-
radleriilic Genus, febrile Infeftion ; and the
Cure eftabliflred on Philofophical Indudtion. By
Rchert Robertjon, M. a Surgeon of his Ma-
jedy’s Navy. 8vo. London, 1790.
7. An Enquiry into the Small Pox, Medical
and Political ; wherein a fucccfsful Method of
treating that Difeafe Is propofed ; the Caufe of
Pits explained ; and the Method of their Pre-
vention pointed out. With an Appendix, re-
prefentlng the prefent State of the Small Pox.
By Robert V/alkcr, M. D. Fellow of the- Royal
College of Surgeons, Edinburgh. 8vo. Lon-
don, 1790.
8. A Treatife on Putrid Intcflinal Remitting
Fevers ; -in which the f.aws ot the Febrile
State,
r 203 ]
State, and Sol-Lunar Influence, being invelUv
gaied and defined, are applied to explain the
Nature of the various Forms, Crifes, and other
Phenomena of thefe Fevers : and thence is de-
duced and inftituted an improved Method of
curing 'hem. By Francis Balfour ^ M. D. Soc.
Reg. Med. Ed. S. H. 8vo. Edinburgh, 1790.
9. Elements of Chemiftry, in a new Syfte-
matic Order, containing all the modern Difco-
veries; illuflrated with thirteen Copper Plates,
By M. Lavoifter^ Member of the Academy of
Sciences, &c. Tranflated from the French, by
Robert Kerr, F. R. & A. S. S. Ed. Member of
the Royal College of Surgeons, and Surgeon
to the Orphan Hofpital, Edinburgh. 8vo.
Edinburgh, 1790.
10. Speculations on the Mode and Appear-
ances of Impregnation in the Fluman Female,
with an Examination of the prefent theories on
Generation. By a Phyfician. 8vo. Edin-
burgh, 1790.
11. Elements of Natural Hiflory and Chc-
miftry. By M. Fourcroy, Dodlor of the Fa--
culty of Medicine at Paris, &c. Tranflated
from the laft Paris Edition, 1789, being the
third, in five vols, 8vo. With an Alpha-
betical comparative View of the ancient and
modern
I
r 204 ] ■
modern Names of Chemical Subftances, with all-
the Tables, and a complete Index. To which is
prefixed, by the fame Tranflator, a Preface,
containing Strictures on theHiftory of the prefenc
State of Chemiftry ; with Obfcrvations on the
Pofitions, Facts and Arguments, urged for and
againft the Antiphlogiftic Theory and new No-,
menclaturc, by Meflrs. Lavoifier, Prieftley,
Kir wan, Keir, Sage, 6cc. 8vo. 3 Vols. £/-
1)0^ and Co. I^ondon, 1790.
12. On the Principle of Vitality ; aDifeourfe
delivered in the firit Church in Bolton, Tuef-
day, June 8th 1790, bcfarc the Humane So-
ciety of the Commonwealth of Mallachufets.
By B. WoAerhoufe, M. D. Profeflbr of the Theory
and Practice of Phyfic, and LeCtnrer on Na^
sural Hiitory in the Univerfity of Cambridge,
4to. Bofton, 1790. • ^
13. An Inaugural Differtation * on the Phe-f
aomena, caufes and effeCts of Fermentation j
fubmitted to the Provolt, Truitees, and MediT
cal Profeffors of the College of Philadelphia, for
'■* By a late Regulation of the College of Philadelphia a
Candidate for the Degree of Doftor of Phylic is permuted to
write his Thefts either in the Latin or Englifli, Language.
This is the firllthat has been written in Englilh.
the
t 2C)5 ]
t^ie Degree of Dodfor of Medicine ; Juiie 1 796,
John Pennington, 8vo. Philadelphia, 179®’
14. A Treatife on the Inoculation of Horfes
for the Strangles s in which is clearly laid down
the Manner and Time of the Operation, the
Preparation neceflary previous thereto, and the
Mode of Treatrrient during the continuance of
the Diforder : the Whble being the Refult
of long and repeated Experience. By Richard
Fordy of Birmingham ; who has made the Com-
plaints of Horfes his Stud)^, for more than fift)^
Years paft. izmo. Birmingham, 1790.
15. The Philofophy of Natural Hiftory. By
Wililam Smellie, Member of the Antiquarian
and Royal Societies of Edinburgh, qto. Edin-
burgh, 1790.
16; The Sexes of Plants vindicated; in a Let-
ter to Mr. William Smellie ; containing a refu-
tation of his Arguments againft the Sexes of
Plants, and Remarks on certain Paflages of
his Philofophy of Natural Hiftory. By John
Rotheram, M. D. Fellow of the Linnsan
Society, London. 8vo. Cad'ell, London,
1790.
17. Obfervations on Animal Life, and appa-
rent Death, from accidental Sufpenfion of the
Fundlion of the Lungs ; with Remarks on the
Bruno-
[ 2o6 ]
Brunonian Syftcm of Medicine. By J, Franks,
/ 8vo. Johnfony London, 1790.
18. An Effay on a Non-Defcript, or newly-
invented Difeaie ; its Nature, Caufes, and
Means of Relief : With fome very important
Obfervations on the powerful and mofl furpri-
ling Effects of Animal Magnetifm in the Cure
of the faid Difeafe, as communicated to the
Author by Dr. Mefmer and Madame de L — o- ?
and a Dedication to the faid Lady. By F. G,,
Profeffor of Phyfic and Aftrology, and Mem-
ber of feveral learned Academies and Societies.
2vo. Bateman, London, 1790.
19. ElTays on fafhionable Difeafes ; the dan-
gerous Effects of hot and crowded Rooms ;
the Cloathing of Invalids; Lady and Gentle*
men Doctors ; and on Quacks and Quackery :
With the genuine Patent Preferiptions of Dr.
James’s Fever Powder, Tickell’s AEtherial Spi-
rit, and Godbold’s Balfam, taken from the Rolls
in Chancery, and under the Seal of the proper
Officers ; and alfo the Ingredients and Compo-
fition of many of the moft celebrated Qiiack
Noftrums, as aaalyfed by feveral of the beft
Chemifls in Europe. By James M. Adair, for-
merly M. D., Member of the Royal Medical
Society, Fellow of the Royal College of Phy-
ficians
[ 207 ]
licians of Edinburgh; Phyficlan to the Com-
mander in Chief of the Leeward lilands, and
to Jthe Colonial Troops ; and one of the Judges
of the Courts of King’s Bench and Common
Pleas in the Ifland of Antigua. 8vo. Bate-
man, London, 1790.
20. A candid Inquiry into the Truth of cer-
tain Charges of the dangerous Confequences of
the Suttonian, or cooling Regimen, under Ino-
culation for the Small Pox. Recommended to
the ferious Confideration of Parents and Guar-
dians, as being of the utmoft Importance to
the Welfare of the rifing Generation. With
fome ufeful Remarks on a fuccefsful Method,
v.fed fame Years ago in Hungary, in the Cure
of the natural Small Pox, and tending to de-
monflrate the Benefit to be cxpedled from a
fimilar Method of Management under Inocu-
lation. By Jamei M, Adair, formerly M. D«j
&c. 8vo. Bateman, London, 1790.
21. - A Treatife on Air, containing new Ex-
periments and Thoughts on Combuftion ; be-
'ing a full Inveftigation of Mr. Lavoifier’s Syf-
tem, and proving, by fome ftriking Experi-
ments, its erroneous Principles ; with Stric-.
tures upon the chemical Opinions of fome emi-
nent
[ 2C)8 ]
ftchc Men. By Richard Bewle)\ M. D. JJvo;
Evans, London, 1790.
12, A Treatife of the Plague; containing
an hiftorical Journal and medical Account of
the Plague at Aleppo in the Years 1 760, 1761,
•and 1762. Alfo Remarks on Quarantines, La-
zarettos, and the Adminiftration of Police in
Times of Peftilence. _ To which is added an
Appendix, containing Cafes of the Plague, and
an Account of the Weather during the pefti-
lential Seafon. By Patrick Rujfell, M. D.
F. R. S. formerly Phyfici^n to the Britifli
Faftory at Aleppo. 4to. Robinfons, London,
1791.
23. Experiments and Obfervations ‘on the
Anguftura Bark. By Augujlus Everard Brands^
- Apothecary to the Queen. 8vo. 'Payne^ Lon-
don, 1791.
' . 24. A Treatife on the Fevers of Jamaica;
with fome Obfervations on the Intermittent Fe*
ver of America : and an Appendix, containing
fome Hints on the Means of preferving the
Health of Soldiers in hot Climatds. By Ro'
hm JackfoHy M. D. 8vo. Murray, London,
1791.
*5. A Treatife on the Extraction of the Ca-
taraCt.
[ 200 ]
taradl. By D, Augujius Gottlieh Richter^ M. and
Ch. D. Aulic Gounfellot and Phyfician to His
Britannic Majefty, Profeflbr of the Practice of
jPhyfic and Surgery in the Utilverfity of Gottin-
gen, Preiident of the College of Surgeons, and
Member of the Royal Academies of Gottingen,
Stockholm, and Copenhagen. Tranflated from
the German, with a Plate, and Notes by the
Tranflator. 8vo. Murray^ London, 1791*
26. Diflertatio Medica tnauguralis de Hyf-
teria ; Auflorc Carolo Bankhead j Hiberno* Svo,
Edihburgi, 17904
27. Diflertatio Medica Inauguralis de Febre
Typhoidea ; Audtore Henrico BowleSy Anglo.
3vo; Edin, 1790.
28; Tentamen Medicum Inangurale de Te-
tetibus inteftinorura Lumbricis ; Auclore Ca~
rolo Daly, Hiberno* 8vo. EdiUi 1790.
29. Diflertatio Medica Inauguralis de Aflh-
mate } AudtOre Gulielmo Dick, Hiberno. 8vo.
Edin. 1790.
30. DiflTertatio Inauguralis compledtens Ob-
fervationes quafdam de Febre ; Auftore Thoma
Evans, Hiberno. 8vo. Edin. 1790.
31* DlflTertatio Medica Inauguralis de Me-
norrhagia; Audtore Rkhardo Feild, Virgi-
riienfe. 8vo* Edin. 1790.
VoL. I. P
32. Ten-
[ 210 ]
32. Tentameri Medicum Inaugurate de In^
flammatione ; Audtore Johanne Gahagan, Hi-
berno. 8vo. Edin. 1790.
33. Diflertatio Chemica Inauguralls de AE-
there ; Joanne Gibney^ Hiberno. 8vo.
Edin. 1790.
34. DifTertatio Medica Inauguralls de Gonor-
rhcEa virulenta ; Audtore Gulielmo Gthfon, Sco-
to-Britanno. 8vo. Edin. 1790.
35. Tentamen Medicum Inaugurate de Gaf-
tritide ; A udtore Hiberno. 8vo.
Edin. 1790.
36. DifTertatio Medica Inauguratis qusedam
de Scorbuto,- Typho, Variola et Podagra pro^
ponens ; Audore Martino Lynch, Hiberno. 8vo.i
Edin. 1790.
37. DifTertatio Medica Inauguratis de Eryfi-
pelate; Audore Joanne M^Cully, Hiberno.-
8vo. Edin. 1790.
38. DifTertatio Medica Inauguralis de Mer-
curio ; Audore Roberto Mackinlojh, ex Comi-
tatu Mofarienfi. 8vo. Edin. 1790.
39. DifTertatio Chemica Inauguralis de Aquis
Mineralibus ; Audore Gulielmo Meade, Hiber*
jcito. 8vo. Edin. 1790.
40. DifTertatio Medica Inauguralis de Poda-
• gTa
I
C ]
gra ; Audlore Caro/o Scott, Anglo. 8vo. Edin.
1790.
41. DilTertatio Medica Inaiiguralis de Vafis
abforbentibus ; Audlore Georgio Spence, Jamai-
cenfi. 8v'o. Edin. 1790.
42. Diflertatio Medica Inaiiguralis de Cy-
nanche Inflamma:ofia; Aucftore Jnnejley Strean^
Hiberno. 8vd. Edin. 1790.
43- E)iflertatio Medica Inaugural is de Per-
tuffi; Audrore Roberto Wood, Scoto. 8vo,
Edin. 1790.;
44. De Ufu Glandularum fuper renalium •
nee non de Origine Adipis; Difquifitio Anato-
mico-philofophica ; Audiore Nicolao D. Riegeh.
4to: Hafnis, 1790;
45* C. G. Th'. Kortum, Medici Tremonienlls
Commentarius de vitio Scrofulofo quique inde
pendent Morbis fecundariis, qui nuper ill. So-
tietatis Reg; Medicorum,. qua Parifijs eft,
plaufum tulit; Tom. II. 8vo. Lemgo, 1790.
46. Medicine omnis ^yi fata Tabulis expo-
uit D; Aug Fr. Hecker. Programma cum mu-
nus Profeflbris Medicine ordinarii in peranti-
qua Erfordienfi Academia adiret. 410. Erfurt
2 790. '• *
4^ De Templis ^fculapi! Griecis quadatn
^ " commen-
[ 1,* ]
cortimentatus eft Frid. Wilh. Gerkcy Med.
8vo. Lipfia:, 1790.
48. Sam. Gotti. Vogel^ M. D. Confil. Aulic,
Prax. Clin, in Univ. Roftoch. Prof. ord. Ma-
nuale Praxeos medics'', Medicorum ilium au-
fpicaturorum ufui dicatnm. Ex editione Ger-
manica' recentiffima iina cum additamentis Auc-*'
toris omnibus loco fuo fuppletis in linguam
tranftulit Latinam notafque hinc inde adjecit
yoann. Bernardi Keup, Med. Dodtor, Tom. I.
8vo. Stendal, 1790.
49. Differtatio de Renum Calculo ejufdem-
que cum aliis Morbis fimilitudine ; Audlore
Ant. Maria i Cova., M. Dv 8vo. Pavia, 1790.
50. Flora Cocb'inchtnenfis : fiftens plantas in ’
Regno Cochinchina nafcentes' ; quibus accedunt
alis obfervats in Sinenfi Imperio, Africa Orien-
tali, Indiaeque locis variis, omnes difpofits fe-
Gundum Syftema fexuale Linnsanum, laboreac
ftudio Joannis de I.oureirO, Regis Scientiarum
Academis Ulyffiponenfis Socii : olim in Co-
chinchina Catholics Fidei Prsconis : ibique
rebus Mathematicis ac phyficis in Aula Prs-
fedti. JulTu Acad. R. Scient.'in lucem edita.
Tom. II. 4to. Ulyffipone, 1790.
^i. Fauna Etrufca fiflens InfcAa, qus in
Pfovinciis Florentina et Pifana prsfertim col-
Icgis
[ *13 ]
>
legit P. ^ojftus, Tom. II. 4to. Livorno,
1790. c. Tab. seneis x.
52. Supplementum Piantar^im feledlarum,
quarum Imagines manu artificiofa doftaque
pinxlt Georgius Dionyjius Ehret ; occafione baud
vulgari in ufum publicum collegit D, Chrijl^
Jacob Trew ; publicavit et illuftraVit D, Bened.
Chriji, Vogel; jn a;s incidendas et coloribus
vivis ornandas curavit fumtufque fecit Joh,
Elias Haidy Chalcographus Auguftanus. Augft
burg, 1790,
53. Analyfes Florum e diverfis Plantarum*
generibus, omnes etiam minutiffimas eorum ex-
temas partes demonftrantes, ad eruendum ha-
rum partium charadterem genericum, philofo-
phiam botanicam, et generum intimiores affini-
tates a Natyra ftatutas ; Audtore A. J. G. C,
Batch. 4to, Vol. I. Fafcic. i, Tab. i.— -x.
Fafcic. ii. Tab. xi. — ?xx. Hals Magdeburgi-
cas, 1790.
54. Fungi Mecklenburgenfcs feledti ; Auc-
tore H. J. Tode. Fafcic. I. nova fungorum ge-
nera compledtens c. Tab. sneis vii. 4to. Lu-
neburg, 1790,
55. Diflertatio Inauguraiis Medica de Ther-
mis Marchio-Badenfibus ; hwdiQxt Ca'folo Fri-
P 3' deric9
r 2J4 ]
derico Hau^, Bada-Badenfi. 8vo, Argento-
rati, 1790.
56. Specimen Phyfica: generalis five de Con-
ctetione Corporum et DiiTolutione'; Audorc
Antonio Bucci in Faventino Gymnafio Philofo-
phise ProfefTore. 8vo. Faenza, 1790.
57. Ant. JoJephi Cavanilles leones et Deferip-r
tiones Plantarum, quse aut fponte in Hifpania
crefeunt, aut in Hortis hofpitantur. Vol. I.
Folio. Matriti, 1790.
58. Dlffertatio Inanguralis Medico-Thcra-
peutica de Cortice Angufturte ; Audtore Frid,.
Alb, Ant. Meyer ^ Hamburgenfe. 8vo, Got-
ting£e, 1790.
In this diflertation the author gives a botani-
cal defeription of the Magnolia Glauca Lisn.,
o'n a fuppofition that the Cortex Anguilurje, as
it is called, is the bark of that tree ; but, on
comparing the Anguftura bark with the bark of
the Magnolia Glauca, vve do not find the lead:
ground for this conjedlure which, it feems,
■ originated
* Mr; Brande, in an ingenious and valuable work on thif
fubjeft lately publifhed, (fee article 23 of the prefent Cata-
logue) obferves alfo, that having procured and dried ihe barks
of two fpeces of Magnolia, the Glauca and Grandiflora, he
found them to differ completely from the Anguftura.
3 Somp
[ 215 J
originated with Mr. Heyer, in a paper on this
fubjed: inferred in the Brunfwick Magazine,
Part V. for the year 1790.
59. Diflertatio Inauguralis medlca de Cortice
Angufluree ejufque ufu medico; Audore Fran^
ctfco Ernejlo Filter^ Nordhufano. 410. Jenas,
1791.
In this differtation alfo we find the author
mentioning the conjecture lately thrown out in
Germany relative to this bark being the pro-
duce of the Magnolia Glauca. He relates
fome inftances of its efficacy in intermittents ;
and recommends it likewife as a tonic and anti-
feptic remedy.
60. De Ophthalmia recens natorum ; Auc-
tore Johanne G. Gbiz, 4to. Jena, 1791.
61. Denonnullis quse ad ufum medicum fuc-
corum Vegetabilium recentium fpeCtant ; Auc-
tore Wilh. Aug. G, Manmjke. 4to. Jena, 1791.
62. Hiftoria Chirurgico-anatomica Faculta-
tis Medic^ Ingoldftadienfis ab Univerfitate anno
Some perfons in this country have afferted that the Cortex An*
gufturaa is the bark of the Brucea Antidyfenterica, or Wooginos
•f the Abyffinians ; but the dried bark of this Ihrub is found
fo be very different from the Cortex AngufturcC. — Edjtoz.
P4
147
[ 2i6 J
J472 condita ad annum 1788; Auftore Hen,
' Palmaz Von Leveling. 410. Ingoldftadt. 1791^
63. leones Plantaruin SyrisB rariorum, De-
feriprionibus et Obfevvationibus illuftpatae •
Audtore Jacobo Juliana La PHlardiere. Decas
prima. 4to. Lutetis Parifiorum, 1 791,
64. Difleitatio Inaugiiralis Medica fiftens
qu^dam Medicamenta Roffovum Domellica j
\
Audtore Joanne Friderico, Grahly Kioviano. 4to,
Jenae, 1790.
We have here an account of the good effedts
of an infufion of the Myrica Gale Linn, (in the
proportion of half an ounce of the dried plant
to a pint of water) in chronic rheumatifrn ; to^
gether with fome obfervations on the medicinal
effedts qf the Ruffian liquor called Kzvas.
65. Jofephi Eyerel Commentaria in Maximi-
liani StoUii Aphorifmos de cOgnofeendis et
curandis Febribus. Tom. III. 8vo. Viennas,.
1790.
66. Dlffi Inaug. Medico-Botaniqa de necef-
iitate et utilitate Studii Botanici; Audtore Er-t
nejio Carolo Rod/chiedy Hanovienfi. 8vo. Mar-
burgi, 1790.
INDEX,
I S'?
1
N ■ D E X,
♦
A.
Absorbent Vcffels, Diflertation on, —r 31 p
Adair, Dr. James M. Eflays on fafliionable Difeafes,
2Z&
... ■ — on the Inoculation of the Small
Pox, ->• 207
^fcLilapins, Greek Temples of, Work relative to, 21X 1
jEther, Dilfertation on, > 210
Air, Treatife on, — — — — 207
Anguftura Bark, Works relative to, 208, 214, 215
is neither a fpecies «f Magnolia, nor the
Brucea Antidyfenterica, as hath been fuppofed, 214
Animal Magnetifm, Work relative to, — 206
Afthma, Diilertation on, ' r — 30^
B.
Balfour, Dr. F. Treatife on Fevers, — — 202
Bankhead, Carolus, de Hyfteria, 209
Batch, A. J. G. C. Analyfes Florum, 313
Baynham, W. Cafe of an extra-uterine Conception, 73
Bewley, Dr. Richard, Treatife on Air, —— 207
BillarJiere, Jac. Jul, la, leones Plantarum Syriac, 216
Bladder, urinary. Cafe in which a Catheter was left in if,
and afterwards extra6Ved, 96
Blagden, R. B. Fa6ts relative to Pemphigus, - 105
Blane, Dr. Gilbert, Account of the FJardus Indica, or
/, Spikenard, k;^,
'Body, human. Account of a Change to which it is fubjeft,
under certain Circumftances, after Death, - 186
Bowles, Henr. De febre Typhoidea, — 209
Brande, Aug. Everard, Obf. on the Anguffur B.irk, 208
Bucci, Ant. de Concretione Corp mnm et Difl’olutione, 214
^urial Grounds, Reafon why the Soil of them does not per-
ceptibly accumulate, — —
Carminative
1
C ]
^ c.
Carminative Medicines, Caution with refpcft to,
Cataraft, Cafes of the Extradlion of, 4^, 50, 55, 6?
, Extra£lion of, a frequent Caufc of its Failure
pointed our, — — 62
r r — , Rerqarks relative to, - 67
— - — , Treatife on, — 208
Catheter, Inftance of one left in the Bladder, and afterwards
extracted by an Operation fimilar to that of Lithotomy, g6
R , flexible, Cafe in which one was kept in the Oelb-
phagus during a Month, 176
Cavanilles, Ant. Jof. de Plantis Hifpanicis, - 214
Cauftics, Obfervations relative to, in the Prevention of Hy4
drophobia, 14
Child, Account of one with a double Head, — 164
Chin Cough, Differtation on, - — 21 1
Conception, extra-uterine, Cafe of, 73
Cova, Ant. M. de Renum Calculo, 212
Cullen, Dr. Remarks on his Arrangement of Difeafcs, 95
Cully, 'Johannes Mac, de Eryfipelafe, — 21Q
D.
Daly, Carolus, de Teretibus Inteftinorum Lumbricis, 209
Denman, Dr. Thomas, his Account of the fpontaneous
Evolution of the Foetus referred to, 76
, Account of a new Fa£l; relative to
Menftruation, 108
Dick, Gulielmus, de Afthmate, 209
Dropfy of the Brain, Obfervations on the Treatment and
Caufes of, — - _ _ — : — - 1 1 1
_ . -, Inftance of its originating in Inflam-
mation, 125
, faid to arife moft frequently from
glandular Obftrudtion and either local or general Pleni-
tude, — — — *26, 129
E.
Epiglottis, Account of an Inflammation of, — 40
Eryftpelas, Dilfertation on, — : — 210
Evans,
[ 219 ]
Evans, Thomas, de Febrc, — — 209
Excilion, recommended in the Prevention of Hydrophobia,
Eyerel, Jofephus, Gommentaria in Max. Stoljii Aphorifmos
de Febribus, ■■ — 216
F.
Fauna Efufca, •" ■ — 212
Feild, Richardiis, de Menorrhagia, 209
Fermentation, Differtation on, 204
Ferriar, Dr, John, Cafe of Hydrophobia, — — I
Fe'ris, Dr. Samuel, Cafe of Pe echia fine Fcbre, 79
Fevers, T)i)iertarion on, — — 209
, Eliiiy on, 202
, putrid, intedinal, remitting, Treatife on, 203
ot Jamaica, Treat ife on, 208
Filter, Fran. Erncrt. de Cortice Angufturae, — 215
Flora Cuchinchinenfis, — — 212
FcEtus, fpontaneous Evolution of, Ca'e of, 76
Ford, Edward, Cafe of a Catheter left in the Bladder of a
female Fatient in drawing off the Urine, 96
an imperforate Redlum, 102
, R. on the Inoculation ol Huides for the Strangles, 205
Fordyce, Sir W. on the Virtues of mu iatic Acid, 202
Fourcroy, M. Klements of Nat, Hidory and Chemiftry, 203
Franks. J. Ool. on animal Life and apparent Death, 205
Fungi Mcckienburgenfes, ~ — 213
G.
Gahagan, Johannes, de Inflammatione,
Garcias ab Horto, his Account of the Tabafheer,
Figure of the Nardus Indica
tioned,
Galfntis, DilTertation on, — "
Generation, Speculations relative to,
Gibney, joannes, de ..Erhere, ■
Giblon, Gulielmus, de Gonorrhoea, — .
Glands, fuper renal, Dillertation on,
Gietz, Joh. G. de Ophthalmia recens natorum,
ponorrhoca, Diflertation on, —
\ f .
210
149
men-
160
210
203
219
ibid,
21 1
215
210
Gout,
t 220 3
Gout, Dlffertation on,
GrafF, Dr. his Diliertation oh Petechlx fine Feire xt(txxt6.
Grahl, J. F. de quibufdam Medicamentis Roflbrum domef-
ticis, ^
Graves, Dr. Robert, Cafe of Meteorifmus Vjentriculi, go
H.
Paid, J. E. Supplementum Plantarum feleftarum, 273.
Hamilton, Dr. Robert, pradlical Hints on Opium, 201
Haug, C. F. de Thermis Marchio-Badeniibus, 213!
Haygarth, Dr, his Mode of preventing Hydrophobia, i6
Head, double, Account of a Child with, 164-
Hecker, Aug. F. Medicine omnis asvi fata, 211-
Holy Innocents, Burial Ground, fo called, at Paris, Obfcr-
vations relative to, — — j
Home, E. Account of a Child with a double Head, 164
Hydrocephalus internus, — See Dropfy of the Brain.
Hydrophobia, Cafe of, j
■ Appearances on Dilledion in, 7, 10
.... , Remarks on the Prevention and Treatment of,-
II, 27
— i — of, by Excifion, 1 3
Caullic, 14
wafliing the
16
walhing the
Wound with pure Water,
Wound with a dilute Solution of lunar Cauftic in Wa-
, 17
— ' — 2og
ter.
Hyheria, Dilfertation on.
I.
fackfon. Dr. R. Treatife on the Fevers of Jamaica, 208^
Jamaica, Treatife on the Fevers of, ibid.
Imperforate R.eftum, Cafe of, 102
Inflammation", DifTcrtation on, — 210
Influenza, its Fatality, in Virginia, mentioned,’ 73
Ingolfladt, Work relative to the Hiftory of Phyfic there, 215 '
Johnfton, Jacobus, de Gattritidci 2 10
Kerr,
f i
K.
Kerr, Robert, Tranfl. of M. Lavoifier’s Elements of Che-'
miftry, ^ _ r
Kidnies, Calculus of^ Diflertation on, — 212
Kortum, C. G. T. de Vitio Scrophulofo, 2 1 1
L.
Lavolfier, M. Elements of Chemiftry, _ 203
Leveling, H* Palmaz von, Hift. Chir. Anat. Facultatis Me-r
dicae Ingold/ladienfis, — 21^
Loftie, W, on the Prevention and Treatment of Hydropho-
bia, — ^ — ‘ I i
Lourciro, Joannes de, Flora Cochinchinenfis, zli
Lynch, Martinus, de Scorbuto, Typhc, Variola ct Po-
dagra, 210
M.
Mackintofl], Robertus, de Mercurio, - — 210
Mainwaring, T. Cafe of Inflammation of the Epiglottis, 40
Mannilke, Wilh. A. G. de ufu med. Succorum Vcgetabi-
lium, — — — 215
Manoury, M. Cafe ofa Gun-fliot Wound of the Mouth, 176
Meade, Gulielmus, de Aquis mineralibus, — 2to
Mederer, Profefl’or, his Method for the Prevention of
Hydrophobia, 17, 30
Membrane, difeharged by fome Women during Menflrua
tion, deferibed.
faid to refemble the ikcidua,
is accompanied with Pain, — -
Mode of Treatment recommended
in
1 04
thid.
ihid.
fuch
1 10
209
108
111
Cafes, — —
Menorrhagia, Differtation on,
Menftruation, Fad: relative to it not hitherto deferibed.
Mercury, its Efficacy in Dropfy of the Brain extolled,
, Inftances of large Dofes of, in a Cafe of Hydroce-
phalus, — . -I . 1 1 7
, DllTertation on, — 210
Meteorifmus Ventriculi, Inftanceof, go
— — — , deferibed by M. Sauvages, 93
- — — , confidered by Dr. Cullen as a Spe-
cies of Tympanites, 9^
Meyer, Frid. Alb. Ant. de Cortice Anguflurse, . 2 14
Monflrous
[ 222 3
Mondrous Child. — See Child.
Mouth, Cafe of a Gun*fliot Wound of,
Myrica Gale, recommended in chronic Rheumatifm, 216
Nardus Indica, Account of.
N.
153
alcertauied to be a Species of Andropo-
how employed, medicinally, by the Natives
of India, — ' —
gon.
highly valued as an Article of Luxury as
well as Medicine by the Ancients, 161, ibz
Im
-, an Ingredient in all the ancient Anti-
dotes, — — — ■ -i- ibi
1 , Difeafes in which it was employed by the
Ancients, — —
O.
Ophthalmia of new-born Infant?, Work relative to^
Opium, pradical Hints on, by Dr. R. Hamilton,
215
201
P.
Pemphigus, FadVs relative to, 105’
Pennington, J. DilT. on the Phenomena of Fennentation, 204
Pe rcival, Dr. Thomas, on the Dropfy of the Brain,' 1 1 1
, Remarks on his Theory of Hydro-
phobia, — — — _ jg
Petechiae, without Fever, Cafe of, — ' yg
, a Difcafe fo named by Dr.Graff, 80
alluded toby Riverius,;L-
, how defined by Dr. Duncan. 81
• — — Dr. Adair, ii.
Remarks on, — 88
, w
Pharmacopoeia of the College of Phyficians of London, new
Tranflation of,
201
Philadelphia, Regulation of the College of, permitting Thefes
to be written in Latin or Lnglifli, — ^ 204
201;
208
— - - ■ • - • ' — - ---
Phyficians, Obf. on the Duties of, by Dr. Rufh,
Plague, Treatife on, — —
Quir, Dr. Remarks on hU Work on Hydrocephalus,-
Rabies
L 223 ]
R.
Rabies Canina. — See Hydrophobia.
Reftum, imperforate, Cafe of, 102
Rheumatifm, chronic, Remedy for, 216
Richter, D. A. G. on the Extradfion of the Cataraft, 209
Riegels, Nicol. D. de Glandulis fuper renalibus, nee non
de Adipe, 21 1
Robertfon, Dr. Robert, Eflay on Fev^ers, — 202
Rodfehied, Ern. Carol, de utilitate Studii Botanici, 216
Roncalli, a Liniment recommended by, Effedls of, 134
Roflius, P. Fauna Etrufea, — ■ — 212
Rotheram, Dr. John, the Sexes of Plants vindicated, 205
Rumphius, his Account of the Tabafheer, 148
Rufh, Dr. Bcnj. his Sentiments relative to the Treatment of
Hydrophobia, 25
, Obf. on the Duties of a Phvlician, 20 1
Ruflcll, Dr. Patrick, his Account of the Tabaflieer, 141
, Treatife of the Plague, — 208
S.
Sabatier, M. Inftances of the EfFedls of Cauterifation in
the Prevention of Hydrophobia, 14
Sauvages, M. his Account of the Meteorifmus Ventriculi
referred to,
Scott, Carolus, de Podagra, — — 210
Scrophula, Work relative to, 211
Scrophulous Tumours, Liniment for, recommended by
Roncalli,
■ Simmons, Richard, Cafe of fpontaneous Evolution of the
Foetus, j,(5
Small Pox, Inquiry into, 202
Smellie, W. Pbilofophy of Natural Hiftory, - 205
' , Remarks on,
by Dr. Rotheram, —
Sore Throat, inflammatory, DIflertatlon on, 211
Spain, Plants of, Work relative to, ^14
Sparrow, Richard, of the Extraftion of the Cataradf, 41
Speculum Oculi, Objedions to its Ufe in the Extradion of
the Ciitaradf,
Spence, Georgius, de Vafis abforbentibus, 211
Spermaceti, a Subftance refembling it, faid to have been
extraded from the Brain of different Animals,
Spikenard.
t 2i4 ]
Spikenard >=See Nardus;
Staphyloma, Remarks relative fo,
Stoll, Maxim. Aphorifm. de FebribuSi ~ iiB
Stomach. — ^See Mettorifniusi
Strean, Aiinellcyj de Cynanche Inflamfnaforia^ ait
Streitt, Henry, hifl Account of a Liniment for fcrophulou^j
Tumours, .a,.;..,;.-.,.,.
Swainfton, Dr^ Alleft* Thoughts phyfiological; pathological^
and pradtical, — 20 i
Syria, rare Plants df( Work relative tOj — - 216
Ti
Tabafliieerj Accounts of, ■ - 141
— , Error of the old Tranflators of the Arabian Wri-
ters concerning it, — 142
— ^ , is a Produdlion of the Arundo Sambos, Linn. 143
two' Sorts of, one genuine,- the other faftitious,
^53
, Obf. relative to it, from a Perfian Work, 153
Thouret, M. Account of a Change to which the human
Body, under certain Circumllances, is fubjcft after
Death, “ ~
Tode, H. J. Fungi Meoklenburgenfes, - — 215
Trew, C. J. Supplementum Plantarum Seleftarum, 213
Tumours, fcrophulous, Account of a Liniment for,- 134
Typhus, Diflertation on, -* — 2og(
V-
Vogel, B. C< Supplementum Plantarum Seieftarum, 215
, S. Gotti. Manuale Praxeos medicae, - 212
W.
Wjilker, Robert, Inquiry into the Small Pox, _ 202
Waterhoufe, Dr. B. on the Principle of Vitality, 204
Waters, mineral. Works relative to, — 2 to, 213,
VVenzel, Baron de, his Work on the CataraA recom-
mended, " 72
Williams, Mr. J. L. his Account of the Tabaflieer, 152
Wood, Robertus, de Pertuili, _ -y~ 21 1
Worms, round, of the Intt dines, Diflertation on, 209
Wound, Gun-lhot, in the Mouth, Cafe of, — - 1 76
ENP OF THE FIRST VOIUME.
(
<
• • * ' x- -
V.
i
r
*\ 'f^-/ *V'** '
^vV.,..,'-'-‘.^^ ;•,.
• . ^ • . .'
>>. : > '•
■• !?>■
'1
' i
-1
»*
I
1
^4
■\i
i
I
i
Live Music Archive
Librivox Free Audio
Metropolitan Museum
Cleveland Museum of Art
Internet Arcade
Console Living Room
Books to Borrow
Open Library
TV News
Understanding 9/11