little more than four pints, of a pretty high colour, saltish taste, and urinous smell.

11th. Not so well; urine rather more than seven pints; pulse 80, firm and regular. Carbonate of ammonia to be repeated. 12th. Urine eight pints; his appetite has been keen, and he takes more food than he can well digest; he is desired to eat less.

13th. Urine little more than seven pints, somewhat sweet to the taste; slight headach; tongue foul; pulse 80, weak, but regular; there is clearly an aggravation of the disease. Flattered by former success, Mr. Watt had again recourse to the lan- ̄ cet, and took from the arm, in a pretty full stream, twenty-four ounces of blood. This the patient bore well, and without feeling the least faintish; pulse, after the bleeding, 72, firm and regular.

14th. Urine only four pints, and in taste, smell, and appearance, nearly natural. "He walked in the afternoon, and was astonished to find a degree of strength and agility, to which, for many weeks, he had been a total stranger." Re-appearance of the powers of virility; pulse 74, firm and regular; blood drawn yesterday inflamed, cupped, and tenacious. "The most violent cases of pneumonia, or acute rheumatism, do not show the blood more sizy and morbid in its texture." Lime-water pre

scribed.

15th. Urine three pints and a half: no thirst. Continues better. 16th. Has had a gentle moisture over the body; the skin becoming soft and healthy, the old cuticle desquamating; gums healthy; strength greatly recovered; urine three pints and a half. At his own desire, 16 ounces of blood taken from his arm in a full stream; pulse, before bleeding, 72; after it, 70, firm and regular.

17th. Urine not quite three pints, has a very salt taste, and strong urinous smell; blood remarkably inflamed, buffy coat, thick, firm, and contracted.

20th. Strength gradually improving; was at work all day yesterday; in short, from the 14th instant, it appears from the

reports, that he has rapidly convalesced. The diabetes appears cured; nor did he afterwards suffer any relapse. The reports of the case, which we have so far presented to our readers in a very abridged form, are carried on by Mr. Watt to the 4th February, 1808, when the patient continued well. The whole case is very minutely detailed, from first to last, by our author. We have only noted occasionally those circumstances which serve most strikingly to connect the recovery of the patient with the treatment pursued. No one, we apprehend, can fail to remark the connection between the changes in the quantity and qualities of the urine with the different bloodlettings; and few will be disposed to attribute much to the different medicines occasionally employed, as the carbonate of ammonia, the antimonial powders, laxatives, lime-water, and bitters. The diet, it is true, all along consisted, in a great part, of animal food, but with some allowance of vegetable aliment. In short, as Mr. Watt has remarked, "Venesection is certainly the most prominent feature in the treatment. The abstraction of one hundred and eight ounces of blood, in less than two weeks, must have had a decided effect. He experienced relief in his feelings every time, and even, during that profuse evacution, gained strength." Yet, again to use our author's words, “In this instance, venesection was employed in the most forbidding circumstances. The pulse was slow, feeble, and not altogether regular; his strength and spirits were almost gone; the lower extremities had been edematous to the haunches, and were always cold and lifeless." He concludes, by stating the following general observations on the good effects of the evacuating treatment.

"Even the first bleeding produced a degree of hilarity, to which, for many weeks, he had been a total stranger. After the third, the pristine vigour of his mind was completely restored, and his feelings rendered more comfortable. After the fourth, the pulse rose to about 80, became firm and regular, and some degree of perspiration appeared on different parts of the

body. Still, however, there was no very remarkable change produced on the urinary discharge. After the fourth, there was evidently a relapse. The fifth seemed to act like a charm. The recovery, after this, was instantaneous and striking. The painful sensation in his bowels left him; the powers of virility returned; the gums became sound; the skin soft and perspirable; the saliva, the urine, and the alvine discharge natural; in six days he returned to his work; in two months he was restored to his original strength."

The next case is that of a student, aged 23. For some time before coming under the care of Mr. Watt, he appears to have suffered much from dyspeptic symptoms, lowness of spirits, and inability of mental exertion. His urine increased in quantity, and very frequently voided. He complained also of uneasiness and pain in the region of the kidneys. His skin was hide-bound; the gums spongy and ulcerated; and he was feeble and reduced. Pulse 80, very weak, but regular. The quantity of urine was six pints, two pints of which yielded one ounce seven drachms of extract, of the consistence of honey, and saltish to the taste.

The reports of this singular case are also very fully detailed. We had prepared an abridgment of them, that we might preserve to our readers the regularity of a journal, and enable them to form some idea of the effects of the uncommon treatment followed by Mr. Watt; but we must content ourselves with the summary which Mr. Watt himself has given us, and refer for the reports to the original. It matters little, whether we allow this to be really a case of well marked diabetes or not; it is at least one of great general debility, with local irritation of the urinary system, successfully treated by depletion, and an antiphlogistic regimen,—one in which health and strength were restored, though about one hundred and fifty ounces of blood had been withdrawn from the circulation during the treatment.

"During the first period, which extended from the beginning of October till the 13th, the patient abstained from animal food, wine, spirits, and every thing of a heating or irritating nature.

The bowels were kept moderately open; diluents were freely used, and an opiate taken at bed-time. This practice was persisted in for eleven or twelve days, without any advantage. On the contrary, the number of times of voiding urine had increased from eighteen to twenty-six or twenty-seven. The pulse had become weak, and intermitting; he had lost three pounds of his weight, and his strength and spirits were declining rapidly. The quantity of urine varied from five to eight pints; at times it equalled the whole liquid ingesta, and afforded, by evapora tion, a copious extract.

"In the second period, which extends from the 13th October till the 26th of the same month, the patient, as to meat and drink, was allowed to live pretty much in his own way; the bowels were kept moderately open, and the opiate was occasionally continued at bed-time. On the evening of the 15th, and morning of the 16th, the patient was persuaded to eat beef steaks, and found all the symptoms greatly aggravated. The four succeeding days he was very abstemious, and every thing seemed to wear a more favourable aspect. On the 20th his appetite became keen, and a second indulgence produced a second relapse. On the 21st the emetic had a good effect, but, on the 23d, his appetite returned, and it was thought hard to deprive a person of nourishment, when his body was sinking so rapidly, and when the depletion had been so considerable. He was bled six times, and had lost above an hundred ounces of blood. But notwithstanding the continuance of some of the most distressing symptoms, the improvement, in this period, was very conspicuous. The pulse, from being weak and intermitting, had become firm and regular; the inflammation of the eyes was gone, and his vision had become strong and distinct; the blood, which he used to pass with his urine, had left him, and the urine itself was diminished in quantity, and more natural in its appearance. But the most striking improvement was the restoration of the mind to its wonted energy.

"In the third period, from the 27th October till the 12th

November, his health and strength were rapidly on the decline. Various injections were tried to allay local irritation, but without any advantage. The perinæum was blistered repeatedly. At first this seemed to afford some relief; but after a more extensive trial, it was found unavailing. The anodyne was increased from thirty-five to sixty drops, and afterwards to an hundred; but even this very large dose produced but a transient respite from the pressure. In this period, the greater part of his diet was animal food; for the last seven days it was entirely so; but made no impression on the disease.

"The fourth period extends from the 12th November till the middle of December. In this interval the treatment was completely changed, and the progress towards recovery was uncommonly rapid. At the commencement, though the patient was greatly worse on the whole than he had been at all, yet, in some respects, he had not relapsed to his original condition. The mind continued serene, and even retained a considerable portion of energy; the blood was still inflamed, and of due consistency. In this period he was bled four times, and lost about fifty ounces of blood. Seven blisters, each of them nearly the size of the hand, were applied to the region of the kidneys, and a pretty rigid abstinence was observed. No medicine whatever was used till the 29th November, when he began the lime-water, which seemed to have a happy effect on the state of his stomach and bowels, and probably contributed to his final recovery."-p. 134–137.

The fourth case, a lady aged 57, bears in many respects a resemblance to this last. There were pain and weakness in the region of the kidneys, impaired strength, and dejection of spirits; increase of urine, and frequent uneasy micturition; thirst, and foulness of tongue; the gums spongy and ulcerated; the skin dry and harsh; the feet œdematous and cold, with vertigo, dyspnea, and palpitation. She came under our author's care on the 26th March; and, by the evacuating plan, she was freed VOL. 1.

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