the island, except Putlam, where a coolie from Jaffna was taken ill with fmall-pox in December last, but has fince recovered, without communicating the diforder to any other person. The vaccine disease has now been so extensively diffused throughout this island, that while the inoculations continue so numerous as at present, we can have no reason to apprehend that the contagion of small-pox will ever spread epidemically in any part of the British possessions on Ceylon; and its occasional appearance here has the good effect of proving the preservative efficacy of the vaccine, and of rousing the natives from their apathy on the subject, as exemplified at Jaffnapatnam, where 1830 people have been inoculated during the two last months, and amongst them several Bramins, men and women, who had hitherto declined submitting to the operation. I shall only add, that with a view of proving the permanency of the preservative efficacy of cow-pox, and the continuance of the purity of the virus on this island, Mr Stutzer has, at my request, in November and December last, inoculated with small pox matter, several patients who had passed through the vaccine disease in 1804, and in 1809, all of whom have resisted the contagion.-I have the honour to be, &c. Colombo, 24th January, 1810. Professor Boyer is preparing an extensive work on Surgery. M. Deschamp is preparing for the press a work on Aneurism. M. Pelletan, surgeon of the Hospice d'Humanité at Paris, has in the press two volumes of Clinical Cases and Observations, illustrated by numerous engravings. Sir George Alley, M. D. of Fermoy, Ireland, is arranging for the press a work to be entitled, " Reports of the Utility and Employment of Mercury in the treatment of Inflammatory and other Diseases, in which the exhibition of that remedy has been neglected, or considered as inadmissible." As this publication will necessarily embrace many important medical subjects, the author earnestly solicits the assistance of the respectable practitioners, civil and military, of Great Britain and Ireland, and will be happy to acknowledge any communications with which he may be favoured. Dr Watt of Glasgow will commence his summer course of Lectures on the Theory and Practice of Medicine, on Tuesday, the 7th May, at ten o'clock, forenoon. By lecturing every day Dr W. will comprise nearly the whole in three months, the time of the Botanical course. Dr Hosack of New York has begun to publish a periodical work, to be entitled "the American Medical and Philosophical Register," froin which much is expected. From the prospectus we quote the following sentence, as expressing the opinion of the Editors on a most important subject:-" They have no hesita→ tion further to declare, that upon the subject of the pestilential or yellow fever, which has lately made so great devastation in different parts of the United States, it will be one of the principal objects of their labours to combat the theories and opinions which many of those works have disseminated, to the discredit of our country, and perhaps to the loss of many valuable lives. To establish the line of distinction between those diseases which are of a foreign source, and such as are engendered at home, 'is an undertaking which must receive the countenance of every person actuated by love of country or humanity, and one in which the editors will embark with all the spirit of generous enterprize. Reply to Dr Stock's Remark in his Memoirs of Dr Beddoes. By the EDITORs. 27 WE have no wish that our Senatus Academicus should incur the displeasure of authors and their friends, whose wrath may sometimes be excited by our critical remarks. Conscious that our intention is always good, we never trouble ourselves whether our criticism be considered witty or severe, provided it be wise. It is incumbent upon us, therefore, to declare, in answer to Dr Stock's observations contained in a note to his memoirs of Dr Beddoes (page 378), that the remark which he attributes to the influence of irritation, from offence taken at the freedom of Dr Beddoes's observation on the Edinburgh Faculty, did not arise from any such cause. The reviewer thought that he discovered a want of the author's accustomed acuteness and consistency in that letter on medical reform, and he honestly said so. He thinks so still; but that idea did not prevent the same hand from penning the character of Dr Beddoes, which Dr Stock has done us the honour to quote with approbation.-The writer had no personal knowledge of Dr Beddoes. That estimate of his character was formed from his writings, and was dictated by a high and grateful sense of his public merits. We may take this opportunity to say, that we have been gratified by the perusal of Dr Stock's memoirs, and to express our wishes that he will soon publish them in octavo, in order that the biography may rest on the same shelf with the writings which it records. The Reviews of Dr Alley's and Mr Haslam's works have been unavoidably delayed till next Number, which will be published on the 1st of July 1811. CORRIGENDUM. No. XXV. p. 101. 1. 17. for suffering and humanity, read suffering humanity. THE EDINBURGH MEDICAL AND SURGICAL JOURNAL. 1. JULY 1811. PART I. ORIGINAL COMMUNICATIONS. I. Cases of Ruptured Spleen and Liver by External Injury, with Res marks thereon. By C. CHISHOLM, M. D. F. R. S. &c. &c. HERE can be little doubt that death is frequently consequential on blows, and injuries of a similar nature, received on the region of the liver or spleen, although, from the integuments remaining uninjured, little room is supposed to be given to suspect that such blows and injuries could have been directly instrumental in the production of such an event. I am led to this remark, by comparing some recent instances of this kind of injury with others which formerly occurred in my practice in Grenada; the former terminating favourably, from the suspicion raised in my mind by the fatal result of the latter directing to an appropriate treatment. A review of these errors and failures instruct physicians more than any other class of men; an ingenious confession of them enables them to instruct others; and a judicious application of the instruction has a tendency to benefit mankind in ge neral. It is with this view I transmit the following cases. If you deem them worthy of insertion in your very excellent Journal, they are at your service. I extract them almost literally as I find them in my West India Journal. On the evening of the 27th July 1792, Joseph Morton, a gun ner of the royal artillery, aged 25, of a moderate height, naturally strong-constitutioned, but for a year before frequently harassed with dangerous attacks of remittent fever, and by trade a blacksmith, carrying on his back a bag containing eighteen gallons of dry peas, down the declivity of a hill of a moderate ascent, fell with his left side, exactly the region of the spleen, on a large stone. That evening, and all the following morning, the fall occasioned so little uneasiness, that he was able to work at the forge: but afterwards he became very feverish, and so oppressed with pain in his left side, the epigastrium, and lower extremities, as to be obliged to desist. On the evening of the 28th he was brought to the Ordnance Hospital, when I found him much in the situation mentioned. I bled him very freely, which however, so far from giving him relief, seemed to increase his fever to an outrageous degree of delirium. Upon this, imagining that there might be more of a nervous excitement than of inflammatory diathesis, I ordered him a pill of gr. iss. of opium, and gr. ij. of James's powder. This gave him no relief. A second pill was given two hours after the first; and half an hour after taking it, he became calm, and fell into a profound sleep. On the morning of the 29th he had still much fever, but the pains were considerably abated. To remove the fever, he took saline mixture, with small portions of sweet spirit of nitre and antimonial wine. On the 30th he complained of pain in his throat, and excessive difficulty in swallowing. For these a blister was applied between the shoulders; and to obviate costiveness and some remains of fever, a solution of Glauber's salts and tartar emetic was given with desired effect. On the 31st all his symptoms had disappeared, and he felt himself apparently easy and well. About midnight, however, he suddenly became delirious, with burning fever, and such an increase of pain in his left side particularly, as to render even the gentlest touch insupportable. I should have mentioned, that during all the 31st he took a good deal of bark and wine, which towards evening his stomach rejected. On the 1st of August he was in this state, his skin parched and dry, and his pulse irregular, tremulous, and frequently intermitting. In addition to all this, the irritability of the lower extremities excessive, with sudden spasms of the muscles; anxiety great, with grievous moaning. In pretty nearly this state he continued till one P. M. when he expired. The heat of his skin increased to an astonishing degree some time before his death; and even two hours after, when I examined the body, the heat of the abdominal cavity, and its contents, were extremely disagreeable, and of such a penetrating nature, as to leave a painful sensation on the hand some time after withdrawing it. I opened the body in the presence of Lieutenant Swiney of the artillery, and Mr Campbell my assistant. I found all the intestines, the liver, kidneys, diaphragm, and heart, in a healthy state. But on the posterior superior convex side of the spleen, there was a rupture through the whole of its substance, at least two inches in length, the edges of which had a florid appearance in some places, and in others something like sphacelus could be perceived. The spleen itself was of a very considerable size, but in other respects had no appearance of disease. The lungs were evidently much inflamed. All the ribs were sound, and the integuments had nowhere any mark of injury, except an almost imperceptible discoloration immediately over the spleen. Nearly about the same time, another case of injury of this nature occurred, in a soldier of artillery of the name of Hill. I find it stated in the following manner: "Lately I have had a case of fever, the predisponent cause of which appeared to be a fall from a considerable height on the edge of a form, in which the side appeared to be much hurt by the internal pain complained of, for no external injury could be perceived. The pain, however, seemed to cease gradually after using for a few days some spirit of wine camphorated. No fever took place till the 11th of August, about three weeks after the fall; and at this time he complained of his side so little that I should not have known of the accident, had it not been slightly mentioned by himself, in the account he gave me of his case. Some time before the fall he was confined to the hospital for dysentery; and at the time he fell, was in convalescent barracks on Mount Cardigan. The symptoms at first did not differ much from those of endemic remittent fever; and my success hitherto, joined to the circumstance of the fall, determined me on giving mercury, in the fol lowing form: B. Nitri, 9j. Calomel, ppt. gr. iv. M. ft. pulvis, sumend. 4 in die. "In the evening of the 12th I gave, besides the four powders he had taken in the course of the day, a bolus of six grains of calomel; and on account of the fall, and consequent apprehension of local injury, I bled him very freely. All the 13th he used the powders; but complaining of much pain in his neck, back, and head, a large blister was applied between the shoulders. The powders hitherto had acted merely as deobstruents, producing most copious and frequent bilious stools. On the 14th much easier, but stomach rather irritable, for which he took saline draughts with |