came through the aperture in the cornea, which I took to be the Jens in an opake state; the size of the eye-ball is much diminished; tumefaction of the palpebræ and discharge have quite ceased.

11th. The parts are now taking on healthy actions; lymph is effused from the remaining part of the cornea.

12th.-Red vessels are shooting into the lymph,

15th. The ulcer is closing fast. Since the 3d his bowels have been occasionally emptied by some mild aperient; the bark was omitted.

17th.-Ulcer nearly healed; the cornea is only transparent at its inner margin; has lost all useful vision in that eye; left eye

continues well.

22d.-Ulcer is quite healed, and the strength of my patient being somewhat recruited, he left Manchester to enjoy the benefit of sea air.

Vehement local action often occurs, where the actual powers of the part and general constitution are but weak. In no instance is this more plainly shewn, than in some cases of sloughing of the cornea. The death of a portion of the cornea, in a young and tolerably healthy subject, takes place from violent inflammation, as may happen in any other part of the body. Here, generally, when the slough is cast out, the restorative process will go on uninterruptedly; but, in the scrofulous, or otherwise debilitated habit, it is widely different. The cornea is a part but feebly endowed with living power; a great effort of the constitution is therefore required to enable it to repair its diseases; so we find, that should the slough of the cornea, occurring in certain habits, become separated, the contiguous parts, participating in the morbid actions, also die. The healing of an ulcer of the cornea differs not from that of any other ulcer. Lymph must be effused; that lymph must be organized; the process of granulation must be completed. Do we not every day see this circumstance happen? An ulcer (let us say on the leg) is healing, granulations have shot forth, but the constitution, from some cause or other, becomes disturbed; suddenly the new formed parts are absorbed, and a deep foul ulcer is left. So again it is with the ulcer of the cornea. Where the constitution has begun to flag, I have seen an ulcer of the cornea, just on the point of healing, have its granulations all absorbed, or large portions of the membrane die, till the whole has been destroyed. In the case I have related, it will be observed that I gave bark in pretty large doses. I have, however, I hope, clearly defined the circumstances under which it was administered. The pulse was feeble; the sloughy spot on the cornea exhibited a well known appearance. I was convinced

VOL. X. NO. 40.

Ee

that,

that, when this slough separated, there would be little power to heal the ulcer. A spreading of this ulcer must therefore in all probability happen. At my third visit, finding my patient's general state so much improved, I omitted the bark, being unwilling to excite, even indirectly, too vigorous an action in parts already enfeebled by disease. I certainly expected that I should soon see the ulcer put on marks of healing. In this I was disappointed; for on the 5th the ulcer had an unpleasant appearance, and was extending rapidly. The bark was again given till the 7th, when, lymph being deposited round the margin, and at the bottom of the ulcer, it was a second time omitted. At the period when the tonic plan is to be adopted, the bowels ought to be regulated with the mildest laxatives, but purging is to be avoided. In the scrofulous subject, after the tumefaction and purulent discharge have ceased, and the ulcers healed, if there have been any, the complaint frequently assumes a chronic form; there is a profuse secretion of tears, and the eyes are morbidly sensible to the light; in short, a species of scrofulous ophthalmia succeeds the puriform. In these cases, I have seen the most decided benefit arise from the exhibition of small doses of calomel and opium combined. The constitution should also be invigorated by tonics, seaair, &c. We must here be careful not to apply local stimulants too soon, even though there is no appearance of general increased vascular action in the organ. Here I have seen much mischief arise, from the indiscriminate use of the vinum opii; though there are cases requiring it. I am much inclined to attribute the second attack of inflammation in Jones's case, to the inadvertent application of a handkerchief to his eyes, which had been stained with the former purulent discharge; but I could never exactly ascertain the fact. The different stages of the disease were admirably shewn 1st, On the left eye, the termination in the adhesive stage leaving opacity. 2dly, The striking difference in the appearances exhibited by this opacity, and the opake spot on the right cornea, previous to the formation of a slough. 3dly, The efficacy of bark in putting a stop to the sloughing; and though in the second attack it failed to do so, until the organ was almost destroyed, yet in the end it did accomplish the object for which it was administered. Had my principal view, in relating the case, been to confirm the fact that cinchona is the remedy on which we must often place our chief reliance in sloughing of the cornea, I could have brought a host of instances. Lastly, The process set up by nature to repair the disease, even when the whole substance of the cornea has been destroyed. Here there is an attempt to form a new cornea, but it is permanently opake. Manchester, June 4, 1814.

:

VI.

Case of Hemiplegia, treated with Tinctura Lyttæ, and cold ShowerBath. By ROBERT HARTTE, Surgeon to the Forces, Member of the Royal College of Surgeons, London.

1

H OPE, a private soldier in his Majesty's 1st West India Regiment, (while at Trinadad,) was admitted into the hospital on the 29th June 1812, with Cachexia Africana, for which bark, steel, and other tonic medicines were given. He appeared to be recovering; but, on the morning of the 18th July, when I visited my hospital, I found, that, from paralysis, he had lost the power of his right side; that he appeared to have no sense of feeling in it, or the extremities of that side; his articulation was scarcely to be understood; he seemingly did not suffer pain, yet he would frequently with his left hand take hold of his tongue, as if with view of squeezing it smaller. Blisters were applied between the shoulders, along the vertebræ of the neck, as well as the region of the sacrum; asafoetida and other antispasmodics were employed without success. On the 29th July, I ordered the tinct. lytte to be given, five drops three times a-day, increasing the dose one drop daily.

a

On the 3d August, ten drops produced ardor urinæ : I discontinued the medicine for one day, and ordered rice-water for common drink, and the region of the bladder to be fomented. The following day, (5th August,) I again commenced the tincture with ten drops (ter in die) increased as before. On the 16th August, he was sensible when any part of his side or extremities was touched, and his articulation began to be more distinct; on the 20th August he could stand, with the assistance of a stick. I then ordered him to have the cold shower-bath every morning. 1st September. When at 37 drops per day, he could make some steps without the stick, I continued giving this quantity until the 20th September, when he was so convalescent, that I discontinued the tincture, and used the cold shower-bath only. 4th October he was discharged, and when I left the regiment, in 1813, he was in perfect health.

VII.

Case of Tenia in an Infant, cured by decoction of Pomegranate. By WILLIAM POLLOCK, M. D. Communicated by ADAM BURT, M. D. superintending surgeon, Bengal.

I WOULD have done myself the pleasure of transcribing for you the case of tænia in an infant, the moment I received your kind

letter,

letter, but my journal for 1811 had been mislaid, and I have only this morning discovered it. I formerly communicated to you some cases of tænia, cured by the pomegranate decoction, which were inserted by Dr Fleming in his Catalogue of Indian Medicinal Plants and Drugs, printed in 1810, and, since that period, I have found the remedy invariably successful, in a very great number of instances. In many of those the tænia had acquired an enormous length, and in some of them it was received in tepid water, and lived for several hours after it was passed. The following case occurring in an infant, not two months weaned, appeared to me to be very remarkable, in consequence of which I reported it to you, and also sent a copy of it to Dr Fleming, at the time it happened. That it is a very uncommon occurrence, may be inferred from an observation of Dr Hamilton's, in his most valuable work on purgative medicines, where he says, that the tænia is altogether unknown in infancy and childhood.

PETER DALY, aged 14 months. 27th August 1811. Was weaned about two months ago, and has since been gradually drooping, in consequence, as was supposed, of dentition. He is now excessively reduced, refuses all food, and is harassed with a constant troublesome diarrhoea. His skin is loose, dry, and shrivelled, and he has the whining fretful cry of a child who has been long sick. Different medicines have been prescribed for this diarrhoea without relief, and for several days his stools have contained small fleshy shreds, some of which considerably resemble halfdissolved portions of the tape-worm. Two ounces of water were added to six of a decoction of the pomegranate root, (prepared by boiling two ounces of its fresh bark in a pound of water to nine ounces,) and a table spoonful was ordered to be given the child every half hour, unless sickness and vomiting intervened.

28th. He took the whole of his medicine yesterday, without either sickness or vomiting, and in the evening he passed a portion of tape-worm alive, upwards of six feet long. The medicine purged him briskly, and to-day he has vomited almost every thing he has taken. Appearing much exhausted, an anodyne carminative mixture was ordered to be given at intervals, to relieve the sickness.

29th. Appears more lively; has had no vomiting since yesterday, and the diarrhoea has been much restrained by the anodyne. Quiescat.

1st September. Is manifestly better in every respect, but his stools still contain portions of the tape-worm. Eight ounces of the above decoction, without dilution, were ordered to be given in the same manner as before.

2d. He took the whole of his medicine yesterday, without

either sickness or vomiting, and with but little effect upon his bowels, until this morning, when it began to purge him briskly, and he passed another portion of the tape-worm, nearly eight feet long. He has been very hungry, and ate a hearty breakfast.

25th.-No portions of the tape-worm have been observed since last report, and the diarrhoea gradually left him, without the use of any other medicine. His bowels have become regular, his appetite keen, and he has filled up apace. He has the appearance of a healthy thriving child, and his strength has improved so rapidly, that he has now begun to walk.

From the above period he continued to thrive until August 1812, when he again began to pass pieces of the tape-worm. The pomegranate decoction was repeated, and he passed an entire tænia alive, fifteen feet long, since which he has been in perfect health, and is at this moment a very fine boy. He is a son of Edward Daly, private soldier in his Majesty's 53d regiment. Merat, 7th January 1814.

VIII.

Two Cases, with Observations, demonstrative of the Powers of Nature to reunite parts which have been, by accident, totally separated from the Animal System. By WILLIAM BALFOUR, M. D. Edinburgh.

THE

HE practice of ingrafting trees first suggested to medical practitioners the idea of repairing mutilated parts. This practice was successfully prosecuted by a few, when the state of society afforded opportunities, but has uniformly been treated with a certain degree of ridicule, by far the greater number of the profession. This distrust in the powers of nature, in the face, too, of evidence which it would be difficult to controvert, is not more unphilosophical in itself, than its influence on practice must be detrimental. What a man believes impossible, he never will attempt. But if a branch of one tree unites with the stump of another, so as not only to live, but to bear fruit, it can be no great stretch of imagination to suppose, that a part totally separated from the animal system, may under proper management, reunite and live, and perform all its proper functions.

A number of years ago, an accident happened, in the management of which I proceeded upon the principle, of the possibility of parts entirely separated uniting again, with all the success I could desire. This idea was suggested by the necessity of doing

something