Chapter D: CALDWELL, Clerk of the Eastern District of Pennsylvania

CONTENTS

OF VOL. II.

No. III.

ORIGINAL COMMUNICATIONS.

ART. PAGE.

I. Description of the Gangrenous Ulcer of the mouths of children. By B. H. Coates, M. D., one of the Physicians to the Philadelphia Children's Asylum, &c. 1

II. Case of Purpura in an Infant, attended with extraordinary symptoms. By R. M. Huston, M. D. 24

III. History of the Natural and Modified Small Pox, or of the Variolous and Varioloid Diseases, as they prevailed in Philadelphia, in the years 1823 and 1824. By John K. Mitchell, M. D., and John Bell, M. D., attending physicians at the then Small Pox Hospital. With a plate. 27

IV. Remarks on the Pathology and Treatment of Yellow Fever. Arranged from the notes of Dr. J. A. Monges, of Philadelphia. 53

V. Remarks on the Prophylactic Treatment of Cholera Infantum. By Joseph Parrish, M. D., one of the Surgeons to the Pennsylvania Hospital. 68

VI. Case of Neuralgia cured by Acupuncturation. Communicated by J. Hunter Ewing, M. D. 77

ANALYTICAL REVIEWS.

VII. Researches into the Nature and Treatment of Dropsy in the Brain, Chest, Abdomen, Ovarium, and Skin. By Joseph Ayre, M. D., &c. 79

VIII. An Essay on Venereal Diseases, and the Uses and Abuses of Mercury in their Treatment. By Richard Carmichael, M. R. I. A. With Practical Notes, &c. By G. Emerson, M. D. 109

IX. Remarks on some Means employed to destroy Tænia, and expel them from the Human Body. By Louis Frank, M. D. Privy Counsellor of her Majesty, Maria Louisa, Duchess of Parma. 114

X. Researches, Physiological and Pathological, instituted principally with a View to the Improvement of Medical and Surgical Practice. By James Blundell, M. D., Lecturer on Physiology and Midwifery at the United Hospitals of St. Thomas and Guy. 119

XI. An Inquiry into the Nature and Treatment of Diabetes, Calculus and other Affections of the Urinary Organs. By William Prout, M. D., F. R. S. With Notes and Additions, by S. Colhoun, M. D. 125

MEDICAL LITERATURE.--RETROSPECTIVE REVIEW.

XII. Tractatus de Ventriculo et Intestinis, cui præmittitur alius, de Partibus continentibus in Genere, et in Specie de iis Abdominis. Authore Francisco Glissonio. Lond. 1677, 4to. 138

QUARTERLY SUMMARY OF MEDICAL AND SURGICAL INTELLIGENCE.

ANATOMY, 155

1, Papillæ of the Tongue. 2, Villi of the Stomach and Intestines. 3, Minute distribution of the Vessels of the Liver. 4, Trachea perforating the Aorta. 5, Monsters. 6, Malformation of the Heart. 7, Acephalous Mummy. 8, New Anatomical Plates. 9, A Manual of Osteology. 10, Soemmering's Work on the Anatomy of the Ear. 11, Does the conjunctiva run over the Cornea?

PHYSIOLOGY, 158

12, Electro-Galvanic phenomena of Acupuncturation. 13, Variations in Milk. 14, Hyoscyamus dilates the Pupils of the Eyes. 15, Worms in the Eye. 16, Digestion.

PATHOLOGY, 161

17, Dothinenteria--Pustules of the small Intestines. 18, Dr. Broussais. 19, Whooping Cough. 20, Antiperistaltic Globus--Globus Hystericus. 21, Non-contagion of Yellow Fever.

THERAPEUTICS, MATERIA MEDICA, AND THE PRACTICE OF MEDICINE, 166

22, Iodine. 23, Non-mercurial Treatment of Syphilis. 24, Cancer treated by Antiphlogistics. 25, Essential Oil of Male Fern as a remedy in Cases of Tænia. 26, Tincture of Bastard Saffron for the expulsion of Tænia. 27, Oil of Turpentine in Tænia. 28, Action of the Oil of the Euphorbia Lathyris. 29, Medicinal Properties of the Apocynum Cannabinum or Indian Hemp. 30, Remarkable Effects from the external application of the Acetate of Morphia. 31, Cure of Urinary Calculi, by means of the internal use of the Bicarbonate of Soda. 32, Attempt to cure Abdominal Dropsy by exciting Peritoneal Inflammation. 33, Artificial Respiration. 34, Secale Cornutum. 35, Animal Magnetism. 36, Sketch of the Medical Literature of Denmark, Sweden, and Norway. 37, Erysipelatous Mumps or Angina Parotidiana. 38, Tænia. 39, Scrophula. 40, Digitalis.

SURGERY, 192

41, Dr. Physick's Operation for Artificial Anus denied to have been performed. 42, Gangrenous Sore Mouth of Children. 43, Operation for Phymosis. 44, Lunar Caustic on Wounds and Ulcers. 45, Hæmorrhage from Lithotomy. 46, Extirpation of the Parotid Gland. 47, Aneurism from a Wound, cured by Valsaiva's method. 48, Protrusion and Wound of the Stomach. 49, Oesophagotomy. 50, Retention of Urine, caused by a Stricture of the Urethra, relieved by a forcible but gradual Injection. 51, Tracheotomy. 52, Fistula Lachrymalis. 53, Aneurisma Herniosum. 54, Extirpation of the Two Dental Arches affected with Osteo-sarcoma. 55, Traumatic Erysipelas. 56, Obliteration of a portion of the Urethra, remedied by an Operation. 57, Artificial Joint cured by Caustic. 58, Epilepsy cured by Trephining.

MIDWIFERY, 205

59, Gastrotomy. 60, Cæsarian Operation, performed with safety to the Mother and Foetus. 61, Extirpation of the Uterus. 62, Uterine Hæmorrhage.

CHEMISTRY AND PHARMACY, 208

63, State in which Morphia exists in Opium. 64, Peculiar Principles of Narcotic Plants. 65, Relative quantities of Cinchonia and Quinia with indention in the most esteemed Varieties of Peruvian Bark. 66, Sulphate of Quinia, extracted from the Cinchona Bark, exhausted by Decoction. 67, Analysis of Rhubarb. 68, Alkaline Lozenges of Bicarbonate of Soda. 69, Presence of Mercury in Samples of Medicinal Prussic Acid. 70, Proposed Method of preparing Protoxide of Mercury by precipitation, for Medical Employment. 71, Goulard's Extract of Lead.

QUARTERLY LIST OF AMERICAN MEDICAL PUBLICATIONS, 214-16

No. IV.

ORIGINAL COMMUNICATIONS.

ART.

I. On the Epidemic of 1825 in Natchez, Miss. By Ayres P. Merrill, M. D. 217

II. History of the Natural and Modified Small Pox, or of the Variolous and Varioloid Diseases, as they prevailed in Philadelphia, in the years 1823 and 1824. By John K. Mitchell, M. D., and John Bell, M. D., Physicians at the then Small Pox Hospital. (Concluded from page 53.) 238

III. Cases of Nervous Irritation, exhibiting the Efficacy of Cold as a Remedy. By S. Jackson, M. D. 250

IV. Remarks on the Pathology of Jaundice. By G. B. Wood, M. D. 260

V. Account of a Case in which a New and Peculiar Operation for Artificial Anus was performed in 1809. By Philip Syng Physick, M. D., Professor of Surgery in the University of Pennsylvania, &c. Drawn up for publication by B. H. Coates, M. D. 269

VI. Observations on Asphyxia from Drowning, to which is added a Case of Resuscitation. By Edward Jenner Coxe, M. D. 276

ANALYTICAL REVIEWS.

VII. Traité Zoologique et Physiologique, Sur les Vers Intestinaux de l'Homme. Par M. Bremser, D. M. Traduit de l'Allemande par M. Grundler, D. M. P. Revue et Augmentée de Notes. Par M. de Blainville, D. M., &c. Avec un Atlas. Paris, 1824.

Anatomie des Vers Intestinaux, Ascaride, Lombricoide, et Echynorhynque Geant. Memoire Couronné par l'Academie Royale des Sciences, qui en avoit mit le sujet au Concours, pour l'année 1818. Avec 8 Planches. Par Jules Cloquet, &c. &c. A Paris, 1824 297

VIII. Precis Theorique et Pratique, sur les Maladies de la Peau. Par M. S. L. Alibert. 2 Tomes. 8vo. Paris, 1810-1820. 322

IX. Thoughts on Medical Education, and a Plan for its Improvement; addressed to the Council of the University of London. Dictu Necessaria. Plin. London, 1826.

Projet de Loi, presenté aux Chambres dans la Séance du 14 Fevrier 1825, par S. E. le Ministre de l'Intérieur, Sur les Ecoles Secondaries de Medécine, les Chambres de Discipline, et les Eaux Minerales Artificielles. 344

MEDICAL LITERATURE--RETROSPECTIVE REVIEWS.

X. Recherches sur le Tissu Muqueux, ou l'Organe Cellulaire, et Sur Quelques Maladies de la Poitrine. Par Théophile Bordeu, Docteur en Medécine des Facultés de Paris, et de Montpélier. Paris, 1767, 12mo. 376

QUARTERLY SUMMARY OF IMPROVEMENTS IN MEDICINE AND SURGERY

ANATOMY, 395

1, Notice of a Double Male Foetus, by W. E. Horner, M. D., &c. 2, Imperfect Development of the Cerebral Organs in Monsters. 3, Imperforate Vagina. 4, Fallopian Tubes. 5, Monsters. 6, Foetus grafted into the Chest of another. 7, Foetus without a Stomach, Head or Anus. 8, Congenital Hydrocephalus, with Transposition of the Viscera. 9, Unusual Arrangement of the Aortic Branches.

PHYSIOLOGY, 403

10, Influence of the Great Sympathetic Nerve on the Functions of Sense. 11, Cutaneous Absorption. 12, Abstinence. 13, Hippomane Mancinella. 14, Cutaneous Absorption. 15, Regeneration of Divided Arteries. 16, Mineral Poisons.

PATHOLOGY, 406

17, Are we followers of Dr. Broussais? 18, Influenza. 19, Diarrhoea Infantum. 20, Tetanus. 21, Small Pox.

THERAPEUTICS, MATERIA MEDICA, AND THE PRACTICE OF MEDICINE. 411

22, Tincture of Iodine in Gonorrhoea, Bubo, Scrofula, &c. 23, Acetate of Lead and Tincture of Opium in Dysentery. 24, Powers of Digitalis in Palpitatio Cordis. 25, Tartar-Emetic Ointment in Epilepsy. 26, Antiphlogistics in Recent Cases of Epilepsy. 27, On the Efficacy of Nitrate of Silver in the Treatment of Zona or Shingles. 28, On the Remedial Effects of Camphor in Acute and Chronic Rheumatism. 29, Examination of the Question, whether the Medical Use of Phosphorus internally, is useful, injurious, or equivocal. 30, Nitrous Acid and Opium in Dysentery, Cholera and Diarrhoea. 31, Tartar Emetic in Pneumonia Biliosa. 32, Bark of the Ampelopsis in Catarrhal Consumption. 33, Obstinate Vomiting cured with Extract of Marigold. 34, Vomiting of Fat and Blood. 35, Rupture of the Spleen. 36, Chilblains cured with Chloride of Lime. 37, Local Spontaneous Combustion. 38, Dr. Painchaud on Tic Douloureux. 39, Duration of Life among the Romans. 40, Difference of Mortality from 1775, to 1825. 41, New Method of Percussion of the Thorax. 42, Acid Nitrate of Mercury. 43, Effects of Ardent Spirits. 44, Colombo Root. 45, Poison of Mushrooms. 46, Antisyphilitic Decoction of Zittmann. 47, Acetate of Ammonia, a Remedy for Drunkenness. 48, Mortality of Leeches. 49, Black Drop. 50, Doses of Calomel in days of yore. 51, Buying a good Practice. 52, Sore Nipples. 53, Anderson's Quarterly. 54, Antiquity of Cow Pox and Origin of Small Pox from it.

SURGERY, 431

55, Lithotritie, on Breaking the Stone in the Bladder. 56, The High Operation. 57, Sutures in Wounds of the Bladder. 58, Paracentesis Thoracis. 59, Stricture of the Oesophagus. 60, Wound of the Brain. 61, Luxation of the Metatarsus; the history drawn up by M. Dusol, D. M.

MIDWIFERY, 438

62, Uterine Hæmorrhage. 63, Polypi of the Uterus. 64, Cæsarian Section. 65, Case of Difficult Parturition. 66, Case of the Pelvis becoming enlarged.

CHEMISTRY AND PHARMACY, 440

67, L'Artigue's Process of preparing the Watery Extract of Opium. 68, Berzelius' Method of Detecting Arsenic in the bodies of Persons poisoned by it. 69, Action of Certain Metallic Substances on the Animal Economy.

QUARTERLY LIST OF AMERICAN MEDICAL PUBLICATIONS, 444-48

CONTENTS

ORIGINAL COMMUNICATIONS.

PAGE

ART. I. Description of the Gangrenous Ulcer of the Mouths of Children. By B. H. Coates, M. D. one of the Physicians to the Philadelphia Children's Asylum, &c. 1

II. Case of Purpura in an Infant, attended with extraordinary Symptoms. By R. M. Huston, M. D. 24

III. History of the Natural and Modified Small-pox, or of the Variolous and Varioloid Diseases, as they prevailed in Philadelphia in the years 1823 and 1824. By John K. Mitchell, M. D., and John Bell, M. D., attending Physicians at the then Small-pox Hospital.--With a plate. 27

IV. Remarks on the Pathology and Treatment of Yellow Fever. Arranged from the Notes of Dr. J. A. Monges, of Philadelphia. 53

V. Remarks on the Prophylactic Treatment of Cholera Infantum. By Joseph Parrish, M. D., one of the Surgeons to the Pennsylvania Hospital. 68

VI. Case of Neuralgia, cured by Acupuncturation. Communicated by J. Hunter Ewing, M. D. 77

ANALYTICAL REVIEWS.

VII. Researches into the Nature and Treatment of Dropsy in the Brain, Chest, Abdomen, Ovarium, and Skin. By Joseph Ayre, M. D., &c. 79

VIII. An Essay on Venereal Diseases, and the Uses and Abuses of Mercury in their Treatment. By Richard Carmichael, M. R. I. A., with Practical Notes, &c. by G. Emerson, M. D. 109

IX. Remarks on some means employed to destroy Tænia, and expel them from the Human Body. By Louis Frank, M. D., Privy Counsellor of her Majesty, Maria Louisa, Duchess of Parma. 114

X. Researches Physiological and Pathological, instituted principally with a View to the Improvement of Medical and Surgical Practice. By James Blundell, M. D., Lecturer on Physiology and Midwifery, at the United Hospitals of St. Thomas and Guy. 119

XI. An Inquiry into the Nature and Treatment of Diabetes, Calculus, and other Affections of the Urinary Organs. By William Prout, M.D. F.R.S. With Notes and Additions, by S. Colhoun, M. D. 125

MEDICAL LITERATURE.

XII. Retrospective Review.--Tractatus de Ventriculo et Intestinis, cui præmittitur alius, de Partibus continentibus in Genere, et in Specie de iis Abdominis. Authore Francisco Glissonio. Lond. 1677, 4to. 138

QUARTERLY SUMMARY OF MEDICAL AND SURGICAL INTELLIGENCE.

I. Anatomy. 155

II. Physiology. 158

III. Pathology. 161

IV. Therapeutics, Materia Medica, and the Practice of Medicine. 166

V. Surgery. 192

VI. Midwifery. 205

VII. Chemistry and Pharmacy. 208

QUARTERLY LIST OF AMERICAN MEDICAL PUBLICATIONS. 214

FOOTNOTES:

THE

NORTH AMERICAN

Medical and Surgical Journal.

JULY, 1826.

ORIGINAL COMMUNICATIONS.

FOOTNOTES:

ARTICLE I.--_Description of the Gangrenous Ulcer of the Mouths of Children._ By B. H. Coates, M. D. one of the Physicians to the Philadelphia Children's Asylum, &c.

Having had opportunities of witnessing the ravages and unmanageable character of this destructive disease, I have long and deeply felt the want of some written account, both of the malady, and of a proper mode of treatment. Some research and observation, made in consequence of this feeling, have terminated in the acquisition of more fixed ideas, and of a practice hitherto successful. This convinced me, that it became my duty to lay the result of these inquiries before the public, for the benefit of others. There is, perhaps, no stronger and more peculiar reason for wishing American physicians to write, than the opportunities they possess, of describing and recording many important varieties of morbid affection, which were either unknown to our predecessors, or the descriptions of which, uncombined and uncompared, are only to be found by searching among the more neglected tomes of a public library. Of this, the present case will afford a fair example; as well as an instance of an American physician, who had described the disease from nature, having, from want of encouragement, false modesty, or some other cause, kept it back from publication.

Ever since the establishment of the Children's Asylum, under the care of a committee of the guardians of the poor, of the city and liberties of Philadelphia, in the spring of 1819, this useful institution has been annually visited by the new and distressing scourge of which we are treating. It has here prevailed in a considerable number of cases, forming the principal source of anxiety and trouble during the winter season, and annually sweeping off its little victims, in a manner rendered peculiarly awful by its insidious approach, its loathsome effects, and its apparently uncontrollable progress. Various scattered cases of a similar affection have come within my knowledge, during the last few years; occurring in the practice of several physicians, as well as in my own. In no place, however, near Philadelphia, other than the above, has there existed, so far as I know, a sufficient number of cases at the same time, to enable a physician to examine it in much detail, or to make comparative trials of different modes of treatment, so as clearly to determine the most successful.

_References to Authors._--The notices of this complaint given by authors, to which I have been enabled to refer, are few, and generally too scanty to supply much means of forming a satisfactory judgment, or a practice in which confidence can be reposed. They consist, principally, of the mere mention of an affection resembling that of which we treat; and, in some instances, it is even doubtful whether they are describing the same disease. No notice is taken of this affection in any of our common books; with the exception of the last edition of COOPER'S Surgical Dictionary,[1] and of UNDERWOOD'S work on diseases of children. It is there described under the erroneous title of _cancrum oris_. A reference is given to PEARSON'S Surgery; and the article in the Dictionary is taken exclusively from that work. As this is the only authority with which I am acquainted, that gives a tolerably full account of a disease somewhat similar to that of which we are treating, I have concluded to extract the whole passage, in the words of the author.

"The canker of the mouth is a deep, foul, irregular, foetid ulcer, with jagged edges, which appears upon the inside of the lips and cheeks; and is attended with a copious flow of diseased saliva.

"This disease is seldom seen in adults; but it most commonly attacks children, from the age of 18 months, to that of 6 or 7 years. When the ulceration begins at the inner part of the lip, it exhibits a deep, narrow, sulcated appearance, and quickly spreads along the inside of the cheek; which becomes hard, and tumefied externally. The gums are very frequently interested in this complaint, and, in such cases, the teeth are generally found in a loose and diseased state; matter is often found in their sockets, and abscesses sometimes burst externally through the cheek, the lip, or a little below the maxilla inferior: and it is not uncommon to see an exfoliation of the alveolar processes, or even of the greater part of the lower jaw. Among the children of poor people, where this disease is neglected or mismanaged at the beginning, a dreadful gangrene will sometimes supervene.

"The remote causes that give origin to this disease are not very obvious. I think it occurs most frequently among children that live in a marshy situation; that are sustained by unwholesome food; and where a due attention to cleanliness has been wanting. The cancrum oris has been described by some writers, as a complaint very common in England and Ireland, where it is sometimes epidemical among infants. It, however, is commonly seen in other kingdoms, and prevails more especially in those houses where a great number of children are crowded together. I am not able to determine whether it is or is not contagious.

"But adults are not wholly exempted from this morbid affection, and it is not easy in all cases, to distinguish the cancrum oris from a cancerous or venereal ulcer in the mouth; since the uvula, tonsils or fauces may be the seat of each disease. I have seen ulcerations on the uvula and tonsils, with all the marks of a venereal sore, in patients where the presence of such a virus could not be suspected; and by treating them as canker of the mouth, they have been speedily cured.

"The canker of the mouth ought to be distinguished from aphthæ, the epulis and parulis, scurvy, cancerous ulcers, venereal ulcers and exulceration from the use of mercury.

"_The mode of treatment._--It will be proper,

"1. To remove the diseased teeth, bone, &c. if possible.

"2. To prescribe a milk and vegetable diet, and to allow a prudent use of fermented liquors.

"3. It will be adviseable to exhibit such remedies as, Peruvian bark; sarsaparilla; elm bark; mineral acids.

"The external applications that I have generally found successful have consisted of such as the following:

"_Preparations of copper_; a diluted mineral acid; burnt alum; decoction of bark with white vitriol; tincture of myrrh, &c."[2]

Of the above articles, those which we have indicated by italics are omitted in the last edition of COOPER'S Dictionary; and, in a former one, they are directly prohibited with strong reprobation. Nevertheless, it is among these that we have found, beyond comparison, the most successful one.

Mr. PEARSON prefixes to the preceding article a list of synonymes, with references to authors, in the manner of writers on natural history. They are as follow: _Aphthæ Serpentes._--SENNERTUS; Medicinâ Practicâ. _Labrosulcium, seu Cheilocace._--ARNOLDUS BOOTIUS. _Oris Cancrum._--MUYS. STALPAART VANDER WIEL. _Gangræna Oris._--VAN SWEITEN. _Gangrene scorbutique des Gencives._--Auctores Gallici.

Of these, SENNERTUS[3] merely mentions, under the article aphthæ, that the latter sometimes spread around the frænum and tongue, occasionally corroding the subjacent parts. He is so far from giving a clear description, under the head of Aphthæ Serpentes, of any affection analogous to that we are about to record, that he quotes GALEN as remarking, very properly, that these are not aphthæ at all, but putrid ulcers.

ARNOLD BOOTIUS, in his little treatise "de morbis omissis," of diseases omitted in the books, published in London, in 1649,[4] gives, from his own observation, an account of a disease, to which he applies the names above attributed to him. It differs from the cases which have attracted our attention, chiefly in its situation. He describes it as an ulcer, soon becoming black and foetid, corroding the inside of both lips, separating them widely from the gums and allowing them to fall outwards upon the face; thus producing a horrible deformity. Besides this, the author states, that a deep fissure usually extended down each half of the inside of each lip; thus adding four deep and ghastly ramifications to the ulcer. This shocking affection is stated to have prevailed extensively, both in England and Ireland; in which latter country the author practised and held several important offices. It occasionally became epidemic, and then destroyed great numbers of children. It principally prevailed between 2 and 4 years of age; though it was occasionally met with both earlier and later in life. It was frequently, but not always, accompanied with aphthæ.

This disease was, in general, successfully treated by our author, with a decoction of "Chærephyllum, Quinquefolium, Myrrhis, Rosæ et Salvia;" in which was dissolved a "sat magna copia" of white vitriol.--A combination about as precise as some of the prescriptions which have been recommended to me, for the present disease, in this country. With this mixture, he touched the ulcers several times a day; and then washed them with a liniment of acetate of lead, aqua plantaginis, and oleum rosaceum. He also used _issues_ in both arms; and confined the patient, in more obstinate cases, for drink, to a decoction of sarsaparilla, china, and several other articles, which we will spare our readers. To this disease, BOOTIUS devotes about five small 18mo. pages, forming his tenth chapter.

VANDER WIEL cites BOOTIUS, and expresses his belief, that the disease described by the latter was identical with one which he saw himself. This last, however, though described in a cursory manner, appears to resemble much more nearly the disease of the Children's Asylum; beginning in the gums, and extending to the adjacent parts. He treats it by the following lotion:

R. Mel. Rosar. [Symbol: ounce]i
---- Ægyptiaci, [Symbol: dram]ij
Olei Vitrioli, gtt. _aliquot._
misce.

Under this treatment, and by removing the teeth, when loose, the small number of cases he saw recovered in a few days.

VANDER WIEL was a practitioner in Holland; and, though he does not specify the fact, his cases were probably in a marshy country.[5]

MUYS, in a little treatise entitled "Chirurgia Rationalis,"[6] published in 1684, has an account of a disease, which is evidently supposed by PEARSON to be that which he describes. This also, however, appears to have been a "labrosulcium;" an ulcer between the lips and the incisor teeth. There is but little to be gathered from his paper; as it is principally occupied with an attempt to prove, that this ulcer is owing to an accumulation of _acidity_ in the blood, increased, at this point, by the putrescence of particles of food which collect there. He illustrates this doctrine by an examination of a _burnt rag_ under a microscope; and this he considers as in a state analogous to the gangrene. "Opinionum commenta delet dies," &c. We give his treatment; which is aimed at acidity.

R. Theriaci, [Symbol: dram]ijss
Ung. Egypt. [Symbol: dram]iss
Gum. Laccæ, et
Spirit. Sal. _Armon._ aa [Symbol: scruple]ij
---- Cochleariæ, [Symbol: dram]ij
_m._ ft. ung.

To be softened with a little alcohol, the part washed with the mixture six times a day, and a rag moistened with the same compound left in the ulcer. Here we take leave of the Chirurgia _Rationalis_.

In the 14th volume of the Memoirs of the French Royal Academy of Surgery, are papers containing accounts of two cases, which have some points in common with the disease of which we treat; but the identity of at least one of which it is hard to establish. The first piece is entitled, "_Sur la gangrene scorbutique des gencives dans les enfans. Par feu M. Berthe._"[7] The author is described, in a note, as a young surgeon of great promise, who was carried off by an early death. M. BERTHE commences by quoting FABRICIUS HILDANUS; who describes a gangrene of the gums, occuring principally at about 4 years of age, and of which all the patients died. FABRICIUS takes the occasion to give a caution to young surgeons, to avoid being too sanguine in predicting recovery from gangrenes. Next a case is given us, drawn from M. SAVIARD, in which death was the result. This author seems, subsequently, to have had somewhat better success, but at the expense of horrible disfigurements; such as great holes through the cheek, and the loss of a large piece of the jaw; which, indeed, are described as having been worse than death. In another case, recorded by M. POUPART, in the "Histoire de l'Academie des Sciences," this affection terminated in death; preceded, however, and in the opinion of the author, caused, by the production of two tumours, one by the side of the tongue, the other inside of the cheek. This is not at all unlike the progress, which will be hereafter mentioned to have taken place in many of the Asylum cases.