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MEDICAL FACTS
t
I
AND
OBSERVATIONS.
VOL. VI.
medical facts
AND
OBSERVATIONS.
's
VOLUME THE SIXTH.
LONDON:
miN + IB roK J. JOHNSON, N® 72, ST. TAVL’s CHURCH YARB
M.DCC.XCV
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Digitized by the Internet Archive "' in 2016 ^ ^
https://archive.org/details/b28042499_0006
C V 3
CONTENTS.
ftgt
I ObSERFJ^IONS on ths XJJe of Arfenlc in the Interniit 'tent Feveirs of a tropical Cli- mate ; to ivhieh is prefixed an Account of the We-ather, at- Sierra Leone ^ during the Seafon in which Juch Fevers are niofi pre- valent, By Thomas Mafterman Win- terbottom, M. D. Bhyfician to the Set- tlement at Sierra Leone. ~ — t
II. An Account of the good EffeSfs of a So-
lution of Sal Ammoniac, in Vinegar, em- ployed, as a topical Application, in Cafes ■ of lacerated W lunds. By Mr. Henry Y ates Carter, Surgeon at Kettley, near Welling- ton, in Shropfinre. — 66
III. Cafe of a difeafed Kidney. By the fame. 85
IV. Cafe of a Gun-Shot Wound of the Head.
By the fame. —
V . An Account of fome extraordinary Symp-^ toms which were apparently connected
with
[ Vi ]
with certain morlid Alterations about the Feins and Nerves. By Mr. John Pearfon, Surgeon of the Lock Hojpitaly and of the Public Difpenfary^ —
VI. An Account of the ExtraSUon of an extraneous Subfance from the ReSium. By Mr. William Blair, Surgeon of the Lock Hofpital ; and of the General Difpenfary
in Newman Street, St. Mary-le-hone, iii
VII. A Cafe of Aneurifm of the Crural Ar-
tery. By Mr. Thompfon Forfter, Sur- geon on the Staff, of the Army, and Sur- geon to Guy’s Hofpital. — 114
VIII, An Account of a Key Infir ument of a new ConJiruHion ; with Ohfervations on the Principles on which it alls, in the Extrac- tion ofPeelh, and on the Mode of applying it. By Mr. Robert Clarke, Surgeon at Sunderland, in the County of Djurham. 120
IX. An Account of a new Species of Swie- tenia ( Mahogany ) ; and of Experiments and Ohfervations on its Bark, made with' a View to afcertain its Powers, and to compare them with thofe of Peruvian Bark, for which it is propojed as a Suhjlitute :
Being
1
[ Vii ] .
Page
Being an AbJlraEt of a Taper on this Sub- Je£i, addrejed to the Honourable Court of Hireblors of the United Eaji~ India Com- pany, ^ William Roxburgh, Af.Z). 127
X. An Account of the EffeUs of Mahogany Wood in Cafes of Diarrhoea. By Mr. Francis Hughes, Surgeon of the General Infirmary at Stafford. — - — 156
XL Account of fome Difeoveries made by Mr. Galvanij.o/ Bologna; with Experi- ments and Obfervations on them. In two Letters from Mr. AlexanderVolta, F. R. S. Profeffor of Natural Thilofophy in the Univerfity of Pavia, to Mr, Tiberius Ca- vallo, F. R. S. — From the Philofophical LranJaSiions of the Royal Society of Lon- don. . — — 162
XII. A Return of the Sick of the Ship's
Company, and of the Military, on Board the Ships in the Service of the Honoura- ble the United Eaft -India Company, for the 7'ears 1792 and 1793. By John Lorimer, M. D. — 21 1
XIII. An Account of a fingular .Cafe of Ifchu- ria, in a young Woman, which continued
for
[ vlii J
Pag*
/or more than three Tears ; during which Time^ if her Urine was not drazvn off with the Catheter, JJoe frequently voided it hy vomiting ; and, for the laji twenty Months, paffed much Gravel by the Catheter, as well as hy vomiting, when the UJe of that Injirument was omitted, or unfuccefs fully applied. To which are added Jome Remarks and Phyfiological Obfervations. By Ifaac Senter, M. D. Affociate Member of the College of Bhyficians of Philadelphia, and Jenior Surgeon in the late American Army.
Vide TranJa3ions of the College of Phyfi- clans, of Philadelphia, — — 212,
Catalogue of Books. — - — 223
Jndex, ^ — — 228
DIRECTIONS TO THE BINDER.
Plate the Firft, the references to which are explained ia pages 92 and 116, may be placed at page 92 ; and plate thp fccond at page lai.
t
MEDICAL FACTS
AND
OBSERVATIONS.
I. Ohfervations on the Ufe of Arjenlc In the Inter- mittent Fevers of a tropical Climate ; ' to which^ is prefixed an Account of the Weather, at Sierra Leone, during the Seafon in which Juch Fevers are niofi prevalent. By Thomas Maftermaii Winterbottom, M. D. Phyfician to the Set- tlement at Sierra Leone.
S arfcnic» though of late years frequently
and fuccefsfully ufed in England for the cure of intermittent fevers, has not, to my know- ledge, been hitherto employed in a tropical cli- mate ; fome account of its ufe in Africa, with the hiftories of a few of the cafes in which it was exhibited j will not, I hope, be altogether unacceptable.
VoL. VI.
B
It
[ ^ ]
It may be proper however to premlfe a fliort ac- count of the weather at- Sierra Leone during the feafon in which intermittents are moft prevalent.
The year may be divided into the rainy, tornado, and dry feafons. The rains on this part of the coaft commonly fet in about the end of May, or beginning of June ; and conti- nue, more or lefs violently, until the beginning or middle of September : they are tlren fuc- ceeded by tornadoes, which continue until the end of November. It muft be obferved, how- ever, that the rains are not only carried off by tornadoes, but alfo brought on by them ; and that the tornadoes preceding the rains are, in general, lefs regular than thofe which terminate them. The dry feafon continues from Decem- ber until May, though ihowers of rain fome- times occur during the dry months.
In 1792, the rains commenced about the end of May, and continued for fome time to be very heavy; from the middle of July, however, until the laid week of Auguft, there vvere fre- quent intervals of fair weather, twelve hours of V rain being generally followed by twenty-four or thirty hours of fair weather, with fometimes a bright fun. During this period the thermo- meter at noon ufually flood at from 78° to 80°.
The
[ 3 ]
The ]aft week of Auguft and firfl week of Sep- tember were remarkable for an almoft inceffant rain, which was for the moft part fmall and drizzly, though it fometimes fell in heavy fhowers; the air at the fame time felt cold and raw, particularly in the evenings and mornings, when a thick fog covered the hills. The ther- mometer at noon was from 77° to 80°.
On the 7th of September a tornado came on, which returned on the loth, 15th, i6th, 18th, 19th, 2 1 ft, 22d, 24th, 26th, 28th, and 30th.* On the 8th, nth, 12th, 25th, and 29th, the fliowers of rain were frequent. '
On the 9th, nth, 14th, and 23d, thunder and lightning occurred during fome part of the day. The 9th, J3th, 15th, 17th, 24th, an^ 26th were fultry and almoft calm. During the con- tinuance of the rains, the winds chiefly blew from between the fouth and weft points, but moft frequently from the fouth-weft, whence alfo the heavieft'rain came.
As foon as the tornadoes appeared, the fea and land breezes had a more regular fucceflion; the fea breeze ufually began from the north- weft about eight or nine A. M., .and towards funfet drew round to the weft : the land breeze then fetting in from the eaft or fouth-eaft, con-
B 2 tinned
[ 4 ]
tinued to blow all night and during the early* part of the morning.
Towards the end of the month the thermo- meter generally flood at 82° at noon, the at- mofphere being lefs hazy, and the air cool.
The month of October was throughout at- tended with regular fea and land breezes ; the atmofphcre was free from haze, but fometimej overcafl with clouds during the day ; the whole of the month was cool and agreeable, though the thermometer at noon generally flood at 82®^ and on the 29th at 84°.
A tornado occurred every night, or early ict the morning, from the ift to the i8th inclu- fively, frequently attended with heavy rain fof fome hours, and with much thunder and light- ning. During the remainder of the month tlic tornadoes became lefs frequent, occurring only* on the 19th, 21ft, 23d, 25th, 27th, 28th, and 29th. The I ft, 17th, and 24th were fultry. On the 24th it was calm all day. On the 3d there was much thunder and lightning. On the 7th, 15th, i8th, 21ft;, and 30th, frequent Ihowers of rain fell. The tornado on the 17th eame from the fouth-weft which is uncommon. The tornado on the 2d was not followed by rain. The 26,tli was remarJtably hazy all day.
The
C 5 ]
The lightning was extremely vivid on the aSth, appearing in long ftreams or chains of fire.
The month of November was much warmer than the preceding one, the thermometer at noon being from 82° to 84°. On the nth it rofe to 85°. It was on the 5th at 75°. There was continued rain till noon, when, the Iky became clear, the day calm and fultry. The atmof* phere during the greateft part of the month was clouded and hazy, at leaft the tops of the bills were covered with haze during fome part of the day. The fea and land breezes continued to blow very frefla, but the mornings were fre- quently calm and fultry till near ten A. M. On the 28th it was calm all day. Tornadoes oc- curred on the 2d, 8th, loth, I2th, i3th, i6th, 19th, and 25th. The 5th, 17th, and 23d were rainy. The 5th, nth, 14th, i8th, and 28th, were fultry, with a little wind.
In December alfo the Iky was generally hazy and clouded ; the fca and land breezes were pretty frelh during their continuance, but the mornings were for the moft part calm, the fea breeze- not fetting in till near ten A. M.; the evenings alfo were clofe and fultry from fun-^fet till late at night.
A tornado came on, the morning of the 7th, f B 3 followed
L 6 ]
followed by much rain, thunder, and lightning; but it cleared up before noon ; a heavy lliower fell in the afternoon of the fame day.
The cleareft days this month were the 3d, 9th, 13th, i8th, 24th, and 25th.
On the 5th, 8th, 14th, 15th, and 22d, gentle fliowers fell : on the 8ih there was much thun- der and lightning. The weather was fultiy, with little wind, on the ift, 3d, 14th, igth, 22d, and 27th. The 14th and 27th were cihn days. The land wind blevv all day on the 13th, and the fouth-we.ft and fouth-fou h weft winds on the 2d, 30th, and 31ft davs. The thermo- meter at eight A. M. ufually flood at from 77° to 80°; on the 13th at 75°, and on the 26th at 81°: at noon it was from 81° to 84°; at eight P. M. from 78° to 80°.
The remittent fever which during the months of June, July, and Auguft, had very generally prevailed here, and had raged with great vio- lence, began to abate in the month of Septem- , ber. Early in the month, this difeale had not only become lefs frequent, but alfo more mild in its fymptoms, gradually changing into the form of an intermittent. Towards the end of the month it became very rare, the cafes which occurred being chiefly among the whites, ef-
pecially
pecially thofe lately arrived in the country; or others who had been irregular and intemperate during the courfe of preceding intermittent com- plaints.
In the months of Odober, November, and December, intermittents were fo prevalent, that fcarcely a family in the fettlement, although the whole number was nearly 400, remained perfectly free from them. They generally obferved the quotidian and tertian type there' were, how- ever, a few inftances of double tertians. Moft of the above cafes were fo mild, particularly among the men, as not to prevent them from following their different occupations, except during the time of the paroxyfm. But in lome inftances, the daily recurrence of the difeafe, the long continuance of the paroxyfm, and a poor diet, confifting chiefly of falted meats, rice, caflada, &c. reduced the patients to a ftate of great debility, and infenfibly laid the foundation of long and tedious complaints. The greateft fufferers from intermittents were thofe who had previoufly laboured under re- mittent fevers, and had not yet recovered their ftrength ; alfo perfons of delicate and irritable habits, children, and women giving fuck.
In every inftance where the bark was takeii
B 4 iij
r 8 ]
in due quantities, and perfifted In for a proper length of time, the paroxyfm was fpeedily checked, and the danger of a relapfe effedtu- ally prevented ; nor did the patient fuffer thofe ill effedts which ufually occur where the difeafe has continued long, and been left to itfelf. Few, however, of the common people could be prevailed upon to take the bark in any form ; and even thofe who took enough of it to obviate the return of a lingle parox\fm, would feldom continue it a fufhcient lenerh of
O
time to eradicate the difeafe. Thcle confidera- tions, joined to an apprehenfion that ferious and alarming confequences might enfue from frequent rclapfes, determined me to try the effedts of the mineral folution, according to the plan recommended by Dr. Fowler*. The tear of difordering the bowels, and inducing dy- fenteric fymptoms, rendered me at firft very cautious in its ufe ; but 'on finding, after re-
i
peated trials, that no ill effedts were produced by its exhibition, I was encouraged to employ it more generally. The fuccefs with which it was attended will appear from the following de- tail of cafes :
* Medical Reports of the EfFedls of Arfenic in the Cure df Agues, &c. 8vo. London, 1786.
CASE
[ 9 ]
\
CASE I.
Odober 4. — S. Peters, a black, aged four years, is affeded every day, about noon, with coldnefs and violent flilverings, which conti- nue near an liour, and are then fucceeded by a hot dry ikin, head-ach, and fometimes vomiting. The paroxyfm is terminated in the evening by a copious perfpiration. , In the ab- fenceof the fit he makes no complaint, but ap- pears languid and weak, and has little appetite. A confiderable degree of hardnefs is felt on the left fide, with a tumour projeding below the cartilages of the falfe ribs. He was ordered to take four drops of the mineral folutlon three times a day.
5. Had no cold fit yefterday at the ufual time, but appeared heavy and uneafy ; no ficknefs or griping was occafioned by the drops.
8. Has had no return of the paroxyfm fines the 3d. No griping nor any fenfible efFed has been produced by the medicine.
The folution was now omitted, and he took, on the 9th, four grains of calomel. This child had no relapfe, and has continued fince to
enjoy
[ lO ]
good health, although the tumour in the fide did not wholly difappear till the beginning of the year 1793.
CASE II.
Odober 4. — Hannah Peters, a black, aged thirty-fix years, has been for two months paft af- feded with an intermittent fever ; at prefent a paroxyfm comes on every day at noon. During the hot fit, fire has a confiderable pain of the • ' head, efpecially over the eyes, which conti- nues till evening, and is gradually abated bj the fweat which then breaks out. Her flrength and appetite are much diminifhed.
Capiat folutionis mineralis guttas x. ter die.
6. Had no return of fever yefterday at the ufual time ; but towards evening had a flight cold fit, fucceeded by heat and fweating. The paroxyfm, however, was neither fo fevere, nor of fo long continuance as ufual. She felt a little griping in her bowels.
Repetatur Solutlo.
8. Has omitted the folution two days, and has had a return of the hot fit each day at the ufual time, without the preceding cold ftage. She was defired to continue the drops regularly. • > 16. Has
t
[ II ]
1 6. Has taken the folutlon regularly fincc the laft report, during which time fhe has not had the leaf! return of her ague, nor any pain of ’the bowels.
Oniittatur folutio et capiat Infus. Coit. Anguft. Jiij ter die-.
CASE III.
Odtober lo.,— David Edmonds, a black, aged ' forty years, has had every day, for near a month paft, a paroxyfm of ague, attended with a very fevere pain of the head. Of late the fit has only returned every fecond day, be- ginning about one o’clock, P. M. In the ab- fence of the paroxyfm he has no complaint but languor and debility.
Capiat Iblut. min. guttas x. ter die.
II. Had a flight attack yefterday evening, which did not continue long ; he felt no griping or naufea from the folution.
Repetatur Solutio.
1 6. Has negledted his medicine for fome days, during which he has miffed the cold fit, but had a pretty fmart hot fit every day, towards evening.
Repetatur Solutio.
20. Has had no return of the cold or hot fit
fincc
[ 12 ]
lince the i6th: he continues the folution without experiencing any difagreeable effed from it*
CASE IV.
Odob. 5. — J. Barnes, ag-d thirty-fix years, of a fair complexion, and florid, with red hair, was attacked with the remittent fever about the end of Auguft laft, from which he recovered by a liberal ufe of the bark ; but foon after, on re- turning to work, and expofing himfelf too much in the fun, he fuffered a fevere relapfe in the beginning of September. His complaint, however, yielded again to the bark, but left him' greatly enfeebled. During the remainder of the month -of September, he continued to take from |i to gifs of bark every day, and re- turned todiis work. . About a week afterwards he was fuddenly feized with a cold fit, followed by a hot ftage and a profufe perfpiration, which left him very weak during the apyrexia. His pulfe is now 100, rather hard and quick : he ![ias a fevere attack every day at noon, at- tended with vomiting, and, during the hot fit, with a quick and hurried refpiration; he is hot
and
[ 13 3
and reftlefs till late in the evening, and has then very profufe night fvveats.
Capiat folut. min. guttas x. ter die.
Od. 6. The folution did not difagree witli him. He had a flight return of the paroxyfon> yefterday.
Repetatur Solutio.
8. Has had no return of the ft, nor felt any fenfible effeft from the medicine. He perfpired much at night; has great debility and languor, with little appetite.
lo. The fymptoms are nearly as before; he did nor reft well, but had no return of the paroxyftrr.
Capiat opii gr. ij h. s. Repetatur Solutio.
\
12 The folution was yefterday omitted; he refted better with the pill : in other refpedts finds no alteration.
13. Had a return of the paroxyfm yefter- day ; the cold ftage lafted half an hour, the hot ftage about two hours. He was much relieved by the opium, and fweated very profufely af- ter it.
14. Had another flight fit yefterday evening, the cold ftage being very fhort ; he fweated much: does not recover his ftrength or appetite. As he could not be prevailed upon to take the bark again, I diredfed that four ounces of the
following
[ 14 ]
following infufion fliould be taken three times a day:
Corticis AngufliirsB Cremor. Tart. 31] Aquae- pur. Ih'Ts.
By this plan his appetite became better, and he regained his ftrength in fome degree ; but in a week or ten days he rclapfed Into his for- mer flate, having every day an ague fit, which was, however, relieved by two grains of opi- um, taken at the commencement of the cold ftage. He now began to take the bark to the amount of |ifs a day, which finally put a Hop to the ague; notwithflanding, he recovered his ftrength fo fiowly, that it was thought necefiary, fix weeks afterward, to fend him to England for the effectual reftoration of his health.
CASE V.
Odober 14. — A. Richardfon, a black, aged forty years, fince her recovery from a remittent fever in Auguft laft, has continued in a very debilitated date, and for fome time pafl; has been affeded with an intermittent fever, the cold fit of which comes on daily at four o’clock, P. M. is very fevere, and of long duration.
Much
‘ [ -5 ]
Much pain of the head, and frequent vomit- ing attend the hot fir, which continues the greateft part of the night, and is fuccecded to- wards morning by a flight partial fweat : fhe remains very weak till the commencement of the next paroxyfm ; her appetite is much im- paired ; her body open.
Capiat folut, min. guttas x. ter die.
1 6. Hus taken the folution two days, and has had no appearance of the ague, except a little uneafinefs and yawning about the time of its ufual attack. No.fenfible effeft is produced by the medicine.,
Repetatur Solutio.
17. Had a return of the paroxyfm yefterday; the cold fit was fhort, but fevere ; the hot fit was alfo violent, and terminated by a profufe perfpiration ; after which, however, fhe ap- peared more eafy and compofed than ufual. She complained of no griping or naufea from the medicine.
Repetatur Solutio.
24. Has had no return of the paroxyfm fince the 17th, nor any fymptoms of its approach. She continues flill very weak, and has little ap- petite.
Omittatur folut. Capiat infuf. gent. c. ^ij ter die.
28. Has had no return of the fit. She be-
gins
[ ]
gins to recover her ftrength and appetite.
Repetatur Infuf.
CASE VI.
Nov. 2. — Mary Bowler, aged forty years, ' a black, has been for fix weeks affedied with a tertian ague ; the cold fit is fcvere ; the hot fit, which is very violent, and attended with great pain of the head, generally continues all night, and fometimes part of the next day, without any ' fvveating ftage. She is much debilitated, but has a tolerable appetite.
Capiat folut. min. guttas x. ter die.
4. Had a return of the paroxyfm yefterday, after the third dofe of the folution. The fit returned at the ufual period, and in the fame manner as before. No fenfible effed was pro- duced by the medicine.
Repetatur Solutio.
8. Has had no return of the cold fit fince the 3d; the hot fit occurred about the ufual time, but it was flrorter and much lefs fevere than ordinary.
Repetatur Solutio.
■12. Has had no return of the paroxyfm ; flie complains of a little griping in her bowels, and continues ftill weak.
Omittatur ^olut. min. Capiat inf. gent. c. |ij ter die.
I 20. She
20. She makes no complaint^ and has nearly recovered her health and fpirits.
Repetatur Infus. Gent. c.
CASE VII.
Nov. I. — E. Perth, a black, aged forty-five years, has been for near fix weeks paft affedted with an irregular intermittent, which moft com- monly follows the tertian type. The cold fit is fevere, and very uncertain in the time of its attack and in its duration. In the hot fit fhe complains of exceflive pain of the head, efpe- cially over her eyes, and of great pain of the • back. The hot ftage generally continues all night, feldom terminating by regular fweats : it is followed by much laffitude and uneafinefs through the enfuing day. Her ftrength is
greatly impaired, her appetite bad ; and Ihe is very coflive.
Capiat ftatim Sal. cathart. amar. |i. Cras incipiat fumerc
Sol. min. guttas x. ter die.
6. After taking three dofes of the medicine, fhe had a return of the paroxyfm on the 3d, but thought the cold fit later in its approach than ufual, and fhorter. The hot fit continued
VoL. VI. C throusi;^'^
D
(
[ >8 3
through a great part of the night, but the pain of the head was much lefs fevere. She has had no return of the paroxyfm fmce, and feels only a little griping from the medicine.
^■Repetatur Solutio.
10. Has had no return of the paroxyfm fince the 3d. She complains only of debility and want of appetite.
Omittatur Solut. Capiat Infus. Gent. c. §ij ter die.
14. Begins to recover her ftrength ; her appe- tite is alfo better.
Repetatur Infus. Gent, c.
CASE VIII.
Odlob. 3. — Ann Bowler, a black, aged four- teen years, has been, for fome weeks paft, af- fedled with an irregular tertian, which is fome- times, but not generally, preceded by a cold flage. The hot ftage continues during the greater part of the day, and feldom terminates by fweating. Her body is open ; her appetite much impaired.
Capiat Solut. min. guttas viii; ter die.
10. The folution has now been taken for a week, during which time fhe has had no return
of
[ '9 ]
of the ague, nor has felt any naufea or griping from the medicine. No complaint remains but debility.
CASE IX.
October 4. —Dinah Lawrence, a black, aged forty-four years, is every other day, about fix o’clock P. M., feized with a fevere cold fit, fol- lowed by great heat and violent pain of the head, efpecially over the eyes, which fymptoms continue through the whole night, and are not fucceeded by any regular fweating ftage ; Ihe is coftive, and much debilitated ; fhe has had this complaint near three months.
Capiat ftatim Sal. cath. am. 3vl • et eras Solut. min. guttas X. ter die.
to. Has had no return of the fit fince fhe be- gan to take the folution ; fhe finds no difagree- able efFedt from it : is flill coftive.
Repetantur Sal cathart. et Solut. min. ut antea.
14. Feels no complaint but what proceeds from debility; her appetite is belter; fhe was a little griped by the medicine.
Omittatur Solut. min. Capiat Infus. Gent, c.fij ter die.
C 2
CASE
[ 20 ]
CASE X.
Sept, 24. — Jane Armftrong, of a fair com- plexion, aged thirty years, is feized every day, at eleven o’clock A. M., with a head-ach fo vio- lent as to produce frequent fhrieking and continual moaning. The pain chiefly affe<fts the crown and one fide of the head ; it is in general preceded by a cold flage, though flight, and of fhort duration. The hot fit, which is not very violent, continues till night, when it abates along with the pain; but is not en- tirely removed till morning : the paroxyfm is ufually terminated by a profufe perfpiration. The patient is naturally of a delicate conftitu- tion, and has of late been much reduced by the remittent fever, from which fhe recovered very flowly.
Capiat Opii gr. iij et Tart, cinet. gr. | ingruente pa- roxyfmo.
25. The head-ach was almoft entirely re- moved within half an hour after taking the pill; the paroxyfm terminated alfo more fpeedily than ufual. Being very coflive, fhe was ordered to take half an ounce of purging fait the fol- lowing morning.
26. The
I
C ]
26. The fait operated gently; flie had a very violent return of head-ach at the ufual time, which was relieved by the opium taken alone.
Odtober 4. — She refufes to take the bark : fhe has every day had a return of head-ach at the ufual time, which was however removed by the opium.
Capiat Solut. min. guttas x. ter die ; et repetatur Opium fub initium paroxyfmi.
10. Has had no retlirn of the paroxyfm fince fhe began the folution ; feels no inconve- nience from its ufe, but a flight diarrhoea, without any pain.
Repetatur Solutio.
14. Has had no return of the head-ach ; fhe fweats much at night ; is very weak, and has no appetite.
Omittatur Solut. Capiat Infus, Cort. Anguft. ^iij ter die.
This woman has never had a return of the paroxyfm, though a twelvemonth has now elapfed fince the laft report. She gradually reco- vered her ftrength by the ufe of tonic remedies.
\
CASE XI.
Sept. 1 2. — Jeffe George, a black, aged twenty
C 3 years.
[ 22 ]
j/f y'cari, )>'ejilerday afternoon feized with a fe-
vere cold fit of an ague, which continued up- wards of two hours, and was fucceed; d by great heatj'fevere pain cf the head, nautea, pains - all over his body, more efpecially in the back and loins, great reftlelsnefs, and anx'ctv. To- wards morning a general but not pr.ofufe per^- fpiration took place; the fhverity of the head- ach at the fame time abated, and all the Other fymptoms wholly difappeared: he has much thirfl ; his fkin is cool ; his pulfe 72, and foft.
Capiat Solut. min, guttas x. ttt die.
13. He had a return of the paroxyfm laft night, at eight o’clock, four hours later than the former one. The cold fir, though very -fe- vere, did not continue long ; the hot fit was ftrong; the head-ach lefs violent. He had a very profufe perfpiration this nrorning. His fkin is now cool and moift, and his tongue clean; but foine pain ftill remains over the orbits of the eyes; he complains of third:, and is coftive.
Capiat Sal. catnart. am. ^i — Repetatur Solut. mih.
14. The head-ach continued yefierday till the afternoon, and then went off; the faks were not taken till this morning. He reded well lad night, and makes no complaint but of debility.
Repetatur Solutio.
15. He
I
[ J
3:5. continued free from complaint yef- terday, till towards evening, when he became hot and feverilh ; and after a very uneafy night, he, this morning, at eight o’clock, had a fevere cold fit, attended with violent head-ach, which lafted near an hour. Two grains of opium, taken at this time, brought on a fwcat, and ter- minated the paroxyfm.
Repetatur Solutio.
16. He flept well laft night, and feels no complaint but from debility. He has omitted the drops this day.
Repetatur eras Solutio.
17. Has had no return of the paroxyfm ; he feels no complaint but a flight griping from the-' ' folution.
Tinft. Opii et Solut. min. 5a 3ij m. capiat guttas sx. ter die.
20. He has had no return of the paroxyfm fince the 1 5th. At that time he probably brought it on by havingexpofed himfelf the night before to the damp evening air in his fhirt. He. feels no griping, or ficknefs, from the drops, which he {till takes. He returned to his work this day.
i
.c 4 "case
[ 24 ]
CASE XII.
Augiift I2j 1793. — Mr. T , a Euro-
pean, of a dark complexion, with black hair, was fuddenly feized, two days ago, with an acute pain of the head, chiefly over the orbits of the eyes, attended with naufea and vomit- ing. Thefe fymptoms were foon followed by great heat and refllefsnefs, which continued ■ through the whole night, and yielded in the morning to a profufe perfpir.ation. On the i ith he was free from complaint ; walked about, and ate heartily. In the evening, however, he was feized with a very fevere (hivering fit, which continued near two hours, and was fucceeded by great heat and refllefsnefs, by fevere pain above the eyes, and bilious vomiting. He was a'gain relieved in the morning by a copious perfpira- tion. At ten o’clock, A. M. his fkin was ftill hotter than natural, and his pulfe rather quick; in other refpedls he appeared free from com- plaint.
Capiat Solut. min. guttas y. ter die.
1 3. The firfl dofe of the folutlon yefterday produced vomiting; the fecond gave him three
ftools^*
[ ^5 ]
ftools; the laft. had no particular effeft. He pafled an eafy night, without feeling any fymp- tom of the fit, except a general uneafinefs, which, however, foon went off. He complains this morning of flight pain over his forehead.
Repetatur Solutio.
14. The medicine again produced ficknefs, and a flight diarrhoea, though he only took two dofes of it. He remained well till two o’clock, P. M.; he then became very hot, and had a fevere return of the head-ach, attended with naufea and vomiting. The heat, pain, and reftlcfsnefs continued till this morning, when a copious perfpiration took place, with which he is yet affeded.
At ten o’clock A. M. his pulfe Is 130; his fkin pretty cool; his head-ach almoft gone; his tongue fomewhat furred. He complains of third:, and of flight pain of his bowels, with a fen- fation of numbnefs about the umbilicus
Omittatur Solut. Capiat pulv. Cort. Peruv. 3I fecundi quaque hora.
At fix o’clock, P. M. he has a very flight head- ach, with a fenfe of weight in the forehead; his eyes are more prominent and brighter than ufual. He has taken two dofes of bark fince noon, the fir ft of which produced vomiting; he has
had
[ 26 ]
had one flool to day; his lirine is very high coloured; pulfe 130, foft, and lefs quick than in the morning.
Repetatur Cort. et capiat h. s. Tind, Opii et Vin. An- tlfn. aa guttas xxx.
1 5th. Ten o’clock, A.M — he has had a good night ; fome pain ftill remains over his eyes, but it is lefs fevere ; his Ikin is rather hot, but moift; pulfe 1 12 ; his tongue dry and white ; his uiine high coloured, with a light cloud fufpended in it. He complains much of third and fever, and of a pain in his back. He has taken, fince yefterday noon, |ifs of Peruvian bark. '
♦ Repetantur Cortex, Tin<St. Opii, et Vin. Antim.
16. He paffed an eafy night, and enjoyed fome refrefliing deep; he complains only of a flight pain over his eyes, and is able to fit up. He had two flools in the night ; his tongue is cleaner, but ftill dry; pulfe 104 and foft, but eafily quickened by the leaft exertion. His urine is not fo high coloured, and exhibits a flocculent cloud. He took |ifs of bark between ten o’clock, A. M. yefterday, and fix o’clock this morning*
Repetantur Cortex, TiiuSt. Opii, et Vin. Antim.
17. He was much griped yefterday by drink- ing foftw; cyder; has no complaint this morn- ing
*
[ 27 J
ing but frofti Weaknefs. His pulfe is 104, and foft; his tongue clean and moift. His urine is much paler than before, and has a kind of gelatinous ftriated cloud fufpended in it.
The fame medicines were repeated.
18.^ He feems much better in every refpeft ; his appetite is returning; his pulfe 90, and foft.
He continued the bark a few days longer, and had no return of complaint.
CASE XIII.
Odiober 4.— Ann and Eliz. Davis, blacks, the former five, the latter fix years old, have been for fome time paft affected with quotidian agues. The cold fit comes on at four o’clock, jP. M ; is very fevere, and frequently attended wbh vomiting. The hot fit ufually continues the whole night, being attended with great reft* leffnefs, anxiety, and acute pain over the eyes; but is feldom fucceeded by a regular fweating ft age. Their appetite and ftrength are much impaired.
Capiant Solut. min. guttas vj. ter die.
9. Each of them had a return of the cold fit
Qjn
[ 28 ]
on the 4-th, after the third dofe of the folutlon. They have fince had no return.
Repetatur Solutio.
II. There has not been any appearance of the paroxyfm, nor any difagreeable eiTedt from the medicine.
CASE XIV.
John Oliver, a black, aged five years, who was affefted nearly in the fame manner as the two laft patients, began, on the i6th,ot Auguft, to take four drops of the folution three times a day.
23, He had a return of the fit on the t 6th, 17th,
and 1 8th, but it commenced every day later, was
lefs fevere, and of fiiorter duration. Since the
/
1 8th he has had no fir, although the folution was difeontinued. A flight tumefaction of the face has been obferved for two days paft, but is at prefent fubfiding; He felt no naufea or pain from the medicine^
I
CASE
[ »9 3
I
CASE XV.
Dec. 10.— Mary Jones, a black, aged thirty- fix years, about three months ago was afFedtcd with a remittent fever, from which (lie reco- vered very flowly, and has fince continued in a . flate of great debility. She has of late been fubjed: to violent pains in the bowels, attended with diarrhoea. During the laft month fhe has had a regular tertian ague, the cold fit of which begins generally at fun-fet, but is not very fe- vere, nor of long continuance. The hot fit is long and fevere, being attended with violent head-ach, intenfe third:, and great reflleffnefs. Thefe fymptoms are not terminated by a regular fwcating ftage ; and have often no remiffion till the middle of the following day. She is feeble, and much emaciated.
Capiat Solut. min. guttas x. ter die ; et Op'u. gr. ij, fub acceifioncm paroxyfmi.
12. The hot fit was much relieved by the opium ; the paroxyfm was Ihorter, and the head-ach lefs fevere. She is very coftive.
Repeutur Solut. nain, et capiat Sal. cathart. Jfs mane.
15. Con-
[ 30 ]
15. Continues the folution without feeling any fenfible effed from it. She has had no cold fit or head-ach during the two lafl: paroxyfms. The hot fit was much lefs violent and of fliorter duration than formerly.
Repet^tur Soliuio.
18. Has had no return of the fit, nor any appearance of it fince the lafl report ; nor does (he perceive any naufea or griping from the folution. Her appetite is ftill much impaired.
Repetatur SoltiUo. Capiat Iqf. Cort. Angufl. |ij ter die,
22. There has been no return of the parox- yfm. She finds her flrength and appetite much increafed by the infufion,
The ufe of the folution was difeontinued.
CASE XVI. "
Feb. T. — John Jonesj a European, of a fal- low complexion, aged twenty-eight years, is affefted in the afternoon, every other day, with a violent cold fit, attended with rigors, and fucceeded by a regular hot fit and fweating. Until within a fevv days, he has been able to do his duty on fhip- board as a feaman; but the paroxyfm returns now with fo nauch violence, I as
[ 3* ]
t
as to confine him to his hammock. He has ta-* ken a large quantity of Peruvian bark at different times, which has never failed to prevent the next return of the paroxyfm ; he has always, how- ever, had a relapfe in a few days, through in- temperance, and expofure to the night air.
Capiat Solut. min. giittas x. ter die.
8. Has taken the folution without perceiving any fenfible effcdt from it. The paroxyfm re- turns as ufual, but, as he fays, with much lefs violence.
Repetatur Solutio,
15. The paroxyfm returns as ufual, but is fhorter and leTs fevere. Through mifiake, he has taken the folution only before the attack of each paroxyfm.
Repetatur Solutio ; et capiat guttas x. ter die.
20. He has had no return of the paroxyfm fince he took the folution as diredfed, and feels, no naufea or griping from it.
He continued the medicine a few days longer, and was reftored to perfed health.
CASE
C 3* ]
' CASE XVII.
Feb. I. — Ann Wicks, a mulatto, aged forty years, has been for a month pall; affe6ted, every other day, with a violent cold fit, attended with rigors, and fucceeded by great heat. She has alfo a fevere pain over the forehead, and on one fide of the head, extending to the neck and Iboulder of the fame fide. There is much ftiff- nefs and pain in moving the neck during the intermiffion. The cold ftage commences about five o’clock, P. M. and continues near an hour. The hot fit does not terminate before morning, and is feldom fucceeded by a' regular fweating ftage. She is much debilitated by the long con- tinuance of the complaint, and has lately given fuck to a young child. Her appetite is alfo greatly impaired.
Capiat Solut. min. guttas viij ter die.
4. She has had no return of the cold fit. The hot fit continued only part of the night, and was unattended with head-ach or any other dif- treffing fymptom.
Repetatur Sohitio.
' 12. She
^ 33 3
12. She has had no return of the paroxyfm, and feels no ill efFedts from the folution. Her ftrength is fomewhat increafed, but her appetite is ftill bad.
Oniittatur Solutio. Capiat Inf. Gent. c. |ifs bis die,
CASE XVIII.
Mrs. D. a delicate woman, of a fair com- plexion, aged twenty-four years, in the month of Auguft laft had a mifcarriage, from which Ihe recovered without much trouble, and en- joyed a tolerable ftate of health till the begin- ning of Qdober, when Ihe w^as feized with the common remittent fever of the place. From this complaint Ihe alfo recovered within a fort- night, by taking largely of the bark in powder and decodtion. About the end of the month, however, Ihe fulFered a relapfe, and made a very flow progrefs towards recpvery; her fto- mach being only able to retain the bark in the form of a decodtion. She laboured under great debility, very profufe night fweats, and fre- quent hedlic flufhings during the day, with lofs of appetite, and general tremors on ufing the IdiR; exercife. Thefe fymptoms were at length VoL, VI. D ' • confide-
■ [ 34 ]
confiderably alleviated by the Infufion of An- guflura barkj elixir of vitriol, and other tonics.
Dec. 15. 'Yefterday, at fix o’clock, P.M. file had a cold fit, with rigors, which lafted near half an hour, and was fucceeded by a hot fit, attended with great pain of the head, nau- fea, vomiting, and reftleffnefs, v.'hich conti- nued through the whole night ; towards morn- ing fhe was relieved by a partial fweat, but re- mained very weak and languid.
16. Yefterday, at the fame hour, flie had a return of the paroxyfm, the fymptoms of w'hich were mitigated by an opiate taken foon after its commencement : flie had a copious perfpiration during the night, and feems free from com- plaint tills morning.
18. Had a return of the fit on the i6th and 17th, but was relieved as before by an opiate. She refufes to take bark.
Capiat Solut. min. gnttas viij. ter die.
20. She has had no return of the cold fit fince the 1 8th. The hot fit w'as much fliorter and lefs fevere. She experiences no inconvenience from the medicine.
f
Repetatur Solutio.
22. She has had no return of the paroxyfm,, but feels a flight pain in her bowels.
Capiat flatiin Tin6l. Opii guttas xx. et fp. lav. c. 3fs.
Repetatur Solut. min.^
24. Tlie
/
[ 35 ]
- 24- The pain of her bowels was removed by the opiate; die has had no return of the pa- roxyfm ; refts pretty well during the night, but fwkts much towards morning.
Omittatur Solutio ; et capiat Infuf. Gent. c. ter die.
30. Her ftrength is returning. Her appetite is good, and die has had no- return of the pa- roxyfm.
This lady continued to enjoy a good ftate of health, till the 20th of March, 1793, when flie was affefted with a diarrhoea, attended with acute pain in her bowels, chiefly about the umbilicus. She was foon relieved from thefe complaints by an opiate, and a few powders, confifting of the Colombo root joined to an aromatic ; but on the 25th, Ihe had a return of an intermittent fever, the cold fit of which was very fevere. It began at fix o’clock in the evening, continued near two hours, and was followed by a hot fit, which lafted all night, terminating towards the morn- ing in a flight perfpiration, and leaving her low and weak the remainder of the day.
28. She refufed yefterday to take an opiate on the approach of the cold fit, having on formet occafions found her head' difagreeably affedled by it. The paroxyfm proved very fevere : the
D 2 hot
\
C 36 ]
I
hot fit continued all night, and was fucceeded by partial fweats about the head and neck. She is very weak this morning, and complains of a great pain of the head and back ; of lownefs of fpirits and general uneafinefs.
Capiat Solut. min. guttas viij. ter die, ex Infiif. Cort.-
Angullur. cyatho.
30. The folution did not difagree with-her in any refpccft; (he had a cold fit lad night, 'but it was much lefs fevere than ufual j fife is alfo in better fpirits to-day.
Repetatur Solutio.
April I . There was no cold fit yefterday l but file had a hot fit, which continued all night, and terminated in a very profufe perfpiration. Her fpirits are much revived ; Ihe is confide- rably ftronger, and has a better appetite.
Repetatur Solutio.
6. She continues the folution without feeling any inconvenience from it ; and has had no re- turn of the fit, or night-fweats, fince the ift: her appetite at prefent is good.
Repetatur Solutio.
8. She has had no fit, and recovers her ftrength gradually. No naufea or griping has ever been produced by the folution.
Omittatur Solutio. Capiat pulv. rad. colomb. gr. xv. ter die.
CASE
C 37 ]
CASE XIX.
Feb. I, 1793 — Mrs. H. of a fair complexion, aged twenty-four' years, during the months of September and October laft, had two feveral attacks of the remittent fever, from which die recovered fpeedily by means of the bark : fince that time die has continued in a very weak irri- table date, fubjeft to pains of the bowels, and to frequent though dight returns of a febrile com- plaint, which continued only for a day or two, and commonly yielded to an opiate. On the 27th of January Ihe had a cold fit at eight o’clock in the morning ; this was fucceeded, in about an hour, by a burning heat of the fkin, with dudiing of the face, great reftlefTnefs, and fevere pain of the forehead. Her eyes, at the fame time, appeared bright and prominent ; die complained alfo of a fenfe of heat in them, and w'as unable to bear the light. In the evening, a copious perfpiration enfued, and confiderably alleviated the fymptoms ; die had, however, a flight head-ach through the whole night : the
D 3 fit
[ 38 ]
fit has returned every morning at the fame time -for the laft four days.
Feb. 2. The paroxyfm appeared this morn- ing as ufual, with a fevere cold fit and head- achy but was rendered much fliorter and lefs diftreffing by an opiate draught taken foon after its acceffion.
Capiat Solut. min. guttas viij. ter die.
5. She had a fight return of the cold fit this morning, with a little head-ach, but the pa- roxyfm was of fliort duration.
Repetatur Solutio.
6. She has had no cold fit to-day, nor.any pain of the head ; the hot fit returned at the iifual time. Her face is much flulhed, and. her fidn hot, but with lefs anxiety and reftleffnefs than heretofore : fire finds no inconvenience from the folution. The opiate'was not taken to-day.
Repetatiu Solutio. ■ ^
10. She has had no return of the paroxyfm, nor has felt the flighted fymptom of its approach fince the 6th ; flie complains only of a flight pain or uneafinefs in her domach. Her appetite dill continues weak.
Omittatur Solut. min. Capiat tindl. opii guttas xx. flatim.
14. She begins to recover her fbrength and
appetite ;
C 39~]
appetite ; the pain of the ftomach was Imme- diately removed by the opiate.
All the patients whofe cafes arc here related, have continued to enjoy good health fince cured by the folucion-; and though feveral months have now elapfed, none of them have expe- rienced the leaft unpleafant fymptom which could be attributed to that remedy. The women continued to labour under a fuppreffion of the ca- tamenia, until their ft re ngth was entirely reftored.
Mrs. H. (Cafe XIX.) though enjoying a good ftate of health, had no appearance of them till the middle of Auguft laft, when they flowed for feveral days rather profufely.
In Cafe IV. I had little profpcd: of fuccefs from the ufe of the folution, the child having become very weak and irritable by frequent re- lapfes : but as he had for a length of time taken the bark in large dofes without any effedt, I was induced to try the mineral folution, with a view of checking the returns of the paroxyfm, hoping afterwards to complete the cure by the bark ; which might prove more efFedlual after Its ufe had been fufpended a few days.
D4
In
[ 40 ]
In Cafes I. X. XIII. and XIV. there was an evident enlargement of the fpleen, forming a projeftion below the cartilages of the ribs. In Cafe X. it was fo large as to extend nearly as low as the crifta of the os ilium. After the ague had ceafed, the patient continued to ufe corrobo- rant medicines, taking at the fame time fmall dofes of calomel, but without any fenfible effedt on the tumor; it yet remains nearly in the fame Hate, not, however, caufing much uneafinefs. In Cafes XIII. and XIV. as the patients fpcedily regained their health after the ague had ceafed, and felt no uneafinefs from the enlargement of the fpleen, I did not think it proper to ufe any medicine, excepting a purgative dofe of calomel occafionally, becaufe, in many fimilar cafes, vvhere this medicine had been ufed, even in very fmall dofes, a falivatlon was very foon ex- cited, the tumor not being at all affedted by it, whereas the patient was rendered extremely weak and irritable. The only inftance of tu- mefadtion which could with any probability be referred to the ufe of thefolution, w^as Cafe XIV. in which, however, it proved fo flight, as fcarcely to deferve notice.
In order to give the mineral folution a fairer |;rial, I avoided, in many inftances, making
ufe
[ 41 ]
ufe of two very powerful means ufually em- ployed for the purpofe of diminifhing the vio- lence of the paroxyfm^ and which frequently indeed put a total ftop to it ; I mean, , opium and emetics : when two grains of opium are given a fhort time before the paroxyfm is expeded, it feldom fails to bring the fit to a fpeedy termination by a profufe fweat ; and generally relieves the violent pain of the head, which is fo diftr effing during the hot fit, as in Cafes X. and XV. The recurrence of the pa- roxyfm being once obviated, I have found that a full dofe of opium at night affords more com- fortable reft, and more certainly prevents the folution from affeding the bowels, than when the tindure of it is added to the mineral folu- tion ; a mixture of this kind always become^ turbid, and the opium is partly feparated.
Intermittents partake m.uch of the nature of remittents, and the two difeafcs have a very uncertain boundary; whenever, therefore, the intermiffions are imperfed and indiftind, the exhibition of an emetic is attended with mofl: beneficial effeds. In many inftances this prac- tice puts a temporary ftop to the returns of the fit, and in every cafe confiderably diminifhes its violence. The proper time of giving an
emetic
[ 42 ]
emetic, is about two hours before the paroxyfni is expected ; and the bell mode is to employ a folution of tartarized antimony in divided dofes, at intervals of eight or ten minutes, until full vomiting be produced. When the patient has vomited a few times, and his ftomach is a little fettled, a more moderate dofe of the antimo- nial folution, joined to a full dofe of opium, feldom fails to produce a copious perfpiration before the attack of the cold fit. This method generally fucceeds in preventing the immediate recurrence of the paroxyfm : but in thofe cafes where the intermittent has continued long, and feems to return by the power of habit, it will be proper to repeat the emetic once or twice more before the time when the paroxyfms are expected.
I think it proper here to obferve, that antimo- nials, in the naufeating dofes in which they are frequently given during the remiffion or apy- rexia, w\th a view of procuring a more perfed folution of the difeafe, are feldom found ade- quate to the purpofe; on the contrary, the con- tinued adion of fo powerful a ftimulus, in ge- neral, produces a correfpondent ftate of debi- lity, and relaxes the mufcular fibres of the fto- 2 mach
C 43 ]
mach fo much, that neither food nor medicine can be properly retained.
The remittent fever is, in many cafes, very mild ; whence the remiffion has often been mif- takenfor an intermiflion. This miftake is more liable to be made when the remittent fever is preceded by an evident and fev'ere cold ftage at each return of the paroxyfm, and is followed by a regular hot, and fweating ftagc. The remittent may, however, be diftlngtiiflied from the intermittent feVer ; ift, by a flight pain which remains fixed in the forehead, or over the orbits of the eyes, during the apyrexia ; adly, by the pulfe, which, though not more fre- quent than in health, yet retains a degree of quicknefs.or- fharpnefs through the whole of the remiffion ; 3dly, by the date of the fkin, which,' though moifl, feels hotter than natural. In fuch cafes I have not found the mineral folution fo fuccefsful as in thofe where the intermiffion was complete ; for which reafon it feems moft prudent to place our foie dependance upon the bark, as in Cafes IV. and XTI. Sometimes, how- ever, when the- patient could not be prevailed upon to take the bark in proper dofes, I have found much advantage from joining It with the rnineral folution, by which means a fmaller quan- tity
C 44 ]
tity of bark wlli anfwer the intended purpofe. But whenever immediate danger prefents itfelf, or is to be apprehended from a continuance of the fever, the bark, given in large dofes, is the only medicine to be depended on.
The mineral folution ufually fails in fome irregular cafes, which at firfl; view refemble in- termittents, and have been improperly ranked with them, under the denomination of erratic or anomalous intermittents. A morbid increafe of irritability appears to be the foundation of thefe irregular complaints ; they alfedt prin- cipally thofe who have been debilitated by fre- quent attacks of fever, or by lingering difeafes ; alfo children; and women, more efpecially thofe who give fuck ; and, in general, perfons of a weak delicate habit. The fymptoms which occur in thefe complaints are nearly as follow ; during the afternoon,, or towards evening, the patient becomes uneafy and refllefs ; his Ikin feels dry, and is hotter than ufual, but with- out imparting the burning heat ufually obferved in the hot ftage of intermittents; the pulfe be- comes quick, and rather more frequent than natural; a pain is fometimes felt in the head, either on the crown, or on the back part of it ; the thirft is fcldom very great; difagreeable
clamtnb
f
[ 45 ]
clariiminefs, however, takes place in the Thefe fymptoms are fometimes preceded by flight chills running down the back, which, however, when they do occur, are not of long continuance, and never accompanied with vio- lent fliiverings.
In this manner the patient is harrafled during the whole night*, but obtains relief towards morning, when a partial fweat fometimes ap- pears about the head and breaft. Excepting a degree of languor and debility, little or no complaint is felt till the return of evening. The duration of thefe complaints is very uncer- tain ; they fometimes affedt the patient daily for one or more weeks ; at other times abate or difappear for a few days, and then return as before. Whatever increafes the irritability of the body, may be coniidered as an occafional caufe of them; but the moft common as well as moft: powerful one is too much fatigue, along with expofure to a hot fun.
In thefe cafes, after evacuating the ftomach and bowels by a gentle emetic or purgative, it is commonly fufficient to exhibit fome tonic, in a form agreeable to the patient’s-ftomach. The
* Hence the denomination of night-fever.
/ Peruvian
/
[ 46 1
PeKivIan bark does not appear to produce any better efFcdts than the other vegetable tonics, as Gentian, Colombo, See. An infufion of Anguflu’ra bark is what I moft frequently eni- ploy, and find mofl ufeful, taking care to pre- vent the coftivenefs arifing from its ufe, by giving, at proper intervals, a dofe of calomel.
For children, who cannot eafily be induced to take bitters, after the previous ufe of an emetic, a few moderate dofes of calomel are commonly fnfficient.
Notwithllanding the effedls of arfenic appear to be equally as powerful and nearly as certain as thofe of bark in the cure of intermittent fe- vers, yet it mu ft be confefifed that perfect ftrength is lefs fpeedily recovered when the cure has been accompliflaed by arfenic alone, than when bark has been employed. This objec- tion to the ufe of arfenic is of lefs confequence in cold climates, where, if the ague has not been of longftanding, the debility induced by it is feldom very confiderable. In tropical countries, however, a few attacks of an inter- mittent'frequently reduce the patient fo much, that even when the paroxyfm has ceafed to re- turn, the extreme debility which remains, is
of
C 47 ]
of itfelf fufficlently alarming to demand every attention from the practitioner.
It does not appear improbable that the bark owes its fpecific power, in the cure of remittent and intermittent fevers, to fome peculiar prin- ciple in its compofition, which has hitherto eluded the refearches of experimenters, and which they have in vain attempted to imitate by various combinations of bitters and aftrin- gents. In whatever this peculiar power of the bark may confift, the fame quality appears to be poflelTed by the arfenic in a confiderable de- gree. Both remedies probably effec^t the cure of intermittents, by their action upon the fibres of the ftomach, fmee they often operate fpee- dily, and even in a fmall dofe;.but the power of the arfenic feems to ceafe here ; whereas the bark is capable of reftoring tone to the fyffem in general. The fame effeeft may perhaps be nearly obtained by joining fome tonic medicine to the arfenic. With this view, in many cafes,, after the folution had been taken a week or ten days, I difeontinued its ufe, and ordered the patients to take the Infuf. Angnft. In'fuf. Gent. c. See. until their ftrength was completely reftored. It may be found flill more, advantageous to em- ploy
t 48 ]
ploy thefe remedies along with the mineral fo- lution.
Arfenic feems to have been oftener employed as a medicine in Germany, than in any other part of Europe ; but chiefly by the empirical clafs of pradtitioners, which no doubt pre- vented its introduftion into general ufe. Many eminent phyficians in Germany, as well as. elfewhere, have, however, fpoken highly in its favour, and occafionally prefcribed it. Like many other adtive remedies, it has been much abufed by the bold and the ignorant, and has been given in dofes which no man of prudence would venture to diredl ; efpecially as we know that the fame good elfedts may be obtained by moderate dofes of it, and without the leafl rilk. The following obfervations, extradled from a German work will fliow how extenfively this medicine has been ufed on the Continent, and how little caution has been obferved in its exhibition.
Dr. Slevogt, ProfefTor of Anatomy at Jena, in 1700, recommended the ufe of arfenic, ex- tolling it as the beft, moft certain, and fafeft cure of intermittents, efpecially of tertians and quartans. He employed it in dofes of a grain
* Nicolai Reccpten und Kurarten. 8vo. Jena, 1780.
or
C 49 J
of a grain and a half mixed with a proper quah- , tity of Theriaca; not only giving it on the days of the apyrexia, but alfo a fliort time before the acceflion of each paroxyfm. He alTerts, that in fifty inftances, two or three dofes were fiifficient to put a total ftop to the difeafe, and that he never obferved the leaft ill efFeft from it.
Melchior Friccius'* recommends arfenic in intermittents, and declares he has ufed many drachms of it in the cure of fuch fevers ; but: coafefles that he had often met with relapfes afterwards.
Lanzonus “f- quotes a letter from Valifnieri to one of his friends, written in 1707, in which he fays the French furgeons were accuftomed to cure long-continued intermittents with a finall quan- tity of arfenic : and he adds, that their remedy feemed to refemble much the famous aqua del petefino, which was a ftrong folution of arfenic boiled in a copper vefiTel
* De Virtute Veneriorum medlca. 8vo. Ulmse, 1701.—** Sec alfo London Medical Journal, Vol. VII. p. 194.
t Lanzoni Oper, omni med. phyf. 410. Lauf. 1738b Tom. I. p. 68.
I The della Toffanina (fo called from the
inventor), Aquetta di Napoli, Poudre de Succejjion, Eau Mi* ruble. See. were preparations of arfenic frequently ufed as poifons during the lall: century.
VoL. VI. 'e
Keil
[ 50 ]
Keil ^ praifes ^arfenic as a certain and fafc fpecific in intermittents, when prepared and adminiftered in the following manner : half an ounce of white arfenic, finely powdered, is to be put into a glafs, or tea-cup ; half an ounce of diftilled vinegar is then to be added, and evaporated over the fire, being conftantly ftir-' red at the fame time with a wooden fpatula; the fame quantity of vinegar is again to be ad- ded and evaporated in like manner. After this procefs has been repeated fix times, the refidu- urn, is finally to be waflied with warm water, and dried ; a drachm of the dry powder is to be made up into fixty pills by means of a feru- ple of wafers foftened with water. Previoufly to the ufe of the pills, the patient is to take an emetic compofed of tart. emet. or fulph. aurat. antim. and a little vitriolated tartar, or fome purgative medicine on the morning free from fever : the next day, or only a few hours before the acceffion of the paroxyfra, one of ‘ the pills is to be taken faffing, and nothing is to be eaten or drank after it for three or four hours. Wh(!;n this has been repeated three days, du- ring the apyrexia, or a few hours before the
* Anatom. Chirurg. Medicin. Haadbuchlein. 8vo. Ko* niglberg, 1761.
z attack
/
C 51 3
attack of the paroxyfm, the fever commonly ceafes. He affirms that this pradlice has been attended with fuccefs in feveral hundred cafes, when every other remedy had been employed in vain ; that he has never obferved the lead ill effe6t to accrue from it; but, on the contrary, that thofe who had before looked thin and ill, had become, in c'onfequence of it, fat and firong ; and that he knew many pcrfons who had ufed this remedy fifteen or twenty years before, and whp continued to enjoy a date of perfed health.
Dr. Jacobi * recommends the ufe of arfenic drongly in fevers : he diredts one part of arfenic and twelve of fait of tartar, to be mixed with i8o parts/ of water, and boiled till one half has evaporated; when cold, as much frelh water is to be added to it as has been lod by the evaporation, together with a little fpirit of wine. The dofe for adults is twenty-five drops, to be given on the day which is free from fever, at feven A. M., at three, fix, and nine, P. M. Before the ufe of this me- dicine, the prims vis mud be evacuated by emetics and purgatives ; and the common febrh
■* De pnidenti ufu Arfenici, fale Alcalico domiti, Interno falutari, Diflert. — Vide Ad. Acad. Eled, Mogunt, Tom. I. p, 216. 8ro. Erford. 1751.
E 2 fuge’
[ 5* ]
fuge remedies fiiould be ufed for fome time. Dr. Jacobi obferves that he has employed the above preparation not only in intermittents, but alfo in continued fevers, with the greateft fuccefs, and without ever experiencing any bad effefts from it.
Heuermann * fays that arfenic is ufed in Hol- ftein, at Copenhagen, and fome other places, as the moft certain remedy for the cure of in- termittents ; that he has himfelf given it with conftant fuccefs, in fevers, to patients who were not able to retain other medicines on the flo- mach in a proper quantity ; and that two cafes, wherein frequent relapfes had occurred, were entirely cured by this remedy. He prepares a folution of arfenic in the following manner: half an ounce of white arfenic, and fix ounces of alkaline fait, are added to ibifs of water, and then evaporated to drynefs. The fame quantity of water is added a fecond' time to the refiduum, and evaporated to one half, which is coloured red by a few poppies. Of this he direfts from feven to ten drops to be taken during the day, beginning immediately after the paroxyfm is over, and omitting it a fliort time before the return of the next. If the
* VermlfchteBemerkungen und Untcrfuchungen. Vol.,I. 8vo. Copenhagen, 1765.
folution
[ 53 3
foiution produces vomiting, it is too ftrong, and muft be diluted ; only one dofe is to be given in twenty-four hours, and the patient muft be kept moderately w'arm, to promote a gentle perfpiration. Expofure to cold, he fays, is as hurtful during the ufe of this as of other febrifuge remedies, as it difturbs Nature in her operations, and retains in the body the noxious matters which fhe is endeavouring to expel. If in the firft three or four days after the ufe of thefe drops, the fever does not ceafe, he re- commends that the fame dofe fliould be repeated twice a day, which commonly proves fufficient. The ill confequences which have been obferved after the ufe of arfenic, as palfy, trembling of the limbs, blindnefs, deafnefs, &c. he afcribes to the improper preparation and imprudent ufe of it; aflerting, that it is a fafe remedy when properly prepared.
In the Ephemerid. Acad. Nat. Curiof.* arfenic is alfo celebrated as an infallible fpecific for in- termittents. Three or four grains of powdered white arfenic are dir.e6ted to be put into a fmajl uncovered glafs with a proper quantity of water, and placed upon the fire till a foiution takes place, when it is to be well ftirred up and given to the patient :* the fever, we are in-
* Dec. II. Ann. III. p. 132,
E 3
formed,
[ 54 ]
formecl, is by this means certainly prevented from returning. The patient lliould eat nothing for twelve hours before ; but a quarter of an hour after having taken the medicine, he is allowed a gill of warm water, in which a quan- tity of butter is diffolved, together with the yolk of an egg ; after which, nothing more is to be given for fome hours. There generally follows a confiderable degree of uneafinefs, and a profufe fweat ; and by thefe means, it is faid, every intermittent, even a quartan, may be rea- dily cured. Two other formulas are given in the fame work*, and recommended as highly ufeful in the cure of inter mittents, viz.
iy. Tart. crud. 31. Arfen.^yft. 3(3. Tip. long. ^fs. Lap, prunell. 3ifs. Specif, fcyidfog. Crollil 3iij. M.
The dofe is from gr. v. to ^fs.
The other is
]y . Arfen. alb. gr. v. Lap. prunell. vel Nitri depur. gr. :iv. M. pro ima dofi.
Profcifor Ackermann-f- relates, that in Paufa, a town of Saxony, a furgeon’s family had been poffefTed for more than a century of a fecret remedy againft melancholy, which con- fided of two grains of arfenic mixed with a ^ drachm or more of white fugar, to be taken
• Dec. II. Ann. V. p. 474.
-j- Neues Magazin fur Aerzte, Vol. II, p.
Lclpfic, 1780,
early
I
[ 55- ]
early in the rnorning, along with a large quan- tity of mucilaginous drink. The medicine produced a violent vomiting, fo as to agitate the whole body, which continued not kfs than fix hours ; after this, he obferves, the patient ufually enjoyed a quiet fleep, and became more rational. The remedy was perfifted in, care be- ing taken that the efFeifts of the firfl: dofe Ihould be completely over before a fecond one was adminiftered. Many repetitions of the medi- cine were not however requifite, as the difeafe, in general, foon yields to this mode of treat- ment ; the patient was afterwards directed to continue a mucilaginous diet for a few weeks. Profefibr Ackermann examined fome of the patients who had been cured by the furgeon at Faufa, and found that no ill elTedls had arifen in confec^uence of it. The fame perfon, it is added, employed arfenic very frequently for the cure of intermittents : he diffolved two orains of ar-
O
fenic in a pint of w'ater, and gave two, or three table fpoonfuls for a dofe every day ; under this treatment the fever feldom recurred ^ more than twice; but he remarked that the patients were longer in recovering their ftrength than when the bark had been ufed.
Profefl’or Ackermann farther obferves, that another furgeon in the fame place likewife
E 4 employed
[ 56 3
employed arfenlc with great fuccefs; he gave fif- teen drops of a folution of arfenlc in water, along with alkaline fait, but the ProfelTorhad not been able to afeertain the exad proportions. A dofe was ordered to be taken as foon as the patient felt the approach of the fit, and a quantity of warm tea was to be drank immediately afterwards. This produced a vomiting, which was encou- raged as much as poffible by repeated draughts of the tea. In this manner, it feems, he had cured many obftinate agues by two or three dofes of the folution ,* and, amongft others, a quartair which had continued upwards of two years.
From fome of the foregoing narratives, ar- fenic feems to have been ufed with as little pre- caution as emetic tartar; and fince it appears, on good authority, not to have been produdtiye of bad confequences, even in very large dofes, we may be induced to lay afide that extrenie
i
anxiety with which we generally preferibe it ; and may be encouraged to perfift in the ufe of a remedy which, when prudently adminiftered, is both fafe and efficacious.
Many of our moft adlive and approved me-/ dicines, as preparations of mercury and anti- mony, the fquill/ foxglove, &c., are capable
qf
r 57 ]
of producing as violent effedts in the conftitu-r tion, when given in too large a dofe, as arfenic itfelf. All thefe medicines met with the fame, if not ftronger, oppolition when firll introduced, as arfenic does from many at prefent. It is well known that antimonial preparations were declared to be poifonous, and that the ufe of them was prohibited by a decree of the faculty of Phylic at Paris in the year 1 566 ; which decree was not repealed till 1637. We fliall ceafe, how- ever, to wonder at the prejudices formerly en- tertained againll thefe medicines, when we confider, that even at the prefent day fimilar objedlions are made upon the Continent, efpe- cially in Germany, to the ufe of the bark, a remedy, the reputation of which has been fo fully eftablilhed by the united teftimony of fo many eminent pradlitioners, fupported by al- moft innumerable experiments.
Mr. Theden, one of the molt celebrated fnr- geons in Germany, and Surgeon General to the Pruffian army, infpeakingof the treatment of intermittents, obferves *, that when his patients had previoully enjoyed a healthy ftate of body, he was generally able to effed a cure in fix or
f Unterricht fur die Uiitcrwundarzte. 8vo. Berlin, 1793.
eight
[ 58 J
eight weeks. As he entertained the common idea that bark is apt to produce obftrudlions and enlargement of the vifeera, oedematous fwel- lings of the extremities, &c. he cautioufly avoided giving this remedy until he had tried every other means. During the firft three weeks he employed different medicines, with a view to loofen the morbific matter, and to ren- der it fit for expulfion from the body; he then gave. two ounces of barjc, in dofes of half a drachm, every two hours. After an interval of eight days, during which only bitters were preferibed, he ventured again to exhibit an ounce of the bark, and thus completed a cure. He cautions us againft the ufe of bark whilfl the face retains a yellow tinge, or whilfl the febrile matter remains in the conftitution ; he confefies, at the fame time, that he has feen oedematous fwellings of the lower extremities after agues where no bark had been employed.
Dr. Vogel* is likewifeof opinion that many cachedic difeafes, particularly obflrudfions of the vifeera, dropfy, jaundice, phthifis,* tympa- nitis, coughs, afthma, hemicranium, deafnefs, catarad, vertigo, Src. are frequently the con-
* Handbuch der praktifehen ArzncywilTcjifchaft. 8vo. Stcndalj 1781.
fequences
I 59 1
fcqiienccs of an improper treatment of intcr- mittents ; more efpecially when the cure has been attempted by aftringents, arfenic, &c. or even by an unfeafonable exhibition of the Pe- ruvian bark, whilft the morbific matter ftill remains in the fyftem.
The objeftipns to the ufe of thefe medicines are fo vague, that they appear to originate from popular prejudice and ill-grounded theories, rather than from any juft practical dedudfions ; they will therefore have little weight with thofe who are not contented with bare afiertions, but make adtual obfervation and experience the ftandards of truth.
Having frequently found the moft beneficial effeefts from the mineral folution, and having; never obferved any ill confequences to arife from its ufe, I may prefume to recommend a trial of it to fnrgeons pradifing in warm climates, and particularly upon the coaft of Africa.
The high price of bark may fometimes pre- vent furgeons of fiiips from laying in, at their own expence, fuch a ftock of this valuable, medicine as will enable them to employ it freely in every cafe which requires its ufe.- For notr- withftanding the frequent complaints of feveral r.cfpeflable furgeons in the navy, the quantity
of
[ 6o ]
of bark allowed by government to fhips on foreign ftatlons, is much too fmall; and mofl of the merchant fhips trading to this coaft arc ftill more infufficiently provided.
Of the two mofl: frequent difeafes upon the coafl; of Africa, the remittent and intermittent fever, it is certain that the latter, though lefs rapid in its courfe, and apparently lefs dange- rous than the former, yet for the moft part oc- cafions that irremediable injury to the conftitit- tion, which fo often befalls Europeans trading upon this coaft. There are few, even of thofe who are faid to be feafoned to the climate by long refidence, who have not fuffered feverely from repeated attacks of intermittents. This in a great meafure arifes from the unhealthy lituation in which they live for the convenience of trade. They generally fix their refidence on the banks of fome river, or narrow creek, whofe oozy ftiores, furrounded by mangroves, and ex- cluded from the wholefome breezes, areaconftant fource of miafmata and contagion ; to this muft be added the debauched and irregular courfe of life which mofl: of them lead. Though fea- foned to the climate, as they fuppofe, their unhealthy fallow complexions and emaciated bodies, the frequent heftic fluftiings of the
face.
[ 6> ]
/ace, fwelled legs, &c. attended with obfiriid- tions and enlargement of the abdominal vifcefa, fufRcientlj'^ indicate to every obferver the Ihat- tered ftate of their conftitutions. The ague probably ftill continues to return once a month or oftener, and harraffes them a few days, without being much noticed ; for the feverity of the difeafe feems to be confiderably abated , by its frequent recurrence, though its bad ef- fects in the end are equally certain. As their appetite during the intermiflion is frequently keen, and even voracious, they flatter them- felves that the conftirution is not impaired by frequent returns of the difeafe; many alfo are negligent, from a confidence in the popular prejudice, that a cold fit fliows the abfence of danger.
In thefe cafes, therefore, when the bark can- not be procured, or, as more frequently hap- pens, wben the patient has conceived a difguft for it, and cannot be prevailed upon to take it in a fufficient quantity, the mineral folution promifes to be a fafe and efleftual fubftitutc for it.
During the laft rainy feafon I have had fre- quent
C 62 ]
qucnt opportunities of exhibiting the mineral folution in intermittents with tlie fame good effefts as in the preceding }'ear. Out of the number of cafes which occurred in the prefent feafon, I have feledled the two following, as being the only inftances of quartans I have met . with fince I began to ufe the mineral folution.
CASE XX.
t _
Sept. II, 1793. — John Thompfon, a mulatto, aged thirty years, was feized, about two mpnths ago, with an ague, which returned every fecond . day. After the fecond paroxyfm he took an emetic, and foon after the operation of this, an opiate, which appeared to put a flop to the dif- eafe. A month ago he was agam feized with' cold fhiverings, followed by an increafe of heat, ' which terminated by a prof ufe fweat. The fit now returns every fourth day; the cold ftage of which, commencing about noon, is very fe- vere : the hot ftage continues through the whole night, with violent head-ach, and to- wards morning is relieved by a profufe fweat-
ing.
, [ 63 ]
ing. His appetite is pretty good ; his body open.
Capiat Vefp. Antim. Tartar, gr. ij. cu. P. Ipecac,
Cras iiicipiat fumere Sol. min. guttas xij. ter die.
20. The emetic operated well. He took the folution regularly for four days, and then omit- ted it, finding no return of his complaint.
30. He has had no return of the paroxyfm, nor has taken any medicine fince he left off the folution. ' V
CASE XXL
Sept. 8. — Anne Crankepoor, a black, aged twenty-eight years, has every fourrh day, at noon, a feverc cold fit of the ague, which continues near two hours, and is attended with violent rigors and pains of her bones ; thefc fymptoms are followed by a hot ftage of long continuance, but which terminates by profufc fweating. She is affefted, during the wLolc paroxyfm, with violent pain of the head, ftom^ach, and back, which alfo continue ^ through the intermiffion, though with fome abatement. She has taken an emetic and two anodyne draughts Without any relief j and
has'
[ 64 3
has l^ad no flool for eight days. Her hfead-aeK is at prefent very fevere ; her pulfe quick and frequent ; her Ikin hot and dry.
Gapiat ftatim Camphor, gr. x. Tin£l. Opii, guttas xxv^ Aq. font; ^fs. et eras mane Sal. cathart. amar. 5ifs, part, vicib.
9. 'She fweated profufely with the draught, and is much eafier this morning. Her head- ach is confiderably relieved ; her pulfe foft and regular. Both dofes of the Sal. cath. amarus produced vomiting.
Capiat llatim Ol. Riciui ^i. — Repetatur Hauftus h. s.
10. She could not yeflerday retain the oil ,/ on her ftomach, nor has yet had a ftoo). She
paffed an eafy night, and feels no complaint this morning, excepting great languor and laf- litude, with a fenfe of weight and fulnefs in the abdomen.
Capiat ftatim Calom. gr. v. Extr. Cathart. ^j.
11. The pills operated gently three times; her bowels are much eafier ; Ihe feels a flight pain of the head and general uneafinefs, as if
the fit was approaching.
Iiicipiat eras fumere Solut. min. guttas x. ter die.
13. The fit returned on the iith at the ufual time with great violence. The pain of her head and ftomach was alfo very fevere ; flie yet
feels
[ 65 ]
feels fome pain of her ftomach, with great refUeffnefs and uneafinefs. The folution has not been taken till this day.
17. The paroxyfm returned at the ufual time on the 14th, when (lie was affefted with very fevere head-ach and pains of the ftomach and back, which ftill continue, being accom- panied with great languor. She has taken only five dofes of the folution fince the 13th, and thofe not at regular times. She was very coftive on the 15th, when fiie took
Calom. gr. v. c. Extr. Cathart. gr. xv,
which operated twice. She expects the pa- roxyfm to-day.
Repetatur Solutio.
18. The paroxyfm did not return yefterday, until fix P. M. ; the cold ftage was very fevere, and attended with great pain of the ftomach and head; but thefe fymptoms were much re- lieved by two grains of opium. She fweated profufely during the night, and feels a flight head-ach and pain of the ftomach this morn- ing, with languor and debility. Her body is open ; her pulfe natural.
Repetatur Solutio. Sumantur Opii gr. ij. urg. dolore
Ventriculi.
20. She continues ftill weak and languid ;
VoL. VI. F the .
the pain of her ftomach was wholly removed by the opiate.
Repetatur Solutio.
23.' She has had no return of the paroxvfm fince the 17th, and makes no .complaint but of debility ; flie is, however, able to walk about, and her appetite is fomewhat better. Omitratiir Solut. min. Capiat Infus. Corticis Anguft. §iij ter die.
' Early in Odtober (lie had entirely recovered her health and (Irength.
■r ^
II. An Account of the good Effehls of a Solution of Sal Ammoniac^ in Finegar, employed, as a topical Application, in Cafes of lacerated (Founds. By Mr. Henry Yates Carter, ftirgeon at Ket-
tley, near Wellington, in ShropJJoire.'
\
IN the fecond yolume of Medical Fads and ObfervatioDS*, I took occafion to mention, in a curfory manner, the good effects I had ex- ^ perienced, in lacerated wotnids, from a folu- tion of fal ammoniac in vegetable acid, em-
[ 67 ]
ployed as a topical application and which, iii - fuch cafes, I obferved, had feenied to promote the union of the parts and to moderate the dif- charge. As this mode of treatment is very dilfi-rent from that commonly in ufe, and [ have had occafion to try it in many cafes of bad compound fradture, and other lacerated wounds, in which there has been a tendency to fphace- lus, I have been Induced to make it the fubjedt of a dillindt paper, and for this purpofe have feledled the following cafes, from a greater number, in which I have ufed it ; and thefe, I hope, may be deemed fufficiently interefling to procure their infertion in a future volume of the valuable collection above referred to.
CA5E I.
A poor man, named Ingram, aged upwards of eighty years, received an injury on his right foot, from a carriage palling over and lacera- . ting it from the inftep to the toes. The wound had been negledled for fome days, when I was requefted by a benevolent gentleman in the neighbourhood to vifit him, and found the foot
F 2 fphace-
/ /
f
[ 68 ]
fphacelated as high as the ancle, and the in- flammation apparently extending ftill farther.
I began with fcarifying different parts of the foot, by which means I gave vent to a confide- rable quantity of acrid ichor. The whole foot was then well covered with lint, continued to fome diftance above the difeafe, and direfted to be kept conftantly wet with a mixture com- pofed of half an ounce of crude fal ammoniac diffolved in a pint of vinegar. Internally he took the bark in fubftance, liberally, with opium, as he had a difpofition to diarrhoea.
On the fecond day after this mode of treat- ment had been adopted, I had the fatisfadion to find that the inflammation had not fenfibly increafed, and that the patient felt at intervals a throbbing, but which, he faid, was not pain- ful, about the ancles. His pulfe, which had been much quicker, was now at loo.
On the fixth day, a vifible feparation of the morbid parts was difcoverable, and matter was perceptible on the verge of the feparating parts; a fluctuation was felt in feveral parts of the foot, particularly beneath thofe places that had been fcarified ; and upon making deeper inci- fions here, we difeovered a collection of good pus and granulations of new flefli. ' In the
courfe
[ 69 ]
courfe of a fortnight, the floughs, having previoufly become loofe, were gradually taken away, and the parts expofed one clear uniform wound. After this the bark was adminiftered lefs frequently, but the ufe of the lotion was continued till the wound was nearly healed, which happened in about two months. ,
CASE II.
A girl, aged nineteen years, was attacked by a maftifF, and had the mufcles of the thigh and leg, particularly the vaftus externus and gaftrocnemitis fo violently lacerated, that the word; confe- quences were to be expedted from the circula- tion being cut off in the large veffels from the extremity, notwithftanding which (lie loft little or no blood ; a circumftance, by the bye, that frequently occurs in lacerated wounds. She fuffered but little pain, although the feparated mufcles of the upper part appeared to be much irritated. The large portions of mufcle yet adhering were cautioufly replaced as near their original fituation as the nature of the cafe would admit ; and after the parts had been well
F 3 bathed
\
[ 70 ] ^
• /
bathed, with warm vinega^', and due proportions of lint apjdied round the limb, the whole was encompalfed with a broad roller, applied merely tight enough to retain the Urtffings ; the l‘mb was then laid in an horizontal pofition, and the prefline taken fom the affected part by iiieans of a pillow placed under the lower part of the leg, confiderabiy below the injury. The whole was then wet with a lotion compofed, of half an ounce of crude fal ammoniac diffolved in a pint of vinegar, and ordered to be kept fo con- Itantly.
The firft; day flie was but little fenfible of the application. At night a draught, containing twenty drops of laudanum^ was given, and Ihe refted well. ^ ,
On the fecond day I found her pulfe but, lit- tle quickened, and her third: moderate ; fhe had perfect feeling in every part of the limb, and complained of an acute fmarting in the wound upon every renewal of the lotion, which continued’ for a few minutes, and then fire became eafy. An opening draught was given this morning, and Ihe repeated the opiate night.
, On the third day matter feemed to be form- ing.
I
[ 71 ]
ing, but there was no appearance of inflam- mation or fvvelling of the limb.
On the fifth day from the receipt of the in- jury, the bandage was' carefully removed, and I had the fatisfii^tion to find that the mufcles had united, and that the parts of the bone that had been laid bare were covered with new flefli. The difcharge was kindly, and in mo- derate quantity, and the limb was free from pain. The fame mode of drefiing and the fame applications were continued without alte- ration during three weeks, at the end of which time the cure was complete.
CASE III.
A young man, aged nineteen years, by a fall of coal in the pit while he was {looping, was preifed to the ground, and had his thigh broke about four lingers breadth above the pa- tella. The upper part of the bone was forced through the mufcles and into the ground, fo that the hollow of the bone was-' filled with dirt, and ftripped bare nearly four inches, and the mufcles much lacerated. In this fituation
F 4 he-
[ 7^ ]
he was brought home, (about a mile) and I then faw him ; the wound bled but little.
In this cafe I determined to t'y the effed: of keeping the limb gently extended, nearlv at its original length, after taking off lb much of the bone as I Ihould find requifite to a complete and exad reduction and to get above the coal flack which had been introduced.
As the bone was fhivered longitudinally, I found it necefl'ary to take off about three inches of it. This being done, and the wound well cleanfed with warm vinegar and a fmall pro- portion of fpirit of wine, I placed the lower part of the limb as exadly parallel to the other as poffible, and retained it in that pofition by means of proper bolflers on each fide of the limb. An eighteen-tailed bandage having been pre- vioLifly laid under the part, the dreffing was made by gently filling the vacancy (the whole fide of the leg externally being o])en) with foft pledgets of lint dipped in the fame folution as that ufed in the preceding cafe, and the ban- dage w'as then applied as gently as poffible, in order to prevent the flefh from being preffied into the part that the bone ought to have occu- pied ; and a fplint applied externally on each fide, merely to give more fleadinefs to the I limb.
[ 73 ]
limb, but without occafioning much prefliirc. I think it right to mention alfo that the mid- dle tails of the bandage were cut fmalk-r than the others, and applied in fuch a manner that the wound might be uncovered, in order that the lotion might be applied immediately to the wound, without difturbing any other part.
He was let blood, and tvyenty-fivc drops of tincture of opium were given at night, and the attendant was ftridliy enjoined to keep the part conftantly wet with the folution, except only during the intervals of flcep.
Upon vifiting him the morning after the ac- cident, I found he had had but little fieep, though his, limb had given him but little pain, except for about a quarter of an hour after the application of the lotion, after which he faid he had felt the whole leg and foot become fen- fibly warmer. The lower part of the limb lay very fteady, exactly in the fituation in which it had been placed; he took this morning three grains of calomel, which procured one ftool.
On the fifth day, including the day of the receipt of the injury, (there having been fome appearance of matter between the folds of the bandage) the dreffings were wholly removed, and the wound was found covered with a well-
concoffed
■ i; 74 ] ■
concoded pus in moderate quantity, and with new granulations. The dreffings were conti- nued in the fame manner as before, the- whole vacancy being carefully filled with doffils of lint, made as fofc as poffiblc, till the whole was level with the fkin ; and over tbefe the bandage was applied as before. He continued, to repeat the opiate every night, and the calo- mel occafioria-lly; his appetite was tolerably good, he ufdd nearly the fame diet as when in health, and ' was permitted to drink a fmail , quantity of ale.
On the eighth day the drefiings were again removed, ^ aixi the appearance^ continued to be' favourable. From this time, the weather being warm, the wound was drefled every day ia the fame manner as at firtt; and in al)out eight weeks the callus was completely •'formed, and had filled up the void fpace, and the wound was reduced to about a quarter of an inch in diameter.
In ten weeks he came down ftairs, and went about on crutches ; and in about fixteen weeks from the time he received the injury, he went with a ftick only, and was able to walk nearly two miles. The limb w^as not quite an inch (hotter than the other ; the fmall ulce,r conti- nued
[ 75 J
nued to difcharge, till a confiderable exfoliation of bone, which .gradually made its way out- wards, was extraded, after which the wound foon healed,.
CASE IV.
✓ '
■ A boy, aged about fifteen years, had the misfortune to Eiip his hand under the axletree of a \yater-\vhe.el, which moves at about the dif- tancc of two inches and a half from a brick \yall or buitrefs fupporting another building; his arm was taken in to the elbo'iv, and the machine performed feveral revolutions on the part before he could be extricated. ..The flelh was firipped down on each fide of the thick part of the arm, and the thumb was nearly feparated ; but the fingers and hand had buf- fered but little, and there was no hcemorrliage. The thumb was not taken off, but carefully re- placed, as w'ellas the other mufcu'ar parts that had been feparated ; and to the whole wound a large quantity of lint was applied, wet with the folutipn of fal ammoniac in vinegar. He took twenty drops of tindlurc of opium at night,
but
[ 76 ]
but he was very refUefs, and complained much of his arm.
Second day. The arm had bled in the night, and the dreffings were become flifF and hard, which rendered it neceflary to remove them. The difturbance this occafioned produced a de- gree of inflammation which, I believe, might otherwife have been prevented, and which proved the fource of misfortune. The parts from this time became exceffively painful, and the inflammation extended to the upper part of the arm, and to the fhoulder and fide, as far down as the pedforal mufcle. He was coftive and feverifh, and complained much of thirft. The whole arm was wrapped in a cataplafm made of oatmeal, with equal parts of vinegar and water ; and three grains of calomel were immediately given. Two ftools were procured by this medicine; but the pains ftill continued to be very diftreffing to him. His pulfe was at too.
Third day. The above fymptoms continued; the pulfe was increafed to no; and he was at times delirious ; the upper parts of the arm, fhoulder, and fide, were become of a dark red colour, and were exceedingly tenfc. He had feveral loofe flools ; the arms and fide were
drelTed
. [ 77 ]
drefled as before, with the addition, in the li- quid of which the poultice was made, of half an ounce of crude fal ammoniac, and an ounce of fpirit of turpentine. He took half a drachm of Peruvian bark, with fifteen drops of tinc- ture of opium, every third hour; and care was taken to diftil fome of the folucion between the dreffings, upon the Ihoulder, very often, in fuch a manner that it might make its way to the affeded parrs.
Fourth day. I found the whole fore arm, from the elbow, completely fphacelated and dry ; but the Ihoulder and fide were nearly in the fame ftate as yefterday, the inflammation not having increafed ; his purging had ceafed ; he was not fo thirfly, and his pulfe was at loo; hut he complained much of head-ach and wea- rinefs. Notwithftanding there appeared forae realon to conclude that his head-ach might, in fome raeafure, be occafioned by the quantity of opium he had taken, I continued the ufe of it in the fame dofes ; a ftool was procured by means of a clyfter. The ufe of the lotion , was continued.
Fifth day. The fymptoms were nearly the fame as yefterday. The fame dreflings and medicines were continued.
Sixth
[ 78 ] ,
Sixth day. The pain anchtenfion were much leflened, he' had refted tolerably well, and was free from third ; the Ihoulder and fide, with a condderable part of the upper arm^ ^feemed approaching to their natural colour, and the extent of inflammation was vifibly decreafing. The bark was dill continued, but without the tincture of opium, indead of which. he took two grains of purified opium at night.
The cataplafm was continued as before for about a week, from this time, when the flioulder and fide having recovered their original tone, it was changed for one compofed of oatmeal and the folution alone. In a few days matter formed plentifully round the bone in thofe parts where the lacerations had been deep, and large portions of the mufcles were cautioufly removed. The matter formed was of a good confidence, and moderate in quantity ; and the wound was perfedly eafy, except’ ng only upon the appli- cation of the lotion, and for fome Oiort time after. The whole hand dropped off at the wrid; the other parts gradually filled up with good flefli, and are now completely healed.
CASE
[ 79 ]
CASE V.
\ * - A man, aged thirty-fix years, by the fall of
a very heavy iron rod perpendiciilady upon his foot, upon that part where die fiioe is ge- nerally buckled’, received a confiderable lace- rated wound, by which the tendons were much injured, and' the integuments and mufcular flefli were dripped olf from the upper part of the tarfus, ar.d hui^g in-a large loofe flap down the fide of the foot. The wound bled confidera- bly, and the whole foot, ‘from the violence of ' the blow, was infenfible. The parts were well cleanfed from the grumous blood with vinegar and water, W'ith a fmall quantity of fpirit of wine, and the loofe flap replaced in the fituati^n frq,m which it had been torn, and dreflTcd with pledgets of lint dipped in the folution ; and a \ cataplafm applied of oatmeal and vinegar.
The morning after the injury, upon rempving the dreflTings, the wound and v;hole foot were ' found to have a favourable appearance; but at night he began to complain of a great degree of hear, throbbing, and fenfe of tenfion.
On
[ So ]
On the third day, on removing the dreflings, the whole upper part of the foot appeared to be hadily approaching to a fphacelated ftate.
It had loft all fenfibility to the touch, and the inflammation had increafed, thouo-h in fo fliort a time, confiderably above the ancle, and to the extremity of the toes. A fenfation of burn- ing heat in the whole foot and leg ftill conti- nued. The parts thatiwere loofe were now re- moved, and the wound, after having been bathed a confiderable time with a mixture of warm vinegar and water, with a fmall quantity of fal ammoniac previoufly difTolved in it, was dreflfed as ufual, the lint being fiift well fatu-
rated with the lotion : and over the whole a ca-
* \
taplafm was applied as before. A purgative medicine, compofed of four grains of calomel, and five grains of aloes, was given, which ope- rated well. He paired this day with fomewhat more eafe, and at night took thirty drops of tindlure of opium.
Fourth day. He complained of having palled a very reftlefs night, and that the pain- ful fenfation of burning heat ftill continued; the inflammation went on increaling ; his pulfe was at 97, and he had much thirft and flulhing eat. Bark, in the quantity of half a drachm,
was
[ s. ]
Was given every third hour, and twenty drops , of tindurc of opium every fixth hour. The fame dreffings were continued, with the poul- tice; but at night the poultice was omitted, and the dreffings kept wet with the folution alone.
Fifth day. He had relied much better; his thirft was more tolerable, and the heat and. other fymptoms were much more moderate ; his pulfe was at 90 ; the inflammation had not ia- creafed; and the tenfion about the ancle was leflened. The fame medicines and local appli- cations were continued as lift night. On renew- ing the dreffings in the evening, he complained of having paflTed a very painful afternoon, and that the fenfe of heat had been greater. He attri- buted all this to the omiffion of the poultice, which was now, at his earned requed, renewed.
Sixth day. In the morning the fymptoms were much increafed, and the inflammation was fpreading, with a violent degree of pain and tenfion, the whole upper part of the foot being in a fphacelated date; and the patient com- ' plained of exceffive pain. The fame dreffings as before were applied, but without the poul- tice, after bathing the parts with warm vine- gar; a broad roller, for the convenience of
VoL, VI. G keep-
I
[ Sz ]
keeping the parts wet, was gently applied over all the inflamed parts ; and as I had a fuf- picion that the increafe of* his pain, &c. yefter- day, if not wholly, was, in a great meafure, owing rather to a want of due care 'in keep- ing the parts conflantly moift, and thus fuffer- ing them to get dry and hard, than to any ef- fect the application could have in producing thofe fyniptoms, I paid this 'day a particular attention to this circumftance, by viflting him feveral times, to fee that the folution was duly applied ; and in a few hours the fymptoms of pain and heat in the whole limb were greatly diminiflied, and continued gradually to abate the whole day His pulfe at night was at 93.
Seventh day. The fymptoms were nearly the fame as ycfterday; the inflammation, upon the whole, was rather lefs, but there was no ap- pearance of matter. He liad paflTed a tolerable night; but his pulfe was ftill at' 93. As he was coflive, the purgative medicine was repeated.
Eighth day. He had paft a good night, comparatively fpeaking ; the pain in the upper part of the limb (or above the difeafe) was confiderably lelTened, and the inflammation was much lefs ; a fmall quantity of matter ap- peared upon the edges of the lacerated parts;
I ' ■ his
[ 83 ]
his pulfe was at 90. He began to complain of fevere fmarting upon the renewal of the lotion, and at times infilled on its application being de- ferred to longer intervals, though when the parts began to grow dry, the heat and fenfe of ftric-^ lure were conftantly renewed.
Ninth day. He had paffed a reftlcfs and painful night ; his foot and leg were in much pain at intervals, but (exclufive of the fmart- ing pain for a quarter of an hour upon the lo- tion being applied) he always became much eafier after the wetting of the parts, which took place once in about two hours, unlefs fleep intervened.
From this time the ufe of the lotion was continued in the fame manner as before, and he continued alfo to perfevere in the ufe of the bark and opium ; the Houghs feparated kindly ; the inflammation went off from the leg and toes, and a feparafion of the- difeafed parts took place at a very little diftance from the edges of the original injury. The wound difcharged a well-formed matter, and as the parts beneath fome of the thickeft floughs granulated, the latter gradually came away without much pain, and the whole was healed in ten weeks, ex- cept a very fmall ulcer upon the lower part
G a of
[ .84 ] ■
of the Tarfus, through which a fmall exfolia- tion made Its way.
As in the preceding cafes I was careful to obvi- ate the cfFedts of irritation, by keeping the bowels moderately open, giving occafionally, and fome- times liberally, of opium; and invigorating the fyftem by means of wine and the Peruvian bark ; it may perhaps be fuggefted, by fomc readers, that the favourable termination of the cafes I have been relating was due rather to the internal than external remedies employed ; and that to fubjeft to a fair and decifive trial this or any other remedy, no other Ihould be employed -at the fame time. This is indeed what I have done in fllghter cafes of laceration, where local . applications only were requifite ; and in all fuch cafes the union of the parts has appeared to me to be much more fpeedily effedfed by means of the lotion, than it is by the ordinary mode of treatment. And 1 am able to recoiled: no inftance of bad compound frad:ure, or of la- , €;erated wounds, attended with or threatening fphacelus, where the warm fomentations and twiapliifms commonly employed in fuch cafes
were
C 85 ]
were made ufe of, in which there was any fuch obvioufly good eifedt from the local treatment, as in the cafes I have been deferibing ; not- with handing there was the fame liberal ufe of opium and Peruvian bark, &c. internally. On the contrary, I have but too often feen the worft effedts from fuch cataplafms, &c.; and in one of the above cafes, (Cafe V.), the bad ef- fedls of a poultice, applied at the earneft re- queft of the patient, were very ftriking, when contrafted with the relief he afterwards expe- rienced from the ufe of the lotion.
III. Ca/e of a dljeajed Kidney. By the fame. SEAMAN, forty years old, of a pletho-
ric habit, applied to me at Port Royal, in Jamaica, in 1782, with complaints nearly as follow :
A conftant aching, and fometimes acute pain, about the region of the right kidney, attended with a numbnefs of that lide, and prickirig
pains
[ 86 J
pains along the urethra, particularly when be paffed his urine ; frequent inclination to make water, fomerimes without ability to 'void any, and never voiding it but in fmall quantity ; the urine itfelf being high coloured, depofiting a gritty lateritious fediment, fmelling very ftrong, and forming a film on its furface, which ap- proached to a yellow colour. He complained likewife of a fenfe of fulnefs and heat at the neck of the bladder and about the perineum, and could get but little reft in any other than an horizontal pofture. He was coftive, and had frequent naufea.
As he had a full pulfe, ten ounces of blood were taken from the arm, and a purging draught was adminiftered; after which he took occafional dofes of a mixture, the principal ingredients of which were diuretic fait and tinfture of opium.
In the courfe of two or three days his pain was much alleviated, but the difficulty with which he voided his urine ftill continued.
He now complained of frequent and painful eredtions, more efpecially when an Inclination to make water came on ; he had likewife pro- fufe colliquative fweats, and was coftive.
Care was taken to obviate this difpofition to
coftive-
[ 8? ]
M
coftlvenefs, by means of purgative medicines and clj’fters. Opium was now more liberally adminiftered, and recourfe was occafionally had to the warm bath. This laft produced a certain degree of eafe while he remained in it, but the fenfc of ftrifture about the neck of the bladder continued, and the quantity of urine he was able to void feemed every day to become lefs, fo that at the end of a fortnight it was deemed neceffary to make ufe of the catheter, as he was unable to pafs a Angle drop of urine with- out it.
By means of this inflrument, from four to Ax ounces of turbid urine were drawn off twice a day. He had now much fever, and the pain about the neck of the bladder was become very acute, and feemed to affedl him fpafmodically, as well after as previoufly to the introdudlion of the catheter. He was likewife frequently feized with violent pain, which began in his fhould- crs, and proceeded along the right Ade to the hip.
'About a month after the Arft ufe of the ca- theter, he complained of a pain in the urethra, near the feat of the proftate gland, particu- larly when the inflrument was paffing; and
G 4 at
[ 88 3
at times the catheter feemed to meet with fomc refiftance at that part.
From this circumftance, together with the con- tinuance of the pain in that and the neighbour- ing parts, and the frequent difcharge of drops of a mucous confidence from the urethra, we were inclined to think that the principal feat of the difeafe was in the prodate gland, (efpeci- ally as no appearance of calculus had been ob- ferved), w'hen a frefh fet of fymproms diredled our attention more particularly to the right kidney.
Thefe fymptoms confided in a pain about the region of that kidney which he had before fcarcely mentioned, but w'hich now (about feven weeks alter he firft made his complaints known) was, at times, very fevere. His Ihoulders alfo, but particularly the right, were fore, and at intervals acutely painful; the in- guinal and axillary glands became fwelled, and fore to the touch ; and he complained frequently of a fenfe of coldncfs in the diredlion of the right ureter, which was fucceeded by a painful inclination to make water.
From thefe circumltances it was fufpedted that the right kidney, if not the chief fourcc of the extraordinary fymptoms I have been
defcribing.
C 89 ]
defcrlbing, had at lead fuffered confiderably. He was therefore urged to recoiled: any exter- nal injury lie might have received.- After a little hefitation he informed us, that about a month prevloufly to his firft applying for relief, he had received feveral Violent blows from the end of a large rope acrofs his loins, wdiich for fome time had given him confiderable uneafi- nefs. In the courfe of a few days, however, he faid, the pain had gone off, but had re- turned at intervals ; and as he had fuffered much, at different times, from gravel, he had afcribed his prefent complaints to that caiife.
At the time he made known thefe particu- lars, he was in a very reduced condition ; his ftomach was become fo extremely irritable, that it retained but little of what was given to him either of food or medicine; and about a week afterwards he died.
On diffeffion the urethra was found to be in a healthy Hate, but the proftate gland was a little enlarged. The bladder contained about eight ounces of turbid urine, mixed with a pu- rulent fluid, very offenfive to the fmell. The right ureter was much enlarged, and filled with the fame kind of foetid matter. The kid- ney
[ 9° ]
/
rcy on the fame fide was enlarged nearly to thrice its natural fize, and on being opened was found to be in a ftate of fuppiiraiion, and to contain a confiderable quantity of foetid pus, fo that the internal fubftance of the kidney was in a great meafure deftroyed.
There was no appearance of calculus ; and tlie other kidney, as well as the reft of the abdominal vifcera, appeared to be in a natural ftate.
Tt may be doubted, perhaps, whether tho affedtion of the kidney, in this cafe, ought folely to be attributed to the effefts of the blows that were inflicted ; but allowing the kidney to have been previoufly difeafed (and the com- plaints the patient had already experienced, ‘and which he attributed to gravel, render it not improbable that it was fo); ftill there can, I ' think, be no doubt that the fuppurative procefs which took place was haftened, if not immedi- ately occafioned, by external violence. And of fuppuration of the kidnies from external in- jury, in any refped fimilar to the prefent, I have been able to meet with no example in books. Different fyftematic writers do indeed
enume-
C 91 J
enumerate external contufion among the remote caufes of nephritis^ but I do not find, in any of them, an inftance of fuch an affeftion from_fuch a fource; fo that I flatter myfelf the cafe I have related will be thought worthy of being recorded.
It flaows that a frequent inclination, without ability, to make water, is not always occafioned by gravel or calculous concretions ; and it af- fords a ftriking inftance of the influence an organ like the kidney may have upon parts not only contiguous to, but even remote from the feat of difeafe.
IV. Cafe of a Gun-Shot Wound of the Head. By the fame.
A HESSIAN grenadier, aged between thirty and forty years, being one of a detachment fent to reduce a fort on the banks of
the
[ 9? j
I
the Delawar, in the a6t of levelling his piece, received a ball (grape fliot) on that part of the os frontis which forms the external canthus of the eye. The ball making its pall'age through the head, came out under and rather behind the oppofite ear, as in the annexed plate
What were the immediate effeds upon the receipt of the injury I am not able to fay, not being immediately upon the fpot ; but he appeared, when brought to the regimental hofpital, to have a perfedt recolledion of every circumftance that had occurred to him, except only for a (liort time after he fell. He complained of little pain, and did not ap- pear to have loft fo much blood as might have been expeded.
The ball being a fpent one, had much fplin- tered the cranium, both at its entrance and exit; and was found in the folds of his coat collar.
The wounds being cleanfed, and the fplin- ters of bone removed, as far as was prac- ticable, from about the external parts, fuitable
* See Plate!. Tig. i. in which refers to the entrance of the ball, and 6 to the part where it paffed out,
d reflings
/acds Sc Ohs Vol . VI. PL. I .
.'MX
' '
2
^4
>
.im:
«kV'
■ (■*•. ''V-i .
;
'•
i
• 1
** I
I
(
(
■•(
i
' j
i
1
i
■ !
I
I
i
1
IJ:
)
;
C 93 i
dreffings were applied; and his pulfe being full, he was let blood ; after which he took twenty-five drops of tindture of opium. The next day he had a fenfe of heavinefs. over his eyes, and obfervcd that objedls did not appear to him fo brilliant as ufual ; towards the even- ing he complained of naufea and thirft. He took tart, vitriol, and antim. diaph. ad gr. xii every third hour, and a clyfter was adminiftered. On the third day he complained of pain of his head, accompanied with drowfinefs ; and, at in- tervals, of a weaknefs of his extremities. As the •lyfters had failed to procure a fufficient difcharge of feces, he was diredled to take three grains of calomel and fifteen grains of powder of jalap, which operated well, and procured an allevia- tion of the fymptoms juft now mentioned. His eyes were but ftightly infiamed, and he complained of but little pain in that on the af- fedted fide.
On the 6th day there was a good difcharge of matter from the wound, and efcars began to fcparate in pretty large ftoughs. From this time he refted tolerably well without the ufe of the opiate, which till now had been repeated at bed- time. Splinters of bone, that had been driven in at the fuperior wound by the ball, came
away
[ 94 ]
away from the dependent orifice at almoft every diefling Cvvhich was twice a day) for feveral days. The naufea, head-ach, weaknefs of his limbs, thirfl, and every fymptom of fever, gradually vanifhed ; the fuperior orifice filled up with new granulations, and cicatrized firnlly ; and in about ten weeks there remained nothing more neceffary than a fuperficial drefling to the inferior opening near the ear.
I did not fee this man after he had adually left off every application to the affeded part ; but from the condition of the wound, and the patient’s health and vigour, I have not any room to doubt, that in a few days, after I lafl: faw him, he was capable of returning to his duty.
On refledling on this extraordinary injury, (inafmuch as it was not a mortal one) 1 am in- clined to think, that as the ball, though a large one, entered low down upon the orbit, and near the external part of the eye, it miffed the os planum and frontal finufes, and confequently that branch of nerves that paffes through them ; fo that, judging from its apparent diredtion, it muft have injured part of the os ethmoides, near the feptum nafi. To this courfe of the
ball.
[ 95 ]
hall, and the favourable fituation of the de- pendent orifice, the favourable event of the cafe was probably owing ; for though he com- plained at certain periods of a fenfe of weight upon the upper and fore part of the head, ge- neral weaknefs of his limbs, and lofs of fight, fymptoms indicating an oppreffion of the brain, yet upon opening the wound, and giving vent to the matter, which was in fome meafure confined by the dreffings, thofe fymptoms gradually va- nifhed, and the patient always became perfedUy eafy after the application, for a few minutes, of a warm fomentation.
An inftance of a ball entering under the right eye, and paffing obliquely through the cerebrum and cranium above the right ear, without hurting the eye or fight, is recorded by Heifter in his Medical, Chirurgical, and Anatomical Cafes and Obfervations, page 7 (of the Englifli tranflation) Obf. VII.
V. An
[ 96 }
V. An Account of fome extraordinary Symptoms which were apparently conneEied with certain morbid Alterations about the Veins and Nerves. Communicated in a Letter to Dr. Simmons by Mr. John Pearfon, Surgeon of the Lock Hof- pitaly and of the Public Difpenjary.
i
Mrs. P. aged fifty-one years, of Miles* Lane, Cannon Street, began to fuffer from a peculiar uneafinefs at the inner part of her left leg, about feventeen years ago, when (he was in the third nlonth of her fecond precr. nancy. The Ikin which covered the particular feat of her complairir, retained its natural co- lour; but there Was a circular induration, of about half an inch in diameter, very little elevated above the furface, which was exqui- fitely painful when fiightly touched or com- preflcd ; this morbid part was fituated in the courfe of the vena faphena major, and was about fix inches above the joint of the ancle. Befides the acute pain which was produced by inadvertently touching this little tumour, Mrs. P. commonly fuffered feveral paroxyfms
of
[ 97 ]
of pain every day; each of thefe attacks was accompanied with an increafed rednefs, and a fenfible elevation of the indurated part, the pain at the fame time extending to the knee, and often darting to the ftomach ; the duration of the fit was about twenty minutes ; it was at- tended with flight conyulfivc motions of diffe- rent parts of the body, and frequently termi- nated with flatulent emulations. Thefe fits of pain did not recur at any regular periods ; fo - that the number which flae underwent in the courfe of a day was various and uncertain ; for a difordered ftate of the ftomach, or a fudden perturbation of mind wmuld at any time excite one of the paroxyfms. She alfo had obferved, that the feverity of her fufferings was invariably increafed during the periods of menftruation and of pregnancy ; and that in the latter months of geftation, the duration of each recurrence of pain was extended to an hour and a half. But although this difeafe was uniformly aggra- vated by certain alterations in the ftate of the uterus, yet it continued with undiminiflied fe- verity after Mrs. P. had ceafed to bear chil- dren; for when her youngtft child was more than fix years old, Ihe had not experienced any abatement of her daily fufferings. About thir- VoL. VI. H
teen
i
[ 98 3
teen years ago, I advifed her to have the mor- bid part removed ; but at that time flie was un- willing to undergo an operation ; fhe however fubmitted to various methods of treatment, under the diredlion of different medical gen- tlemen, but without obtaining any relief.
In the month of April, 1793, Dr* Lowder, who had been long acquainted with the circum- fiances of this painful complaint, informed Mrs. P. of the fuccefs which had attended the removal of a fimilar tumour, by the applica- tion of a can flic. She read the hiflory of the cafe, which is publifhed in the third volume of the Memoirs of the Medical Society of Lon- don, and very foon determined to feek relief from the fame mode of treatment.
Accordingly, on the aad of April, I applied the lapis infernalis to the morbid part ; fhe en- dured the moft excruciating tortures during fe- veral minutes after its application ; but the pain gradually diminifued with the fenfibility of the part, fo that in about twenty minutes the efehar was completely formed, and flie then , felt no more pain than what is the ufual confequence of a cauflic applied to any part of the body. From this day fhe never experienced the recur- rence of a fingle paroxyfm of pain; the efehar
2 exfoliated
C 99 ]
f
exfoliated in about twelve days; and on tile 7th of June the fore was perfectly healed.
As the preceding hiftory contains fome cu- rious and rather uncommon circumftances, I beg leave to offer a few obfervations upon fome of them. The indurated part having been de- ftroyed by a cauftic, it was not in my power to examine its internal ftrudbure, fo as to difeover the true nature of the morbid alteration. I af- certained, however, that a portion of the vena faphena major, and that branch of the crural nerve which accompanies it in its courfe down the infide of the leg, were completely included within this tumour. This fad: was clearly de- monftrated after the exfoliation of the efehar ; for I then law a portion of the vein hanging down at the fnperior part of the fore, and the naked nerve in contact with it ; and on touch- ing the nerve with my probe, Mrs. P. inftantly complained of an acutely painful fenfation, fimilar to that which fhe had been accuftomed to feel before the tumour was removed. I then deftroyed that part of the nerve which was ex- pofetl with lunar cauftic, and my patient fuf- fered no more uneafinefs. After thus proving
H 2 that
[ 100 ]
that a vein, and a confiderable ramification of a nerve, were contained within the difeafed part, I proceed to obferve, that the paroxyfms of pain were excited every thing that acce- lerated or otherwife difturbed the circulation of the blood; whether applied to the induration, or affedting the general fyftem ; as all ftrong exertions of the mufcles, external impulfe, or mental commotion. The afeent of the blood, in the veins of the lower extremities, is necef- fiirily impeded in the ftate of pregnancy; and during this period, the fits of pain were always fliarper, and were alfo of longer duration ; and ' at the time of parturition, when the action of the heart and blood -veffels is confiderably in- creafed, Mrs. P. fuffered exceedingly; for, to ufe her own expreffion, flie had all her labour pains in her leg.”
It is alfo highly probable, that the portion of vein which paffed through the tumour was nnufually didended w'ith blood at the time of the paroxyfm ; for upon thefe occafions, the- morbid furface became redder than common ; and the tumour was fenfibly elevated. Vv'"e may therefore, perhaps, venture to conclude, that the vein and the nerve being confined within a fub- ilancethat could not be eafily diftehded, when- ever
r loi ]
ever the vein became preternaturally turgid, the nerve was comprelTed between its parietes and ' the internal furface of the induration; and th at confequently the fympcoms were conneded with this ftate of the part. I do not fuppofe that it will be neceffary for me to undertake a proof • in detail, that a certain degree of preffure upon a nerve will produce pain, fpafms, and con- vulfions ; it may be fufficient for my purpofe to refer to a few of the many inftances which are recorded in medical books. In the fourth volume of the Edinburgh Medical Effays, Dr. Short has related the hiftory of an epilepfy, which was caufed by the preflure of a hard cartilaginous fubftance upon a nerve ; he cured his patient by removing the tumour, and di- viding the nerve. Guattani, in his Treatife de exiernis Jneuryjmatlhus, (Hilt, XX.) has recorded a cafe in which violent fpafms were occafioned by the preffure of an aneurifm upon a nerve. In the Effays and Obferva- tions Phyfical and Literary, Vol. III., the late Sir John Pringle has publilhed a Cafe, where a tumour formed by extravafated blood, by preffing upon the intercoftal nerves, pro- duced pain, irritation, and perhaps a hic-
H 3 cup,
1
[ 102 ]
cup, which could not be flopped*. I do not intend to deduce any general conclufion from a particular inftance ; for although the remarka' ble fymptoms which occurred in Mrs. P.’s cafe, were connedled with a morbid ftate of a vein and a nerve ; yet as no account has been pub- lifhed of the internal ftrufture of parts which have been affeded by a fimilar complaint, it would be improper to conclude, that every in- fiance of local morbid fenfibility, accompanied with convulfive motions and pain, mull depend upon fuch a peculiar condition of the fuffering parts. I have indeed feen another cafe, very much refembling that of Mrs. P.’s, in which there is a fmall exquifitely fenfible iiiduratiori
*** For inftahces of convulfive motions, and even cpilepfy, produced by local difeafes about fome of the extremities, or that were cured by the removal of matter, carious bone, or fome portion of the integuments, confult Willis dc Mor- tis Convulf, ; Riverius de Epilepjia ; Schenckii Ohfervat. (Lib. dc EpUepJjd.) ; Foreftus de Cerebri Morbis, Lib. Xi Obf. 67 ; Petri Borelli Hijior. fsf Olfervat. medico phyfica- rum. Cent. II. Obf. 95. Joh. Rhodii Obferv. Med. Cent. I. ; Tulpii Obferv. Med. Lib. IV. Cap. 2 ; Boncti Sepuh ■ehretum. Lib. I. Se£l. 13; Van Svvieten Comment, in Aph. H. Boerhaave, Tom. III. § 1075. Flaller Ele- menta Phyjiologire, Tom. IV. § 30. Simfon on the Vi- ^1 and Animal Addons, Effay I. cb. 3.
at
r 103 ]
at the pofterior part of the leg, near the be- ginning of thetendo achillis, from which the pa- tient fuffers acutely whenever it is touched. She has occafional paroxyfms of pain, but they re- turn at uncertain intervals ; and flie thinks that they grow milder. In this inftance, as in that recorded by Dr. Biffet the tumour becomes uneafy in rainy and windy weather; but it does not appear that the difeafe had ever any con- nexion with pregnancy. I fufpedt that the tumour, which 1 have juft now mentioned, may be connedted w'ith the vena faphena minor, and that confequently it may include or com- prefs a fmall branch of the fciatic nerve ; but as I could not render the cutaneous veins of the leg turgid by moderate preftlire, its exadt fituation was not afeertained f.
In
* Memoirs of the Medical Society of London, Vol. III. Art. VI.
f The firft volume of M. Pouteau’s pofthumous works, contains a very curious hiflory of a difeafe which he there calls cancerous ; whether properly or no I Iliall not inquire ; but as it refembles Mrs. P.’s cafe in fome of its charadlcrs, I fliall take the liberty of prefenting an abftradl: of it :
“ On voyoit a la partie bafle du Sternum une furface ov}ib de largeur d’un ecu de fix livres dans fon petit dia-
H 4 ' u metre,
\
f 104 J
In the early part of the laft Spring, a young married woman applied to me at the Public Dif- penfary, complaining of pain and latnenefs of the right arm. She flaewcd me a tumour of a pale red colour, and of about the fize of a filberd,
metre, fans elevation, fans rongeur, ians engorgement ‘ cii convoilin. L<a pcau fculement cjui la recouvroit ctoit “ un pe.Li moins nette, que par tout ailleurs, mais fcmblable a la fenlitive qui paroit craindre la main qui I’approche. “ Cette portion des tegumens auroit fait reflentir les plus “ vives doulcurs, li le doigr, ians la toucher, cn eut ap- “ proche avec trop de ccierite. Le molndre infedte, un fetu que le hafard auroit fait pofer deifus, eufient auffi- “ tot rappelle les convulfions. Les retours de ces convul- “ fions ctoient periodiques, fc montrant a fept heurcs & “ demie precifes dii foir, Dans le plus grand calmc, on ne “ les attendoit quc4e deux jours I’un ; & a la moindre agita- “ tlon, les mouvemens couvulfifb etoient journalicrs. Leur “ duree etoit de deux heures. Sc memeplus.” The hif- tory prefents us uith many other extraordinary clrcum- liances; but it may be fufficient at this time to add, that iM. Pouteau made a crucial incifion in this morbidly fcnfi- blc part, which afforded an immediate althdugh but a tem- porary fufpcnfion of the pain and convulfions. He then extirpated the portion of diftafed integuments ; but as the young lady was not perfcft'.y relieved by this operation, he finally completed the cure by burning a cylinder of cotton upon the parr. Vide Oeuvres pofibumcs ch M, Pouteau^ Tom. I. ch, I.
which
[ 105 ]
' which was fituated in the courfe of the vena mediana bafilica, at the ‘bend of the arm : this morbid part was conftantly uneafy; but when ' it was prefTed or handled, fhe complained of acute pain, which extended along the upper arm, and produced flight convulfive motions in the mufcles. She derived no advantage from mild difcutient and emollient applications; but her pain increafed fo much, that her health became iniured, and (lie w'as at length confined to her bed. On vifiting her at home, I found \he tumour unaltered in its appearance, except- ing a Ipdntaneous feparation of the cuticle from its furface ; Are was in conftanc pain ; the unea- finefs not only proceeding along the upper arm, but allb to the neck, and affcdfing the breaft and mulcles on the right fide. Her pulfe was feeble, but not too frequent ; flie complained of a great fenfe of weaknefs, and convulfive motions were excited in the mufcles of the upper arm, neck, and thorax, on that fide, by the gentleft exa- mination of the morbid part. I ordered a large veficatory to be applied on the inner part of the fore arm, and directed her to take ten grains of pulvis ipecacuanhie compofitus, when- ever her pain Ihould be unufually feverc. She foon derived confiderable relief from this mode
of
[ io6 ]
of treatment : the bliftering plafter was repeated twice during my attendance ; the tumour gra- dually became lefs painful, and diminilhcd in bulk ; and in about a month it had entirely dif- appeared. It was not more than three weeks after fhe was difmifTed, when flie applied to me again, on account of a tumour very much re- fembling the former one, which was fituated at the bend of the arm, in the courfe of the vena cephalica; fo that a portion of the vein evidently paffed through, or, rather, was included within the center of the morbid part. The pain and morbid irritability affected the fame parts as before, but in a much inferior de- gree. I directed a mode of treatment fimilar to that which had been employed on the former bccafion, and it was attended with equal fuc- cefs.
This young w^oman had fome fymptoms which indicated a difeafed flate of the lungs ; and (he occafionally fpat blood : but (he had not been formerly fubjedt to any particular corn- plaints ; (lie menftruated 'regularly ; and had never been pregnant. I cannot afhgn any pro- bable caufe for the appearance of fo lingular a complaint as that which I have now deferibed ; but fome of the elfedfs which took place would • , perhaps
[ 107 ]
perhaps admit of an explanation, if it could b© proved that a fmall ramification of a nerve, as, well as a portion of a vein, were included within each of the tumours. That this was aftually the cafe is highly probable, becaufe the cutaneous nerve diftributes feveral of its branches in the vicinity of the vena mediana bafilica ; and fmall fibrils belonging to the mufculo-cutaneous nerve, are commonly feen near the vena cephalica, and the vena mediana cephalica ; fo that tumours fituated at the bend of the arm, and In the courfe of thefe blood veffels, muft be almoft ne- cefTarily in contadt with one or more branches belonging to the internal,' or external cutaneous nerves
• The late Profeflbr Camper, in a valuable work entitled Demo7tJirationuiH Anatomlco-Patholflgicaru?n Liber primus continens Bracai. humatil Fabricam et Morbos, has given a very diflincl: view of the mode in which thefe fmall branches of nerves are dillributed at the bend of the arm ; and his engravings are accompanied with fome good pradical obfervations. Mr. Abernc.thy allb publiflied two engravings, laft year, in the fecoud part of his Surgical and Phyfiolog’cal PifTays, in which the courfe of thefe nerves is very neatly and corredly delineated: and the.eflay to which they are annexed, contains many ufeful remarks “ on the ill coufequences fometimes fucceedhig to vena-
fedion,”
I beg
[ loS ]
I beg leave to refer it to the intelligent reader, how far the following account of a difeafe of the fubcutaneous nerves, as deferibed by Pro- felTor Camper in the work already referred to, bears any rdemblance to the preceding hiflories.
“ Non raro in nereis ciitaneis tubercula par- “ va ac dura obfervantur, qu£ vera ganglia ‘ funt, pifi magnitudinem licet non excedant ; “ dies tamen nodlefque acutiflimis lancinanti- “ bus doloribus tegros torquent : externis re- mediis non cedunt ; fcalpello igitur ea attin- “ gere oportet. Franequers ex cubito femins “ tale, plagafadta, fuftuli, quodramo mufculo- cutanei nervi adhserebat : poll operationtm optime fe habuit. In fubcutaneis nervis: fre- “ quenter effe videntur. Amftelcedami fiOille ‘‘ ganglium genu mulieris occupans, eodem modo fanari curavi. In viris ''plus femel ea vidi : albicant intus, cartilaginete duritis funt, renitentia, & intra nervorum tunicas “ fedem habent.” Lib. I. P. ii. Can. 2. § 5.
I have feen many f) mptoms refembling thofe which occurred in the preceding cafes, appa- rently follow, as confequences of wounds in- flifted on fmall branches of nerves ; but as this paper is already much longer than I expeded it would have been, 1 mud defer giving an ac- count
[ 109 ]
cdunt of diem to another opportunlt3^ As the following cafe exhibits fome uncommon clrcum- ftances, I infert it as a kind of fupplement to the foregoing hiftories.
‘‘ The lingular effedfs of an iflue in the in- ‘‘ fide of the thigh, which appeared in the cafe “ of a clergyman ; written by himfelf, Auguft ‘'25th, 1793.
“ The Rev. Dr. T- , of Knightlbridge,
above 60 years of age, having had a hint “ from a medical friend, that an iffue might be of ufe to his health, he had one made by a “ blifter, in the lower part and at the infide “ of his right thigh, about the end of May laft.
Two days after the pea was put in, he was “ feized with a ficknefs and vomitinp- v.-hicli
O'
continued feveral hours. In about fix days after this fi'rfl: attack, he had a return of the “ fame fymptoms ; and thefe fits recurred every “ fix or feven days. But what is very remark- “ able, when the iflue began to difeharge, he “ became' deaf in both his ears, and the deaf- “ nefs arrived to fuch a degree, that in preach- “ ing he could but juft hear his own voice.
“ After the ififue had been kept open fix weeks, it occurred to him, that perhaps the ‘‘ regular fits of ficknefs and vomiting, and the
unufual
r I lo
imufual deafnefs, (both of uhich he recol- “ leded had commenced with the iffiie) were occafioned by a fympathy of the nerves ; and ‘‘ having made obfervations for one week longer, which confirmed this opinion, he determined to dry it up. This he did gradually, by ufing peafe of a fmaller fize, till the ulcer was not more than one eighth of an inch in diameter. ** When the pea had be^n out only twelve hours, he was fenfible of fome fmall return of his hearing, and on looking at the fore, he found *' it healed ; whieh he confidered as a farther confirmation of his opinion, refpeding the caufe of his deafnefs, as well as of the ficknefs and vomiting. He found, that as the wound healed, the deafnefs lefTened, and when it was completely healed, his hearing was quite reco- vered, nor has he had one fit of ficknefs fince.”
When Dr. T related his cafe to me, I
defired him to let me fee the cicatrix of the ifiue ; and on carefully examining it, it ap- peared probable that the pea had prelfed againft the fide of the vena faphena. I would alfo far- ther add, that my examination of the part ex- cited a flight degree of naufea.
VI. Jn
[ J
VI. An Account of the ExtraElion of an extra- neous Subjiance from the Return. By Mr. Wil- liam Blair, Surgeon of the Lock Hofpital ; and of the General Difpenfary in Newman Street, St. Mary-le-bone. ^
N Tuefday, the 25th of March laft, a
French gentleman was fent to me by an Apothecary in this neighbourhood, complaining of a pungenr, hot, and irritating fenfation in the reSium ; which was confiderably augmented during every evacuation per anum. Thefe pain- ful fymptoms had commenced on the preceding Sunday, and continued to encreafe in fo alarming a manner, that, upon the day following, he was induced to examine with his finger, whether or not any foreign fubftance, or other caufe of his uneafinefs, could be difcovercd in the inteftine. He had the good fortune to feel fomething in the redtum, which he thought w^as unnatural, but could not remove it ; and therefore he ap- plied the next day for chirurglcal affiftance.
Having fubmitted the patient to a proper ex- amination, I readily perceived an hard body confined in the interior membrane of the in- teftine. With the help of a pair of forceps, I
extracted
r II2 ]
cxtra£led two portions of a brittle black fub- ftance; which, on careful infpedlion, appeared to be bread toafled nearly to a cinder : the two pieces, which were whole before the extraiftion was attempted, might be together about an inch in length, half an inch in width, and one third of an inch in diameter.
The patient remembered to have fwallovved foniething with confiderable difficulty two davs before, while partaking of fo'me foup ; which was probably the fame morfel of bread that diftrefled him upon this occafion.
Does it not appear from this cafe, that bread when toafted islefs fit for digeflion than fome per- fons would have us believe ; and that it affords » but little nourifhment compared with that which is moderately baked }
However trifling the circumflances of the above cafe may be regarded in its earliefl ftage ; there can be no doubt entertained of the pro- bability of its terminating very ferioufly, if the patient had not applied for fpeedy relief : inflam- mation, abfeefs, and all their confequences, might have enfued, if the efforts of 'nature, or the power of aperient and antiphlogiflic reme- dies had alone been trufted to.
' In fimilar inftances, without lofing time by
endeavours
[ II3 3
endeavours to relieve the patient’s fufferings by medicine, it will be immediately proper to fub- jedl him to a careful examination. If the fimple introduction of a finger be infufficient to difen- gage the extraneous body, and it can be felt adhering to the ruga, or piercing the coats of the reCtum, a pair of blunt-pointed feiflars, or forceps, (as the cafe may indicate) fhould be gently conduced upon the finger, in order to divide, break in pieces, or loofen the foreign fubftance : if a pointed bone, or other hard and (harp body, Ihould be confined acrofs the gut, endangering the neighbouring parts, it will be prudent to empty the urinary blad- der, previous to any attempt to remove it by mechanical means : and, Ihould the pain, and Other ill effeCts become urgent, it might be ne- ceflary, after milder methods had proved inef- fectual, to make a judicious incifion either into the reClum, or circumjacent integuments, as the peculiarities of the cafe fhould require to fa- cilitate the extraction. To obviate the inflam- mation, and its concomitant fymptoms, leeches, anodyne and laxative clyfters, w'ith the ufual antiphlogiftic remedies, ought to be diligently employed.
Inftances of the kind above related, with
VoL. VI. I fuitable
I
[ II4 ]
fuitable remarks, are recorded by feveral prac- tical authors ; but the reader may fpare himfelf the trouble of pcrufing fome of them, by con- fulting the Memolres de i'Acadmk Royale de Chirurgte, Tom. I. p. 540, et feq. 4m Edit.
Rc’voman Street^ OSl, 6, 1 794.
VII. A Cafe of Aneurifm of the Crural Artery ; communicated in a Letter to Dr. Simmons, by Mr. Thompfon Forfter, Surgeon on the Staff of the Army, and Surgeon to Guy’s Hofpital.
' Dear Sir,
r O the two cafes of Aneurifm which you
have done me the honour to infert in
the fifth volume of Medical Fadts and Obfer- vations, I am defirous of adding the following, as I flatter rnyfelf it will, tend ftill further to elucidate the peculiar utility and advantages of the operation in queflion.
TO DR. SIMMONS
AW. 3, 1794.
Believe me. Dear Sir,
Your’s^ &c.
THOMPSON FORSTER.
CASE.
\
[ II5 ] '
CASE.
' Lawrence McCarthy, a labouring mah, aged thlrty-fe,ven years, was admitted, as my patient, into Guy’s Hofpital, on the 30th of July 1794, for the cure of an aneurifm of the crural artery.
About nine months before his admiffion, he had perceived a fmall tumor on his right thigh, near that part where the crural artery dips under the triceps mufcle ; as it occafioned no incon- venience, nor prevented his working, he took but little notice of it ; it came fpontaneoufly, without any external violence, and remained ftationary for near fix months before it became painful : when the tumor had acquired the fize of an egg, a pulfation was perceptible in it, but not before.
At this period of the difeafe he was advifed to foment the part, and to make ufe of lini- ments : this he continued to do for fome time ; but finding no relief from thefe reme- dies, he applied to a furgeon, who recom- mended the ufe of a bandage, which he made ufe of for near three months, but without any abatement of the pain ; and the tumor in the mean time had increafed to a very confiderablc
I a fize,
[ ]
fize, and the limb in general had acquired fomething more than its natural bulk.
The patient, naturally hypochondriacal, be- came anxious, irritable, and dejeded ; com- plaining of great pain in the limb, and parti- cularly in the tumor, which was in fome mea- fure eafed by preffure. In this ftate he came into the hofpital; and his general habit havino- been lowered by bleeding, purgatives, and a fuitable regimen previoully to the operation, I performed it on Monday, the' 1 1 th of Auguft, by making an incifion in the eourfe of the lower edge of the fartorius mufcle, and about an inch below where the profunda is ufually given off. Having laid bare the artery, * I paffed a ligature under it with an eyed probe, and ap- plying the flick, furrounded by adhefive plafter. See. as deferibed in the former cafes ■f-, the ar-
With a view of conveying to the I'eader a more precife idea of the operation, I have made a iketch of the parts con- cerned in it, from a fubjedf dilTedted for the purpofe. Set the annexed engraving (pla^e i, fig. 2.) in which a refers to Poupart’s ligament 3 to the crural artery, with a li- gature pafied under it at the part where it was tied ; e to the profunda; and ^ to the fartorius mufcle. It feems hardly necefiary to remind the reader that the objedt of this fketch being merely to point out the feat of the operation, the parts are delineated in their natural Hate.
+ Vide Vol. V. p. 6.
tery
C ”7 ]
tery was thus furrounded, and by thefe means equally comprefled; the pulfation below of courfe ceafed : but, for fear of a fudden he- morrhage, I pafled a fecond ligature about half an inch above the former, laying it loofe, that an affiftant might inftantly tie it in cafe of fuch an accident.
Auguft 2 1 ft. The firft: ligature, with the flick, came away with eafe.
Auguft 22d. The fecond ligature came away with equal eafe.
An account of the ftate of the pulfe at the wrift, and of the temperature of both limbs, at the ham, and atthe foot, was taken every day with great accuracy by Mr. G. Babington, according to the annexed Table *, until Auguft the 27th, when the temperature of each was found to be equal.
The fize of the tumor gradually decreafed, and the patient, having the perfedl ufe of his limb, was difmifled, cured, Odlober 10, 1794.
I
The preceding cafe differs materially from the two former, not only in the circumftance of the tumor in this having been fituated in the
* See page 1 19.
1 3
upper
[ i‘8 ]
upper part of the thigh, fo that the artery could not be fecured lower than about an inch below where the profunda is uTually given off, but likewife in the very great pain the patient en- dured both night and day for three weeks before the operation. The tumor was as confidcrable, but the enlargement of the limb below it was much lefs than in the former cafes. After the operation, the fymptoms were much flighter than in the other cafes, probably owing to the low ftate I thought it proper to reduce the patient to for the purpofe; and the ligature came away on the tenth day after the operation without the leafl trouble. But the ciicumdance in which it differed the raoft effentially from the odier two, was, that the tumor was completely abforbed in feven weeks, and the patient had then acquired a perfedf ufe of the limb, while, in the former cafes, the patients did indeed acquire the ufe of their limbs, but the tumors, though leflened and free from.puKation, flill remained.
TABLE.
[ ”9 ]
TABLE.
|
Day of the Month. |
pulfe at wrift |
tom, of arm. |
tern. right ham. |
right foot. |
1 eft ham» |
left foot. |
I'ime of day when the obf. were made. |
|
Aujfuft 11 |
684“ |
qSt |
94 " |
97 " |
96 « |
toi P. M. |
|
|
12 |
684 |
97 |
91 |
91 |
89 |
8^ A. M. |
|
|
128 |
70 |
99 |
91 |
94 |
93 |
io| P. M. |
|
|
13 |
109 |
68 |
98 |
92 |
9° |
88 |
84 A.M. |
|
U* |
71 |
too |
95 |
98 |
95 |
loh P. M. |
|
|
M |
104 |
68 |
98 |
91 |
9‘ |
g'z |
84 A.M. |
|
116 |
72 |
99 |
96 |
96 |
96 |
8i P. M. |
|
|
15 |
. 96 |
69 |
97 |
91 |
94 |
88 |
8^ A.M. |
|
112 |
725 |
97 |
93 |
94 |
95 |
8 P. M.- |
|
|
16 |
97 |
72 |
98 |
93z |
94 |
90 |
8 A. M. |
|
112 |
73 |
98 |
95 |
94 |
94 |
8 P. M. |
|
|
17 |
96 |
7» |
98 |
92 |
95 |
89 |
8 A. M. |
|
112 |
74 |
97 |
94 |
94, |
94 |
8 P. M. |
|
|
18 |
92 |
7® |
93 |
91 |
924 |
89 |
8 A. M. |
|
1 10 |
72 |
97 |
92 |
94 |
93 |
9 P. M. |
|
|
19 |
10» |
68 |
94 |
90 |
9i |
91 |
8 A.M. |
|
124 |
7'2 |
101 |
964 |
'97 |
97 |
84 P. M. |
|
|
20 |
U4 |
67 |
100 |
93 |
96 |
94 |
84 A.M. |
|
116 |
70 |
99 |
95 |
95 |
94 |
84 P. M. |
|
|
21 Firfl ligature and ilick came away with eafe, there being a perfetl folution of continuity. |
|||||||
|
100 |
1 66 “ |
97® |
93 “ |
e oc |
8 A. M. |
||
|
too 1 69 1 98 1 92 1 95 22 Second ligature was removed. |
94 |
8 P. M. |
|||||
|
1.00 |
69“ |
g6° |
0 00 |
93 ° |
84 • |
84 A.M. |
|
|
J08 |
69 |
g8 |
94 |
97 |
95 |
9 P. M. |
|
|
23 |
100 |
672 |
96 |
91 |
93 |
90 |
9 A.M. |
|
104 |
7°2 |
98 |
94 |
95 |
93 |
»4 P. M. |
|
|
24 |
96 |
69 |
97 |
89 |
95 |
87 |
10 A.M. |
|
104 |
69 |
99 |
95 |
98 |
95 |
8 P. M. |
|
|
25 |
104 |
664 |
98 |
93 |
96 |
92 |
84 A. M. |
|
26 |
106 |
69! |
95 |
92 |
93 |
91 |
8 P.M. |
|
100 |
64 |
96 |
90 |
91 |
86 |
8 A. M. |
|
|
106 |
66 |
98 |
92 |
94 |
90 |
84 P. M. |
|
|
27 |
100 |
64 |
96 |
91 |
92 |
9» |
8,4 A.M. |
|
95 |
63^ |
I96 |
90 |
96 |
Igo |
8 . P. M. |
I4
Ail
[ 120 ]
VIII. An Account of a Key Injlrument of a new Con- JiruEiion ; with Cbjcrvations on the Principles on which it acls^ in the pMtr action of Teeth, and on the Mode of applying it. By Mr, Robert Clarke, Surgeon at Sunderland, in the County of X>urham. Communicated in a Letter to Mr. AntHony Carlille, Surgeon of the Wefiminfter Hofpital, and Reader of Anatomy in London ; and by him to Dr. Simmons.
To Mr. Carlisle.
Sir,
7ITH this I fend you a Key inftrument.
for the Extraction of I'eeth, of a con- jftrudtion different from any in common ufe, and which in praftice fully anfwers to the expectations I had formed, a priori, from a care- ful examination of the principles of its adtion.
I cannot, perhaps, give you a clearer idea of its advantages, than that which you will obtain by purfuing the fame train of inveftigation which 1 followed rnyfelf. I fliall therefore pro- cetd to lay it before you, that I may more thoroughly convince you of the propriety of the alteration I have made, or be corredted by your pointing out any error I may have fallen into.
In
[ I2I ]
»
In the fiift pkce then, it appeared to me that as the fulcrum, or point, upon which the tooth is carried roqnd as on a center, is that part of the bolfter which refts upon the gums, the axis of motion of the inftrument would always be found by drawing a line through that point* and the middle of the handle ; and CQnfequently that the old conftrudtion of the Key InUrunient was free from an inconvenience which attends the more modern one ; I mean the axis of the bolfter and axis of the fhank making an angle with each other \ on which account it is dif- pofed to Ihift its point of aftion on the gums, and to raife the tooth in a plane inclined to the throat, inftead of a vertical one, as may be clearly feen by infpe(fling Figures I. II. (Plate II.*) where a, h, reprefent the axis of motion; c, df the diredtion in which each inftrument raifes the tooth ; and e. f (Fig. II.; the axis of the bolfter.
Now as the line of diredion In Fig. I. is per- pendicular to the jaw, it is needlefs to fay that it is highly preferable to Fig. II. where the line of direftion is inclined backw'ard, making the
Jt feems right to obfervc here, that all the figures of this plate are on a reduced fcale of two thirda ot their proper lize.
cKtraftioa
[ 122 ]
extra<flioii of the tooth more difficult, and ex- pofing that which is lituated behind it to be driven from its focket, or even to be caught in the arch of the claw. Befides this, the bolfter refts only upon the corner d, adding greatly to the injury of the gums.
The conftruftion then of the Key-inftrument delineated in Fig. I. would feem perfed, were it not that in drawing teeth inwards, with refped to the jaw, the fore teeth prevent its due appli- cation, confining it to the diredtion reprefented in Figure V.
. To remedy this imperfedion I have made the.infirument with a bend in its fhank, to clear the fore teeth, and to allow its proper application, as in Figure III. where the fame obfervations and references apply as in Figure I. and there- fore it is unncceflary to repeat them. But in order that the comparative merits of the three inftruments may be feen at a glance, 1 have added Figures IV. and V. wherein the axis of motion, -and the diredion of thcrifing tooth, are Ihown by dotted lines.
Flaving fully confidered what relates to the diredion of the tooth, I fhall next examine the mechanifm which takes hold of it. For this purpofe recourfe muft be had to the engraving.
Let
[ ^23 ]
Let h, Figure VI. reprefent an end vlevf of a Key infl rument, fixed upon a piece of hard, fmooth wood. Then it is obvious, that if it be turned from left to right, by means of its handle, it will break the wood in the direction d, c, and caufe the upper fragment to revolve on the point r, as a center. It is equally ob- vious, that if a line be drawn from the point crofling the oppofire furface of the folid e^f, at right angles, the counterpoife of the claw will fall into that line before it can take hold ; for then the point is at the giearefi; poffible dif- tanc'e from the furface e,f; confequently if the inftrumcnt be placed as in Figure VII. the point c wnll dcfcend ; or, if as in Figure VIIL it will afcend until it coincides with the line a, b,
I fhall now endeavour to apply this to prac- tice. Let I, 2, 3, in Figure IX. reprefent a tooth with its roots fixed in a fedbon of the jaw, and its corona engaged in a Key-inftrument ; then it will readily appear that upon the adlion of the infirument, the tooth will be drawn from its focket, and carried round the point b, as a center, rather than the joint fubfcance of the tooth and jaw be broken in the line b, as happens in Figure VI. This however happens
[ 124 ]
only under particular circumftances : For if the bolfter be placed too high, the tooth will be broken ; and if too low, the alveolar procefs will always be torn away with it. It is therefore a matter of importance to determine the bell point ofcontadt for the bolfter, and this I have uniformly found to be at two-thirds the depth of the tooth, the claw being fixed at one third, as reprefented in Figure IX.
It will always be eafy to afcertain this point, by attending to the fize of the corona, and the part of the jaw where the tooth is fituated ; and equally fo to make the inftrument a<5t upon it, by ufing a larger or fmaller claw as the cafe may require. For illuftration, howeyer, I fhall refer to Figure X. which reprefents a piece of wood grafped by the tooth inftru- ment in the fame manner as in Figure VI. Now If a larger claw, fhewn by the dotted line, be ufed, the bolfter will fix higher upon the wood than before. For as the center pin of the claw will always reft in the line b, the bolfter muft rife higher before It can come Into contact. But notwithftanding the ufe of a larger or fmaller claw, in proportion to the fize of the tooth, enables us to fix it at a proper height, the ufe of a very difproportionate one is always-
inconvenient.
C 1^5 ]
inconvenient, by depriving us of the ufe of the crank, in drawing teeth inwards, and by en- croaching upon the cheeks in drawing them outwards. I have therefore in the conftrudlion of this inftrument, taken care to make the bolfter of fuch a depth, as to be free from either inconvenience.
The form of the bolfter is by no means a matter of indifference ; for if it be too fmall, it prefents fo fmall a furface to the gums, that the preflure. made upon them, by the extradfioa of a tooth moderately firm, cuts them through, and even penetrates the bone, efpecially if the bolfter be of the ufual form. I have therefore been careful to make it of a proper fize, and to give it a prolate fpheroidal figure, as being the leaft difpofed to injure the gums, and applicable with exadnefs and eafe to all parts of the mouth ; and in order ftill further to guard
O -
againft this bruifing of the gums, I wrap the bolfter to the thicknefs of a line, with tow, wound on as tight as I can, before 1 ftide for- ward the bolt and put in the claw.
1 have alfo been attentive to the form of the claws, that they may touch the tooth only with their points. And the inftrument is fo con- trived, that they can be quickly changed or
turned
[ 126 ]
turned to an oppofice dire(5tion as the cafe may require : this is done by means of a fiiding bolt, inftead of a fcrew, which paffes through the claws.
I have always found that when the tooth is to be turned from right to left in drawing it, that the handle anfvvers beft placed perpendi- cularly; and when from left to right, horizon- tally. The reafon of this will be obvious, if we confider that in the firft cafe, the prona- tor miifdes of the operator’s arm, which are thofe exerting the force, adt with moft advan- tage when the hand is vertical ; and in the fecond cafe, that the fupinators adl moft advan- tageoufty with the hand prone. I have therefore contrived the handle fo that it may be eafily turned, as often as there is occafion to turn the claw.
I am. Sir, &c.
Sunderland, Robert Clarke.
Aug. i8, 1794.
/
IX. An
[ 1^7 ]
IX. An Account of a new Species of Swktenia (Mahogany ) ; and of Experiments and Obfer- ‘vations on its Bark, made zmth a Viezv to afcer- tain its Powers, and to compare them with thofe of Peruvian Bark, for zvhich it is prcpofed as a SuhJUtute : Being an AbJlraSl of a Paper on this Subject, addrejfed to the Honourable Court of Directors of the United Eaft- India Company. By William Roxburgh, M.D.
fpecies of Swietenia defcribed in this a paper, and which Dr. Roxburgh names Swietenia Febrifuga^y is a native of the moun- tainous part of the Rajamundr}^ Circar, North of Samulcotah and Peddapore. It is a very
* Dr. Andrew Duncan, junior, who has made this new fpecies of Swietenia the fubjeft of a very ingenious inaugu- ral Differtation, gives a good reafon for preferring, at a trivial name, the Hindoo appellation, Soymida, to one founded on its medicinal properties ; limilar properties, he obferves, being aferibed by Dr. Wright (London Medical Journal, Vol. VIII. p, 286) to the mahogany tree of Ja- maica (S-wkte7iia Mahagoni), another fpecies of the fame genus. — Vide Tenta?nen inangurale de Swietenia Soymida ;
Andrea Duncan. 8vo. Edinburgi, 1794. Edi i or.
large
p
[ 128 ]
large tree, known among the Hindoos by the name of Soymida, and flowers about the end of the cold or beginning of the hot feafon. Its feeds ripen in three or four months after.
Of this tree Dr. Roxburgh gives the follow- ing botanic defer! ption :
“ TRUNK. Very flralght, rifing to a great “ height, of a great thicknefs, and covered “ with a grey, fcabrous, cracked bark.
“ BRANCHES. Numerous, the lower fpreading, the higher afeending, forming a very large fliady head.
LEAVES. Alternate, about the extre- “ mities of the brachlets (turiones) abruptly feathered, about twelve inches long.
‘‘ LEAFLETS. Oppofite, very fhort, pe- tiolated, three or four pair, oval, obtufe, or end-nicked, the lower fide generally extend- ing a little further down on the petiolet than “ the upper ; fmooth, fhining ; from three to five inches long, and from two to three btoad, the inferior fmalleft.
“ PETIOLE. Round, fmooth, about nine to ten inches long.
« STIPULES none.
PANICLE. Very large, terminal, dif-
fufe,
r 129 ]
*
“ fufe, bearing great numbers of middle-fizccl, white, inodorous> flowers.
PEDUNCLE and PEDICLESi Round “ and fmooth.
“ BRACTS. Very minute. >
“ CALYX. Below, five-leaVed ; LEAF-' ** LETS. Oval, deciduous.
COROL. Petals five, Inverfe, egged, obtufe, concave, expanding. NECTARYi ‘‘ Not quite half the length of the petals, a “ little bellied ; mouth ten*toothed, teeth bi- fid (two-cleft).
“ STAMEN. Filaments ten, very fliorr, inferted juft within the mouth of the nedtary* ANTHERS. Oval.
« PISTIL. Germ conical. STYLE. Thick, ** tapering. STIGMA. Large, targetted, fhut- ting up the mouth of the nedtaryi “ PERICARP i Capfule egged, large, five- “ celled, five-valved, vaivdets gaping from the topi
“ RECEPTACLEi In the centre, large, ‘‘ fpongy, five-angled ; angles (harp and con- nedted, with the futures of the capfule, be- “ tween them, deeply fulcated.
“ SEEDS. Many in each cell, imbricated, obliquely wedge-fhaped, enlarged by a long VoL. VL K mem-
t rjo ]
“ membranaceous wing, infertcd, at the upper point of the wing, into a' long brown lpe.:k ‘f on the upper part of the excava'ions ot the “ receptacle : all the relt of the receptacle is white.’*
The wood of this tree, we are told, is of a dull red colour, remarkably hard and heavy; and is reckoned, by the natives, by far the moft durable timber they know; on which ac- count it is ufed for all the w'ood work in their temples.
The bark of the trunk and large branches^ of large and middle-fized trees, is covered with a dark rufty-coloured coat, of about an eighth of an inch in thicknefs, which cracks in various diredlions, and fometimes peels off in irregular pieces, according to the direcflions of the cracks. Immediately under this is a very firm, but brittle coat, of about three-eighths of an inch in thicknefs. When firft cut, it is light-coloured ; but on drying, or even expo- fure to the air for a few minutes, it turns to a •reddifh brown. The inner lamina are thin, confining of tough, lighter-coloured layers.
The bark of the younger branches is not cracked, is pretty fmooth, of a much lighter
- colour.
[ ]
colour^ and has not the rufty coat above de- fcribed, but has often many blotches of various Coloured lichen over it : it confifts wholly of the brown, folid, and inner layers*
The outer ruft- coloured layer of the trunk has but little tafte ; the other two poflefs a lit- tle aromatic fmell, and their tafte is very bitter and aftringent, accompanied with fomething aromatic, but in a trifling degree. There is nothing difagreeable in the tafte, more than may be expedted from a pure, fimple, ftrong bitter and aftringent united. The middle la- mina are eafily reduced to a very fine rofe or light brown-coloured powder.
Cold water, in the courfe of an hour, our au- thor obferves, acquired from this bark a deep but clear reddifli colour. The moft minute portion of a chalybeate (one drop of a folution of twenty grains of fal martis in an ounce of water) in- ftantly changed a much-diluted cold infufion to a deep purple^ which, on ftanding, became darker and darker, with a reddifh tinge ; and no decompofition took place till about the tenth day; the colouring matter then began to fepa- rate, and fall to the bottom in black flakes, leaving the liquor almofl; colourlefs. If the infufion was fome days (from four to thirty)
K 2 old,
C 13^ 3
oW, the colour produced by the martial folu* tion was as inftantaneous as when frefh, and deeper; and at n^o period, up to thiity days, did it (liow the leafl: tinge of green. Ten times the fame quantity of the fame martial ibiution, it feems, did not produce fo great a change upon a fimilar infufion of the common pale Peruvian bark ; and its cflfedt on the latter was much flower. Its bitter qualities are alfo defcribed as much more intenfe than thofe of the common fort of Peruvian bark.
The infufion, we are told, bears to be mixed in any proportion with fpiri's, without becoming turbid, or producing any kind of decompofition. The firfi; decodfion is confiderably deeper-colour- ed than the infufion (which colour it retains in pafling the filter), and polfefiTes the fame powers in a higher degree, but does not retain them fo long, nor is it fo pleafant to the tafte. On Handing any length of time with the chalybeate, the colour becomes prde, and is fooner decom- pofed than the cold infufion : on ftanding fome days it lets fall a fmall quantity of a reddifh, earthy fecula, which is intenfely bitter and aftringent; the fuperincumbent liquor becom- ing gradually clearer and clearer, and at the fame time of a deeper red, much refembling the tincture. Lime-water added to the decodtion,
infufion.
• • ' [ 133 ]
infulion, or diluted tinfture, darkened them confiderably, and caufed in all a copious depo- iition of reddifli brown fecula, which became purple coloured in twenty four hours. The de- coftion, it is obferved, gave the greatefl; quantity of fecula- An infufion of pale Peruvian bark, prepared in every refpedtthefameas the infufion of Swietenia bark, was treated with lime-W'ater in the fame manner, and formed a feparation, but in a much lefs degree.
Bark of Melia Azadirachta (Margofa tree) treat- ed exactly in the fame manner, formed a fepara- tion of a lighter-coloured fecula, in a much greater quantity than the common Peruvian bark, but much lefs than the Swietenia bark.
The clear reddifh-coloured liquor, weare told, that floats over the precipitate caufed by the addi- tion of lime water, is void of aftringency to the tafte, or has it only in a trifling degree ; but for a farther proof, it fcems, a chalybeate was employ- ed, which did not in the leafl; darken this liquor; but a greenifh tinge was produced, together with a further decompofition and precipitation of a reddifli fecula. This experiment, our author thinks, ferves to fhow that at lead the aflringept part of the bark is entirely thrown down by lime-water; and he confidered this as fo intereft-
K 3 ing
[ 134 ]
ing a point, that he repeated the lame experi- paent with this, as well as with other allringent barks, and found the refult exadlly the fame.
The fame chalybeate added to lime-water of the fame llrength as that employed in the above- mentioned experiments, produced a fmall, green cloud ; the Swietenia bark infufion thrown into this produced a muddinefs, and foon after, a copious precipitation of dirty-coloured fecula.
An infufion of this bark in lime water is deeper coloured than the plain infufion, but polTelTes very little bitternefs, and Hill lefs aftringency, A chalybeate added to this infufion rendered its red colour a little deeper only, and no decom- pofition took place : after Handing fome time, the infufion had no tafte of the lime-water.
From tfiefe experiments. Dr. Roxburgh con- fiders lime-water as a very irhproper addition ; and obferves that, in this refpeft, they agree with thofe made by Dr. Irving on the red and quil- led Peruvian barks.
Vitriolic acid rendered the firfl decodtion, or watery infufion, paler ; and, upon Handing, it became a little turbid, and let fall a fnrall quan- tity of a light-brown fediment,
Vinegar had the fame effedl.
Mild, or cauHic yegetable alkali, or mild
fofiil
[ 135 ] .
foffil alkali, foon deepened and rendered brighter the cold watery infufion or decoction, nor did any decompofition take place in forty-eight hours.
Mild magnefia, fimply added, rendered the colour of the infufion paler, without fenfibly altering the tafte.
Alum has been at times fuccefsfully em- ployed for the cure of intermitting fevers, and the analogy it bears to other tonics renders it -a likely remedy. Our author was therefo,*'e de- firous to try what would take place on adding it in a final I quantity to infufions and decodtions ' of this bark. The addition, it feems, rendered their colour paler, and a little decompofition took place, with a precipitation of a fmall quan- tity of a light-brown fecula : to the tafte it in- ■ creafed the aftringency without fenfibly dimi- nilhing the bitter; but with alum they did not change their colour when a folution of green vitriol was added.
Eight ounces of the coarfe powder were boiled in ten pints of fofc well-water to four pints ; the refiduum was repeatedly boiled in frefti parcels of water, exactly in the fame manner for eleven times, when the liquor
K 4 came
[ 136 ]
came off fllll much coloured, but taftelefs, and fliowed no figns of aftringency with the chaly- beate ; the tenth decodtion excepted, which did fliow figns of aftringency, as it was darkened a little by it;
The frefli decodtion of common Peruvian bark, made fimilarly, but in a ftnaller quan- tity, ftruck ftowly about as deep a colour with the fame chalybeate, as the fourth or fifth de- codion of Swietenia bark did quickly.
As the eleventh decodion was taftelefs, al- though coloured, it was thrown away ; the other ten had been regularly ftrained, while hot, and fuffered to ftand till perfedly cold, then poured off, clear from fediment ; they were mixed, and evaporated to a hard extrad, which weighed two ounces and three-quarters. The extrad, when foft, was of a dark red colour, fiavourlefs, fmooth, homogeneous, and unduous when rub- bed between the fingers and thumb. The tafte of the decodion was well preferved In this ex- trad ; the moft minute part of it, diffolved in wa- ter, ftruck a black colour with martial folution as quickly and as deep as the decodion itfelf, but the tafte was not fo ftrong as might be expeded from that of tite bark. This, our author thinks^^
might
C 137 ]
might perhaps be owing to the more fixed^ inert parts, extraded by the long and repeated boil^ ings (which lafted two days) being mixed in the raafs of extrad. But this, he obfcrvcs, , would not be the cafe, or but in a fmall degree, with one prepared from only one or two boil- ings. To determine this point, he boiled one ounce of the powdered bark in tw'o pints of water, pretty briikly, down to one pint; after the liquor was poured off, to the refiduum were . added two other pints of water, and boiled in the fame manner. The decodions were mixed, and evaporated to a dry extrad, which weigh- ed two drachms and a half, and was in tafte, &c. much as the former from ten codions ; the proportion of extrad from two boilings is there- fore, he obferves, nearly equal to that of ten : fo that, although the decodions were highly co- loured, and confiderably bitter and aftringent, even to the tenth, yet they could have contained but a fmall portion of the powerful qualities of the bark.
The refiduum, when perfedly dry, weighed four drachms and a half ; and fpirit of wine being poured on it, though affifted at times with the heat of the fun for many days, extraded
ireither
3
[ 'i3S ]
neither colour nor tafte, fo completely had -the virtues of the bark been extracted by the water.
Dr. Roxburgh obferves that the dry extra6t imbibes much moillure when the weather is damp; fo much as to make it (lain the fingers, or any thing that touches it : that it melts readily in the mouth ; is eafily folublc in water and in fpirits ; and, like the decoftion and tindlure, bears to be mixed without decompofition. Thefe folutions and mixtures, we are told, re- femble much the original decodtion and tinc- ture, and their mixtures, both in tafte and co- lour.
Should this ever become the valuable drug it promifes, it would be advifable, our author thinks, to have the extradt prepared on or near the fpot where the trees grow. Tf this is done during the hot feafon, the evaporation, he ob- ferves, might be effedted by the heat of the fun and hot winds, which would certainly produce a much more elegant, efficacious extradf than could poffibly be prepared in any other way or place, and would alfo preclude every idea or chance of its being Ibphifticated.
This bark, he finds, contains much muci- laginous matter, the cloth that the decodfions
were
[ 139 ]
were ftrained through, having become, when dry, ftiif as if ftarched. This, he thinks, may account for the decodions remaining fo many days turbid, which is, no doubt, he adds, favour- able for the adion of the ftomach upon the bark. The late Dr. Fothergill, he obferves, recom- mended an addition of tome mucilage to decoc- tions of common bark, in order to keep them
»
turbid, that the adive parts might be kept more completely fufpended in the liquor
In the way of diftillation, this bark, it fcems, yields nothing, not the fmalleft apparent quality, either with water or fpirits. In this refped. Dr. Roxburgh thinks, it refembles exadly both the pale and red Peruvian barks, viz. in having its powers or virtues of a very fixed nature.
Redified fpirit of wine extrads from the bark a clear, deep red tiadure, poirelTing the aftrin- gency of the watery infufion or decodion, and more of the bitter. If not too ftrong, it makes, we are told, one of the moH pleafant bitters we are in pofleffion of; and it bears to be diluted with water in any proportion, without decom-
♦ Med. Obf, and Inq. Vol. b p. 321. 2d Edit, 8vo. London, 1758.
pofition.
[ 14° J
portion, which renders it in many cafes the more defirable.
Four ounces of powdered bark were infufed, by our author, for eight days, in three pints of French brandy; thefe were poured off, and four pints more of the fame brandy added, which, af- ter {landing four days, were alfo poured off : both thefe infulions were mixed, and he drew off, by diftillation, a quantity of the fpirit, which (as be- fore obferved) did not in the lead partake of any of the qualities of the bark : the refl was gently evaporated to a dry extradl, which weighed nine drachms. The cxtra6l itfelf was of a much darker colour than that procured by water, and was dried with more difficulty ; but the tafle of the two extracts was much the fame. The refiduum was boiled in fix pints of water to two, and the decoftion was found to be flill pretty ftrong to the tafte, both in bitternefs and aflringency. This induced him to repeat the boiling, twice more, with frefh parcels of water ; and the laft decoclion, though weak, was flill bitter, and {bowed figns of aflringency, with a martial folution. Thefe four decodlions were mixed and evaporated to a dry extracl, weighing three ([{rachms, which added to the fpirituous ex-
tradl.
t
[ MI j
traft, made in all twelve drachms, from four ounces of powdered bark, and agreed nearly with the quantity procured by water alone.
The antifeptic powers of this bark, accord- ing to our author’s experiments, are not infe- rior to its bitter and aftringent qualities; for watery infufions in open phials kept perfeftly good for fixty days, without any tendency to fer- mentation, except a few' air bubbles, which they difeharged about the fecond day ; indeed they acquired ftrength, we are told, as the co- lour produced at the end of that time (fixty days), by the addition of a chalybeate, was darker, and as inftantaneous as at any prior period.
Sixty grains of the lean of raw mutton were preferved fweeter and firmer in an infufion of ten grains of this bark in four ounces of water, than an equal quantity of the fame mutton in a fimilar infufion of pale quilled Peruvian bark. The flefh was tinged red by the infufion of Swi- etenia bark, and its fibres were firm and diftindt at the end of twelve days ; while that preferved m the Peruvian infufion was white, and its fibres ' fofter, and infinitely more fetid.
Almofi all the foregoing experiments, it is
obferved.
C 142 ]
obferved,' were made firft with bark of the fmaller branches, and a^ain with bark of the trunk of a large tree j the latter was evidently ftrongeft.
The feeds of this tree are defcrlbed as a flrong, fimple, pleafant bitter, without any of the af- tringent power. The leaves poffefs nearly if not all the ahringency of the bark, and a very large proportion of its bitter ; but their tafte is faid to be not fo agreeable either in fubflance or in infufion.
From the foregoing analyfis. Dr. Roxburgh ventures to draw the following conclufions :
Firft. That the adtive parts of the bark of this fpecies of Swietenia are much more foluble than thofe of Peruvian bark, particularly in watery menftruums.
Secondly. That it contains a much larger proportion of adlive (bitter an'd aftringent) powers, than Peruvian bark.
Thirdly. That the watery preparations of this bark remain good much longer than fimilar preparations of Peruvian bark.
Fourthly. That the fpiiituous and watery pre- parations bear being mixed in any proportion, without decompofition.
Fifthly. That the bark in powder, and its
preparations,
[ 143 ]
prcparationsj are much more antifeptic than Peruvian bark, or fimilar preparations of it.
Now, fince this bark yields fo much of its virtues to cold water, as to prefer ve flefli from corruption, in a hot climate, with the thermo- meter from 87“ to 102°, it is reafonable, he contends, to fuppofe it will yield ftill more of its tonic and antifeptic virtues in the ftomach, where it meets with the moll powerful folvents : we have therefore, he thinks, much to expedt from it in the cure of gangrene and other pu- trid difeafes.
Bitters and aftringenls, in a feparate ftate, our author obferves, are confidered as tonic reme- dies; but when found combined in the fame fubftance, they become ftill more powerful : it is from thefe qualities, he contends, that the 'belt judges allow the Peruvian bark to derive its virtues. On this point he quotes the autho- rity of Dr. Cullen, who has remarked, “ that the “ recurrence of the paroxyfms, in intermitting “ and remitting fevers, depends on the recur- rence of atony in the extremities of the arterial “ fyftem; hence they are prevented by fuch tonic medicines as obviate this atony ; a “ great variety of aftringents and fimple bitters “ have been found to anfwer that end, but ‘‘ none, hitherto difeovered, fo effecfually as the
Peruvian
[ H4 3
Peruvian bark, on account, It is tbouglit, of “ its poffeffing thofc powers conjoined
The antifeptic qualities of Peruvian bark, our author obferves, are alfo great; hence itsufe in the cure of all febrile putrefcent diforders, at- tended vvith debility, putrid ulcers, &c.
From the evident qualities of this new bark, and from the fuccefsful experience he has had with it, in intermittent fevers-f- , &c. Dr. Rox- burgh
* Treatife on the Materia Medica.
* Hiftories of feveral of thefe cafes have been communi- cated by Dr. Roxburgh to the College of Phyficians at Edin- burgh j and an account of them is given by. Dr. Duncan In the differtation referred to in a former note, together with the re- fults of feveral trials made with this bark, by his father, in the Clinical Ward of the Royal Infirmary at Edinburgh. Wc lhall take the liberty of tranfcribing this part of his work :
“ Morbus, quo Roxburgius hunc corticem fsepiflime adhu bendum curavit, febris quotidiana apud Cullehum nun- ** cupatur. Rarius ex toto, fed ex partCy etad breve tantum- ** modo tempus, remittent, periculofiflimus erat. .ffigroti fere “ omnes hoc morbo correpti fuerant, dura inc'olebant iftos montes ingentes, qtii Indiaspeninfulam tranfeurrunt. Inter ** hos montes fylv® opaca:, denfa ferarum tefta, convalles pa-* ludofas, hominum generi peftiferas, ubique obombrant. Se- deseft indigenis efiam, confuetudine licet obfirmatis, infa- ** lubris, advenis autem adeo pernieiofa ut pauci, perpauci “ quldem, quos dira neceflltas inter hos montes hiemare coege- jit, morbo hoc atrociffimo immunee fait. Tali febre, tali
“ tempeftate
r 145 3
burgh has every reafon to imagine it will prove equalj if not fuperior, to the Peruvian bark, for every purpofe for which that medicine is ufed.
Our
" tenipeftate laborantium ne dimidiam quidem partem coni- valefcere Roxburgius affimat.
"Cal. Junii, A. D. 1791. Indus annos natus viginti,
" habitus tenuis, nonnullis ante menfibus, dum prope montes occupabatur, febre quotidiana afieftus erat. Corticem " Cinchonas officinalis aliquantifper fine fruftu afTumpferat ; idcirco Roxburgius, et quia ipfe parvas corticis Seymidx quantitates impune adhibuerat, asgro nihil a periculo ab- “ horrent! grana viginti pulveris ex aquje cyatho fum- nda " prasfcriplit. Duabus exinde horis, ferupuli duo adhibiti " funt ; et, poft fimile temporis intervallum, drachma. Cor- tex aegro nequaquam ingratus erat, alvumque folvit. ^Eger,
" cortice poftea ad drachmam, unaquaque intermiflione, af- " fumpto, triduo febre immunis erat.
" Pridie Iduum Augufti, A. D. 1791, J — V — Lufi* tanus*, annum agens quadragefinum quintum, ejufque duae ' filia:, altera fex, altera tres annos nata, manferant aliquan- “ diu, inter menfem proximo prjeteritum, intra montium ter-»
" minos ; initioque menfis labentis, febre quotidiana, qua nihil ferme quicquam remifit, affefli funt. Febre remit- " tente, femper altera quaqile hora fumebant aqux ex cortica " Soymidae* pater fefcunciam, filia major natu unciam, et ** minor femunciam. Duos poft dies, a morbo valebant.
■* “ R. pulv. coit. Swiet. Soymidec unciam unam,
“ aquae fontanae libras duis. '
‘‘Mifceantur,tft phiala prius agitatl, modo prseferipto fumantur.”
VoL. VI,
'* Vide p. 148,
L
" Morbus,
L 146 j
Our author next enumerates different fpecics of Cinchona, viz.
Firft.
“ Morbus, quo hi quatuor aegroti laborabant, partim ob anni tempus, quo febre correpti funt, atque partim ob " tempeftat;is ficcitatem, Iblito levior erat ; atque Roxbur- gius, propter agrorum debilitatem, neque evacuantia ad- “ hibebat, nec intermifliones expedlabat.
“ XV. Cal. Sept. A. D. 1-91, B— Lufitana, habitus ** infirmi, nonnullos dies, febre gravi, nunquam ex toto re- “ mittente, laboraverat. Antimonium tartarifatum ex multi “ aqua, partitis vicibus, ufque ad vomitionem, adhibuit. ‘C Poftero die drachma corticis Soymida, in remiflione mi- nime adhuc notablli, ter affumptaeft. Intermilfio proxima “ plenior evafit, atque, ex corticis ufu, biduo poftea morbus “ ipfe, fimulque diarrhoea qua laboraverat a?gra, ceflarunt.
“ Menfe Septembris, A. D. 1791, J. E — decurio Euro- pteus, annos natus quadraginta, febre remittente graviter “ affeftus eft, Receflus principio fere nulli, ex ufu praepara- “ torum ex antimonjo notabiliores evaferunt ; et xger, quan- “ quam omnl generl intemperantix deditus, cortice ter fin- gulis intermiflionibus adhibito, paucis diebus convaluit.
“ VII. Cal. Sept. A, D. i79i» T. L — annos natus “ oftodecim, quofdam dies febre biliofa laboraverat ; cujus “ receffus, etiam poft antimonii tartarifati ufum, parum notabiles erant. Debilitate autem urgente, ferupuli duo “ corticis Soymidte, omni rcceffu, ter adhibebantur, et, ad " alvum folvendam, lixiva tartarifata.
“ A cortice autem nihil proficiente, in. Cal. decelTum eft i atque medicamentis idoneis aflumptis, febris prorfus
“ fere.
[ 147 ]
Firft. Cinchona Officinalis fanicula hrachiata ; to this fpecies, he obferves, belong the pale,
quilled,
** fere, ftatis temporibus, intermifit. Soymida nunc iterunj adhibita, quatuordecim diebus, morbum penitus fugavit.
“ Menfc Septembris, A. D. 1791. S — nutrix ladlans, “ annos nata triginta quinque, febre quotidian! correpta eft. Alvo, inter primam intermiffionem, foda vitriolata foluta, morbus triduo cortice Soymida depulfus eft; fed " lac interim flucre ceflaverat.
“ Menfe Septembris, A. D. i79t. Indus, fervus domef- *'ticus+, febre lingulariter intermittente agrotavit. Sub occafum folis, acceflit febris gravis, qua bora nona vef- pertina intermifit. Oriente autem foie, iterum acceffif, “ atque, horam circiter nonairi ante meridiem, denuo inter- “ mittens, agrura viribus integrum reliquit. Exinde cor- tice Soymida ter, fingulis intermiflionibus matutinis, ad ** fcrupulos duos adhibito, triduo morbus omnino evanuit.
“ J — R — Europaus annum agens trigefimum, vitio pul- " monis multum debilitatus, ineunte Odobri febre quotidi- ** ana, cui erant accefliones vefpertina, affeftus eft. Tertia “ intermiffione, duo corticis ferupuli bis adhibiti alvum magnopere folverunt. Soyibida nihilominus continuata, “ ager quatuor diebus a febre valebat.
“ Pridie Iduum Decemb. R — miles Indicus, annos natus " triginta, febre quotidian! tredecim dies, medicamentls vernaculis nihil proficientibus, laboraverat. Intermiffione proxima duo corticis Soymida ferupuli ex aqua ter adhi- “ biti alvum bis cierunt, morburaque levarunt. Cortex “ repetitus agro fanitatem reftituit.
“ Pridie Iduum, Dec. A. D. 1791, L— miles Indicus,
+ Vide p. 148.
L 2
annos
[ hS ]
quilled, and red barks, which the beft judges imagine are from the fame tree ; the thick-
red
*' annos natus viginti tres, antecedente die, febre quotidiana *' afFecius eft, Cortice ter fingulis interraiilionibus adhibuo, ** alvus foluta eft, morbufque mox remifit.
*’ Pridie Iduum Dec. S. N — miles Indicus, annoi natus quadraginta, iv. Non. Decemb. febre correptus erat. Nullis haftenus medicamentls ufus, magis nunc magifque d^bilis evaferat. Cortex in remiftion* ter adhibitus ventrem “ folvit) triduoque morbum depulfit.
“ Pridie Iduum Dec, A. D. 1791. N — miles Indicus, annum agens vigefimum quintum, pridie febre quotidiana “ affefius erat. Cortex Soymida:, ter in unaquaque inter- “ miflione adhibitus, alvum movit, atque morbum brevi fu- “ peravit.
“ VIII. Cal. Martli, A. D. 1792. J. V — per biduum “ febre iterum* laboraverat, Morbo autem duo acceffus totidemque remifliones quotidie erant, ejus inftar paulo “ fupra deferiptae +, Cortex Soymidic, in matutinis inter- “ mifiionibus, altera quaque bora adhibitus, triduo febreni curavit.
“ Circiter medium Februarii, R — infeftor tels xylinaj, “ annos natus viginti quinque, laborans tumore hypogaftrii sequali, dolente, quemcomitata eftfebrisomni mane rece- “ dens, atque alvus aftridla, ad Roxburgium adduftus eft ;
cui dixit, fe duodeciin ante dies affeftum effe dolore circa “ umbilicum torquente, qui uno alterove die gravis evafit, “ atque profundus, et, quafi inter vefic® urinarise fundum atque inteftinum Yeflum, fedem cepit; abdomen mox tu- “ muiffe, ipfumque toto corpore febricitafle ; caufam autem
* Vide p. 145. f Vide p. 147.
“ ignoraffe
r 149 ]
red fort being from the trunk, while the pale- quilled fort is from the branches, and from
young
ignnrAflc malorum ; multa denique reraedla vernacula “ incafsum adhibuiffe.
Ei praecepit mcdicus, ut afllimeret parvas lix'ivise tar- “ tarifatae quanrifates, donee fuperveniret catharfis, pro potu communi hiberet aquam ex tamarindis coftam cum faccharo, et ut interea diasta ex oryza fainem tolleret.
Alvo his exonerata, meliufcule fe habere fenlit Jeger ; “ tumori autem nequaquam decrefeenti, velicatorium ad- “ mofum eft, alvufque lixivA tartarifatA et aqua ex tama.- “ rindis cum faccharo commifta foluta eft,
“ Per noftem febris invaluit. Die autem, a curatione “ incepta, tertio alvus vehementer fluxit. Dejefliones “ purulentae admodum erant, peffime olentes, colore per- virldes. Tumor ftatim fubfedit.
,dEgcr maxime debilitatus, per noftem, graviter fe- “ bricitabat. Mane igitur, cum prlmftm febris fe remiftf- “ fet, ei pulvis ex Soymida cortice et lixivA tartarifatA com- “ pofitus adhibitus eft, et, die progrediente, ter repetitus. “ His fadis, alvus purulenta quaedam quater dejecit. Hac “ curatione triduo port a febre valebat, et, cortice nuac “ femel tantum in die adhibito, decern diebus domiim re- “ diit fan us.
“ Roxburgius unam tantam occafionem corticis Soymida; “ contra gangraenam adhibendi nadus eft. Viro diflbluto, “ per idem tempos lue Venerea laboranti, fuper mediam tibiam ulcus erat. Cum Soymidx pulvis eius ftoma'cho “ nigratus clTet, extrado ufus eft, atque, expedatione ci- tius, morbo immunis evafit. Perhibet praetcrea Roxbur-
L 3 “
[ '5° 3
young trees. The Spaniards themfelvesj he adds, employ the red fort.
Second.
“ gius, Duffinum chirurgiim valetudlnarii MadrafienGs pri- marium hunc corticem contra iftiufmodi mala maximo “ cum frudlu adhibuiffe.
“ His memoratis, Roxburgius ingenue fatetur inGgnem tempeftatis Gccitatem, hujus nova Swietenise corticis “ ufum feliciorem forfitan reddidifle. Notat praeterea, cor- “ tlcem primo die alvum plerumque moviffc, poftea autem “ nunquam, neque profettg, praster morbi curationem, ** ullos ex ejus ufu efFedlus obfcrvafle. Cur, ante corticis ufum, non faspids, ut mos plerilque eft, vomitum et al- vum moviflet, banc rationem reddit, nempd ex regionis natura, ex vidtu, ex vita, atque ex rcligione, corpora Indis efle gracilia, nec plena, nec inflammationibus ob- ** noxia ; atque remediis, quae ante corticem adhiberi for “ lent, febres, ut ille putat, in longum faepe trahi, et iis, ** aeque ac morbo fere ipfo, aegrotos inftrmari.
“ Ha;c uberius dixi atque fuftus c6 quod ex his potiffi- mum, quantum polleat hie cortex, apparet. His adduc- tus pater meus, cum aegrotos nofocoraio Edinburgenli curabat, atque difeentibus de iis przlegebat, nova hujus corticis tentamina facere voluit. Hac autem regione, “ cum febris intermittens perrara Gt, nobis nulla, quid pro- ficiat cortex nofter, experiendi idonea fatis occaGo oblata eft. Nonnuliis autem aegrotis adhibita eft.
“ XIII. Cal. Jan. A. D. 1793. Joannes M’Kay, annum agens vigeGmura tertium, priufquam in nofocomio recep- “ tus erat, duodecim dies febre, cujus accefliones alterb “ quoque die redibant, laboraverat. Sed, cum, ab initio
“ horror
[ >51 J
Second. Cinchona Caribaa; the Caribcean
or
“ horror et calor per idem tempns dciraviiTent, fudor pror- “ sus defecilFet, atquc mala pedtoris, coma, et torpor fc- “ brem comitata eflent, haec affedlio mlni'me idonea, in quam “ Hovum medicamen tentaretur, videbatur. Cortex igitur “ Cinchonar rubrs, per duodecim dies adhibitus eft ; cum “ autem acceffus poft intervalla, licet valde diffimilia, ad- “ hue redirent, aegro, ut Soymida:! drachmam altera qiia- “ que hora fumeret, prajfcriptum eft. Alvuiii torminibus “ magnopere movit, acceffus autem proximus poftremus “ erat. Convaluit.
“ Jacobus Grant, annos natus viginti quinque, qui ali- “ quandiu in nofocomio propter teftis tumorem manferat, VIII Iduftm Junii, A. D. 1793, herbS humida vefperi “ recumbens, frigore, gravi dyfpnoea atque anguftix in **• faucibus fenfu, affedus eft. Hare facile astheri vitriolico cefferunt, cortexque Cinchona, quo vires proftratas re- “ ficeret, adhibitus eft. v. Iduum iterum frigore, dyfpnoeA, “ atque vomitione fanguinolenta, correptus eft. Quinto “ poftea vefpere horrores, intermittentis inftar, accefferunt. “ Ufum corticis Cinchona?, quippe qui acceflionibus nihil “ obftaret, intermilit medieus, pulveremque corticis Soy- “ midse, duplici autem quantitate, in ejus locum adhibuit. “ Hoc fadlo morbus nunquam poftea rediit.
“ Duabus adolefcentulis, alter! a fingulaii pffedfione hyf- “ teried, convalefcentibus cortex Svvieteni* Soymida, ut “ corpora firmaret, ft non cum militate faltem fine incom- “ modo, adhibitus eft.
“ Vi infuper aftridoria pollere, fatis cbnftat h muliere annorum quadraginta fex, quse leucorrhcea laborabat.
^ 4 Duobus
[ ]
or Jamaica bark 'of Dr. Wright *. This lad, our author obfervcs, poffeffes in a higher degree the bitter, but is very weak in the aftringent power, and ought not to be depended on when the other is procurable.
Third. Cinchona San6i^ Lttcia, Jlortbus pa- niculatiSj glabris, laciniis linearibus tubo Ion- gioribuSy Jlaminibus exertis, foliis ellipticis gla- bris ; Saint Lucia, or new bark. This is ano- ther fort, Vv^hich Iras been introduced into prac- tice : but its being poflefled of flrong emetic and purgative qualities, renders it, in our au- thor’s opinion, lefs eligible, particularly after the paflages have been cleared. Thefe proper- ties, he obferves, the Jamaica bark does not pofl'efs ; which eftablifhes a ftriking difference. Fourth. Cinchona Corymbiferay foliis oblon-
Duobus fenibus ventris fluxu afFefbs nihil profecit> Hi “ autem, omnia, qu2e alvum aftringunt, experti, morbo “ non levato, e nofocomio egrelii funt.
Cortex Soymidte, ut multum, necne, contra putredb “ nem poffet, appareret, quinque sgrotis typho putrido laborantibus adhibitus eft. Omnes convaluere. His ventrcm adeo non movit, ut, per totiim morbum, alvum “ aliis niedicamentis ducere opus eflet.” Vide Duncan 1’entatn, de Swiete?iia Soymida, p. 41. et fcq.-r— Editor.
* See Philol. Tranfaft. Vol. LXVII. page 504; Dondon M>;dical Journal, Vo!, VIII. page J39.
Ph
J
. [ 153 ]
gls, lanceolatis, corymbis axillaribus ; of Dr. Forfter; is a native of the South-Sea Iflands : but of its virtues we know nothing more, than that he lays, “ it is like Peruvian bark, bitter and aftringent.”
Fifth. Cinchona Orixenjis^ foliis oppofitiSy to- mentnfts, ftiptilis interfoliaceis^ femilanceolath, jlo- ribus terminalibus, paniculatlsy lomentofis, capjula valvis contrariis a vertice dehifcens', of Dr. Rox- burgh. The ftrufture of the capfule, he ob- ferves, forms the chief difference between this and Cinchona Officinalis, for the feeds are exadlly as delineated by Gaertner, and the reft of the. definition correfponds with that given by Lin- naeus, It is a native of that chain of mountains which feparates- the northern provinces, or cir- cars, from the Mahrattah dominions immedi- ately behind them. The bark of this fpecies likewife is bitter and aftringent.
Dr. Roxburgh has alfo found another new fpe- cies of Swietenia, a middle-fized tree, the wood of which is very heavy, clofe-graincd, and yellow ; the bark likewife is yellow, and very bitter, but pofleffes much lefs aftringency than that of the S. febrifuga, and its aftringengy, he obferves, is of a peculiar kind, for the colour produced, on an in- fufion, with a martial folution, was a dark brown.
There
C >54 ]
There is alfo the bark of another large tree, which, at the time of writing this account, he tells us, he had under examination, and which is likevvife very bitter : the H.ndoos call it Wallurje. It will, he imagines, form a new genus in the clafs Decandria, and order Monogynia, Its elTential charaders are calyx quinquejidus , petala qninque, nedlaritm duplex^ exterius cylindricum ore decemfido, antheras gerens, interius annularium, hafin germinh cingens, bacca monofperma.
The bark of this tree, we are told, is in high repute as a medicine amongft the Hindoo phy- licians ; and gives name to a compound foft ex- trad, called IValluvodufay, which they em- ploy in a variety of difeafes.
It alfo poflefles powers of a very different nature ; for, powdered and thrown into pools w'here there are fifh, it foon intoxicates them to that degree, that they are eafily taken with the hand.
Dr. Roxburgh obferves that the bark of Melia Azadirachta, already taken notice of'^, has frequently and fuccefsfully been employed as a fubftitute for Peruvian bark, in the cure
* i’age 133*
2 of
C 155 ]
of remittents and intermittents ; and that an infufion or decodlion of its leaves is alfo a good anthelmintic, and as fuch employed by the Hin- doos.
The bark of another large tree, which our author calls Nauclea Daduga^ poffeffes alfo, he tells us, in a confiderable degree, both the bit- ternefs and aftringency of Peruvian bark ; and he thinks it is next in power to that of the Swie- tenia febrifuga. Although this tree differs widely in its flower from the hitherto known fpecies of Cinchona, yet in its parts of fructifica- tion it agrees with them, itfeems, almoft exaClly,
X. An
[ 156 ]
X. An Account of the Effects of Mahogany Wood in Cafes of Diarrhoea. By Mr. “Francis Hughes, Surgeon of the General Infirmary at Stafford. Communicated in a Letter to Mr. John Pearfon, Surgeon of the Lock Hofpual, and hy him to Dr. Simmons.
J
An accidental circumftance firft fuggefted to me the idea that mahogany wood might prove ferviceable as a medicine ; for I did not then know that any part of the tree had been employed for medicinal purpofes. I was accordingly induced to make ufe of it in cafes of diarrhoea, both in decoftion and in the form of an extradl ; and after repeated trials, I can' venture to aflert that I have not' been difap- pointed in the expectations I had formed of its efficacy.
For the decoction I boil an ounce of the fliavings of Jamaica mahogany wood in two pints of water, till one pint of the liquor is wafted, and then ftrain off the remainder for ufe.
The extract I make life of has been prepared
by
C 157 3
♦ by boiling the (havings of the fame wood irt repeated alfufions of frefh water, in the fame proportion and manner as are directed for the cxtraft of logwood (extra^ium ha;matoxylt) of the London Pharmacojjoeia. The quantity of extraft obtained in this way amounts to fome- thing more than i of the (havings employed. The Honduras mahogany wood is of a paler colour, and lefs aftringent than the Jamaica, and does not yield quite part of extradt.
Both the decodion and exCrad are very bit- ter and aftringent, leaving a rough nefs in the mouth for fome time after they have been tafted.
The extrad, in its appearance, refembles gum kino. It dilTolves completely in water, and in fpirit of wine, and ftrikes a black colour with fait of (led.
The following are fome of the Cafes in which I have employed thefe remedies.
CASE I.
1793? 3, foldier belonging to a re- giment on the Irifh eftablifliment, who is a na- tive of Stafford, was fent hither from his re-
giment
[ 158 ]
giment for the recovery of his health. He had for fome time been unfit for duty, and was much reduced by a diarrhoea, which having come on after a fever, had continued feveral months, and relifted a variety of medicines.
I gave him an ounce of the decodion three times a day, and as it fat eafy on his ftomach, and feemed to have a good effed, the dofe, after the third day, was increafed to an ounce and a half. He perfevered in the ufe of it during fix!- teen days ; the diarrhoea gradually fublided ; his appetite and ftrength returned ; and at the end of that time he v^as'fufficiently recovered to go back to his regiment in Ireland.
CASE II.
A woman of a thin, delicate habit, applied to me in Odober, 1 793, on account of a violent diarrhoea, for which fhe had taken different me- dicines without any good effed. It had come on, file faid, after fitting up a whole night in wet clothes, and had continued more than a fortnight; Ihe was free from fever.
I direded her to take pills compofed of fix , grains
[ 159 J
grains of the extrad, three times a day. With- in the fpace of a week the diarrhoea was much abated, and fhe had acquired ftrength ; file pet- fevered, however, in the ufe of the medicine for the fpace of three weeks, at the end of which time the complaint had entirely ceafed. A fluor albus, with which Ihe had been troubled many months, was likevvife much abated ; but per- haps this latter circumttance ought rather to be afcribed to the improved ftate of her general health, than to any fpecific effect of the medi- cine. '
CASE III.
In January, 1794, I was applied to by a man fifty years old, who for feveral years had been a hard drinker, and was now extremely emaciated ; his legs were oedematQUs; he had no appetite; was fubjedl to frequent vomiting, and had a flight diarrhoea.
1 gave him aromatic. bitters for feveral days, but finding no amendment, I determined to have recourfe to the mahogany. I gave him eight grains of the extraft, made into pills-, three times a day. At the end of five days his
difpofition
[ i6o ]
difpofitlon to vomit had ceafed, and he had a little appetite. He continued the ufe of the medicine for ten days longer, and was then fo much relieved as to be able to walk and ride out every day. Xhis ftate of amendment continued for a fortnight, when he relapfed into his old habit of drinking, and his former fymptoms returned. RecouiTe was again had to the fame medicine, but without effect.
To the above I could add many other in- ftances of the good effedts of the extradt and decodlion in cafes of long continued diarrhoea, where the complaint feemed to depend on a morbid irritability of the ftomach and inteftines, and where the ufe of tonic and aftringent me- dicines appeared to be indicated* The few hif- tories I have related will, I truft, be fufficient to point out the modes of adminiftering the re- medies in queftion, and the effeds that may be ' expeded from them; and perhaps will induce medical praditioners to extend a trial of their efficacy to other difeafes.
The dofes in which I have hitherto given thefe remedies have been fmall ; but much larger dofes may be given with fafety, and in many 'cafes will, I am perfuaded, be more efficacious.
To
[ 3
To try the effed; of a confiderable dofe on the ftomach, I took two ounces of a decodlion, prepared by boiling two ounces of the lhavings in two pints of water-to a pint, which is twice the ftrength of the dccodtlon deferibed in Cafe 1. and which I have ufually adminiftered. ’At firft I perceived no effedl from it ; but at the end of ten minutes a difagreeable naufea came on, with a flight pain at the ftomach, and a glowing fenfation fimilar to that produced by the taking a glafs of ftrong wine. ■ Thefe effedls gradually w'ent off in about half an hour, and I felt no other inconvenience from the dofej
Stafford, Feb. 12, 179-f.
/
N
VoL. VI.
M
XL Account
C 162 ]
XI. Account of fome Difcoverles made by Mr. Galvani, of Bologna ; with Experiments and Obfervations on them. In two Letters * from Mr. Alexander Volta, S. Profejfor of Na- tural Ehilofophy in the Univerfity of Pavia, to Mr. Tiberius Cavallo, F. R, S. — From the Phi- lofophical TranJaPtions of the Royal Society of London, for the Tear 1793. Part I. 4ta- London, 1793.
fubject of the difcoveries and re- A fearclies, concerning which I am about to write to you. Sir, is animal electricity ; a fubjedt which cannot but be extremely intereft- ing to you. I know not if you have yet feen the work of a Profeffor of Bologna, Mr. Gal- vani, which appeared about a year fince, wkh this title ; Aloysii Galvani de Viribus FJec- tricitatis In Motu Mufculari Commentarius. Bo- nonite, 179I1 in 58 pages, 410, with four large plates ; or at leaft if you have had any
* In the Philofophical Tranfaftions thefe two letters are given in French; for the prefent tranflation of them we are indebted to the kindnefs of a friend. — Editor. *
account
[ 1^3 ]
account of it*. It contains one of the mofl; beautiful and furprifing difcoveries, and the germe of feveral others. Extradls from this work have appeared in different Italian Jour- nals, and, among others, in that entitled Gio- mle Fijtco-medico, publifhed by Dr. Brugna- telli, of Pavia, to whom I myfelf have fent two long papers, which will be followed by feveral others, as I have confiderably extended my ex- periments and inquiries on this fubjedl. The letters I now addrefs to you are intended as a fketch both of the admirable difcovery of Mr. Galvani, and of the progrefs which I have been fortunate enough to make in this new path ; and I requeft 3^ou, Sir, to prefent them to Sir Jofeph Banks, Bart, the worthy Prefident of the Royal Society, to be communicated, if he thinks proper, to that learned body, as a feeble reftimony of my gratitude for the honour they have done me in electing me one of their num- ber, and of my zeal and eagernefs to comply with their invitation to communicate to them, ' from time to time, the fruit of my refearches.
(i.) Mr. Galvani having differed and pre- pared a frog, in fuch a manner that the legs re- mained attached to a part of the back bone,
* See Vol. III. p. I So.— Editor.
M 2 feparated
y
i
[ *<54 ]
feparated from the reft of the body, folely by the crural nerves, which were laid bare, ob- ferved that very lively motions w'cre excited in. thefe kgs, with fpafmodic contradions in all the mufcles, every time that (this part of the animal being placed at a confiderable diftance from the condudor of an eledrical machine, and under certain circumftances, which I lhall explain hereafter) a fpark was drawn from this condudor, not on the body of the animal, but on any other body, or in any other diredion. The requifitc circumftances, therefore, were, that the animal thus difleded fliould be in con- tad: with, or very near fome metal or other good condudor, of fufficient extent, or, what was ftill better, between two fimilar conduc- tors, one of which ftiould be turned towards the extremities of the legs of''the animal, or fome one of its mufcles ; the other towards the fpine, or its nerves : it was likewife very ad- vantageous that one of thefe condudors, which the author diftinguilhes by the names of con- du^or of ihe nerves, and condudor of the 'mufcles, and preferably the latter, ftiould have a free communication with the floor. It was in this fituation efpecially, that the legs of the frog, prepared as above deferibed, received violent
(hocks.
[ ]
ihocks, fprang up and contraftcd with vivacity at each fpark drawn from the condudor of the ma- chine, although it was at a confiderable diftance, and although the difcharge was made neither on the condudor of the nerves, nor on that of the mufcles, but on any other body, equally re- mote from them, and having any other com- munication through which the difcharge might be tranfmitted, for inftance, on a perfon placed in the oppofite corner of the room.
(2.) This phenomenon furprized Mr. Gal-r vani, perhaps more than it ought to have done; for the power, not only of eledric fparks when they immediately ftrike the mufcles or nerves of an animal, but of a current of this fluid traverflng them, in any manner whatever, with fufficient rapidity, its great power, I fay, of exciting commotions, was a thing fuffici- ently known ; befides, it was obvious how, in this experiment, and in all thofe of the falne kind, related in the firfl; and fecond parts of his work, and which are reprefented in the two flrft plates of figures, his frog became liable to be affeded by fuch a current. We have only to conflder that w^ll-known property of eledrical atmofpheres, or what is called comprejjive eleSlri- fity, by which the fluid of conduding bodies,
M 3 place4
[ i66 ]
placed within the fphere of adion of an eledri- fied body, is comprelfed and difplaced, in pro- portion to the force and extent of this fphere, and kept in this ftate of difplacement fo long as the eledricity fubfifts in the predominant body ; and when this is removed, returns to its place gra- dually, if the eledricity of that body is flovvly diffipated, or in an inftant if it be deftroyed in- ftantaneoufly, by difcharging fuddenly the body that contained it. It is this returning current, therefore, this reflux of eledrical fluid in the conduding bodies contiguous to the frog, or near it, its fudden paflage from the condudor of the mufcles to the condudor of the nerves, or vice verfa, through its body, cfpecially when fuch a current is comprefled in the Angle and narrow channel of the nerves, which excites the fpafms and movements in the- experiments in queflion. Mr. Galvani, who feems not to have fuificiently refleded on this property of eledrical atmofpheres, and who was not aware of the pro- digious fenfibility of his frog, Angularly pre- pared in the manner above deferibed ([ muft here obferve that I have found this fenAbility nearly equal in all the other fmall animals, fuch as lizards, falamanders, and mice) was ex- tremely flruck with fuch an efted, which will
probably
[ i67 ]
probably not appear fo marvellous to other phi- lofophers. This, however, was the firft ftep which led him to the grand and beautiful dif- .covery of an animal eledricity, properly fo cab led, and which belongs not only to frogs and other animals of cold blood, but likewife to every animal of warm blood, quadrupeds, birds, &c. ; a difcovery which forms the fubjed of the third part of his book, a fubjed alto- gether new, and very interefting. It is thus he has opened to us an immenfe field, into which I propofe to enter, and purfue my re- fearches, after I flrall have dwelt a little more on thofe preliminary experiments which relate to the adion of artificial or extraneous eledricity on the nervous and mufcular fibres.
(3.) It was chance that prefented to Mr. Galvanl the phenomenon I have been defcri- bing, and which aftoniflied him (I repeat it) more than it ought to have done. Still who would have believed that a ftream of eledricity, fo feeble as not to be rendered fenfible by the molt delicate eledrometer, fliould be capable of affeding fo powerfully the organs of an ani- mal, and of exciting in its limbs, cut off one or more hours before, movements, nowife ini- ferior in ftrength to thofe produced in the living
animal;,
t' ,68 ]■
animal, fuch as vigoroully darling out its legs,, fpringing up, &c. to fay nothing of the moft violent tonic convulfions ? And yet fuch is the ftream that affefts the little animal, placed, for inftance, on a table, near fome metal, or be- tween two good conduftors, not infulated, when a perfon draws from the prime conductor, fuf- pended. feveral feet above, a moderate fpaiTe, and conveys the difeharge through quite another channel.
(4.) I fay moderate ; for if it be very ftrong, and the conduftor, large and highly charged, be not at a very confiderable diftance from the bor dies on the table, little fparks will be perceptible in the interftices of tbefe bodies, efpecially the metallic ones, and even in the place where the frog forms a ring of communication between them, which fparks are evidently produced by the returning flream of elecfricity, of which I have already fpoken, (fed. 2.) Qr if matters do not come to this point, inftead of fparks w^e may perceive movements, fufficiently obvious, ipf eledrometers placed on the fame table and in the fame places. In this cafe, therefore, where the eledrometer affords the fign, and much more in the other, where the above-men- tioned fparks are obtained, ♦we may obferve,
that
[ i(S9 ]
tliat even a frog, entire and untouched, or any other fmall animal, -as a lizard, a moufe, or a fparrow, is feized witkftrong convulfions in all its limbs, efpecially in its legs, which dart for- w'ards with vivacity, if the palTage of the elec- tric fluid (the returning flream) follows the di- r.edlion of thefe fame legs from one end to the , ofher. So far there is nothing wonderful ; the circumftance that may excite furprife is in the cafe where the flream of eleftricity, though no longer fenflble, not even to the moft delicate eledlrometer, continues to excite the fame com vulfions, the fame movements, if not in the en- tire frog, at leaft in its limbs, when difledlqd and prepared in the manner pradtifed by Mr. Gal- van i.
(5.) I have endeavoured, with much atten- tion, to determine what might be the leaft elec- trical power requifite to produce thefe effedls, as well in the entire and living frog, as in one diflfedted and prepared in the manner above de- feribed, which is what Mr. Galvani has omitted to do. I have preferred the frog to every other animal, becaufe'it is endowed with a very dura- ble vitality, and it is very eafy to prepare it. - I have, however, made experiments on other fmall animals with the fame view, and with a fpccefs nearly fimilar. In order to, eftimate well
the
I
[ lyo ]
the ftrength of the ftream of eledlriclty, I have thought it right to fubmit the animal intended for experiments of this kind, not to the return- ing ftreams occafioned by eledtrical atmofpheres (Se6l. 2.), but to direft eledfrical difcharges, , fometimes from a fimple condudlor, fometimes from a Leyden phial, and in fuch a manner that the whole ftream muft have pafled through the body of the animal. For this purpofe I was careful to keep it infulated in one way or other, and moft frequently by fixing it, with pins, to two fiat pieces of foft wood, fupported by glafs columns.
(6.) I have found then, that for the living and entire frog the electricity of a fimple con- ductor, of a middling fize, is fufficient, when \t comes only to be able to give a very weak fpark, and to, raife Henley’s electrometer from five to fix degrees ; that if I make ufe of a Ley- den phial, likewife of a middling fize, a much weaker charge of this produces the effeCt, fuch a one, for example, as yielding not the leaft fpark, and being nowife fenfible to the qua- drant-eleCtrometer, is fcarcely fufticiently fo to Cavallo’s eleCtrometer to feparate its little pen- dula. about i -tenth of an inch.
(7.) This, as I have juft nov/ thov.'n, fora
frog
2
C 171 ]
frog entire and untouched ; for when It is dif-^ fetted and prepared in different ways^ and par- ticularly after Galvani’s manner, in which the legs are connected with the dorfal fpine merely by the crural nerves, a much weaker degree of electricity, whether from the conductor or from the Leyden phial (the fluid being- obliged to pafs through the narrow paflage of the nerves), fails not to excite convulfions, &c. Yes, an electricity forty or fifty times weaker, as a charge of the phial that is abfolutcly impercep- tible to the laft-mentioned electrometer (Ca- vallo’s), and even to that extremely delicate one of Bennetj a charge, that 1 was able to render fenfible only by means of my condenier, and which I think may be eftimated at five or fix hundredths of a degree of Cavallo’s elec- trometer.
(8.) Thus then, in the legs of a frog attached to the fpine of the back folely by its nerves (thefe being laid bare), w^e have a new fpecies of electrometer ; fince eleCtrical charges, which from their yielding no fign to the deCtrometers > already in ufe, would feem null, afford fuch ob- vious ones to this animal ele^rometer j if I may be allowed the expreflion.
(9.) When
[ i72'J
(9.) When we have feen how, in a ’frog thus prepare.d, flrong convulfions are excited by an extremely weak.elecftricity, by an imper- ceptible ftream of fluid, we ought furely to be no longer furprifed, that the animal fliould be afFeftcd in the fame manner when any body whatever difeharges fuddenly the prime con- duftor of an eleftrical machine, and oeca- lions another ftream of electric fluid, great or fmall, of the fluid before difplaced in the con- ducting bodies near the frog, and which re- eftabliflies itfclf, in the manner already ex- plained (SeCt. 2.), to pafs rapidly through its nerves. Let us fuppofe this returning ilream to be fcarcely equal to that which a conductor, fuf- ficiently bulky, throws off direClIy, with an electricity that yields no fpark, and that is al- moft infenfible even to Cavallo’s^ eleCtrometer, or a fmall Leyden phial, charged fcarcely a tenth of a degree of this fame eleCtrometer'; let us fuppofe, I fay, that the ftream of eleCtricity is not ftronger than this, ft ill it will be fufficient, as my experiments, above related (SeCt. 6. and 7.), fhow, to excite the movements in queftjon.
(10.) But if, after the experiments juft now
referred
[ 173 ]
referred to, we ought no longer to be furprlfed at thofe of Mr. Galvani, defcribed in the firll and fecond parts of his work, how can we avoid being fo at thofe entirely new and wonderful ones related in the third ? Experiments in which he obtained the fame convulfions and violent movements of the limbs, without having re- courfe to any artificial electricity, or extraneous excitement, by the fimple application of a conductor, one end of which was made to touch the mufcles, and the other the nerves or fpineof .the frog prepared in the manner al- ready defcribed. This conductor, he found, might be either entirely metallic, or compofed partly of metal and partly of other bodies of the clafs of conductors, as water, one or more perfons, &c. Even wood, the walls and floor of the room^ plight enter into the circle pro- vided they were not too dry; it was only by the interpofition- of non-conduCting fubftances, as glafs, rofin, and filk, that the effeCt was pre- vented. Bad conductors, however, did not do fo well, and only during the firfl; moments after the animal was prepared, and fo long as the vital powers remained in full vigour ; after which good conductors only were found to fuc-
ceed.
/
[ '74 ]
ce6d, and in a fhort time it was found impoffi- ble to produce the effedt unlefs with excellent condudtors, that is, with conductors entirely metallic. He moreover found a great advantage from applying ,a fort of metallic armour, or coating, to that portion of the fpine which he left. attached to the crural nerves, and to the nerves themfelves, and particularly from cover- ing this part witli a thin leaf of tin or lead.
(II.)' Mr. Galvani did not confine himfelf, in thefe truly aftonifliing experiments, to frogs j he extended his trials with fuccefs, not only to feveral other animals of cold blood, but like- wife to quadrupeds and birds ; in all of which he obtained the fame refults, by means of the fame preparations, which confided in laying bare fome principal nerve at the part where it paffes into a limb fufceptible of motion, and after arming the nerve with fome metallic, fubdance^ forming a communication, by means of his con- ductor, between this coating and the mufcles to which the nerve is diftributed.
(i2.) It was thus he fortunately difcovered> and demonftrated to us, in the mod evident manner, the exidence of a real animal eleBricity in all, or almoft all animals. It feems in faCt to ]3C proved by his experiments, that fhe eleCtric
duid
C 175 3
^uid ten'ds inceffantly to pafs from one part to another of a living organized body, and even of detached limbs, fo long as any remains of vitality fubfift in them; that it tends to pafs from the nerves to the mufcles, or vice verja, and that the mufcular movements are owing to a fimilar transfufion, more or lefs rapid. In truth, it would feem that no objections can be railed to this, or to the manner in which Mr* Galvani explains it, by a kind of difeharge fi- milar to that of the Leyden phiah But a great number of new experiments that I have made on this fubjeCt, will ferve to fliow that many reftrictions muft be made with regard both to the thing itfelf, and to the deductions the au-^ thor has drawn from it ; my experiments likc- w’ife'will be found confiderably to extend the phenomena attributed to this animal eleClricity, and will difplay it to us under a great number of new circumftances and combinations.
(13.) Mr. Galvani, purfuing the idea he has formed to himfelf from his experiments, and adhering in every refpeCt to the fuppofed analogy of the Leyden phial, and his con- ductor, imagines there is naturally an excefs of eleCtric fluid in the nerve, of in the interior part of the mufcle, and a correfponding defeCt of this
fluid
- [ lyfi 1
fluid in the outer parr, and vice verfa ; and hd fuppofes confcquently that one end of this con- dudtor mufl: communicate with the nerve, which he confiders as the conducing wire or hook of the phial ; and the other end with the external furface of the mufcle. All the figures of his third and fourth plates, and all his explanations relate to this. But if he had a little varied his experiments, as 1 have done, he would have feen that this double contadt of nerve and of mufcle, this circuit which he imagines, is not always neceflaryi He would have found, as I have, that the fame convulfions, the fame move- ments may be excited in the legs and other limbs of frogs, and of every other animal, by placing metallic fubftances in contadf with two parts of a nerve only, or with two mufcles, or even with different parts of a Angle and fimplc mufcle.
(14.) It is true we are very far from fucceed*- ing fo well in this way as in the other, and that in this cafe it Is neceflary to have recoui fe to an artifice, of which we.fhall have occafion to fpeak more fully hereafter, and which con fills in employing two different metals; an artifice, which is not abfolutely neceffary when the ex- periment is condudted according to Galvani’s
method
r 177 ]
ftietliod above defcribed (Seft. 10 and il), at lead fo long as vitality remains in full vigour in the animal, or in its detached limba ; but, at any rate, fince by arming the nerves only, or the mufcles only, with different metals, we are able to excite contractions in the latter, and movements in the limbs, we muft conclude that if there are cafes (and this may perhaps dill be very doubtful) where the pretended difcharge between nerve and mufcle (SeCt. 12 and 13.) is the Caufe of the mufcular movements, there are likewife many and more frequent circumflances, where the fame movements are obtained by quite another play, quite another circulation of the eleCtric fluid.
(15.) Yes, it is quite another play of the electric fluid, of which we may be faid rather to difturb than to reftore the equilibrium, info- much as it paffes from one part to another of a nerve, a mufcle, &c. as well internally by their conducting fibres, as externally by mean's of the metallic conductors that are applied, not in confequence of any refpeCtive excefs or defeCt, but by a peculiar aCtion of thefe fame metals, when they are of different kinds. It is thus I have difcovered a new law, which is not fo much a law of animal elcCtricity as a law of VoL. VI. N
common
[ 178 J
common eleflricity ; to which w'e mull attribute the moft part of the phenomena, which, from the experiments of Galvani, and from feveral- others which I made myfelf, ‘ feemed to belong to a true fpontaneous animal electricity, but which in truth do not : they are really the efFefts of a very feeble artificial eleCtrIcity, which is excited in a way never before fufpedted, by the fimple application of two coatings of different metals, as 1 have already hinted, and which I fliall explain better elfewhere.
(16.) I think it right here to fay, that at the dlfcovery of this new law, of this, till now,
' unknown artificial eleCtricity, 1 was miftruftful of every thing that feemed to me to demonflrate a natural eleClrlcity, in the Arid; fenfe of the term, and that 1 was on the point of giving up this idea. But upon carefully reeonfidering all the phenomena, and repeating the experiments under this new point of view, I found that fome of them fupport fuch an idea, (thofe, for in- fiance, in which there is no need of different coatings, or even of any coating, a Ample me- tallic wire, or any other conducting body, per- forming the office of conduClor between the nerve, and one of the mufcles conncCled with if, being capable of exciting convulfions in the
•latter).
[ 179 ]
latter), (Sedt. lo, &c.) and that thus a natural animal and properly organic eledlricity fubfifts, and cannot be entirely overturned. The phe- nomena which eftablilhit, although much more limited, are however fufhcient to demonftratc its exiftence, as I have juft now mentioned, and as will more clearly be fliown hereafter.
(17.) What will perhaps be found more dif- agreeable is, that we muft likewife confine with- in narrower limits its influence in the animal oeconomy, and give up the fineft ideas we had formed of it, and which feemed to be about leading us clearly to explain mufcular. motion. My experiments, varied in every manner pof- fible, fliow that the motion of the eledtric fluid excited in organs, does not adt immediately on the mufcles ; that it does nothing more than ex- cite the nerves, and that the latter, put into action, excite in their turn the mufcles. What this adtion of the nerves is ; how it propagates itfelf from one part of a nerve to another ; how it pafles to the mufcles, and how the motion of the latter refults from it ; thefe are problems, in the explanation of which we are not farther advanced than before the difeovery in queftion.
Cl 8.) I come now to the experiments that prove all the aflTertions I have advanced in thefe
N 2 laft
-* [ i8o ]
laft paragraphs. From a great number I (hall feleft only a few, which feem to me the beft calculated to eftablilli certain principles, for the moft part new and different from thofe adopted by Mr. Galvani. But 1 muft fir ft fay a few words' more concerning the experiments of this writer.
I know not w'hether he has made others, but thofe he has defcribed in his W'ork are included in too narrow a circle ; in all of them the ob- jedl is to lay bare and infulate the nerves, and to eftablifli a communication, by means of coii>- dufting bodies, between thefe nerves and the mufcles ^that are dependent on them (as may be feen in all the figures of the four plates annexed to his work), in order to excite convulfions and movements of the mufcles, by the atftion of the eledtric fluid. He fuppofes therefore, in every cafe, and he explains himfelf pretty clearly on this point, that the transfufion of the eletftric fluid that is produced, whether by artificial elec- tricity, or by natural animal eledfricity, muft take place from the nerves to the mufcles, or vice verfa ; that thefe two limits at leaft muft be included in order for the mufcular move- ments to take place; and in truth all the expe- riments he has defcribed feem to prove this. But then they arc confined, as I have juft now
fitid,
I
[ .8. ]
faid, within a circle that is too limited, and be- yond which he has never, or fcarcely ever, ex- tended his inquiries. By varying the experi- ments of this kind in dilferent ways, T have fliovvn, that neither the one nor the other of thofe conditions, viz. the laying bare and in- fulating the nerves, and the touching fimulta- neoufly thefe and the mufcles, in order to pro- cure the fuppofed difcharge, are abfolutely ne- celTary (Seft. 13.). It is fufficient, when, for inllance, we have laid bare the ifchiatic nerve of a dog, lamb, &c. if we pafs a ftream of electri- city from one part of this nerve to the other, even though it be near, and leave all the reft untouched and free ; it is fufficient, I fay, to do this in order to excite in the limb very ftrong convulfions and movements ; and this whether we employ an extraneous artificial eleCtricity, or excite the eleCtric fluid that is inherent in the nerve itfelf. Here is the manner in which I make thefe experiments.
(19.) Experiment A. I comprefs, with a pair of forceps, the ifchiatic nerve a little above its infertion into the thigh, and I apply, a few lines higher up, a piece of money, or a plate of metal, on this fame nerve, carefully feparated from the parts that adhere to it, and fupported \ N 3 .by
[ iZz
by a thread, a plate of glafs, a flick of fealing wax, a piece of dry wood, or any other fubftance that is a bad condudor. Then placing the belly of a Leyden phial, very weakly charged, on the forceps, I bring the hook into contad with the other piece of metal ; and the moment the dif- charge takes place, although it be too feeble to produce the leafl fpark, convulfions take place in all the mufcles of the thigh and leg, the whole limb being agitated and fpringing up with more or lefs violence. And yet the whole of this leg, and even a part of the nerve which pafles to it, are, as w'e fee, our of the track which the eledric fluid takes in its paflage, fo that only a fmall portion of the nerve can have been irritated ; and yet this is fufflcierit to occa- flon the convulfion of the mufcles.
(20.) Experiment B. The fame effeds, that is to fay, firailar convulfions and motions of the leg, take place, without our having re- courfe to an extraneous eledricity, by the dif- charge which takes place, in a certain manner naturally, when we apply, as above, the fame forcepsj or a plate of filver,* to one part of the nerve, and a plate of fome other metal, and above all, of tin or lead, to another part, and then bring about a Ample communication be- tween
[ 1 8.3 ]
tween them, either by an immediate contadt, or by the interpofition of a third piece of metal made to perform the office of a condndtor.
(21.) Thus we fee that the fame effedts, that is, convulfions and violent mufcular contrac- tions, take place without any difcharge of elec- tric fluid between the nerves and mufcles, in the manner Mr. Galvani fuppofes ; and without requiring one end of a condudlor to communi- ' cate with the one, and the other end with the other. Neither is the other condition, that of laying bare the nerve, and freeing it of its ad- hefions, at all more neceflary, as will appear from the following experiments.
Experiment C. I apply coatings, or platesj of different metals, (and it is this difference of coatings that is eflential) (Sedl, 14. and to an entire and living frog, that is covered with its Ikin, and, in fhort, is untouched. I apply, for example, a thin piece of tin-foil on its back, or its loins, and I place a piece of filver money under its thighs, or its belly, flightly compreffing it ; this done, I Aide forward the piece of mo- ney till it comes into contadt with the tinfoil, or I form a communication between the two metals by means of a piece of iron wire, or any other metal j and at that inftant convulfive motions
N 4 take
[ 1^4 ]
\
take place in all the mufcles of the belly, thighs, and back, with violent tremors of -the legs, contradion and curvature of the fpine, &c. which convulfions and fpafms, although nearly univerfaj, are however moft confiderable in the limbs and mufcles contiguous to the coatings, and ftill more fo in thofe which are dependent on the principal nerves neareft to the two metals.
(22,,) Thefe experiments fucceed in fome
other animals; in filhes, and particularly in eels,
\
in none of which is it neceflary to remove the fkin, though it does not fail, in a fmall degree, to leffen the elfed. This is why, by removing it, at leaft in part, particularly in the frog, we obtain the effeds with more certainty, and to a greater degree. We like wife gain fomething, ' in this refped, by cutting off the head of the frog, and thrufting a large pin into the fpinal tnarrow ; we then excite, by means of different coatings in the manner above defcribed, ftronger movements, or at leaft fuch as are more ob- vious, becaufc they are no longer confounded with the movements the animal gives itfelf while living.
(23.) If it be advantageous, as we have feen, to take off the Ikin of frogs, althovigh very thin
and
[ >85 3
and pretty, mqift, it is much more fo, and evert neceflary, to remove it from almoft all the other animals^ as lizards, falamanders, ferpents, tor- toifes, and more efpecially from quadrupeds and birds, thr|t are furnilhed with a drier and much thicker Ikin, to fucceed in thele experiments. The following, therefore, is the mode I adopt.
Experiment D. I fallen to a table, by met], ns of fume large pins, a lizard, a moufe, a fowl, &c. and after making an incifion through the Ikin, and other integuments, to the bare delli, on the back of the animal, 1 turn back the integuments on each fide ; 1 do the fame on the thigh or the leg; after which I apply the two metallic coatings on the eifpofed parts, viz. on one the tin foil, and on the other a fpoon or a piece of money ; I then form a communica- tion between the two coatings, and every time I do this I excite ftrong contradions in the ad- jacent mufcles, and particularly in thofe of the thigh and leg,' which moves and agitates itfelf with great violence. Thefe convulfions are much more confiderable when the tin foil is ap- plied near the ifchiatic nerve, and the piece of filver on the gluteus mufcle, or on that named gaftrocnemius ; and the effeds are Hill greater if the nerve itfelf is laid bare, and coated with
the
r i86 ]
the tin foil ; if, leaving it attached only to the mufcles to which it is diftributed, we deprive it of every other adherent part; or if, in Ihort, we feparate the entire limb from the reft of the body, with its nerve hanging out, and fubmit it in this ftate to our experiments.
I am, &c.
September 15, ^792.
A. Volta.
SECOND LETTER.
(24.) It will be fufficiently underftood that what I have faid with refpedt to the ifchiatic nerve, and the leg, is applicable to the brachial nerve and to the arm, as well as to every other nerve relatively to the rnufcles under the in- fluence of that nerve.
(25.) Thefe laft preparations are analogous to thofe of Mr. Galvani ; and they clearly prove that it is advantageous to lay bare the nerves, and ftill more fo, to detach them all round from the adherent parts ; but they are far from ftiow-
ifig
[ i87 ]
ing that this is a neceffary condition, fince we never fail to obtain the fame convulfions and movements of the limbs when we fimply lay bare the mufcles, and leave the nerves covered and concealed under them in their natural ftate, as all my other experiments above related (Sedt. 21, 22, 23.) ferve to fhow.
(26.) After thefe trials on reptiles, birds, and fmall quadrupeds, I proceeded to other and larger animals, as rabbits, dogs, lambs, and bullocks ; and I not only fucceeded in obtaining fimilar effects in all the ways above defcribed, but even ftronger and more durable ones, by realbn- that the vital heat maintained itfelf in thofe large animals, and in their limbs, a longer time. For I ought not to omit to fay, that if in the moll part of animals of cold blood, and particularly in frogs, the vital principle fubfifts in detached limbs feveral hours, that principle which renders them fo fenfible to the w ^keft eledtrical irritation, it hardly continues beyond a few minutes in animals of warm blood, and commonly difappears before the whole of this animal heat is diflipated.
(27.) Having had fuch fuccefs with my ex- periments on large and fmall animals of every kind, in Tome inftances alive and entire; in
others
\
[ i88 ] ■
Others deprived of thejr fkin, or their head, or diffed:ed in different ways ; and having obtain- ed fimilar effedts in their large detached limbs, and almoft always without the preparation re- quired by Mr. Galvani, that is to fay, without laying bare the nerves, I was defirous of going flill farther, and of making fimilar trials on fmailer limbs, on a Tingle mufcle, and even on fmali portions of mufcles ; and the frefh fucr cefs 1 had in thefe trials led me to* other difeo- verles, which I will foon mention, after having deferibed Tome of thefe experiments.
(28.) Experiment E. 1 cut off, In Tome inflances, the leg and thigh of a frog, in others, the leg only, and in Tome half or a quarter of a leg ; and on applying, as ulual, to one part of the amputated portion the tin foil, and to the other the plate of filver, and forming a commu- nication between thefe two coatings, I conftant- ly excited convulfions and movements; I have even feparated a fingle mulcle, for inttance the gluteus, or the gaftrocnemius, and fometifnes only a portion of mufcle not larger than a bar- ley-corn, and yet the fame effedts, that is to fay, very ftrong contradtiojis of thefe mufcles, or parts of mufcles, have been produced by means of two different coatings, &c.
Ex PE-
1
C 1S9 ]
Experiment F. I have repeated the fame experiments on a leg, on a half or a third part of the leg, on a Angle mufcle, or part of a mufcle, of a fowl and other birds ; on a flice of the gluteus of a rabbit, a lamb, &c. and I have had the fame effedts as long as the flefli preferved a fenfible heat. (Sedf. 26.)
(29.) Thus then we are able to excite very ftrong contradtions in the mufcles of animals of warm as well as of cold blood, and in every detached portion of mufcular flefla ; and this by means of the Ample artiAce of different metal- lic armours or coatings, applied to the mufcle itfelf, without any preparation of the nerves, and even without laying them bare. We have beAdes feen that we can excite thefe cf- fedts quite as well, and by the fame means of metallic coatings applied to two neighbouring parts of the fame nerve, (Sedt. 19, and 20. Ex- periments A. and B.) whence 1 have reafon to conclude, that there is no neceffity for a dif- charge of eledtric Auid to take place between nerve and mufcle, or for any tranfmiAion of it from the interior to the exterior part of the lat- ter by means of the nerve and metallic conduc- tor, as Mr. Galvani fuppofes, or vice verja: and that there is no comparifon to be made be- tween
[ 190 ]
tween the mufcle and the Leyden phial and its difeharge, in the experiments in queftion. In fadl, what refemblance or analogy is there to the Leyden phial, where the two plates of me- tal, a communication between which is formed by the condudor, are applied very near to each other on the external furface of the fame nerve, (Experiments A. and B.) or on the external fur- face of two mufcles, or even of the fame mufcle (Experiments C. D. E. F.) ; it mull be con- felTed it would be in vain to attempt to fupport any analogy between any of thefe experiments and the Leyden phial.
(30.) Experiment G. Having placed two coatings, one of filver leaf, the other of tin foil, on exadly correfponding parts of the two thighs of a frog, I excited contradions of the mufcles, and the ufual motions of the less, at the inftant I formed a communication between the two coatings by means of the condudor.
(31.) Is it thus, I alk, that the difeharge of two Leyden phials takes place, by forming a communication between their homologous fur- faces ? Let us lay alide, therefore, thefe ideas of phial and difeharge, and every forced expla- nation^ and let us fay fimply, that in thefe and other analogous experiments, a tranfmiliion of
the
[ 3
the eledric fluid takes place from one to an- other of two parts properly coated; a tranf- miflion determined, not by a relative excefs of this fluid, which cannot naturally be fuppofed between parts that are fimilar, but by the di- vcrfity of thefe fame coatings, which muft be of different metals, as I have taken care already to point out, (Sed:. 20, and 21. Experiments B. and C.) and uniformly to inculcate in the fubfequent parts of my paper.
In fa6t,
(32.) Experiment H. If two mufcles, or two parts of the fame mufcle, are fimilarly coated, that is, with two plates of the fame ■ metal, both of them equal in temper and hard- nefs, in foftnefs or rigidity, in the roughnefs or fmoothnefs of their furface, and both are ap- , plied in the fame manner, it will be to no pur- pofe to bring about a communication between them by means of a conductor, as no convul- fion, no motion will take place.
(33.) I confefs it is not eafy to conceive how and why the Ample application of two diffi- milar coatings, I mean of two different metals, to fimilar parts of the animal, and even to two parrs very near to each other of any one mufcle, ihali difturb the equilibrium of the eledfric
fluid.
[ 192 ]
fluid, and drawing it from its date of repoTe attd inadivity, (liall induce it to pafs inceflantly from one part to another ; which transflux takes place as foon as a communication, by means of the condudor, is formed between thefe two dif- fimilar coatings, and continues all the time this communication fubfifts. But conceivable or not, and whatever may be the caufe, it is a fad that the experiments I have already related fuf- ficiently prove, and which will be confirmed by many others, to the defcription of which 1 lhall endeavour to add folne explanation. It is a fad, to be added to what we already know in eledricity ; a fad which muft furely appear ex- traordinary, and difficult to be reconciled with the laws commonly eftablilhed. It is truly a new and very Angular law, which I have dif- covered ; a law that belongs not properly to animal eledricity, but 'to common eledricity, fincethis transflux of the eledric fluid, a trans- flux, not momentary, as a difeharge would be, but which continues as longasthecommunication be- tween the two coatings fubfifts, and takes place whether thefe Coatings are applied to living or dead animal fubftances, or to other condudors not metallic, but fufficiently good, as water, or moift bodies. But before I proceed to the ex- periments
[ 193 ]
periments which decifively prove all that 1 haVc advanced, I think it right to offer a few more remarks on thofe I have already dcfcribed (Sedt*
20 — 32. )•
(34.) It would feem from thefe that by means’ of the fimple artifice of coatings of different metals fuitably applied, we are able to excite very ftrong convulfions in every mufcle of every animal, fo long as it continues to poffefs any de- gree of vitality. Such a conclufion, however, would be too general, my experiments having taught me that it is to be admitted only with cer- tain refiriduions, as well with refpedl to the claffes and genera of animals, as with refpedt to the dif- ferent mufcles of each animal.
(35. J And firft with refpedt to the different claffes of animals ; although it has uniformly happened that all the quadrupeds, birds^ fifhes, reptiles, and amphibious animals, which have been fubmitted to my experiments^ exhibited the phenomena above deferibed, it is no lefs certain that worms in general, and feveral fpe- cies of infedts, remained unaffedted. I have in vain tried with worms, leeches, fnails, oyffers, and different caterpillars ; 1 have not even been able to excite the leaff motion in them by fmall and moderate fparks, and difeharges of artificial
VoL. VI> O eledtricity.
[ 194 ]
eledlricity. Here is the manner in which I pro- ceeded.
Experiment I. I applied the tin foil, and filver leaf, to different parts, as well external as internal, of thefe fnails, leeches, earth worms, &c. and in the beft way I was able ; I then formed a commiinicatiort between thefe metallic coatings, fometimes by bringing them into con- tadl; with each other, and at others by means of another metal that performed the office of a condudfor ; but by neither of thefe means could 1 ever obtain the leaft motion in any part of the body.
Experiment L. I conveyed through their bodies, both when infulated and not infulated, difeharges of a Le3^den phial of fufficient ftrength to excite a moderate fpark, and to give me a flight fliock, but they were not fenfibly affedted by it; no motions or cohvulfions were produced.
(36.) Does it follow from hence that the more imperfedt animals, the whole clafs of worms, and feveral fpecies of infedls, are defti- tute of that fenfibility and iriitability, that elec- trical mobility, if I may be allowed the expref- fion, with which other more perfedt animals are endowed ? T am unwilling to draw this general conclufion from my experiments, becaufe I have
as
i
, [ 195 ]
as yet extended them only to a^fniall number of worms and infedts ; and with regard to the lat- ter, I think it right to obferve that I have fuc- ceeded, without much difficulty, with craw .fiffi, beetles, grafshoppers, butterflies, and flics. It may not be ufelefs that I explain one of the ways in which I fucceed with thefe animals, as they are with difficulty fubmkted to experi- ments, on account of their minuienefs, or of the fcales with which they are covered.
Experiment M. After cutting off the head of a fly, a butterfly, beetle, &c. I flit open, with a penknife or fmall fciffars, the whole length of the corflet, and introduce deep into the flit, near the neck, a bit of tin foil, (what is improperly called filver paper is very fit for this purpofe) and a little below I introduce, and likewife deep into the flit, a bit of filver plate, or fmall fil- ver coin ; and when I bring the latter into con- tact with the piece of tin foil, the legs begin to bend and tremble, and the other parts, and even the trunk of the animal, are thrown into agitation. It is very amufing to excite in this \nanner the chirping of a grafshopper, &c.
(37.) After what I have juft now faid, I Ihould be wrong to rank infedls among the ani- mals that are deflitute (like the clafs of worms
O 2 above
9
[ 196 ]
above menrlonea) of the eledlrical property in queftion. At the ntmoft, if caterpillars appear to be fo, it may be faid that in this ftate of lar- va, before they have attained, by their meta- morphofis, a perfed; ftate, and acquired new organs, 6cc. they may be compared in many refpeds to worms, and, like thefe, are not en- dowed with cledric fenfibility.
(38.) In fhort, if I may be allowed to ftate here what I think, ihofe animals only that have very diftind limbs, with joints, and mufcles fitted for the morion of thofc joints, or, in other words, mufcles that are called flexors, or le- vators, and nerves proper to regulate them, fuch animals onl}'', I fay, are fenfible to, and become feized with real fpafmodic contradions in con- fequence of either fmall difeharges of artificial eledricity, or a weak current of fluid occa- fioned Amply by different metallic coatings; . which contradions and fpafms bring on the mo- tion, and even a violent agitation of the faid limbs. On the contrary, worms, and fuch in- feds as have not fufficiently diftind limbs, or joints properly fo called, or which are deftitutc of flexor mufcles, or enjoy only a vermicular motion, are nowife affeded by fuch an eledri- city. The motions of thefe animals depend on
a different
t
I
C 197 .]
a different animal oeconomy; on a different me- chanifm, which in feveral fpecies has been very well difeovered and explained. Such arc my ideaSj ftill indeed fomewhat vague, and founded only on a few experiments ; it is the fequel of thefe that muft either confirm or rectify them.
(39.) With rcfpedl to different mufcles in the fame animal, I am able to advance fomething more certain. I fay then, that all mufcles are very far from being fufceptible of contraction from the weak electricity in queftion. There is a great dlftinCtion to be made with regard to their functions in the animal oeconomy ; all of them are not fubjeCt to the empire of the will, and fitted for fpontaneous movements : and, ftriCtly fpeakingj it is only thofc which are fo that are capable of fpafniodic contractions by the means above deferibed ; yes, the mufcles fubjeCt to the will arc the only ones I have found fufceptible of irritation and motion, by the ac- tion of that weak current of eleCtric fluid occa- fioned by the Ample contaCt of two different metals. The other mufcles, over which the will has no direCt power, as thofe of the fto- mach, inteftines, &c. are not at all fo, not eveii the heart, though in other refpeCts fo irritable. We muft except, however, the mufcles of the
O 3 diaphragm.
[ 193 ]
diaphragm, (and I conjedlured it before I made the trial) thefe being of the number of thofe whofe motion depends on the will.
Experiment N. Tt is very furprihng that a nice of good mufcular flefli, cut, for indance, from the thigh of a lamb killed half an hour or an hour before ; that this piece, I lay, of mufcle, almoft quite cold, and which is no longer fenfible to the adlion of any mechanical or chemical dimulus, fliould be fo powerfully affedfed by the eleftric fluid conveyed from one part of it to another, as to be feized with very flrong fpafmodic contradlions ; and that, on the contrary, the heart recently taken out of the fame animal, and ftill warm and very irritable, fhould, when treated in the fame manner, with the befb adapted metallic coatings, fuffer no altera- tion upon our making a communication between the two metals by means of the condudtor ; and that its pulfations, when weakened or flackrced, or altogether fufpended, fhould not beincreafed, or even revived, notwithftanding all this takes place from the application of the fignteft me- chanical or chemical ftimulus.
(40.) The eledfric fluid, therefore, which feems to be the ftimulus appropriated to the mufcles of the will, is nowife fo to the heart.
or
4
[ 199 1
or to the other mufcles formed for involuntary vital and animal fundions. But what will be faid if I make it appear that it is not the imme- diate or efficient caufe of motion in the volun- tary mufcles } that even in thefe it is a mediate caufe only, the nerves alone being direfUy af- feded by it ? And yet this is what I have learned from feveral experiments ; experiments that have obliged me to give up the fineft and moft extenfive ideas I had formed on the fubjedt. I was fond of thinking, with Mr. Galvani, that as often as a current of the eledlric fluid, put in motion in the organs, was impelled with a cer- tain degree of ftrength to the mufcles, this fluid did itfelf perform the office of a ftimulant, and excited the irritability which.is peculiar to them; that every mufcular movement was executed in confequence of a fimilar irruption of eledlrical fluid into the mufcles, either by means of arti- ficial eledtricity, or by ’putting in motion the natural artificial eledlricity ; that, in flaort, even the motions which are performed naturally in the living animal machine, at leaf! the volun- tary motions, acknowledged the fame caufe, that is to fay, the immediate adtion of the elec- tric fluid on the mufcles. ,But I repeat it, I have found myfelf obliged, with regret, to
O 4 give
[ 1200 ]
give up all thafe fine ideas by which it feemed poffible to explain things to admiration. Yes, we muft confiderably limit the adlion of eledtri- city in animals, and confider it under another point of view, that is to fay, as being capable of exciting, of itfelf, the nerves, as I have al- • ready hinted, and as I fhall now proceed to prove.
(41.) In the firil place, then, that it can adt, and that it really does aft, on the nerves, and that the latter, excited by it, excite in their turn the mufcles connefted with them, without even the elcftrical flream’s arriving at thofe mufcles, is a faft which no longer Hands in need of proofs after thofe furnifhed by the experiments A. and, B. (Seft. 19. and 20.) and even by an expe- riment of Mr. Galvani, which, according to his account, was the firft he made, and the ori- gin of all his other experiments. It is fuffi- , ciently obvious that the eleftric current, in the experiment in queftion, as well as in thofe made by me, and which I have juft now referred to, pervades only a part of the crural nerve, but . not one of the mufcles of the leg ; and yet as the latter depend on the nerve, they are af- fefted with convulfions.
(42.} Bpt I go farther, and maintain, that
cvep
[ 201 ]
even in the cafes where the electrical current (it will be clearly underftood that I am fpcaking only of weak artificial difeharges, or of the current which takes place by the fimple appli- cation of coatings of different metals) ftrikes and penetrates mufcles fufceptible of move- ment, it is not by irritating the latter imme- diately that it occafions them to contract, but by flimulating their nerves. This is what is fhown by my experiments C. and D. (SeCt. 21. and 23.) where, upon the tin foil and piece of filver being applied immediately to the mufeu- lar parts of the animal, whether the animal or only a detached portion of it is the fubjed: of the experiment, it is not fo much the mufcles covered by the two metallic coatings that fuffer the mod: violent contractions, as thofe which depend on fome principal nerve, to which one or other of the coatings is contiguous. It is in this manner that in the frog, when the tin foil is applied on the loins, where the crural nerves lay at but little depth, the mufcles of the legs are feized more than any others with ftrong con- vulfions, more fo even than thofe contiguous to the other coating, that is to fay, to the piece of filver. I have already pointed out the fame thing in quadrupeds, dogs, lambs, &c. with re- gard
. [ 202 3
gard to the ifchiatic nerve, (Experiment D.) and I have only to add, that the leg never fails to be convulfed when this nerve does not lay too deep under the flefh and other integuments, and one of the coatings is properly applied to this part ; even although the other coating fhould be made to correfpond neither with the gluteus nor any mufcle of the leg, but with any other mufcle whatever, provided it be not at too great a diftance. Here is another proof why this happens ;
Experiment O. If we apply in a frog, or any other fmall animal, the tin foil the whole length of the fpine of the back, from which proceed all the nerves of the trunk and limbs, and the other coating to any other part what- ever, all the limbs become aftedted ; the mufcles, not only of the legs, but of the belly and back, experience fpafmodic contradlions, and the trunk itfelf becomes curved ; in a word, the convulfions are general. The experiment is ftill more ftriking in a lizard than in a frog, and I fliall therefore defcribe it.
Experiment P. After cutting off the head of a lizard, and laying bare the mufcles of the back by removing the flcin, I apply a piece of tin foil to the mutilated end, in fuch a manner
that
[ 203 ]
that the tin foil is fpread beyond the edges of the wound, fo as to rife a little over the fnoul- ders, and I place a piece of money on the mid- dle of the fpine ; this done, I Aide forward the piece of money till I bring it into contact with the tin foil. At that inftant the legs move, the tail twids itfelf,. and the whole body of the ani- mal becomes agitated, and darts from right to left, and from left to right. Is not this becaufe the upper part of the fpinal marrow, the prin- cipal fource of the nerves, is irritated ?
(43.) Nearly the fame effedfs may be obtained by a fimilar operation on a moufe, a fmall bird, &c. but in thefe it is neceflary to remove not only the ikin and other integuments, but like- wife fome of die flelh, and this becaufe their back being more fleftiy, the principal nerves of the fpine are more concealed by this ficfli, and by the bones alfo of the vertebral rube. It is in fadl eafy to comprehend that the current of eledric fluid, occafioned by the two coatings, penetrating only to a certain depth the parts of the animal covered by thefe coatings, can hard- ly reach the fpinal marrow, or the principal branches of the nerves that enter into the in- terior parts of the limbs, if the bones, flefli, and other intervening integuments are of con-
fiderable
C 204 ]
fidcrable thicknefs. The reafon alfo mufl be obvious, why, in the larger animals, as dogs, lambs, &c. we fall to excite contradlions in all the limbs by the application of the two coatings to the back, although ftripped of its flelh. The large trunks of the nerves remain ftill at too great a depth ; and it is only the fmaller branches or ramifications that lay but a little below the coatings, and thefe branches termi- nate, for the moft part, only In the neighbour- ing external parts ; confequently we fee pro- duced only fuperficial contratffions or palpita- tions imone or other of the mufcles : or if by chance a whole limb is put in motion, it is be- caufe the nerve that goes to it, and influences this motion, is but thinly covered, fo that only a thin layer of fibres intervenes between it and one or other of the metallic coatings, as appears , from Experiment D. and the following ones (Sedt. 2,3. &c.) in which the application of one of the coatings near the ifchiatic nerve, in a dog or a lamb, was fufficient to excite confider- able movements in the leg ; and the nearer the coating was to the nerve, and the thinner the layer of flefh was that furrounded it, fo much ftronger in proportion were the contractions of the limb.
2
(44.) It
[ *05 3
(44-) It becomes therefore neceffar}'’ to know the fituation of the nerves, their diredion, &c. ; and it is reqiiifite to remove not only the com- mon integuments, the fat, &c. but likewife part of the flelli that covers and furrounds the nerves, in order that this furrounding mufcular fubftance may be more or lefs extenuated, previoufly to the application of the metallic coating, to enable us to obtain in the larger animals contradions In. any particular limb, to fay nothing of the fu- perficial contradions and palpitations of one or more mufcles. It is perhaps impoffible to ex- cite thefe fame motions and contradions in all the limbs at oncej although this is not difficult in the fmaller animals, as vve have already feen, (Sed. 42. Experiments O. and P.) merely by depriving them of the Ikin or a part of the other integuments ; and even this is not necef- fary in frogs, for in thefe animals we may leave the fkin,' it being fo extremely thin and moift, as not to prevent, by its interpofition, the eledrical current from reaching the prin- cipal nerves or thefpinal marrow.
(45.) But if it be neceffary to pay attention to the diredion of the principal nerves, in or- der to bring on the contradions in the different limbs, it is not lefs fo to be careful of the po-
fition
[ 2o6 ]
fition of the coatings relatively to (The mufeles; for thofe mufclcs which are neareft to one or other of the coatings, are in general the moft liable to contract fpafmodic convulfions, and are oftentimes the only ones in which fuch an elFedt takes place ; as, for inftance, when the coatings do not correfpond with any confiderable nerve, or if there be a nerve, when it is fur- rounded with too much mufcular flelh, or Is too deeply feated.
f46.) This, and the Experiments E. F. (Sedt. 28.) where a fingle mufcle, and even a part of a mufcle, treated in the ufual way, ex- perienced very flrong contractions, might lead to a fuppofition that the eledtric fluid produces thefc effedts by irritating the mufcular fibres them- felves, without the intervention of nerves ; the adtion of which would confequently be neither •primary^ nor abfolutely neceflTary, as I pretend. But an argument of this fort, founded on thefc fadts, can have no weight, unlefs it could be proved that in thefe mufeles, or portions of mufeles, there are no nerves ; for if there are nerv<es, (and certainly there muft be, and are, nervous filaments in every fenfible portion of a mufcle, I had almoft faid in every mufcular fibre) 1 may flill maintain that it is thefe ner- 'X vous
[ 207 ]
vous filaments, ramifying through the whole •fubftance of a mufcle, that are immediately af- fected by the eleClric fluid which penetrates this fame fubftance ; that this fluid exerting its in«-, fluence on their nerves, an influence that finiflies there, the latter exert theirs on the mufcles, &c. I may, I fay, be able to maintain, with fufficient probability, that- the elcCtric fluid has no other influence, in the phenomenon of muf- cular contractions, than that of exciting the nerves ; in a word, that it is. not the immediate caufe. Such an aflertion, which the things al- ready explained render more than probable, is proved direCtly, and in the moft obvious man- ner, by feveral experiments I have made on the tongue ; experiments that have led me to other difeoveries equally interefting and curious.
(47.) Having fucceeded in exciting tonic convulfions, and the moft violent motions in the mufcles and limbs, not only of fmall but -of large animals, without laying bare any nerves, by the fimple application of coatings of different metals to the mufcles when freed from their in- teguments, I foon thought of trying whether the fame effeCts might not be obtained in the human body. I conceived that the thing might fucceed very well in amputated limbs; but in the en- tire
V
f 208 ]
tire and living fubjedt how was it to be effedled ? It fet med likewife to be ncceffary to remove the integuments, make deep incifions, and even diffea; off portions of the flefli from the parts on which we might think of applying the me- tallic coatings (as I have remarked we are often obliged to do in the larger animals). Fortu- nately it came into my head, that we have, in the tongue, a mufcle that is bare, or at leaft deftitute of thofe thick integuments with which the external parts of the body are covered, a mufcle which is extremely moveable, and move- able at will. Here then, I faid to myfelf, are all the conditions requifite to enable us to ex- cite movements by the ufual artifice of different metallic coatings. With this view I made, on my own tongue, the following experiment.
(48.) Experiment Flaving covered the point of the tongue, and a part of its upper furface^ to the extent of fome lines, with a piece of tin foil, (what is called filver paper is the fitted: for the purpofe) 1 applied the convex part of a filver fpoon farther on, on the flat part of the tongue, and by inclining the fpoon downwards brought the handle of it into con- tadt with the tin foil. I expedted to fee my tongue affcdled with tremor; and on this ac- count
C 209 ]
count I made the experiment before a looking- glafs. The effed, however, I had ventured to foretel did' not take [place ; but inftead of it I had a fenfation I nowife expeded ; this was a pretty ftrong acid tafte on the point of the tongue. < .
(49.) I was at firft mitch furprifed at this ; but upon refleding a little on the fad, I ealily conceived, that the nerves which termi- nate on the point of the tonguej being the nerves deftined for the fenfations of tafte, and not for the motion of this flexible mufcle. It was perfedly natural, ‘that the irritation of the eledric fluid, put in motion by the ufual arti- fice, Ihould excite a tafte, and nothing more ; and that in order to excite in the tongue the motions of which it is fufceptible, it would be neceflTary to apply one of the metallic coatings near its root, where the nerves enter that influ- ence its motion ; and this 1 foon verified by an- other experiment, as follows :
(50.) Experiment R. Having cut our, from a lamb recently killed, the tongue near its root, I applied a piece of tin foil at the end that was cut, and the filver fpoon to one of the furfaces of the tongue;' and then forming a communication between thefe two metallic co^t- VoL. VI. p
ings.
[ 210 ]
ings, I had the pleafure to fee the whole tongue affected with tremor, railing its point, and turn- ing and bending itfelf in different diredions, every time, and as long as fuch a communication took place.
(51.) I have repeated this experiment on the tongue of a calf, which I placed, coated in the fame manner with a piece of tin foil near its root, on a lilver plate, that the latter might ferve as another coating; and thefuccefs was the fame. I have likewife repeated it on the tongue of other fmaller animals, as mice, chicken, rabbits, &c. and I have almoft always obtained the fame effedt. I fay almofi always, for in the tongue of the fmaller animals it fometimes failed; either becaufe the tin foil was not applied exadlly to the proper place, where the nerves that influ- ence the motions of the tongue are inferted ; or becaufe the tongue being cold, had loft its vitality, which feldom lafts long in the mufcles ’ of animals of warm blood, as I have already had occafion to obferve (Sedl. 26.), and parti- cularly in the tongue.
I am, &c.
A. Volta.
OiI$ber 1792.
XII. AReiimi
L 2” J
XII. Return* of the Ship's Company, and of the Military, on Board the Ships in the Service of the Honourable
1792 1793. jB}i John Lorimer, M.D.
the United E'ajl- India Company, for the Tears
|
j |
Shic |
s’ |
Re- |
|||||||
|
Ships* |
Re- |
CoiT |
||||||||
|
Ships’ Names , |
DefUnation, |
Compa- ny out- |
Sick. |
cove- red. |
Dead |
pany home- |
Sick. |
cove- red, |
Dead |
|
|
ward. |
wai |
d . |
||||||||
|
Ocean |
Sc. Helens, Madras, 1 and China J |
134 |
102 |
100 |
I |
12 |
4 |
45 |
45 |
0 |
|
Notcinphnm |
Coaft and China |
I 28 |
67 |
65 |
2 |
I |
2 |
12 |
12 |
0 |
|
Lord Macartney |
Ditto |
105 |
49 |
49 |
0 |
K |
5 |
22 |
2 I |
I |
|
Ganp:es |
Ditto |
106 |
40 |
33 |
7 |
1C |
>4 |
14 |
H |
0 |
|
Sir Edward Hughes |
Ditto |
No Reg |
ular Return out. |
I |
0 |
5& |
53 |
3 |
||
|
Europa |
Ditto |
103 |
86 |
85 |
I |
IC |
6 |
136 |
132 |
4 |
|
Mclviilc Caftlc |
Coalt and Bay |
106 |
U |
13 |
I |
K |
3 |
25 |
22 |
3 |
|
Contractor |
Ditto |
105 |
53 |
53 |
0 |
lOO |
50 |
47 |
3 |
|
|
Ponfborne |
Ditto |
ro6 |
47 |
45 |
0 |
c |
19 |
I 2 |
10 |
0 |
|
Bufbridge |
Ditto |
106 |
56 |
55 |
I |
c |
)4 |
12 |
1 1 |
I |
|
Rofe |
Ditto |
104 |
25 |
^5 |
0 |
I |
I |
42 |
40 |
- |
|
ICing George Rockingham |
Ditto |
99 |
19 |
19 |
0 |
I |
0 |
^5 |
23 |
2 |
|
Bombay and China |
106 |
42 |
4' |
I |
IC |
51 |
9 |
8 |
1 |
|
|
Suli van |
Ditto |
113 |
5' |
49 |
0 |
IC |
>3 |
94 |
93 |
I |
|
Middlefcx |
Ditto |
1 I I |
20 |
15 |
5 |
ir |
>7 |
10 |
9 |
1 |
|
Duke of Montrofc |
Bombay |
lOI |
46 |
46 |
0 |
lOI |
3' |
3‘ |
0 |
|
|
General iilliot |
Ditto |
10; |
16 |
16 |
0 |
1C |
>5 |
26 |
3 |
|
|
Earl of Wycombe |
Bencoolen and China |
87 |
83 |
82 |
I |
l2 |
U |
24 |
3 |
|
|
Valentine |
St. Helena, Bengal, \ and Bencoolen / |
106 |
'9 |
■9 |
0 |
17 |
3° |
27 |
3 |
|
|
General Goddard |
Bengal |
106 |
27 |
26 |
I |
104 |
31 |
29 |
2 |
|
|
Bcllinont |
Ditto |
go |
1 10 |
I 10 |
0 |
55 |
65 37 |
60 |
5 |
|
|
Earl Talbot |
Ditto |
90 |
40 |
36 |
4 |
18 |
36 |
I |
||
|
Lafcclles |
China |
108 |
67 |
67 |
0 |
IC |
)8 |
I I |
8 |
3 |
|
Walpole |
Ditto |
105 |
53 |
52 |
I |
I |
57 |
43 |
41 |
2 |
|
Thetis |
Ditto |
106 |
95 |
94 |
I |
I |
15 |
136 |
4 |
|
|
Royal Admiral |
Port J addon and 1 China J |
121 |
25 |
24 |
I |
120 |
54 |
33 |
3 |
|
|
2657 |
'253 |
I2ig |
28 |
27c |
31 |
105S |
987 |
|||
|
Dublin T |
of thefe three Ships, |
|||||||||
|
Airly Caftle 1 |
which i'ailed in the Y ear |
1791 |
, there are no |
retiu |
||||||
|
Bridgewater ) |
|
Number of Re- cruits outward |
Sick. |
Re- cove- red. |
Dead |
Inva- lid.';, c^C. lionic- waid. |
Sick. |
Re- cove- red. |
Dead |
|
309 |
. 62 |
61 |
I |
8 |
I |
I |
0 |
|
218 |
lOt) |
106 |
3 |
T |
0 |
0 |
|
|
181 |
144 |
140 |
4 |
2 I |
B |
8 |
0 |
|
16^ |
69 |
64 |
5 |
70 |
0 |
0 |
0 |
|
No Return. |
5 |
0 |
0 |
0 |
|||
|
428 |
264 |
263 |
1 |
6o |
45 |
4^ |
3 |
|
387 |
i2<; |
1 19 |
I |
39 |
12 |
10 |
3 |
|
W3 |
186 |
1,83 |
3 |
82 |
53 |
48 |
5 |
|
157 |
22 |
20 |
2 |
98 |
5 |
4 |
I |
|
138 |
74 |
72 |
2 |
46 |
2 |
0 |
|
|
142 |
35 |
32 |
3 |
88 |
■3 |
I I |
2 |
|
L55 |
26 |
24 |
2 |
69 |
■3 |
I I |
2 |
|
168 |
68 |
67 |
1 |
25 |
0 |
0 |
0 |
|
95 |
39 |
39 |
0 |
10 |
3 |
3 |
0 |
|
160 |
So |
7^ |
4 |
6 |
2 |
- 2 |
0 |
|
186 |
60 |
59 |
I |
7^ |
18 |
r8 |
0 |
|
176 |
26 |
H |
2 |
6z |
3 |
I |
2 |
|
8 |
0 |
0 |
0 |
I |
0 |
0 |
0 |
|
73 |
23 |
23 |
0 |
96 |
50 |
45 |
5 |
|
155 |
I 10 |
109 |
I |
64 |
14 |
■4 |
0 |
|
t7 |
2 |
2 |
0 |
30 |
29 |
I |
|
|
15 |
2 |
I |
1 |
28 |
10 |
7 |
3 |
|
4 |
0 |
0 |
0 |
7 |
0 |
0 |
0 |
|
0 |
0 |
0 |
0 |
2 |
0 |
0 |
0 |
|
0 |
0 |
0 |
0 |
6 |
0 |
0 |
0 |
|
Convifls |
■3 |
||||||
|
39^ |
225 |
■39 |
3 |
0 |
0 |
0 |
|
|
3929 |
1751 |
1623 |
5° |
1 ‘075 |
282 |
256 |
27 |
|
In Port. |
Sick. |
Re- cove- red. |
Da |
id |
|
St. Helena, Madras,! |
||||
|
and China J |
77 |
74 |
3 |
|
|
Coaft and China |
54 |
44 |
[0 |
|
|
Ditto |
8o |
78 |
2 |
|
|
Ditto |
25 |
24 |
1 |
|
|
Ditto |
No Return. |
|||
|
Ditto |
148 |
126 |
f |
|
|
Coaft and Bay |
38 |
30 |
> |
|
|
Ditto |
89 |
82 |
7 |
|
|
Ditto |
59 |
58 |
I |
|
|
Ditto |
3° |
26 |
4 |
|
|
Ditto |
39 |
37 |
p |
|
|
Ditto |
26 |
a4 |
» |
|
|
Bombay and China |
58 |
55 |
i |
|
|
Ditto |
89 |
82 |
’ |
|
|
Ditto |
35 |
3' |
1 |
|
|
Bombay |
61 |
61 |
||
|
Ditto |
47 |
43 |
1 |
|
|
Bencoolen and China |
20 |
20 |
||
|
St. Helena, Bengal,! |
SA |
|||
|
and Bencoolen J |
04 |
' |
||
|
1 Bengal |
71 |
61 |
I |
5 |
|
'Ditto |
106 |
89 |
I |
[ |
|
1 Ditto |
27 |
25 |
Z |
|
|
jChina |
1 16 |
I 1-0 |
) |
|
|
Ditto |
73 |
70 |
3 |
|
|
1 Ditto |
75 |
73 |
2 |
|
|
d^ort Jacklbn and 1 |
||||
|
1 China J 1 |
4 |
) |
||
|
■533 |
00 0 |
9 |
0 |
ns.
* In this Table the number of Tick fometimes exceeds the number of the fhip’s company. If the fame man is two this mull be the cafe. Sometimes alfo the number of recovered and dead. are not equal to the number of Tick ; but this fome Hill remain on the lick lilt.
three times fick during the voyage, and recovers, mtifl alfo happen when, at the end of the voyage,
XIIT.. An
C 212 3
^Ili. An Account of a fingular Cafe of Ifchuria, in a young Woman, which continued for more than three Tears ; during which Time, if her Urine zuas not drazvn off with the Catheter, floe fre- quently voided it by vonpting ; and, for the laji twenty Months, paffed much Gravel by the Ca- theter, as well as by vomiting, zvhen the UJe of that Injirument was omitted, or unjuccejs fully applied. To which are added Jome Remarks and Phyfiological Obfervations. By Ifaac Senter, M. D Affociate Member of the College of Phy~ ficians of Philadelphia, and fenior Surgeon in the late American Army. Vide Tranjaflions of the College of Phyftcians, of Philadelphia. Vol. I. Part I. 8 VO. Phila4elphia, 1793.
fubjedt of this extraordinary cafe A was a healthy-lookir.g fervant girl, who, in June, 1785, being then in her fifteenth year, was feized with a pain in the left hypochon- drium, accompanied with cough, oppreffion at her bread:, dyfpnoea, .and fever.
She had menftruated pretty regularly from the age of thirteen till within five weeks of her prefent illnefs, which was aferibed to cold.-
P ^ Venie-
[ 213 ]
Venafedion and ether fuitable remedies were had reconiTe to by Dr. Senter, to whom flie applied for relief, and her complaints foon fub- fided ; but about a month afterwards flie vo- ' mited up a quantity of bloody pus, which in- duced him to think a vomica had burft in her ftomach ; for during the whole of this illnefs, her ftomach, it feems, was fo irritable, thatflie could with difficulty retain in it cither food or' medicine.
She had now a fuppreffion of urine, which, after continuing twenty-four hours, went oft' without any medical affiftance. After this flic became regular in her menfes, and in about two months was fufficiently recovered to re- fume her employment as a fervant, which flie continued to follow till the 3d of June, 1786, when all her former complaints (except the fuppreffion of the menfes) returned with greater feverity than before.
Her pulfe was now at 120 ; her ftomach, as- during the former attack, vvas fo irritable, that fhe vomited up immediately almoft every thing, ftie took. Of the different remedies that were had recoLirfe to, opium, when flie could retain it on her ftomach, and repeated blood-letting in fmall quantities, gave her the moft relief.
On
[ 114 ]
On the 2d of July, when the feverity of the fymptoms had fubfided, fhe was feized with a total fuppreffion of urine, which continued till the beginning of the fixth day, when a vomit- ing came on, which lafted till flie brought up nothing but water ; and this water, Ihe faid, tailed like urine.
As the vomiting continued fhe found relief from the forenefs nnd fwelling flie had felt for feveral days in the lower part of the abdomen.
She now thought herfelf much better, but the vomiting continued to return, more or lefs, every day, till the 14th of July, when Dr. Senter again law her, and prevailed on her to fubmit to the introdu(5lion of a catheter, by mean^ of which he drew off about three pints of clear, but high-coloured, urine.
From this time, till December, llie conti- nued with very little abatement of her com- plaints ; and as fhe could lie in no other 'poli- tion, was conllantly fupported in an arm chair, in a reclined pofture, with pillows under her hips.
During the whole of this period, whenever her water was omitted to be drawn off once in thirty or thirty-fix hours at fartheft, llie never failed, we are alfured, to vomit it up. To af-
F 3 certain
[ 21^ ] '
certain fo extraordinary a fa6t^ our author tells us he ofren'‘vifitcd her about the time he knew die mufl; vomit if the catheter was not intro- duced ; and after examining her bladder, and finding ir full, hard, and tender, fat by her till the vomiting returned, faved the water that die brought up in this way, and on comparing it ■with what he drew off by means of the cathe- ter, found it the fame in every refpeCt.
During the time her urine came off by vo-; miting, fhe fuffered, it feems, great arlxiety and third, and complained of a fenfation of inverfion or turning up of fomeching (running, as die expreffed it) that appeared to tear her bowels.
In January, 1787, from dome caufe unknown, die could not be relieved with the inflruraenr, nor could die vomit up her urine for feveral days ; but at length it paffed by the navel for three days fucceffively ; after which the catheter was ufed with the fame effedt as before.
About thr beginning of Auguft a brick-co- loured gravel began to pafs off through the ca- theter, and continued to be difeharged in con- fiderable quantity, whenever her urine was drawn off, till the beginning of November ; at '^hicli time die felt more diftrefs than ufual,
w'hen-
I ■
■[ ]
whenever her urine came off by vomiting, and fhe foon obferved a gritty fubftance in her mouth. When our author was informed of this new phenomenon, he requefted her to fave the urine for his infpedfion the next time Ihe vo- mited; and on comparing it with what he drew off, found it contained the fame kind of gravel as that which paffed the catheter.
From this period, to the fummer of 1788, her complaints, he obferves, continued much the fame ; but during that fummer (he twice paffed a fmall quantity of urine through the urethra, each time in confequeuce of being frightened. The hypogaftrium became more tumid, and fhe complained of great forenefs about the bladder, even after it was evacuated; the bladder itfelf feemed to be much thick- ened, and the apparent inequality of its furfacc was fo great, and the tumour fometimes fhifted fo towards the right or left inguen, according as her body was moved, that our author fuf- pedfed the exiftence of a ftone.
Through the month of September her urine, we are told, could very rarely be drawn 'off; for upon the introdudlion of the catheter, a fpafm feized the urethra and neck of the blad- der, fo that although the inflmment feemed to
P 4 pafs
[ 217 i
pafs high up into the bladder, not more than a gill of urine could be drawn off, before it flopped entirely, with a fenfation of fomething falling down againft the cervix, which flie was confident was a flone ; and early in the follow-, ing month, Dr. Senter being able to introduce a found, readily met with a flone, which feemed to be of a fmall fize,‘ and fofter than urinary calculi commonly are.
She had at different feafons of the year feverai fmall abfceffes on different parts of her body, but they did not appear to relieve her general complaints. She alfo voided at times (after file had thrown up her urine) a bloody pus, of a coppery tafle. This purulent difcharge, it is obferved, was never expeftorated by coughing, though fhe had at times a dry cough, but was conftantly brought up by vomiting.
In the fpring of 1789 her urine began to pafs per anum, loaded with the fame kind of gravel that had come away by the catheter. This diminifhed but did not put a flop to her vomiting ; for fhe continued to throw up more or lefs gravel that way every week. This new courfe of her urine occafioned a troublefome diarrhoea and tenefmus, but flie felt lefs incon- venience from the done in the bladder.
After
[ ]
After the 13th of May her bladder never be-, came fo much diftended with urine as it had been before ; and the fecretion of urine^ as well as the formation of .gravel, we are told, evi- dently diminilhed in proportion to her lofs of ftrength, and the increafe of the diarrhcea. The menfes, which, during the whole of her jllnefs, had returned at irregular periods, now entirely ccafed. During the fummer, the fre- quency of vomiting increafed ; Ihe had feveral convulfive fits after vomiting ; became more and more emaciated, and heftical ; and, at Jaft, lethargic; and on the nth of Auguft, ^ 1789, died.
The body was examined the day after her death, by Dr. Senter, in the prefence of Dr. Waterhoufe, of Cambridge, and Dr. Mafon, of Philadelphia, who, as well as feveral other rerpedlable medical practitioners, had occa- lionally vifited her in her life-time, and feen her vomit up both urine and gravel.
On difleCtion, nothing was difcovered that could throw any light on the nature of the difeafe.
In the thorax, the only morbid appearance was an adhefion of part of the right lobe of the lungs to the pleura.
C 219 ]
In the abdomen, the omentum was found much wafted, and of a dark gangrenous co- lour; the ftomach aUo is defciibed as being in a gangrenous ftate, 'and containing ‘ a femi-pu- ‘ rulent matter, of a foetid fcent but the wea- ther, we find, was very warm, and the body in an ofFenfive ftate, at the time the diftedion was made. Nothing particularly worthy of notice was obferved in' the ftate of the liver, gall- bladder, inteftines, kidneys, or ureters. The urinary bladder was alfo in its natural ftate, not in the leaft thickened, and contained no fand or gravel. The uterus contained about a drachm of thick, feetid pus, but had no other appearance of difeafe ; the Fallopian tubes were larger than ufual, and ftrung with feveral hyda- tids of the fize of a walnut ; the corpora fim- briata had a gangrenous appearance^ ; the ova- ria were enlarged to the fize of a fmall hen’s egg, and diftended with a clear limpid fluid.
To the preceding hiftory Dr. Senter has added many judicious remarks ; and in his at- tempt to account for the phenomena of fo very uncommon a cafe, has not omitted to avail
himfelf of the modern dodrine of the retro-
*
grade motion of the lymphatics, and of the opinions of thofe writers who have maintained
the
[ 220 3
the exiftencc of a direft communication between thp alimentary canal and the urinary bladder.
There are many inftances, he obferves, in medical books, of fudden and partially-in- creafed actions of the_ veil'ds of the human body ; but he candidly acknowledges that his reading has furnifhed him with no fadt fimilar to the extraordinary one which is the fubjed: of the paper before us ; that which he confiders
as
* There are, however, upon record, two cafes which exr hibit a ftriking analogy to that of Dr. Senter’s patient ; and although they may have been overlooked, or perhaps difre- garded on a fuppoiition of their improbability, they mull now become extremely interefting by the tendency they have to corroborate the curious and extraordinary fadfs he has re- lated, Both the cafes we allude to occur in the Hiftory of the Academy of Sciences at Paris, and are as follows :
Cafe I. “ M. Maraldi has communicated to the Aca- demy the following cafe, from a letter addrelfed to him “ by M. Marangoni, phyfician at Mantua;
“ A Nun, of the Order of St. Francis, in the convent of St. Jofeph, at Mantua, aged thirty-five years, of a thin aitd delicate habit of body, and who had long been fub- jedl to hyiferical complaints, was attacked with pains, “ fpafms, and fweliing of the abdomen, to which fucceeded “ a violent and alarming fuppreflion of urine. Soon after this fire felt a pain, which fire deferibed as afeending from f' the lower part of the abdomen to her Itoirrach ; aird fire
‘ ‘ vomited
[ 221 ].
as coming the neareH to it, is a cafe defcribed by Dr. Percival, in the fecond volume of his Effays, Medical and Experimental, (8vo,
London,
vomited a fluid which, without any difficulty, was “ known to be urine. This vomiting continued forty days, “ during which time the patient voided no urine by the *« ufual channel, unlefs the furgeon drew it off with a cg,'- theter, and even then the quantity fcarcely amounted to •* an ounce a day. At the end of the forty days, the urine “ fpontaneoufly refumed its natural courfe, and in a day or two the patient found herfelf perfedlly recovered. But the vomiting of urine returned, and at the end of twenty- feven days, the patient complained of very acute pain “ about the region of the pubis. Her furgeon was defirous “ oh relieving her by means of the catheter, but there was fuch a contradiion of the urethra, that he found it itnpof- ‘f Able to introduce even a probe into the bladder. The “ vomiting of urine has continued, and what is remarka- ble, there is no appearance of food mixed with it, even “ when the vomiting takes place foon after her meals. “ When M. Marangoni wrote this account, the patient had ‘f been in this ftate thirty-two days.
“ This Angular complaint would lead one to think there is an immediate though hitherto undifcovered coinmu- nication between the flomach and the urinary bladder ; but M. Marangoni and the celebrated Lancifi are of a “ different opinion; they both of them think, that in cafes of this kind a fuppreffion of urine takes place in the kid- neys; that is to fay, that the kidneys ceafc to extradl this
“ flui^
f 222 3
London, 1773) of ai woman who, after a fpon- .taneous vomiting of feveral days, during which file brought up three gallons of w'ater, was en- tirely cured of a dropfy of the ovarium.
“ fluid from the blood, and that in their ftead the glands of “ the ftomach perform this function.”
Cafe II. “ M. Lemery is acquainted with a Monk, who, “ for about eight years, has been fubjeft to a periodical vo- “ miting, the fits of which are as regular as thofe of a quar- “ tan ague. Five hours, or thereabouts, before the voinit- “ ing begins he complains of violent pains in his kidneys. “ The vomiting continues, with Intervals, four or five hours. What he vomits is of a dirty red colour. It is “ almoft entirely water, but has a flrong urinous fmell, and “ the patient has no doubt of its being really urine, as he eats but very little, and drinks more than the ufual portion ■“ of a Monk. He drinks only wine, the colour^of which “ agrees with that of the fluid he vomits. A few hours “ after the vomiting he finds himfelf well, and remains fo “ till the next fit. He ufes a great deal of exercife, with- “ out which he thinks he fhould fuffer more. It is a known “ faft, that in nephritic pains, which are always occa’lioned “ by obftruftions of tire kidneys, the patients are fubjeft to “ frequent vomiting, and that what they bring up fmells
“ much of urine.” See Hiftoire de I’Academie Royale
des Sciences, Annees iyz2. Editor.
CATALOGUE
[ ]
CATALOGUE op BOOKS,
^f^HOUGHTS on the Effeds of the Ap*- X plication and Abflradion of Stimuli on the Human Body; with a particular View to explain the Nature and Cure of Typhus. By y. Wood^ M. D. 8vo. Murray f London, 1793*
2. An Account of the Bilious, Remitting, Yellow Fever, as it appeared in the City of Philadelphia in the year 1793. By Benjamin Rn/hy M. D. 8 VO. Philadelphia, 1794.
3. Obfervatlons on the Canfe, Nature, and Treatment of the Epidemic DIforder prevalent in Philadelphia. By D. NaJJjy M. D. Mem* ber of the American Philofophical Society. 8vo. Philadelphia, 1793.
4. A Short Account of the Malignant Fever, lately prevalent in Philadelphia ; with a State- ment’of the Proceedings that took place on the Subjed in different Parts of the United States. 'Qy Matthew Carey. 8vo. Philadelphia, 1793.
5. A Treatife on the Extradion of the Ca- tarad. By Frederick Bifehoff, F. M. S. Oculifl to his Majelly in the Eledorate of Hanover,
I and
[ 224 3
and to her Majefty in England. 8vo. Nicolf London, 1793*
6. An Account of a Fever which appeared in feveral Parts of Somerfctfliire in the year 1792. By Richard Poole, Surgeon, Sherborne. 8vo. Johnfon, London, 1793*
• 7. A Guide for Sclf-Prefervation and Paren- tal Alfedtion ; or plain Directions for enabling People to keep themfelves and their Children free from feveral common Diforders. By Pho- mas Beddoes, M. D. i2mo. Murray, London,
1793-
8. A Chemical Differtation on the Thermal Waters of Pifa, and on the neighbouring aci- dulous Spring of Afciano ; with an Hiftorical Sketch of Pifa, and a Meteorological Account of its Weather. To which are added. Analy- tical Papers refpeCting the Sulphureous Water of Yverdun. By John Nott, M. D. of Brillol Hot-well?. 8vo. Walter, London, 1793.
9. Horti Botanici Cantabrigienlis Catalogus. 8 VO. Cantabrigifc, 1794.
10. Flora Oxonlenfis, exhibens Plantas in agro Oxonienfi fponte crefcentes, fecundum Syftema fexuale diftributas. AuCtore Joanne Sibthor-p, M. D. Profeflbre Regio Botanico, Re- gia Societatis Londinenfis aliarumque Societa- tum Socio. 8vo. Oxonii, 1794.
1 1. Differ-
C ^2^ ]
ii. Differtatio Inauguralis de Angina ma- ligna. Auftore Arthuro Bedford, Anglo. 8voi ^ Edinburgi, 1792.
12. Diffeitatio Inaugnralfs de Refpiratione. Audtore Idhoma Blair, Scoto-Britanno. 8vo. Edin. 1792.
13. Differtatio Inauguralis de Variolis. Auc- x.ort Joanne Bower, Scoto. 8vo. Edin. 1792.
14. Differtatio Inauguralis de Vifu. Auc- tore Wheaton Bradijh, Hiberno. 8vo. Edin*
. ^792-
15. Differtatio Inauguralis dc Rheumatifmo acuco. Audlore Joanne Bradley, Anglo. 8vo*. Edin. 1792.
16. Differtatio Inauguralis de Coell Effedtibus,
Audtore Jacoho Buchan, Scoto. 8vo. Edin* 1792. ' V
17 Differtatio Inauguralis de Rheumatifmo acuto. Audtore Andrea Grieve, Scoto. 8vo. Edin. 1792.
18. Differtatio Inauguralis de Hypochon-
driafi. A\od:o\-Q David Corbin Kerr, Virginienfe. 8vo. Edin. 1792* 1
19. Difiertatio Inauguralis de Variolis. Auc- tore Gulielmo Marfden, Anglo-Britanno. 8vo* Edin. 1792.
20. Difiertatio Inauguralis de Pneumonia*
2 , ‘ Audtors
C ]
Auftore Carolo Merivether, Virginienfe. 8vo.' Edin. 1792.
21. DiffertatTo Inauguralis de Variolis. Auc-
tore Roberto Montgomery, Hiberno. 8vo. ,Edin.. 1792. ^ ^ ^
22. Differtatio Inauguralis de Hydrdpe Ana-‘ farca. Autflore Thoma Pollard Pierce, Barba* denfe. 8vo. Edin. 1792.
23. Diflertatio Inauguralis de Angina ma-. ligna. Auflore Georgia IVier, Scoto. 8vo Edin, 1792.
24. DilTertatio Inauguralis de Alimento.,
' Auftore Gulielmo- Tates, Anglo. 8vo* Edin.
1792.
25. Diflertatio Inauguralis de Coitu ejufquc Tariis Formis quatenus Medicorum funt. Auc* tore Joh’anne Paul Gottleib Kircheifen, 4^0. Jena, 1792.
26. Analyfe du Syfteme abforbant ou lym- phatique. Par M. des Genettes, D. M. 8vo. Montpellier, 1791.
27. Memoire fur une Maladie de I’Ovaire. Par Jean Baptijle Ph. R. N. Laumonier, Chirur- gien en chef de I’Hotel Dieu de Rouen. 4to. Rouen, 1 790.
28. Avis aux Sages Femmes ; par M. Sacomhe,
VoL. VI. Medecin
C 227 ]
Mcdccin-Accoucheur, Membrc dc plufieurs Academies. 8vo. Paris, 1792.
29. Recherches Phyfico-cliyrniques. Cahlers I. II. 111. 4.10. Amfterdaai, 1793-4,
30. Memoires de I’Academie Royale dcs Sciences et Belles Lettres depuis TAvenement de Frederic Guillaume II. au Trone. 1788 ec' 1789. Avec PHiftoire pour le meme Terns. 4to. Berlin, '793.
31. Sammlung der DeutfChen Abhandlungen wclche in der Kdniglichen Akademie der Wif- fenfchaften zu Berlin vorgelefen worden in den Jahren 1788 und 1789. i.e. A Collection of German ElTays, read before the Royal Academy of Sciences at Berlin, in the Years 1788 and 1789. 4to. Berlin, 1793.
32. MemOria Chirurgica 'ul Labbro leporino complicato ; di Giufeppe Sonfis, R. AlTelT. Me- dico, '&c. .-4to. Cremona, 1793.
33. Pifaiira Automorpha e Coreopfis formofa ; Piante nuove pubblicate da Giufeppe Antonio Bor- ■nato, Dott. di Medicina, pubblico Biblioteca- rio, Ifpettore e Soprantendente all’ Orto me- dico dell’ Univerlii;a di Padova. 410. Padoyaji
1793-
INDEX.
C 228 j
INDEX.
A.
AGID, Vegetable, Solution of Sal Ammoniac In, good cffe6ts of, in lacerated Wounds, — 66
Africa, Coaft of, Obfervatlons on the DIfeafes moft frequent there, — — 60
Aliment, Dlflertatlqn on, 226
Ammoniacal Salt, Solution of, in Vinegar, gqod ejffefts of, in
lacerated Wounds, 66
Anafarca, Differtatlon on, 226
Aneurifm, of the Crural Artery, Cafe of, — 114
Angina, malignant, DIlTertations on, — 225,226
Animal Eleftricity, Obfervations and Experiments relative
to, — 1 16 1
Antimony, tartarifed, recommended as the beft Emetic in the
Intermittents of Tropical Climates, 42
— — , ill effefts of naufeating Dofes of, during
the State of apyrexia in fuch Cafes, ihid^
Arfenic, Obfervations on its life in Intermittents, 1, 46, 61 , E^cdts of, in fuch Cafes, when combined with Pe- ruvian Bark, 43
faid to be as powerful and nearly as certain as the Bark, in the Cure of Intermittents j but allowed to be in- ferior to the Bark in its tonic Elfefts, — 46
, Conjedlure concerning its fpecific Adiion, and that
of the Bark, in the Cure of Intermittents, 47
, Account of irregular Cafes of Intermittents in
which it fails, 44
Hiftorical Account of its Ufe in Intermittents, 46 Atmofpheres, Eledrical, Etteds of, on Frogs and other Ani- mals, 166
B.
Bark, Peruvian, the only Remedy to be relied on in the In- termittents of Tropical Climates threatening immediate
Danger, — 44
; : , Conjedures relative to its fpecifie Adion
in the Cure of Intermittents, ’ 47, 143
CL* Bark,
[ 229 ]
Peruvian, Prejudices which ftill prevail againft its
> different Species of, enumerated,
Beddoes, Thomas, Guide for Self-prefervation,
Bedford, Arthur, de Angina maligna.
57
146
224
225 227 223 22^
Berlin, Memoirs of the Academy of Sciences at,
Bifchoff, Fred, on the Extradlion of the Cataraft,
Blair, Thomas, de Refpiratione,
— — , William, of the Extraftion of an extraneous Subftance
from the Reftum, — —
Bonato, G. Anton. Defcription of two new Plants,
’Bower, Joannes, de Variolis,
Bradifh, Wheaton, de Vifu,
Bradley, Joannes, de Rhcumatifmo acuto.
1 1 1 227 225 ibid, ibid.
Bread, toafted, Inflance of its producing painful Effefts in
the Reftum, i j x
Buchan, Jacobus, de Coeli Effe£tibus, 225
C.
Cambridge, Catalogue of the Botanic Garden at, 224
Camper, Profeflbr, his Demonjlr. Anat. Pathol, referred to,
107, 108
Carey, Matthew, Accouot of the Yellow Fever at Phi-
. ladclphia, — 223
and 66 85
9* 223
193
146 120 225
Carter, Henry Yates, on the Effeds of Sal Ammoniac Vinegar on lacerated Wounds, — .
■ , Cafe of a difeafed Kidney,
Gun-fhot Wound,
Catarart, Treatife on the Extraftion of, ^
••Caterpillars, not affefted by Eleftricity, '
Cinchona, different Species of, enumerated, ' —
; Clarke, Robert, Account of a new Key Inftrument,
Climate, Differtation on the Effefts of, —
Coating, Metallic, Advantages of, in Experiments of Animal
Eledtricity, 174
, of two different Metals, Obfervations on the Ufe
; . of, in Experiments of Animal Elef.ficity, 178, 183
D.
. Biarrhoea, Effcdls of Mahogany Wood in Cafes of, 156 Duncan, Dr. Andrew, Junior, his Differtation on the Swi- ctenia Soymida referred to, 127, 144
Eledlricity, Animal, Obfervations and Experiments relative
' ^ 161
Eledlricity,
[ ^30 ]
feleflricity, Difcovery of a new I^w in, — 1 77, ig»
r Eftimate of the Quantity of, neceffary to produce
certain EfFeds in a Frog, 1 70
Eleftrometer, Animal, what fo called, — 171
Emetics, good Effedls of, in Intermittents, 41 , 42
F. ^
Fever, Epidemic, in Somerfetlhire, Work relative to, 224 , Intermittent, of a Tropical Climate, Obfervations
on.
guiflied from the Remittent,
how diftin- 43
anomalous
Cafes of, deferibed,
44
• , See A7UiiH07iy,
Arfenic, Bark, Emetics, Opium.
-1 , Intermittent and Remittent, the mofl: frequent Dit-
eafes on the Coaft of Africa, 60
-, Yellow, at Philadelphia, Works relative to, 223
Forfter, Thompfon, Cafe of Aneurifm of the Crural Artery,
^ 114
P'rogs, EfFeftsof Elcftric Atmofpheres on, — 166
G.
Galvani, Lewis, Account of his Difeoveries relative to Ani- mal Eleftricity, • ■ - 1 61
Genettes, M. des, Analyfe du SyftemeLymphatique, 226 Gravel, voided, with Urine, by vomiting, — 213
Grieve, Andreas, de Rheumatifmo acuto, 223
H.
Hare Lip, Work relative to, 227
Head, Cafe of a Gun-lhot Wound of, — 91
Hughes, Francis, on the Effedls of Mahogany Wood in Di- arrhoea,
Hypochondriacal Affedlicn, Differtation on, — 22^
I
Infedls, feveral Species of, not affedled by Eledlricity, 194 Intermittents of a Tropical Climate, Obfervations on theUfe
of Arfenic in, 1
, Ufe of Opium in, 4*
Emetics in, iii^.
a Remittent Fever,
-, how diftinguifhed from
43
; ; Circiimftances of,. in
which the Bark alone is to be relied on, ^ ^
Intermittent^
t
231
]
Intermittents of a Tropical Climate, anomalous Cafes oi;
defcribed, — — ~
Ifchuria, fingula'r Cafe of, —
IlTue, fingular Effeils of,
K.
ihido
212
109
Kerr, David Corbin, de Hypochondriafi, 22^
Key Inftrument, of a new Conltruftion, Account of, 120 ^ , Obfervatioi’is on the Principles ^on which it
afts, ■ - - 124,
Kidney difeafed. Cafe of,
'Appearance of, on Diffeftion, 89
Kircheifen, I. P. G. Differtatio de Coitu, — 226
L
Lancifi, his Theory of a Cafe in which Urine was voided by- vomiting, — - 221
Laumonier, M. fur une Maladiede I’Ovairc, ■ — 226
Lemery, M. Cafe of a Monk who vomited Urine, 222 Leyden Phial, the fuppofed Analogy of, to fome Phenomena
of Animal Eleftricity, 190
Lizard, Experiment on, . 202
Lorimer, Dr. John, Return of the Sick on Board the Eaft- India Company’s Ships forthe Years 1792 and 1793, 211 Lymphatic Syftem, Work relative to, 226
M.
Mahogany, a new Species of, defcribed, and its Bark recom- mended as a Subftitute for the Peruvian Bark, 127
, Wood, Account of its Effefts in Diarrhoea, i
»- , of Jamaica, defcribed as rnore aftringent
than that of Honduras, 157-
iVIarangoni, M. Cafe of a Patient who vomited Urine, 220
Marfden, Gulielmus, deVariolis, 22^;
Mdia Azadirachta, the Bark of, recommended as a Subftitute
for Peruvian Bark, 1 94
Merrivether, Carolus, de Pneumonia, — 225-
Montgomery, Robertus, de Variolis, 226
Mufcles, Experiments on, 188, 191, 198, 202
■ , not immediately affeded by Eleftricity, 179, 200
— , voluntary, the only ones affeded by weak Currents
of Eleftricky, 197
N. _ _
^^alfy. Dr. D. Obfervations on the Epidemic Fever at Phila- delphia, — ^ — 223
J^cle*
1
C ^3^ ]
Nauclea Daduga, Bark of, its Properties defcribed,
Nerves, the only Parts immediately affedled by Eleftricity,
179, 200
— , Effefts of certain morbid Alterations 6f, — -, Experiments on.
-, painful Effefts of PreiTure on,
-, iubcutaneous, a Difeafe of, defcribed.
96
i8t
lor
108
224
Ndtt, Dr. John, on the Waters of Pifaand Yverdun,
O.
Ppium, its Eifefls in the Intermittent* of a tropical Cli- mate, — ' — — ^ — 41
Ovarium, Dropfy of, cured by a fpdntaneous vomiting, 221
P.
fearfon, John, Account of extraordinary Symptoms arifing from certain morbid Affeftions of the Veins and Nerves, 96 Percival, Dr. his Account of a Dropfy of the Ovarium cured
by a fpontansous vomiting, referred to, 221
Philadelphia, Works relative to the Yellow Fever at, 22 j
Pierce, Thomas Pollard, de Hydrope Anafarea, 226
Pifa, Differtation on the Thermal Waters of, — 224
jPneumonia, Differtation on, 22^
Poole, Richard, Account of an Epidemic Fever in Somer-
fetfhire, 224
Pouteau, M. his Pofthumous Works quoted, iqj
Q:.
Quadrupeds, Experiments on,
R.
Recherches Phylico-chymiques,
Remittent Fever, Fever.
Refpiration, Differtation on, —
Rheumatifm, acute, Differtation on, —
Roxburgh, Dr. W, Account of a new Species of
l8i, 187
227
Rulh, Dr. Benj. of the Bilious Remitting Yellow
S.
Sacombe, M. Avis aux Sages Femmes Sal Ammoniac. — See Ammoniacal Salt.
Senter, Dr. Ifaac, of a fmgular Cafe of ifehuria
Sibthorp, Joannes, Flora Oxonienfis
Sierra Leone, Account or the Weathe a'.
Small Pox, Differtations on,
Sonfis, G. his Work relative to the Hare L.’p jStimuii, Work relative to the Effefts of.
225
225
Swietenia,
Jbever, 223
226
212
224
— 2 225, 226 227 ' 223
Swietenia,
[ ^33 ]■
ywietenia, Accounts of two new Species of, 127, 1^3
T.
Xeeth, Obfetvatlons on tlie Extradlion of, by the Key Inftru-
ment, — 121
Tongue, human. Experiments on, 208
, of Quadrupeds, Experiments on, 209, 210
Typhus, Work relative to the Nature and Cure of, 22^
V.
Vinegar, Solution of Sal Ammoniac In, Effe^s of, on lace- rated Wounds, r J 66
Vilion, Differtatioii on, ^ 2.25
Volta, Alexander, Tranflation of his Letters on Animal
Eledlricity, 161
Urine, Cafes in which it has been voided by vomiting,
212, 220, 222
W. _
Wallurfe, a Tree fo called by the Hindoos, deferibed, 1 54 Wier, Georgius, de Angina maligna, — 226
Winterbottom, Dr, T. M. on the Ufe of Arfenic in Inter-
mittents, — i
, Account of the Weather at Si- 2
J94
erra Leone,
Worms, not affefled by Eleftricity,
Wood, Dr. J, on the Application and Abftraftlon of Stimuli,
1 ^
Y.
Yates, GuIIelmus, de Alimento, 226
Yellow Fever, Works relative to it, • 223
Yverdun, Work relative to the fulphureous Water of, 224
• XND QF THE SIXTH VOLUME.
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