sounding (says the Doctor) somewhat like haghss, in an extremely harsh, loud, and disagreeable tone"!! "To gain time for reflection, as well as for observing the course of this liver cough, and supposing it possible that some suppression of the cuticular discharge had been produced during his long walk, I ordered him to remain in bed, and to take a mild saline sudorific mixture, and to have his legs and feet well stuped for an hour"!! Two days after this judicious treatment he was no better. The bowels being confined, the patient expressed a wish to take some active physic; the learned Doctor accordingly did order him some active physic, viz. " calomel, James'spowder, and a saline purging draught." These medicines produced several very offensive bilious stools. Two days afterwards he complained of a pain in the right side, an indication to the seat of the disease. The learned Doctor “made him stand up and lean forward over the back of a low chair, and on flattening the abdomen by a deep inspiration, he discovered a tumour, Occupying a space, that, in his opinion, was a circumference measuring about four inches. It was evident to the touch and sight." He was free from fever; he said he was thirsty; but this the Doctor " considered only an excuse for eating oranges.' The Doctor now began to attack the enemy in good earnest. He ordered six leeches to the side immediately over the tumour, and the bleeding to be encouraged after their dropping by hot stupes. He also ordered a scruple of the blue pill with ten grains of calomel to be mixed and divided into twenty pills, with the conserve of roses, and two to be taken night and morning. "The leeches entirely removed the sharp pain, but on pressure he felt sore." To render the tumour evident to the touch and sight, the ingenious contrivance of the chair, &c., was not necessary. It was now evident to the touch on lying down. On finishing the box of pills, the cough was as bad as ever. The Doctor now ordered him to remain in bed during the day, "because while occasionally up for a few minutes, to have his bed made, &c., he found himself much more shook by the cough, than when in the recumbent posture with his head on a soft and WELL stuffed pillow"!! After attacking the malady in this decisive manner for eleven days, the patient was no better. The Doctor having gained time for reflection, the result of this reflection was, a determination to call in assistance.. A consultation was proposed to his friends, and an eminent physician was called in. After putting their heads together, (not soft but well stuffed) they determined to apply a blister over the tumour, (better late than never) and to keep up the discharge. They prescribed blue pill with gum ammoniac and James's powder, to be taken every night." In about ten days, the mother found a favorable difference in the cough" (and in her purse). In eight more days the mouth was affected by the mercury; he now coughed but seldom, and instead of the peculiar sound of haghss, he barked. The mercury was omitted, and a purgative administered; the tongue became clean; the cough ceased, and a few tepid baths enabled him to return to school, where he remained for six months, perfectly well, frequently singing a favorite song of "the happy escape."

The Doctor observes, on concluding his narrative, "It was my first intention to have given Master H.'s as a perfectly naked case, merely as a beacon to my young brethren." His case was indeed very likely to

prove a naked one, and the result, in that case, would have proved an useful beacon to invalids, as well as to young practitioners. That the lungs sympathize with the liver, the learned Doctor refers his readers for evidence to the " Facts and Observations on Liver Complaints, by Doctor Faithorne, of London"!! What an insult to the celebrated Doctor James Johnson, who has particularly treated on cutaneo-pulmonicohepatic sympathy, and to Dr. Solomon, for his admirable dissertation on cerebro-genital sympathy, and on the draining of the spinal marrow!! The opmion of the eminent Physician whose assistance he called in, with respect to the origin or nature of the disease, the learned Dr. Brooke has (unintentionally, no doubt) omitted to notice. The idea of the cough being symptomatic of an affection of the liver was, in our opinion, an unfortunate one for the patient. The tumour was more likely to be the consequence of the cough, than the cough of it. The alteration in the voice, and the aggravation of cough on moving, were pretty strong proofs of the lungs having been principally affected. Besides, it does not appear clear that the tumour was an enlargement of the liver, or any portion of it. We really suspect that it was a spasm of the upper part of the rectus muscle, or of the right external oblique, a very common attendant on cough. Had this patient been bled, blistered, and purged, and an anodyne expectorant administered, would the cough, instead of two mouths, have continued a week? Was not the treatment adopted by Dr. Brooke an abuse of the system of Abernethy?

CORROSIVE SUBLIMATE.-Mr. Lendrick, of Dublin, has published the case of Mr. Edward Byrne, to whom his wife and a son by a former marriage administered a quantity of corrosive sublimate, with the view of terminating his life. Mr. Lendrick, on his first visit, found him suffering excruciating pain in the region of the stomach, attended with violent retching. Mr. B. observed to him, that he felt all on fire. He was in a very debilitated state, his limbs cold, the pulse frequent, and intermitting, and the surface of his body covered with clammy sweat. A practitioner, ignorant of the cause of his affliction, had administered an emetic, which failed to afford relief. Mr. Lendrick, having discovered the mixture of which Mr. B. had taken a dose, to be saturated with corrosive sublimate of mercury, immediately determined to have recourse to the treatment lately recommended by Dr. Orfila, of Paris. The whites of several eggs were accordingly beaten up, with an equal quantity of water, and administered, at intervals, in quantities the stomach could bear, without occasioning painful distention. On repeating his visit in the evening, he had the satisfaction to find his patient in less pain: the alarming symptoms had gradually diminished after the first exhibition of the antidote; his pulse was firm, and he appeared to be very drowsy. On the following day, the bowels being tender, and the pulse quick, Mr. Lendrick ordered a draught of castor oil, and the bowels to be fomented. In the evening of the same day, he found him free from pain; the castor oil draught had operated, which, with the fomentation, removed every local effect of the poison. From this time his advance to health was progressive. About the tenth day the membrane covering the shin bone became tumefied, and very painful. This affection, which often follows a long course of mercury,

gave way to the use of the warm bath. A slight degree of palsy of the right side, with nervous irritability in other respects, attended with some loss of memory, supervened, and from these complaints he was not free when Mr. Lendrick finished his report.

In cases of too great a quantity of corrosive sublimate being taken into the stomach, Dr. Orfila thinks, and every experienced or reflecting practitioner must coincide in the opinion, that vomiting is best promoted by a diluent liquid, and for this purpose the whites of eggs, mixed with water, is perhaps as good as any other. In the above instance, it appears that this remedy not only suspended the further action of the poison, but also removed its effects. Notwithstar ding the favourable result of the exhibition of this albuminous remedy, in this stance, and the reports of Dr. Orfila, of its uniform efficacy in counteracting the poisonous effects of corrosive sublimate, when administered in time, we confess we are inclined to give a preference to a solution of the sulphuret of potass in water, because we know it to be capable of decomposing the oison and of rendering its active ingredient comparatively inert, and when the quantity of corrosiv sublimate amounts only to a few grains, which is generally the case, this solution will render it iucapable of doing serious mischief to the stomach or intestines, if it should not be brought up by vomiting.

SMALL-POX.-A Dr. Robinson has published two cases of smail-pox, which occurred in children who had been vaccinated. The disease proved so mild in both instances as to induce the Doctor to conclude" that cow-pox alters the effect of the contagion of smail-pox, where it suffers the agent to exert its force on the constitution, so materially as to render the consequent disease almost, if not altogether, a new one of mild character." Unfortunately for the Doctor's sup、sition, the matter taken from this modified or new disease, or its contagious effluvium, operates on the system of those who have not been vaccinated, in the same manner as that of unmodified or even confluent small-pox. From the two cases, the Doctor draws the following three inferences:

1. That an eruptive disease is produced by the contagion of smallpox on some, who had undergone the vaccine inoculation.

2. That this eruption has in some degree the form, and affects the course and changes of small-pox, although of shorter duration, but it is not dangerous to human life, and may be considered a new and mild species of that disease. (Dr. Clarke, of Dublin, calls it a Hybrid.)

3. That vaccination, so far as experience goes, appears fully capable of preventing the falul effects of sinall-pox, and of ultimately banishing that formidable and loathsome disease from among mankind.

MERCURY.-Dr. Richard Grattan, of Dublin, has lately communicated to the profession a case of mortification which terminated fatally, which was " occasioned by the use" (query, abuse?)" of mercury The unfortunate patient was a female of only ten years of age. When the Doctor first saw her, "she laboured under febrile excitement, and appeared to be in the last stage of disease. The head seeming to suffer most, and from general appearance, he concluded that water had either collected in the brain or was on the point of being effused in the ventricles. Delirium, with frequent screaming, alternated with occa

sional intervals of stupor, or heaviness, black, dry tongue, long pulse, seldom under 180, beating of the temples, face sometimes pale, sometimes flushed, were the most prominent symptoms." The Doctor ordered two grains of calomel to be administered, and afterwards a castor oil draught; leeches to be applied to the temples, and the head to be shaved. The symptoms continuing, five ounces of blood were taken from the temporal artery, and a blister to the back part of the head, and to the nape of the neck; a pill composed of two grains of calomel, and two of ipecacuan powder, was given twice, or sometimes thrice a day, with the exception of those days on which the oil draught was administered; so that on the sixth day of admission, only ten pills had been taken. The gums now became sore, and every alarming symptom disappeared. "A high degree of salivation came on, the face and lips becoming tumefied. After four or five days, a small vesicle appeared near the left angle of the mouth, which soon became black. The fermenting poultice was applied, and bark, opium, and wine were administered. The symptoms of salivation continued unabated; the breath became extremely offensive, the mortification spread, and the patient gradually sunk till death terminated her sufferings." The head not having been opened, the Doctor does not venture an opinion as to the nature or cause of her fever. The result has given rise to the following very sensible reflections, which cannot fail to prove highly satisfactory to the parents of the unfortunate patient.

"It is," says the Doctor, "the peculiar misfortune of our profession, that the physician, however great his information, or extensive his experience, cannot pronounce with certainty as to the effects of medicines. The functions of the animal economy are so easily disturbed, and diseased actions are produced by so many various causes, either acting from without, or originating in the system itself, that it is always difficult to distinguish between those different actions, and often impossible to trace them to their original sources. Could we uniformly succeed in doing so, the practice of medicine would then rest on a sure foundation, and no longer continue what it now is-conjectural and uncertain"!!

"Great improvements, it is true, have been made. The study of physiology has corrected many errors, and by suggesting more accurate and extensive views of the different functions, has rendered our practice more judicious and consistent than heretofore. Still, however, it must be acknowledged, that we have at best but a faint glimpse of the truth, and that the instances in which we can decide with certainty are far inferior in number to those of which we are in a great measure ignorant. Hence it is, that, in the treatment of disease, we are so often obliged to feel our way with caution, judging of the propriety of our practice more by the result, than from any previous conviction of our own. We succeed, and we felicitate ourselves-sometimes without reason, for it sometimes happens that nature alone was sufficient to effect the cure. We fail, and we blame ourselves—often unjustly, for the fault was not our's, but owing rather to a want of sufficient energy in the vital principle to second our efforts. Sometimes, on the contrary, we expose ourselves to well-merited censure, either for omitting to use the proper remedies, or for employing them without sufficient discrimination.

A similar case to the foregoing one was published by a bookseller at Leeds, about fifteen years ago. The unfortunate subject was much younger; the affection of the mouth and face came on a day or two after taking Ching's worm lozenges, the basis of which is calomel. That patient died in great agony.

It is worthy of notice, that nauseating medicines administered with or during the use of mercury, promote its absorption. The antimonial powder or wine, taken during the use of mercury, evidently hastens salivation, probably by increasing the action of the absorbent vessels of the stomach. The effects of mercury administered at short intervals during fever, should be most attentively watched, for on some constitutions half a grain administered at intervals will have as great an effect in producing salivation, as six times the quantity will on others. If therefore a small dose exceeds the intended effect in the course of a day or two, no blame can attach to the prescriber.

GALVANISM.-For the following cases of affection of the stomach, &c. in which galvanism, &c. proved beneficial, we are indebted to Mr. La Beaume of Southampton Row.

Case 1.-T. F. Esq. was recommended to me by an eminent country practitioner, with the following statement of his case, dated 28th July, 1820. "That Mr. F. had not been in good health for years, having always more or less of stomach derangement, indigestion, irregular bowels, vitiated appetite, and affected with wandering pains and misplaced gout. In November, 1819, he became very feverish, with oppressed breathing and great uneasiness in his right side, and symptoms which pointed out inflammation of the liver, for which he was bled freely, and such means were used as I judged efficient and proper in his case. After the inflammatory diathesis had subsided, he went through a regular course of mercury, with a proper attention to the excretions of the bowels, by judicious purges; and this was particularly necessary, as the excretions were always faulty and clay coloured, urine highly coloured, what is commonly called bilious. The use of mercury brought on a complete attack of gout in his feet, and the ancle joints suffered much from the inflammation and deposit of lymph, &c. Mr. F. has still great stiffness and weakness in the ancles, and cannot take his usual exercise, neither does the liver at present secrete any active bile. He is now recommended horse and walking exercise, attention to diet, and the regular discharge from his bowels secured by a pill composed of the blue pill and rhubarb, in equal parts. Every minutiae of his disease he is well able to describe to you, having here pointed out the leading features of his case. I have therefore recommended to him to consult you upon the propriety of the galvanic stimulus to the liver, and the neighbouring parts subservient to digestion, and the air-pump vapour bath, to his crippled ancle joints. He is quite willing to follow your directions, and in your hands I leave him, in full confidence of your skill."

This patient is about sixty years of age, and of a sanguine temperament. I judged that the employment of galvanism would be productive of great benefit in the improvement of his general health, as well as the removal of his gouty affection. In this I was not mistaken, as appeared by the result of a short trial. In the first instance he had