called pain. This prickly sensation was excited by firmly grasping the part.

"I told my patient that percussion was the only remedy from which I could expect any benefit in her case; and that it must be applied daily, and continued till a cure should be obtained. She assented, delighted with the prospect of being cured by any means. I proceeded to the operation; and the first application diffused the nervous power through the whole limb. A mixed sensation of pleasure and pain darted through it to the very point of the great toe. From that moment I entertained not a doubt that I would be able to effect a cure; but I warned my patient to expect that it would be very gradually accomplished. I continued my attendance every day for a short time, applying percussion over the whole limb and sole of the foot. This I did on the principle I have often mentioned, that, wherever a stimulus is applied, to that place there is an afflux of blood and nervous energy. If this principle is admitted, and it is self-evident, the objection raised by some writers to the application of percussion in cases of lameness and debility of the extremities from gout, must fall to the ground. Percussion must be admitted to be stimulant, and therefore cannot be repellent. No application can attract and repel at the same time. Those, therefore, who attempt to frighten gouty patients from the use of percussion, as calculated to repel the disease to internal parts, have other objects in view than truth or the welfare of their patients. Such writers merely cavil,-they do not reason; and, instead of instructing, only betray their own ignorance.

"In the course of ten days, an improvement was perceptible in my patient's walk. She trusted her weight with more confidence on the limb, and planted her foot with greater firmness. And, having by this time learned to apply the remedy equally well as myself, I left her, in the conviction of ultimately recovering the full power of her limb.

"A short time after I left off visiting her, she returned to the country, and I neither saw her nor heard of her for about twelve months. Standing in the middle of the street one day, in conversation with other two gentlemen, I observed a young lady crossing from the pavement towards us, with a firm and equal pace, smiling as she approached, and bolding out her hand to me. I gave her my hand, but did not recognize her till she spoke. As her whole manner indicated happiness, I was not afraid to say, 'And how are you?' 'Perfectly well,' she replied with emphasis. Did you continue the operation of percussion?' Every day since I saw you; and I have used no other remedy whatever.'"

This patient had, for some time, delayed consulting Dr. Balfour, in consequence of having been prejudiced against his mode of treatment, by the surgeon-apothecary of the family with whom she was on a visit. His draughts and embrocations having failed to afford any relief, she determined to place herself under the Doctor's

care.

Mr. Simpson, surgeon to the 56th regiment, gave Dr. Balfour's treatment an extensive trial at Malta, the beneficial results of which,

be says, astonished his professional brethren there. This gentleman · found it very successful in cases of sprains. The opposition and illiberal conduct Doctor Balfour has experienced from some of his brethren, have had the effect of exciting him to more vigorous exertions. A correspondent informs us, that he sometimes nearly exhausts himself in percussing and pommelling his patients; and that he performs the processes with the agility and dexterity of a young man. In some hospitals, the rheumatic patients are directed to pommel each other for some hours together, to the great amusement of the lookers on.

STRANGULATED RUPTURE.-Dr. Sherwin, during a short stay at Enfield, in the course of last summer, by the request of Mr. Jessop, visited an old man on the second day of strangulated rupture in the groin, which Mr. Jessop had not been able to reduce. His skin was hot, face flushed, and the pulse far from being feeble. The doctor ordered Mr. Jessop to bleed him, and to administer the usual tobacco clyster, and a dose of calomel. The patient was then placed with his head and shoulders resting on a mattrass upon the floor, with his legs and thighs upon the bed, as high as the furniture would permit ; and in this position, napkins wetted with a refrigerating solution (nitre powder, sprinkled between a folded napkin, wetted with cold water, is probably the best), were ordered to be continued, and repeatedly changed during five or six hours. On the expiration of that time, Mr. Jessop was directed to attempt a reduction; when he had the pleasure to find the contents of the tumor (about the size of a large fist), slip up on slight pressure. The symptoms of fever continuing to run high, the doctor ordered a repetition of bleeding in the course of the night, and from that time his convalescence advanced rapidly. "In respect to this continued position," observes the experienced Doctor, "it must be evident, that if the finger and thumb could be applied, within the abdomen, to that portion of the intestine, contiguous to the internal ring, the slightest effort would immediately retract a contiguous portion, which the rudest, the roughest, and, let me add, even the most judicious external pressure, with every advantage of scientific relaxation of muscles and ligaments, would in vain attempt; but what is denied to the finger and thumb, is, perhaps, afforded by due attention to this position." An intelligent medical friend of the doctor's, after reading this remark, observed to him :

"I should not be surprised, if hereafter, some enterprising surgeon, of plain good sense (the best of all sense), should adopt your hint; and, by making an opening into the cavity of the abdomen, apply his finger and thumb, in the manner you mention, and, with facility, effect the reduction.' May it not be added, will the patient, by such an operation, undergo as much pain,-will he have as large a surface exposed, or will the internal cavity of the abdomen be more subjected to the danger of inflammation, from the admission of external air, than in the usual operation?-Will there be as much danger of wounding, either the epigastric artery, or the spermatic vessels? If none of these dangers will be augmented, but all of them lessened, why should he hesitate to adopt the hint? The

E

practical operating surgeon may probably advance unanswerable objections: none occur at present to the writer,-old adhesions excepted.'

The following practice of reducing strangulated rupture, in Russia, is mentioned by Mr. Hiltebrand:

"A pot, capable of holding several pints, is applied in the manner of a cupping-glass to the abdomen, previously rubbed with oil or soap. The parietes and bowels are thus drawn (with pain) into the pot, and the parts contained in the rupture into the abdomen.' He asserts that many, under very desperate appearances, have been thus cured. He might have added, that it was the dictate of plain good sense. The cupping may, with the least inconve nience, be performed, by dropping a piece of silver paper, wetted with rectified spirit, and lighted, into a large bell-tumbler, or any other vessel properly capacious.'

The following case of strangulated rupture in the groin, which occurred lately in the neighbourhood of London, shews the necessity of a ruptured person paying attention to the state of the bowels, and of preventing the escape of a portion of the intestines, &c. into the sack, by the use of a proper truss. A lady having neglected to apply the truss, after being costive three days, was not able to effect its reduction. The aperient medicine she had been in the habit of taking, not having operated, and experiencing considerable pain in the bowels, she requested the attendance of an apothecary. On his two first visits, she did not acquaint him with her having a rupture, complaining only of obstinate costiveness. Active purgatives, and aperient clysters, having failed to produce an evacuation of fæces, and her pains increasing with accession of fever, she thought proper to acquaint the apothecary with the cause of her sufferings. On examining the tumor, he found it in such an alarming state, that he immediately urged a consultation. A servant was accordingly sent to the experienced, scientific, and gentle Mr. Vincent, to request his immediate attendance. This gentleman, after examining the tumor, recommended the operation as the only means of giving the patient a chance of recovery. This was accordingly performed, but the circulation of the contents had been so long stopped, that mortification had taken place. The patient was greatly relieved by the operation, and the intestines were afterwards sufficiently emptied. She, however, survived it only three days. The portion of the intestines, within the tumor, was distended by very hard fæces. The best instrument that has been invented for keeping up the bowels, is Mr. Ody's patent truss; and the most efficacious medicine for obviating costiveness, is the Bengal aperient pills, noticed in a former number.

Rupture in the groin might, in our opinion, be effectually cured, by producing adhesion of the integuments over the abdominal ring. This may be safely done, by removing the cellular substance between it and the skin; for which purpose, a very small opening would be

sufficient.

HARE LIP. Having found the usual method of operating for this natural defect to fail in infants, from the pins becoming loose

in three days, in consequence of the sloughing of the skin which covers them; from the pressure of the ligatures completely stopping the circulation, we were induced a few weeks ago to perform the operation on a young woman, at Hounslow, without pins. After removing the edges of the fissure on each side, by means of a scalpel, we passed a ligature through the left portion, about one-eighth of an inch from the edge near the bottom, and brought it out on the opposite side, about the same distance from the edge; and then, by securing at the end of the ligature, a short thin piece of whalebone, surrounded with lint, brought the edges in contact, and kept them in that state, by fixing to the other end, close to the puncture, the same contrivance. Another ligature in the same manner was applied between it and the nose. It then had the following

appearance.

The wound was then covered with lint, and over it strips of adhesive plaster were applied. In the course of six days the ligatures were removed, and, in three days afterwards, the part had completely healed. The cicatrix is considerably less than that which follows the use of pins; indeed, it is now scarcely visible, even on close inspection. This method of operating for infants, is, in our opinion, very superior to that by pins, inasmuch as the edges of the fissure cannot be separated by crying, or by the infant's hands. GOUT CORDIAL.-SIRS,-The following is a copy of the gout stomachic cordial, of which I spoke to you when I was in town last June. I have given the receipt to several noblemen, who are occasionally subject to gout and spasms in the stomach, who have informed me, that they have found it a most valuable remedy. It is also an excellent medicine for flatulence and indigestion of elderly people of debilitated or leucophlegmatic habits:

Take of the lesser cardamom seeds, husked and bruised-
Caraway Seeds bruised, of each two ounces;

The best Hay Saffron, half an ounce;

Turkey Rhubarb, thinly sliced, one oz. and half;
Gentian root, do. three-quarters of an oz.

Mix, and infuse in a wine quart bottle of white brandy for a fortnight. I put it within the heat of the fire for an hour or two the first four days, so as to warm the bottle, and shake it for about two minutes every day. The person who gave me the receipt, desired me to pour off the clear liquor, after it had stood a fortnight, but this I have not done. I keep the liquor on the ingredients, and pour it off clear when I want it. The dose is a table-spoonful, with an equal quantity of water: I generally take it about every third day. It keeps up digestion, and a regular state of the bowels. I have remained

free from spasms of the stomach and bowels, and in a great degree from flatulence, since I bave been in the habit of taking it. I, however, take four grains of the blue pill every other night for a week, about once a month, agreeably to your directions.

With many thanks for the valuable information I have derived from your very useful publication, I beg to subscribe myself, Sirs, Dec. 27, 1820. Your much obliged well wisher, A SUFFOLK BARONET. RHEUMATISM.-SIRS,-In the 60th No. of your valuable work, you recommend the cajeput liniment to remove local attacks of Rheumatism, after correcting the habit by the wine of the colchicum seeds. I have certainly not used that remedy, but have applied an unguent for the same purpose with great success. I am encouraged to send you a copy of the receipt for making it. In order to recommend it to the attention of your readers subject to rheumatism in the joints, I beg to state, that I received the prescription from a very eminent physician during a short residence at Edinburgh. It is as follows:

Take of Crystals of Tartarized Antimony, finely powdered,

thirty grains;

Rectified Oil of Turpentine, three drachms;

Fresh Hog's Lard, one ounce;-Mix well together. The skin over the part affected should be well rubbed with this ointment every night till eruptions appear, when the part may be dressed with spermaceti cerate. When the irritation in some degree subsides, the unguent may be again used, and continued at intervals, so as to keep up an inflammatory action in the skin till the rheumatic pain ceases, and the swelling has subsided, which it in general effects in the course of a week. The wine of the colchicum seeds should be previously taken for three or four days, with the view of rendering the rheumatic affection local, or, as you say, to remove the state of system which favours the disease. I am, Sirs,

Dec. 27, 1820.

Your constant reader and friend, J. RAIKES. BUCHU LEAVES.-(Diosna Crenata L.)-A scientific gentleman residing at the Cape of Good Hope, has sent us a considerable quantity of these leaves, that the faculty may give them a trial in those diseases for which the natives represent them to be a certain specific. An infusion of them made by steeping an ounce in a pint of boiling water, for four hours, taken in the dose of three tablespoonsful two or three times a day, he says, is an effectual remedy for gleet, mucous discharges from the bladder, fluor albus, rheumatism, and gravel. The leaves, moistened with boiling water, and applied whilst warm, by means of a napkin, in the manner of a poultice, to a paralytic limb, or a part affected with rheumatism, he has known to succeed in many bad cases of long standing. As he wishes the leaves to have a fair trial in this country, a quantity of them is deposited at the Medical Hall, 170, Piccadilly, with directions for supplying the faculty with them at a very low price. The leaves are slightly astringent, and contain an essential oil, very similar in flavour to a mixture of the oil of turpentine and rue. They resemble in appearance the uva ursi.