by rendering it impossible to carry the discharge farther, until the contractile power of the heart and arteries be somewhat restored. The interval for effecting this renewal of power, is that which should determine the repetition of bleeding in inflammatory affections possessing any kindred violence to hydrophobia and gastritis, and this will in general be found to be about three hours rather than twelve or twenty-four, as usually enjoined and acted on. I am firmly persuaded that a more valid and useful rule could not be proposed in the cure of visceral inflammation, than that of drawing blood every three hours, in such quantities at each time as the action of the heart will bear, and continuing the practice as long as the characteristic symptoms of inflammatory disease may remain. Would not phrenitis, pleuritis, pneumonia, carditis, hepatitis, enteritis, cystitis, and other similar affections, be at least equally benefited by such treatment as hydrophobia and gastritis? Experience, the unerring touchstone of truth, will surely answer in the affirmative. Taunton, June 14, 1813. I am, &c. ROBERT KINGLAKE. To the Editors of the Medical and Physical Journal. ERFECTLY coinciding in your opinion on the variouslyuseful information to the profession and to the public, likely to be obtained by a medical view of the different counties of the United Kingdoms, I now endeavor to contribute my mite to the general stock, by transmitting a topo- graphico-medical survey of the county of Nottingham. I trust you will excuse me suggesting to your correspondents the additional advantages deducible from an enumeration of the inaugural theses of the different physicians, and from a notice of whatever essays or memoirs may have been given to the world by the different medical characters of each county, whether diffused in the extensively-circulated monthly journals, or in separate volumes. This may be accomplished without any considerable trouble. Allow me also the liberty of remarking, that no very essential benefits can result from publishing these surveys in alphabetical order, which may have the effect of preventing for a length of time the appearance of many of the different counties, and altogether of retarding the views which I am disposed to entertain on this subject. I would recommend that the topographical surveys should be published in each Number as they are received by the respectable Editors of the the Medical Journal; and when they have been given to the medical world in this detached manner, I should have great. pleasure in seeing them collected in regular alphabetical order in one number of the same work. This number will always prove a valuable source of reference, and our brethren with a very inconsiderable degree of trouble may be acquainted with the names, residence, and different departments, of all the medical men in the United Kingdoms, with the inaugural theses of graduates, and the publications of every practitioner. Proceeding now to the topographical survey of Nottinghamshire, I remain, Gentlemen, Your constant reader, and occasional contributor, H. B. In the neighbourhood of Nottingham is a large handsome Infirmary, supported by voluntary subscription, and gratuitously attended by the medical officers. The number of patients admitted into this Infirmary during the last year (1812) amounted to 45, and the out-patients to 336. This Infirmary has received patients during the last 31 years, and has admitted and discharged in that period, in and out patients, to the number of 37,161. Of this number 4107 persons were admitted on sudden accidents; and there have been, since its first opening, 190 amputations, 9 trepanned, and 51 cut for the stone. The medical officers of this excellent institution are the following:-Dr, John Storer, consulting phys. extra. for life; Dr. William Marsden, Dr. Charles Pennington, Dr. Alexander Manson, physicians; Mr. Thomas Wright, Mr. John Attenburrow, and Mr. John Wright, surgeons; Mr. Robert Thompson, house-surgeon, apothecary, and secretary; Mr. Carden Thompson, apprentice in the hospital. A handsome and extremely commodious building has lately been erected in the neighbourhood of Nottingham for the reception of lunatics; the medical officers of which are:Dr. John Storer, consulting physician; Dr. Charles Pennington, physician; Mr. Henry Oldknow, surgeon; Mr. Morris, director. Physicians practising and residing in the town, with their inaugural theses, &c. Dr. John Storer,* (De Angina Malignâ,) Glasg. 1771. * Dr. Storer has given an instructive paper in the third volume of the Medical and Chirurgical Transactions, intitled, "An Instance of the entire Want of Pulsation in the Arteries of Paralytic Limbs." 0 2 Surgeons Surgeons practising and residing in the town of NottingHAM: Mr. Thomas Wright, Mr. Attenburrow, Mr. John Wright, Mr. Maddox, Mr. Basnett, Mr. Butlin, Mr. Williams, Mr. Calvert, Mr. Buck, Mr. Watts, Mr. Stanley, Mr. Higginbottom, Mr. Allen, Mr. Oldknow.* NEWARK.-The following medical gentlemen practise and reside in Newark :-Physician, Dr. Robert Buck, (De Ischuria Renali,) Edinb. 1778.-Surgeons, Mr. Lacey, Mr. Parker, Messrs. Bland and Deeping, Mr. Ashwell, Mr. Thompson, Mr. Cooke. RETFORD.-Physician, Dr. John Bigsby.-Surgeons, Messrs. Cavie and Holmes, Messrs. Russel and Hartshorn, Mr. Flower, Mr. Ince. SOUTHWELL.-Mr. Thomas Falkner, Mr. Hutchinson,+ Mr. Cooke. MANSFIELD.-Mr. Paulson, Mr. Savage, Mr. Bowmer, DUNHAM.-Mr. Eyre. SUTTON-ON-TRENT.-Mr. Spry, Mr. Mann. WARSOP.-Mr. Robinson. ARNOLD. Mr. Keyworth. CARLTON.-Mr. Mann. BINGHAM.-Mr. Rose. CAR-COULSTON.-Mr. Blagg. ALLERTON.-Mr. Ward, WORKSOP.-Mr. Marson,‡ Mr. Clarke. To the Editors of the Medical and Physical Journal. ON GENTLEMEN, N looking over your last Number, (for July,) I find there a case of obstinate vomiting related by Dr. Yeats; in which, after having used many ineffectual remedies, he at length discovered the utility of mercury, in arresting the progress of so obstinate a disease. As a farther proof of the success of this practice, when properly directed, * Mr. Oldknow has given two ingenious papers in the volumes of the Edinburgh Med, and Surg. Journal on Hydrophobia, and on the operation of tying the great Saphena Vein. + Mr. Hutchinson is the author of the Biographia Medica, and of several papers in the Memoirs of the Medical Society of London, and in the London and Edinburgh Medical Journals, &c. ↑ Mr. Marson is the author of one or two papers on the subject of Vaccination, in one of the early volumes of this Journal. I shall I shall here add a few cases, which will at once convince any unprejudiced observer of its good effects in such cases. Mrs. Chesen had for many years been affected with stomach complaint, attended with vomiting. At length she became quite confined to bed, and regularly vomited every thing taken. She also complained of much pain at the pit of the stomach, with much oppression over the whole epigastric region. During the first week of her confinement, I tried all the common remedies used in such complaints, viz. purging, anodynes, cardiacs, and tonics, without the least benefit. As she appeared now in a hapless condition, I determined to lay all other medicines aside, and put ber under the influence of mercury as soon as possible; by which I knew, from former experience, I could at least stop the progress of her disease for a time. She was therefore ordered two grains of calomel, with half a grain of opium, every three hours, in form of a small pill, which remained on the stomach, as no liquid was taken more than could possibly be avoided. In about forty-eight hours, the mouth began to be affected, and the vomiting to subside. The calomel was continued for another day, when it was laid aside, her mouth being now her chief complaint. No more vomiting appeared, and all the load at the stomach, as well as the pain, ceased. Her mouth remained sore for a week or ten days, during which she took some weak decoction of bark, and recovered her strength rapidly. 2. Mrs. Lanham had been ill of similar complaints for near a fortnight when I first visited her. She was now quite confined to bed, and unable to retain any thing upon her stomach. As she appeared almost reduced to a skeleton, I first attempted to check the vomiting by tonics and anodynes, as her bowels were pretty regular; I soon, however, found that these had no effect, and without farther delay gave her the calomel in doses of four grains with one of opium every four hours, with a view to affect the mouth as soon as possible. The case being severe, it required even at this rate almost a week's perseverance before the mouth was affected, when, as in the former instance, all her retchings and vomitings began to subside. She now omitted the calomel, and took the decoct.cinchon. as a tonic, which com. pletely restored her in about a fortnight more. N.B. In the first part of her complaint she vomited a stomach-worm of the teres kind, which seemed, however, to have little cause in producing her complaint, as the sickness and vomiting remained equally severe till the mouth became affected. 3. Mrs. Allen.-This was a still more obstinate case, as it was was more chronic. She had been for months attended by a physician and surgeon, without any permanent benefit. She was confined to bed, and appeared in the utmost danger. I was called up to her in the night, and, as she appeared. dying, the retching and vomiting having continued incessant for several hours, with a burning heat at her stomach, I at first attempted to allay it by giving several drams of tinct. opii, which was no sooner taken than it was ejected. In this state, knowing not what to recommend, I gave her cold water only, in small quantities, as fast as she could swallow it, and applied cloths wetted with vinegar over the region of the stomach, which were renewed every ten minutes. This produced such a shock as to check the vomiting for several hours, when I seized the opportunity of introducing the calomel and opium, as in the last case. The desired effect was produced in about a week, and the result. was equally pleasing. Here, as in the former instances, just in proportion as the mouth became affected, in the same. proportion did all her other complaints subside. She afterwards took the bark, and has had no return of the disease since, although now more than five months. 4. Mrs. Bond had been attended by a medical gentleman for near a fortnight, who finding no abatement of the disease, ingenuously confessed his doubts with regard to her recovery. Under these circumstances I was called in all haste, when I found her complaining of much pain over the epigastric region, a sensation of weight or oppression at the pit of the stomach, constant retching and vomiting on taking any thing into it, pulse rapid, skin hot, bowels regular. On pressing the hand over the region of the stomach and umbilicus, I could easily perceive a considerable enlargement of the left ovarium and spleen, which latter seemed to press against, the stomach, and was no doubt the chief cause of vomiting in this case, especially as the sickness was only induced by taking something into the stomach which naturally enlarged it. Here, then, I had two strong inducements to use the calomel: first, to prevent organic disease; and, secondly, to arrest the vomiting, which was in this instance a necessary consequence of the former. She was therefore ordered to lay aside all medicines except the calomel, which she took at the rate of twenty grains a-day, with three of solid opium, in form of three pills, at the distance of six hours for six days, without either materially affecting her mouth, or making much impression on the disease. The sickness, however, was considerably abated, and the oppression at the stomach nearly removed. Here the calomel was omitted for two days, fearing a violent ptyalism would ensue on its farther 3 |