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she drank about an ounce, and bathed her ancles with the remainder.

In about three hours after this, she felt something twisting itself about her thigh, and upon examination found a living tape-worm, upwards of three yards long; and from that time to this, now more than two years, has been entirely free from pain in her stomach. Her daughter has returned the visit, and found her mother in good health, with some of the "gude stuff" in the window, ready if the pain should

return.

Since knowing of the above, a Mrs. Pipe applied to me on account of a bilious, nervous affection, with loss of appetite, &c. for which she had medicines and advice; but not getting quite well, observed she had forgot to mention a strange unpleasant sensation in her stomach, attended with slight pain at times, and a rising up to her throat, as of something alive; and saying also, that a long worm had lately crept into her mouth, I advised her to take a glass of gin, with two tea-spoonsful of spt. vin. camph. in a morning fasting, which she readily did, and from the time of doing so, lost all the distressing sensation in ber stomach, has recovered her health and appetite, and been well ever since, now several months. She has no doubt but the worms in the stomach were the cause of her ill health, and firmly believes the spirits killed them; but as she visited the temple in the garden, no examination for the vermes was thought of. Mrs. E- -, a single woman, about 60 years of age, till about 20 years since, was of a natural fair complexion; when having an illness of some continuance, she perceived on her recovery that her complexion had changed to a dark hue, which has since gradually increased to that of the darkest native of Africa.

Mrs. E. is in general good health, but occasionally com plains of rheumatism. I should be glad if some of your correspondents would favour us with their opinions of the cause of this singular phenomenon.

To the Editors of the Medical and Physical Journal.

GENTLEMEN,

On the 15th of March, 1809, a lady, 63 years of age, was attacked with pleuritis, but being from home when her friends sent for me, and detained by unavoidable circumstances until noon the day following, I consequently could not see her until the 16th about three o'clock in the afternoon. I found her

in a very distressed situation: the pain (which was on her left side) was violent; lancinating from the sternum to the scapula with great severity; inspiration remarkably difficult, increasing the pain so much as to induce her to scream out; pulse very hard and contracted, beating irregularly from 90 to 100 strokes in the minute; tongue covered with a thick white fur, except the sides of it, which were preternaturally red; bowels costive; urine scanty; thirst very distressing, but the pain occasioned by the effort of deglutition prevented her from alleviating it as she wished. I immediately took a pound of blood from her arm in as sudden a manner as possible, and induced syncope. The blood shewed no buff; the time of its flowing was about four minutes. I then directed the application of hot flannels to her side, until the arrival of a servant whom I had dispatched for a blister, and some powders composed of super tartras potassæ; nitratis potass, and gr. 4. pulv. digitalis every third hour; immediately after the bleeding, she felt herself much relieved and breathed more freely; her pulse was much softer and fuller, and she now took copiously cooling acidulated drinks.

17. Symptoms varied very little since yesterday; urine high coloured; the blister rose well.

18. Pain much more violent; inspiration extremely difficult; pulse nearly in its original state, hard, tremulous, and contracted; cannot bear any other position than lying on her back with her head raised. Repeated the venæsection to a pound in the same sudden manner as before, and she was relieved; the blood was now covered with a thick opaque crust, and the surface was very concave; prescribed tart. antim. gr. and ætheris nitros. gutt. xv. in mist. camphorat. with each dose of the powders as before.

19. 9 A. M. Has had no sleep, pain still acute, yet something more like a weight or faliness (as she expressed herself); bowels gently open, urine high coloured and scanty; puise 80, a gentle moisture upon the skin; thirst very troublesome.. Ordered six leeches to the side. Evening very restless, pain as in the morning, pulse 75, beating more regular and soft; prescribed a draft as follows, and left her for the night. R. Ext. byosciam gr. x. ætheris nitros. oxymel colchici ää zj mist. camphorat. 3j. M. H. S. S.

Monday morning, 20th. Had no rest, pulse compressed, 70-feels a great weight and pain in her left side quite up to her shoulder; if raised so as to sit up, she immediately becomes faint, and is obliged to recline on her pillows again; countenance expressing great anxiety, pale and dejected, except that on each check there is a circumscribed redness inclining to a purple hue; has not voided more than three (No. 148.) E

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ounces of urine since last night eight o'clock; suspecting an effusion within the chest, I prescribed as follows.

R. gum. gamboga. gr. iv. ætheris nitros. oxym: colchici, tinct. scillæ. aa ziij. tinct. digitalis zij. mist. camph. aquæ puræ, aa ziiiss. M sumat. cochl. dua 2a. qq. hora."

Repetatur H. anod. c. extra hyosciam. gr. xij. H. S. S. 21. Last night slept two or three hours, pain still severe, pulse 60 and compressed, intermitting at times one or two strokes; hands benumbed and cold, particularly on the left side; last night awoke from a dream much frightened, and was a long time before she could be composed; if she sits, faintness still immediately supervenes; has not voided more than six ounces of urine the preceding twenty-four hours.

Continue the mixture and draught at bed time as before. 22. Has had several fluid stools, and made about half a pint of water; fell asleep last night about twenty minutes after taking the draught, and remained so nearly two hours, when she awoke again in a fright and fancied she was suffocating: pulse 55, much compressed and intermitting frequently; hands and face cedamatous; the symptoms now evidently and distinctly mark the case to be hydrothorax.

Continue the mixture and draught as before.

230 and 24th. Much as before, except that the flow of urine is more copious and she has two fluid evacuations e recto in the twenty-four hours. Continue as before.

25th and 26th. Has voided about fourteen ounces of urine and two stools in the twenty-four hours, these last two days, which is somewhat less in quantity than what she takes; pulse 53, frequently intermitting; cannot bear an erect posture.

27th. A considerable remission of pain, pulse 55, compressed and low; she has made about a pint and a half of water the last day, and there is a free action of the bowels, so that the fluid discharged is nearly equal to the quantity drank. Continue as before.

S0th. Flow of urine as before, a pint and a half; hands and face still cedematous, breathing very difficult, and she still awakes at times greatly alarmed and terrified; I added to her mixture, ætheris nitros. oxymel. colchici, tinct. scilla a 5j. tinct. meloë vesicat. zij, to be taken as before with the draft at bed time.

April 5th. Urine discharged copiously; pulse 60, fuller and more regular, swelling of the hands and face subsiding; her breathing is not so confined, and she has slept tolerably composed the last two nights. What is to me most remarkable in this case is, that since the time of her last parturition, twenty-one years ago, she has never menstruated from the vagina, bat invariably and regularly from the rectum, with

this difference, that sometimes it has been to the amazing quantity of four, five, or even six pounds; yet this enormous discharge has not reduced her so low as might be expected, but merely kept her in a state of common debility. Notwithstanding her advanced age, the discharge still appears at regular periods, and is preceded by the common symptoms; a sudden check which was incautiously given to it, may, I think, be deemed the proximate cause of the pleuritis, in which form the system was first attacked; and consequently the serous effusion in the chest was the effect of the increased inflammatory action of the minute secreting arteries on the surface of the pleura; and with respect to the vicarious hæ morrhage, I cannot see any other method of accounting for it, than by supposing the principal branches of the uterine arteries obliterated, and some anastamosing branch of the hypogastric assuming the action, perhaps the hæmorrhoidea media.

April 11th. Hæmorrhage returned from the rectum; pulse 66, breathing much easier, can sit up four or five hours in the day; prescribed a mixture with extr.cinchon. solut. arseaic: and ætheris nitros. and to make free use of wine.

12th. Has had a restless night, hæmorrhage considerable, pulse 66; last night awoke from a dream frightened, swelling of the hands trifling, the quantity of urine voided is nearly double to the fluid drank, bowels freely open. Continue the

cinchona, &c.

14th. A considerable pain in her head, pulse 70, natural, has a large flow of urine and one fluid evacuation e recto, per diem; nausea with an inclination to throw up; I consider it as the effect of the cinchona. She therefore omits it.

16th. Hæmorrhage stopped, pulse 70, natural, no thirst or pain, no sickness, appetite still poor; bowels regularly evacuated every day once, flow of urine copious; no swelling of the face or upper extremities. She appears convalescent.

She has had regular returns of the discharge until lately; it has varied both in quantity and regularity, and now seems as if it were about to cease; her health has been tolerable, except occasionally, when walking quickly, or otherwise exerting herself, she feels a little difficulty of breathing; she is under the necessity of taking some opening medicine occasionally, that the discharges from the system may be freely pro moted.

I am, Gentlemen,

Your most obedient humble Servant,
JOHN KENWORTHY.

Dobcross, Yorkshire,
Oct. 16, 1810.

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Case

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For the Medical and Physical Journal.

Case of strangulated Hernia reduced by the administration of Ether. Communicated by ARDUSSET, M. D. at Bazas, to the Editor of the Gazette de Sante, March 1809.

DELOUMES, a hatter, aged about sixty years, of very

Spare habit, and bilious sanguine temperament, had been afflicted during fifteen years with inguinal hernia of the right side, which he reduced by the taxis, and kept up by means of a truss. This, however, he had discontinued about eighteen months, without any signs of the rupture being apparent.

In June, 1808, he rode a considerable distance on horseback in a very hot day; on his way he was seized with severe griping in the bowels, and a sharp pain in the right groin. He continued his journey, however, and returned home the next day without any further complaints than slight bead-ach, and a painful sensation in the lower part of the abdomen.

The following day, June 17, whilst occupied in his shop, he was suddenly afflicted with a violent pain near the abdominal ring. Upon applying his hand to the part, he felt the tumour of the hernia, which he succeeded in returning within the abdomen. Two hours afterwards he ate a hearty dinner, and again entered his shop; but had scarcely commenced his usual employment, when the pain returned with a degree of intensity that scarcely permitted him to reach his chamber, and throw himself on his bed.

Whatever efforts he now made to reduce the hernia were unavailing. A common glyster was immediately thrown up, blood taken from the arm, and some hours afterwards he was placed in the warm bath, where he continued about an hour. The pain became easier, but the hardness and the volume of the tumour remained the same, and the following day the pain returned to an alarming degree. The patient was bled again, and put into the warm bath, which he could not bear beyond half an hour, although in the horizontal position. Upon being taken out of the bath, the swelling was covered with a large emollient poultice, which was renewed as often as it became cool. His drink was lemonade, and his nourishment chicken broth. He passed a restless night: the pain continued, and he was affected with hiccup and bilious vomiting. The pulse was small and frequent.

On the 19th, further assistance being deemed requisite, Dr. Ardusset was called in. His attempts at reduction proved ineffectual, and the symptoms became more threatening. He

then

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