■
m
MEDICAL FACTS
AND
OBSERVATIONS.
VOL. V.
MEDICAL FACTS
AND
OBSERVATIONS.
VOLUME THE FIFTH.
LONDON:
PRINTED FOR J.JOHNSON, N° 72, ST. PAUl/S CHURCH YARD,
.T*0+
[ v J
CONTENTS,
Page
I. AN Account of two Cafes of Popliteal
Aneurifm. By Mr. Thompfon Forfter,
Surgeon on the Staff of the Army, and Sur-
geon to Gufs HofpitaL — — x
II. An Account of the good EffeBs of Opium in
the Cafe of a Perfon poifmed by Digita-
lis. By Thomas Beddoes, M.D. 17
III. Some Obfervations on the DiJ cafes that
occurred on Board the Ship Europa, in the
Service of the Hon. Eaft India Company ,
during a Voyage from England to and from
Madrafs and Bengal. By Mr John Wat-
Ton, late Surgeon of the faid Ship, and
now Surgeon at Wellingborough 9 in Nor-
th amptonjhire. — — — 2 a
IV. Cafe of a compound Diflocation of the
Tibia and Fibula, accompanied with a
FraElure and Lofs of a confiderable Portion
of the AJtragalus, and likewife with a
£r allure of the Thigh Bone ; with Re-
marks.
[ VI ]
Page
marks. By Mr. James Rumfey, Surgeon
at Amerjham in Buckinghamshire. — 44
V. A Cafe of violent Di/hrtion of the Foot,
cccafioned by a Rotation of the Afiragalus,
in confequence cf a Fall, and accompa-
nied zvith a Laceration of the Integu-
ments at the outer Ancle, and Expo fare of
a Portion cf the Fibula. By Mr. William
Guv, Surgeon at Chicbejter. — — 54
VI. Cafes of the Urticaria or Nettle Rajh,
with Obfervdtions; By T. M. Winter-
bottom, M. D. Phyjician to the Settlement
at Sierra Leone. — — — 57
VII. An Account cf the Effects of Vitriolic
JEther in a Cafe of fpafmodic Affeclion of
the Stomach ; and in two Cafes of Inter-
mittent Fever. By Mr. William David-
fon, Apothecary in London. r— — 68
VIII. An Account of the poifonous Effects of
the Seeds of the Datura Stramonium Linn.
By Mr. James Johnfon, Surgeon at Lan-
( after. — - — - — — 78
IX. A Cafe of Hydrophobia. By Mr. Rich-
ard Simmons, Surgeon to the Britijh Ly-
ing-in Hojpiial. — — s — 87
X. An Account of a Child born without Or-
gans of Generation. By Air. Edward
Ford,
Psge
[ Vii J
Ford, . F. A. S. Surgeon to the V/ef.minftQr
General Difpenfary. — — — 92
XI. Cafe of Apoplexy in a pregnant Woman ;
zvith Obfervations. By Mr. Philip Wil-
liams, Surgeon at Rugby in JVarwichJtiife. 96
XII. Def riptlon of Ki.burn Wells ^ and Ana-
lyfis of their PVater. By Mr. Joh. Godfr.
SchmeilTer. From the Fhiiofoph'ual
Tranfaclions of the Royal Society of Lon-
don. — — 100
XIII. An Account of the remarkable Effects
of a Shipwreck on the Mariners ; zvith
Experiments and Obfervations on the In-
fluence of Imfnerjion in frcjlo and jolt
Water j hot and cold, on the Powers of the
living Body. By James Cuirie, of Li-
verpool, M. D. Fellow of the Royal Col-
lege of Fhyfuians at Edinburgh. From
the fame Work. — — 103
XIV. An Account of the §uaj/la Polygama,
or Bitter -wood of Jamaica ; and of the
Cinchona Brachycarpa, a new Species of
J ef nit's Bark found in the fame I/land. By
Mr. John Lindfay, Surgeon in IVefimore-
landy Jamaica. From the Tran/xclmis of
the Royal Society cf Edinburgh. — 140
XV. Extracl of a Letter from the Re-
4 ■ . verend
Page
L vlii ]
verend Charles Perceval to Robert Per
ceval, M. D. and M. R. I. A. From
the Tranfaclions of the Royal Irijh Aca-
demy. — — — 157
XVI. An Attempt to determine with Precifion
Juch Injuries of the Head as neceffarily
require the Operation of the Trephine. By
Sylvefter 6'Halloran, Efq. M. R. LA.
Honorary Member of the Royal College of
Surgeons in Ireland, and Surgeon to the
County of Limerick Hofpital. From the
fame Work. — — 161
XVII. Account of a fijlulous Opening in the
Stomach. By George Burro wes, M. D.
M. R. L A. From the fame Work. 185
Catalogue of Books. < — — — 190
Index. — — — — — 223
DIRECTIONS TO THE BINDER.
Plate the Firft may be placed at page 9;, where the refe«
rence* to it are explained ; and Plate the Second at-page 98,
IRXATUM.
In Vol.. IV. page i«2, line t, for but the uterus, read but the dif-
charge from the utcrui.
totary of
^**-
'.YLSND
MEDICAL F ACTS
AND
OBSERVATIONS.
I. An Account of two Cafes of Popliteal Aneurifm ;
communicated in a Letter to Samuel Foart
Simmons, M. D. F. R. S. by Mr. Thompfon
Forfter, Surgeon on the Staff of the Army, and
Surgeon to Guy*s HofpitaL
To Dr. Simmons.
Dear Sir,
THE mode of operation for the popliteal
aneurifm, adopted by that truly-ingenious
phyfiologift, the late Mr. John Hunter, may
perhaps be coniidered as one of the moft valua-
ble improvements of modern furgery. It ap-
Vol. V, B pears
[ * ]
pears evidently to have been the refult of a ju-
dicious chain of reafoning, founded on a tho-
rough knowledge of the vafcular fyftem, and
of the powers refiding in the abforbents •, but
the full extent of its merits or defects, and
confequently the grounds on which it may be
fufceptible of farther improvement, can be af-
certained only by the accumulated obfervations
of different practitioners, accurately and can-
didly related. Hence it is that having lately-
had two cafes under my care, in which I have
performed the operation in queftion, I confider
it as a fort of duty to communicate them to the
Public : I therefore take the liberty of tranfmit-
ting to you the following account of them, to
be inferred, if you deem it fufficiently inte-
refling, in your valuable collection of Medical
Facts and Obfervations.
Believe me, Dear Sir,
Yours, &c.
Oftofov 2 2, I793.
Thompson Forster.
CASE
[ 3 ]
CASE L
jofeph Keeping* aged thirty -five years, a
ftrong, healthy, hard-working man, by trade
a carpenter, was admitted as my patient into
Guy's Hofpital, on the 17th of Auguft, 1791*
for the cure of an aneurifm of the popliteal
artery.
This complaint had begun about a year be-
fore, with a fudden pain in the calf of his leg*
followed by a flight univerfal fwelling of the
whole limb, but not attended with fufficient in-
convenience to hinder him from working daily
at his bufinefs.
At the end of a fortnight he perceived a
fmall tumour more immediately in the ham;
and in the courfe of about fix weeks from its
firfl appearance, it increafed to the fize of half
a golden pippin, forming a protrufion which
appeared, in fome meafure, diftincl; from the
general cederriatous enlargement of the limb.
To this tumour he applied embrocations and
oils recommended by different perfons of his
acquaintance, for two months more, at the ex-
B % piratiori
C 4 "J
piratidn of which time, he was fo far from be-
ing better, that it was not without great pain
he could attend his bufintfs, the limb being
more univerfally enlarged, and the difficulty of
moving it fo much increafed, that he now found
himfelf obliged to defift intirely from all manner
of work. In this fta:e he remained fome time
longer, with the hope that reft, which gave
him eafe, would in time cure his complaint.
He ftill continued, however, to rub the limb with
oils of fome kind or other, till at length his
hand, by frequently going over the fmall tu-
mour in the ham, became fenfible of a pretty
ftrong pulfation in ir. Being much alarmed at
this, he came into Guy's Hofpital in Decem-
ber, 1790, where red, an horizontal pofition,
and the continued ufe of a bandage from the
foot to the middle of the thigh, confiderably
diminifhed the general enlargement of the limb,
but the protruding pulfating tumour remained
in the fame Hate as before.
As he was very defirous of returning to his
bufinefs, and no immediate danger of his life
was then apprehended, he was permitted, to-
wards the end of January, 1791, to go out of
the hofpital, as he worked near it, but was de-
fired to come again whenever the complaint
mould
C 5 ]
{hould give him any inconvenience, and was
directed to favor the limb as much as he could,
and to keep it conftantly rolled from the foot
upwards. We heard nothing of him till Au-
guft 17, 1791, when he appeared to be in a
very alarming fiate. His foot, leg, and ham,
were.now very much enlarged, and the tumour,
before mentioned, was increafed and tenfe; the
fkin was very thin, exhibiting that appearance
which an abfcefs acquires when in a ftate of per-
fect fuppuration ; and the pulfation of the tu-
mour was vifible, even at fome diftanee from
him; his pulfe was very quick and full; he
was extremely irritable and weak ; he had a
dry fkin, with confiderable third; and anxiety
was ftrongly marked in his countenance.
1 immediately ordered ten ounces of blood
to be taken from his arm, and a purgative me-
dicine to be given in the morning, as he had
not had any evacuation for four days.
On the morning of the 22d, in confultation
with my colleagues, MefTrs. Lucas and Cooper,
it was judged advifable, in order to preferve
his life, that the femoral artery ihould be fe-
cured, and to truft to the abforbing powers to
leffen the tumour and the enlarged limb.
B 3 I placed
r 6 ]
I placed a tourniquet on the limb as high as
poflible, in order to have rcom enough ; but
the tourniquet was intirely loofe, and of courfe
made no prerTure on the artery. It was fo
placed, however, as to be capable of inltantly
flopping the circulation if required. I then
made an incifion in the courfe of the under
edge of thefartorius mufcle, about three inches in
length, and, by railing up the lower edge of that
mufcle, I came at the artery, about two inches
before it perforates the triceps femoris; after
carefully feparating it from the vein and nerve,
I pafTed a broad ligature by means of a com-
mon eyed-probe under it, placing a doflil of
lint on the artery immediately over the ligature,
upon which lint I laid a cylindrical piece of
wood, about a third of an inch in diameter,
and three quarters of an inch long, fo that on
tying the ligature, the artery, lint, and flick
became included in fuch a manner as to make
the artery fpread itfelf more than half round
the (lick thus cufhioned with the doflil of lint.
I conceive all this precaution to be abfolutely
neceflary to guard againfl the circumflance of
the coats of the artery being cut through by
the ligature in the fir ft infhnce; and, in the fe-
cond, to prevent the impetus of the blood from
throwing
I 7 3
throwing off the ligature at the end of fome
days, when the ulcerative procefs may have
weakened the coats of the artery at the com-
prefTed part : and if we allow a poffibility of
this happening before the depofit of coagulable
lymph lhall have become fufficiently vafcular to
render it capable of refitting the force of the
column of blood oppofed to it, every precau*
tion mould be taken to prevent an haemorrhage
from fo large a vefTel, which mod likely would
prove fatal before affiftance could be procured ;
thefe were my reafons for interpofing the lint
and flick between the ligature and the artery.
I then drew the ligature tight enough to (lop
all pulfation in the tumour below; I left the
ends of the ligature out of the wound, which
I partially clofed ; the dreflings were fuperficial,
and I applied an eafy bandage.
The firfl confequence refulting from this li-
gature, was an immediate flop to the pulfation
in the tumour, and an evident ly-increafed fulnefs
in the pulfe at the wrilt. The patient was kept
perfectly quiet, and allowed only diluting
drinks; at eight in the evening, (about feven
hours after the operation) his pulfe being quick
and full, fix ounces of blood were taken from
his arm, and he took a grain of opium.
B 4 Aug.
[ 8 ]
Aug. 23d. He had patted a reftlefs night,
with thirft, and pain in his thigh. The tem-
perature of the limb was this day feveral degrees
lower than that of the other limb; but as I
fubjoin a table of temperature, I fhall omit it
in the narrative ; his pulfe, however, was more
moderate ; he had fome good fleep during the
day, and his pain became lefs, but his pulfe
was quicker towards the evening ; the opiate
was repeated.
24th. This morning he fcarcely complained
of any pain in the limb As he was coftive, I
ordered him fomecaftor oil, by means of which
(tools were procured.
The next day, (the 25th) he was very calm,
and without any pain in the limb, having flept
well the preceding night 5 (till, however, his
pulfe kept at from 102 to no. I gave him a
faline julep and the opiate as before.
Except a quicknefs of his pulfe, which
came on every evening, coftivenefs, which
was occafionally relieved, and a certain irritabi-
lity about him, nothing occurred till the 27th,
when an uneafinefs and fetor in the limb obliged
me to drefs the wound. There was then a very
great difcharge of good matter; I ordered him
the bark, and a more nouriihing diet. From
this
C 9 3
this time he loft that quicknefs of his pulfe,
and that irritability before mentioned ; his limb,
below the ligature, -about this time became re-
laxed, particularly the tumour in the ham ; the
frze of the whole limb was perceptibly lefs, and
his appetite returned ; but the difeharge remain-
ing very confiderable, he continued to take the
bark and opium, and care was taken to obviate
coftivenefs.
On the eighth of September, that is, on the
feventeenth day from the operation, the liga-
ture, flick, and lint came all away together,
without the leaft pain or force; fo that a total fo-
lution of the continuity of the artery muft have
taken place. The limb, at this time, meafured
two inches lefs in circumference than it did be-
fore the operation. Embrocations and a mode-
rately-tight bandage of flannel were daily ufed
from the toe to the wound.
From the time the ligature came away,
the difeharge gradually lefTened, and in the
courfe of the month the wound was nearly
healed ; but it then putting on an ulcerating
appearance, and foon after fpreading cutaneoufly
over a considerable portion of the thigh, I con-
ceived that country air, and moderate exercife,
might be highly beneficial to the patient. I
accordingly
accordingly procured him a lodging at Lam-
beth, where I occafionally attended him, and,
in a months refidence there, the whole ulcerated
furface was intirely healed, and by gradual and
moderate exertions he became able to work at
his bufinefs as well as ever. I faw him about a
week ago, and examined the limb, which was
fcarcely perceptibly larger than the other. The
tumour in the ham, though much diminiihcd,
remains in a flaccid (late, without the leaft pul-
fation or pain ; and he tells me he can ufe it
in every refpecl: as well as ever he could in his
life.
The comparative heat of the found and of
the difeafed limb was carefully ascertained by
means of a thermometer every evening *, for
fome days after the operation, and found to be
as follows :
* On the evening of the day of the operation, the dif-
eafed limb was found to be fome degrees colder than the,
other ,• but as the exact degree of heat was omitted to be
noted at the time, it could not be inferted in the table. The
bulb of the thermometer (Fahrenheit's) employed in thefe
obfervations, was flat. It was applied each day on the ham
and foot, and was continued for fome minutes on thofe parts
before the degree of heat could be fatisfa&orily obtained.
Davs
Days
after the
Operation
ift.
2d.
3d.
4th.
5th.
6th.
L w J
Temperature of the
found Limb,
At the
Ham.
96°
94°
94°
95°
94°
95i°
At the
Foot.
9 6°
93'
94°
94°
93°
94°
Temperature of the
diieafed Limb.
At the
Ham.
95°
97°
99°
99°
98°
98°
At the
Foot.
9&
960
95-
95°
960
The temperature was thus taken for. three
weeks, and it was obferved, that the difeafed
limb became gradually lefs warm, compared
with the other ; and that at the end of that pe-
riod both limbs became equal in heat.
CASE II.
Nicholas Tatteiiliall, aged 37 years, was. ad-
mitted into Guy's Hofpital, under my care, on
the 5th of June, 1793, for the cure of a large
pulfating tumour, which occupied the whole of
the hollow of the left ham, and appeared ante-
riorly in fuch a manner, as almoft to furround
the lower part of the thigh ; the leg and foot
were alfo much enlarged and hard ; the knee
retained its motion, though every exertion of it
was attended with pain in the tumour. The
patient rn'mfelf afcribed the origin of his com-
plaint
[ ** ]
plaint to a fevere blow from the helm in a ftorm
at fea, which had difabled him for a fortnight;
and after that he had frequently, he faid, felt
pain on any quick motion of the limb. It was
about fix weeks after the blow that he firft dif-
covered a fmall throbbing fwelling in the ham,
precifely at the place where he had fo frequently
felt the acute pain before mentioned ; and this
tumour had kept gradually increafing in fize
and hardnefs till the time I faw him, which in-
cluded a fpace of fourteen months.
On carefully examining the tumour, and col-
lecting the preceding account of it from the pa-
tient, I had no difficulty in pronouncing it to
be an aneurifm of the popliteal artery.
The patient being a very athletic ftrong man,
I ordered fourteen ounces of blood to be taken
from his arm ; an aperient medicine to be given
him twice a week ; and the warm bath to be had
recourfe to every other day. I moreover put him
upon an abftemious diet. By purfuing this
treatment for three weeks, he was coniiderably
lowered and relaxed, and confequently lefs lia-
ble to any high degree of inflammatory action;
the tumour in the ham, however, and the ge-
neral enlargement of the limb, remained much
in the fame (late as at his admiffion.
2 Thinking
C 13 J
Thinking him now in a favourable ftate for
an operation, I propofed it to my colleagues
in the hofpital, MefTrs, Lucas and Cooper, for
whole opinions I entertain the highell refpect.
They intirely agreed with me in the neceffity of
an operation ; and as I had fo recently fucceeded
in tying the artery in the middle of the thigh,
I propofed that mode, to which they likewife
aflented, and they thought with me, that this was
a very favourable cafe for fuch an operation. I
accordingly performed it on the 24th of June,
precifely in the fame manner as in the preceding
cafe ; with this difference, however, in the re-
fult, that two mufcular branches of the artery
were divided, and fecured with the ligature and
tenaculum before rhe main trunk was laid bare ;
I then opened the fafcia enveloping the femoral
artery, and having paiTed a double ligature in an
eyed probe with eafe under it, applied the lint
and flick as before ; and for the fame reafons,
which need not be here repeated, one ligature
was drawn tight upon the artery, flick, and lint,
and the other was placed about half an inch
higher upon the artery than the other, and left
looie in order to be tied in cafe of haemorrhage.
The fymptoms of inflammation were much
milder than in the former cafe, probably owing to
the
C H ]
the precautions which I had taken to lower the pa-
tient during three weeks before the operation ; for
where the urgency of a cafe does not make an
operation immediately neceffary for the prefer-
vation of the patient's life, I think it advifable,
previoufly to this, as well as to moft other ca-
pital operations, to reduce the patient to that
flate in which he is the leaft liable to fuffer from
fubfequent inflammation.
On the fixth day after the operation, I found
it neceffary to drefs the wound ; the difcharge
was great, (but by no. means equal in quantity
to that in the former cafe) much lefs fsetid, and
the edges of the wound had a difpofition to
heal; but the ligature, of courfe, prevented
them.
As a knowledge of the comparative tem-
perature of the limb operated upon, with that
of the found one, the ftate of the patient's pulfe,
and of the atmofpheric heat, were objects I
conceived to be both ufeful and curious, I was
anxious to have them accurately attended to.
This tafk was readily undertaken by Mr. Wil-
liam Hall, of Gloucefter, who was then a pu-
pil at the hofpital, and on whofe accuracy I knew
I could rely. The annexed table, which con-
tains the refult of his obfervations, may therefore
be
[ M 3
be depended on. As the atmofpheric heat is per-
petually varying, I thought we Chould arrive at a
greater degree of exactnefs if we prevented the
accefs of the common air to the bulb of the ther-
mometer during the time of its application to
the limb, by covering both limb and thermo-
meter with flannel. This was carefully attended
to every day, till both limbs fhewed the fame
temperature, which they did in about a month.
After the firft opening of the wound, it be-
came neceffary to drefs it every day. On the
fifth of July, the ligatures from the mufcular
arteries came away ; and on the flxteenth, the
ligature, ftick, and lint came all away toge-
ther, as in the foregoing cafe. I permitted the
fpare ligature to remain till the twenty-third,
when conceiving that it occafioned irritation,
and of courfe excited difcharge, I withdrew it;
from this time the difcharge gradually dimi-
nifhed, and the wound was healed on the
28th of Auguft. The fwelling in the ham at
this time was fcarcely vifible; the leg and foot
were become of their natural fize, and the pa-
tient ufed that limb as freely as the other. He
was difmiffed the hofpital, and entered dire&Iy
on board a fhip of war.
TATILZ
[ 16 ]
TABLE,
Day of the
Month.
Right
Ham.
Left
Ham.
Right
Foot.
[ Tempe
Left ]rature of
Foot. : the At-
mof-
| phere.
Time of Day when
the Obf.rvations
were made.
Pulfe
at the
wrift.
June 24 <
25
26
27
28
29
3°
July x
2
3
4
5
6
7
8
9
1 1
12
»3
J5
16 j
18
*9
21
24
25
27
29
3^
Temp.
96 °
96
99
102
98
101
99
99
98
99
97
101
100
99
98
100
99
99
101
Ligatures
came a-
way.
100
99
97
97
94
97i
98
98
98
Temo.
1 emo
Temp.
95 •
79 °
78 °
95
90
91
9»
93
95
96
93
82
94
88
8:
97
94
91
90
93
90
95
91
81
95
94
»4*
97
93
88
97
95
9°l
97
95
93
93
92
92
99
97 h
99
98
97
97
S62^
96
95
97
94
9;
97
97^
90
9«
97
9b
98
95t
95
98
9*>k
94
97
98
96
97
95
94
90
90
82
95
88
80
98
93
89
97
94
93
97
93
85
9«
84
80
98
94
94
75}
69
68
66
75
73
66
66|
67
9*
8o
140
94
100
105
92
86
72
'4
82
70
88
88
84
74
78
8o
84
86
86
74
84
7*
90
80
86
9o
86
II. An
r *7 ]
II. An Account of the good Eff efts of Opium in the
Cafe of a Perfon poifoned by Digitalis, Com-
muni cat ed in a Letter to Dr. Simmons, by
Thomas Beddoes, M. D.
THE following cafe may perhaps be in-
ftructive to practitioners the fir ft time
they meet with a difficulty of the fame kind.
A perfon, much emaciated and enfeebled,
and labouring under anafarca and hydrothorax,
took, by miftake, from two to four dofes of an
infufion of digitalis, more than were ordered
for him. He had naufea during a considerable
part of Tuefday night, which, by 10 o'clock
on Wednefday morning, had increafed fo much,
that every five or ten minutes he threw up a
fmall quantity of bile, with the moft dreadful
retchings that can be imagined.
I had once, while I was a ftudent of medi-
cine, feen a much ftronger patient deftroyed by-
digitalis ; but the practice of the phyfician who
had the management of the cafe was exceed-
ingly feeble and fluctuating. He only admi-
Vol. V. C niftered
[ i8 ]
niftered fome flight opiates, a little port wine,
and effervefcing draughts.
From the weaknefs of my patient, and the
terrible effects always produced by digitalis,
when improperly adminiftered, I entertained
very flight hopes of his recovery. I refolved,
however, to attempt fcrnething towards his re-
lief. For a (hoi t time I herniated between opium
and brifk emetics, (of white vitriol and muf-
tard (qc3, for inftance) which laft, I hoped,
might change the action of the ftomach and li-
ver, induced by the digitalis. I determined in
favour of opium, of which I ordered three grains
to be given at two dofes ; one immediately, and
the other at the end of an hour ; and afterwards
fifteen drops of tincture of opium, every hour,
in port wine, till the patient fhould fall afleep.
He dofed a good deal in the evening, and
the vomitings had become lefs frequent by
Thurfday morning, occurring never oftener
than once in half an hour, and fometimes only
every hour and a half. The patient flept be-
tween each fit of ficknefs, and always awaked
with naufea.
I gave him now fixty 'drops of tinct. opii by
clyfler, and three dofes of 8 grains of pulv.
Ipecac, comp. made into pills with extract, cicut.
to
r. 19 3
to be taken at the interval of two hours between
each dofe, and ordered the clyfter to be repeat*
ed in the evening.
During the night he perfpired copioufly, al-
ways awaking fick ; the fickneffes more infre-
quent, but fometimes attended with fingultus.
On Friday he ceafed to vomit bile ; and as he
feemed entirely under the influence of opium,
no medicines were prefcribed on that day.
Saturday — he had drank toalt and water du-
ring the night, which agreed well with his fto-
mach. He had no ficknefs this day ; he had
been able to lie down ever fince Wednefday,
which he had been utterly unable to do before,
and his feet only fwelled a little towards night.
He now began to tot with a very keen appetite,
and drank almoft half a bottle of wine a day ;
he had before led a very abftemious life. The
bark in fubftance, with aromatics, was ordered
for him, and he took about half an ounce every
other day, for four times. The fwelling of his
legs, towards night, went off, and he has now,
for fome time, been perfectly well.
This cafe mows that opiates may be freely
adminiftered to a perfon poifoned by digitalis.
I dare not draw any bolder conclufion from a
C % fingle
[ *o ]
fingle cafe, but I would purfue the fame plan
of treatment under a (imilar emergency.
P.S. The pulfe did not come down below
fixty ; perhaps the opium counteracted the effect
of the digitalis.
Briftol Hot WeUs,
July 14, 1793.
111. Some Obfervations on the Difeafes that oc-
curred on Board the Ship Europa, in the Service
of the Hon, Raft India ConQany, during a Voy-
age from England to and from Madrafs and
Bengal; by Mr. John Watfon, late Surgeon
of the f aid Ship, and now Surgeon at Welling-
borough, in Northampton/hire. Communicated
to Dr. Simmons, by John Lqrimer, M.D.
Fellow of the Royal College of Phyftcians of
Edinburgh, Phyftcian to the Army, and to the
Hon. Eaft India Company.
HP^HE difeafes which prevail in the begin-
JL ning of Southern voyages, have been fo
often
C *> ]
often pointed out, that I fhould have thought it
quite unneceflary to offer any obfervations on
the fubjecl, if we had met only with the com-
mon predifpofmg caufes to combat with ; but
this, I have great reafon to believe, was not
our cafe.
A fever, which we carried out with us, join-
ed its influence to the common inflammatory
fever, which is aim oft always met with upon
approaching a warm latitude in a crowded fliip,
and I believe was the chief caufe of our contin-
uing a fickly fhip during the voyage. The
cafe I allude to, as the caufe of this mifchicf,
is that of Samuel Hall, one of the fhip's com-
pany, who had been ill forhe days before we
left Gravefend *, with fymptoms of fever, for
which, in the beginning, he had little medical
afliftance. When I firit faw him, which was
not till about the tenth day from the commence-
ment of the difeafe, he had a quick fmall pulfe,
with coftivenefs ; a dry and parched tongue ;
hot and dry fkin ; and naufea. This man re-
covered, but continued, for feveral weeks, in
a ftate of convalefcence ; and, during this
* The Europa failed from Gravefend in January, 1792
and returned to England in April, 1793.
C 3 time,
[ M ]
time, a fimilar fever attacked every man in the
birth he was in, and it was very obfervable,
that wherever it fpread, the whole of the birth
or mefs, in which it made its appearance, were
more or lefs affected with it. We were now ap-
proaching the line, and with nearly two hun-
dred recruits on board, (all of them young
men, unaccuftomed to hot weather, and, in
general, of plethoric habits) could not expeel
to be free from the complaints which ufually
occur in fuch latitudes, and more efpecially in a
crowded (hip.
A fever began to fpread itfelf among them,
attended with the ufual fymptoms ; viz. an in-
creafed action of the heart and arterial fyftem,
great thirft, naufea, a hot dry fkin, and, ge-
nerally, coflivenefs.
This difeafe, in the firit inftances, eafily
yielded to the common antiphlogiftic plan ; but
tb we advanced, I found, to my great mortifi-
cation, that our number of fick continued to
increafe ; and that the fever, which at firft had
been merely inflammatory, now put on the ap-
pearance of a remirtent, and was clearly epide-
mic. The recruirs, from their fituation on the
orlop deck, were more affected than the (hip's
company,
C *3 ]
company, who breathed a purer air, though
the latter by no means efcaped its effects*.
To render this fituation more tolerable, as
many as could be accommodated were brought
upon the gun deck, where a pktform was
ere&ed for them, and every mode that could
be devifed to remove the foul air from be-
low, was made ufe of. Cleanlitiefs, of courfe,
was the firfl flep ; and the next was", to dry up
thofe hot moift vapours, which are allowed
to be fo baneful, not only to the fick,
but even to the mod robuft and healthy.
Fumigations, and warning with vinegar, were
daily made ufe of; but the means I principally
depended on, and which had the defired effect,
confided in having Moves on the lower deck,
that were gradually moved fore and aft, and
occasionally fprinkled with nitre. The fire had
the good effedt of drying up the moift vapours,
* On the voyage Outwards, the Clip's company confided
of 103 ; of thefe, 86 were fick, and only one died ;
This death was in confequence of a fall. The recruits
and paiTengers from England were 1 58, to which were after-
wards added, from Madrafs to Bengal, 270 more, making
in the whole 428 ; and of thefe, 264 were on the fick lift,
but only one of them died.
C 4 «nd
[ 24 3
and the nitre fupplied the Tick with good air.
For a hint upon this fubjedt, I am obliged to
Dr. Lorimer, to whom, I am lure, it will give
pleafure to be informed that it was attended
with very falutary effects.
The fever, as I have before obferved, changed
its type, as we advanced to the fouthward. Its
general mode of attack was with rigors, head-
ach, giddinefs, naufea, and vomiting of bile ;
a quick but not a hard pulfe, fometimes flut-
tering and unequal; great pain in the loins,
with laflitude -, a dry parched fkin ; eyes full,
heavy, and yellow; and great third. On the
firft attack I ordered fome of the antimonial
emetic mixture * to be given ; and I obferved,
that, in general, the patient was relieved by it,
whether a vomiting of bile was the confequence
or not; for that was not always the cafe. And
I conceived, that fome irritating matter (which
perhaps had been fwallowed with the faliva, and
caufed the naufea) was removed by the vomit-
ing. An aperient antimonial mixture -f was then
* Mijlura Antimomalis Emetica,
Y^. Antimonii Tartarifati, gr. xvj
Aquae; Purae, fti. M. '
•j- See the note in page 32.
given,
[ *5 ]
given, until it had operated by ftool, by which
time, generally fpeaking, a gentle perfpiration
had taken place, and then the bark was imme-
diately adminiflered in as large dofes as the flo-
mach would bear. The very early exhibition
of this valuable medicine, I think, never had a
fairer trial, than I had an opportunity of giving
it; and the fuccefs was equal to my molt fan-
guine expectations, for in no one cafe did it fail,
although I had, at one period of the voyage,
upwards of feventy patients making ufe of it,
and that for a confiderable length of time, ha-
ving had a conftant fucceilion of them. One pa-
tient only died, viz. J. Thompfon ; but even in
this inftance the failure, I am of opinion, ought
not to be afcribed to the bark. The cafe itfelf
was attended with lingular circumftances, and
as it ended fatally, I have tranfcribed it from nly
diary, and mall infert it at the end of my pa-
per *, with the addition of one of the fuccefs-
fu'l cafes -j^, in order to give a more perfect idea
of the nature of the fever.
If we, for a moment, confider ^the fingle
circumftance of fo many people confined in a
* See Cafe I. page 3^8.
+ See Cafe II. page 41-.
fmall
C 26 3
fmall place with fevers, it will not appear ex-
traordinary that one mould die, but that fo
many ihould recover; for during our paflage
to Madrafs, three hundred and fifty perfons were
at different times affected.
In general, the bark was given within thirty-
fix hours after the fir ft attack; very often in
lefs, and feldom later than forty-eight hours. If
the flomnch retained the firft two or three dofes,
(which were given hourly) it generally brought
on a difrinct remiflion ; i:nd in four or five days
the patients were left in a convalescent ftate;
and then the bark was adminiftered (but in lets
frequent dofes) with wine. To recover them from
this convaiefant ftate, required fome attention;
and their diet was regulated with as much care
as pofBble ; for although our powers were very
limited, yet it was found that much might be
done by attention, and that the different provi-
fions which are allowed, might be fo managed,
as to render them much mote conducive to
health than the general mode of ufing them is,
and, at the fame time, quite as grateful. Salted
provifion, for men in their fituation, was evi-
dently very improper; but unlefs we could fa-
tisfy them with fomething elfe, it was impoffi-
ble to prevent their ufing it. For this purpofe,
lor-
C *7 ]
I ordered a foup to be made, by cutting up and
boiling one piece of fak beef, which had been
previoufly wafhed, in a great quantity of water,
and afterwards thickening it with oatmeal and
barley. This made a tolerably grateful and
fre(h foup; at lead it gave fo much the appear-
ance of foup to the gruel, as to induce the pa-
tients to eat it with fatisfaclion ; and I had the
pleafure of feeing them recover by this kind of
management.
The necefTary attention to fo many people,
could not fail, as may be eafily conceived, to
take up the time of myfelf and affirmant (Mr.
Walker) very completely. There was, indeed,
fcarcely a moment in which one or both of us
were not employed in vifiting the fick, in ad-
miniftering medicines to them, or in attending
to other duties equallv neceffary. By other du-
ties, I mean the attending to the execution of
every plan which could be conducive to cleanli-
nefs, good order, and a free circulation of good
air ; for I cannot help confidering thefe as the
firft and great caufes of health, or difeafe, on
board a (hip, and without them medicine will
avail but little Thefe avocations, as I have
juft now obfervedj fo completely employed us,
that
C a8 ]
that it was impoffible to be very minute in each
clay's report. Any material alteration was, in-
deed, noticed in the diary ; but in general, only
the ftate of the fever, and medicine given, were
noted. Both myfelf, and Mr. Walker (whofc
great affiduity and attention to the fick I fhall
ever remember) frequently felt the effedh of
the fever ; for my own part, I never, for fomc
time, came up from vifiting them, that I did
not experience headach and a quickened pulfe.
The only precautions I made ufe of, confided
in keeping my ftomach and bowels clear, and
in taking occafionally a little bark. By thefe
means I lived, as it were, in the midftof fever
for three months, without experiencing any
other effecls of it than thofe I have juft now
mentioned ; and Mr. Walker, who adopted a
fimilar plan, was equally fortunate.
We (lopped at St. Jago, one of the Cape de
Verd iflands, with the hopes of procuring a fup-
ply of fruit and other refreshment ; but here we
met with a difappointment, owing to a drought
which had prevailed in the ifland during three
or four feafons, fo that we left it without deriving
much advantage from our viilt.
From thence we proceeded to Madrafs, with-
out
[ *9 ]
out flopping any where, and had rather a te-
dious paffage; the fever gaining ground in
point of numbers all the time, but without
being attended with any fatal confequence,
except in the fingle cafe already related.
In the month of June, (at the latter end of
which we arrived at Madrafs) feveral of our
convalefcents were attacked with fcurvy, but
not in any very material degree ; the very few
antifcorbutics we had, were made ufe of, and
the difeafe was kept under till our arrival, when
the fick were all fent afhore, and remained there
till the 1 8th of July, when they again embarked
for Bengal, with a detachment of His Majefty's
76th regiment.
During our (lay at Madrafs, every means
were made ufe of to remove, if poffible, dif-
eafe from the fhip, by warning and fumigating
every part of hen But our fhip's company ftill
continued fickly, fo that on our arrival at Dia-
mond harbour, the fick lift was upwards of
twenty. The unhealthy fituation of this place
is well known ; but the hofpital, though placed
on fo unhealthy a fpot, has ail the advantages
that could be given to it. It is raifed confidera-
bly, and Hands upon arches ; and the ground
near-.
C 30 ]
near it is drained as much as poiTible ; but ftill
it is a maiihy fituation, and the patients cannot
fail to be arTe&ed by the low fwampy grounds
which furround it for fome miles.
Notwithstanding it was not fo eligible a place
as could be wifhed, it was thought more ad-
vi fable tc have our fick there than in the fhip,
for two reafons ; firfl, for the fake of ftpara-
ting the fick from the healthy; and fecondly,
to give an opportunity of effectually cleaning
the flii p. Thofe who were removed from the
fhip to the hofpital, (which at this time
was empty, fo that we could give them
large accommodation) very foon benefited by
the change ; others, who were taken ill whilft
we remained there, were not fo fortunate, as
their complaints were in general aggravated by
their intemperance. Their principal complaints
were fevers of the remittent or marfh kind, at-
tended with bilious vomiting and purging, and
great tendency to dyfentery. In moil of thefe
cafes there was a greater or lefs tendency to de-
lirium, in proportion as the patients were more
or lefs of a plethoric habit, In feveral of thefe
the pulfe was fo full and hard, that I mould have
been induced to take fome blood from them,
2 had
C 3* J
had I not feen the ill effects of it, even in very
fmall quantities, during a former voyage, un-
der fimilar circumflances. In general, the
early exhibition of the bark was very effectual,
provided proper attention was paid to the (late of
the ftomach and bowels. The aperient antimo-
nial mixture * was what I principally made ufe
of to clear the ftomach and bowels, and in ge-
neral it had the good effect of doing both, and,
at the fame time, excited a gentle diaphorefis ;
the bark was then given freely, but, I obferved,
if it had not a good effect in a few days, the
difeafe became obftinate, and generally ended
in vifceral obstruction ; to remove which it was
neceflary to ufe mercury, which feldom failed
to produce the defired effect. Thefe cafes were
alfo frequently caufed by relapfes, in confequence
of thofe irregularities which it is impolTible to
prevent feamen committing.
In the month of September, dyfenteries, ac-
companied with fever, were frequent. In ma-
ny of thefe cafes, alfo, after proper evacua-
tions, the bark was given freely. In fome other
cafes of dyfentery, I found the ufe of diapho-
* See the note in page 32,
retics
[ r- J
retics very efficacious. This mode of treat-
ment confided in giving fuitable dofes of the
antimonial aperient mixture* during the day,
which fometimes excited vomiting, bur always
caufed copious flools, and generally brought on
a gentle diaphorefis ; this was encouraged by
warm diluting liquors, and in the evening a pill
was given, compofed of one grain of opium, and
gr. \ of antimon. tartariiat. In the morning
the mixture was again had recourfe to, and
this plan was continued till the bowels were re-
lieved, and the ftools were become more natu-
ral, after which the antimonial opiate only was
given.
Upon leaving Bengal, to return to Europe,
our complaints were principally intermitting fe-
vers, the remains of the marfh fever, which had
taken.that type; dyfenteries ; vifceral obftruc-
tions; and inflammations, principally of the
* Miflura Antimonialis Aperiens,
&. Antimonii Tartariiati, gr. ij.
Mannas, %(s.
Cremor. Tart. Jij.
Kali.Tartarifati, 3HJ.
Spir. iEther. Nitr. 3'ij.
Aquae Purae, fofs. M.
liver,
C u ]
liver, but often of the fpleen and mefenteric
glands.
Every opportunity I have had of obferving
the difeafes of hot climates, confirms me in the
opinion 1 have long held, in common with ma-
ny other medical men, that the great fource of
health or difeafe, in hot climates, is centered
in the natural or difeafed condition of the liver;
and that every chronic difeafe arifes, in a confi-
derable degree, from fome defect of that vif-
cus. In many acute diforders, alfo, this or-
gan has its mare ; and in every kind of ficknefs,
whether local or general, that is peculiar to
hot climates, it is material to examine it ; for no
perfect cure, I am perfuaded, can be made,
or a relapfe prevented, without having a flridt
eye to it. Fluxes are frequently caufed by
obft ructions of this vifcus, and however they
may be palliated, can never be cured, without
firft removing the fource of the difeafe, ih the
liver, which, I believe, is only to be done by
mercury.
In our voyage outwards, feveral of our men
had frequent relapfes of fever, attended at times
with a flux, which I never could totally remove,
till I joined mercury with the bark. This pro-
ved efficacious in promoting good fecretions,
Vol. V. D and
C 34 ]
and confcquently more natural (tools; and the
fever afterwards gave no trouble. In all thofe
patients I found the urine much affected, as,
indeed, it is in all cafes where bile prevails.
A long-continued ule of the bark has been
faid to occaiion thefe complaints; but, I think,
with great injuftice. It is certain, that we can-
not remove the caufe of the fever or flux by
means of the bark alone ; but in the many cafes
in which I have given it, combined with mer-
cury, I never could perceive any ill effect from
it; on the contrary, the difeafe has yielded
to their united powers, and I have thought that
the patient was lefs reduced, than by ufing
mercury alone.
In fluxes only, proceeding from obftru&ed
liver, the bark will feldom be neceflary; but
in fuch cafes, if there be a difpofition to fever,
it will generally be found ufeful, more particu-
larly: io if given a day or two before the fpring
tides ; for at thofe periods the difpofition to fe-
ver will always be found to increafe, and conft-
derable advantage will arife from attending to
this circumltance. I experienced this, not only
whilft we were lying in Diamond harbour, but
during the whole pafTage from Bengal to the
Cape of Good Hop:.
As
[ 3S ]
As we advanced to the Southward, the (curvy
began to make its appearance on board, more
particularly among the con vale fcent, and thofe
who had lately recovered from fevers.
If we refkcT a moment upon a diet fo de-
prived of nutritious powers, as laic beef and
bifcuits, with a fmall allowance of water, we
cannot be at a lofs to account how eafily fuch a
difeafe as the fcurvy might arife in the habit,
even of thofe who had before enjoyed health,
much more fo of thofe whofe blood had been
impoverifhed by difeafe. And here I cannot
but lament, that there is not a more liberal al-
lowance of thofe things, which have been found
to be fo beneficial in counteracting the effects
of this dreadful difeafe ; for as the caufes, be-
fore mentioned, are not the only pre-difpofing
ones, but are much aiTifted by a moid cold air,
it naturally follows, that upon a change of air
we have not fo much to combat with.
Inftances I have repeatedly feen, where the
fcurvy has attacked numbers in a fhip going
round the Cape of Good Hope ; but upon
(landing to the Northward, and having a
clear dry air, with ftrict attention to their diet,
cleanlinefs and exercife, and giving as largely
of the antifcorbutic provifions as could be al-
D 2 lowed,
C 36 ]
lowed, the difeafe has been removed. And
when it is confidered, that by proper manage-
ment it would be attended with very little, if
any, additional expence, to put on board a fuf-
ficient quantity of fuch provisions, it leads me
to hope, that it is only neceffary to point them
out, in order to their being adopted. The
known humanity and liberality of the owners
in general, warrant fuch a fuppofition.
If they would take the trouble of examining
any of their furgeons upon this fubject, who
have been long enough in the fervice to ex-
perience the want and to fee the utility of
thefe things, I doubt not but fuch regulations
would take place as would be very gratifying
to a humane mind, and beneficial to the fervice
in general.
With refpeft to the mode adopted for the re-
lief of thofe who were affected with this com-
plaint, I have only to obferve, that a diet was
formed as void of putrefcent things as poffible.
They had plenty of acidulated liquors, and were
recommended to ufe as much exercifcas poffi-
ble. The only alarming fymptom was a dyfp-
ncea, which many of them were affected with, and
which I found was greatly relieved by camphor,
given in the fotrm of a bolus. This was almoft
the
[ 37 ]
the only medicine I gave them; it generally
caufed a gentle perfpiration, and relieved their
breathing.
Upon our arrival at the Cape of Good Hope,
on our voyage homewards, the Tick were plen-
tifully fupplied with vegetables and foup, which
foon recovered them. A few of them remained
in a convalefcent ftate for a little time ; but the
very ample allowance of frefh provifions, which
was ferved out for a confiderable time after-
wards, removed every appearance of fcurvy,
and we became at length a healthy fhip ; fo that
after we left St. Helena, we fufTered very little
inconvenience from difeafe.
We were fo fortunate as to meet with few
accidents that required chirurgical affiftance ;
and thofe we did meet with were attended with
no circumitances worth relating; therefore I
have not thought it necefTary to mention them
in this brief account of the difeafes we had to
encounter with.
D 3 CASE
C 38 ]
CASE I.
May 24th. John Thorn Ton, aged thirty
years, was attacked with iymptoms of fever,
viz. a quick full pulfe ; giddinefs; great head-
ach ; naufea and vomiting; heat and drynefs
of the fkin, and great thirit. He was dlrecled
to take the emetic antimonial mixture*.
25. The emetic brought up much bile; the
headach was now lefs violent ; body coftive ;
other febrile fymproms as yeflerday. He was
ordered to take of the aperient antimonial mix-
ture -f every two hours, till a ftool mould be
procured.
26. Symptoms as yeflerday. Medicines re-
peated.
27. Fever continued, with coftivenefs. The
mixture was repeated, and a purgative clyfter
adminiftered. Stools being procured by thefe
means, recourfe was had to the following
mixture, of which, from an ounce to an ounce
and a half, was given every hour.
* See page 24. + See page 32.
ftiPulr,
C 39 ]
F£. Pulv. Cort. Peruvian. Jiifs.
Tin6turse ejufdem ^iij.
~ Aquas Purae, ftij. M.
28. A flight rcmiffion; pulfe better; body
natural. The bark mixture was continued.
29. He was free from fever all night, and
continued the ufe of the bark till about four
-o'clock, P.M. when a fudden proftration of
ftrength took place ; the pupils of the eyes were
much dilated, and he appeared comatofe ; but
his pulfe continued good, and he perfpired
freely. Towards midnight, however, his pulfe
funk confiderably. A blifter was applied be-
tween his moulders.
30. He continued comatofe, but feemed at
times fenfible ; refufed every thing offered to
him; his pulfe was rather quicker ; the blifter
rofe.
June 1. He appeared to be more fenfible,
but his pulfe was quick and low. He took li-
berally of a camphorated mixture, decoclion of
bark, and Madeira wine.
2. He was much the fame as yefterday. The
fame plan of treatment was continued.
3. The fymptoms, in general, were worfe ;
he had taken very little medicine during the
D 4 night,
C 40 ]
night, and fwallowed what he did with diffi-
culty. Took his medicines and Madeira wine
alternately; his extremities were cold ; finapifms
were applied to the feet.
4th, 5th, and 6th. No material alteration.
7. Continued in the fame ftate. As he had
not had a (tool for fome days, an enema was
given, and his medicines and wine were ordered
to be continued.
8. The enema procured feveral copious and
very fetid (tools. He appeared more ienfible;
took his medicines and wine in the night.
9th and 10th. On each of thefe days was
free from fever, but continued the uie of his
medicines.
11. In the fame (late; refufed his medicines.
12. Very low, but appeared more fenfible ;
refufed every thing that was offered to him.
13. Refufed his medicines, but took wine
frequently ; iome livid blotches appeared over
the trochanter major, os facrum, and lower
vertebra? lumborum. Had a very fetid {tool
this morning.
14. Pulfe very feeble.
15. Pulfe continued to fink all night, and
he expired about four, A. M.
In
C 41 3
In this cafe the bark was not given quite fo
early as in the generality of the other cafes,
owing to an obftinate coflivenefs during the firil
three days of the fever ; but when it was given,
it appeared to have a good effect. I am unable
to account for the fuddc-n change in this cafe,
at a time when I was beginning to flatter myfelf
that the patient was out of danger. Had this
change taken place fooner, it might by fome,
perhaps have been imputed to the evacuations
by {tool, which were rather copious, but they
had taken place two days before, and the pa-
tient had been free from fever that day, and had
a tolerable pnlfc ; but from the moment the
fatal alteration commenced, the pulfe began to
fink, and continued to do fo till he expired.
CASE II.
April 11, 1792. Lat. 13. 52. S. Long. 30.
46. W. James Armand, aged twenty years,
and rather of a full habit, was taken with the
ufual train cf febrile fymptoms, as headach,
great pain in his loins, and nanfea. He was
ordered an antimonial emetic.
12. The
[ 4* ]
12. The emetic operated well. The fymp-
toms of fever continued. Four grains of pulr.
fcntim. were directed to be given every two hours.
"13. The medicine had operated both upwards
and downwards. The naufea 2nd febrile fymp-
toms were as before. The antimonial was re-
peated, and after it had operated, the bark mix-
ture was given frequently.
14. The febrile fymptoms were abated.
The ufe of the bark was continued.
15. He had an increafe of fever in the
sight* The bark was continued.
16. He had lefs fever. The fame medicine
was continued.
17. The fymptoms were about the fame as
vefterday. He continued the ufe of the bark.
18. He was free from fever. The bark was
continued.
19. He had a flight return of heaeiach, with
naufea, and took fome of the aperient antimo-
nial mixture.
20. The antimonial brought up much bile,
but procured no (look He had an exacerbation
of fever in the evening. The baik mixture
was repeated frequently.
21. He had lefs fever. The ufe of the bark
was continued.
22. Symp-
[ 43 ]
22. Symptoms the fame as yeflerday, till the
evening, when he had a return of ficknefs and
fever. The antimonial aperient mixture was
ordered to be repeated on the morning of the
23d.
24. The medicine had operated freely. He
had a remlflion this morning, and continued to
take the bark mixture frequently.
25. He had fome fever in the night. The
fame medicine was continued.
26. He was free from fever.
From this time to the 3orh, he continued to
take ihe bark with wine, and perfectly recovei d.
In this cafe nothing particular occurred diffe-
rent from the general run of fevers, which we
had at this time, except a greater difpofition to
bile, than I generally met with. This made it
neceflary to continue the antimonials longer, and
even to recur to them after giving the bark.
Wellingborough,
IV. Cafe
[ 44 ]
IV. Cafe of a compound D [/location of the Tibia
and Fibula, accompanied with a Fratlure and
Lofs of a confide r able Portion of the Aftraga-
lus, and likewife with a Fratlure of the Thigh
Bone*, with Remarks. By Mr. James Rumfey,
Surgeon at Amerjham in Buckingham/hire.
ON the 21ft of June, 1792, Mr. Tolfon,
aged forty years, a reputable tradefman
in New Bond Street, Wed minder, was thrown
from a curricle on Gerrard's-Crofs Common,
eight miles from this place, in confequence of
the horfes taking fright, and drawing the car-
riage with great velocity againft a tree. The
injury he received from this accident confifted
in a compound diflocation of the tibia and fi-
bula at the outer ancle of the left leg, with a
fracture of the aflragalus, (the fuperior half of
which was attached to the diilocated bones of
the leg) and likewife (though, as we (hall fee,
not immediately noticed) a fimple fracture of
the os femoris on the fame fide. He was im-
mediately conveyed to a friend's houfe on the
common, where he had the advantage of an
airy, healthy fituation, with every kind do
meitic attention the family could adminifter.
I faw
I 45 J
I faw him about two hours after the accident, and
found the bones protruding at the ancle through
a very large wound, with the foot turned in-
wards and upwards; and the integuments, be-
neath the wound, exceedingly confined by the
diilocated bones, which defcended nearly to the
bottom of the foot. A confiderable haemorrhage
had taken place, but was flopped by the fpon-
taneous contraction of the lacerated veflels.
From fuch a formidable accident in Co large
a joint, there appeared very little probability
of the patient's recovery, without immediate
amputation. I therefore requefted that a con-
futation with fome other furgeons might be
expeditioufly held on the cafe, and exprefles
for this purpofe were accordingly fent to Mr.
Pearfon, furgeon in London ; and to my bro-
ther, Mr. Henry Rumfey, furgeon at Chefham,.
in this county. While I was waiting for their
arrival, the patient requefted me to examine
his thigh, which till then he had not particu-
larly noticed, when I plainly difcovered an ob-
lique fracture of the os femoris, at its fuperior
part. This additional evil appeared to me a
great obftacle to an amputation.
My brother, when he arrived, being of a
(imilar opinion, I attempted to reduce the frac-
tured diilocated joint into its proper fituation.
This
[ 46 j
This I found very difficult to effect, without
firil feparating that pun of the aftragal us which
was pendulous to the tibia, having its capfular
lig.iment lacerated one half way round the
joint*; I therefore removed it without hefi-
tation, being perfuaded, that if it had been
practicable -to reduce it into its original fituation,
fo large and moveable a portion of bone would
have been a fourceof pain and irritation, and have
rendered the cure more difficult and uncertain.
I then divided that portion of the integuments
of the foot which was confined by the protruded
end of the tibia, which enabled me with eafe to
reduce it and the fibula into their proper
fituation. I applied fome doffils of lint, dip-
ped in tindture of opium, to the wound, and co-
vered the whole with a poultice of dale beer and
oatmeal. We now reduced the fraclured fe-
* This portion of the aftragal us confifb of the broad
fmoOth he:id by which it is articulated to the tibia ; of al-
mod the whole of the inner and outer fides of this head by
which it moves on the inner and outer malleoli ; and of
about the upper half of the pofterior cavity on its under
furface, by which it is united to the os calcis ; fo that the
bone was divided nearly horizontally, and the part left be-
hind confifts of thelower half of the latr-mentioned cavity,
and of the whole of the other or anterior cavity which con-
nects it with the os calcis ; and of the anterior portion or
procefs by which it is articulated to the os naviculare.
mur>
[ 47 3
mur, and placed the limb in the bent pofrtion,
expecting that our greatejt fuccefs would be in
procuring a complete anchylofis, the failure of
which, I concluded, would leave a ufelefs foou
The under fplinter was a firm excavated piece
of deal, of the fnape of the leg and foot, with
a hole op polite the ancle.
Mr. Pearfcn arrived in the evening, and ap-
proved of the preceding treatment, giving it as
his opinion that it would be fafer to attempt the
prefervation of the limb, than to amputate un-
der fuch complicated circumftances. The
wound was concealed as much as poffible from
the external air, and the cataplafm renewed no
oftener than the difcharge rendered necefTary.
22. The preceding night had been very-
painful, with delirium and vomitings; the
pul(e was full and frequent ; I took away ten
ounces of blood, and gave Kali Tartarifat. and
Manna, in dofes fufficient to procure ftools.
A common (aline draught, with antimonial
wine and tincture of opium, was given every
four hours, and a fuller dofe of tincture of
opium at bed-time.
23. The vomiting continued ; the ancle and
thigh had been lefs painful through the night;
the faline draughts were continued, but with-
out
C 48 ]
out the antimonial, on account of the vomiting.
During this period the antiphlogiftic regimen
was flri61y adhered to.
24. The night had been tolerable ; the vo-
miting had ceafed ; the pulfe was fofter; the
faline draughts were continued, with the opi-
ate, at bed-time. This evening the leg was
very painful.
25. He had had a pretty good night; a difcharge
from the wound now commenced, and the tenfion
of the mnfcles of the thigh began to diminifh.
26 and 27. The fame treatment was conti-
nued. The difcharge increafed, and the ten-
sion of the thigh was much abated.
28. The ancle was much fwelled and in-
flamed ; I therefore exchanged the beer grounds
in the cataplafm for the Aq. Litharg. Acetat.
The patient had this day much pain in
the bowels from flatulence ; from which circum-
ftance, and that of the difcharge being very
thin, it was judged expedient to vary his mode
of living, and likewife his medicines.
29. He was allowed a fmall portion of animal
food, fome table beer, and fome port wine; and
he took the bark liberally, both in fubflance and
decoction. This change of treatment agreed
with him perfectly well. At this time I found it
neeeffary
C 49 3
h'eceffary to alter the pofition of the limb, on
account of the preflure on the wound, occa-
fioned by its laying in the bent pofition, and
the pain it gave in turning to drefs it, which,
from the copious difcharge, there was now a
neceflity of doing night and morning. 1 there-
fore placed it on the heel, ufing the common
deal flexible fplint, of the length of the limb, and
confined it in a box, whofe fides and lower end
let down. The fpace between the fides of the box
and the fplint was filled with pieces of flannel.
By thefe means, and the ufe of the eighteen-tail
bandage, the dreflings^were applied with very
little disturbance to the leg, whereby the patient
efcaped much pain : the upper end of the box
under the ham was raifed ; which gave the muf-
cles fome degree of flexion, and, at the fame
time, was favourable to the difcharge.
The foot hiving a tendency to fall inwards,
and the end of the fibula to protrude through
the wound, it required great attention to prevent
the deformity the neglecl of thefe circumftances
might have occafioned. The mode of preven-
tion I adopted, and which proved fuccefsful,
confifted in employing a number of fmall deal
wedges, about fix inches long, two broad, and
a quarter of an inch thick ; as many of thefe as
Vox. V; E were
[ So J
v. ere found fuiRcient were placed opponte the
infide of the foot., between it and the fide of
the box ; others in the lame manner on the out-
fide of the calf of the leg ; by which means the
limb was kept fteady : and by placing the heel
CLiiy, and rather hollow, none of the ufual evils
acifing from preffure on the heel occurred.
30, The bark. agreed very well; the opiate
was continued at bed-time ; the difcharge was
great, but more purulent ; the pulfe was become
fofter and leis frequent ; and the urine, which
hitherto had been clear and very high coloured,
was now turbid : the pain and inflammation be-
ing much diminifheel, the cataplafm was difcon-
tinued, and the wound dreiied with dry lint,
with a pledget of Cerat. Litharg. acet. c. over
it, and a moderate comprefTion was made by
means of the bandage. From this period the
wound progrefiively mended ; the difcharge di~
minilhed ; granulations formed ; and the fur-
rjunding fkin began to heal. The ufe of the
bark and of the opiate was continued till the
beginning of Auguft. About the end of July
the progrefs of the cure was retarded by mat-
ter, collected under the integuments above the
inner ancle, which, on preiiure, came out at
the wound. After trying the effects of perma-
nent
c 51 i
bent preflure, for the prevention of this depofitj
in vain, I made an incifion into the cavity, and
filled it with dry lint to produce inflammation
on its internal furfacc, which perfectly confoli-
dated it ; and from this time the wound rapidly
healed, and became perfectly cicatrifed by the
middle of September, without any exfoliation
of bone, larger than the head of a pin, having
taken place.
The fracture of the femur went on Very well,
excepting that the obliquity of it, with the im-
poffibility of producing a permanent extenfion,
on account of the leg, occafioned a degree of
curvature, which it otherwife would not have
had.
The limb gradually acquired flrength ; and it
is a very remarkable facl, that the patient is
now able to walk very well, with only the aid
of a fmall flick, and even this afTiftance he will
probably not require long. There is no anchylofis
to render the ancle immovable ; but a fufficient
firmnefs has been produced in the furrounding
parts, by the long-continued inflammation, to
aflift in the formation of an artificial joint,
which pofTefTes a degree of motion nearly equsJL
to that of the natural one*
E % The
C i* 3
The rcfult of this cafe affords an additional
argument againft immediate amputation in cafes
of bad compound fracture ; a fubjedt. on which
furgeons, eminent in their profeffion, have been
'much divided.
The impure air of London and other great
cities, but more particularly of large hofpitals
in fuch Situations, probably renders thefe acci-
dents more generally fatal there than in the
country ; and the conftitution of many patients
is, no doubt, more endangered in cities, by the
long-continued copious fuppuration confequent
to extenfive injuries, than it would be by amputa-
tion ; and cities being commonly the refidence of
the moft eminent men, thefe circumftances may
have occasioned fome of them to lay it down as ge-
nerally neceflary to amputate in cafes of bad com-
pound fracture : but in the country I fhould ever
attempt to fave the limb, except in cafes where
the divifion of large blood vefTels, or a confi-
derable lofs of the mufcles, mould call for im-
mediate amputation. I believe that many of
thofe cafes which prove fatal without the ope-
ration, :would have a fimilar termination if it
were performed, and vice verfa. The caufe of
their fatality feems oftentimes to depend on
fome-
[ 53 3
Something unfavourable in the habit of body;
and this rendeis it neceliary for the furgeon to
difcovcr, as clearly as he can, the preceding
{late of his patient's health, and very ftudioufly
to watch the progrefs of each day in the early-
part of all formidable accidents, as this only
can direct him in what degree he is to adopt*
and how far continue, the relaxant, antifeptic,
or tonic modes of treatment ; as in cafes of this
kind, no one general rule of conduct will be
equally fuccefsful.
The fame attention will be necefl'arv to be
oblerved refpecting the local treatment, that irri-
tation and pain may be avoided as much as
poffible.
The pofition of the limb in compound frac-
ture mull depend on the fituation of the wound.
In Ample fracture, during rhe procefs of fweliing
and inflammation, great advantage refults from
the bent poiition, which is certainly iefs painful,
from the mufcles being relaxed ; but when the
tendon has entirely fubfided, I confefs I keep thg,
fractured ends of the bones better in their place
by the ftraight pofition ; and the time of con-
finement being divided in the two fituations,
the patients generally bear it better j and when
E 3 the
C 54 D
the union is perfect, flexion may be again per
mitted with propriety.
Amcrjham,
March 31, 1793.
V. A Cafe of violent Bijlortion of the Foot, occa*
foiled by a Rotation of the Aflragalus, in con-
fequence of a Fall, and accompanied with a
Laceration of the Integuments at the outer An-
cle, and Expofure of a Portion of the Fibula.
Communicated in a fetter to Dr. Simmons by
Mr. William Guy, Surgeon at Chick eft er.
IF any apology be neceffary for my wifhing
to fee the following hiftory inferred in the
next Volume of Medical Facts and Obfervarions,
I apprehend it is furnifhed by the circumftance
of two cafes of the fame kmd having happened
in this neighbourhood, in both of which am-
putation was judged neceifary, and performed.
1 was defired by a furgeon to vifit a young
gentleman who had received a fevere hurt in
the foot, in confequence of his horfe having
reared
[ 55 3
reared up and fallen on him ; the injury ap-
peared of fuch magnitude, that the furgeon had
little doubt but that amputation would be ne-
ceffary. § I faw the patient in about four hours
after the accident, during. the whole of which
time he had fufTered excruciating pain ; his
left foot was wrenched round-, fo as to de-
fcribe a quarter of a circle, in which pofition
it remained, refting (as the patient lay on his
back) on the great toe, and forming a light
angle with the inner tide of the tibia. The
violent and fudden difiortion of the foot was
fuch, that the integuments were torn over the
outer ancle, leaving about two inches of the
fibula expofed.
Though appearances were fo formidable,
there was reafon to hope that the real injury fuf-
tained by the parts concerned, was not anfwera-
ble to them : a violent diftortion had happened,
but there was no luxation ; the aftragalus, and
confequently the foot, had only undergone a
rotation ; and the laceration was caufed, not by
any difplacement of the fibula, but by the in-
teguments being violently flretched and torn
over the head of that bone.
Impreft with thefe ideas, we made a genrle
eztenfion of the foot, and replaced it without
E 4 the
t f6 ]
the Icaft difficulty in its natural fituation ; the
integuments being thus relaxed, as readily re-
turned over the head of the fibula, and the lips
of the wound came nearly in contact ; loft, eafy
dreflings were applied, and the leg and foot
were fomented with flannel cloths, wrung out
of hot water, and laid on the limb, all motion
being carefully avoided; fome blood was drawn,
an opiate adminiftered, and the antiphlogiftic
regimen ftri&ly enjoined. Iii a very fhort time
the patient fell into a profound ileep, in which
{late he continued feveral hours; he awoke much
refreshed and tolerably eafy; no confiderable
pain or fwelling enfued; at the end of the month
he was able to ride on horfeback, and with the
aid of a (tick could walk pretty well; and in
lefs than three months after the accident he
recovered the perfect ufe of the joint.
It will clearly appear to any one, on exa-
mining the fkekton, that the ligaments of the
joint were not lb much ftretched in this cafe as in
a luxation; and that the aftragalus, when turned
round ^s above defcribed, is almoft as well a-
dapted to the cavity of the inferior extremity
of the tibia, as when in its natural pofition;
the head of the fibula covering the pofterior in-
stead of the lateral part of the aftragalus, and
the
[ 57 3
the lower extremity of the inner ancle falling
into a fmall depreflion of the anterior part of
the fame bone.
Chichefter,
Ottober 20, 1793.
VI. Cafes of the Urticaria or Nettle Rafn, with
Obfervationsi by T. M. Winterbottom, M. D.
Pbyftcian to the Settlement at Sierra Leone:
communicated "in a Letter to Robert Willan,
M. D. Pbyftcian in London, and by him to Dr.
Simmons.
A Black woman, aged thirty-fix years, ftrong
and healthy, after having eaten of a fruit
which (he found in the woods, in form and fize
refembling a damfon, and for which (he mif-
took it, was next morning affected with a fenfe
of uneafinefs and liftleflhefs over her whole
body, accompanied with naufea and opprefilon
at the przecordia; and with a. fenfation of creep-
ing over the whole bor!y, which was followed by
a general tumefaction, efpecially of the face.
The
[ 58 ]
The nofe was remarkably fwoln, hot, itchy,
and painful, particularly the ate nafi ; the up-
per lip was alfo much tumefied. She moreover
complained much of a forenefs in the throat,
attended with a troublefome tickling and fenfe
of conflridtion of the fauces, which rendered
deglutition difficult. About die fame time an
eruption took place over the whole body, more
efpecially on the neck, breaft, and arms, of
large red fpots elevated above the fkin, very
hot, and intolerably itchy. On becoming warm
in bed fhe felt as if flung all over with nettles ;
and the fpots at that time appeared more nume-
rous. The next morning ihe took a dofe of
JaL cathart. amar. afcer the operation of which
the tumefaction of the body was entirely re-,
moved, and the afTe&ion of the throat was very
much relieved.
The eruption was much diminiihed in the
courfe of the day, but did not entirely difappear
until three or four days after, upon taking a fe-
cond dofe of the falts. The itching continued
troublefome for a week or two longer, and was
always aggravated during the night.
Her huiband, who had eaten of the fame
fruit, was fimilarly affected., except in feeling
but
C 59 1
but little forenefs of throat, and in having his
face more fwoln, especially rhe lips.
A woman and child, whom I did not fee till
after their recover)', were affected, according
to their own report, in nearly the fame manner,
from eating the fame kind of fruit; they re-
covered without any other medicine than a dofe
of purging filts.
The tree which bears this fruit is, I believe,
hitherto undefcribed ; the fruit, when ripe, is
not unlike a damfon, having a (tone within,
being black, and of a fweetifh tafte. Its juice,
which at nrrt is nearly colourlefs, gives a very
durable black or dark-brown colour to linen.
An eruption fimilar to the above occurs from
a variety of fubftances taken into the ftomach ;
it is commonly termed a furfeir, or bv the vul-
gar in fome parts, poifoning, This may de-
pend either rpor an idbiyncracy with regard to
certain articles of diet, as crabs, and fome other
fhell tifti* ; or it may arife from a mixture of
different
* A man was always affected with urticaria afteKeating
crabs, whether boiled or in foup; he was affected thus even
by the vapour which arofe from them ; as alfo by taking the
jap. cancr, Pr. Tode, from whom this is quoted (Med.
chir
[ 60 }
different fubfeances in the ftomach, producing
a noxious compound, though any of them fingly
would be harmlefs. Of this, Salmon, taken along
with milk, affords an example.
Under the former head, perhaps nothing is
more curious than the efTedts of the vegetable
bitter. I have myfelf been twice violently af-
fected by eating the iweet Almond : the firft
time, within a few hours after eating this fruit,
though in no great quantity, I was feized with
flight naufea, uneafinefs in the ftomach and
bowels, without any fixed pain; great reftleflhefs
and increafed heat. Thefe fymptoms were foon
followed by an oedemstous fwelling of the face,
especially of the lips and nofe, which were ex-
tremely hot and itchy. There was, at the fame
time, an uneafy tickling fen fation in the throar,
which excited a troublefome cough and a com
ftriction of the fauces, which feemed to threaten
fuffocation. The tongue likewife became en-
larged and ftifT, caufing a flownefs and faultering
in the fpeech. Soon after going to bed, an
chir. tfcbl.) obferves that he is himfeif frequently, though
not always, affe&ed with a llight urticaria after eating crab
foup. — A woman by eating ltrawberries was conilantly
affected with urticaria. See Vogel's Handbuch der Pract.
Arzneywiffenfchaft, vol.3, p. 277.
erup-
C 6! ]
eruption took place over the whole body, of
ipots nearly as large as a fixpence, of a dead
white colour, a little elevated above the fkin like
the wheals produced by the (ling of a nettle,
and intolerablv itchv. In their interfaces
the fkin was of a hi-h red colour ; the whole
body was alio tumefied, though in no great
degree. Thefe fymptoms continued during
the greater part of the night, but gradually
abated towards morning, upon the breaking out
of a gentle perforation which was encouraged
by warm diluents ; the next day, not the lead
veftige of the complaint remained.
The fecond time this affection occurred, the
appearances were nearly the fame, except that
they began a few hours later than in the firft
inftance — The eruption alfo continued the
greater part of the enfuing day, and then gra-
dually declined. From eating the blanched
Almond I feel no inconvenience, but have
never ventured fmce to eat them in their un-
blanched flate.
During my refidence in Edinburgh, a patient
was received into the clinical ward affected
nearly in the manner above defcribed ; I (hall
tranferibe his cafe from the clinical reports
taken at the time.
« Nov.
C 62 ]
" Nov, 19, 1787. Alex. Roberifon, aged 18,
" a Labourer; has a colourlefs puffy fvvelling over
" his whole body, but more efpecially over his
cc head, upper extremities and thighs. The
ic (Veiling is pretty di(tinc~tly feen and felt upon
cc the forehead, which pits upon preffure ; the
tc palpebral and upper lip are likewifc a little
u tumefied. The parts chiefly affected are fre-
u quently attacked with almofl intolerable itchi-
" nefs, and when Scratched have an appearance
*' as if (lung with netties — pulfe natural; appe-
<; tite good ; body regular. Two or three days
" previous to thefe complaints he was, at dif-
ferent times, fuddenly attacked with great
vertigo, and on the j8th, fir ft obferved the
fwclling and itchinefs — Heattributeshis com-
plaints to fudden alternations of heat and cold,
u Has ufed no Medicines.
" 20. He took a dofe of Pulv. e/ Jalap, co,
ec which did not operate — on the 21ft having
<c had only one natural (tool, the purgative was
Ci repeated. The fwclling wa$ nearly gone,
fcC but the itching continued—
(C 22. Had three motions from the phync: —
<c the itching had ceafed.on the head, andwas eafier
<< on the trunk of the body ; but now began
C 63 ]
<k to affect the lower extremities-*- He was or-
" dered to employ the warm bath, and after-
cc wards to take Pulv. Dover, gr. x with a dia-
-l phoretic Julep occalionally.
" 23. He had fweated properly : — his voice
" and countenance were natural — the itching
" was gone from all parts but the legs and feet:
" the Julep was directed to be continued.
" 24. Some itching ftill remained about the
" legs and thighs; he was ordered to take next
" day a decoction of Tamarinds with Senna.
" 25. The itching was almoft gone —
" On the 26th he left the houfe, cured."
Dr. Gregory, in his clinical lectures, men-
tioning this cafe, laid he fufpe&ed it might have
arifen fromiornethingdifagreeable to thepatient's
ftomach of the nature of the vegetable Bitter —
The Doctor alio obferved that he had himfelf
been fubject to a fimilar complaint from eating
Almonds ; that he had a violent attack of fever,
fwelling of the body, and a copious eruption on
the fkin, attended with a lofs of voice and cold-
nefs of the extremities, which, however, went off
the next day — ; Nearly the fame lymptoms, he
added,.had occurred to him from eating a green
cucumber with the lkin upon it ; and continued
C HI
four days, but were at length removed by t
cathartic.
About two years before this period, Doctor
Gregory had feen, he faid,a patient affected in a
fimilar way by drinking porter; he was feized
with ficknefs, High: fever, head ach, and great
icching over his body, occafioned probably by
the bitter in the porter — The patient Robertfon,
whofe cafe is related above, alfo faid that he
was taken ill foon after drinking fome porter.
The above difeafe appears to me to belong
to the genus urticaria* Authors have divided
urticaria into an acute and a chronic fpecies ;
the former has had various denominations, as
febris urticata^fcarlatina ur tic atd purpura urticatd,
* febris rubra pruriginofa — Some Writers, how-
ever, feem to have confined the term urticaria
wholly to the chronic kind* — Thefedi functions
appear unnecefTary if we reflect how difficult it is
to account for the effects of ftimuli upon diffe-*
rent conftitutions ; and how varioufly the difeafe
may be modified, either by the peculiar irrita-
bility of the patient, or by a greater or lefs de-
gree of activity in the irritating matter taken
into, the ftomach. — Befides, the term, febris urti-
cata is highly improper; for the fymptoms which
* See Medical Tranfatftions, vol. II.
occur
f 65 ]
occur in the acute, or febrile flare, as it is called,
are not thofe of fever, but merely of erethifmus,
being the confequences of a greater or lefs degree
of irritation.
The Jc aria tina, urticaria, and effera have been
coniidered, by fome *, as difeafes of a fimilar
nature ; but between fcarlatina and the others,
the difference is fo ftriking that it need not be
minutely pointed out — The diftinction between
urticaria and effera does not appear fo obvious —
Some have confidered effera only as a chronic
flare of urticaria ^ but a much more efTential
diftinction may be eflablifhed between the two
difeafes — Urticaria feems always to be connected
with an affection of the fyftem, and of the flo-
mach and prima? vis in particular, whereas the
effera appears to be merely a local affection of
the fkin unconnected with any difeafe of the
conflitution.
Many perfons who have an irritable or deli-
cate fkin are liable, during the fpring and fum-
mer feafons, to frequent eruptions on the arms,
face and neck, commonly called heat-fpots, re-
fembling the flings of nettles, which obferve
no certain period of duration, but fometimes
* See Selle Rudimenta Pyretologlae.
F quickly
r 66 ]
quickly difappear, and fometitnes are very per-
manent. A lady of my acquaintance is always
affected with an eruption of this kind when her
fkin is touched with the common wall flower.
The bites of infects have confiderable effect in
producing a fimilar eruption on thefkins of fomc
perfons, while others are little affected by them*
Aftruc fays this ejfera is very common in Lan-
guedoc, but he confiders it as the fame with ur-
ticaria.
Thofe who account for the effects of the ve-
getable bitter, upon the fuppofition of its be-
ing carried into the blood before it exerts its ac-
tion on the extreme veffels, afford little fatis fac-
tion to pathological inquirers. How can we,
indeed, imagine that fo fmall a portion of mat-
ter as is probably extracted from the ikins of a
few almonds, mould, when mixed with the
mafs of circulating fluids, produce fuch power-
ful effects ? It appears, therefore, more ratio-
nal to conclude that the ftomach is the part pri-
marily affected ; and that the eruption is only a
confequence of the clofe connexion which fub-
fifts between this organ and the fkin. That
connexion is proved by a number of inflances;
I (hall, however, adduce one more which is
peculiar to the climate wherein I ani at prefent
fituated.-
C 67 ]
fituated. This is the prickly heat, a papulous
eruption which appears chiefly on parts covered
by the clothes. Strangers are generally moft
liable to it, though fome never have it, and
yet enjoy good health. Fair people are more
affected by it than thofe of very dark complex-
ions ; yet I have fometimes feen it affect even
black people. This eruption is generally con-
fidered as a mark of health ; from what I have
feen of it, I am rather inclined to confider it as
indicating an active and healthy flate of the fto-
mach. The flighted indifpofition or uneafinefs
of the (lomach is commonly followed by a con-
(iderable abatement or total difappearance of
the eruption ; in fuch cafes, a dofe of bark, a
glafs of wine or any warm liquor, is frequently
fucceeded by a general tingling over the body,
and a copious eruption of prickly heat; where
the eruption is already out, it is often much in-
creafed and rendered more vivid by the fame
means.
It has often been fuppofed that bitters pofTefs
a narcotic quality ; for which reafon the gentian
has been omitted in fome of the foreign difpen-
fatories. The long-continued ufe of bitters cer-
tainly tends to deftroy the tone of the ftomach
and of the conftitution ; and thence produces
F 2 J irre-
C 68 ]
irregularities in the circulation, and more efpe-
cially congeftions in the head. The fatal effects
afcribed to the Portland powder may be thus
accounted for ; at leaft with more probability
than by the common hypothecs of a repulfion of
gouty matter from the extremities, and its con-
iequent depofition upon other parts, of which
we have no proper evidence.
Free T'cwn,
Oierra Leone,
June 3, 1793,
VI I. An Account of the Effetls of Vitriolic ALther
in a Cafe of Jpajmodic Affetlion of the Stomach ;
and in two Cafes of Intermittent Fever. By
Mr. William Davidfon, Apothecary in London.
IN the month of November, 1791, a young
married lady, of a delicate habit, having un-
dergone much fatigue, was feized with a violent
fpafm of the ftomach, which came on immedi-
ately after dinner, everyday, for eight days, and
continued fometimes for one, and fometimes
for two hours, without her finding any relief,
although
[ 69 ]
although a variety of warm things were given
to her for that purpofe. On the 9th day (he
dined at my houfe, and was taken as nfual.
Having a high opinion of aether as an antifpaf-
modic, I gave her a draught compofed of a
drachm of vitriolic aether, and fimple pepper-
mint water, deiiring her to drink it quickly,
which (he did,
The moment it got into the Stomach it gave
a confiderable Shock, (if I may fo exprefs my-
felf) to the whole constitution. She thought it
very Strong, and faid I had nearly fuffocated
her ; however, the pain went off immediately,
and never returned after, ghtsere, was not this
effect produced by the (hock given to the com-
mon fenforium through the medium of the fto-
mach, from which the distribution of nervous
influence was disturbed, and a flop thereby put
to the difeafed action then exifting ?
Seeing fuch fuccefs from this medicine, and
the commotion it excited in the body, I con-
ceived it well adapted for anfwering one of the
intentions exprelfed by the illuflrious Whytt,
in his Treatife on Nervous Difeafes ; and I re-
folved to put it in practice as foon as an oppor-
tunity Should offer, which happened foon after, as
will appear by the following cafe of a quartan
F 3 inter-
C 7° ]
intermittent, which was fpeedily flopped by it.
The paflage alluded to in Dr. Whvtt's work,
being of great importance towards eftablifhing
a rational pathology of fome nervous difeafes, I
fhall beg leave to mention it. He fays, page
221, (8vo edition) " And as an intermittent
agrees with epileptic and other convulfive
diforders, as to its caufe, fo its returning pa-
roxyfms, like theirs, may be often prevented
or weakened by raifing, a fhort time before
the approach of the fir, an acute pain or any
great commotion in the body." And the
practice appears very rational with a view to
difturb or fufpend the nervous influence. The
latter is to be mofl earneflly wifhed for in the
treatment of thefe complaints : for, if fufpen-
ded only for a moment, there is great probabi-
lity that the exifling morbid action will either
ceafe or be changed into a milder affection.
But if this cannot be accomplifhed, we often
gain our purpofe by diverting the nervous in-
fluence into a new channel.
Cafe
C 7' 3
Cafe of a Quartan Intermittent cured by JZther.
Mrs. K — , aged about forty-fix years, having
loft her only child on the 30th of Auguft, 1791?
was fo much affected, that fhe became very low
and weak; and, towards the end of September,
was feized with a fevere quartan ague, which
continued to return at regular periods, but for
which me ufed no remedy until the 15th of Ja-
nuary, 1792, when fhe applied to me. She
was then in a feeble ftate, but had no particular
fymptom of vifceral obftruction.
Having firft cleared the printce vix by an
emetic and a purgative medicine, I began to
treat her in the ufual way, by giving the bark
and different tonics in the intervals of the fits,
and endeavouring to fhorten the paroxyfms,
when prefent, by the common methods.
This plan of treatment I purfued until the
5th of February, without any benefit as to the
periodical returns, although her general health
was better. Being now tired and difappointed,
fhe would take no more medicine; and in this
refolution fhe perfifled until the 16th, when fhe
F 4 again
[ 7* ]
again folicited my affiftance. She was now ex-
tremely weak and thin, and her ague had regu-
larly continued.
Having been unfuccefsful in mv former at-
tempts, I refolved to adopt Dr. Whytt'$ method
of exciting a commotion in the fyflem jufl be-
fore the approach of the fit. With, this view I
ordered an seiher draught, fimilar to that given
in the above cafe of fpafm, to be taken when
the leafl feeling of the fit mould come on.
Some minutes, however, elapfed after the ac-
ceffion of the cold fit before the draught was
taken; which, notwithflanding, produced the
defired effect. When taken into the flomach
it gave her fo cor.fiderable a fhock, that fhe
imagined fomc mi flake had been made in pre-
paring her medicines, and was therefore much
frightened. The coldnefs went off immedi-
ately, and being fucceeded by a plealant fenfa-
tion of warmth, without any fever or perfpira-
tion, fhe was in good fpirits all the reft of the
evening.
Fearing this one dofe might not be fufHcient,
as the fit had commenced before the draught
was taken, I requefled fhe would take another
at the time the next paroxyfm was expected,
whether it appeared or not. Accordingly, on
the
C 73 ]
the 20th, perceiving (to ufe her own exprefilon)
her nails were becoming black, which {he had
found ro be the conftant precurrent fymptom of
a fir, fhe took her draught, which affected her
ftill more than the former.
At firft (he feeme*d like to burft, (as fhe ex-
prefTed herfelf ) but foon after felt comfortable,
and fpent'a very cheerful evening. Her ague
difappeared from this time, nor has fhe had
any return of it fince. She took fome tonic
medicine twice a day for feveral days, and ac-
quired frefh ftrength and fpirits daily.
In the above cafe it is probable that no parti-
cular vifceral obftruction exifted, and that the
difeafc originated from weaknefs of the nervous
fyftem, brought on by grief for the lofs of her
child ; and might therefore be confidcred as a
nervous difeafe that had become periodical, and
as fuch was to be treated like epilepfy, and fome
others of that clafs ; many of which might be
fuccefsfully attacked on the above principle.
That many intermittents are nervous, would
appear probable from the great number of pa-
tients who are daily cured by frights, charms,
accidents, or, in fhort, any thing which, for
the moment, diverts or fufpends the nervous
influence, and thus breaks the habit of attack.
In
C 74 ]
In confirmation of this idea, I mall take the
liberty to add a few more fads. A worthy ba-
ronet, whom I have the honour to attend, ha-
ving been affected with an obftinate ague for
eighteen or twenty months, for which he had
tried the bark, given in the' bed manner, with-
out effect, was determined to follow the hounds
on the approach of the next fit, in hopes that
the exercife might prevent it from coming on.
He made the attempt, and certainly fncceed-
ed ; for in leaping a five-barred gate, his horfe
fell, by which accident he broke one of his col-
lar bones, and his ague never appeared after.
Here the violent mock to the constitution from
the fall, and the fymptomatic fever induced by
the fracture, cured the intermittent; perhaps
by flopping the habitual difeafed action, and
inducing another action, where the nervous in-
fluence was determined more firmly and fteadily
to a particular point.
Many patients have been cured by falling acci-
dentally into a river on the acceffion of the cold fit.
A large dofe of laudanum has alfo flopped a fit ;
and a fimilar effect has been produced by a glafs of
brandy and hartfhorn. I know a very refpectable
private gentleman, who has cured many agues by
the following draught, of his own compofing;
viz.
C 75 3
viz. brandy, ftrong vinegar, and water, of each, a
wine-glafs full, to be taken juil before the fit.
Every practitioner is more or lefs acquainted
with fads of this kind ; and however mortifying
it may be for profeflional men to hear, yet it is alfo
well known that an ague, which has for months
baffled the united efforts of talents and experience,
has been often cured by fome charm, or by
great emotion of mind, excited by the faga-
city of fome good old lady on the approach
of the fit. That the principle is rational, and
confident with the laws of the animal ceconomy,
will appear probable from obferving the rules of
the nervous influence, which cannot be directed
to two points, atone and the fame time, with
any degree of fleadinefs or permanency.
Cafe of a Tertian Intermittent J 'topped ly jEther.
Towards the end of February, 1793,
a young man, about twenty-four years of
age, of 2 delicate ftructure, and fair com-
plexion, became feverifh, and was perfuaded
by a medical friend to be blooded. Immedi-
ately after the operation was performed, he grew
weak, hyfterical, and continued in a fainting
ftate, more or lefs, during the remaining part
of
t 7& 3
of the day. The next morning, about eight
o'clock, an intermittent, of the tertian type,
made its appearance, and went through the
ufual ftages. After proper attention had been
paid to the (late of the firit paifages, the hark was
given every two hours in the abfence of the fit.
This plan, with the addition of a nourifhing
diet, and the occafional ufe of port wine and
porter, was continued for four days, but with
no good effect ; and the cafe of Mrs. K — ha-
ving occurred to my remembrance, I now
thought of trying the fame means of cure in
this cafe.
Accordingly, on the 8th of March, I fent
him the fame aether draught, as had been given
in the farmer cafes, to be taken on the approach
of the next paroxyfm, which he expected the
following morning. On the 9th he took his,
draught, exactly as the paroxyfm was begin-
ning, and it went off directly by a gentle moif-
ture on the fkin. Having proceeded with his
bark for fix days, gradually diminidring the
frequency of exhibition, and having had no
return of his ague, I left him feemingly in per-
fect: health.
From the above cafes it appears evident, that
fome intermittents may be cured by exciting
the
C 77 3
the commotion recommended by the celebrated
author above mentioned. It remains, there-
fore, with practitioners to afcertain what is the
beft medicine for anfwering this indication ;
Whether sether, electricity, a mock from the
cold bath, or any particular impreflion on the
mind, is the be'l ; or whether they ought not
all to be adopted occafionally, and only varied
according to the different conftitutions affected,
and the different dates of each different patient;
and alfo, wherher all kinds of agues can be
cured or relieved in this way. I exhibited the
aether twice to a patient labouring under an in-
termittent, who was much affected with different
internal complaints, and where the kidnies did
not perform their functions, without flopping
the difeafe, although the fit was much fhortened
by the fecond dofe. From this I fufpect that
the method above practifed will not fucceed
when the difeafe is attended with vifceral ob-
ftructions; but that when the ague arifes from
debility, occafioned by grief, or whatever weak-
ens the nervous fyflem, from which habitual
fits have been induced, the habit of attack may
be flopped, and the difeafe cured as already-
mentioned.
But I prefume the fuccefs, even in the latter
cafes,
[ 78 ] '
cafes, will depend much upon the commotion
being excited as near as poffible to the moment
of attack. I have lately fucceeded in one cafe
of epilepfy, which was of many years (landing,
and had been induced by intenle application of
mind, by giving an aether draught on the ap-
proach of the fit, and purfuing a tonic plan in
the intervals.
Queen Anite Street Eaft,
October 10, 1793.
VIII. An Account of the poifonous Effecls of the
Seeds of the Datura Stramonium Linn. By Mr.
James Johnfon, Surgeon at Lancafter.
ON the 1 2th of November, 1789, about
five o'clock in the afternoon, Mifs S.
of this town, aged twenty years, fwallowed fome
of the feeds of the ftramonium or thorn-apple.
Three hours afterwards (lie began to be lick, and
her mother gave her a mixture of flour of muftard
and water to make her vomit, and it produced
this effect feveral times. At eleven o'clock the
fame
C 79 3
fame evening I vifitcd her, and immediately
fufpected what fhe had been eating from the
defcription her mother gave me of the plant,
(the patient having deftroyed all Ihe had of it);
and the next day I was convinced of its being
the datura ftramonium, by a frefh fpecimen of
the plant, which was procured from the fame
place where the other had been gathered.
As (be had vomited feveral times before I
was called to her, I contented myfelf with ad-
miniflering a purgative medicine, which pro-
cured feveral {tools. She parTed, however, a
reftlefs night, complained of great pain of her
ftomach and left arm, fancied (he faw objects
that did not exift, and had repeatedly a fenfa-
tion of a flaming light, which made her think
that (lie faw it lighten.
After the operation of the purgative, ihe
took repeatedly of an oily emuliion.
Nov. 14, As her ficknefs, and pain of her
ftomach, {till continued, I gave her an eme-
tic, of antim. tartar, and ipecacuanha, which
brought off feveral of the feeds of the (tramo-
nium.
15. The ficknefs and uneafinefs at her fto-
mach (till continuing, {be repeated the purga-
tive medicine, and it operated feveral times.
2 1.6. She
C so J
1 6. She had paffed a much better night, and was
free both of ficknefs and of thepain at her flomach;
17. As fhe now had no complaint but weak-
tie fs, fhe was directed to rake the Peruvian bark
infufed in port wine ; and when I faw her again
on the 20th, (he found herielf quite recovered;
Of the inftances of the po'ifonous effects of
flramonium, recorded by different writers, thofe
defcribed by Dr. Rum *, ProfefTor Lobflein -f ,
and Dr. Fowler, feem to have the greatefl af-
finity to the cafe I have related.
The fubject of Dr. Rum's account was a
girl between three and four years old. She had
fever, delirium, tremor of her limbs, and a
general eruption on her fkin. The real caufe
of thefe fymptoms not being fufpected, purga-
tive medicines, the warm bath, and cataplafms
to the feet were employed, but without effect.
At length it was difcovered that me had fvval-
* An Account of the Effects of the Stramonium or Thorn
Apple. By Benjamin Rufli, M. D. ProfefTor of Cheniifhy
in the College of Philadelphia. — See Tranfaclions of the
American Philofophical Society, Vol. I. p. 31S.
+ In an Appendix to a DifTertation de Vegetabilrbus Ve-
netians Alfatia?, by F. A. Guerin. 4to. Stralburgh, 1766.
lowe^i
L 81 J
lowed fome of the feeds of the ftramonium.
She was now vomited with emetic tartar, but
brought up only phlegm. Sweet oilj however,
mixed with a little caltor oil, brought away a
great number of the feeds by ftool. The relief
this oily medicine gave her, occafioned ix to be
repeated every day for a week ; but the tremor
ftill continued, at times, in her hands, and (he
was blind and ftupid. The pupils of her eyes
were much dilated, and (lie caught at the bed-
clothes, and every thing around her, like a per-
fon in the lad ftage of a fever.
Being perfuaded that the oily mixture had
evacuated all the feeds that were in the intef-
tines, Dr. Rufh fufpedted that her complaints
were kept up by a few feeds retained in the
ftomach. He therefore gave her a larger dofe
of emetic tartar, which brought up eighty of
the feeds ; but the ftupor and blindnefs ftill
continuing, the emetic was again repeated, and
brought up above twenty more of the feeds;
after which all her complaints vanimed.
Dr. Rufh fuppofes, that in this cafe the ef-
fects of the poifon would have been greater, if
the feeds had been frefher ; for they were, it
feems, of the preceding year's growth, and
were become dry and hard;
Vol. V. G He
C 82 ]
He adds, in a note, that Dr. Bond and Dr.
Harris had informed him, that in a limilar cafe
they had experienced good effects from lemon
juice, after the ftrongeft vomits bad failed to re-
lieve the patient.
The cafe related by Dr. Lobftein was as fol-
lows :
Two children at Strafburgh, a brother and a
lifter, the former fix, the latter nine years old,
ate fome feeds of the ftratiionium about five
o'clock, P.M.
At nine the girl complained of laffitude, and
went to bed. Her mother foon after finding,
her feverifh, and talking in her fleep, con-
cluded that fhe was about to have fome eruptive
difeafe, and gave her fomething warm to drink.
She continued in this Hate till one o'clock in
the morning, when the boy alfo, who had flept
in another room with his father, was become
extremely reftlefs. At (even, A. M. when
Dr. Lobftein firft faw thefe children, they were
both much convulfed ; their faces and cheeks
were fwelled ; their lips were of a deep red;
their eye-lids fwelled and clofed : on feparating
the eye-lids, the pupils of the eyes were found
to be much dilated ; the eyes themfelves were
convulfed. Their bellies were tumid, but not
hard*
[ §3 J
hard. When they were loudly fpoken to, or
when any body touched them, their convulflons.
became more frequent and violent. In each of
them the tongue was fwelled and protruded out of
the mouth ; and their fauces were fo conftridted
that refpiration was performed with difficulty-.
By degrees the fpafms became lefs violent, and
their fkin, from being intenfely hot, became
moift ; their pulfe was (till quick, but fofter.
They now rejected every kind of liquid, and
feemed to labour under hydrophobia; for on
offering a cupful of drink to them, Dr. Lob-
ftein found that the moment it touched their
lips the fpafms returned with great violence^
While he was endeavouring to afcertain the
caufe of thefe alarming fymptoms, he acci-
dentally obferved, in the chamber, a portion of
the plant which had occafioned the mifchief.
He now began, therefore, to excite vomit-
ing; but no feeds of the ftramonium were
rejected. He wav more fuccefsful, however,
with clyfters, which were repeatedly adminif-
rered, to the number of twelve, and brought
away feeds of the plant with the {tools. The
bellies of the patients now became lefs tumid ;
their refpiration was eafier ; and the fwelling of
G 2 their
[ s4 ]
their faces fubfided. Lemon juice, and like-
wife vinegar and water, were now adminiflered
to them.
At eleven, A. M. when Dr. Lobftein favv
them a fecond time, he found the girl more
quiet, but flill at times convulfed. She drank
freely of vinegar and water; her pulfe was
(ofter ; fhe perfpired confiderably ; the tume-
faction of her belly had fnbfided ; and fhe was
free from delirium, but the pupils of her eyes
were dill dilated. The boy remained unre-
lieved.
At eight, P. M. the girl was fufficiently re-
covered to give her friends an account of Che
plant, the feeds of which (lie and her brother
had eaten. She had got fome refrefhing Deep,
but her pupils were flill fo dilated as not to con-
tract on the approach of a candle.
The boy likewife now began to m/end ; and
at eleven, P. M. opened his eyes and fpoke to
thofe about him. The next day they were both
of them pretty well recovered.
Of thefe cafes, from Dr. Lobflein, I have
been induced to be the more particular in my
account, as the Diflertation to which they are
annexed is fcarce; but, for the particulars of
Dr.
[ Si j
Dr. Fowler's cafes, I (hall content my felt" with
referring to the collection in which they are
publifhed, as being a work pretty generally in
the hands of medical readers in this country*.
From none of rhe facts hitherto published,
relative to the poifonons effects of this plant,
does it feem to be afcertained what quantity of
the feeds may be iwallowed without destroying
life. Their effects, no doubt, will vary ac-
cording to the foil and climate in which the
plant is produced, and according to the greater
or lefs degree of maturity to which the capfules
have arrived,
In one of the two cafes related by Dr. Fow-
ler, the patient, a girl not quite fix years
old, is faid to have fwallowed three-fourths of
the feeds of a frelh, ripe, middle-fized thorn-
apple ; and I have reafon to think thar my pa-
tient fwallowed nearly as many feeds as were
contained in one apple ; bu: it would feem that
in the Eaft Indies thefe feeds are much more
deleterious ; for there, according to Dr. An-
* See Edin. Med. Comment. Vol. V. page 161. — Refe-
rences to other inftances of the poifonous effects of the feeds
of the plant in queftion, may be found in the late ProfelTor
Murray's Apparatus Medicaminum, 8vo. Gotting. 1776.
Tom. I. p. 456, and in Dr. Woodville's Medical Botany,
Vol. II. p. 33S.
ft 3 derfon,
[ 86 ]
derfon *, the feeds of one thorn-apple are ge-.
nerally urn Lent to induce immediate death.
Both my cafe and Dr. Ruih's (how the utility
of repeated and active emetics in fuch cafes^
and how long '.he fymptoms may he kept up:
by the retention of feeds in the ftomach. In
the cafe oi my paient, as we have feen, fe-
yeral of the feeds were brought up on the fe.-
cond day, by means of an antirnonial emetic,
notwithftanding the patient had been fo freely
puked on "he day me fwajlowed the feeds ; and
in Dr. Rum's patient a fiinilar effect refulted
from a Urge dofe of emetic tartar, at the end
of a week, notwithftanding an emetic of left
activity, given foon after the poifon had been
fwallowed, brought up only phlegm. All the
cafes I have fpoken of tend to ihow that our;
endeavours in fimilar inftances mould be di-
reeled to the fpeedy evacuation of the feeds, by
means of active and repeated emetics, and of
purgauve medicines and clyfters.
This plant, though not originally a native of
Europe, is now but too common in every part
of it. Our countryman Gerarde fpeaks of it
as. being, in his time, a rare and ft range plant
* London Med. Journal, Vol. X. p. 285.
C 87 1
in England *; but it is now fo frequent, that by-
later writers we find it defcribed among our in-
digenous plants.
JX. A Cafe of Hydrophobia. By Mr. Richard
Simmons, Surgeon to the Britijh Lying-in Hof-
pital.
ON Friday, Auguft the 23d, 1793, about
one o'clock in the afternoon, I was te^
quelled to fee Mary Strong, a poor woman, at
No. 11, Lewkner's Lane, aged forty-three
years. The account fhe gave me was, that (he
had been unable to fwaliow any liquids during
the lad two days, as fhe no fooner put fome to
her mouth, than (he was feized with a kind of
fufFocation. She obferved, however, that fhe
could fwaliow folids. She had, I was told,
eaten an apple very well juft before I faw her,
and in my prefence (he ate fome bread.
* See Johnfon'» edition of Gerarde's Herball, Folio.
London, 1633, p. 34.8.
G 4 She
[ 88 ]
She was coflive ; her pulfe was natural ; but
her third was extremely diftreffing. I de fired
(he would try to drink Tome water, and (he ac-
cordingly made the attempt; but no fopner had
flie brought the pot containing fome near her
lips, than (he threw her head back with great
agitation, and could not get any into her mouth.
I then afked for a pan of water, which \ put up
to her face ; this produced in her very great
emotion. A woman, who was prefent, thought
this agitation might arife from an idea that
the water was going to be thrown at her ; but
the patient's manner being fufficient to convince
me there was no ground for fuch a fuppoiition,
I aiked her to approach her face to it gently,
when placed near her. This (he very readily
tried to do, but the event was the fame as when
I held the pan.
From thefe circumftances I had no doubt
that fhe laboured under hydrophobia; and
upon farther inquiry, I learnt that fhe had been
bitten about two months before, by a dog, on
the middle finger of her left hand. The
wound being trifling, (he had thought no more
of it ; the dog, I was informed, had been kil-
led by fome people in the neighbourhood, on
a fuppofition of its being mad.
[ s9 ]
I directed for her opium, in fubftance, to be
occafionally repeated; but the next day (the
24th) when Dr. Hemming accompanied me to
her, we found that fhe had refufed to take any
thing in the way of medicine, but that fhe had
taken often of fome bread foaked in wine and
water. She had puffed but an indifferent night,
and her pulfe was much quickened. Upon our
requeuing her to endeavour to drink fomething,
fhe told us fhe would, if poffible, do any thing
we defired of her; but that aJthough her third
was Hill exceffive, it was not in her power to
drink. We advifcd her to try to drink fome-
thing but cf a tea pot, but the attempt threw
her into great diftrefs. After we had been with
her a little while, however, fhe fwsllowed a
tea fpoonful of wine and water in a hafty con-
fufed manner. This induced us to perfuade
her to try to take a larger draught; (he took
fome in a tea cup in her hand, and threw it
into her mouth nattily, and with great difficulty
(wallowed a very little of it; but immediately
after threw herfelf back in the bed in a convul-
sive kind of manner.
We now left her, and advifed that (he fhould
have a clyfter injecled immediately; and that
an ounce of ung. hydrarg. fort, fhould be rub-
bed
[ 9° ]
bed in on her thighs during the day ; fbe was
likev. ife advifed to make trial of the opiate.
I faw her again ab air half pail twelve o'clock
on the 25th. She had had no fkep, talked in
an incoherent manner, hiccoughed, and fpate
frequently a vifcid . faliva, ard foamed at the
mouth ; her pulfe was now not perceptible; the
clyfter had produced one copious ftool ; Hie
had been unable to take any of the opiate, and
had refuted to have more than two drachms of
the ointment rubbed in. Her countenance was
wild; her fpecch altered; and every appearance
indicated a fpeedy diffolution, which accord-
ingly took place that afternoon, about three
o'clock, two hours after I left her. From the
people who were about her, I afterwards learnt
that fhe died very quietly, and that juft before
her death fhe vomited about a pint of fome-
thing, as they deferibed it, like coagulated
blood.
Leave could not be obtained to open the
body.
There is fo little' to be deduced from this
cafe, that fome apology might be neceflary ror
offering it to the public, if the difeafe of which
it
it is an inftance, were lcfs rare or better under-
ftood ; but in the pre'ent imperfect ftate of our
knowledge with refpect to the pathology and
treatment of hydrophobia, every well-authenti-
cated inftance of it fecms to deferve to be re-
corded. Some valuable observations refpecting
this difeafe, by Dr. John Hunter, drawn up from
cafes and materials co'-lected by a Society for
the improvement of medical and chirurgical
knowledge, have been lately publilhed in their
Tranfactions ; and a fimilar arrangement of
facts, made from time to time, may perhaps,
by degrees, lead us to a more fuccf/fsfui mode
of treating a difeafe which has hitherto bafHcd
every attempt to relieve it.
The little deviation from the natural ftate of
the pulfe, which occurred during the firft two
days in my patient, has been obferved in other
inftances at the beginning of the difeafe.
In this cafe, notwkhftanding her inability to
fwallow any thing liquid, the patient, as we
have feen, complained of very diftrefling thirft;
a fymptom which I do not find mentioned in the
defcriptions I have met with of ether inftances of
the difeafe.
Newman Street,
~$.cvcmber 23, 1793.
X. An
[ 9* 3
X. An Account of a Child born without Organs of
Generation, By Mr. Edward Ford, F. A. S.
Surgeon to the Wefiminjter General Difpenfary.
IN December, 1792, I was defired to fee a
child, born a few days before, with the
anus imperforate in its ufual place, the faeces
appearing to be difcharged through the va-
gina. The extefnal parts were remarkably
fmali in their conformation ; the orifice of
the meatus urinarius admitted a probe into
the bladder ; but on attempting to pafs a di-
rector, and afterwards a fmall probe into the
pafTage from which the faeces were difcharged,
I found it impracticable from the fmallnefs of
the aperture ; and at the fame time I difcovered
that there was no cavity fimilar to the ufual one
of the vagina.
It was propofed a few days afterwards to
form an artificial opening for the difcharge of
the fasces in the ufual fituation of the anus, by
introducing a probe into the preternatural open-
ing, and pufhing it backwards, fo as to project:
it
t 93 3
It below the os coccygis, and then to cut upon
the inftrument, in order to form, if poffible, an
outlet for the feces, lefs liable to the inconveni-
ences which mud inevitably have refulted from
the unfortunate derangement of parts which at
pre fen t fubfiflcd. A time was fixed for the ope-
ration, but the infant foon after becoming difor-
dcred in its health, it was judged unneceffary
to attempt it.
The child died when it was three weeks old,
and I had an opportunity of examining it after
death, in the prefence of Dr. Jackfon, of
Hanover Street, and Mr. Hunt, apothecary, of
Swallow Street.
The flrft confideration which prefented itfelf
to my mind, was to perform fuch an operation,
on the dead body, as would have been thought
requifite to be done if the child had lived. In
doing this, it was ftill found im poffible to pafs
an inftrument into the redtum from the exter-
nal parts, till they were dilated downwards, in
order to difcover the orifice through which the
feces were difcharged. This dilatation being
effected, the aperture became vifible; and on
prefling the abdomen witji my hand, the feces
were copioufly difcharged.
I then
C 94 ]
I then introduced a director into the rectum,
and projecting it backwards, eafily cut upon it,
and, without much difficulty, formed an externa!
communication with the gut in the part where
the anus is ufunlly formed. Had the child fur-
vivec! to have had this operation performed-it
may be queflionable, whether it would have fully
anfwered the purpofe of relieving the great in-
convenience it laboured under. It might have*
been difficult to have procured the entire pafTage
of the faeces through this artificial opening;
and even had fuch an attempt fucceeded, the
want of a fphincter ani would have been a mis-
fortune not likely to be fupplied by art. Still,
however, the difagreeable circ'um fiance of liv-
ing under lb great a calamity as this child was
born with, was fuffidently obvious to juflify
every attempt towards its relief.
On opening the cavity of the abdomen^
and tracing the inteftinal canal from the ftb-
mach, every part was found to be in a heal-
th v itate, and nothing preternatural occurred,
till we came to tne rectum, which was found
to terminate clofe to the bladder, in the aper-
ture before mentioned, juft below the urinary
paffage.
The
A
C 9i J
The liver, gall bladder, fpleen, and pan-
creas, were in a healthy and natural ftate.
On removing the interlines, an unufual pro-
minence was obferved on the left fide, which
proved to be the left kidney much enlarged;
with its ureter dilated through its, whole
length (but principally at its origin) and ter-
minating nearer to the neck of the bladder
than ufual. The oppofite kidney, on the light
fide, formed a finking contrail: to the left;
it was very imall and flat, and refembled, in fize
and figure, a common bean ; its ureter was
about an i^ch in length, and had no connexion
with the bladder.
The renal glands were wanting.
With regard to the contents of the pelvis, the
bladder and reclum were as above dcfcribed,
contiguous to each other ; and the termination of
the reclum was clofe to that of the urethra * ;
but
* In Fig. I. of the aunexed engraving, (fee Plate I.;
the external parts are a little dilated, in order to Ihotf
the preternatural termination of the re6tum a little below
the meatus urinarius ; a refers to a probe palfed into the
meatus urinarius ; b to a probe paned into the anus; c to
the fundus of trie blad4er ; d to the rectum ; e to the left
kidney
[ 96 J
but upon the mod accurate infpedtion, both by
Dr. Jackfon and feveral other gentlemen whor
have fince viewed the preparation, it is evident
that this child, which can fcarcely be called a
female, was born without either ovaria, uterus,
or vagina.
XL Cafe of Apoplexy in a pregnant Woman ; with
Obfervations. By Mr. Pnilip Williams, Sur-
geon at Rugby in Warwick/hire. Communicated
in a Letter to John Clarke, M. D. Teacher
df Midwifery in London ; and by him to Dr.
Simmons.
THE following cafe, which I offer to you,
appears to me to defer ve attention, not
only from the remarkable fituation of the chil-
dren, but alfo from the circumftances attending.
kidney much enlarged ; andy to the termination of the left
ureter.
Fig. II. (hows the right kidney, uncommonly (mall.
the
C 97 1
the death of the patient. I fhall firft take no-
tice of the latter, and then proceed to make fome
few, remarks on the former.
A woman, about forty years of age, who was
the mother of feveral children, had advanced
to the laft month of her pregnancy without
any thing remarkable having occurred. One
day, when fhc was in apparent good health,
and going about her ufual occupations, upon
a flight exertion (he fuddenly complained of
a violent pain in her head, and had fcarcely
time to reach a chair, into which (lie funk, and
never ftirred nor fpoke afterwards.
On my coming to her, and finding her quite
dead, I introduced my finger into the vagina,
and found the os uteri dilated to the fize of a
crown piece, but was prevented, by the huf-
band's coming, (who would notfufTer any thing
to be done) from afcertaining what part pre-
fen red.
Dr. Baillie and Mr. Cruikfhank afterwards
examined, with me, the body at their differ-
ing room. On opening the head coagulated
blood was found in all the ventricles, and fome
had penetrated the very fubftance of the right
optic nerve.
From the quantity of blood, (for there was
Vol. V* H between
[ 93 j
between two and three ounces) and from the
fituation in which it was found, we need not
wonder at the fudden death of the patient. But
it deferves attention to enquire how far we mall
be able to trace the caufe of the extravafation.
The woman was by no means of a plethoric
habit; neither was Hie, at the time of her
feiznre, ufing any violent exertion,.
Might not a difpofition to labour having come
on, from the connexion known to exift between
the brain and the uterus, produce a greater
determination of blood to the brain than its
veiTels were capable of bearing, and hence oc-
cafion the rupture ? That there had been an
afTecYion of the uterus, appears very probable
From the ftate in which the os uteri was found.
The prefentation has, I believe, never been
before delineated. Both children, as will be
feenby the plate *, prefent preternaturally ; one
with the breech, the other with the foot.
It may become a queftion whether any difficulty
would have occurred in the delivery ? And
alfo which of thefe children would have been
born firft had labour come on ? It is moft pro-
* See Plate II. in which the letters a, a, refer to the
parietes of the abdomen, and b to the fundus uteri with the
placenta adhering.
2 bable
my?/™/ Farfy ,1- Ofo.Fol.VI'/.u
f
-■■J^-..<»k:':- ■
'fl
#Brt
JrJF
Jtnier:/
C 99 1
bable that the woman would have been deli*
vered without any thing unufual occurring or
having been known of the fituation in which
the children had lain in the womb. Had
the labour been fuffered to proceed of its own
accord, I think that the one whofe breech now
prefents would have been born firft. For though
the child, whofe foot prefents, (and which is
under the breech of the other) has its head
nearer! to the fundus of the uterus, and confe-
quently when the uterus came into adtion, the
longitudinal fibres would have acted moil com-
pletely upon it ; yet from the circular form in
which it lies, its head, inftead of acting upon its;
own body, would probably have acted upon the
head of the other child whofe breech prefents,
and forcing it down, might either itfelf have
gradually gone round, and, before the fir ft child
had been born, making a complete evolution,
have been born head firft'; or it might have re-
mained with its head where it now is, and after
the birth of the other child have come with its
feet firft.
One of the above circumftances, I think, would
have happened had Nature been left to herfelf ;
but had the woman been attended in labour
H 2 by
m oF
by v&t Who Was impatient of delay, .it is moft
probable that when the foot was found pre-
^'feLftSg^rfiat child would have been brought flrft,
in which cafe I do not think that any difficulty
would have occurred in the delivery of the other.
Query. Might not the labour mentioned in the
thirty-eighth chapter of Genefis, v. 28, 29, and
30, have been fimilar to the cafe which I have re-
lated ; and that though the hand of one of the
children was lowed at the beginning of labour,
yet as the mod bulky part of the other child was
below the body of this child, the hand receded,
and the other child came fir ft into the world ?
XII. Defcription of Kilburn Wells, and Analyfis of
their Water. By Mr. Joh. Godfr. Schmeifler.
Vide Fhiiofophical TranfaElions of the Royal
Society of London, for the Tear 1792. Part I.
4to. London, 1792.
r^HESE wells lie in a meadow, to the right
1
of the Edge ware road, about two miles
from London.
The author obferves that they fpring about
twelve feet below the furface ; that the water is
not
C '°i 1
not perfectly bright, but of rather a milky hue ;
that it has a mild and bltteriQi taite, with little
or no brifknefs, as containing a very fmall pro-
portion of fixed air; that on dipping for it, or
otherwife agitating it, a fulphureous fmell is
perceived near the furface, which, however,
foon goes off in a temperature of 8o° of Fah-
renheit's thermometer; and that the changes in
the atmofphere do not appear to affect either the
quantity or quality of the water.
Mr. SchmeifTer found the fpeciflc gravity of
the Kilburn water to be to diftilled water as
1,0071: 1,0000; and its general temperature
^3°, which was not affected by a change of ten
degrees in the temperature of the atmofphere.
While the water continued at reft, no ebul-
lition of fixed air, we are told, was perceived,
and fcarce any fulphureous fmcll.
That this mineral -water fo eafily parts with
the hepatic air (perceivable on agitating it) if
it be ihaken in a warmer temperature, or tranf-
ported from one place to another, is, our au-
thor thinks, probably owing to the fixed air
which it contains; for as this aerial acid has a
great affinity to phlogifton, fo, he obferves, it
may hence be inferred, that fixed and hepatic
air cannot exifl: together in a mineral water, but
H 3 that
[ ioi ]
that the latter will be deftroyed, as the fixed
air is developed by gentle warmth.
For the detail of Mr. Scbmeiffer's ingenious
experiments on this water, we mult refer the
chemical reader to the work itfelf, as they can-
not well be abridged. They confift of experi-
ments with reagent fubftances ; of experiments
to afcertain the properties and proportion of
the elaftic fluids contained in the water ; and,
laftly, of experiments to afcertain the fixed
conftituent parts of the water, and their proper-
ties.
The refults of this feemingly very accurate
analyfis are included in the following fummary
of the conftituent parts of the Kilburn water,
in 24 pounds.
Fixed air
84 cubic inches
Hepatic air - near
36
Vitriolated magneiia -
910 grains, equal to Jij jiiss,
Apothecary's weight.
Vitriolated natron
282 gr. rr gv. lij grains
Muriated natron
60 gr. = 75 gr.
Sclenite
130 gr. = 31 j xhj gr.
Muriated magneiia
128 gr. = 5'ij xl gr.
I2| gr. = 15 gr.
Aerated magriena
24 gr. = 30 gr.
*■ <_ allill LIJUS till III
Calx of iron
3s gr. = 4 gr.
Ueiinous matter
6 FT- = l\ gr-
Sum 1561 {- grains, equal to medicinal
weight, 4 ounces, o drams, and
32 grains
XIII. An
£ l°3 •]
XIII. An Account of the remarkable EffeEis of a
Shipwreck on the Mariners ; with Experiments
and Obfervations on the Influence of Immerfion
in frefh and Jalt Water, hot and c old, on the
Powers of the living Bodj\ By James Currie,
of Liverpool, M. Z). Fellow of the Royal Col-
lege of Phyficians at Edinburgh, Vide Philo-
fophical Tranfaclions of the Royal Society of
London, for the Tear 1792. Part II. 4to.
London, 1792.
THE circumftances of the fhip wreck, which
fuggefted the ingenious experiments de-
fcribed in this paper, were as follows :
On the 13th of December, 1790, an
American fhip was call: away on a fand-bank
that lies in the opening of the river Merfey into
the Irifli Channel. The crew got on a part of
the wreck, where they pafled the night ; and a
fignal which they made being difcovered next
day from Hillberry iiland, a boat went off,
and took up the furvivors. The unfortunate
men had remained twenty-three hours on the
wreck; and of fourteen, the original number,
H 4 eleven
[ *°4 ]
eleven were ftill alive, all of whom in the end
recovered. Of the three that perifhed, one
was the mafter of the veffel ; another was a
pallenger who had been a mafter, but had loft
or fold his fhip in America ; the third was the
cook.
The cook, who was a weakly man, died 3
few hours before the boat reached the wreck;
but the two mailers had been long dead.
Roth the mafters, we are told, were ftrong
and healthy men, and one of them a native of
Scotland, in the flower of life, early inured to
cold and hardfhips, and very vigorous both in
body and mind. On the other hand, feveral of
'the furvivors, it is obferved, were by no means
flrong men ; and moft of them had been long ac-
cuftomed to Carolina and other warm climates :
the perfon among the whole who feemed to have
fuffered leaft was a negro.
The death of the two mafters was faid to
have been owing to their having taken poffef-
fion of a keg which had contained cherry-
brandy, and which ftill contained the cherries ;
thefe, it was reported, they had kept to them-
felves, and eaten in large quantities after the
fhipwreck; and this, having produced intoxi-
cation, was fuppofed to have haftened their
death.
[ io5 1
tieath. Some experienced Teamen were fatis-
^fied with this account, which indeed feemed
verv rational ; for though fpirituous liquois may
fortify the body againft the effects of heat com-
bined with moilture, and may perhaps fupport
it for a fhort time under great fatigue, they
would feem, as our author very properly ob-
ferves, to be uniformly hurtful when taken un-
der fevere and continued cold. Pleafed to fee
a doctrine becoming popular which has been
fo ably fupported by Dr. Aikin*, and others,
he was induced to think it might receive a Un-
king confirmation from this cataftrophe, into
the particulars of which he determined to exa-
mine accurately. He therefore obtained acceis
to the furvivors of the crew, and from them,
but more cfpecially fiom Mr. Amyat, the mate,
an intelligent young man, he received the infor-
mation which he required.
From repeated converfations with this per-
fon, £)r. Currie learnt that Captain Scott, the
matter of the veffel, died in about four hours
after the fhip (truck ; and that Captain Davifon,
the paifenger, died in about feven; but that
* See Tranfa&ions of the Philofophical and Literary So-
ciety of Mancheiler, Vol. I.
the
[ io6 ]
the incident of their having eaten the cherries wa«
entirely without foundation: of this Mr. Amyat
was certain, for he faw the keg which contained
them (laved, and the cherries, falling on the
wreck, were immediately warned into the fea.
Mr. Amyat, we are told, exprefTed his furprife
at the early death of the two mailers, but could
not affign any caufe for it. He faid there was
no liquor of any kind faved, nor any fort of
food 3 that the whole crew were on an equality
in all points, except that fome were deeper in
the water than others, but that the two mailers
had the advantage in this refpedt, for they fat
on the only part of the wreck that was out of
the fea, whereas the negro, who efcaped almoft
unhurt, was perhaps deepeil in the fea of any. Mr.
Amyat, it feems, explained this in the following
manner: when the ihip flruck they cut away
her mads to prevent her from overfetting, and
after this (he drifted over the fand-bank, into
what he called a " fwafh." on the other fide.
Here (he floated, and they let go their bed bower
anchor, but it dragged, and the veifcl flruck
again in a few minutes on another bank. In
this fituation fhe lay fome time, beating againfl
the fand, and the fea breaking over her. In
a little while Mr. Amyat faw the tar barrels,
which
[ io7 ]
which formed her cargo, floating towards the
land, and foon after the bottom parted entirely,
and was carried in the fame direction. Hap-
pily for the men, the part of the wreck on
which they were lafhed was held by the anchor,
and floated in the water, a fmall portion of the
after part of the quarter deck being above the
furface. On this fat the two matters, generally
out of the fea, but frequently overwhelmed by
the furge, and at other times expofed to heavy
fhowers of fleet and fnow, and to a high and
piercing wind. The temperature of the air,
Dr. Currie obferves, as nearly as could be guef-
fed, was from 300 to 330 of Fahrenheit, and that
of the fea, from trials in flmilar circumftances,
from 380 to 400. Immediately before the
two mailers was Mr. Amyat himfelf. As he
was fitting, and the deck floped pretty rapidly,
he was generally, we are told, up to the middle
in the water ; and fome of the others were up
to the moulders. They were not, it is obferved,
at any time able to change their pofition, but
kept their legs in pretty conttant motion to
counteract the cold, their arms being employed
in holding by the wreck.
The matter of thefhjp, Captain Scott, a na-
tive of North Carolina, and about forty years
of
C 108 ]
of age, died firft. As they were in the dark,
Mr. Amyat could not lee his countenance; but
he was firft alarmed by hearing him talk inco-
herently, like one in the delirium of fever.
By degrees his voice dwindled into a mutter,
and his hearing feemed to fail. At length he
raifed himfelf up in a fort of convulfive mo-
tion, in which he continued a (e\v feconds, and
then fell back dead on the deck. This hap-
pened about eight in the evening; four hours
after the fhip went aground. Soon after this,
Captain Davifon, who was about twenty-eight,
began to talk incoherently, in the fame manner
as the other. He flruggled longer, but died
in the fame way, at about eleven at night.
The cook died in the forenoon of the fucceed-
ing day. He was a low-fpirited man, we are
told, and defponded from the beginning. All
the reft held out, as has been already mentioned,
till they were taken up about three in the after-
noon. Mr. Amyat (aid that his hands and feet
were fwelled and numb, though not abfolutely
fenfelcfs ; he felt a tightnefs at the pit of his
ftomach, and his mouth and lips were parched;
but what diftrefled him moft was cramps in the
mufcles of his fides and hips, which weredrawn
into knots. Though immerfld in the fta, they
were
t **$ j
*vere all of them, it feems, very thirfty ; arid
though expofed to fuch fevere cold, Mr. Amyat
himfclf was not drowfy, nor were any of the
men drowfy, nor did ileep precede death in
thofe that perifhed.
Dr. Currie reflecting on thefe carious fads, had
no doubt that the death -of the two mafters was to
be imputed to their peculiar pofition on the
wreck. Expofed to heavy mowers of fleet and
mow, they might, he thought, fuffer from be-
ing wet with frefh rather than fait water; or
from being expofed to the cold of the atmof-
phere, probably feven or eight degrees greater
than that of the fea. The chilling effects of
evaporation, he conceived, might operate againft
them, promoted as thefe muft have been by
the high wind ; or they might receive injury
from their frequent immerfions in the fea, pro-
ducing an alternation in the media furrounding.
This lad fuppofuion, however, did not, he
confefTes, ftrike him at the time; but the others,
he obferves, dwelt on his mind.
Of the powers attending animation, Dr. Cur-
rie remarks, that which feems fundamental, is
the capacity of the living body of preferving
the fame heat in various degrees of temperature
of the fame medium, and, indeed, in media
of
[ no ]
of very different denfity and preflure. If a
definition of life were required, it is, he thinks,
on this faculty that it might bell be founded.
It is known, heobferves, that fome fluids, ap-
plied to the fkin, vary in their effedts according
to their impregnation ; that in the fame degree
of temperature, for inftance, pure water on
the furface of the body is much more hurtful
than water in which fair, is diflblved. Seafaring
men, he remarks, are univerfally acquainted
with this, and for a (biking proof of the truth,
as well as of the importance of the obfervation,
he refers us to the Narrative of Lieut. Bligh.
Our author thought it probable that the faline
•impregnation might Simulate the veffels of
the £kin, fo as to counteract the fedative or de-
bilitating ad ion of the cold. At any rate, it
iecmed to him not unlikely that fome light
might be thrown on this curious fubjeft, by ob-
ferving the effects of immerfion in frefh and
fait water, of equal temperature, on the animal
heat; and this, he conceived, might alfo affift
in accounting for the death of the unfortunate
men already mentioned. He therefore made
the following experiments.
Expe-
in 3
Experiment I.
A large veiTel, containing one hundred and
feventy gallons of fait water*, was placed in
the open air. The atmofphere was damp and
raw. The thermometer, both in the air and
in the water, flood at 440. The fubject of the
experi rierit was Richard Edwards, a healthy
man, twenty-eight years of age, with black
hair, and a ruddy complexion. The hour
chofen for his immerfton was four in the after-
noon, about two hours after his dinner ; a time,
Dr. Currie tells us, appointed rather for his
own convenience, than as being mod propeF
for the purpofe.
The heat of the perfon who was the fubject
of the experiment was 980 before undreffing;
his pulfe 100 in the minute. He was undreiTed
in a room where the mercury was at 56° ; and
afterwards flood naked before the fire till his
* In a fubfequent part of his paper the author obferres
that the fait water, employed in this and the following ex-
periments, contained fait in the proportion of one to twenty
four,
heat
heat and pulfe were examined again, and found
as before. He then walked pretty brifkly
through a flagged paflage into an open court,
where the north-eaft wind blew fharply upon
him : he was exnofed to it for a minute, and
then plunged fuddenly into the water up to the
moulders. The thermometer, which had been
kept in a jug of warm water, at the heat of ioo°,
was in i rod need into his mouth, with the bulb
under his tongue, as foon as the convulfive fob-
bings occafioned by the fheck were over. The
mercury fell rapidly, and a minute and a half
after immerfion it flood at 87^. He remained
motionlefs in the water, and the mercury rofe
gradually ; at the end of twelve minutes it
flood at 930 2. While he fat in the water, it
occurred to the author to examine his heat
when he rofe out of it into the air. He had re-
flected, he tells us, on the power that muft be
employed to keep up his heat in a medium fa
denfe as water, and where an inanimate body,
of the fame bulk, would have cooled fo much
more fpeedily than in air of the fame tempera-
ture. Suppofing that this heat producing pro-
cefs, whatever it may be, might continue its
operations fome time after the extraordinary
ftimulus (the preflure of the water) was re-
moved^
[ "3 J
moved, he expected to fee the mercury rife by
the accumulation of his heat, on changing the
medium of water for air, and theiefore he kept
him expofed, naked, to the wind, two minutes
after taking him out of the bath. To his fur-
prife, although the attendants were rubbing
him dry with towels during this time, the mer-
cury fell rapidly. He was put into a warm
b^d, and his heat, when examined under the
tongue, was 87°, at the axilla 890. Fric-
tions were ufed, and brandy mixed with water
adminirlered ; but Dr. Currie found that the
beft mode of counteracting the cold, was to
apply a bladder, with hot water, to the pit of
the ftomach, a fadt which feetns important;
this being done, his (hiverings, which before
were fevere, foon ccafed, and he became
more comfortable. Three hours afterwards,
however, he had not entirely recovered his for-
mer heat; but by eight at night, he was in all
refpects as ufual.
The author obferves that he has been very
minute in detailing the circi _-s under
which this experiment was made ; becaiife fome
of the particulars which, at the time, he thought
of little confequence, he found afterwards of
Vol. V. I import-
[ "4
e
mined to repeat as exactly as podible.
importance. The experiment itfeif he detefr-
EXPERIMENT II.
On the next day, at the fame hour, the fame
pevfon was again immerfed as before. His
pulfe previoufly was 85, his heat ioo°. He
had been put to bed an hour before, to fave the
time fpent in undreffing. The heat of the wa-
ter and of the atmofphere was 440. The wind
was north-earl:, and ftrong. On this occafion, as
before, there was a rapid fall of the mercury ;
the following table mows the progrefs of the
return of his heat :
2 min. after immeriion
3
5 " *
6
7
8
Thcr.
90 J
9* i
94 i
95 I
95 4
Ther.
9 min. after immerfiong^0!;
10 min. - - 94 I
11 - " 95
12 " " 95
13 — .- - 95 i
14 and 15 mm. - 95
At the end of fifteen minutes he was taken
out. and flood three minutes, naked, expofed
to the north-eaft wind, at the end of which
time the mercury had funk to 83°. A draught
of
L *i| 1
of ale was given him, and he was put into X
warm bed ; in three minutes after the mercury
rofe to 930. .An hour alter his heat was 950.
The effects produced by this alternate expo-
fare to water and air of the fame temperature,
gave a new direction to our author's ideas,
and determined him to inquire again into this
lingular phenomenon. The mod obvious me-
thod, he obferves, would have been to have
prolonged the procefs of alternation, and re-
plunged the perfon cooled by the external air
into the bath ; but this, he adds, was running
too great a rifk, unlefs fome more fudden and
certain method could be found of reftoring the
heat that might be loft. He deemed it prudent,
therefore, to proceed more cautioufly. In the
next experiment he refolved to try the methods
of heating as well as cooling the body.
Experiment III.
On the following day, at the fame hour, the
fame perfon was again immerfed in the falt-wa-
ter bath. His heat previoufly was 9 8°, his
pulfe 100 ; the temperature of the water and of
I * the
[ n6 ]
the atmofphere, as before/ 440* The mercury
funk rapidly to 900.
2 minutes after
mometer wa
O) min.
the ther
5 at -
88°
88
88 \
90 §
92
92
94
94
4
5
6
7
8
9
10 min. after the ther-
mometer was at
11 min.
13 -
14
1 5 _ -
16
94°i
94 I
95
96
96
96
96
He was now taken out, and flood in the wind
three minutes, fhivering violently. This cir-
cumflance, we are told, rendered it difficult
to afcertain exactly the fall of the mercury,
which was, however, it feems, confiderable.
When examined in the room in which he un-
dreffed, it Hood at 90°. He was now plunged
into a frefh- water warm bath, heated to 97°!,
and yet the mercury fell two degrees.
1 min. after immerfioB, 5 min. after • - 94°
in the warm bath, the 6 96
mercury was at - 88° 7 96
2 min. - . 92 j 8 96
3 - - 92 I 9, 10, 11, ]2, to 16, 96
4 " " 94 I
Dr. Ctirrie obfe'rves, that if the rife of heat
in the cold bath at 440, and in the warm bath
at 97°f> be compared, the firft will be found
more
^tnore flow ; but that after being fixteen minutes
in the one and in the other, the heat was the
fame in both cafes, when taken at the mouth.
It muft, however, he adds, be acknowledged,
that in the cold bath the extremities were chil-
led and cold, while in the hot bath the heat was
equally diffufed.
When the man got out of the hot bath, he
put on his clothes, and was remarkably alert
and cheerful the whole evening. Encouraged
by the fafety of thefe experiments, our author
refolved to increafe the time of immerlion in
the cold bath, and to inquire more generally
into its effects on the fenfations, as well as heat.
Experiment IV.
At the fame hour of another da}', the fame
perfon was again immerfed as before, his heat
previoufly being 97 °i, and that of the water
420 ; the wind was north-earl, and brifk.
1 minute after, heat
2 minutes
3 "
4 - -
5 "
7 " - "
8, 9, 10, 11
9cr
92
02
92
92
9-
94
94
94°§
94 I
94
94 f
94
r us ]
It will be obferved, that in the above table
there are b]anks left in the report. At fuch,
times the thermometer, we are told, was taken
out of Edwards's mouth, to admit of his anfwer-
ing the queftions put to him. He laid, that on
plunging into the water he felt an extreme cold,
which he could not but think was partly owing
to his being expofed, naked, to the wind be-
fore; that this cold diminifhed, and in a little
while he felt comfortable, but that after a while
the fenfe of coldnefs returned, though lefs than
at firft ; diminifhing again, bur in a lefs degree.
At length his fenfations became pretty fixed.
In this ftate, when the water was at reft, he
fliould not even have known, by his feelings
from the upper part of his cbeit to the pubes,
that he was in, water at all. His feet and legs
were very cold : fo were his hands and arms ;
and fo alfo the penis and fciotum. He men-
tioned, likewife, that he fek a cold ciicle
round the upper part of his body, though not
conftantly. On examining into this, Dr. Cur-
rie found it was greateft at firft, and that it ex-
tended over the (pace which, from the undula-
tions left in the bath by the plunge of immer-
fion, was alternately above and under the furface
of the water: when the bath fettled, it was lit-
tle
[ "9 ]
tie felt ^ but by agirating the fluid, he could re-
produce it, at any time when the cold in the ex-
tremities was not fo great as to prevent its be-
ing felt. This curious particular ferves, our
author thinks, to explain a circumftance much
dwelt on by Mr. Amyat, in giving an account
of his fufTerings on the wreck; that what he
felt moft (cverely was the cramps in the mulclcs
of his hips and fides, parts which, from his
fituation on the wreck, muft have been alter-
nately under and above the furge. From Mr.
Amyat's account, it appeared that the fea did
not break over the fuflerers all the time they
were on the wreck. The wind moderated, as
well as the waves, and for the lafl fifteen hours
they were not at any time overwhelmed, or at
leaft Mr. Amyat himfelf was nor. The cold
never abated. Being all lamed to the wreck,
they never changed their pofitions : the bodies
of thofe who died occupied the fpacc where
they were originally placed. Mr. Amyat, there-,
fore, during the whole time fat nearly up to the
middle in water, but fubject to the variations
occafioned by the motion of the fea.
To return to the fubject of the experiment.
When he was expofed, naked, to the wind,
the mercury funk as ufual five or fix degrees,
I 4 and
[ 1:0 ]
and his fhiverings were great. With a view to
reftore his heat as fpeedily avpoffible, the bath
was heated to 1040 : but after being half a mi-
nute in it, he fcreamed out with pain, efpe-
cially in his extremities, and ^bout his fcrotum.
When taken out, his fhiverings we are told,
almoft amounted to conv-ulfiop. The bath was
lowered to 8&°, and he was replaced in it, and
its temperature progreflively, but pretty ra-
pidly, increafed to ioo°. He continued, how-
ever, to fhiver much, his heat remaining about
900 ; but a bladder, with very hot water, being
introduced under the furface of the bath, and
applied clofe to the flomach, the good effedts,
it is remarked, were inftantaneous, his fhiver-
ings ceafed, and his heat mounted rapidly
to 98*.
All thefe experiments having been made on
one perfon, Dr. Cunie determined to repeat this
lad on another.
Experiment V.
Rich. Sutton, aged 19, of a pale complexion,
and a feebler frame, was immerfed in the bath,
under
[ 121 ]
under the circumftances of the preceding ex-
periment. His heat was previously 96°!.
I a minute after, heat
I minute
2
3 - -
4 -
5 " "
6 - -
7 to 10
I I ■
12 to
16 —
17 —
5
9^
QC
83
S9
90
92
92
92
92
92
93
i» annates
l9
20, 21
22 ■
23
24
25
26
21
28
29
30 .
93
93
94
92
92
92
94
94
92
92
94
94
or
4-
Dr. Currie obferves, that although this per-
fon Teemed to bear the cold bath well, having
loft in thirty minutes only 2j degrees of heat,
yet that when expofed afterwards to the wind,
he Shivered violently, and loft his heat very
faft. He was put into a warm bath, heated to
960, but recovered his heat very Slowly, as ap-
pears from the following table :
1 minute after, heat
2 minutes
2 —
4 -
5' ' " "
6 —
7 —
8,9
10 -
88°
90
90
90
90
90
90
90
92
great fhivering.
here the bath was heated to
joo°.
fhiverings flill.
ditto.
ditto.
ditto.
1 1 mi*
C '" ]
ii minutes after, neat Cjz° bath heated to 104*.
12 . . 94
,3 93 heated to ic8°. Shi*
verings.
14 ■ 93 a bladder with very hot
water applied to the {to-
rn ach.
«5 - * 9+
16 1 — 96 very comfortable,
Experiment VI,
Richard Edwards, the original fubjecl: of ex-
periment, was again immerfed in the cold bath,
of the temperature of 400, and remained in it
three quarters of an hour. His heat, it is re-
marked, was previouily 970 ; his pulfe 90 in
the minute. The mercury fell to 920, was fta-
tionary for a few minutes, and then mounted,
though, as ufual, with no regularity. In twenty-
two minutes it Hood at 960 ; it then began to
decline, and in twenty-three minutes more had
funk to 940. Upon his being expofed as ufual
to the wind, the mercury, we are told, funk
as before, and he fhivered violently. In the
warm bath at 96° his fhiveiings continued fe-
deral minutes, his heat remaining at 90 and
91 °. In feven minutes the mercury began to
rife faft, and five minutes after was at 96°.
Expe-
C I23 ]
Experiment VII.
The effects of forty-five minutes immerfion,
in the cold falt-water bath, at 400, were pro-
pofed to be tried on Richard Sutton. He was,
it feems, much under the impreffions of fear,
and his heat previouily raifed the mercury only
to 94°. The mercury, we are told, funk, as
before, on his immerfion, but to an unufual de-
gree. It did not flop in its fall till it got to
&30, which the author thinks might be in part
accounted for by the extraordinary chattering
of his teeth, admitting fome contact of the
air. It then mounted in the ufual irregular
way, and at the end of thirteen minutes had
got to 9 20. Here it flood for nineteen minutes
longer with little variation ; at the end of
this time it began to fall rapidly, though irre-
gularly, and in three minutes was down at 850.
He had now been thirty-five minutes in the
water, and Dr. Currie did not think it fafe to
Retain him longer; he therefore hurried him
into a warm bath, heated to 960, where he
Shivered much. The bath was heated gradually
to 1090, and in this heat he recovered his pro-
per
[ "4 ]
per temperature in about twenty- eight minutes.
Being then put into a warm bed, he fell into a
profufe peifpiration, which left him in his ufual
health.
With refpect to the (late of the pulfe in thefe
experiments, Dr. Currie obferves that it was
not poffible to keep the fubjedfcs of them from
fome degree of previous agitation, and that
this always quickened the pulfe. The natural
pulfe of Edwards, it feems, was about 70 in
the minute; but Dr. Currie found that it was
never flower than 85 before irnrrier/fion, and
generally more. However this might be, it
invariably, we are told, funk to 6$, or from that
to 68, in the water, and became firm, regular,
and fmall. After being long in the bath, it could
hardly be felt at the wrift, but the heart pulfated
with great fteadinefs and due force. In the lad
experiment, it feems, when the heat funk rapid-
ly, Sutton faid he felt a coldnefs and faintnefs at
the ftomach, which he had not perceived be-
fore, and the motion of his heart was then found
to be feeble and languid. In fome other trials
of the effects of immerfion in frelh water, (one
of which is related in a fubfequent part of the
paper) the fame coldnefs at the flomach is faid
to have preceded a rapid fall of tie mercury ;
and
[ "5 3
and thefe fads, together with the effects found
from applying a confiderable heat to this part
when the body was chilled with cold, have con-
vinced our author that there is fome peculiar
connexion of the ftomach, or of the diaphragm,
or both, with the procefs of animal heat.
Whoever, he, remarks, will confider the rapi-
dity with which a dead body would have cooled
immerfed in water of the temperature of 400,
may form fome eflimate of the force with
which the procefs of animal heat mufl have
acted in the experiments already recited. Thefe
experiments, however, he contends, furnifh
irrefragable proofs of the futility of fome of the
theories of animal heat. The increafe of heat,
in fever, he obferves, has led fome perfons
to believe that animal heat is produced by, or
immediately connected with, the action of the
heart and arteries ; but in thefe experiments,
he remarks, although heat mufl have been ge-
nerated in the bath with more than fourfold its
ufual rapidity, the vibrations of the arterial
fyftem were unufually flow. Another, and a
very beautiful theory of animal heat, conti-
nues the author, fuppofes it immediately to de-
pend on refpiration ; but in the bath, after the
firft irregular action of the diaphragm from the
2 fljock
c »»« i
fhock of immerfion was over, the breathing,
he obferves, became regular, and unufually
flovvi Laftly, the curious phenomenon of the
heat rifing and falling, and riling again, in the
bath, with the body at reft, and the tempera-
ture of the furroUndi ng medium unchanged, is^
he thinks, fatal to thofe theories of animation
which coniidcr the living body as a mere ma-
chine, acied on by external powers, but not
itfelf originating action, and differing from
other machines only in the peculiarity of the
powers which -re fitted to fet it in motion. He
has faid that the temperature of the medium
continued unchanged, but it may be fuppofed
that the bath was heated a little during the ex-
periments ; he allows that it was fo ; but being
expofed, with a large furface, to the open air,
the wind blowing briikly over it, its heat, he
obferves, was little altered ; in twelve minutes
immerfion it had gained nearly one degree, and
in forty-five minutes, the longed duration of
any of the experiments, it had gained three de-
grees. As this acceffion was regular, it would
not, he obferves, have invalidated the forego-
ing obfervations, even if it had been greater.
Many other trials were made on the effects of
immerfion in water on the human heat, which
the
C I27 1
the author fpeaks of generally, under the ge*
neral conclufions which they fuggefled.
The experiments already recited, fuggefled
to him the notion, that in all changes from one
medium to another of different denfity, though
of the fame temperature, there is a lofs of ani-
mal heat. He found, however, that this con-
clufion requires many reflridtions.
i. His experiments being made on bodies
of fuch very different denlity as air and water,
do not, he obfeives, admit an univerfal infe-
rence of this fort.
2. Being all made in a temperature fifty de-
grees under the human heat, no certain con-
clusion, he thinks, can be drawn as to what
might happen in degrees of heat much higher,
where it is probable the effects of the change,
if it appeared at all, might be lefs flriking.
It would feem, however, he obferves, that
after a perfon is long chilled in cold water, the
firft effect of paffing through the external air
into the warm bath, is a fall of heat in the
air, and after this a (till greater fall in the
warm bath, followed, however, by a fpeedy
rife.
The air and the water being equally cold,
and both 450 or under, he found the lofs of
heat
[ "8 ]
heat in paffing from the one to the other to be
regulated in the following way :
i. If, inftead of being expofed naked to the
wind previous to irhmerfion in the water, the
body was kept warm by a flannel covering, the
mercury fell much'lefs on the nift plunge.
2. If, after plunging into the water, the
perfon continued in it only a minute or two, a
fubfequent fall of the mercury did not always
take place, on his emerging into the air. On
the contrary, there was fometimes a rife on fuch
occafions of the mercury, efpecially if the at-
mofphere was at reft.
3. In one inftance, after continuing in the
water fifteen minutes, on Kfing into the air in a
perfed calm, though during a froft, there was
little or no feeming diminution of the heat;
while cxpofure under fimilar circumftances,
with a north-eaft wind blowing fharply, though
the air was many degrees warmer, produced a
rapid diminution. The effecTs of the wind in
diminifning the human heat, are, he obferves,
(Inking, and are not, in his opinion, explained
by the common fuppofitions.
4. The lofs of heat by a change of media,
depends, he thinks, much on the rapidity of
the change, for the plaftic power of life in va-
[ I29 3
rvirig the procefs of animal heat, fo as to ac-
commodate it to the external changes, acts for
a time with great celerity, though this celerity
feems to diminifh with the ftrength.
Experiment VIII.
In a large room, where the mercury flood at
36°, two flipper baths were placed at the dif-
tance of fix yards from each other. One was
filled with cold fait water of the temperature
of 360, the other with water heated to 96°,
which was the author's own heat. Undreffing
himfelf in an adjoining room' by a fire, he
afterwards flipped on a loofe flannel drefs, and
descended Jlowly into the cold bath, where he
remained two minutes ; he afcended Jljwly into
the air, and then funk himfelf in the warm
bath, where he remained two minutes alfo ; he
returned to the cold bath, where he ftaid two
minutes as before, and removed from it again
to the warm bath. But during all thefe changes
of media and temperature, the thermometer
with its bulb under his tongue never varied
from 96^. He attributes this partly to the
heat of his body being in fome degree defended
Vol. V. K by
[ *3o ]
by the flannel drefs, partly to the calm of the
air, but chiefly to the flownefs of morion in
thefe changes. He is aware that it may be
faid that the time of (laying in the different
baths was not long enough to produce any fen-
fible change in the heat of circulating fluids of
fuch a mafs ; but this, he obferves, is not
confiftent with many of the other facts.
j. The influence of the application of cold
water to the fur face of the body on the heat,
is in fome refpects, he obferves, regulated by
the animal vigour, as the following experi-
ment will mow.
Experiment IX.
In the fame room he placed a large empty
vefltl : in this two young men fat down in fuc-
ceflion, each with the bulb of a thermometer
under his tongue. A man ftanding on a bench
with a bucket containing four gallons of cold
fait water, poured the whole of this quan-
tity on the head and fhoulders of each of
ihem, fufTering it to run down on the reft
of the body. This procefs took up nearly a
minute, during which our author examined
the mercury, and found it unchanged. They
were
t *3< 3
were both, we are told, directed to continue
fitting without motion for a minute after, du-
ring which, in both in fiances, the mercury
rofe two degrees. A third, much inferior in
vigour, fub. rutted, it feems, to the fame expe-
riment, and the mercury continued during the
afTufion of the water unchanged, but in a mi-
nute after funk half a degree. In fevers, Dr.
Currie obferves, where the heat is generally in-
creafed from two to fix degrees above the Iran-
dard of health, pouring a bucket of cold
water ori the head always reduces the pulfe in
frequency, and commonly lowers the heat from
two to four or five degrees. Of this falutary
practice he hopes foon to fpeak at large to the
public.
6. The power of the body in preferving its
heat under the impreflions of cold, and the
changes of temperature and of media, feems
in fome jjieafure, our author thinks, to be re-
gulated by the condition of the mind. .That
fear increafes the influence of cold, and of
many other noxious powers, will not, he ob-
ferves, be doubted ; but the flate of the mind
to which he alludes, is that of vigorous attention
to other objects. This, it is well known, will,
to a certain degree, deaden, or, indeed, pre-
K 2 vent.
f i3* ]
vent, the fenfation of cold ; and what doe's
this, he apprehends, prevents, or at lead weak-
ens, its phyfical action. Thus, in fome fpe-
cies of madnefs, he obferves, where the ideas
of imagination are too vivid to admit the im-
preflions of fenfe, cold is refitted to an extraor-
dinary degree. He has feen a young woman,
once of the greateft delicacy of frame, (truck,
with madnefs, lie all night on a cold floor,
with hardly the covering that decency requires,
when the water was frozen on the table by her,
and the milk that fhe was to feed on was a mafs
of ice.
7. There are, he thinks, particular condi-
tions of the atmofphere, not perfectly under-
ftood, that feem to have an influence in de-
priving us more fpeedily of our animal heat,
than others where the cold is greater.
In addition to his experiments with fait wa-
ter, Dr. Currie made fome trials to afcertain
the effects of immerfion in frefh water on the
animal powers, and particularly on the heat ;
of thefe he has thought it fufficient to relate the
following :
*
C *33 J
Experiment X.
In the fame vefTel, containing an equal bulk
of fre(h water, Richard Edwards, the fubjedt
of his firft experiments, was immerfed, at the
fame hour of the day. His heat previoufly
was 98°, his pulfe beat 92 in the minute; the
heat of the air was 41 °|, that of the water 40*.
The wind was in the weft, fo that in the court
where the bath flood there was a perfect calm.
As the author had fome fears of the iilue of
this experiment, inftead of expofing him for a
minute naked to the wind before immerfion, he
was covered with a flannel drefs from the air till
the inftant he defcended into the water, into
which he was fuffered to fink himfelf ilowly,
with the bulb of the thermometer under his
tongue. The following table exhibits the re-
fult:
Immediately on immer-
iion, heat - 98*
1 minute after
2 minutes -
3 _.
5
6 -
7,8
9-—
10 —
97 I
97
98
97 i
95
96
97
97
14 min. after, heat - g6°|
96
96
95
9+
93 i
28, 29 - - 94
30 - - 93
31,32 - - 94
33*34 - '■ 9* i
15
16, 17, 18, 19, 20
25
26
27
k3
He
[ iS4 ]
He now, we are told, got out into the air
very flowly, and flood in it three minutes, the
wind not blowing on him. He loft one degree
of heat at firft, which he recovered. He was
then put into a warm bath at 900, which at
firft he felt warm, and his feet and hands were
painful : but in two mirutes he fell into a very
vio]ent fhiver, and his heat fell two degrees.
The bath was then heated to 95 and 960, but
ftiil he felt cold. It was heated to 990 ; he
continued in it five minutes, and his heat was
910. The heat was gradually raifed to 106^,
when the fefife of coidnefs of which he had
complained at the pit of the (lomach gradually
went off. Before this Dr. Currie had ufually
kept him in the warm bith till his natural heat
was nearly recovered ; but after being hdf an,
hour in the heat of 1060, his own heat was
flill 930. He now became fick and very lan-
guid, a cold fweat covered his face, and his pulfe
was very quick and feeble. He was removed into
bed, but pafTed a fevcrlfh night, and next day
had wandering pains over his body, with great
debility, refembling the beginning ftage of a
fever. By cordials and reft this went off.
This experiment, the author obferves, clearly
enough
[ i35 J
Enough confirms the greater danger of being
wet with frefh than with fait water ; but in itfl-lf
points out nothing certain befides, except that
it is not to be rafhly repeated. He means, he
tells ns, to try fome of thefe experiments to a
greater extent on the brute creation, when he
has procured thermometers better fuited to his
views. The thermometers he employed had
not a fufficlent mobility for very nice experi-
ments, and he is aware that in particular in-
ftances this may have milled him, though the
general refults, which is all that is of import-
ance in fuch experiments as thefe, will, he
hopes, be found jult and true.
Towards the conclufion of his paper he of-
fers the following obfervations on the fubjeel:
that led to thefe experiments.
i. It is; he thinks, already well known
among feamen, that where there is only the
choice of being wet with fait or with frefh water,
it is always fafeft to prefer the firit. In the heavy
fhowers of rain, hail, or fnow, by which gales
of wind are generally accompanied, the men
that mud be expofed to them, ought, he ob-
ferves, like Lieutenant Bligh and his crew, to
wring their clothes out of fait water*
K 4 2. In
E 136 ]
t. In all cafes where men are reduced to fuel}
diflrefs by fhipwreck or otherwife, that they
can only choofe between the alternative of keep-
ing the limbs conftantly immerged in the fea,
cir of expofing them to the air while it rains or
{hows, or the fea is at times warning over them,
it is, he thinks, fafeft to prefer a conftant im-
merfion ; becaufe, in the northern regions,
where the cold becomes dangerous to life [be
fea is almoft always warmer than the air, as the
experiments of Sir Charles Pouglas fhow * ; and
becau'e there is not only a danger from the in-
creafed cold produced by evaporation, but alio
from the lofs of heat by the rapid changes of
the furrounding medium, as the foregoing ex-
periments point out.
3. Whether, in high and cold winds without
rain or mow, and where a fituation may be
chofen beyend the reach of the waves, it is.
fafer to continue in the air, or to feek refuge in
the ka, mud, he thinks, depend upon feveral
circumftances, rnd cannot perhaps be certainly,
determined. The motives for chobiing the
fea will, he is of opinion, be ftronger in pro-
portion.
* Sec Philofophical Tranfa£tions, Vol. LX. p. 39
[ »? ]
portion as the wind is high and cold, and in
proportion as the (hore is bold.
The foregoing narrative, our author obferves3
fhows that men may furvive twenty-three hours
immeriion in the fea, of the temperature of
38 or 40°, (as great a cold as it almoft ever
pofTefies) without food or water, and almoft
without hope of rplicf; bir that any man, he
adds, ever furvived an equ lly long expofure
to the higher degrees of cold of the atmof:
phere, in the fame circumftances, docs not
appear. Though in the cafe related, immer-
iion in water did not prevent thirft, yet there
is no doubt, he thinks, that it alleviated it ; a
circumftance of high importance, he observes,
towards the preservation of life.
In a poftfcript to his paper, Dr. Currie re-
marks that he has purpofely avoided any rea-
foning on the caufes of rhe lofs of vital heat on
the change of media in the experiments recited.
Jt may, he is aware, be fuppofed that during
immeriion, the water immediately in contact
with the ikin having become heated to a certain
degree, the naked body, on rifing from it into
the air, was in fad: expofed to a colder medium,
and thus the lofs of heat, in this inftanse, pro-
duced. His examination of the heat of the
>yater during immeriion not having been made
m
C 138 3
in contact with the body, he does not deny that
there is fome foundation for the fuppofition ; and
the cafes, he allows, are by no means exactly
parallel between immerfion in an open vtilel,
however large, and immerfion in the fca, where
the conftant undulation may be prefumed to
occahon a continual change in the furroundinor
fluid. But whatever allowance may be made
for the circumftance mentioned, he is perfuaded
that the difference between the denfity of air
and water being coniidered, it is not fufficicnt
to explain the lofs of heat in the inflance al-
luded to. The changes of temperature in the
living body are governed, he obferves, by laws
peculiar to itfelf. He has found, in certain
difeafes, greater and fuddener variations than
any mentioned, from applications of cold very
gent'e in degree, and momentary in duration.
Mr. Hiinter, in his " Experiments and Ob-
fcrva'iorts on Animals producing Heat,'* has
objected to taking the heat of the human body
by introducing the bulb of the thermometer
into the mouth, becaufe it may be affected by
the cold air in breathing. This objection our
author allows to be founded, if the bulb be
placed on the upper furface of the tongue ; but
if it be under it, and the lips (hut, the effects
of
[ 139 ]
of refpiration, he aflures us, may be difrer
garded, as he has found fiom many hundred
experiments. The heat, we are told, may be
obfervea m this way with eafe and certainty,
by employing thermometers curved at that end
to which the bulb is affixed, (the bulb being in-
troduced at the corner of the mouth) fome of
which have been made for him by Mr. Ramf-
den, according to a form given, as well as
others on Mr. Hunter's plan. From repeated
trials it appears to him, that when the ufual
clothing is on, the heat of the living body may
be taken, with nearly the fame refult and equal
certainty, under the tongue with the lips fhut,
at the axilla with the arm clofe to the fide, and
in the hollow between the fcrotum and the
thigh ; but that every other part of the furface
is liable to variation and uncertainty. It is evi-
dent, he obferves, that of thefe three methods,
the firft only can be employed when the trunk
of the body is irnmerfed in water ; and even
when the naked body is expofed to the cold
air, the nrft method feems to him the beft, the
heat remaining moil Heady under the tongue :
the axilla, according to his experience, is the
next beft in order; and the word, the lower
part of the groin : for the fcrotum and the
parts,
L 14® ]
parts of generation, he obferves, lofe their
heat on the application of cold more fpeedily,
perhaps, than any other part of the hody, the
extremities not excepted.
XIV. An Account of the §jua£ia Polygamy or
Bitter-wood of Jamaica; and of the Cinchona
Brachycarpa, a new Species of Jejuifs Bark
found in the fame I/land, By Mr. John Lind-
fay, Surgeon in Weftmor 'eland, Jamaica. Vide
f*ranfaclions of thi Royal Society of Edinburgh ^
Vol. III.
THE tree, which is the fubjeel: of this paper,
has been long known in Jamaica, and in
fome other iflands in the Well Indies, not only
as an excellent timber, but as affording an ufe-
ful medicine in putrid fevers and fluxes. In
Jamaica it is called Bitter wood; in the wind-
ward iflands, Bitter aJJp; and in the French
iilands it is known by the name " of Ecorfter*
The
f Hi ]
the bark has for fome time been prescribed by
medical practitioners in Jamaica, and confide-
rable quantities of it have been exported to
England for the purpofes of the brewers of ale
and porter. On thefe accounts Mr. Lindfay
has been induced to communicate the prefent
defcription of this tree to the public.
Prefixed to this defcription is a fhort hiftori-
cal account of the tree in queftlon, collected
from preceding writers,
The firft of thefe is Sir Hans Sloane, who, in
his vifit to Barbadoes, having noticed the Bitter
wood, has given the following defcription of it in
his Catalogue ; " Melanomma et melanoxylum,
" arbor iaurifoiia nucifera, gemmis nigricanti-
" bus, Americana :" and refers to Plukenet's
Phytographia, Tab. 205, fig. 3; but the plant
there delineated, our author obferves, is diffe-
rent from the prefent.
Dr. Patrick Browne, and after him Mn
Long, in their Hiftories of Jamaica, mention
this tree by the names of Xylopicrutn, Xylopia
glabra, Hitter-wood, or Bitter AJlo. Mr. Long,
in fpeaking of the Quajjia Amaray thinks the
Bitter Afh of St. Chriftopher's is the fame, but
does not feem to know whether the Bitter Afh
has been found in Jamaica.
Dr.
[ H* j
Dr. William Wright, in his Account of the
Medicinal Plants growing in Jamaica •, men-
tions this tree under the title of Pkranla Jmara,
a new genus belonging to the clafs Pentandrid
Monogynia, and fays it is u'fed in putrid fevers
as an analeptic, and that lefs of it will do than
of the Quaffta Am at a of Linnaeus. Dr. Wright,
our auiior obfervts, was naturally led to place
this tree in the clafs and order he has done,
from finding hermaphrodite flowers and feeds
on the fame tree ; but at the fame time he was
aware that this tree has a great affinity to the
genus Quaffia.
The lait writer referred to by our author is
Dr. Olof Swartz, concerning whom he re-
marks, that having examined mo ft of the
plants in Jamaica, he probably had feen this
tree in flower and fruit, as he ftyles it in his
Prodromus, " ShiaJJia Ex. el/a, floribus herma-
" phroditis jjdris paniculatis, foliis impari-pin-
" natis, foliolis oppofitis petiolatis, petiolo
" nudo."
Mr. Lindfay fuppofes that no other defcrip-
tion of this tree has yet appeared ; of courfe he
had had no opportunity of knowing, at the
* London Medical Journal, Vol. VIII. p. 275.
time
t '43 3
time his paper was written, that Dr. Swart2#
in the fame year in which he publifhed his Pro-
dromus, communicated to the Royal Academy
of Sciences at Stockholm a botanical defcrip-
tion and figure of the Quaflia Excelfa, which
the Academy have publifhed in their Tranfac*
tions for the year 1788.
We now come to Mr. Lindfay's Account of
this tree, which he defcribes as being very
common in mod of the woodlands in Jamaica;
and as being beautiful, tall, and (lately. He
has meafured one, it feems, which was an
hundred feet in length, and ten feet in circum-
ference.
He obferves that the trunk is ftraight, fmooth
and tapering, fending off its branches towards
the top ; that the outlide bark is pretty fmooth,
of a light gray or am colour, from various li-
chens; that the bark of the roots is of a yel-
low caft, fomewhat like the Cortex Simarouba ;
and that the inner bark is tough, and compofed
of fine flaxy fibres ; that the wood is of a yel-
low colour, tough, but not very hard; that it
takes a good poiifh, and is ufed as flooring;
that the leaves are fuh-alternate ; the fmall
leaves being in pairs, from five to eight, (land-
ing, eppofite to each other on fnort foot-flalks,
and
C 144 J
anci ending with an cdd one; that they are of
srn oblong oval fhape, and pointed ; the ribs
reddilh, and the young leaves covered with a
fine brownifh down ; that the flowers come out
in bunches or ciufters from the lower part of
the laft Ihoot before the leaves, and (land On
round footftalks ; that the flowers are fmall,
of a yellowifh green coloir, with a Very fmall
calyx; and that the male or barren tree produces
flowers nearly fimilar to the hermaphrodite* but
which have only the rudiments of a ftyle.
The fruit, he tells us, is a fmooth black
drupa, round (haped* and of the fi2e of a pea.
There is but little pulp, and the nut covers a
round kernel. Thefe drupx, he obferves, are
generally three, fometimes two, and often only
one, attached lideways to a round ifh flelhy re-
ceptacle. It flowers in October and Novem-
ber, and its fruit is ripe in December and Ja-
nuary.
Except the pulp of the fruit, every other
part of this tree, we are told, has an intenfely
bitter tafle. From this quality, Sir Jofeph
Banks, Dr. Solander, and Dr. Wright, were
induced, it feems, to give it the name of Pi-
crania Amara* In tafle and virtues, our author
has found it nearly equal to the Quaflia of Su-
rinam*
C J45 ]
rinam*, and has been credibly informed that it
IS fold in London for the Quaflia Amara, and.
he thinks, it may be fafely ufed in all cafes
where
* From a paper entitled " of the true Quaffia Amara,
14 and of the falfe {Om den rette Quajfia Amara, og om
•« denfaljke)" lately publiflicd by Mr. N. Tender Lund,
in the Tranfac'tions of the Natural Hiflor) Society at Co-
penhagen, it would feem that what has been generally im-
ported into Europe under the name of Quaffia Amara, is
fpurious. ' Mr. Von Rohr,' fays the author of the pa-
per in q'ueftion, * who in the years 1783, 4, and 5, vi-
4 fited different parts of the Continent of America, and fe-
4 veral of the Weft India iflands, and collected many rare
* plants, has fent to me, among other things, a fpecimen
• of the Quaflia Amara, and with it the following note :
•* In my whole voyage I faw only a fingle wild fhrub of
*4 Quaflia Amara, and that was near the river Tamaco, in
44 the neighbourhood of St. Martha. The planters in Su-
44 rinam and Cayenne cultivate it on account of the mag-
44 nificence of its flowers, and its ufe. In Surinam, the
44 flowers alone are ufed as tea. The wood is extremely
44 dear ; and I can with truth fay that I know not where I
" could buy a fingle pound of it. The Hem never exceeds
" two inches in diameter. Had I been defirous of extir-
44 pating this fhrub from the neighbourhood of the Ta-
4t maco, I might perhaps have got together ten pounds of
44 it. It is certain, therefore, that impoftors have fent
** into Europe, under the name of Quaffia Amara, the
44 wood of another fpecies of Quaffia, which has the ap-
Vot. V. L *4 psaraae*
C h6 ]
where that drug has been thought proper, whe-
ther as an analeptic, or in cafes of weaknefa
in the ftomach and bowels. It may either, he
obferves, be given alone, or joined with the
Peruvian bark*
He has feen, he tells us, the happieft effects
from the ufe of this medicine in obftinate re-
mitting fevers from marfh miafmata, in agues
which had reiifted the ufe of Peruvian bark, and
in dyfenteries of long Handing. In Jamaica,
it feems, it is in daily ufe in dropfies from de-
bility, either in fimple infufion or tindture, or
joined with aromatics and chalybeates.
Dr. Drummond, an eminent phyfician in
Jamaica, is faid to prefcribe it with great fuo
•* pearance of an afh tree, and which is likewife bitter. In
4t a word, you may be allured that any fpecimen of Quaf*
ct fia, the ftem of which, including the bark, is more than
" two inches in diameter, is not the true Quaffia." From
6 this account," adds Mr. Lund, *' it feems pretty cer-
* tain, that the pieces of wood which are met with in the
4 fhops, and which have more the appearance of timber
* than of a medicine, are not the true Quaffia, but are
* procured from that lpecies of it which the Englifh call
* the bitter afh." — See Skrivter af Naturbiftoric-Seljkabet .
8vo. Copenhagen, 1790. Vol. I. Part 2, page 68.
Editor.
cefs
C '47 ]
cefs in the above cafes, as well as in amenorrhoea,
chlorofis, dyfpepfla, and in that fpecies of pica,
called Dirt-eating, fo fatal to a number of ne-
groes.
The bark of the treej but efpecially the
wood, Mr. Lindfay obferves, is intenfely bit-
ter. He has ufed both in various forms.
The bark, it feems, is difficult to be re-
duced to powder. The dofe, he obferves, is
from 15 grains to 1 drachm, either by kfelf,
or joined with the Peruvian bark.
Mr. Lindfay has employed the wood as well
as the bark of this tree, both in infufion and
decoction ; for the former he directs the pro-
portions to be from two drachms to half an
ounce of the bark or wood to a pint of water *
and for the latter the fame quantities to a pint
and a half of water, which is to be boiled to a
pint. Of either of thefe the dofe is directed
to be a wine-glafs full every three, four, or fix
hours, according to circumftances;
In certain cafes of dropfy, in amenorrhoea
and chlorofis, he joins to this remedy aromatics
and other medicines ; and in worm fevers, the
cabbage bark or other vegetable anthelmintics.
Mr. Lindfay gives the following botanical
L 2 defcrip-
[ i4« ]
^eiCiiption of the Quaffia Polygama*. 'thii
defcription i-s accompanied with engraved
figures
* As we think it will be a gratification to many of our
readers to fee Dr. Swartz's defcription of the fame tree, un»-
der the name of Q^ Excelfa, we mall here infert it.
*c Arbor excelfa.
if Truncus craflus. Cortex cinereus, rimofus.
94 Lignum duriffimum, album.
** Rami patentes.
** Folia pinnata cum impari, alterna, fparfa. Petioli t*-
** retes grabri.
" Foliola petiolata, 4-ojuga, oppofita, elliptica, acumi-
u nata, integerrima, nervofa, venofa, glabra, confiftentia.
rt Petiola part tales breves, teretiufculi, glabri.
<c Racemi axillares, compofiti, paniculati, ramis dicho*
*' tomis patentibus, difrufis, multifloris.
" Flares parvi, albidi, polygami, mafculis et hermaphro*
'• ditis ineodem racemo.
"" Masc.
•* Cal. 5phyllus. Foliola conica, dentiformia, minuta.
. *' Cor. Petala 5 fub receptaculo inter dentes calycis in
'* ferta, oblonga, adfeendentia.
** Stam. Filamenta 5 a latere receptaculi exferta, fubu*
*« lata, adfeendentia, petalis longiora, villofa. Anther*
" fubglobofse, bivalves.
" Pist. rudimentum.
'« Hermaphrod.
*< CAuetCoR. ut in mare.
" Filamenta 5 breviora. Anther* fertiles.
" Put,
C *49 3
$gures of the leaves and fructification, for
.which we muft refer our readers to the work
itfelf.
" Arbor excelfa fzepe centum pedes alta.
" Caudex fpedtabilis, ere&us, glaber. Cortex
" cinereus in Epidermic! e, interne albido fla-
" vefcens, tenax et ex fibris lentis con feet us.
if Ramuli alterni teretes.
" Folia fub-alterna. Foliola 5—10 jugata
/' impari-pinnata, oppofita, oblonga, obtufe*
" acumi-
fr Pist. Germina 3. contigua, receptaculo tumido infi-
" dentia, globofa, glaberrima. Stylus ftaminibus longior,
*' 3queter, 3-fidus. Stigmata fimplicia.
f? Per. Drupce tres, globofae, uniloculares, bivalves, re-
■■ ceptaculo ampliato, hsmifphaerico infidentes, diftantes,
f? magnitudine pifi raajoris.
?f Sem. Nuces folitariae, globofse, glabrae, nauco fra-;
" gili."
From this defcription, Dr. Swartz obferves, we may
perceive the near affinity of this tree to the genus of Quaffia.
It approaches, he thinks, nearer to the Q^ Simarouba than
to the Q^ Amara ; but differs from both in being without the
fquamulcs neftarii, which are placed under the germen on the
baiis of the filaments, and in having in general five, and
fometimes, though rarely, only four (lamina inftead of ten.
Thefe two characteristic differences, however, are not, in
.his opinion, fufficient to conflitute a diftinft genus.
L 3 Dj.
t 15° 1
66 acuminata, glabra, integerrima, vcnofa, brc-
f? viter petiolata. Petiolus communis fubtus mi-.
?' dus. Stipule laterales parvae, lanceolate,
<c ereclae, decidual.
" Inflorefcentia cymofa. Pedunculi folitarii,
" teretes, plerumque nudi, in plurimos ramq-
" los divifi.
" Flos Masculus.
cc Gal. Tcrianthium, infernum, minimum, ex
\c fquamulis quatuor compofitum. Folwlls
" ovatis perfiftentibus.
" Cor. Petala 4, oblonga, obtufa, sequalia, feffi-
*' lia, fuberecta. Netlarium ex fquamis 4 ovatis,
*' villofis, baii filamentorum interiori infertis.
Dr. Swartz agrees with Mr. Lindfay in his account of the
intenfely bitter tafte poffeffed by every part of the tree;
and obferves that the negroes have recourfe to an infufion
of it in rurn in fome affections of the ftomach. Ke like wife
mentions its ufe as an anthelmintic. His figure of the plant
agrees with that given by Mr. Lindfay. — See Kongl. Ve-
tenlkaps Academien nya Handlingar, Tom. 9, p. 302. 8vo,
•Stockholm, 1788. Editor.
" St am.
C *J' J
" St am, filament a 4, 5, b, flliformia, fube-
(e recta, asqualia, corolla longiora, receptaculo
C( inferta. Anther a fimplices erects.
f( Flos Hermaphroditus in diver/a Arbor*.
H Cal. et Cor. ut in mane.
" St am. ut in mare, fed filamenta corollam
ft vix fuperant.
" Tift. Receptaculum carnofum, orbicula-
" turn, elevatum, gcrmine latius. Germen Tub-
fi ovatum, ex duobus, tribus, raro quatuor
" compofkum, leviter coherentibus. Styli
" craffiufculi, eredti. Stigmata 2, 3, 4, fim*
" plicia, deelinata.
" Per. Drupse 2, 3, 4, globofse, laterales,
" diftantes, nigerrima?, nitentes, receptaculo
*' infertac.
" Sem. Solitaria globofa, unilocularia, nauco
" fragili te&a."
Mr. Lindfay next gives an account of the
Cinchona Brachycafpa, a new fpecies of Cin-
chona growing in Jamaica. This tree was
firft difcovered by him in November, 1784, on
h 4 the
t i& ]
the north-eaft fide of the hill that overlooks
the works of Mountain Spring eftate, in the pa-
rim of Wcftmoreiand, and afterwards on fome
of the mountains near the Moreland eftates in
the fame parifh. As it has hitherto been un-
known to naturalifts, he has given the following
botanical account of it, which in the work ltfelf
is illuftrated by an engraving.'
" Pentavdria Monogynia.
" CaL Perianthium monophyllum, fuperurq,
cc campanulatum, parvum, 5 dentatum, per-
" fiftens, dentibus acutis, eredlis.
" Cor. Monopetala, infundibuliformis. Tu-
u bus cylindraceus longiflimus. Laciniis, an-
" gufto oblongis, patente revolutis.
" Stam. Filamenta 5, interdum fex, fili-
ce formia, tubo longiora, in fauce tubi inferta.
" Anther* lineares erecTse.
" Tift. Germen ovatum, inferum. Stylus
" filiformis longitudine ftaminum. Stigma
*e cralTiufculum ovatum llmplex.
" Per. Capfula oblongo ovata magna, calycc
•* roronata, bipartibilis, dehifcens in duas
' ' ; ' J ic partes
t m 3
fi partes intcrius dehifcentes, difTepimento p$-
f« rallelo.
u Semina plurima, parva, eomprefTa, mar-
M ginata.
f* Arbor ere&a 20 pedes alta, ramis patenti-
f.f bus. Cortex fufco-cinereus, fapore primo
ff dulci, mox amarefcente.
U Folia oppofita, oblongo-ovata, integerri-
" ma, glabra, fubtus venofa, petiolata. Pe-
" tioli breves, fupra fulcati. Stipula lateralcs,
" ovato-lanceolatx, integral, caulem ar&e am-
" plexantes.
*c Infiorejcentla panicularo-corymbofa, termi-
Jf nalis. Pedunculus plerumque brachiato-tri-
" ternatus, teres, nudus. Corolla glabra, pal-
" lide rubra vel carnea, tres circiter pollicei
« longa.,,
Mr. Lindfay has met with this tree only in
three places ; in the inland, woody, and moun-
tainous parts of Weftmoreiand and Hanover
parilhes. The talleft he has ever ken was
about thirty feet high, and 7 or 8 inches in dia-
meter. The branches, we are told, are few
and fpreading. The leaves (land in pairs, are
fmooth and Ihining, and are very like thofe of
the Portlandia grandijlora. The flowers grow
in pretty large clutters, on the extremities of
the
C *54 ]
the branches ; and have nearly the beauty and
appearance of the common honey fuckle, but
arc rather larger.
The feed-pod, he obferves, is larger than in any
other plant of this genus ; is oval, adorned with a
Calyx of a firm confidence, fomewhat ftriated,
and black-coloured; and when ripe, fpiits in
two, and discharges a number of fma.ll, flat,
brown feeds, with a membrane nearly round
the edges.
The trunk and branches are defcribed as be-
ing of a brownifh gray colour, with a few fur
perficial furrows, and crofs cracks like the Pe-
ruvian bark. The bark of the trunk, we are
told, is pretty thick ; and when wounded, ex-
udes a fmall quantity of a milky juice. The
bark, when dried, is of a purplilh brown co^
lour on the infide. It is fibrous, and more
difficult to pulverife than the Peruvian bark.
The powder is of a purplilh gray colour, and
jcaftes fweet, then bitter and aftringenr.
This fpecies, our author thinks, might be
ufed as a fubftitute to the Peruvian bark ; but
unfortunately the tree is fcarce and fmall, and
enough of it cannot be had, at lead in thofe
parts of Jamaica in which he has found it
growing. This lofs, he obferves, may be corn-
pen fated
C *s$ J
penfatcd by the abundance of the Cinchona
Caribaea feu Jamaicenfis, defcribed by Dr.
Wright in the 67th vol. of Phil. Tranf. and
which, he is aflured, has been found to anfwer
all the purpofes of the Cinchona Officinalis.
He does not pretend to hold up this new
bark as fuperior, or even equal to the Peruvian.
He has given it, however, in the (lighter cafes
pf intermitting and remitting fevers, with good
effed:; and in a few inftances, it produced a
cure, where the patients had taken the common
and red barks to no purpofe.
To perfons afflicted with intermittents, he
gives of the powder from twelve grains to
thirty every hour, or every two hours in the
abfence of fever. By this means, a (lop hag
been put to the fever, and the patients have
recovered. He has alfo adminiftered this new
bark in dyfpepfia, both in powder and infufion,
and found that it fat eafy on the flomach, and
promoted appetite. He had ffiewn this fpe-
cics of Cinchona to Dr. Wright, before he left
Jamaica, and gave him a little of the bark.
The Doctor gave it in powder to a patient,
but found it emetic, which could only happen,
gur author thinks, from feme peculiarity of
con-
[ }&6 ]
jtonftitution *. In a letter to Mr. Lindfay, he
intimates, that probably the fame thing would
happen, with the bark of every other tree of this
genus, if given before it is completely dried.
Mr. Lindfay's paper clofes with fome few
remarks on the red Peruvian bark.
This fubflance, when genuine, and given
brilkly in pretty large doles, will, he obferves,
in particular cafes, occafion a degree of anxiety,
deprefTion, giddinefs, and faintnefs, that are
alarming to the patient and his friends, and
perhaps, if not timely attended to, might be
of ferious confequence. This, he adds, only
happens in certain constitutions, and in weakly
habits, or thofe rendered fo by difeafe.
This effect of the red bark, fo far as he
knows, has not been taken notice of by any
writer, and when it occurs in private practice,
is either not attended to, or imputed to fome
other caufe. Mr. Lindfay gives the following
extract of a letter from James Graham, Efq.
a refpcctable inhabitant of Jamaica, which, he
thinks, places this circumftance in a ftrong
light.
* See London Medical Journal, Vol. VI U. page 24 1.
Mr.
C 157 3
Mr. Graham, after having been affii&eci
with a fever and ague for feveral months, at
length took the red bark in dofes of thirty
grains each. " On taking the firft," fays he,
" I inftantly perceived an unufual pungency
" on my tongue. After the fifth, I felt an
" anxiety about my breaft with faintifhnefs ;
" and had hardly done fwallovving the fixth,
" when I was feized with giddinefs, an uni-
" verfal tremor, and a profufe cold fvveat. A
** little wine, which was given me in this fitua-
" tion, relieved me confiderabiy. In about
€€ an hour, all the1 alarming fymptoms difap-
" peared, but I remained weak and languid.
" From that day, however, the fever left me,
" and did not return till feveral months after,
ic when it was brought on by a cold, and wa»
" removed by the bark adminiftered in the
" fame manner, and attended nearly by the
fame fymptoms as before."
«
XV. Ex-
i: iss ]
XV. ExtraEl of a Letter from the Reverend
Charles Perceval to Robert Perceval, M. D.
and M. R. I. A. Vide Tranfatlions of the
Royal Irijb Academy. Vol. IV. 410. Dubliru
THIS letter contains an account of Jane
Bern, a girl, eleven years old, low in
ftature, but of an healthy appearance, whom
Mr. Perceval accidentally met with in the char-
ter fchool at Dunkerrin, in the King's County,
and whofe eyes are conftructed in an extraordi*
nary manner.
Their motion, inflead of a regular horizon-
tal one, frqm left to right, and vice verfa-, is
tremulous in all directions, and partly perpen-
dicular, with a prominent motion of the globe
of the eye ; what lateral motion the eye is ca-
pable of is fhort, interrupted, and gives that
organ the appearance of being bound by liga-
ments, from which it ftruggles to get free.
The child cannot ealily look upwards, or fee
any object placed above her eyes; and when
(he reads, which (he does without any hefita-
tlOR
[ <59 1
tion or difficulty, me reads perpendicularly
from the bottom upwards, and holds the book
accordingly.
The whole globe of the eye is of a reddim
cad, the white is ftreaked with ftrise of a fainter
red ; the iris is of an uniform deep red, ap-
proaching to brown ; both her eyes are weak
and watery : and, when turned from the light,
glow with a more fiery and vivid colour than
when expofed to it.
Mr. Perceval obferves, that although fhe
reads very well, and feems poflefTed of a mo-
derate plain underftanding, fhe is unable to
write, knit, or fpin. She has remarkably fine
hair, it feems, of the colour of flax, but con-
fiderably whiter.
The mivrrefs of the fchool informed him
that the child was fent to her from a nurfery in
the county of Longford, in the North of Ire-
land.
Mr. Perceval was not informed whether any
more of her family had thefe peculiarities.
The Angularity of this cafe feems to confift
in the motion of the eyes ; for the rednefs of
the iris, and the white colour of the hair, evi-
dently fhow that it mufl be clafTed with thofc
inftance*
[ i6° 3
inflances of lufus naturae *, which depend os|
a white colour of the pigmentum of the eye„
correfponding with the colour of the hair, and
which have been fo ably defcribed by the late
Mr. John Hunter ; and likewife by Dr. Blumeri-
bach -f.
* For the application of this term here we have the au-
thority of Mr. Hunter, who, in his Eflay on the Colour
of the Pigmentum of the Eye in different Animals, ob~
ferves that " the variation of colour appears moft remark-
*' able when a white flarts up, either where the whole fpe-
** cies is black, as in the crow or blackbird ; or where only
•' a certain part of the fpecies is black (but permanently
44 To), as a white child born of black parents ; and that a
•4 perfectly white child, whofe hair is white, and who ha»
• the pigmentum alfo white, though born of parents who
44 are fair, ihould as much be conlidered as a play of Na~
** ture as the others. All thofe lufus naturae," he adds,'
44 fuch as the white negro, the pure .white child of fair
44 parents, the white crow, the white blackbird, white
** mice, &c. have likewife a white pigmentum correfpond-
44 ing with the colour of the hair, feathers, and Ikin."
See Obfervations on certain Parts of the Animal Oecono-
my. By John Hunter. 4to, London, 1786, page 204.
Editor.
•j- Fide Jo. Frid. Blumenbacbii de Oculis Leucsethiopurm
etlridis motu Cornmentat. 410. Goettingae, 1786,
XVI. M
[ Ifel ]
"XVI. An Attempt to determine with Precijion fuch
Injuries of the Head as necejfarily require ths
Operation of the Trephine. Ey Sylvefter O'Hal-
loran, Efq. M.R. LA. Honorary Member of the
Royal College of Surgeons in Ireland, and Sur-
geon to the County of Limerick HofpitaL From
ihe Tranfaclions of the Royal IriJJj Academy,
Vol. IV.
Kon fingendunr, ant excogitandum, fed inveniendum, quid
natura faciat aut ferat. Bacon.
WERE we to eftimate the lights thrown
on particular diforders by the number
of eminent men who have treated of them, we
fhould conclude that thofe produced by external
injuries of the head mud be bed underftood, as
from the days of Hippocrates to our own they
have been confidered with mod particular atten-
tion. But however great our obligations to our
anceftors, and to many illuftrious and learned
moderns and contemporaries may be, yet our
knowledge of this fubject, fo intereiling to
mankind, is ftill incomplete. The various
Vol. V. M diforders
C i6* ]
diforders fubfequent to injuries on the head
have by no means been difcriminated with fof-
ficient precifion ; nor have their fymptoms or
modes of treatment been clearly afcutained ;
even the ufe of the trepan is now more indefi-
nite than it was a centui y ago. The late Mr.
Pott, as diligent and accurate an obferver as
any age or nation has produced, complains
" of the darknefs and obfeurity of this part of
" forgery."
Enabled by clofe and diligent obfervations,
and by cxtenfive pra&ice in this line for above
thirty years, I have ventured, under the auf-
pices of the Academy, to determine a queilion,
perhaps the nicefl and molt involved in forgery.
The operation of the trepan is very ancient;
but being confined to narrow limits, was fel-
dom performed without the greateft caution
and circumfpecTlion ; for it was interdicted
over or near the futures, near the os fquamo-
fum, and on or very near the occiput. This
well explains an anecdote in our early hiftory;
for Connor Mac NeaiTa, King of Ulfter, that
generous protector of the literati of his days,
and cotemporary with Julius Casfar, having his
fkull fractured in battle, his firft furgeon, Fi-
nighin, refufed to apply the trepan till his fafety
wa$
[ 163 3
was guaranteed by the nobles of the country,
i«n cafe it did not fucceed.
But the experience of the lad and prefent
centuries has proved, that there are very few
parts of the head on which the trephine may
not be applied when necefTary. However,
this information, in itfelf fo intere fling, has by
no means anfwered the ends that fhould be ex-
pected from it ; for inftcad of our determining,
or even attempting to limit the cafes to which it
Should be confined, it has been fince adopted
in almoft every fevere injury of the head, ac-
companied with untoward fymptoms. To point
out with perfpicuity and precision the cafes in
which it can alone be ufeful to the patient, is
the object of this paper. Thefe obfervations
may be arranged under two articles — Fractures
of the Cranium, and depofits on the furface
of the Brain or on its Mr mbranes. Yet, even
in the cafe of fractures, long experience has
convinced me that many of them require no
operation. As this is an object of great mo-
ment, I mall be as clear and concife as poflible.
To this purpofe, I have felected three out of a
great number of cafes ; and the rather becaufe
each had its particular fymptoms, though ali
tending to the fame point.
M 2 Cafe
[ i64 ]
Cafe I. Mrs. Grogan fell from a window
into the (beet, and received a violent cor.tufion
on the front of the coronal bone. I law her
the next morning, and found a considerable
tumour, which to the touch feerried o contain
fome fluid ; but as I had feen man) lim lar ones
fubfide in four or five days, by the ufe of com-
prefTes wet in fpirits, I treated this in the fame
manner. The fweiling, however, remained,
and in five days I propofed opening ir, which
fhe would not permit. The fixth day (he again
fent for me ; the tumour was ftill the fame, but
the fluctuation not fo fenfible. I laid open the
part, and a good deal of coagulated blood was
difcharged. She complained all that and the
next day of pain, and a thin bloody fanies came
from the wound. I found not only the bone
bare, but a considerable fracture, with fome
depreffion. I preffed with my finger the fides
of the bone, but it remained firm to the touch,
and fhe felt no uneafinefs from ir. I kept the
wound open for fome days, and finding no
alarming fymptoms, fuffered it to helai, which
it did by the end of the month. I recommended
her to keep the part covered for fome time, on
account of the thinnefs of the cicatrix. This
ihe neglected. In fome days after, leaning over
a gar-
[ **? 3
a garden wall, with a fmart wind in her face,
fhe was feized with a violent pain, and imagined
the wind was piercing into her head. She flept
little, and was the whole night in a fever.
Next morning; I found the forehead great lv
fwelled, and let out a considerable quantity of
matter. In fome time it got well; (he had it
covered with adhefive plaifter, and never after
complained.
Cafe II. Samuel Hade received a wound on
the upper part of the right parietal bone, of
two inches long, with a loofe bone and fradture.
Though the fracture could not admit of a
doubt, yet there feemed to be but little depref-
fion, and the fides of it were firm to the touch.
I faw no reafon for the operation at prefent, but
carefully attended to the fymptoms. In the
fpace of four weeks the bone became covered,
the wound healed, and he has fince enjoyed
perfectly good health.
Cafe III. M'Namara received a wound on
the forehead, and near the left fide of the
frontal finus. In a few days after he was brought
to the hofpitai ; his pulfe was full, and he com-
plained of a great head-ach. Upon examining
through a fmall aperture, I perceived the bone
bare and rough, and concluded there was a
M 3 frac-
[ 166 J
fracture. I removed the integuments, ani
found the bone fractured near two inches in
length, but (till the parts were nearly upon an
equality, and the bone firm to the touch. As
he bled a good deal I did not direct vencefec-
tion, but ordered fome powders of nitre and
jalap, md the faline mixture. His heed-ach
was not abated next morning, fo 1 di reeled a
large blifter to his back, which I defired ihould
remain on for twenty-four hours. This removed
the head-ach, and the wound went on well.
In five days after, he complained of violent
fhiverings, and I fhou'd have concluded them
ro be the precurfors of matter forming on the
brain, had I, in the courfe of many hundred
fractured ikulls, feen a fimilar inftance; but I
had not. He was not- trepanned ; the bark, in
fome time, removed thefe complaints, and he
is again abroad.
Having thus, 1 apprehend, clearly proved,
that many fractured ikulls do not demand the
trepan, it remains that I Ihould clearly difcri-
minate between thofe and other feemingly
flight fractures, which abfolutely require it.
Tn the courfe of my practice I have constantly
obferved, that fractures of the cranium are
more extended in the inner than the outward
table.
C i67 ]
tabic, and of courfe, that fimple fractures,
fuch a$ I have defcribed, may do confiderable
damag-e within, whiift all is fair without.
Fractured fkulls in general (with a very few
exceptions) are attended with no very alarming
fymptoms for many days. They are free from
fever and inflammation ; nor is reafon in the
fmalleft degree impaired. But in the courfe
of ten, twelve, or fifteen days, if any preflure
red on the brain, the patient becomes heavy,
grows drowfy, comatofe, and ibmetimes con-
vulfed. Thenrfl appearance of any of thefe
fymptoms is the critical time of alarm, and the
operation mould be immediately proceeded to.
Cafe IV. J. C'Mara received a violent blow
over the middle of the left parietal bone. It
was for a good many days drefTed by a perfon
in the neighbourhood, but not appearing to
mend, I was applied to. I found a feemingly
flight contufed wound, with a bare bone; and
feeing him heavy and drowfy, I concluded a
preflure on the membranes of the brain. As
he appeared more ftupid the next morning, I
removed the fcalp, and found underneath a
confiderable depreflion. The operation imme-
diately followed the incifion ; the deprefTed part
M 4 was
[ r6S ]
was raifcd, fonie fmall fplints removed, and he
is, at this day, a healthy man.
Cafe V. William O'Neil received a very
extended wound on the fuperior part of the lefc
p.irietal, which bared the bone for near two
inchec, ^tih a violent contufion about the cen-
ter of that bone. The wound was dreiTed, and
every precaution taken to prevent fever and
inflammation. He went on tolerably well for
twelve day?, except that the wound on the pa-
rietal never exhibited a pleating afpedt. About
this time I perceived him to grow heavy and
drowfy. I more narrowly infpecled the head:
but though the bare bone became fenfibly difco-
loured,and though I expected exfoliation would
follow, yet I was well convinced that no frac-
ture was there. I interrogated him clofely.
He told me the leaf! noife difturbed him, and
he imagined that found was conveyed through
the fide of his head, as well as through his
ears. I now more narrowly infpecled the con-
tufion on the fide of the head, which had hi-
therto been dreflcd with a com pre fs dipped in
fpiritsonly. 1 thought I felt an obfeure fluc-
tuation : at any rate the fymptoms determined
me to open this part. But what was my fur-
prife when I found the bone underneath not
onlj
t '69 ]
only fra&ured, but beat into final] pieces, an
the point of percuffioa. I trepanned on the
fpot ; removed bits of bone, afcd raifed others
to their level. After this every thing went on
well, except the wound at top, which threw
off feveral exfoliations, and remained open
many days after the fractured parts healed.
This man became as (tout and well' as poflible.
After thefe proofs, that even in many frac-
tured fkulls the operation of trepanning may
be difpenfed with, what pretence can we offer
for trepanning in wounds of the cranium in-
flicted with incifive instruments ? I know of
none that can juftify fo violent an outrage to na-
ture, except fymptoms of extravasation appear,
which I believe very feldom happen where the
fkull itfelf is injured.
Cafe VI. Edward Power received a defpe-
rate wound of a baek fword, extending from
the top of the coronal bone to the orbit of the
•left fide, forming an extended and frightful
chafm, in which were included the bone, mem-
branes, and brain. It bled confidcrablv, as
may well be fuppofed. He remained expo fed
to the open air for near three hours after, and
had not fo much as a bit of rag to cover it.
Fever and inflammation of the brain might rea-
sonably
t «7° ]
fonably be apprehended ; yet, by a couple eff
bleedings, and forne other antiphlogiftics, the
man was completely cured in five weeks, with-
out exfoliation or the fmalJcft operation. To
this I {hall add an inftance given by La Motte*,
of a man who received a blow of a fabre on
the right parietal bone, which divided the
longitudinal finus and the left parietal, extend-
ing a'moft from ear to ear; and yet this mart
recovered without any operation.
Having difpofed of the above very inte rett-
ing queftions, we fliall now remark on fuch
fractures as neceffarily require the operation in
the fir ft inftance. Thefe are fractures accom-
panied with depreflion, with or without wounds.
For, not to advert to the reftraint fuch prefiure
muft neceffarily caufe to the motion of the
brain, fumctent in itfelf to produce fatal effects,
if the depreffed parts be pointed and fharp, as
is moftly the cafe, acting againft the uniform
pulfation of the brain, the membranes muft in
fome time be cut through, and the brain itfelf
wounded ; and whilft this tragic work is going
on, we have no fymptoms to indicate the ap-
proaching danger till it is paft remedy. The
* Traitc complet de Chirurgic, t. Hi, p. 343.
two
[ i7' J
two following infbnces contrafted will explain
and juftify this pofition.
Cafe VII. A girl about feven years of age
received a fevere fracture, with profound de-
preflion, on the left parietal bone ; the integu-
ments were entire, the girl quite compofed and
fenfible, but the depreffion was fo deep that it
could contain a very fmall egg. Such was her
firuation when brought to me, half an hour
after the injury. Seeing that it would require
three or four crowns of the trephine to raife
this extended fracture, I requeued of Mr.
Wallace, a military furgeon, and Mr. Pierce,
to amft me in this charitable work. I removed
all the integummts, wiped away the blood, and
whilft thefe gentlemen with their fingers made
eompreflions over the bleeding veflels, I began
to operate on the inferior parts of the bone. I
then commenced a fecond on the upper parr,
and in a line with this ; but the two elevarois,
though acting at the fame time, had no effect
on the depremon. Two more crowns were
then applied to the fides of the bone, and pa-
rallel to each other. Four levers acting in
conjunction, it aftonifhed me to fee with what
a fudden fpring the deprefied parts refumed
their former ftation. Notwithstanding the great
extenfion
[ i-7* ]
extcnfion of this fracture, the lofs of covering,
and of the bone irfeif, by four crowns of the
trephine, this girl never after had the fmalleft
untoward fymptom.
What muft have been the event of th's cafe
if not fpecd ily relieved, the following will fhow.
Cafe VIII. Patrick Cafey, aged about eigh-
teen, was thrown from his horfe with great
force; the confluence was a fraclure hi part
of the coronal bone, with a considerable de-
preflion. I was rcquefted next morning to vitir
him; and feeing his fituation, I was ju ft pro-
ceeding to the operation, when a furgeon of
the city appeared, who faid he was employed
by Cafey' s matter to attend to him. The de-
prefiion was fo confidcrable, that the lower edge
of the fracture was beaten under the uninjured
part ; here I intended my operation, in order
the more fpeedily and effectually to difengage
the fracture. But this was oppofed ; it was ob-
ferved, that trepanning fo low down would
leave a great deformity, and that the end pro-
pofed would be as well anfwered by perforating
the bone at top. I onpofed it in vain. I favv
that the friends of the boy, who were prefent,
as well as himself, wifhed to have it done fo.
I trepanned, introduced the elevator, but could
make
t '73 J
make no impreffion, as the deprefied parts
were beyond the reach of the inftrument, I
now propofed a fecond opening on the lower
edge of the fracture, the firft being impoflibie
to anfvver the end propofed. This was not
agreed to. It was obferved, that an opening
being made, no depofit could be formed, and
that the deprerTed part would become gradually-
detached, and probably tome away, which has
fometimes happened. The fore was carefully
dreffed, but the dura mater never aijumed a
right afpect ; however his fpirits were good,
and he had no complaint but what arofe from
the fore itfelf. The difcoloration of the dura
mater made me try, on the 15th day, and again
on the 1 7th, the effects of ihe elevator, but in
vain. He was up every day. The 24th, look-
ing out of a window for fome time, he per-
ceived a flight chillinefs ; at bed-time he grew
hot and feverifh, was very redlefs, and had a
flrong fhaking fiu This alteration was afcribed
to his making too free with himfelf. But I
faw and dreaded the confequences. I told the
people that thefe alarming fymptoms proceeded
not from cold, but frpm the conftant and uniform
prefTure on the brain ; and that if any chance
remained for his recovery, which I much
doubted,
[ '74 ]
doubted, ir muft be by a fpecdy removal of
the caufe ; and if they con Tented I would not
fhrink from this difagreeable bufinefs. I di-
rectly made the fecond perforation, and foon
railed the part; but, alas! the mifchief had
been already completed. That day and the
next he feemed a good deal lighter : but, about
ten at night of the fecond day, his neck was
obferved to be covered by a bloody ichor ifluing
from the fore. Next morning his pulfe was
more languid, and the dura mater quite black.
Towards night the bloody ichor increafed; he
became ilightly convulfed, with ftupor. About
ten the fubftance of the brain poured forth, and
he expired next morning.
Fractures with a deprefTed bone always re-
quire the operation ; and though fome cafes may
be adduced where an happy recovery has fuc-
ceeded without this adoption, yet it muft arife
from particular circumftances by no means to
be depended on. For initance, the depreflion
may be uniform, fo that no point of the fradture
may prefs on the brain. In fuch an initance,
no doubt things may come about without tre-
panning; but have we any fymptom to deter-
mine this point ? None that I know of. Num-
bers I have fecn perilh by neglecting the ope-
ration.
C '75 1
ration, becaufe they found themfelves free fron>
pain and fever at the beginning. As, thenf
trepanning is a fafe operation in any tolerable
hands, no consideration fhould make the fur-
geon decline or procraftinate it. He has al-
ready feen the happy confequences of it when
performed in the firft inftance. He will now
fee what may be hoped for from nauire, even
in the moft deplorable cafes, from neglect or
jdelav.
Cafe IX. I was fent for to Patrick Kelly, who
had received repeated blows on the left parie-
tal bone, which produced a very extended
fracture, with a flight contufed wound of the
integuments. He had been attended for fomc
time by a young man in the neighbourhood.
In the courfe of about ten days he became
heavy and drowfy ; the complaints increafed,
and when I was fent for he was comarofe, lan-
guid, and opprefTed ; fo much fo, that I ap-
prehended any operation ufelefs. and had fomc
thoughts of immediately returning. But re-
flecting on the great refources of nature, and
that it would be in fome fort criminal not to
difcharge my duty, I removed the integuments
on the- interior part, where the depreflion was
greater!:, and directly applied the large ft crown
I had.
I 176 ]
I had. On removing the piece I introduced
the elevator, railed the deprefTLd parrs, and
was fatisfied, from the extent of the injury t
that many pieces of bone would come away.
Immediately after this he opened his eves, knew
me, and fpoke. I left directions for managing
the dreiiings, and ordered fome medicine- of
the nervous tribe. In eight days after I again
vifited him, and found a cqnfiderable part of
the bone loofe. I made a flight incifion over
it, and extracted it with my forceps. The
next day he found a weaknefs of the neck and
arm of the oppofite fide, and by night it at-
tacked that entire extremity. In a few days
after two more pieces of bones were removed,
and again another. He laboured under this
partial paralyfis for about fifteen days, and then
gradually recovered.
Cafe X. I vifited Patrick Hayes, who, thirteen
days before, had received a blow which had
made a profound deprefSon on the pofterior
and near the fuperior part of the right parietal
bone, and very near its junction with the occi-
put. It was attended with no wound, but a
imail perforation fcarce fufheient to admit the
point of a probe.- In fome days fymptoms of
ft deprcirei bone came on. 1 found the man
with
r 177 1
with a flow, weak, but regular pulfe. He
was quite comatofe, and could not articulate.
Upon paffing a fine probe through the little
perforation, 1 found the bone had been crafhed
into fmall bits, and was for fome time at a lofs
what to do, on account of the fituation of the
man and the nature of the injury. I de-
clared to his friends that I ftrongly apprehended
the cafe mortal, but would do what depended
on me if they confented. Upon removing the
fcalp, the bone had been fo far beat in that I
concluded I mould find the membranes cut
through. Could I raife any part of the fracture
I faw to a certainty I could remove the whole,
the injury being confined to the circumfcribed
part. With my forceps, probe, and elevator,
fucceeding each other, I was fortunate enough
to remove one fplint. This afforded me more
room ; and fo, by degrees, and with fome pa-
tience, I cleared the dura mater of all incum-
brance, without recurring to the trephine. It
was greatly deprelTed, and though wounded in
two or three places by the point of the bone,
yet no where cut through, but difcoloured and
blackifh. He opened his eyes after this, and
appeared lighter. Antifeptics and the bark
were not omitted, as well as a generous diet ;
Vol. V. N thai
[ 173 ]
that is to fay, ftrong feafoned broths, fago, eft
gruel with wine, and wine whey, at times. In
fome time the dura marer roie to its natural
height, the difeafed parts floughed off, it
gradually aiTumed its natural colour, and he
recovered*
The next fpecies of injury that requires tre-
panning is, depofits of matter on the mem-
branes of the brain, or on its furface. On
this very obfeure and truly lamentable malady,
my cfteemed friend, Mr. Deafe, of the Royal
College of Surgeons, has thrown much light, in
a late ingenious treatife *. It is beyond doubt
a complaint of a moft hrious and alarming na-
ture. In the co-urfe of many years pra&ice, and
painful obfervations, I cannot give m)ftlf cre-
dit for a tingle cure I ever performed in this way,
when the fymptoms of depofit were formed;
and whether the patient was or was not trepan-
ned, the ftsene clofed with death ! However,
this ill fuccefs I complain of fnould not deter
others; for in this cafe the operation is indif-
penfible; inftances of recovery from it can be
adduced; and when a practitioner makes ay
fair prognoftic he cannot be cenfured.
* Obfervations on Wounds of the Head.
This
t *79 ]
.This complaint is moftly confined to wounds
of the fcalp and pericranium^ but particularly
of the latter. The fymptoms of matter form-
ing under the cranium commence generally
about the eighth day, fomeiimes later, but
feldom exceed the fifteenth : thefe are, iicknefs
at itomach, head ach, a fmart fever, and ftrong
fhaking fit; the wound afiumes a pater colour,
the difeha'rge is thin and pale, and the pericra-
nium becomes more and more detached from
the fkull. Thefe are the uncquivoc 1 fign$
that matter is formed on the ceiebmm, or on
its covering ; and in thefe cafes, however de-
plorable the event, there is no reicurcc but in
trepanning. It is a fad: well known to perfons
of exteniive pradice, that thdugh this matter
begins under the immedhte point of percuffion,
yet that it extends much farther. To operate,
then, to any effect, I would recoifimend the ap-
plication of more than one crown of the tre-
phine. For inftance, the firil perforation be-
ing made, I would immediately proceed to a
fecond, including a fegment of the former cir-
cle-, in it, by which means the iilue of ma ier is
inore facilitated, and if it ihoald be found ne-
ielTary to open the dura mater, it will be done
N z with
[ i8o ]
with greater effect by extending the wound
of it.
Concuffions of the brain are generally fup-
pofed to require the trepan. Dionis, an able
writer of the laft century, judges that the lofs
of fenfe and memory, immediately fucceeding
a violent injury, are fufficient motives to pro-
ceed directly to the operation, and he illuftrates
his pofition by a cafe in point*. Mr. Pott,
though he very judicioufly points out what can
be effected by the operation, namely, the railing
of dcprefTed bones, or the iffue of blood or
matter, yet he becomes an advocate for it on
ftupors immediately following a hurt. " For
" though it may be refolved into fymptoms of
cc concuflion," fays he, " yet extravafation
fe may fo fpeedily follow the firft fhock, as to
ei carry all the appearance of the firft, whilft
u the fecond is the real caufe." But to a certain-
ty extravafarions of blood, matter, or water, (for
I have met with them all) do not immediately,
nor for fome days after, produce flupor or in-
fenfibility. Fractures with considerable depref-
fion, extravafations, &c. (how no alarming figns
for many days ; but flupor immediately follow-
•
* Cours d' Operations dc Chirurgic, p. 510.
ing
[ i8f 3
ing a fall or hurt is an unequivocal fign of con-
tujjion, and of concujjion only. Not but that
I have met with three cafes, and each of them
mortal, where the fymptoms of concufTion imme-
diately appeared, though in each the fracture
and deprefflon were evident. But this only
proves that in each the injury was fo great that
the yielding of the fkull was not fufficient to
deftroy the force of motion.
In cafes of death, after injuries of the head,
where concuflion was the caufe, I have invaria-
bly obferved the following appearances : — the
pericranium and fkull were injured; the dura
mater adhered to the latter ; there was rarely any
extravafation of blood, and this but flight, and
out of the reach of any inflrument. In a word,
I could get no information, except that in thofe
who died foon after the accident I have fome-
times thought the brain did nor completely fill
the cavity of the cranium. To this let me add,
that inftances can be adduced where leaps or
falls from an high place5 on hard ground, where
the head has been far removed from the feat of
the injury, have produced all the fymptoms of
concuflion. I well know that many have been
trepanned, and great cures boafted of in thefe dif-
$rders ; but fure I am, that whatever merit they
N 3 might
C i8* 3
rnight juftly claim, by endangering nature's en-
deavours and protracting recovery, they had
none with reipe<9: to the merit of the ca
I divide concuflions of the brain into three
claffes. i. Mortal ones. 2. Where there is re-
covery with infanity. And 3. Where there is
perfect recovery. From what has been Lid it
is evident that I had early made up my mind
with refpecl to trepanning in this com, hint : I
have fmgled out two ftriking cafes in point in
fuppoFt of my opinion.
Cafe XL. A gentl -nan was thrown from his
horfe, and found fp ^chiefs and fenfclefs ; and in
this condition was brought home A phyfioian
was fen t for, who immediately let blood; but
findiwgthe comsftoft indifpofition continue afra£-
turewashupeclcd.and I .va^c lied upon. Thcih-
tegume-nrs were very hin behadbeen clofefhav-
ed, and 1 could not be e:l decided. After r he
moi >r I was convinced there
ne; befides, hisfym >ms-werethe
revei / 6\ thofe >trerk ing .1 fracture. Bleeding,
blifterSj finarpifms, 6rc. fuccenSvely fecceeded
each other; but he gained no ground. He re-
maincd for ten davs af r n the fame fituatidh^
with frequent rr tfkhou eihg ca-
pable or uttering a woui, thoiigl 1 rook
nourifhrnent,
C 1S3 ]
#miri(hment, drink, and whatever was offered
bin). About this time dawns of reafon and
fymptoms of convalefcence appeared, and in a
very fhort time he was reftored to perfect fanity
of mind and body, and lived for many years af-
ter.
Cafe XII. Mr. M. was thrown from his horfej
and pitched on^the crown of his head on a (lone
pavement. He alfo received a confuted wound
from a kick of the horfe on a poiterior part of
the right parle'al bone, which denuded the bone.
He was taken up fenfekfs and fpeechlefs. He
was profulely bled, and fullered other evacua-
tions in the courfe of the two fucceeding divs,
without the fmalleft amendment I was then
fent for ; and from the above recital of the cafe
was faiisfied that there was no fracture. The
pulfe, as in fuch cafes, was flow and full ; he
moaned much, and frequently put his hand to
his head. Experience had taught me that pro-
fufe evacuations anfwer no good purpofe in
thefe maladies, fo I gave him medicines of the
nervous tribe, with a cold infufion of the bark';
and for his diet, veal broth, beef tea, and fome-
times wine whey. In two days after his pulfe
became firmer, but his reftlefnefs and anxiety
iiicreafed towards evening. About one next
N 4 morning
[ 1 84 ]
morning he grew perfectly outrageous, fo as with
difficulty to be kept in his bed, and I was cal-
led up. On reflection, nothing feemed to me fo
proper to calm thefe fymptoms as fedatives. I
fent immediately to the apothecary's, gave him
myfelf a dofe ; and finding him calmer, in half
an hour, I left him, with directions that at what
time foever it returned the dofe mould be re-
peated. At five in the morning the medicine
was again given. He remained compofed,
was much better, and vifibly clear in his intel-
lects. In a word, I left him perfectly reftored the
third day after ; the wound in the head healed
in fome days after, and he recovered*
From the preceding facts and obfervations
the following proportions may be deduced.
i. That many fractures of the fkull do not re-
quire the application of the trephine.
2. That fome apparently flight fractures do
abfolutely require its application ; in fuch cafes
the inner table of the fkull is generally more
hurt than the outer, and bad fymptoms do not
arife till towards the end of a fortnight after the
injury.
3. That fractures with deprefflon require the
application of the trephine, and that from
fuch there have been fome furprifing recoveries.
4. Thaj
r 185 ]
4. That depofits of matter on the mem-
branes or furface of the brain require the tre-
phine, though it feldom proves fuccefsful.
5. That concuflion of the brain, characterifed
by immediate Jl up or and infenfibility, does not re-
quire the trephine, unleis accompanied with
evident depreffion of the fkull or extravafation,
neither of which produce bad fymptoms for
fome days after the accident which has given rife
to them.
XVII. Account of a fijiulous Opening in the Sto-
mach ; by George Burrowes, M. D. M. R. L A.
Vide Tranfaclions of the Royal Info Academy^
Vol IV.
THE perfon whofe cafe is here related and
who had been an inferior officer in
the fervice of the Eafl India Company, re-
ceived, we are told, in a voyage to India,
a wound from a blunt-pointed wooden in-
ftrument in the abdomen, between the cartilage
of the eighth rib, on the right fide, and the um-
bilicus, penetrating the flomach ; much in-
flammation and fever followed the wound, and
continued
continued a very considerable time. When {ho
inflammation fubfided an opening remained,
through which, when the ten: was withdrawn, a
fluid of a -\ hi tifh colour flowed; the fides, in-
stead of clofing, turned in, and no union could,
£>y any means,, be induced. The man was there-
fore advifed to keep the qpedjng con.it mjtly phig-
ed up : this he did far the reti iai his life,
never withdrawing the plug but to gratify cti-
riofity* or to replace it with a new one. The open-
ing was about the third of an inch in diameter,,
The plug he ufed was generally cotton wick
i willed hard.
It was twenty-feven years from the time
he receiveel the injury to that at which
our author firft faw him» This was about
November, 1790, when he was admitted into
the Hoiife of Induftry at Dublin. He had
then attained his fixty- fifth year, and was, to all
appearance, we are told, a healthy man, regu-
lar m his bowels and in all his fractious. He had
been, it feems, extremely drunken and diffi-
pared, and was, even at that time, frequently-
intoxicated ; yet he never complained of anv in-
convenience from it, but returned the next day
to occupation or debauch with vivacity and
nith ftrength. He had procured a livelihood
foif
C i«7 J
for a few years before Dr. Burrowes met with
him by teaching French in Dublin, being toq
old for his former occupation. — To this account
our author adds, that in a voyage fubfequentt o
that in which the patient received the wound,
he was feverely afflicted with fcurvy, in com _
mon w.th feveral others in the fhip, and in
confequence of that difeafe loft all his teeth. A! I
the alveolar piocefles were abfot bed, notwith-
standing which he contrived, it feems, to break
his food, his gums being much hardened, and.
ate with conficierable appetite and a good di-
geftioit .
On removing rhe plug, after he had taken
milk, a part of the milk, we are told, quite pure,
efcaped through the opening; and the patient
obferved that when his fkomach was empty of
meat, and he took the plug out, a whitifh
fluid adhered wit that tailed {.veer. He never
felt any pain in the opening, nor inconvenience
from any particular food.
After paffing rhe winter in the Houfe of Induf-
ry, he went into the country; but returned at the
end of autumn, extremely debilitated, having
buffered much from h 1 dfhip and intemperance.
From this time, it is 6bferved, he .gradually de-
clined, his appetite continuing tolerably good, but
his.
C '88 }
his bowels weak, till he died, which happened
about fix weeks after his return.
On examining the body after death, the wound
was found to penetrate the ftomach in the centre
of the great curvature, and from the adhefions of
the liver, colon and integuments, a very con-
fiderable ftritture was formed, fo as to give the
ftomach the appearance of a double bag, with
the opening in the middle; the duodenum was
enlarged beyond the fize of the colon, and
feemed to have in fome meafure performed the
functions of a fecond ftomach. The colon was
firmly attached to the lower part of the ftomach
by a ligamentous fubftance, that our author
thinks, mud have been formed by the inflam-
mation fubfequent to the wound. All the other
vifcera, he obferves, were found, and per-
fectly natural both in appearance and fitua-
tion.
Dr. Burrowes concludes the hiftory of this ex-
traordinary cafe, with expreiTing his regret at
his having been prevented from rendering it
more fubfervient to medical purpofes by the
man's fuddenly departing from the Houfe of In-
dustry without his knowledge, and returning to
it in fo debilitated a (late; as fuch an opportunity,
his.
C 1S9 ]
he obferves, of expofing aliments to the aclioti
of the fuccus gaftricus alone, of afcertaining the
effects of feveral medicines when confined to the
flomach, and of making experiments on narco-
tics, he can hardly again expect to meet with.
For accounts of fimilar cafes Dr. Burrowes
xefers to Mem. de l' Acad. Royale de Cbirurgie,
Tom. IV. page 124, where, in addition to two
fuch inflances related by Schenkius, (fibs. Med.
X-.ib. in. de Vuln. Ventric. Obs. cxxi.) wc
learn, that M. Foubert preferved, in his inu-
feum, the flomach of a man who died in the
Hotel Dieu at Orleans, which had an opening
externally from a wound, and into which the
perfon, while alive, ufed frequently to inject dif-
ferent alliments, and digefled them as well as
thofe taken by the mouth ; and that Covillard,
in his Obfcrvations Iatro-Chirurgiques (Obs.
xli.) relates the cafe of a foldier who re-
ceived a wound in the upper and lateral part of
the epigaflrium, through which his aliment
irTued. His furgeons by means of tents enabled
him to retain his food, and by degrees he re-
covered his health ; but the wound of the flo-
mach never clofed, and he was conflantly obliged
to make ufe of a filver plug. Covillard
made him take out this plug in the prefence of
feveral
t *9° J
fcveral medical men, and they fa\V about: ft
Ipoonful of an imperfe&lv dfgefted chylous Jub-
ilance iilue from the fiftulou^ opening ; after this
he hvailo \ ed a glafs of wine, which was imme-
diately difcharged through the fame paffnge.
It was obferved that in other refpetts the patient
bad the appearance of a man in perfect health;
CATALOGUE of BOOKS.
1. A Treatife on the Dropfy of the Brain, il-
hiftrated by a Variety of Cafes : to which are ad-
ded Obfervations on the Ufe and Effects of
the Digitalis purpurea in Dropfies. . By
Charles William Qui??, M. D. Fellow of the
King's and Queen's College of Phyficians, Phy-
iician General of his Majeity's Army in Ireland,
and of the Royal Hofpital for Invalids near
Dublin. 8 vo. Murray, London, 1790.
2. A Practical DifTertation on the Medicinal'
EfTe&s of the Bath Waters. By William Fal-
conery
[ '** 3
, M. D. F. R. S. and Phyfician to the h
Hoipital. ^vo. Robin Jons > London, 179 1.
3. Inllitutes of Natural Hiftory ; contain-
ing: the Heads of the Lectures in Natural
Hiftory, delivered by Dr', Walker, in the Uni-
.' Edinburgh. 8 vo. Edinburgh, 1792,
4. A fketch of a Plan to exterminate tfe
cafual Small Pox from Great Britain, and to
introduce general Inoculation; to which is ad-
ded aCorrelpotidence, on the Nature of variolous
Contagion, with Mr. Dawfon, Dr. Aikin, Pro-
feffor Irvine, Dr. Percival, Piofeflbr Wall, Pro-
fcilbr Waterboufe, Mr. Henry, Dr. Clark, Dr.
Odier, Or, James Currie: and on trie beft
means of preventing the Small Pox, and pro-
moting Inoculation, at Geneva; with the Ma-
gi (Iraus of the Republic. By John Haygarth,
M. B. F. R. S. Lond. F. R. S, and R. M. S.
Edinburgh, and of the American Academy of
Ans and Sciences. 2 vuls. 8vo. Job? Jon, Lon-
don, 1792.
5. An Experimental Inquiry into the condim-
ent Principles of the Sulphureous Water at Not-
tington, near Weymouth : together with Obfer-
Vations relative to its application in the Cure of
Difeafes. By Robert Graves, M. D. Swo.
; ^London, J 792.
wbkrvations on die Bark of a particular
Species
[ I92 ]
Species * of Willow, fhowing its fuperiority to
the Peruvian, and its lingular Efficacy in the
Cure of Agues, Intermittent Fevers, Haemor-
hages, etc. illuftrated by Cafes. By Samuel
James, tux gtor\. 2\~o: John/on, London, 1792.
7. Obfervations on Cold Bathing. By Wil-
liam Simp/on, furgeon at Knarefborough. 8vo.
John/on, London, 1792.
8. Effay on the Materia Medica ; in which
Dr. Cullen's Theories are confidered. By James
Moore, furgeon. 8vo. Cadell, London, 1792.
9. Obfervations on the Blindnefs occafioned by
Catara&s ; (bowing the Practicability and Su-
periority of a Mode of Cure without an Opera-
tion. By Henry Barry peacock* 8vo. P ridden,
London, 1792.
10. A Guide for Gentlemen ftudying Me-
dicine at the Univerfity of Edinburgh. By J.
John/on f, Efq. 8vo. Robinjons, London, 1792.
11. An EfTay en Generation. By J. F. Blu-
menbach, M. D. Aulic Counfellor to his Britan-
nic Majefty, and Profeflbr of Phyfic in the Uni-
verfity of Gottingcn ; tranflated from the Ger-
man J. 1 2 mo. Cadell, London, 1792.
* Salix Latifolla Linn.
f Fictitious.
J By Alexander Crichton, M. D«
12. Obfer-
C *93 J
12. Obfervations on the Scurvy; with a Re-
view of the Opinions lately advanced on that
Difeafe, and a new Theory defended, on the
approved Method of Cure, and the Induction of
Pneumatic Chemntry ; being an Attempt to in-
veftigate that Principle in recent vegetable
Matter, which, alone, has been found effectual
in the Treatment of this lingular Difeafe; and
from thence to deduce more certain Means of
Prevention than have been adopted hitherto.
Second Edition. By nomas Trotter, M. D.
Surgeon of his Majefty's Ship the Duke. 8vo.
Longman, London, 1792.
13. Medical Botany; containing Syftematic
and General Defcriptions, with Plates, of all
the Medicinal Plants, indigenous and exotic,
comprehended in the Catalogues of the Materia
Medica, as publifhed by the Royal Colleges
of Phyiicians of London and Edinburgh, ac-
companied with a circumftantial Detail of their
medicinal Effects, and of the Difeafes in which
they have been mod fuccefs fully employed. By
William Woodville, M. D. of the Royal College
of Phyiicians, London. In 3 vols. 4to. Phillips,
London, 1790 — 3.
14. Experiments on Animal Electricity, with
their Application to Phynology ; and fome Pa-
thological and Medical Obfervations. By Enfe-
Vol. V. O bm
[ J94 ]
bius Falli, M. D. Correfponding Member of the
Royal Academy of Sciences of Turin. 8vo.
Johnfon, London, 1793*
15. Experiments and Obfervations relative to
the Influence lately difcovered by M. Galvani,
and commonly called Animal Electricity. By
Richard Fowler. 8vo. Edinburgh, 1793.
16. An Account of the Veterinary College,
from its Inftitution in 1791. 8vo. Phillips, Lon-
don, 1793.
17. A Treatife on the Structure, Economy,
and Difeafes of the Liver ; together with an In-
quiry into the Properties and component Parts of
the Bile and biliary Concretions ; being theSub-
ftance of the Gulftonian Lectures read at the Col-
lege of Phyilcians, in the Year 1 792. By William
Saunders, M. D. Fellow of the College of Phy-
ilcians, of the Royal Societies cf London and
Edinburgh, and Senior Phyfician to Guy's Hof-
pital. 8vo. Robinfons, London, 1793.
18. Experiments and Obfervations on the
Anguftura Bark. By Auguftus Everard Brande,
Apothecary to the Queen. The fecond Edition
enlarged. 8 vo. Payne, London, 1793.
19. Of the Hot- Waters near Briftol. By
John Nott, M. D. 8vo. Briftol, 1793.
20. Obfervations on the Nature and Cure of
Calculus, Sea-Scurvy, Confumption, Catarrh,
and
C m 3
and Fever ; together with Conjectures upon fe-
veral other Subjects of Phyfiology and Patho-
logy. By Thoius Beddoes, M. D. 8vo. Murray,
London, 1793.
21. A letter to Erafmus Darzvin, M. D. on a
new Method of treating Pulmonary Confump-
tion, and fome other Difeafes hitherto found in-
curable. By Thomas Beddoes, M. D. 8vo. Mur-
ray, London, 1793.
22. Practice of Phyfic ; wherein is attempted
a concife Expofkion of the Characters, Symp-
toms, Caufes of Difeafes, and Method of Cure;
with Formula?, in which fuch new Articles are
introduced as feem from Trial to be valua-
ble Additions to the Materia Medica : with a
copious Index of Difeafes and Medicines; the
whole intended for the Affiilance of the young
Practitioner. By Richard Temple, M. D. Licen-
tiate of the Royal College of Phyficians, London.
8vo. Jobnfon, London, 1792.
23. New Experiments with Mercury on the
Small-Pox, by which is demonftrated its fpecific
Virtue in that Difeafe. By F. Van JVoenfel, M. D.
translated from the French, by William Fowie,
M. D. Svo.Crowder, London, 1793.
24. Obfervations on the Hiftory and Cure of
the Afthma; in which the Propriety of ufmg the
O 2 Cold
C 196 3
Cold Bath in that Diforder is fully confiderecFr
By Michael Ryan, M. D. and Member of the
Royal Antiquarian Society of Edinburgh. 8vo*
Robinfons, London., 1 793-
25. The Morbid Anatomy of fomc of the
mod important Parts of the Human Body. By
Matthew Baillie, M. D. F. R. S. Fellow of the
Royal College of Phyficians, and Phyfician of St.
George's Hofpital &vo. John/on, London, 1793.
26. The Caufes of the great Number of Deaths
amongft Adults and Children, in putrid,
fcarlet Fevers, and ulcerated fore Throats, ex-
plained; with more fuccefsful Modes of treat-
ing thofc alarming Diforders, as pradtifed at
the St. Mary-le-Bone Infirmary. By William
Rowley, M. D. 8vo Ntwbery, London, 1793.
27. An Appendix to a Treatife on the Hy-
drocele *. By James Earle, Efq. Surgeon Ex-
traordinary to his Majefty's Houfehold, and Se-
nior Surgeon to St. Bartholomew's Hofpital.
8vo. John/on, London, 1793.
28. Practical Obfervations on the Operation
for the Stone, in which an AfTertion of the late
Dr. Auftin is confidered ; with a Preface con-
taining fome Account of Dr. Auftin's Life. By
James Earle, Efq. 8vo. John/on, London, 1793.
* See Volume II. page 208.
29. A
C *97 3
29. A DifTertation on the Structure of the Ob-
ftetric Forceps, pointing out its Defects, and ef-
pecially thofe with the double curved Blades ; at
the fame Time, mewing particularly the fafe Ap-
plication of thofe with fingle curved Blades, as
geometrically proportioned and conftructed :
and likewife, mewing the Neceflity and good
Effects of feveral new Forms of the fingle cur-
ved Blade, as the narrow, fanged, and refluted, in
certain Cafes of retarded Labours; together with
Cautions, Remarks, and Reflections on the Con-
duct and Management of Labours in general.
By R. Rawlins^ Surgeon, Oxford. 8vo. White,
London, 1793.
30. Practical EfTays on the Management of
Pregnancy and Labour, and on the inflamma-
tory and febrile Difeafes of lying-in Women.
By John Clarke > M. D. Phyfician to the Lying-
in Hofpital in Store-ftreet, and to the Afylum for
female Orphans ; and Teacher of Midwifery in
London, 8vo. John/on, London, 1793.
31. An EfTay towards a Definition of animal
Vitality ; read at the Theatre, Guy's Hofpital,
January 26, 1793 ; in which feveral of the Opi-
nions of the celebrated John Hunter are. exa-
mined and controverted. By John Thelwall,
O 3 Member
[ i98 ]
Member of the Phyfical Society, 8cc. 4to. Ro-
binfons, London, 1793.
32. Facts * tending to fhow the Connection
of the Stomach with Life, Difeafe, and Reco-
very. ' 8 vo. Murray, London, 1793.
33. Friendly Cautions to the Heads of Families,
and others, neceffary to be obfervcd, in order to
preferve Health and Long life. Containing, alfo,
ample Directions to Nurfes who attend the
Sick, Women in Child-bed, &c. By Robert
Wallace Johnfon> M. D. at Brentford. 12010.
Robinfons, London, 1793.
34. A Pofologic Companion to the London
Pharmacopoeia.- i2mo. John/on, London, 1793.
35. Advice to Parents on the Management of
their Children in the Small-Pox, and during
Inoculation : with a few Cafes confirming: the
o
Author's Opinion. To which are added, fome
general Obfervations on the Ufe of Tea, and
the prefent Regimen of Diet among the higher
Ranks of Society. 8vo. Rob in f cm 9 London,
1793-
36. Lectures on the Elements of Farriery, on
the Art of Horfe-fhoeing, and on the Difeafes of
the Foot. Defigned qhiefly for the ufe of the
* By Charles Wtbjler, M. D.
Pupils
C J99 J
Pupils of the Veterinary College, London. By
Charles Vial de Sahib el, Yrofeffov of Veterinary Me-
dicine in the College. 4to. Bell, London, 1793.
37. The Language of Botany ; being a Dic-
tionary of the Terms made ufe of in that Science,
principally by Linnaeus : with familiar Explana-
tions, and an Attempt to eftablifli fignificant
Englifh Terms. The whole interfperfed with
Critical Remarks. By Thomas Martyn, B. D.
F. R. S. ProfeiTor of Botany in the Univerfity 0f
Cambridge. 8 vo, fphite, London, 1793.
38. Indigenous Botany; or Habitations of
EngliQi Plants : containing the Refult of feveral
Botanical Excurfions, chiefly in Kent, Middlefex,
and the adjacent Counties, in 1790, 1 79 r, and
1792. By Colin Milne, L. L. D. Author of a
Botanical Dictionary, and Inftitutes of Botany ;
2nd Alexander Gordon, Reader on Botany in
London. Vol. I. 8vo. Lowndes, London, 1793.
39. Popular Obfervations on apparent Death
from Drowning, Suffocation, &c. with an Ac-
count of the Means to be employed for Reco-
very. Drawn up at the Defire of the North-
amptonfhire Prefervative Society. By James
Curry, M. D. Phyfician to the Northampton
Hofpital. 8vo. Law, London, 1793.
40. Obfervations on the ErTe&s of Buxton
O 4 Waters.
[ 200 ]
Waters. By Jofeph Denman, M. D. 8vo. John-
Jon, London, 1793.
41. A plan for preventing the fatal Effects
from the Bite of a Mad-Dog, with Cafes. By
Jejfe Foot, Surgeon. 8vo. Becket, London*
I793-
42. Obfervations on the Difeafe of the Hip-
Joint; to which are added, fome Remarks on
White Swellings of the Knee, the Caries of the
Joint of the Wrift, and other fimilar Com-
plaints ; the whole illuiirated by Cafes, and En-
gravings taken from the difeafed Parts. By Ed-
ward Ford, F. S. A. Surgeon to the Weftmin-
fter General Difpenfary. 8vo. Dilly, London,
2793-
43. Oratio Anniverfaria in Theatro Collegii
Regalis Medicorum Londinenfium, ex Harveii
Inllituto habita, A. D. 1790, Feito divi
Luca?, a Joanne AJIj, M. D. Coll. Reg. Med.
Lond. Soc. R. et. S. A. Socio. 4to. Londini,
1790.
44. Floras Cantabrigienfi Supplcmentum ter-
tium. Audtore Ruhardo Relhan, A. M. Col-
legii Regalis Capellano, Villas de Hemingby in
Agro Lincolnienfi Reclore, Regias Societatis
Londinenfis et Societatis Linneanas Socio. 8vo,
Cantabrigias, 1793.
45- Mf-
[ *#« ]
45* DifTertatio Inauguralis de Afcke. Auc-
tore Joanne Barry, Hiberno. 8vo. Edinburgi,
1792.
46. DifTertatio Inauguralis de Gonorrhoea
virulenta. Au£tore Georgio J. Binham, Jamai-
cenfi. 8vo. Edin. 1792.
47. DifTertatio Inauguralis de Apoplexia.
Audtore Joanne Bolton, A.B. Hiberno. 8vo.
Edin. 1792.
48. DifTertatio Inauguralis de Scrophula.
Au&ore Gulielmo Sullen, Hiberno. 8vo. Edin.
1792.
49. DifTertatio Inauguralis de Vita Submer-
forum refufcitanda. Auclore Jacobo David/on,
Scoto. 8vo. Edin. 1792.
50. DifTertatio Inauguralis de Febre flava In-
dorum Occidentalium. Au&ore Joanne EJien9
Bermudenfi. 8vo. Edin. 1792.
51. DifTertatio Inauguralis de Scorbuto.
Audtore Georgio Goodman, Anglo. 8vo. Edin.
1792.
52. DifTertatio Inauguralis de Dyfpepfia.
Audore Gulielmo Ledger, Hiberno. 8vo. Edin.
1792.
53. DifTertatio Inauguralis de Dyfenteria.
Au&ore Gulielmo S. Lewis, VirginienTe. 8vo.
Edin. 1792.
54- Dif.
[ 202 3
54« DifTertatio Inauguralis de Rhcumatifmo
acuto. Au&ore Jacobo Drew MCaw, Virgi-
nienfe. Hvo. Edin. 1792.
5 j. DifTertatio Inauguralis de Afcite Abdo-
minali. Au&ore Jofepbo Miller > Hiberno. Svo.
Edin. 1792.
56. DiiTerratio Inauguralis de Apoplexia.
Au&c e Phtlippo Syng Pbyfick, Philadelphienft.
8vo. Edin. 1792.
57. DifTertatio Inauguralis de Dyfenteria.
Auctore Joanne Sten:^iy Jamaicenfi. 8vo. Edin.
1792.
58. DirTertatio Inauguralis de I&ero. Auc-
tore Gulielmo Vavafour, Anglo. 8vo. Edin,
1792.
59. DifTertatio Inauguralis de Amenorrhea.
Audtore Joanne IFeems, Marylandienfi. 8vo.
Edin. 1792.
60. DifTertatio Inauguralis de Dyfpepfia.
Au&ore Alexandr. Philip. PVilfon, Scoto. Svo.
Edin. 1792.
61. DifTertatio Inauguralis de Variolis. Auo
tore Samuele Wilfon^ Virginienfe. 8vo. Edin,
1792.
62. Bibliothecse Collegii Regii Medicorum
Edinburgenlis Catalogus, fecundum AucTorum
Nomina difpofitus. Svo. Edin. 1793.
63. >
[ 2°3 ]
63. Joa nnis Andrea Murray, Equitls Old.
Suecic. de Wafa, Prof. Gottingens. &c. Enu-
meratio Librorum picecipuorum mcclici Argu-
menti ;• recudi curavit et permulra Additamenta
adjecit Frid, Gull, vom Halem. 8vo. Auricb.
1792.
64. Joannis Andrea Murray, Equicis Ord. Jv.
de Wafa, ProfefT. Medic, et Botan. ord. in
Acad. R. Gotting. &c. Apparatus Medicaminum
tam fimplicium quam praeparatorum et com-
pofitorum in Praxeos Adjumentum conlideratus.
Volumen fextum, pod Mortem Aucloris
edidit Lud. Cbrifiopb. Allbof, M. D, 8vo.
Gottingae,. 1792.
65. DifTertatio Inauguralis de Cortice Cari-
boo Cortici peruviano fubftituendo. Audtore
Fried. Wilbelm. Aufmkolk. 8vo. Gottingas, 1792.
66. DifTertatio Medica Inauguralis qua in?
quintur in Theoriam Weikhardianam de Hy-
drope Cerebri, nee non in verarn ejufdem Morbi
Indolem. Audtore Job Georg. Lodemann. 8vo.
Gottinga?, 1792.
67. DiiTertatio Inauguralis fiftens veram in
Medicamentorum Vires inquirendi Rationem.
Auctore Job. Dan. Droop. 8vo. Gotting. 1792.
68. DifTertatio Inauguralis de Afphyxia Neo-
3. natorum*
C 2°4 ]
natorum. Auctore Job ami. Ulrich von Wald-
birch. 8vo. Gottingse, 1792.
69. DifTertatio Inauguralis de Audita difticili.
Au&ore Job. Fried. Kritter, Gottingenfi. 8vo.
Gottingse, 1792.
70. DifTertatio Inauguralis fiftens Infardtus
DiiFerentias. Audtore Chrijl. Jac. Friedr. Riiji.
8vo, Gottinga?, 1792.
71 Obfervationes de Virtute Corticis Geoffrseze
Surinamenfis contra Tseniam. Au&ore Augufto
Jacobo Schwartze, Hanovienfe. 4to. Gottingas,
1792.
72. Georg. Chrijl. Bonbard, Haffia-Darmfta-
dienfis, DifT. Inaug. de ufu Lienis veriTimilli-
mo. 4to. Jena, 1792.
73. DifTert. med. Inaug. de Suicidio in Foro
medico non femper culpofo. Auclore Job.
Eberbard Gagel. 4to. Jena, 1792.
74. DifTertatio Inauguralis medica de Rebus
Pathematum in Specie Gaudii in Corpus hu-
manum Efficaciam moderantibus. Auclore J.
G. Kleefeld, Gedanenfi. 4to. Jena, 1792.
75. DifTertatio Inauguralis de ufu Glandular
Thymi verifitnillimo. Auclore Gottl. Karch.
4to. Jena, 1792.
76. DifTertatio Inauguralis de Operationibus
atque Viis Medicamentorum externorum States
1 Syftc-
t 205 .3
Syftematis lymphatici fubmoventium. Au&orc
Johanne Georgio John. 4to. Jena, 1792.
77. DiiTertatio Inauguralis de Hydrometra.
Auctore Johanne Petro Kommer. 4to. Jena, 1792.
78. DiiTertatio Inauguralis de Annis Climac-
tericis. Au&ore Fhilippo Daniele Benjam. Seifert.
4to. Jena, 1792.
79. DirTert. Inaug. Anatomico-Phyfiologica
qua demonftratur Cor Nervis carere : addita Dif-
quifitione de Vi Nervorum Arterias cingentium.
Auclore J. B. J. Be hr ends, Moeno-Francofur-
tano. 4to. Moguntiae, 1792. c. tabula xn.
80. DiiTertatio Inauguralis medica de Frac-
turis Offium Pelvis. Au&ore C. C. Creve, Con-
fluo. 4to. Moguntia? 1792.
81. DilTertationes medico in Univerfitate
Vindobonenfi habitat ad Morbos chrcnicos per-
tinentes et ex Max. StoHii Pradedtionibus potifli-
mum confcriptse. Edidit et prasfatus eft Jofe-
phus Eyerel. Volumen quartum et ultimum.
8vo. Viennse, 1792.
82. Jofephi Eyerel Commentaria in Maxi-
miliani Stollii Aphorifmos de cognofcendis et
curandis Febribus. Tomus quintus. 8vo. Vi-
enna?, 1792.
8$. Apparatus Medicaminum ad ufum No-
focomii Ticinenlis* 8vo. Pavia, 1790.
84. Baf-
C "6 ]
84. Baffinni Carminati, Hygiene Therap.
gencr, Mat. Med. et Chirurg. ac Pharmacia^ in
Ticin. Gymnaf. reg. ProfeiToris, Nofocomii
Med. primar. &c. Hygiene Therapeutice, et
Materia Medica. Vol.1. 8vo. Pavia, 1791.
$c. Job. Diet. Eggert Commentatio de Vir-
tute anthelmintica GeorTnese Surinamenfis ad-
iedis Obfetvationibus recentioribus. 8vo. Mar-
burg, 1 79 1
86. Anton. L. B. de Stbrck Praecepta me-
dico-praclica in ufum Chirurgorum caflrenfium
et ruralium Ditionum Auftriacarum, e Lingua
Germanica in Latinam verfa per J. M. Schofu-
lan, Facultatis medicae Vindobonenfis p. t.
Decannm. Editio altera au&a. Tom. II. 8vo.
Vienna?, 1791-
87. Critiees Semiologize medieinalis Rudi-
menta pro Gradu Do&oris exhibet Diderkus
Fridericus Buettner, Medicinae Practicus apud
Palseo-Stretlitienfes. 8vo. Roftochii, 1791.
88. Brafchia? Plants novi Generis Defcrip-
tio, Nomini Majeftatique Pii fexti P. M. di-
cata; Auctore Nicol. MarteM, Med. Doct. et
Botan. Prof. 4to. Roma?, 179 1.
89. ScriptoresNeurologici, five Opera minora
ad Anatomiam, Phyfioiogiam, et Pathologiam
Ner-
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Nervorum fpedlantia. Tom. II. 4to. Lipfise,
1792. c. tabulis seneis.
90. Thefaurus Semiotices pathologies, quem
collegit atque edidit Joannes Chrifi. Traug*
Schlegel, Screniflimi Principis de Schonburg
Confil. Aulic. et Archiater. Vol. II. 8vo. Sten-
dal, 1792.
■91. Chrifi. Georg. Ludov Gottlieb Diujburg%
Schauenburgo-Lipplac. Diflertatio lnauguralis
fiftens Phyfiologiam ct Pathologiam Uteri. 4to.
Jena, 1792.
92. Epiftola gratulatoria ad Viros illuftres et
cxperientiffimos Dominos Doctores et S. R. L
libera? Reip. Norimbergenfis Phyficos ordina-
rios, nee non inclyti Collegii medici hac in
Urbe CC. Annos feliciter florentis, hodieque
Szecularia facra folenni Aclu celebrantis, Affef-
fores fpedtatiflimos, qua animum fuum hoc felto
Die exultantem, devota Mente, fummoque Ob-
fervantiae Cultu, teflari, fimulque Narrationem
fuccinclam de Vita et Meritis Joach. Camerarii,
Condkoris hujufce celeberrimi Collegii adnec*
tere, conatur Auftor Paulus Sigifmundus Ca~
rolus Preuy Med. Stud. 4to. Altdorfii, 1792,
93. Johann. Kdmpf, M. D. Enchiridium me-
dicum paffim emendatum et auclum; denuo
edidit
[ 2°S ]
edidit D. C. 77j. Kortum, Med. Stollberga-Jt?-
liacenfis. 8vo. Francofurti ad Moenum, 1792.
94. Pharmacopoeia in Ufum Oflicinarum Rei-
publicse Bremenfis confcripta. 8vo. Bremen.
1792.
95. Francijci de Paula Scbrank, Theologian
et Philofophias Docftoris, Sereniflimo ac poten-
timmo Electori Palatino-Bavaro a Confiliis Eo
clefiafticis, in Univerfitate Ingolftadienfi Profef-
ibris, Primitive Florae Salifburgenfis ; cum Dif-
fertatione previa de Difcrimine Plantarum ab
Animalibus. 8vo. Francofurti ad Moenum,
1792.
96. Difpenfatorium Lippiacum Genio mo-
derno accomodatum ; Auctoritate Collegii
medici redegit Joannes Cbrtftianus Friedericus
Scberf, M. et Ch. D. S. Princip. Lipp. Aulae
Confil. et Medicus, Collegii Med. Sodalis, &c.
Pars prima. 8vo. Lemgo, 1792.
97. Hiftoria Epidemic varioloid Erlangenfis
Anni 1790; Audore D. Joann. Maximil. I Hint a*
8vo. Erlangen, 1792.
98. Exercitationes Academics Argument!
aut anatomici aut phyfiologici, quas ex DifTer-
tationum Regiomontarum Penu in Fafciculum
col legit Job. Dan. Metzger, 8vo. Regiomonti,
1792.
99-7-
C 209 ]
99. Joannis Chrijiiani Reil, Med. et Chirurg.
D. Prof. Therap. p. o. Dire&oris Scholas cli-
nicse, Civit. Halens. Phylic. Memorabilium
Clinicorum medico-pra&icorum3Vol.II. Fafcic.
II. 8vo. Hate, 1792.
100. Seb. Joann. Lud. Dovering, Commentatio
mcdica de Vomit u. 8vo. Marburg, 1792.
ro 1. De Ele&rici Ignis Natura DifTertatio ab
Jofepho Gardinio, Philofophias et Med. Doct.
Domo Alba Pompeia reg. Scient. et Literar.
Acad. Mantuanse exhibita 1788 ab eademque
probata. 4to. Mantua, 1792.
102. DifTertatio Phyfiologica Inauguralis de
Structura et Ufu Vaforum Abforbentium. Auc-
tore Edvardo Holme y Anglo : e Soc. Med. Edin.
Soc. Litt. et Philof. Mancunienf. Litterarum
Commercio Conjunclio. 4to. Lugduni Bata-
vorum, 1793.
103. Differtatio Inauguralis de Signis Mor-
borum qua? ex Oculorum Habitu petuntur.
Auctore Lebr. Chrifi. Fabricio, Magdeburg. 8vo.
Halse, 1793.
104. Differtatio Inauguralis de Irritabilitatis
Notione, Natura, et Morbis. Au&ore Lud. Gau-
tier^ Vratislav. 8vo. Halse, 1793.
105. De Baryte muriato Specimen fecun-
dum, quo medica hujus Salis Hiiioria proponi-
Vol. V, P tUT.
[ *» ]
tur. Auttorc Job. Aug. Schmidt, Med. BaccaL
8vo. Lipfis, 1793.
106. DilTertatio Inanguralis de Febre Scar-
latina. Auctore Eujlachio a Khittel. 8vo.
Hals, 179;.
107. DilTertatio Inauguralis dc Febris ner-
vofs lents Pathologia. Audtorc Paul. Sigifm.
Brofg: 8vo. Hals, 1793.
108. DifTertatio Inauguralis Meletamata cri-
tica in Theoriam illuftris Reillii de Morbis Ve-
nereis fiilens. Auclore Job. Aug. Chemnitz;'
8vo. Hake, 1793.
109. DilTertatio Inauguralis de Profopalgia.
Auctore Salomon. Simon. 8vo. Hals, 1793.
no. DifTertatio Inauguralis qua Qusftiones
qusdam de Suppurationis Indole ventilantur.
Auftore Job. Ban. Arnold. 8vo. Hals, 1793.
in. DilTertatio Medica de Cortice Anguf-
turs quam Prsfide Carol. Petr. Thunberg, Eq.
Aur. Reg. Ord. de Wafa, Med. Docl. Prof.
Med. et Botan. &c. pro Gradu Docloris pub-
lice ventilandam fiftit Carolus F^. Blumenberg,
Stip. NelTel. Di'ekirlus. 4to. Upialis, 1793.
112. Piojet cie Reforme fur TFxercife de la
Mcdecine en France; par M. Ant. Petit, Doc-
teur Regenr de la F. cuke de IVLdecn. de Paris,
de TAcademie dts Sciences, anci.n ProfelT ur
d'A-.a-
C »« 3
d'Anatomie et de Chirurgie au Jardin du Roi.
8vo. Paris, 1790.
113. Phytozoologie pbilofophique, dans
laquelle on demontre comment lc Nombre des
Genres et des Efpeces, concernant les Animaux
et les Vegetaux, a ete limite et fixe par la Na-
ture ; avec les Mo\ ens de donner THiftoire la
plus compiette et la plus parfaite de ces Corps
organifes difTerens felon la Decouverte du Syf-
teme Naturel : par Noel Jofeph de Necker, Bo»
tanifte de S. A. S. E. Bavaro-palatine ; Hifto-
riographe du Palatinat du Rhin et des Duches
de Berg et Juliers ; Membrc de 1' Academic des
Sciences de Manheim, et AfTocie de diverfes
Academies des Sciences de l'Europe. 8vo.
Neuwied fur le Rhin, 1790.
114. L'Horame Phyfique et Moral, ou Re-
cherches fur les Moyens de rendre I'Homme
plus fage, et de le garantir des diverfes Mala-
dies qui l'affligent dans fes difTerens ages ; par
M. Ambr. Ganne, Dodleur en Philofophie, an-
cien Chirurgien-aide-Major des Hopitaux de la
Marine et des Caribiniers. 8vo. Strasbourg,
1791.
115. Traite de la Gonorrhee, et des Mala-
dies des Voies Urinaires qui en font la fuite ;
dans lequel on indique des nouveiles Bougies
P 2 medica-
[ *" ]
medicamenteufes pour les gucrir. Par Fr. Tey-
taud, Chirurgien a Paris, et Chirurgien-Major
de la Garde Nationale. 121110. Paris, 1 791.
116. Cours Complet ou Traite des Fievres.
Par M. Grimaud, ProfeiTeur dans lTJniverfite
de Montpellier. Tom. I. Svo. Montpellier,
1791.
117. Memoire de Medecine pratique fur les
Efforts, comme Principes de plufieurs Mala-
dies, tant aigiies que chroniques. Par M.
Balme, Medecin au Puy. i2mo. Paris, .1791.
118. Hiftoire des Champignons de la France,
ou Traite elementaire, renfermantdans un Ordre
methodique les Defcriptions et les Figures des
Champignons qui croifTent naturellement en
France. Par M. Bulliard. Tome Premier, Fol.
Paris, 1 79 1.
119. Obfervations de Phyfique et de Mede-
cine, faites en differens Lieux de 1'Efpagne ; on
y a joint des Confiderations fur la Lepre, la
petite Verole, et la Maladie venerienne. Par
M. Thiery, Docteur-Regent de la Faculte de
Medecine de Paris, Medecin Confultant du
Roi, 2 tomes. Svo. Paris, 1792.
120. Acles de la Societe d'Hiftoire Naturelle
de Paris. Tome premier. Premiere Partie.
Folio. Paris, 1792. With 13 Plates.
121. Me-
[ 213 ]
I2i. Memoircs fur les grandes Gelees et leurs
EfTets; ou Ton effaie de determiner ce qu'il
faut croire de leurs Retours period iques, et de
la Gradation en plus ou moins du Froid de
notre Globe. Par M. l'Abbe Mann, Chanoine
de l'Eglife de N. D. a Courtray; Membre de
la Commiffion Royale des Etudes : Membre et
Secretaire perpetuel de l'Academie Imperiale
et Royale des Sciences et Belles Lettres de
Bruxelles ; Membre de la Societe Royale de
Londres, de l'Academie Electorate Palatine
de Manheim, des Societes de Milan, Liege,
Rotterdam, Zelande, &c. 8vo. Gand, 1792.
122. Verhandelingen uitgegeeven door de
Maatfchappy ter Bevordering van den Land-
bouw te Amilerdam. Negende Deel, /. e*
Eflays publifhed by the Society for the Im-
provement of Agriculture at Amflerdam. Vo-
lume the ninth *. 8vo. Amflerdam, 1793.
* The volume here announced, coniifts of a {ingle Ef-
fay, the author of which received the gold medal offered
by the Society, in 1788, for the beft treatife on the fubjecl.
It is entitled " Verhandeling over het Verloffen der Koei-
** jen; door Johan Guniher Eberhard, Med. Doctor en
" Vroedmeefter te Zeift ; met Plaaten." i.e. " A Treatife
*\ on the Parturition of Cows; by John Guniher Eberhard,
«■ M. D. and Man Midwife at Zeift- with 12 Plates."
P 3 123. Bey-
C »H ]
123. Beytrag zur Gefchichte epidemifchcr
Gallen Fieber. u e. Materials for a Hiftory of
an Epidemic Bilious Fever. By Charles Chrift.
Eckner, M. D. Phyfician to the Garrifon at
Schwarzbourg-Rudolftadt, and Member of
the Imperial Academy of Nat. Curiof. 4to.
Leipfic, 1790.
124. Verfuch einer Befchreibung der haupt-
faechlichen in Reval herfchenden krankheiten.
u e. EfTay towards a Defcription of the princi-
pal Difeafts that prevail at Reval. By Her-
mann Blubm, M. D. 8vo. Marbourg, 1790.
125. Ueber die Vortheile die dem Staat aus
einer Schule der Gerichtlichen Arzneywiflenf-
chafFt zufliefTen. /'. e. On the Advantages
which a State derives from a School of Medi-
cal Jurifprudence. By F. G. Wezeler, Doctor
of Phyfic and Surgery, Profeffor of Medical
Jurisprudence and of Midwifery in the Univer-
sity of Bonn. 8vo. Bonn, 1790.
126. Von den Vortheilen der Krankenhaufen
fur den Staat. i. e. Of the Advantages of Hof-
pitals to the State. By Adalbert Frederick Mar*
cus, firft Phyfician of the General Hofpital at
Bamberg. 8vo. Bamberg, 1790.
127. Ueber die Cretinen, eine befondere
Menfchenabart in den Alpen. u e. On the
Cretins,
C «5 J
Cretins, a particular degenerate Race of Men in
the Alps. By J. F. Ackermann. 8vo. Gotha,
1790, with Copper Plates.
128. Verfuch die Metamorphofe der Pflan-
aen zu erklaren. i.e. An Attempt to explain
the Metamorphofes of Plants. By J. IV. von
Goethe, Privy Counfellor to the Duke of Saxe-
Weimar. 8vo. Gotha, 1790.
129. Ghemifche Unterfuchung der Mineral-
quellen zu Carlfbad. i. e. Chemical Exami-
nation of the Mineral Springs at Carlfuad. By
Martin Henry Kiaprotb. 8vo. Berlin, 1790.
130. Bevtragen zur gericiitlichen Arzneyge-
lahrheit und zur medicinifchen Polizey. i. e.
Collections relative to medical Jurifprudence
and Police. By William Henry Ssbaftian Bu~
cholz, Counfellor of the Mines, and Phyfician
to the Duke of Saxe-Weimar, 3 vol. Zvo.
Weimar, 1782-90
131. Abhandlung von der Umbeugung der
Gebahnnurter. i. e. A Treatife on the retro-
verted Uterus. By John Melitcb, M. D. and
Practitioner of Midwifery at Prague. 8vo.
Prague, 1790.
1 32. Lehrfatze des Chirurgifchen Verbandes.
:. e. Principles of Surgical Bandages. By
Francis Jofepb Hofers, public Teacher of Ana-
P 4 tomy.
[ "6 j
tomy. 8vo. Erlangen, 1790. Part. I. with
fix Copperplates.
133. Neues Archiv der Praktifchen Arzney-
kunft, fur Aerzte, Wundarzte, und Apothe-
ker, von verfchiedern VerfavTern. i. e. New
Archives of the Practice of Phyiic, for Phy-
ficians, Surgeons, and Apothecaries, from dif-
ferent Authors. By Profeflbr Meckel, of Halle.
8vo. Leipfic, 1790.
134. Archiv fur die Gefchichte der Arzney-
kunde in ihrem ganzen Umfange. u e. Ar-
chives for the Hiftory of Phyfic in all its
Branches. By P. L. Wittwer, M, D. Vol. I.
Parti. 8vo. Nurnberg, 1790.
135. Ueber die Durchkreuzung der Sehener-
ven. i.e. On the DecufTation of the Optic
Nerves. By Philip Michaelis ; with fome Ob-
servations by S. T. Soemmering, M. D. &c. 8vo.
Halle, 1790.
136. Medicinifche Skizzen. i.e. Medical
Sketches. By J. C. K. Ackermann, Phyfician
at Zeiz. Parti. 8vo. Leipfic, 1790.
137. Materia Medica ; oder Abhandlung
von den auferlefenen Arzneymitteln, nebft
derfelben Urfprung, Gute, Beitandthe'Je, MafTe
und Art zu wirken, nebft Vorfchrifton, wic
diefelben aus der Apotheke zu verordnen. i. e.
Materia
[ «7 ]
Materia Medica; or a Treatife on the mod ap-
proved Remedies, their Origin, Virtues, con-
ftituent Parts, Dofe and Mode of operating,
together with Prefcriptions, how to order them
from the Apothecary. By John Lewis Lebe-
recht Loefeke, M. D. The fixth Edition, cor-
rected and enriched with the lateft Difcoveries,
by John Frederick Gmelin, M. D. 8vo. Berlin,
1790.
i$8. Tabellarifche Verzcichnifs der einfa-
chen ArzneymitteldesGewachs Reiches; nebft
jedes Gewachs officineller fowohl als fyftematif-
cher Benennung, Vaterlande, Sammlungfzeit,
Eigenfchaften, Beftandtheilen, arzneylichcn
Kraften, Anwendung, &c. in alphabetifcher
Ordnung. 1. e. Tabular Catalogue of fimple
Remedies of the vegetable Kingdom; with the
officinal and fyltematic Name of each Plant, its
Place of Growth, Seafon for gathering it, its
Qualities, conftituent Parts, medicinal Virtues,
Ufe, &x. the whole arranged in alphabetical
Order. By William Gefenius, M.D. Phyfician
at Nordhaufen. Folio. Stendal, 1790.
139. Abhandlung uber die Wirkungen der
Starkften und reinften Pflanzenfaure als aufler-
liches Heilmittel. 1; e. Treatife on the Effects
of
C «« ]
of the ftrongeft and pureft vegetable Acid as
an external Remedy. 8vo. Leipfic, 1791.
140. Beobachtungcn ueber die Kratze ge-
fammlet in dern Arbeitlhaufe zu Prag. i.e.
Obfervations on the Itch, colle&ed in the
Workhoufe at Prague. By E. F. Guldener von
Lobes, M.D. 8vo. Prague, 1791.
141. Von der Caftration. i.e. Of Caftration.
By Francis L. Marfchal, Surgeon at Salzburg.
8vo. S lzburg, 1 791,
142. Von der Gcduld, befonders des Arztes
aai Kiankenbette; ein Aufsatz, vcranlailt durch
die funfzigjahrige Jubelfeyer eines verdienten
Arz:es. u e. Of Patience, particularly that of
the Phyfician at the Bedfide of the Sick ; an Ef-
fay occalioned by the Celeb; ation of a Fifty-
Years Jubilee of a deferving Phyfician. 8vo.
Frankfort on the IVhyne, 17 91.
143. Vermiichre medicinifch-chirurgifchc
Schriften. i. e. Mifcellaneous medico-chirur-
gical Writings. By J. F. Bottcher. 8vo. Ko-
nigfberg, 1791.
144. Verfuch einer aligemeinen Gefchichte
des Keichhuftens. i. e. An EfTay towards a
general Hiftory of the Chin -cough. By F. G.
Dan%y Demonftrator of Anatomy at Giefl'en.
8vo. Marburg, 1791.
2 145. Lahr*
[ 2I9 ]
145- Lchrfatze der medicinlfcher Polizey-
whTenfchaft. i.e. Principles of Medical Po-
lice. By Em. Benj. Gottlieb Hebenftreit, M. D,
Profeflbr of Phyfic at Leipfic. 8vo. Leipfic,
1791.
146. Annalen des KUn'fchen Inftituts zu Ber-
lin, i.e. Annals of the Clinical Inftitution at
Berlin. By J. F. Ftize, M. D. 8vo. Berlin,
1791.
147. Handbuch ueberdie Venevifchen Krank-
heit. i. e. A Manual on the Venereal Difeafe.
By J. F. Prize, lM. D. 8vo. Beilin, 1791.
148. Neue Chemifche Nomenkla ur fur die
Deutfche Sprache. /. e. A New Chemical No-
menclature for the German Language. By
Chrijlopher Girtainer, M, D. &c. 8vo. Berlin,
1791.
149. Onomatologia Chvn^icn-pradtica; oder
vollftandig praktifcher Handbuch der Chemie
in alphabetifcher Ordnung. i.e. A complete
practical M nual of Chemiftry in alphabetical
Order. By H. W. Rels : with a Preface by J.
Fr. Gmelin. 8vo. Ulm. 179 1.
150. Befchreibung des Fachiager Mineral-
Waffers, und feiner heilfamen Wirkungen. i. e.
A Defcription of the Mineral Water at Fa-
fhingetj
C 22° ]
chinger, and its falutary Effects, By Maurice
Gerhard Tbilenius, M. D. 8vo. Marburg, 1791.
151. Vom Baue dcs Menfchlichen Korpers.
i.e. Of the Structure of the Human Body. By
S. T. Soemmering, M. D. et Prof. &c. ift, 2d,
3d, and 5th Parts. 8vo. Franckfort on the
Mayne, 1791.
152. Ueber der Gebranch und die Krafte der
Sauren Schwererde in verfchieden Krankheiten.
i. e: On the Ufe and Effects of the Muriated
Barytes in different Difeafes. By C. Wilh.
Hufeland, M. D. Phyfician to the Duke of
Saxe-Weimar. 4to. Erfurt, 1792.
153. Ueber die Natur und den Gebrauch der
Birder: i. e. On the Nature and Ufe of Baths.
By Henry Matthias Marcard, Body Phyfician to
the Duke of Holftein-Oldenburg, &c. 8vo.
Hanover, 1793.
154: Delia filutare Ifpirazione Ragiona-
mento filofofico Critico fulla Trasfufione degli
Aliti umani per foccorfo della Salute. 8vo
Nizza, 1788.
155. Dei Segni della Verginita preffo gl
Antic'ni. Lettera di D. G. A. al Sig. A. F. 8vo
Montalbano, 1790.
156. Ammaeftramenti intorno ai Parti pub
blicati d'ordine de Nobili Provveditori alia
Sanita
[ 221 ]
Sanita di Bergamo a Inftruzione delle Comafi
principalmente di Campagna. 8vo. Berga-
mo, 1790.
157. Piano della Scuola Clinica oflia Inftru-
zione per gli Scolari Clinici del Profeffore Cli-
nico Nicolo Olhari, approbata e ftabilita in Ge-
nova dagli Eccellentiflimi ed Illuftriffimi Sig-
nori dodeci Protettori dello Spedale grande
l'Anno 1789. Seigne il Difcorfo dell' inligne
Profeffore Clinico Cullen, fulla Maniera di ftu-
diere la Medicina pratica. 8vo. Genoa, 1790.
158. Saggio di alcune Ricerche fu i Principi
e fulle Virtu della Radice di Calaguala. 8vo.
Pavia, 1 79 1.
The plant which is the fubjecl of this Effay,
was firft mentioned in the London Medical
Journal, Vol. V. p. 423. Its botanical hiftory
has not yet been fatisfa&orily afcertained, but it
is faid to be a fpecies of fern growing in Quito.
For feveral years it has been much employed
in different parts of Italy, particularly in the
Duchy of Mantua, in inflammatory complaints,
in catarrhs, phthifis, and dropfy. The Aca-
demy of Sciences at Mantua, were therefore
induced, in 1790, to make it the fubject of a
prize queflion, the objects of which were to
determine the chemical and medicinal proper-
ties
[ 222 3
tics of this plant. Signor Carminati, Profeflbr
of Phytic at Pavia, made fome inquiries rela-
tive to this fubjeft, the refults of which he has
given to the public in this Efiay, but without
having afpired to the prize. He gives a che-
mical analyfis of the root in queftion, and de-
fcribes its feniible qualities, together with its
effects in different difeafes.
159. Sulla polmonare Tifichezza; DifTerta-
zione epiftolare indirizzata al Nobile Signore
Benigno Cannella celebratiffimo ProfefTore di
Medicina e Chirurgia nella Citta di Riva, da
Luigi Francefco Cajiellam, Medico primario dell*
Archiofpedale di Mantova, e Prof, di Medic.
Prattica. 8vo. Mantua,, 1791.
- 1 60. Lettere Fifico-Mediche del Dottor Fran-
cefco Vacca Berlinghieri, ProfefTore neir Univer-
fita di Pifa. 8vo. Pifa, 1791.
161. La Efplorazione propofta come fonda-
mento dell* Arte Oftetricia da D. Vincenzo Ma-
lacarne, Saluzzefc P. P. d'Iftituzioni Chirur-
giche e d'Oftetricia nell' Univcrfita di Pavia.
8vo. Milan, 1791.
162. Paralleli tra la Pellagra ed alcune Ma-
lattie, che piu le ravlbmigliano, del Dottor
Francefco Fanzago. 8vo. Padua, 1792.
INDEX.
[ *23 3
N D E X.
A.
ABSORBENT Syftem, Work relative to, 20$
Acid, vegetable, Treatife on the Effects of, 217
Ackerman, J. F. Ueber die Cretinen, — 215
, J.C. K. Medicin. Skizzen, 216
iEther, Vitriolic, its Effects in Spafm of the Stomach 68
. in Intermittents, 71, 75, 77
in Epilepfy, — " 78
Almonds, Effects of, . 1 60, 63
Amenorrhoea, DilTertation on, « 202
Amputation, immediate, in compound Fractures, Argu-
ments againir, ■ 52
Amfterdam, Effaysby the Agricultural Society at, 213
Anatomy, morbid, Treatife on, 196
, Treatife on, 220
Aneurifm, popliteal, Cafes of, ■ 3, 11
Anguitura Bark, Works relative to it, — 194, 210
Animation fufpended, Works relative to, 199, 201, 203
Anthelmintics, Works relative to, 204, 206
Apoplexy, Cafe of, in a pregnant Woman, . — 96
— — — , DifTertations on, 201, 203
Arnold, J. D. de Suppuratione, ■ — 210
Afcites, DifTertations on, 201, 203
Afh, Joann. Oratio Harveiana, 200
Aftragalus, Cafe of Fracture of, ■ — 44,
■ Rotation of, ■■ $4
Aufmkolk, F. W» de Cortice Caribso, — 203
B.
Baillie, Dr. M. morbid Anatomy, ■ 196
Balme, M. Mem. de Medecine pratique, — 212
Bandages, furgical, Treatife on, 21c
Bark, Obf. on the Ufe of in Fevers, ■ 234
, Caribaean, DilTertation on, •■ 203
— -, red, Obfervations relative to it, — 156
' See Anguitura.
Barry, Joannes, de Afcite, <* 201
Barytes, muriated, Works relative to, — 209, 220
Bath
[ "4 ]
Bath Waters, Treatlfe on, 190
Baths, Treatifeon, 220
Beddocs, Dr. Tho. on the poifonous Effedls of Digitalis, 17
on Calculus, &c.
on pulmonary Confumptioiij
Behrends, J. B. j. Dilfcrt. de Corde,
Bengal, Obf. made in a Voyage to,
Berlinghieri, F. V. Lettcre Fifico.Med.
Bibliography, Medical, Works relative to,
Binham, Geo. J. de Gonorrhoea, —
Bitter Afli. See Quaflia Polygama.
Bitter, vegetable, remarkable Effects of, 60
— , fuppofcd to poflefs a narcotic Quality, 67
Bitter Wood. See Quaffia Polygama.
Bluhm, H. on the Difeafes of Reval 214.
Blumenbach, J. F. his Obf. on the pigmentum of the Eye
referred to, ■ 160
. Eflay on Generation, — 192
Blumenberg, C. F. de Cort. Anguftura?, 210
Bolton, Joannes, de Apoplcxia, 201
Bonhard, G. Chr. de ufu Lienis, ■ ■ 204
Botany, Works relative to, — 193, 199, 200, 206
Bottcher, J. F. vermifchte Schriften, — 218
Brande, A. E. on the Anguitura Bark, 194.
Brafchiae (plantas nov.gener.) Defcript. — 206
Briftol Waters, Work relative to, . 194.
Broiig, P. S. de Febre nervofa, 210
Bucholz, W. H. S. on Medical Jurifprudence, 21$
Bucttner, D. F. Semeiologia; Rudimenta, 206
Bullen, Gulielmus, de Scrophula, 201
Bulliard, M. fur les Champignons, 212
Burrowes, Dr. Geo. Account of a fiflulous Opening in the,
Stomach, 185
Buxton Water:, Work relative to, 199
Calaguala, Efiay on the Root fo called, ■ 221
Calculus, Urinary, Works relative to, 194., 196
Carlfbad, Work on the Mineral Waters of, — 215
Carminati, Baff. Hygiene Therapeutice, . 206
. on the Root called Calaguala, 221
Caftellani, L. F. fulla Tifichezza, 222
Cataracts, Treatifc on, 192
Caw-
[ "5 ]
Caw, Jac. Drew M', de Rheumatifmo, — 202
Chemnitz, J. A. de M01 bis Venereis, ■ 210
Chin Cough, Work relative to, - — t\, 218
Cinchona Bachycarpa, botanical Defcription of, 152
. , its medicinal Properties, .15$
Clarke, Dr. J Eflays on Pregnancy and Labour, 197
Cold Bathing, Obf. on, -« 192
College, Veterinary, Work relative to it, — - J94
Concuffion of the Brain, Obi. on l. j8o
— , three ClafTes of, diftiuguifhcil, 182
Confumption, Works relative to it, 194,19^,222
Coviliard, his Account of a fiftulous Opening of the Sto-
mach, !j b ' 189
Cows, Eflay on the Parturition of, 2I5
Cretins, Work relative to, — . - 214
Creve, C. C. de Fracturis Oflium Pelvis, — - 205
Crichton, Dr. Alex, his Translation of an Effay on Genera-
tion, ' 192
Cunie, Dr. James, on the Effects of a Shipwreck on the
Mariners, — 103
Curry, Dr. James, on fufpended Animation, 159
D.
Danz, F. G. Gefchichte des Keichhuftens, — 218
Datura Stramonium* Effects of the Seeds of, — 78
Davidfon, Jac. de Vita Submerforum refufcit. 201
, W, on the Effe&s of Vitriol. iEther, 68
Deafnefs, Differtation on, 204
Deafe, Mr. his Work on Wounds of the Head recom-
mended, 178
Denman, Dr. Jof. en Buxton Waters, 200
Diamond Harbour, its unhealthy Situation, — 30
Diet, antifcorbutic, Obf, relative to it, — — 3C
Digitalis purpurea, Account of the poifonous Effects of, 10
, , Work relative to its Effects in Dropfy, 190
Dovering, S. J. L. de Vomitu, ■- 209
Droop, J. D. de Viribus Medicamentorum, — 203
Dropfy of the Brain, Treat ife on, 190
Duilburg, C. G. L. de Phyliologia et Pathol. Uteri, 207
Dyfentery, Differtations on, . 201,202
Dyfpeplia, Differtations on, 201, 202
Vol. V: 0 E.
[ M ]
E.
Earle, Jimes, en the Hydrocele, — *. 196
■ . — ~, on Lithotomy »««^^- jfaj.
Eaft Indies, Obf. made in a Voyage to, — — 21
Eberhard, J. G. on the Parturition of Cowi, 213
Eckner, G. C. Hift. of a bilious Fever, -. — - 214
Edinburgh, Cat. of the Library of the Coll. of Phyf. at, 202
- 1 ■ ■ , Guide for medical Students at, — « 192
Eggert, J. D. de Geoffraea Surinam. — 2o6
Electricity, animal, Works relative to, 193, 194
Epiiepfy relieved by Vitriolic jEther, — — 9$
Eflera, Diitinction between it and Urticaria, — 65
Eften, Joannes, de Febre flava, •- 201
Eyerel, Jof. his Edition of Prof. Stoll's Works, 205
Eyes, lingular Conduction of, in a Girl, — 158
F.
Fabricius, L. C. de Signis Morb. ex Oculorum Habitu, 209
Fachinger, Defcription of the Waters of, — - 219
Falconer, Dr. W. DiiT. on the Bath Waters, — 190
Fanzago, Fr. fopra la Pellagra, 222
Farriery, Lectures on the Elements of, 198
Fever, bilious, epidemic, Hift. of, "— 213
•— — , remittent, Cafes of, ■ 38, 40
■ r-, putrid, Works relative to, — — 196
— — , Yellow, DifTertation on, r* 201
Finighin, an ancient Irifli Surgeon, Anecdote of, 162
Foot, Cafe of Diftortion of, 54
Foot, Jeffe, on the Prevention of Hydrophobia, 200
Forceps, Obftetric, Work relative to, ■ 197
Ford, Edw. Account of a Child without Organs of Gene-
ration ■ — 9*
, on the Difeafe of the Hip Joint, 200
Forfter, Thompfon, Cafes of Popliteal Aneurifm, 3, 1 1
Fowler, Richard, on animal Electricity, 194
Frize, F. H. Annalen der Klinifch. Inft. zu Berlin^ 219
— ueber die Vener. Krankheit, — 219
G.
Gagel, J. E. de Suicidio, - — 204
Gannc, Ambr. PHomme Phyfique et Moral, ii 1
Gauiier, Lud. de Irritabilitatr, ■ < 209
Gardiniui,
C W J
Gard'mius, Jof. de Ele&rico Igne., , — 209
Generation, EfTay on, »— 192
Gefenius, W. Catai. of Gmple Remedies, — an 7
Girtanner, C. Neue Chem. Nomenklatura, — 219
Gmelin, J. F. Materia Medica, ■■■ 2 1 7
Goethe, J. W. von, on the Metamorph. of Plants, 21$
Gonorrhoea, Works relative to, — — 201, 211
Goodman, Geo. de Scorbuto, ■ 201
Gordon, Alex. Indigenous Botany, — 199
Graves, Dr. Robert, on the Nottington Water, 191
Guy, William, Cafe of Diftortion of the Foot, 54
H.
Halloran, Sylv. O', on the Ufe of the Trephine, 16 1
Haygarth, Dr. John, Plan to exterminate the Small Pox:
from Great Britain, ■ 191
Head, Injuries of, that require the Trephine, Obf. on, 161
Heat, animal, Experiments to afcertain the Effects of Im-
merfion in Water on, — 1 1 r
1 , Obf. relative to, 1 125
Hebenftreit, E. B. G. ueber der Med. Polizey, 219
Hip- Joint, Obf. on the Difeafe of, 200
Holme, Edvard. de Vaf. Abforbent. — 209
Hofers, F. J. on Surgical Bandages, ■ 21$
Hofpitals, Work on the Advantages of, — 214
Hufeland, C, W. ueber der Sauren Schwererde, 220
Hunter, John, his Obf, on the Colour of the Pigmentum
of the Eye quoted, ■ 1 c. r
Hydrocele, Work relative to, . 196
Hydrocephalus, Treatifes on, — — 190, 203
Hydrophobia, Cafe of, _—— 87
— , Plan for preventing it, ■ 200
I.
James, Samuel, Obf. on the Willow Bark, — 191
Jaundice, DhTertation on, ■ 202
Immerfion in hot and cold Water, EfFedte of, on the living
Body, — — — • no
Intermittents, may be cured by exciting Commotion in the
Body, . 70, 74.
, cured by Vitriolie iEther, 71, 7^
John, J. G. de Medic. Syft. lymph, fubmovent. 204.
Johnfon, J. (a fictitious Name) Guide for medical Students
at Edinburgh, — — i^2
Q»2 Johnfon,
[ 228 ]
Johnfon, James, on the Effects of the Seed of the Stramo-
nium, 78
• , Dr. R. W. Cautions to Families, -» 198
Itch, Work relative to, 218
Jurifprudence, medical, Works relative to, 204, 214, 215
K.
Kampf, Joh. Enchiridium medicum, 207
Karch, Gottl. de ufu Thymi, — 204
Khittel, Euft. a, de Scarlatina, — 210
Kilburn Wells, Aiialyiis of tne Water of, — • 100
Klaproth, M. H. on the Cirlfbad Waters, ~— 215
Kleefeld, J, G. Difiert. lnaug.de Pathemat. 204.
Kommer, J. P. de Hydrometra, 205
Kritter, J. F, de Auditu dilheili, - — — 204
L.
Ledger, Gul.de Dyfpepfia, - — 20 r
Lewis, Gul. B. de Dyfenterin, - 201
Lindfay, John, Account ot the QuafTia Polygama, 140
■ ■ Cinchona Brachyca-pa, 152
Liver, State of, its Influence in Difeaics of hoc Climate:, 33
, Treatife on its Economy and Difeafcs, 194
Lobe?, E. F. G. von, on the Itch, ■ 213
Lobftein, Dr. on the Effects of the Stramonium, 82
Lodemann, J. G, de Hydrocephalo, — 203
Loefeke, J* L. L. Materia Medica, 216
Lund, Mr. N. Tonder, of the true Quafiia Amara, 14$
M.
Madrafs, Obf. made in a Voyage to, 21
Malacarne, Vine, fopra la EfplcraT'ione, - ■ 222
Mann, Abbe, fur les grnndes Gelees, — 213
MarcarJ, H. M. ueber die Badcr, . 220
Marcus, A. F. on the Advantages of Hofpitals 214.
Marfchal, F. L. on Caftration, 218
Martelli, Nic. Defer. Brafchiae Plantae nov. Generis, 206
Mart)n, Tho. Language of Botany, 199
Materia Medica, Works relative toj 192, 193, 203, 206,
210, 216, 22 1
Meckel, Prof, neuc Archiv der Prakr. Arzncyk. 216
Melitch, J. on the retroverted Uterus, — 215
^lercury, combined with Bark, in Fevers, Ufe of, 33
Metzger,
r 229 ]
Metzger, J. "D. Exerc'tat. Acad. ~ 20*
Michaelis, P. on the DecuflUtion of the Optic Nerves, 216
Midwifery, Works relative to, 197, 213, 215, 220, 222.
Miller, Joiephus, de Aicite, 203
Milne, Dr. Colin, Indigenous Botany, 199
Mineral Waters, Works relative to, too, 190, 191, 215, 219
Moore, James, ErTay on the Materia Medica, 192
Murray, Jo. And. Etium. Lib. piaecip. Argum. med. 203
• Apparatus Medicaminum, 203
N.
Natural Hi&ory, Institutes of, ■ ■ igt
Neckcr, N. J. de, Phytozoologie Philof. ■ 21 1
Nerves, Optic, Work on the Decullation of, 216
Nettle Rafli, Cafes of, ■ §7
Neurology, Work relative to, ' 206
Nitre, in Fumigation, good Effects or, • 24
Nott, Dr. John, on the Briftol Waters, 194.
Nottington Water, Work relative to it, — 191
O.
Olivari, Nicol. Piano della Scuola Clinica, — 221
Opium, good Effecls of, in a Perfon poiibned by Digitalis, 18
P.
Patience, in Attendance on the Sick, Eflay on, 218
Pavia, Pharmacopoeia of the Hofpital at, — 20$
Peacock, H. B. Treatife on Cataracts, ■ 192
Pellagra, Work relative to it, ■- 222
Pelvie, Diilert. on Fnctures of the Bones of, 205
Perceval, Charles, Account of a Girl whole Eyes are con-
ftrucled in an extraordinary Manner, — 158
Petit, M. Ant. Projet de Reformede la Med. 210
Pharmacopoeia of London, pofologic Companion to, 19S
of Bremen, 207
1_ of Lippe, 208
of the Hofpital at Pavia, — 2o$
Phthifis, D'fi-rt. on, — — 222
Phytic, Materials for the Hiftory of, — 216
Phyfick, Phil. Syng, de Aooplexia, ■ ■■■ 203
Pigmentum of the Eye, Oof. relative to it, —^ i£i
Plants, Metamorpholes of, Work relative to, 215
Plinta, J. M. Hill. Epidem. variolof. — 208
Police,
[ 23° ]
Police, medical, Trcatifeon, — 215, 219
Popliteal Aneurifm, Cafes of, .. 3, n
Preu, P. S.C. Epiftola gratulatoria, ■ 207
Prickly Heat, Obf. relative to it, — 67
Quanta Amara, fpoken of as a very rare Plant, 14$
. . , a fpurious Sort of, has been imported into
Europe for the true, — — ibid*
. Poly gam a, Account of, — 140
, defcribed under the Name of Picrania
Amara by Dr. Wright, — — 142
_ '• , the Quafiia Excelfa of Dr. Swartz, 142,
148
Quin, Dr. C. W. on Dropfy of the Brain, — 190
R.
Rawlins, R. on the Obfletric Forceps, ■ 197
Reil, J. C. Memcrab. med. pracYica, — 209
Relhan, R. Florae Cantabr. Suppl. _ 2oo
Rels, H. W. Onomatologia Chymica, — 219
Reval, Work en the Difeafes of, • 2 1 3
Rheumatifm, acute, Diflertation on, — • 201
Rohr, Mr. Von, his Account of the true Quaffia Amara, 14$
Rowley, Dr. W. on Scarlatina Anginofa, — 196
Rumfey, James, Cafe of a Diflocation of the Tibia and
Fibula, 1 — 44
Rufh, Dr. of the Effects of Stramonium, — 80
Riift, C. J. F. de Infar&us DifFerentiis, — 204
Ryan, Dr. M. on the Afthma, — - 195
S.
Sainbel, C. Vial de, Elements of Farriery, 194
Saiix Latifolia, Bark of, Work relative to it, 194
Saunders, Dr. W. Treatife on the Liver, — 190
Scarlatina, Work relative to, 213
Scherf, J. C. M. Difpenfat. Lippiacum, — 208
Schlegel, J. C. T, Thefaur. Scmeiol. Pathol. 207
Schmeifler, J. G.f Description of Kilburn Wells, 100
Schmidt, J. de, de Baryte Muriafo, - — • 209
Schwartze, A. J. de Cortice GeofFrasae Surinam. 204
Scrophula, Diflertation on, ■ 201
Scurvy,
C 23* ]
Scurvy, Sea, Obf. and Works relative to it, 36, 123, 194,
201, 202, 208
, Dyfpncea an alarming Symptom in, how-
relieved, 36
Seifert, P. D. B. de Annis Climactericis, — 205
Semeiology, Works relative to, — 206, 207, 209
Shipwreck, remarkable Effects of, on the Mariners, 103
Simon, Salom. de Profopalgia, — 210
Simmons, Richard, Cafe of Hydrophobia, — 87
Simpfon, William, Obf. on Cold Bathing, — 192
Small Pox, Works relative to, 191, 19^, 198, 208,212
Societe d'Hiftoire Natur. de Paris, Actes de la, 212
Soemmering, S. T. Works by, 216,223
Spleen, Differt. on the Ufe of, -* 204
Stennet, Joannes, de Dyfenteria, ■ 203
Stoll, Maxim, de MorLis chronicis, 20c
Aphorifmi de Febribus, Ibid.
Stomach, filtulous Opening in, Inilances of, 18;, 189
, Work relative to its Connection with Life, 198
Storck, Anton. B. de, Prsecepta medico-practica, 206
Stramonium. See Datura.
Stupor, immediately following a Fall, defcribed as a certain
Sign of Coneullion of the Brain, 18 c
Swartz, Dr. Olof, his Defcript. of the Quaflia Excelfa, 14S
T.
Temple, Dr. R. Practice of Phyfic, ior
Teytaud, F. de la Gonorrhee, — 2II
Thelwall, John, on animal Vitality, jq7
Thicry, M. Obf. dc Phyfique et de Med. — 212
Thilenius, M. G. Befch. des Fachinger Mineral-WafTer, 219
Thorn Apple. See Datura.
Thymus, Diflertation on its Ufe, — 2q±
Trephine, Obf. on the Ufe of, ■ J()l
Trotter, Dr. Tho. Obf. on the Scurvy, ,, jq-
U.
Valli, Dr. Eufebiui, on animal Electricity, x.q~
Vavafour, Gulielm. de Ictero, . — 20«
Venereal Difeafe, Works relative to, 210,211,212, 210
Verginita, dei Segna della, Tto
Vitality, animal, Diflert. on, 20-
Urticaria, Cafes of, — . — A
Urticaria,
[ 232 3
Urticaria, Obf. on, — 64
Uterus, DifTertation on the Phyfiology and Pathology of, 207
— — , retroverted, Treatife on, _— 2i$
W.
Waldkirch, J. U. de Afphyxia Neonatorum, 204.
Walker, Dr. Inftitutes of Natural Hiftory, — jgr
Watfon, John, his Obf. on Difeales in a Voyage to the
Eaft Indies, 21
Webfter, Dr. C. on the Connexion of the Stomach with
Life, 198
Weems, Joannes, de Amenorrhcea, ■ 202
Wezeler, F. G. on Mea. Jurifprudence, 21 4
Williams, P. Cafe of Apoplexy in a pregnant Woman, 96
Willow, Bark of a particular Species or, Work relative to, 192
Wilfon, Alex. Phil, de Dyfpepria, 203
■ , Samuel, de Variolis, 203
Winterbottom, Dr. T. M. Obf. on Urticaria, 57
Wittwer, P. L, ueber die Gefchichte der Arzneyk. 216
Woenfel, Dr. F. Van, on the fmall Pox, — 195
Woodville, Dr. W. Medical Botany 193
END OF THE FIFTH VOLUME.
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