Art. XXIII. Remarks on the Cure of Confumptions, by J. Fothergill, M. D. F. R. S. There are no cafes in which the advice, principius obfta, is more indifpenfably neceffary, than the confumptive. We cannot, fays our Author, I think, be too industrious in propagating the following doctrine: That the time at which a phyfician Can be of moft ufe in the cure of confumptions, is at their firit beginning. The flightest catarrhal defluction ought not to be neglected, if it does not go off in a few days. I know, gentlemen, that you, as well as myfelf, often have occafion to look back at the fatal neglect, committed both by the fick themselves, as well as thofe who ought to have had their future health more at heart. With what ease would many of the most incurable confumptive cafes have been prevented, or cured, at their first commencement? A perfon whofe emaciated figure ftrikes one with horror, his forehead covered with drops of fweat, his cheeks painted with a livid crimfon, his eyes funk, all the little fat that raifed them in their orbits, and every where elfe, being wafted; his pulfe quick and tremulous, his nails bending over the ends of his fingers, and the palms of his hands as dry as they are painfully hot to the touch, his breath offenfive, quick, and laborious, his cough inceffant, fcarce allowing him time to tell us, that fome months ago he got a cold, but he knew, perhaps, how he got it; he neglected it for this very reason, and neglected every means of affiftance, till the mischief was become incurable, and fcarcely a hope left of palliation. You fee multitudes of fuch objects daily, and fee them with a mixture of anger and compaffion for their neglect and their sufferings.' We have in this paper fome useful obfervations, both with respect to the manner of diftinguishing and the method of treating a recent pulmonary affection. Art. XXIV. An Account of a late epidemical Diftemper, extracted from a Letter addreffed to Gedney Clarke, Efq; by William Sandiford, M. D. of Barbadoes. This epidemic was a putrid remitting fever, which prevailed in the island of Barbadoes, during the months of May, June, and July, of the year 1769.-Our Author gives a plain and pertinent defcription of the difeafe; and his method of cure appears to have been judicious and fuccefsful.-His obfervations coincide with thofe of Sir John Pringle, who has treated this subject more at large. Dr. Sandiford thus briefly points out the external caufes of this epidemic : It may, however, not be unworthy notice, that for these two years last paft, it has been remarkably warm and moift in this ifland: that great quantities of rain have fallen: that the days have been very hot and fultry, whilft the nights have been fo damp and chill, as to ftrike perfons with great coldneffes and fhiverings who have been expofed to them: that moft of thofe who have been attacked with this fever, were fuch as lived in the lowelt and moift fituations; in places thick befet with trees, and furrounded with wa ter, ter, and where the springs lay nearest to the furface: that fishermen, and fuch as were most expofed to the cold and moiftness, as alfo, those of the weakest and most lax conftitutions, were particularly objects of it. In all the epidemics, as they have of late feverally obtained here, there was ever to be observed fomething of a putrefactive tendency.' Art: XXV. Appendix to a Paper on the Hydrocephalus Internus, by William Watson, M.D. F.R. S. This appendix contains another hiftory of a supposed hydrocephalus internus.-An healthy boy, of fix years, received a fmart blow from a ftone on the top of the head. About a fortnight after this, a very dangerous difeafe fucceeded; from which the patient at laft recovered. It does not however appear quite certain that this was a cafe of the hydrocephalus internus; for all the fymptoms here mentioned might arife from an injury of the brain, or its membranes, without there being any extravafation. Art. XXVI. An Extract of a Letter from Dr. William Thomson, Phy cian at Worcester, to William Hunter, M. D. giving an Account of a fatal Effufion of Blood into the Cavity of the Pericardium. It is very probable that this extravalation was flow and gradual, both from the length of time which the patient lived after the oppreffive fymptoms came on, and from there being no rupture difcoverable by an attentive infpection of the parts. The heart was remarkably pale and flaccid Art. XXVII. An Account of the good Effects of dividing the Aponeurofis of the Biceps Mufcle, in a painful lacerated Wound, by Mr. B. Wilmer, Surgeon at Stony Stratford, in a Letter to Dr. Hunter. This wound was a little above the inner condyle of the bu The fafcia of the biceps mufcle was lacerated, and acted as a tight and painful bandage upon the wounded parts. As foon as this fafcia was fufficiently divided, the stricture was removed, and the unfavourable fymptoms difappeared. Art. XXVIII. An Obfervation on the Infenfibility of Tendons, by Mr. John Teckel, Surgeon; with an Introduction by Dr. Hunter. A labouring man, fervant to Henry Bates near Bovintong, in Buckinghamshire, by fome accident in loading a cart, cut off the ends of the middle and ring fingers; the latter in fuch a manner, that about half an inch o: the tendon of the perfurans projected. in this condition I faw him, about ten minutes after the accident. It immediately occurred to me, that I now had a fine opportunity to convince my felf of the truth or fallacy of your opinion concerning the infenfibility of tendons, &c. I therefore paffed a piece of ftring, about the fize of the tendon, round his wril, from thence brought it about the injured finger, and placed it in fuch a manner, as to make it project parallel to, and beyond the ftump, of equal length with the expofed tendon. I then told my patient that I intended to cut the one or the other of these projecting parts, with my fciffars, while he should turn his head away; but he was to tell me which I cat, without feeing what was done. He laughed, and asked me whether I thought he had no feeling; however, he com plied. I then divided the tendon with my fciffars: he was asked which I had cut; he answered, "the ftring;" but when he turned his head around, and found it was actually the tendon, he was much furprised that he had felt no pain: and when I talked to him afterwards, he declared he felt not the leaft pain, and abfolutely thought I had cut the ftring only.' Let it be remembered, that many parts are infenfible in the healthy, which acquire a very exquifite fenfibility in the diseased ftate, Art. XXIX. An Account of a fuccessful Method of treating fore Legs, by Mr. Jofeph Elfe, Surgeon to St. Thomas's Hospital. This method is fo exceedingly efficacious, that Mr. Elfe fays, it will feldom fail where there is not a carious bone.-The method is this: The first thing we do, if the ulcer be foul, is, to endeavour to make it clean, by the application of a bread and milk, or fome other emollient poultice. When we have obtained this end, we apply a linen cloth moistened with tincture of myrrh or Goulard's eau vegetau-minerale, as from experiment we may find beft to agree. If thefe fhould give pain, we then firft apply dry lint, and upon that a piece of cloth fpread with the ceratum epuloticum, or ceratum album. Over this we lay a very thin plate of lead, cut to the figure of the fore, and juft large enough to cover its edges. This is fecured upon the part with a bandage drawn as tight as the patient can bear it, even io as to make the leg feel numb, which is rolled from the toes to above the knee. In proportion as the fore contracts we leffen the fize of the plate. When the patients are well, we recommend it to them for the future, to keep the leg conftantly rolled tight in the day-time. Now, though this method be exceedingly efficacious, yet it is not without its difadvantages. I have faid that it is fometimes dangerous to heal thofe old fores: when, therefore, from the long continuance of this drain, or from the bad habit of body, we apprehend ill confequences from healing the ulcer, we content ourselves with bringing it into a better condition, and with keeping it fo, by a judicious application of the bandage. Even where we have no great fears about healing the ulcer, it may be prudent to advife an iffue in the other leg, to order now and then a dofe of fome laxative medicine, and to confine the patient to a spare diet for some time after the fore is well. But if, notwithstanding thefe precautions, any dif order should fupervene, which may be imputed to the healing of the ulcer (fuch as pulmonic complaints, which are the most frequent) we immediately endeavour to open the fore again.' Art XXX. An uncommon Cafe of a fatal Hernia, by Mr. Jofeph Elfe, Surgeon to St. Thomas's Hospital. From this hiftory and diffection we learn, that a fatal strangulation may happen, though the whole circumference of the gut is not inclofed in the ftricture; and that where only a very small portion of the inteftine has defcended, an hernia may be be formed, and yet the external appearances be either very inconfiderable or none at all. Art. XXXI. An Account of the Effects of the Cicuta, and a Carrot Poultice upon a Can.er of the Breaft, in a Letter from Arthur Nicolfon, M. D. Phyfician at Berwick, to Richard Huck, M. D. F.R.S. This was undoubtedly a genuine cancer of the breaft. The carrot poultice was firft applied alone, and afterwards joined with the boiled tops of the cicuta; and with fuch good effect, that the cancerous cavity was filled up, and the cicatrix advanced fo far, that from a fore four inches broad, and two inches deep, it, in the space of fix weeks, would not receive an almond. But foon after the ulcer was brought into this ftate, behold the catastrophe! She was feized with violent fits of anxiety, orthopnæa, globus byftericus, and the most horrid fridor dentium I had ever heard; fo that I really thought her teeth must have been ground to pieces. When the recovered from the fit, fhe faid this grinding of her teeth was to keep down the lump in her throat. These fits were fo fevere, that we often thought her expiring. They lafted for a few hours at first, but increased gradually in length, till the 15th of February, when he died in one of them.' Is there not fome little degree of probability that these fatal appearances might be the effects of a metaftafis, in confequence of the difeafed part being brought into a healing ftate? This, however, could be no objection to the ufe of the remedies; for had the disease been left to itself, it must neceffarily have proved mortal. Art. XXXII. An Account of the Usefulness of Wort in fome ill-conditioned Ulcers, in a Letter from Benjamin Rufh, M. D. Profeffor of Chy mistry in the College of Philadelphia, to Dr. Huck. The great efficacy of wort, as an alterative, has frequently been pointed out, and is confirmed by the cafes here related. Art. XXXIII. Cafe of an incifted Tumor in the Orbit of the Eye, cured by Mers. Bromfield and Ingram, Surgeons in London. This cure was performed by evacuating the fluid, extracting the cyft, and afterwards treating it as a common fuperficial wound. A fimilar cafe is related by St. Yves. The two fucceeding papers contain two hiftories, which are a fatisfactory confirmation of what has been very usefully and ingeniously fuggefted by Dr. Hunter, in the preceding volumes of thefe Obfervations, concerning the aneuryfmal varix. In the next article, Mr. Lynn gives us the hiftory of a retroverted uterus, accompanied with fome important obfervations by Dr. Hunter. In this difeafe the gravid uterus falls backwards into the pelvis, and is lodged with its fundus downwards between the rectum and vagina. Dr. Hunter has seen several of these cafes, and they all occurred about the third month of pregnancy. When taken early, the uterus may easily be reftored 1 reftored to its natural position; but if allowed to remain till the impregnated uterus is fo much enlarged, as to be locked within the grafp of the pelvis, no effectual relief can be administered. Art. XXXVII. and laft. An Account of a fimple Fracture of the Tibia in a pregnant Woman, in which Cafe the Callus was not formed till after Delivery: By Mr. Edward Allanfon, Surgeon at Liverpool. The contents of this paper merit the attention, both of the phyfiologist and of the practical furgeon. D. ART. VIII. A Tour in Scotland. MDCC LXIX. 8vo. 7 s. 6d. W E have, on feveral occafions, with pleasure recommended the works of this eminent naturalift, to the notice of our Readers. His British Zoology, and Synopfis of Quadrupeds, are now become very generally known, and defervedly esteemed but if any perufer of this article is unacquainted with thofe ingenious and entertaining productions, we refer him to the works themselves, or to what we have faid of them in the 39th volume of our Review, p. 403, and in our number for October laft, p. 328. Mr. Pennant takes his departure from Downing, in Flintfhire, the place of his abode, and begins his defcriptions with that of Chester, where the narrative of his Tour properly commences. Hence the course of his Itinerary carries him through the counties of Derby, Lincoln, and York, the bishoprick of Durham, Newcastle, Northumberland, and fo on to Berwick, and to Scotland; giving an account of every town, and place of note, or object of curiofity, that lay in his rout; or that he thought it worth his while to quit the direct line of his way to vifit. And as he undertook this Journey from only the laudable view of perfecting his, British Zoology, by an actual vifit to a part of the island which he had not feen, he was in no difpofition to injure his defign by hurrying along, after the manner of those who make tours for pleasure and improvement, as though they were riding exprefs. It has, for a few years paft, been the fashion, with a popular party in this kingdom, to ridicule and vilify the Scots and Scotland, in the keeneft and grofleft manner; but more dishonourable, however, to the abufers than the abufed. The natives of North Britain have been reprefented-we need not fay how they have been represented; and the country itself defcribed as the feat of indigence and mifery; as (in the strong expreffion of the acrimonious Churchill) the land "Where half-ftarv'd spiders feed on half-ftarv'd flies." In the month of June. But |