SEVENTY FOUR SELECT CASES, WITH THE MANNER OF CURE, AND THE PREPARATION of the REMEDIES, IN THE FOLLOWING DISEASES.

  • I. The Schirrus, Cancer, and Ulcers of the BREAST and WOMB.
  • II. Scrophulous Swellings and Ulcers about the Neck and other Parts; commonly cal­led the King's evil.
  • III. The Specks and Opacity of the Cornea of the EYE; in which Sight hath been restored, by internal Medi­cines only.
  • IV. Old ULCERS of the LEGS, cured in Persons much ad­vanced in Years.

THE WHOLE BEING An APPENDIX to the TREATISES already published on these SUBJECTS.

BY WILLIAM ROWLEY, M. D.

Morbi non eloquentia, sed remediis curantur.

CELSUS.

LONDON: Printed for F. NEWBERY, at the Corner of St. Paul's Church-yard, in Ludgate Street.

MDCCLXXIX.

[Price One Shilling and Six-pence.]

THE PREFACE.

THE following collection of Cases is the practical part of a considerable work written on glandular affections in general; in which their causes will be explained, and a new theory drawn from the latest anatomical discoveries in the lymphatic system. As numbers are daily suffering under these ra­vaging complaints; humanity dictated to me the necessity of the present publication, and it is hoped this attempt to alleviate human misery, will be received with candor.

THE names of the generality of patients have not been introduced; but several of dis­tinction may be referred to, should it be es­teemed necessary.

IT would be highly unbecoming the dig­nity of the profession, not to have a tender con­cern for the reputation of others: the candid, therefore, will perfectly conceive my motive for concealing the practitioners, who, un­successfully, attended the subsequent cases, previous to my being consulted.

INTRODUCTION.

THE uncertainty of curing ulcerated legs by rest, salivation, &c. and the frequent re­lapses of patients discharged from hospitals, induced me, near twenty years ago, to search for remedies more adequate to the nature of the com­plaint. The cause of ulcers I conceived to be owing to some scorbutic or other taint in the habit; in which the lymphatic system was principally af­fected; an internal alterative treatment was a­dopted, success in many instances was the conse­quence, and the improvements were made public in the year 1767* The doctrines that ‘old ulcers were difficult of cure; that it would be dangerous to attempt the healing them, as it might endanger the patient's life, or produce a diarrhoea, fever, or asthma,’ were refuted by undeniable facts.

The seat of the ulcer is commonly in the adipose membrane, which is sometimes thickened and very frequently callous. I discovered in the cure, that these hardened parts became soft and pliant; and from hence some hopes were entertained that a si­milar practice might remove glandular complaints. A trial proved the conjecture not ill founded; for a considerable number of indurated breasts, which an extensive employment in midwifery fur­nished, were in general cured by gentle alteratives. Numbers of patients in disorders of this nature pre­sented themselves, as advice and remedies were given for many years without any gratuity. Afterwards an hospital was opened, to which the poor might daily [Page 2]apply, with no other recommendations than distress and sickness. There were seldom less than four or five hundred patients under cure in diseases of the eyes, schrophulous, cancerous, ulcerous and other indispositions The experience obtained from this great variety of cases, enabled me to comprehend a more beneficial treatment than the common, which was acknowledged defective, by that excel­lent surgeon, the late Mr. Samuel Sharp. Im­provements were gradually made from a more mi­nute knowledge of the complaints, and some dread­ful affections formerly thought incurable, were conquered by the gentlest means. The disorders in­cident to the breasts, after delivery, could in ge­neral be prevented chiefly by a partial abstinence from liquids; or, if tumors or inflammation hap­pened, remedies more efficacious than shaking the breasts, embrocations of oil, brandy, and vinegar, plaisters of diachilon, or treacle on brown paper, &c. could be administered with a certainty of advantage in every case. A treatise has been written on these subjects, and the curative intenti­ons fully explained.* The confidence of several persons of rank, the public protection, and the pleasure which reiterated success produced, ex­cited fresh ardor in the pursuit of new enquiries.

The usual methods of managing distempers of the eyes seemed to be exceedingly defective, and in many instances cruel. These subjects next en­gaged my attention; the ancient and modern treatment was examined, and in a publication censured, or praised, in proportion as it experi­mentally appeared to have had merits or de­fects. External applications to the eyes, par­ticularly [Page 3]poultices, were in general condemned, with the reasons assigned; the inflammatory in­dispositions were reduced under four heads;* new methods of cure were recommended, and il­lustrated by proofs of persons relieved. The manner of extracting the cataract was successfully improved, and many patients were restored to sight.

To demonstrate that it is on facts alone that these assertions are made, the following collection of cases now make their appearance as an addition to the former; in order to extend and confirm the utility of the improvements, and render them more beneficially useful to society.

The principal remedies used in the cures were,

  • Cinnabar antimonii.
  • Cinnabar factitium.
  • Aethiops mineralis.
  • Sulphur antominii precipitatum.
  • Aquila alba.
  • Nitrum purissimum.
  • Aethiops antimonialis.
  • Camphora.
  • Spt. Salis ammoniac.
  • Aether nitri.
  • The Caput mortuum, of spirits of nitre.
  • Calx antimonii.
  • Unguentum saturninum.

[Page 4]The Aethiops mineralis should be prepared by rubbing a considerable time without any heat.

The aquila alba is the calomel ten or twelve times sublimed, by which its purgative and drastic qualities are destroyed; a quarter, or half a grain joined with an equal quantity of sulphur antimonii precipitatum, when well rubbed for a long time together, and formed into a pill, with confectio damocrat. is called Pilula rubra.

The nitre should be rendered perfectly pure, by fusing in a crucible, and rechristallisation. When mixed with equal parts of aethiops min. and a small portion of cinnabar antimon. by a long tritura­tion; the composition is called Pulvis mineralis.

Camphorated julap has been often prescribed, with the other remedies, as a resolvent and cor­rector.

The aquila alba, is given in the dose of a quar­ter or half a grain, formed into a pill, with sugar, and a mucilage of gum arabic; this is named pilula alba.

The calx antimonii, and the aethiops antimo­nialis, are given in general to persons who have a dry skin.

The spiritus salis ammoniaci is sometimes added to the solutions of simple nitre, and is called mistu­ra nitrosa volatilis. The aether nitri is given to patients exceedingly nervous, or who have hectical symptoms; it acts by allaying irritation, without producing the ill qualities of opiates, and is pre­pared from one part of pure strong spirit of nitre, and two of alcohol, without heat, in a long necked cucurbit, with a head, tubes and receivers proper for conveying the white fumes; and is called Es­sentia volatilis,

The caput mortuum of spirits of nitre, is what remains after the distillation, according to the me­thod of Glauber, and is called Sal neutralis*.

The success in the cures will greatly depend on the purity of the remedies. An unadulterated nitre is rarely to be obtained; as what is sold, com­monly contains a portion of sea salt, and is united sometimes with a worse ingredient.

Crude antimony is often impure. The argentum vivum, even when it passes through leather, is fre­quently adulterated with poisonous ingredients; therefore that used in the following cases, has al­ways been revived from cinnabar. The aqulla alba at present is not commonly prepared; the calomel, however, which it is hoped will not be substituted for it, will not answer the purposes intended.

The sal neutralis is seldom to be had genuine. The medicine in the shops nearest to it is the sal po­polychrestum. The goodness of the calx antimonii, and the aethiops antimonialis, will greatly depend on the purity of the articles which compose them. The factitious and the antimonial cinnabar is fre­quently adulterated with red lead, and if taken in­wardly, or received as a fumigation, must do in­finite mischief.

Every one accustomed to the study and practice of chemistry, will see the necessity of insisting on exactness to be observed in the preparations, which when properly administered, produce little, or no sensible operation. At first small doses should be prescribed, which may be gradually increased, as the constitution becomes more habituated to them.

A COLLECTION OF CASES IN THE SCHIRRUS, CANCEROUS ULCER, AND OTHER DISORDERS OF THE BREASTS.

CASE I.

MRS. A—, at Lady T—, aged between 40 and 50, had been afflicted with a hard­ness of the breast, which drew in the nipple; the pains had been exquisite on change of weather for between four or five years; at no time was the breast easy, and the motion of the arm was impaired. Ap­plication had been made to several practitioners; some of the first eminence were consulted; but not the least advantage obtained, and the patient be­came exceedingly reduced, from the tortures and an­xiety of mind; not having the least prospect of being cured, or even relieved. She was recommended to me by an Apothecary near Grosvenor Square, and took the pilula rubra, and the pulvis mineralis. In about six months the cure was perfectly accomplish­ed. It is now three years since; the patient enjoys a good state of health, and has had no return of the disorder. This cure is known to several persons of rank.

CASE II.

MRS., formerly servant to — M, Esq. aged 40, had three large stony hardnesses in the left breast, which had been very painful between four and five years, so as often to prevent her rest; she had repeatedly consulted a skilful court surgeon, had taken several remedies without relief. She was ordered the pilula rubra, and the solutio ni­tri three times a day. In nine months, during which time the pains decreased and the swel­lings gradually resolved, she was cured and re­mains well.

CASE III.

MRS. M., well known to several families of fashion, aged betweeen 40 and 50, had been for above two years laboring under great pains in the breast, the veins of which were tumid and tortuous, and there were several hardened swellings detached from each other. The patient was of a remarkable delicate constitution, exceedingly nervous and irrita­ble, and had undergone repeated bleedings, by the advice of an eminent city surgeon, without any be­nefit. She took the pilula rubra three times a day, and a solution of nitre, and in about six weeks all the swellings were resolved, and the veins of the breasts reduced to their natural size. This patient, con­trary to my advice, neglected taking her remedies, and was attacked with a disorder in the womb, and afterwards the breast became painful, the veins swelled again; but on returning to the medicines, a cure hath been obtained.

CASE IV.

MRS. C, aged 44, Old Street, had a schirrus or hard swelling of the whole breast [Page 8]for six years, and for above two years before she applied, had been in constant and violent pains. There were four foul livid ulcers, which discharged a very offensive acrimonious humour; the veins of the breast were enlarged, and she was in such tortures, as to be deprived of rest night and day. An eminent hospital surgeon had advised her to have her breast cut off; and declared it to be impossible to cure her. She took the pilula rubra ter de die, and so­lutio nitri. The hardened parts gradually resolved; the breast which was before fixed became movea­ble, the ulcers healed, and the cure was accom­plished in between two and three months. This person has remained ever since in good health, and has not had the least symptom of a complaint in the breast, though it is between six and seven years.

CASE V.

A Very respectable Baronet recommended Mrs. E—, of Hertfordshire, for advice in a large hard swelling in the whole breast, which was greatly distended, immoveable, and as hard as a stone; besides this, there were five large ul­cers discharging an exceedingly offensive matter, excrescences were likewise forming and sloughing away continually. This disorder had been bad nine months. The pains were acute, and the matter discharged was so corrosive, as to erode the adjacent parts. Neither ease nor rest could be ob­tained even by the use of opiates. The arm on the diseased side was with difficulty moved, espe­cially in elevating it towards the head. The pi­lula rubra, and the pulvis mineralis, were given, to which was added sal neutralis; the external parts were anointed with oleum camphoratum, and the cure was effected in a few months; [Page 9]above a year and a half has elapsed since, with­out any return of the complaint.

CASE VI.

MRS. D—, aged 64, formerly belonging to the houshold of her late Royal Highness the Prin­cess Dowager of Wales, had a swelling and hard­ness in her right breast for twelve years, from a blow, which not increasing was not much attended too. About two years ago an ulcer was formed, surrounding the nipple; which discharged a great quantity of acrimonious serum; the hardness much increased in size, was very painful, and it was with difficulty her right arm could be lifted to­wards the head. By bleeding occasionally, the use of the pulvis mineralis and pilula rubra, the swelling has been considerably reduced, the use of the arm recovered; the ulcer has not become lar­ger; and though the perfect cure of this case can­not be expected; yet life may be rendered tolera­bly comfortable for a number of years, in a disor­der that rough methods might have put a period to.

I sincerely believe, that if these remedies of the al­terative kind were always used on the first ap­pearance of any hardness, or swelling in the breasts or womb, that either their increase would be pre­vented, or a perfect cure would commonly be effected. Complaints in the breast are evident; but those of the womb are often misunderstood by physicians, and treated very improperly, owing to a want of practical skill in midwifery. The bark and acids frequently do irreparable mischief, if given in the schirrus or ulcer, as likewise the use of hemlock, opiates, salt water, baths, injec­tions, &c. &c. Many melancholy instances of this nature have happened, which, were they publish­ed, would strike minds, susceptible of feeling, with horror.

CASE VII.

A LADY, near 40 years of age, had for a consi­derable time a large hardened swelling in the right breast, supposed originally to have arisen from an accidental blow; it had not been much noticed for some years, as it had not occasioned pain. About the time the menses were partially suppressed, a pain was felt, the swelling gradually increased, and soon occupied and hardened the whole breast: the nipple was drawn in, and an ulcer formed, with a large excrescence like a mulberry near it. This case was cured by the pilul. rub. and pulv. mineralis in less than four months. The breast became soft, the excrescence dropped off, and the ulcer healed; the external application used was the ung. saturninum to the sore*, and the oleum camphoratum, where the skin was not broken. This lady has remained perfectly well since the cure, which is now above five years, and has been advised to take the remedies one month, or six weeks in spring and autumn by way of prevention, because there has been an hereditary cancerous and schrophulous complaint in the family.

CASE VIII.

MRS. B—, in Oxford-road, had suffered un­der a painful hardness of the left breast for above five years, which extended towards the axilla, and greatly incommoded the use of her arm. The pilula rubra and the solutio nitrosa were taken internally four times in the day, and the oleum camphoratum was used externally. This case was cured in be­tween three and four months.

CASE IX.

MRS. F—, Milbank Westminster, had her whole breast exceedingly swelled, and indura­ted adhering so firmly to the pectoral muscle, as to be immoveable; there were likewise some glan­dular swellings in the armpit. The patient was of a delicate constitution, very nervous, and her apprehensions had been so greatly alarmed, from the misery she had undergone, and the fruitless en­deavors that had been used to relieve her, that her anxiety of mind joined with the disorder, had brought on a universal relaxation of the habit. She looked pale and hectical, was afflicted with a cough and shortness of breath, fever, and night sweats. She took the pilula rubra ter de die, and the pulvis mineralis, mixed in water, immediately after each pill. A light diet was recommended, and an abstinence from all acids; which last circum­stance should be observed always when alteratives are given In one month the constitution was considerably amended; though little impression had been made on the tumor, except that it was not so painful. By a perseverance in the remedies, and gradually increasing the doses, in two months after the breast was perfectly cured. The me­dicines were directed to be continued for six weeks more, good health was restored, and no return of any of the symptoms have since appeared. Six years have elapsed since this cure.

CASE X.

MRS. D—, High Holborn, had a violent in­flammation and hardened tumor of the breast; her child in sucking had torn off the nipple; the pains were exquisite, the hardnesses were numer­ous, small and detached from each other. This case was not of the cancerous kind*, but equally distressing to the patient, who had no rest. The pilula rubra was given, and the solutio ni­trosa. In one month the cure was accomplished; the patient suckled her infant during the cure with the other breast; the diseased part became as soft as ever, and a flow of good milk continued till she weaned her child.

CASE XI.

MRS. H—, near Charlotte Street, Blooms­bury, 1770, had a large induration of the left breast, extending to the axilla, attended with vio­lent pain and inflammation. Bleeding was ordered; the pilula rubra, the camphorated julap, with so­lutio nitrosa, were taken; externally, a poultice was applied, with the oleum camphoratum. This case was cured in less than a fortnight, and the infant sucked without any disadvantage during the taking of the medicines.

CASE XII.

MRS. S—, West Street, St. Anns, had been labouring under a diseased breast between two and three months. Abscesses had repeatedly formed [Page 13]and broken; the matter was discharged, but still they were succeeded by other tumors. Several hard swellings were in different parts of the breast, and the exquisite pains had greatly emaciated and re­laxed the whole habit. The pilula rubra, the solu­tio nitrosa, with the camphorated julap, cured this case in the course of three weeks.

CASE XIII.

MRS. F—, in King Street, St. Anns, had been delivered between two and three months; on receiving cold the left breast swelled, became hard and scarce moveable through excessive distension; the shooting acute pains attending it were intole­rable. Shaking the parts, fomentations, poultices of lilly root, ointments and diachilon plaisters, had been administered; but the complaint increased, and the patient was truly miserable, not having the least ease night or day. Bleeding was at first prescribed; the pilula rubra, and the solutio ni­trosa were given in large doses. The inflammation soon subsided, the hardness dispersed, and the breast became perfectly soft in about four weeks.

CASE XIV.

MRS. G—, Pater-noster-row, between 30 and 40, had a diseased breast near two years; there were at least eight or nine different swellings, hard, painful, and the surface of the breast was inflamed in several parts. Swellings which had formed mat­ter, had broken into many fistulous ulcers, dis­charging an acrimonious serum; some of these had healed and formed fissures. The pains, and the [Page 14]constant misery of the patient, were almost inex­pressible. Various remedies in the forms of poul­tices, plaisters, liniments, &c. &c. had been used, without success. Bleeding was ordered, the pilula rubra and solutio nitrosa. In about four­teen days the patient was considerably relieved; the breast was much relaxed, and the cure was finished in about ten weeks after.

CASE XV.

MRS. C —, Woodstock Street, Marybone, had suffered great misery for near two years, from a disease of the right breast. At first there were several hardnesses which broke into ulcers, and being deep seated, were very tedious in coming to suppuration. The swellings in different parts had broken and discharged matter thirteen or fourteen times, occasioning the most exquisite tortures, which greatly reduced the patient; she could not lift her arm to her head. Application had been made to a physician of eminence, and a surgeon, for relief; the common poultices were directed, and laxative physic; but neither ease, nor the prevention of fresh formations of matter suc­ceeded their use. The pilula rubra, with the calx antimonii, and the solutio nitrosa were prescribed; ease was soon obtained, the hardnesses seemed to be resolving, and in nine weeks this case, which had been so truly distressing, was cured.

CASE XVI.

MRS. W. recommended by Lady H—, near Berkley Square, being in the sixth month of her pregnancy, was attacked with a violent inflamma­tion and sharp pain of the breast; succeeded by a [Page 15]hardness, which resisted pressure; an abscess near the nipple had also been formed, and discharged a great quantity of matter. The hardness, however, still remaining, attended with exquisite pain; not­withstanding the patient's situation, I prescrib­ed the pilula rubra quater de die, with the solutio nitrosa, and in about three weeks a perfect cure was effected. She has since had two chil­dren, and the breast remains well. This case▪ amongst many others, might be adduced as proofs of the safety of these alterative remedies, and the mildness of their operation.

CASE XVII.

I was recommended by Her Grace the Dutchess of—, to Mrs. P—, who had a cancerous complaint in her breast. She had been for near two years under the care of a surgeon, who as­serted, with confidence, that she would certainly be cured. He applied caustics to some hardened tumors under the arm, as likewise to the breast; and it was reported, that he had given some pre­parations of arsenic; this last circumstance, however, can scarce be credited, we should hope it not true. The ulcer where the caustics had been applied was at least an inch and half deep, and four or five inches long, discharging a most offensive matter. She was in exquisite tor­tures day and night. At first sight of the case, I pronounced it incurable, to the noble friends of the patient; and all that could be attempted, was a mitigation of the symptoms. The ulcerated parts were dressed with the ung. saturninum with camphor. The pulvis mineralis was given in small doses, and considerable ease was pro­cured. The putridity of the discharge, however, [Page 16]and the other miserable circumstances of the cases brought on hectical symptoms; a difficulty of breathing every day increased, and the patient died, most probably a victim to the pretended knowledge and cruel practices of her surgeon.

CASE XVIII.

MRS. M—, in the year 1767, perceived a drawing in of the nipple, without any hardness of the right breast. An eminent surgeon in town advised an issue; afterwards was prescribed the aethiop. vegetabil. and mercurial pills. The disorder, after this, did not increase till towards the year 1771, hemlock was then ordered by a very learned physician. The breast swelled and was hard; under the arm were likewise tumors. In May 1772 a caustic was applied, under the specious name of a plaister, to draw the cancer out. The caustic was continued weekly, and a poultice used, till the whole schirrus was sphacelated and removed, which happened July the 6th. It was afterwards dressed with Turner's cerate, healed, and continued well for two years, though little indurations, about the size of pease, appeared on the remaining part of the breast. From the latter end of 1774, until the spring of 1775, the pa­tient had considerable pains. The part where the caustic had been fixed, broke out again; the swel­ling in the axilla was enlarged, and pressing on the great vessels, occasioned a considerable swelling in the arm. The surgeon, mentioned in the last case, was consulted, who promised confidently a cure, and boldly applied caustics to the tumors in the axilla; this produced a large ulcer, brought on great pain in the parts, accompanied with a cough. Afterwards, by his utmost efforts, the sore could [Page 17]not be healed. On June the 12th I first inspected the diseased parts, and acquainted a relation of the patient's, that little success could be expected, as violent methods had been used. An attempt, however, was made, the pilula rubra and the pul­vis mineralis, with the calx antimonii, and a pec­toral mixture, were given with great success; for in about three months the ulcers, both in the axilla and breast, were nearly healed; and the lady went into the country happy beyond expression. In lest than a twelvemonth, however, the ulcers broke out again, and the patient languished for two or three months and died. Perhaps if no remedies whatever had been used, the advice of the first surgeon consulted, attended to, this lady might probably have been living now.

CASE XIX.

LADY [...], had for one year and a half a tumor in the left breast, which was not very pain­ful, but a great part was indurated. This lady was advised to apply to a gentleman, who endea­vours to persuade the world, that he can safely ex­tract cancerous tumors with a plaister. Though in the present case there was no sore, nor any pres­sing symptoms, the operator rashly applied his caustics, with the most confi [...]nt promises of success, and repeated them for four or five months, the patient suffering the whole time the most shock­ing tortures. The malady increased; which is most commonly the case where violent methods are adopted; a large cancerous ulcer, surrounded with considerable spongy excrescences, appeared, which, from time to time, were destroyed by the caustics, but returned soon again. The disease extended it­self to the other breast. Hemlock, opiates, pow­dered corns of a horse, carrot poultices, had been [Page 18]administered without success. Upon my being consulted, an opinion was delivered, that the cure could not, under such circumstances, be expected, and mitigating the symptoms would be doubtful. This judgment was pronounced from experience in a multiplicity of cases, where such barbarous treatment had precluded every hope of relief. The patient, however, wished for some trial to be made; the pilula rubra, and the pul­vis mineralis, were given, and the inflammation, which had chiefly arisen from the caustic salts, subsided, the progress of the disorder was pre­vented from [...]ing its dreadful ravages on the other breast; but no other advantage was obtained, except that the pain was in some measure abated. Sloughs succeeded sloughs, and occasioned a most offensive stench; the acrid discharge was consider­able; the patient became hectical; opiates could not produce relief, and thus lingering under the most distressing and accumulated miseries, shock­ing indeed to the spectators, but inexpressibly so to the worthy lady who languished under them; she died about two months after.

From experience it may be asserted, from the circumstances of the foregoing case, the lady might have lived years, and even though she might not have been cured; by bleeding, the alterative reme­dies occasionally, a proper diet, and mild applica­tions to the part, the complaint might have occasion­ed little trouble, and perhaps not increased. Many, too many similar examples have occurred, of life being shortened, and the most inexpressible mi­series created, by the cruel application of caustics, as well as an unfeeling use of the knife. There are many instances of cancers, in which it would be fruitless to attempt the cure; the physician is [Page 19]then the true friend, who advises the patient to do little or nothing, and submits the case chiefly to nature.

CASE XX.

A MAIDEN lady aged 47, about eight years ago, applied for advice in an induration of the right breast; the nipple was inverted, and dis­charged an acrimonious serum, attended with con­siderable pain; there were likewise glandular swel­lings in the axilla. The hardness was of such a nature, that there were not the least hopes of re­solving it; the amputation of the breast had been recommended by a surgeon, which, had it been performed, would have been exceedingly cruel, and probably fatal, as no prospects of success could have been entertained, owing to the axillary af­fection. The pulvis mineralis alone was ordered ter de die; and was continued for six weeks at a time, spring and autumn; a regular diet was ob­served, wine, acids, and salt meats were abstained from, a quarter of a pint of warm water was ta­ken every day before meat. The disorder by this means did not increase for three years, about which time the part excoriated, afterwards became ulcer­ous, and a considerable slough was thrown off. An ulcer has continued ever since, which is not pain­ful, except at changes of weather in the winter season; the pilula rubra was used for one month, but as no advantage was obtained, it was discon­tinued. This lady visits her friends, and suffers little or no inconvenience from her cancerous com­plaint, nor is she even suspected by any of her most intimate acquaintances, to labor under any such indisposition. Many similar cases to this have come under my inspection.

CASE XXI.

MRS. P—, aged 42, had been mother of six children. After the delivery of the two last she had each time a fever from cold, which occasioned a great hardness of the left breast, that continued nearly in one state for nine years. In the year 1771, the breast was painful, and rather increated in size for above three months. This alteration succeeded a violent inflammatory fever. From this time, until Jan. 1773, there were shooting pains: when, the menses ceas­ing to appear, some eruptions, discharging a sharp watry humor, were discovered; the advice of an eminent physician was taken; salts and manna tinctura senae and hemlock pills were ordered, and persisted in for seven months: but the disease grew considerably worse. In the latter end of July and all August, the salt water was drank; which greatly relaxed the stomach and intestines, and answered no good purpose. On October 3, 1773, she applied to me for relief; the breast was then as large as a child's head two years old, excessive hard, inflamed, uneven in its surface, extending to the axilla, where likewise were some indurations, and the arm on that side was considerably swelled. On the lower part of the breast was a cancerous ulcer, some part of which was soft and fungous; there were many fissures, from which issued a very acrid discharge. The pains were so acute and distres­sing, that no rest could be obtained; a continual crying was heard, like to a person in labour. Bleeding was first prescribed; the pilula rubra, the pulvis mineralis, and the solution of camphor, with the essentia volatilis, were administered. To the wound was applied the [...]ng. saturninum; to [Page 21]the surrounding, enlarged, and distended parts, the oleum camphoratum. In fourteen days the breast was greatly relaxed, the pains were conside­rably diminished, and rest at night was attained, before the remedies had been taken four days. The plan was persevered in; about three months after the ulcer was healed; and the indurated parts were perfectly resolved. The remedies how­ever were continued ten weeks more, when the cure was accomplished.

CASE XXII.

A lady of rank, between 70 and 80, had a large hardness of the cancerous kind in the left breast; a great part of the induration was extremely hard, and on the lower part was a very livid ap­pearance with little fissures. The whole breast was diseased, inflamed and extended, so as to affect the edge of the right breast, and there was a large tumour towards the axilla; the pains had become exceedingly troublesome, the swellings had increased rapidly, and were very alarming. This was a case in which no cure could be expected; an alleviation of the misery alone could be attempted. The opinion I gave to several ladies of quality, friends to the afflicted patient, and the noble Lord her sons was, that a cure was impossible; but that some hopes were entertained, that the inflammation, swellings and pains, in a great measure, could be removed. The pilula rubra was administered, with the pulvis mineralis ter de die. In about three weeks the inflammation entirely subsided, and all the swelling, except that very hardened part, in a great degree resolved, the breast was relaxed, and the pains nearly abated. The pill was then inreased in its dose, and the powder. This [Page 22]course was continued for between two and three months, and the patient was very easy. The livid part at this time, as had been prognosticated, broke and formed an ulcer; this was succeeded by a spha­celus of the stony induration, which was thrown off gradually, and with proper assistance gently re­moved. The discharge was now exceedingly of­fensive, from the putridity of the parts sloughing away; the carrot poultice was applied, but answered no good purpose whatever. In this manner the whole of the diseased part came away, and there was an ulcer, in which me hand might be buried. The remedies were continued, the ulcer became clean and not offensive, and little or no pain was experienced. The discharge from this large ulcer was very considerable, which would have been much larger, had not the medicines fortunately resolved a very considerable part of the tumor: the patient gradually became weaker, and the medicines were then discontinued Oedematous swellings of the legs afterwards made their ap­pearance, probably owing to the universal relaxa­tion of the habit, and with very little or no pain the patient languished for same time, and died.

CASE XXIII.

MRS. B—, aged 50, was recommended for relief by a lady of fashion, having several hardened swellings in her left breast. The right breast had been taken off by the knife, about one year and a half before at St. George's Hospital; the wound afterward healed; but the disorder being trans­ferred to the other sound breast, which is no un­common thing where the amputation is perform­ed, caused great pain and inflammation. The pi­lula rubra was given four times in the day, and [Page 23]the pulvis mineralis, with the sal neutralis. In a­bout two months the swellings considerably di­minished, the stony hardnesses, detached from each other, were much softened, and the pains entirely abated. The remedies, during between three or four months in the summer, whilst I went to France and Holland, were persisted in, and on my return I found the whole of the swellings dispersed, and the breast appeared quite sound. This person then went and officiated as cook in a family, which was her former employment, and remained well for above a year; but on receiving a violent cold, the swellings in the breast appeared again without any ulcer; she neglected applying for some time; and from appearances, there was no reason to hope, that the remedies could again succeed. The trial confirmed the opinion; for no impression whatever could be made afterward on the disease. The patient became hectical, suffered very little pain indeed, and in about ten months after died.

CASE XXIV.

A noble lady recommended a poor woman, aged 43, mother of eleven children; who had suffered considerable time from an ulcer and schirrus of the breast. The pains were exceedingly distressing, and the discharge so acrid, as to corrode the ad­jacent parts. The saturnine ointment was applied externally, and the pilula rubra, with the pulvis mineralis were taken. In a little more than three months the ulcer was healed, and the schirrus part perfectly softened. The remedies were continued longer to confirm the cure, and there has been no return since, which is near two years.

CASES in Complaints of the WOMB, RECTUM, &c.

CASE XXV.

Mrs. S—, Fleet Street, had an ulcer of the womb, with a considerabla large schirrus; of nine years duration; the discharge was purulent and offensive; the pains at times excruciating, similar to those of hard labor. The os uteri* was rough, uneven, and rather open; the ascertaining this fact occasioned the most; inexpressible uneasiness. The pilula rubra, and the pulvis mineralis, were prescribed; the essentia vol. with the camphora­ted julap, were given to alleviate the pain, as well as to promote the resolution of the schirrus. These medicines were continued near four months, du­ring which time the schirrus part was softened, and the ulcer healed. The patient, soon after proved pregnant, went her full time, was safely delivered, and recovered, contrary to my expec­tation, in the usual time. This patient has had one child since, and remains in perfect good health. It may be remarked, that though a schirrus of that part rarely happens to persons be­tween twenty and thirty, yet many cases have oc­curred of this nature.

CASE XXV.

THE following case has made its appearance be­fore, though with great reluctance of the author, in a letter addressed to Dr. Hunter, on the dan­gerous tendency of medical vanity, occasioned by the death of the late lady Holland. The republica­tion was never intended; but a report having been for some years industriously circulated, that the lady, mentioned in that epistle, died miserably of the disorder, pronounced by me to be perfectly cured: in vindication of the truth, and lest such a story should preclude all hopes of relief to pati­ents in similar circumstances, it may be necessary to declare, that the lady who is now living in the neighbourhood of Missenden, Bucks, has enjoyed the most perfect health since the cure.

CASE XXVI.

IN the year 1767, M. S. a lady in the country, perceived some small eruptions in several parts of the skin. Dr. Bates, a physician esteemed in the neighbourhood, prescribed a lotion. Afterwards, by the advice of Mr. Edmonds, a skilful surgeon, at Wendover, a quicksilver girdle was worn a con­siderable time, and the eruptions disappeared.

In the year 1768, an acrimony in the skin was again very troublesome on using any considerable exercise. Various medicines were administered, but without any benefit; and the lady was advised to go to Brighthelmstone, to use the warm bath, and drink sea water. These methods produced a great relaxation without curing the eruptions, and pro­bably laid the foundation of these complaints, [Page 26]which afterwards became so dangerous and alarm­ing: for a pain was soon felt near the neck of the bladder, succeeded by a swelling, which fre­quently suppressed the urine.

From this time the symptoms became more vi­olent, the pain in the tumour was so exquisite, that the lady was frequently deprived of rest. Dr. Bates prescribed the common uterine remedies, thinking (as I have been informed by the family) the case to be an ulcer of the bladder, or a schir­rus of the uterus.

These complaints gradually increased for two or three years, and the lady finding no relief from any remedy which was prescribed by the medical gentlemen of the county in which she resided, it was thought necessary to consult another physi­cian. Dr. Smith, a gentleman of distinguished reputation, and one of the professors of the universi­ty of Oxford, was accordingly consulted.

At this time the lady was incapable of using any exercise without pain. The urine was some­times suppressed; at others, it issued involunta­rily, commonly occasioning great uneasiness. There was a sanious discharge, which was consi­derable. Dr. Smith prescribed as follows.

℞. Emuls. commun. sine sacch. ppt. ℥iss.

Sperm. Caet. in muc. g. Arab. solut.

Terr. rub. bristol. subtiliss. laevigat.

Bals. Canadens. solut. aa ℈i

Tinct. Stypt. Eaton. ver.

— Cinnam.

Syr. alth. aa ʒi m. f. Haust. sumend. 6ta quaq. hora. Bibat aq. pyrmont. rec. cyath temp. inter. Haust. med. addendo primo chalyb. solut. in succ. cydon. rec. coch. i. vel minim.

For M. S.
J. S. Oxford.

These remedies not in the least alleviating the symptoms, the same Gentleman was again con­sulted, The following is an authentic copy of his letter, on this occasion, to Mr. Edmonds, surgeon, at Wendover, the original of which I have in my possession.

SIR,

I am sorry for the account you give of our patient; it is not improbable, but the steel may be a little too rough an astringent for her. I was desirous of attempting something more than barely to palliate, and still am unwilling to give up the attempt; at the same time I wish, most sincerely, that M. S. could be conveyed to town, in order to have a consultation of the most emi­nent physicians and surgeons upon her case. They probably may be able to find out, by ex­amining carefully the urinary passages with a leaden or wax candle, or bougie, exactly the seat of the complaint, which is a circumstance of great importance; mean while she may take as follows.

℞ Pulv. e Tragacanth. comp.

Sperm. Caet. pulv.

G. Olib. pulv.

Terr. rub. Bristol. subtiliss. laevigat aa ʒii cum Syrup. alth. q. s. f. Electar. cujus. capiat, Q. N. M. mane. meridie. et nocte.

Superbib. Decoct. seq. ℥iij vel iiij.

℞. Decoct. pectoral q. s. coquend.

Addendo Fol Tussilag.

Heder. Terrestr. aa ʒij. Rad Helen ℥ss co­lat lbss.

℞ Elect. Lenitiv. ℥i.

Magnes. Alb.

Flor. sulph. lot. aa ʒij m. et cum Syr. Ros. solut. f. Electar. cujus capiat ʒi vel ij in alvus nimia astrictione.

Asses milk, fresh whey, and milk diet in gene­ral, are certainly proper. The Pyrmont water may be drank ad libitum, provided it does not occasion the curdling of milk in the stomach.

I have been looking into Boerhaave, Hoffman, Sauvage, and others, for some light in this very troublesome case, but can find nothing greatly to my satisfaction. Milk diet, soft mucilages, Balsam Capaiba, sulphureous waters These are the principal things recommended; I can­not conclude without wishing again, that a con­sultation may be had, and the sooner the bet­ter: I am, Sir, with best wishes for our pati­ent's recovery, and compliments to the family, Sir, your most obedient servant.

J. Smith, Oxford.

After the patient had persisted about fourteen days in this plan, without any relief, the family, according to the candid advice of Dr. Smith, care­fully removed the lady to London, to Mrs. Bil­ton's in Tavistock Street. The great reputation, which Dr. Hunter had acquired from his extensive practice in feminine diseases, induced her friends to consult him, in a case which had such affinity with that branch of practice, for which he had been so distinguished.

When consulted, he declared the case to be a schirrus of the uterus, and prescribed the fol­lowing,

For M. S.

℞. Aq. Menth. pip. simp. ℥iss.

G. Arab. ʒij.

Tinct. Thebaic, gutt xxv. m Haust h. S. Sumend.

W. H. the initials for William Hunter.

This first prescription, it is evident, was only intended as a palliative, to act by its opiate qualities, and was, by no means, calculated to re­move such an inveterate distemper.

From perceiving the case very dangerous, a con­sultation was recommended with Dr. Fothergill; and, after a deliberate examination of the case with Dr. Fothergill, the following prescription was written.

℞. Aq. Menth pip. Simp. ℥iss.

G. Arab. ℈ij

Tinct. Thebaic gutt. xxv. m. f. haust, hăc nocte sumend. et crastina repetend.

℞. Aq. Purae

— Cinnam. ten. aa ʒi.

Ol. Ricini ʒiij

G. Arab. ʒss Syr. Simp. q. S. f. haust cras primo mane sumend. et post horas iv repetend. si opus fuerit

℞. Aq. Menth. pip, simp. ℥vj

— Spirit ℥ss

Syr Croci ʒjj

Tinct. Thebaic gutt xij m. capiat coch ij ur­gente nauseă.

W. H. J. F. the initials of William Hunter, John Fothergill.
[...]

From these prescriptions, it seems that no­thing more was intended, than to palliate the symptoms.

The opiates were prescribed to ease pain, the ol. Ricini, to keep the intestines gently lax, and to counteract the astringent qualities of the opium; for a costiveness immediately had followed the first prescription. The mixture, with the mint water, was ordered for a sickness of the stomach and vomiting, which the pains had occasioned; at this time, then, no method was attempted to cure the disease.

On the 26th of November, Doctors Fothergill and Hunter met, consulted again, and prescribed,

℞. Aq. Menth. pip. simp ʒiss

Tinct. Thebaic gutt xx.

G. Arab ℈ij f. haust. omni nocte sumend

Cras mane capiat haust. cu ol. Ricini

Praescript. et diebus alternis repet.

Addendo ol. Ricini ʒi vel ʒij si opus crit.

Pergat in usu Julepi praescripti pro re nată.

W. H. J. F. the initials for William Hunter, John Fothergill.

The same plan we find was persisted in, though not the least relief had been obtained. On the 26th, there was another consultation. And the pre­scription was as follows.

Repet. Haust. anodyn. novissime praescript. omni nocte sumend.

℞. Extract. Cicutae ʒij f. pil. xxx (non deau­rand.) capiat aegra. ij. meridie ij vesperi, et iij h. s.

℞. Rad. Sarsaparel. ℥iss coq. in aq. pur. lbiss ad lbi colatur: adde aq. nuc. mosch ℥i capt. coch [Page 31]viij post pil. praescript meridie et vesperi. H. S. capiat haust anodyn. post easdem pilulas.

℞. aq purae ʒx

— nuc mosch ʒi

Magnes. Alb.

Troch. de sulph. aa ʒss. f. haust

Sumend. manè, quotidie addendo Tinct. Jalap gutt. XXX vel XL loco aq. nuc. mosch. si alvus quo­tidie non responderit.

W. H. J. F. the initials for William Hunter, John Fothergill.

We now find that the hemlock, that fashiona­ble and destructive drug is administered, but with­out the least advantage. It however enables us to draw this conclusion, that the case was treated as a cancer. Soon after the lady had taken the hem­lock, a giddiness of the head was complained of, and a loss of memory was the consequence, which continued a considerable time.

These last prescriptions were persisted in till the 7th of December, during which time the symp­toms became more violent; the lady continued in extreme misery, and her memory became so much impaired, that she could scarce recollect any trans­action one minute past. This last complaint I must attribute to the hemlock; because I have known several instances where this noxious drug has produced similar effects; and one in particu­lar, where it brought on comatose symptoms, and incontestibly proved fatal. I could here animad­vert on the impropriety of the foregoing prescrip­tions; but it is sufficient at this time to observe, that they were not successful.

On the 7th of December, in consultation with Dr. Fothergill, was prescribed,

℞. Julep, e. Cretă cu. dimid: sacch ℥iss Amyl vulg. ʒss

Aq. cin. ten. ʒi

Tinct. Theb. gutt. ij. f. haust. 8 vă quaq. horă sumend. H. S. repetatur haust. anodyn. prae­script.

W. H. J. F. the initials of W. Hunter, J. Fothergill.

On the 10th, Dr. Fothergill visited the patient, and ordered

℞. Julep, e Cretă ʒx

Aq. Cin. Spirit. ʒiss

Pulv. Rhei gr. vij. f. haust quamprimum sumendus. Deinde pergat in usu Haust. e Cretă praescript. horis octavis. addend. singul. P. nuc. mosch tor. gr. vij H. S. Capt. Haust. anodyn. prae­script.

J. F. the initials of John Fothergill.

These cretaceous preparations, joined with gen­tle cardiacs, were intended to relieve a diarrhoea, that probably arose from an irritation in the rec­tum, which was afterwards productive of an ulcer in that intestine.

On the 14th of December a fifth consultation was appointed; the ill success of the prescriptions, joined with some additional symptoms, which were concluded very dangerous, induced the physicians candidly to acknowledge the impossibility of re­lieving the lady; Dr. Hunter declared to Capt. S. the brother of the patient, in the presence of many other friends and relations, that the disorder was absolutely incurable. On being questioned by [Page 33]a Lady present, who had a sincere affection for the patient, How long it was thought M. S. would live? it was answered that it would be impossible to determine; but Dr. Hunter expressed in a pa­thetic manner, that he was sensibly affected on the reflection, that she would suffer extreme misery be­fore her departure. It was then advised, that M. S. should be removed with all possible care into the country.

The last prescription is as follows.

Persistat in usu haust. anodyn, praescript. si alvus adstricta fuerit, manè capt. aq. purg. (Jessopens dict.) ℥vj vel ℥viij. vel q. S. ad alvum semel quo­tidie submovendum.

W. H. J. F. the initials of William Hunter, John Fothergill.

The foregoing prescriptions were certainly in­adequate to the cure of such an obstinate disease: but, as it is the common mode of practice, a de­viation from it perhaps would have been consider­ed erroneous, as being contrary to the rules of art. Established maxims, however unsuccessful, are seldom relinquished, though the preservation of life is frequently dependant on it.

The lady had a schirrus of the uterus, which produced an inexpressible and constant pain. There was a continual sanious discharge of that complex­ion and fetor, which characterise a cancerous ul­cer; the patient was under the disagreeable neces­sity of lying in bed, for the evacuation of the urine and feces, and both were attended with great pain, and a considerable quantity of puru­lent matter, consequently there was an ulcer in the rectum. These symptoms, after the administration of the opiates and cretaceous medicines, were ac­companied [Page 34]with costiveness, the most excruciating pains, cold shiverings, nausea, and sometimes vo­mitings, loss of memory, and a countenance, which seemed to foretel a total dissolution. So emaciated and exhausted was the patient, that na­ture seemed too weak to assist the operation of any medicine. A great part of the surface of the body was covered with scorbutic eruptions; and the least motion, even from the bed to a sopha, occasioned the most painful sensations. At this time Lord le Despenser did me the honour to re­commend me, in consequence of my success, in a case which his Lordship was acquainted with. At the request of the brother, Captain S. I visited the Lady on the 15th of December, 1772. I exa­mined minutely every circumstance, and endea­voured to gain a clear information of what had been already attempted by the gentlemen who had been consulted, and committed the whole immediately to paper, which was just as I have related it.

A consideration of this complicated case, dis­posed me, however, to believe, there yet remained some hopes of effecting a cure. I resolved, there­fore, to administer some remedies, which expe­rience gave me reason to think were more adequate to the cure of such inveterate complaints, than those which had been already prescribed. I began with the pilula rubra and pulvis mineralis, in very small doses, and forbad the use of opiates, as their bad effects in weakening, greatly overbalance the little temporary relief they give.

These remedies produced such excellent effects, that the costiveness was removed, and all the symp­toms were alleviated in a fortnight. The patient was then removed into the country, and recovered daily. In about one month she could sit up three [Page 35]or four hours, though in the most inclement part of the winter. In about four months more by continu­ing the remedies, the Lady recovered her memory perfectly, and every discharge had a more favour­able appearance. The eruptions entirely disap­peared. She recovered her appetite and natural rest, which for some years before she had been de­prived of. By a perseverance in the same medicines, and by gradually increasing their doses, a perfect cure was at last accomplished.

The Lady continues in perfect health, and rides on horseback, without the least inconvenience.*

CASE XXVII.

MRS. B—, was recommended by a surgeon, who had a large induration, ulcer and distension of the womb. Violent floodings had repeatedly distressed the patient; great pains and bearing down had rendered her truly miserable. Various medicines, amongst the rest injections, had been prescribed by practitioners of eminence, both as [Page 36]physicians and men-midwives; but no relief what­ever had been obtained; hemlock had likewise been administered. The pilula rubra and the pulvis mineralis were prescribed; the enlarged uterus, which was distended above the os pu­bis, was reduced within the pelvis in the course of three months; the os tincae, which was uneven and ulcerated, and the surrounding parts enlarged, so as to prevent the free discharge of urine, were perfectly cured in less than five months. The patient has had not the least return, it being now near three years since the cure.

CASE XXVIII.

MRS. K—, Castle Street, Leicester Fields, re­ceived a hurt in lying-in, which occasioned an ul­cer of the uterus, the os tincea; was opened consi­derably, rugged at its edge, the discharge was great, offensive, and when dryed on the linen had a darkish hue towards the edges of the stains. The patient was palid, and nearly exhausted by the vi­olence of the pain she suffered. The pulvis mi­neralis and the essentia volatilis, joined with cam­phor, were given, and the cure was effected in a, few weeks. The patient is now living, and has had no return of the complaint since the cure, which is about four years and a half.

CASE XXIX.

MRS. B—, Berwick Street, aged 43, had been afflicted with great pains in her back, loyns, thighs, with a bearing down, a suppression of urine, and contractions of the uterus, for near one year. Various medicines had been given, according to the opinions of the different practitioners to whom she applied. Remedies for the stone, gravel, lum­bago, had been recommended; burnt sponge, millepedes, cathartics, sope pills, spiritus nitri dulcis, &c. &c. opiates and hemlock had been administered without any advantage. This last re­medy nearly deprived her of her senses.* On ex­amination it was found, that the case had been misunderstood; for all the symptoms had arisen from a schirrus of the womb, which pressed on the neck of the bladder; there was likewise an ulcer; the discharge issuing being extremely offensive, thin, and such as ever comes from cancerous ulcers of these parts, easier to be conceived by the ex­perienced in midwifery, than described. The pa­tient was exceedingly exhausted, palid, and scarce able to take food. The pilula rubra was given in the dose of a quarter of a grain, and eight grains of the pulvis mineralis, with the essentia vola­tilis occasionally. These agreeing, in a week the doses were increased, and the patient was rather easier. The continuance of the remedies, with occasionally a few grains of the sal neutralis, ef­fected the cure in about five months.

CASE XXX.

A lady of fashion, naturally of a delicate con­stitution, above 40, who formerly had several hard labors, and particularly with her last child in 1761, had been suffering for near fourteen years with a complaint in the rectum. In the early months of pregnancy the piles were continually troublesome, and for fourteen years after the last delivery, on every evacuation of the feces, was a quantity of blood discharged. When the disorder was first dis­covered, a very eminent surgeon and a man-mid­wife injudiciously advised turpentine glisters to be injected*; which greatly irritated the inflamed part, and after this, a purulent matter as well as blood was discharged, which proved exceedingly relaxing. The practitioners consulted, finding the rectum ul­cerated, and after exerting their utmost efforts to remove the complaint, persuaded the patient, as is too common, that the discharge was healthful, and carried off other bodily disorders. Upon ex­amination afterwards, it was declared, by a very eminent surgeon, that there was a large fungus in the intestine, but that no operation could prove useful. Depending on the opinions given, and the reputation of the practitioners consulted, the misery was bore with the greatest fortitude, there not appearing the least hopes of relief. Having seen the successful treatment of M. S. mentioned Case XXVI, this lady was induced to apply to me, Sept. 8, 1774. The countenance was very pale, the whole body was exceedingly relaxed, with a great languor of spirits, and a hectical look; [Page 39]twice in a day was discharged a cupful of blood and fetid matter. The opinion I gave to the friends, was, that the rectum was ulcerated, that it would be impossible to determine whether relief could be obtained; upon the whole, that any suc­cess was doubtful. A trial was made. Ten grains of the pulvis mineralis were at first given, which agreed perfectly well, and every week the dose was increased, until twenty-five grains were taken four times a day, for six weeks. Nourishing diet, rather of the animal gelatinous kind was recom­mended. In about two months the discharge had considerably diminished; the patient continued the powders, with one grain of the calx antimonii, and had the inexpressible pleasure of finding the ulcer healed, both discharges had ceased in nine months. This lady has remained perfectly well ever since, which is now above four years; but has taken occasionally the sal neutralis and the pulvis mineralis since the cure, by her own desire.

CASE XXXI.

MRS. C. had, for above one year and a half, suffered extreme misery, from a schirrus and ulcer of the uterus. The first practitioners in London had been consulted, and after trying various reme­dies, as opiates, laxatives, hemlock, &c. gave up the case as lost. The pains were acute, and de­prived the patient of rest; the schirrus was large, pressing both on the rectum and neck of the blad­der, occasioning a difficulty in the expulsion of urine and the feces; a fetid, purulent and acri­monious matter was discharged in great quanti­ties, very offensive, and evidently of the cancer­ous kind. Sometimes the pains were equal to the strongest labor pains; the whole body was greatly [Page 40]emaciated, and the patient had not been able to sit up for many months. The pilula rubra and the pulvis mineralis, with one grain of the calx. antimonia, were given three times in the day, and the use of opiates entirely left off. In the course of six weeks, during which time the symptoms daily decreased, the patient could sit up; the re­medies were continued for about three months more, and all the complaints were nearly remov­ed. About this time I went abroad, was gone for near three months, and on my return found that no one complaint remained, except some lit­tle discharge and weakness. The medicines were still continued, with the julep. e camphor. and there was every reason to conclude the patient nearly cured. Some time after, however, came on a violent diarrhoea, which proved fatal.

When an ulcer accompanies a swelling and hardness of the womb, the prospects of cure are doubtful; in many such instances the reme­dies, however, have afforded a very com­fortable relief for years, and kept the patients from those intolerable pains, which must strike every humane spectator with horror, when the common modes of treatment are alone pursued.

It is reasonable to conclude, that, what gives such extraordinary relief in desperate cases, and which in some instances has proved a positive cure, would in general prevent these complaints at a certain time of life; or when the disorders first make their appearance.

Practitioners in general, and all authors, either an­cient or modern, have considered these uterine com­plaints incurable; upon this principle, when the disorder is discovered, they often persuade the suffering patient, that nothing more than the ad­ministration of palliatives can be done. I have [Page 41]often been called in, after much mischief has been done by improper practices; where there remain­ed not the least probability of affording relief; nay, sometimes but a few hours before death, and then it has been with exultation reported, but with what degree of candor or humanity let the world judge, that the patient has died under my care.

CASE XXXII.

MR. C—, at St. James's Palace, had been a long time afflicted with a large spongy excres­cence, almost surrounding the sphincter ani; a very considerable discharge issued from the rectum, exceedingly acrimonious, which inflamed the skin wherever it came in contact; several parts were likewise coroded, and formed a number of small ulcers, not only in the perineum, but likewise in the posterior part above the anus, causing most exquisite torture night and day. When the faeces were evacuated, a prolapsus, or falling down of the intestine happened. He had applied for relief to the most able practitioners, laxatives had been administered, lotions, unguents, &c. without any advantage. The misery he experienced was inex­pressible. He took a solution of pure nitre, join­ed with the mercurius corrosivus sublimatus, in very small doses. The sal neutralis was likewise occasionally given, with the aethiops mineralis. Externally as a palliative was applied with a fea­ther, ℞. Litharg. aur. ʒij aceti distillati, olei amygdalini aa ℥j m. f. liniraentum. By these means ease was soon procured; in the course of six weeks the excrescences had dropped off, the ulcers were healed, the discharge from the rectum ceased, and the absolute cure was effected. Many instan­ces have occurred, where the excrescences about the anus, the fistula, &c. have been cured by the above means.

CASE XXXIII.

H. F—, Esq; a married gentleman, had an ob­struction in the urethra, arising from excrescences, and a schirrus of the prostrate gland. Bougies had been used a considerable time without remov­ing the complaint. The patient was frequently under the necessity of having the urine drawn off by means of a catheter; the most exquisite pain accompanied the discharge of urine, which issued in drops, and from the contracting and expulsive efforts of the bladder, joined with the resistance near its neck, the most inexpressible misery was experienced; and this happened very often; for there seemed, almost, a constant irritation of the parts. All diuretics and emollients had exaspera­ted the symptoms; by promoting the secretion of urine in a disorder which resisted powerfully its evacuation. A costiveness prevailed, and most cathartics irritated. Solid meat was sure to cause pain; a milk diet had been persisted in by the advice of a physician, and the solvent medicines had been administered under the care of a reputa­ble surgeon, but without success. On passing a small bougie, I perceived a slight resistance, as nigh as could be conjectured, within half an inch of the prostrate grand; on pushing on the bougie, another powerful resistance was felt near the last mentioned part. Concluding that the first oppo­sition was from an excrescence, and the last from an induration, and enlargment of the prostrate gland;* some hopes were suggested that what had [Page 43]so effectually removed other glandular complaints, might prove beneficial in this. The pilula rubra was given, at first, in the dose of half a grain, four times in the day, and persisted in for near three weeks, without any advantage, except that the urine was discharged with rather more ease, and the inclination to evacuate it was more distant in point of time. A solution of camphor, with the essentia volatilis, and the eighth of a grain of a well prepared mercurius corr [...]sivus sublimatus were administered after each pill, which last was given in the dose of a grain; a mercurial ointment, charged with camphor, was rubbed into the pe­rineum, and a fumigation of cinnabar was used every night previous to anointing. The effects were beyond expectation; for in three weeks after the urine was discharged with ease, small sloughs passed daily through the urethra, rather fibrous, putrid, and scarce more tenacious than coagulated blood. The remedies, except the ointment, were continued for three months, and a perfect cure was the consequence.

CASE XXXIV.

The Lady of a Member of the House of Com­mons, aged 43, had an enlargement and induration of the womb, with a discharge which indicated an ulceration of the part. This complaint had been of two years standing, and the patient previous to that time had been attacked with frequent and immoderate floodings. A court physician, not a practiser in midwifery, ordered the most astringent remedies, as the bark, elixir of vitriol, tincture of roses, &c. These injudicious methods of treat­ment, by checking the efforts of nature to relieve [Page 44]herself, most probably produced the schirrus of the womb*, for great pain succeeded.

After the patient had suffered inexpressible tor­tures, and was in the last stage of the disorder, pale, emaciated, feeble and hectical, I was con­sulted, and declared the case to be incurable. I attempted an alleviation of the symptoms, and, in great measure, succeeded, by giving the essentia volatilis and the pulvis mineralis in small doses ter de die. In a few weeks, however, pains came on, with contractions of the womb, similar to those of labor: great quantities of coagulated masses of the polypous kind were expelled, which had most probably been detained in the uterus ever since the floodings, when those very powerful astringents had been used; for vitriolic acids have frequently this property. In a few days the discharge became exceedingly putrid, and the disorder put a period to the patient's existence.

SCHROPHULOUS CASES, commonly called the KING's EVIL.

CASE XXXV.

MISS D—, Chancery Lane, about the age of 14, had many swellings, and some of them ulcerated, about the neck, of the schrophulous kind, which threatened suffocation, accompanied with a cough. Several skilful practitioners had been consulted, and the cutting them out had been advised; but this proposal alarmed the friends and the patient to such a degree, that it was determined rather [Page 45]life should be lost than such a disagreeable opera­tion should be performed in a part always exposed to the view. This case was perfectly cured by the pilula rubra, and the pulvis mineralis, with the aethiop. antimon. in about four months; an oleous mixture being taken at first to allay the cough. The patient has had no return of the complaint; it is now above six years since the cure.

CASE XXXVI.

MR. S—, aged 18, had perceived swellings and an induration first under the chin for above ten years; three years after the first tumors ap­peared, both the maxillary glands tumified and became hard. Harrowgate water was prescribed without any effect. Fresh swellings arose, till at last the whole throat towards the chin and ears was one continued swelling, so as to disfigure the face exceedingly, the wind pipe and oesophagus were greatly compressed, daily threatening suffocation. In this situation of the patient I undertook the cure, and commenced with bleeding, a gentle ca­thartic, and ordered the pilula rubra and the pulvis mineralis four times in the day. The swellings in a few months were greatly diminished, and by a conti­nuance of the remedies, and increasing the dose of the pill to two grains, in about fifteen months the cure was effected.

This patient has been cured three years, and not the least return of the disorder has happened. Such complaints in general prove fatal, instances of which must have occured in all our hospitals. One remarkable case of this nature I remember happened, which proved fatal in the year 1764 to a young man, a patient to Mr. Cowell, Surgeon of St. Thomas's Hospital, whose morbid parts [Page 46]were publicly inspected afterward in the theatre; and it appeared that, besides the compression of the asperia arteria, the oesophagus was entirely ob­structed, so that no food whatever could pass.

CASE XXXVII.

MRS. I—, Harley Street, had for between four and five years been afflicted with a swelling and stiffness of the knee, in which there were five or six foul ulcers. On inspection, the case evi­dently appeared schrophulous. The pilula rubra was given, and this obstinate disease was cured in a­bout four months. The patient now remains in perfect health.

CASE XXXVIII.

MR. F—, had been afflicted with a disorder many years about the fingers and metacarpal bones, many parts were ulcerated, and could not be healed. A skilful surgeon had advised the cut­ting off of the hand; for, various remedies had been used without advantage, as the millepedes, burnt spunge, hemlock, &c. &c.

This patient took the pilula rubra and the pul­vis mineralis, and was perfectly cured in about ten months, by which means the hand was saved.

CASE XXXIX.

MRS. T—, at Lady F—, aged 23, after a cold, in her 19th year, a swelling appeared under the lower jaw, about the size of a hazle nut; this was succeeded by several tumors about the neck, some suppurated and discharged matter, others were opened. The disorder increasing, and the patient having had, what is called, the best advice from a celebrated court surgeon, without [Page 47]any advantage, despaired of ever receiving relief. The swellings increased, and at last seemed to unite, forming one hard stony tumor, from the chin towards the ear; the tip of which it pressed out considerably; the patient's mouth was drawn aside, and occasioned a disagreeable and distressing appearance to the face. Bleeding was first pre­scribed, the pilula rubra, and the pulvis mineralis, with the aethiop. antim. were taken four times in the day. In fourteen months, during which time the tumor had been gradually diminishing, the cure was effected, and the face, which before was greatly disfigured, was reduced to its natural form. One of the salivary glands remained a little swel­led, but as many similar instances have happened where it has been of no consequence, any farther attempts were thought unnecessary.

CASE XL.

A YOUNG gentleman, aged 10, son to an officer in the army, came under my care August 1774. He had been inoculated about five years before for the small pox*, under the care of a reputable surgeon; soon after, there appeared several glandu­lar swellings about the neck and throat, some came to suppuration, and were opened by a skil­ful court surgeon, who advised the use of salt wa­ter. This was complied with for a considerable time, but fresh swellings came before those which were opened, or had broken, healed. The neck was covered with scars, and swellings were continually succeeding each other; in both eyes there were specks in the cornea, in one, sight was [Page 48]greatly impeded, in the other, except a glimmer­ing, it was lost. The eyes were likewise inflam­ed. Bleeding was first prescribed, the pilula ru­bra, and the pulvis mineralis, with the aethiop. ant. and the decoctum nitrosum, were given. By these means the specks and blindness were re­moved, fresh swellings were prevented, those, whether hard or ulcerated, were cured in the course of about eighteen months, and the patient, who is now at a public school in town, remains per­fectly well.

CASE XLI.

MR. H—, St. Martin's Lane, in December, 1774, applied for advice in a noli me tangere, which had been bad about two years. He had caught cold, and a soreness was perceived on the lower part and side of the nose, with inflammation and a dark red appearance; it was first washed with a solution of nitre. Afterwards a surgeon recom­mended some mercurial pills, but no success at­tending the use of the remedies, he applied to a physician of an hospital, who ordered the hem­lock in pills, gradually increasing the dose, till six­teen were taken in twenty four hours for a length of time, by which his memory was affected. Two consultations of physicians and surgeons were had, and it was concluded on, to give him a solu­tion of mercury, with the sarsaparella decoction. This was persevered in for near five months; but the disorder grew worse, and had spread itself all over the internal surface of the nose; a part of the cheek near the left ala of the nose was like­wise hardened in several little swellings, about the size of grey pease, of a very dark red colour, which afterwards became ulcerous. Despairing of obtaining any relief from the regular practitioners, he unhappily was induced to apply to one of those [Page 49]pretenders to the cure of cancers, who uses caus­ticts under the name of plaister. This person boldly applied a caustic twice, and destroyed the left ala and some part of the nose, and would have repeated it, but the patient had already suffered so much by this cruel treatment, that no persua­sion could prevail on him to undergo a third trial. In this situation he applied to me; he was ordered a simple soliation of pure nitre, with camphor, in which was dissolved some mercurius corrosivus sublimatus, so that he took the eighth of a grain three times in the day of this last mentioned pre­paration, preceded by a red pill of one grain. A fumigation of cinnab. fact. and aethiop. min. p. e. was used to the parts every other evening, for three weeks, and then omitted. By these means, in about nine months, the ulcer in the nose was healed, and all the parts which had been saved from the ravages of the caustics became sound: the ulcers in the cheek likewise were cicatrised; and, considering the circumstances, the face did not appear much disfigured.

CASE XLII.

J— B—, servant to a Baronet, had for a long time labored under a complaint in the low­er and external part of the thigh; a very large, painful swelling and stiffness in the knee. The tumor of the first suppurated and broke; the matter was very deep, lying between the muscles of the thigh: there was a considerable sinus, and the external opening being small, might have been properly termed a fistula: hectical symptoms were likewise evident. This patient had been for relief at an hospital, but obtained none. The pilula rubra was given, and the pulvis mineralis. The [Page 50]opening was enlarged, and by a long continuance in the remedies, the stiffness and swelling in the knee were removed. The ulcer in the thigh, by compress and common dressings, was entirely healed. This patient is at this time in perfect health.

CASE XLIII.

MR. T. Wych Street, had lost the use of his leg, by a large swelling in the middle and out­ward part of the thigh; he could not, without great torture put his foot to the ground. He had rather swelled lips, and other evident marks of a schro­phulous habit. The swelling increased; suppu­rated, and was opened; discharging a great quan­tity of matter. He was ordered the pilula rubra and the pulvis mineralis; the abscess was treated in the common manner. After it had been open some time, a considerable exfoliation of the thigh bone worked its way through to the mouth of the wound, which was carefully extracted. The re­medies were continued; and in a few weeks after the perfect use of the leg was restored, and the scrophulous swellings in the lips subsided.

CASE XLIV.

A CHILD, in a family of fashion, between three and four years old, had several eruptions in the face, at first red and inflamed, then a serum was discharged, and the skin scaled off. The lips were swelled, and the glands about the neck were in a tumified state. The aethiops mineralis, and the sal nitr. had been given for some time; when this disagreeable disorder appearing so disgusting in parts most exposed to view, was in a few months entirely removed. Some time after the child lost [Page 51]the use of one leg: there was an exquisite pain in the hip, thigh, and inner part of the loins. On inspection, from all the circumstances, I was per­suaded that it was the commencement of that shocking disorder, well known by surgeons under the name of a psoas case*. Something decisive was necessary: bleeding was first prescribed, the pilula alba ad gr. ss. was given every night; a solution of the nitre, with the sal neutralis, was taken four times in the day, and a pediluvium every night was used. The effects were excellent: for in about three weeks the child was restored to a perfect and free use of the limb, and has remained well ever since.

CASE XLV.

MR. Townley, aged 26, at No. 34, Suf­folk Mews, Middlesex Hospital, had been af­flicted three years with a disorder in his knee. He had applied to a public charity for above seven months without any relief, and had been deprived of getting his livelihood by his business. There was a very large swelling and contraction of the part, so that he could not bring his heel to the ground. He took the pilula alba every other night, and was perfectly restored to the use of his limb in less than two months. In this case I must confess I had not the least prospect of success; and had even told the patient as much: when, on his just going out of my house, almost in a state of despondency, I came to a sudden determination of trying the pilula alba, having formerly expe­rienced its use in small doses in a diseased ankle joint.

CASE XLVI.

A GENTLEWOMAN, in the early part of life, had accidentally let a small pin drop into her ear, from which issued a few drops of blood: lit­tle or no pain succeeded; but some time after a discharge of a very fetid matter was perceived, and a deafness on that side. There was no secre­tion of wax. She was advised, very properly, by an eminent surgeon, not to suffer the use of injec­tions, or any other applications; as in so delicate an organ, that fine membrane, the tympanum, might be probably destroyed, as likewise the little bones*, which form part of the mechanical struc­ture of this curious organ. Satisfied with this opi­nion, nothing was attempted for years; but the discharge continued, and was at times very offen­sive. This lady had a fever in August 1774, of the putrid kind, with ulcerations in the throat, for which I was consulted. It terminated happily by the use of the common anteseptic remedies; as bark, elixir of vitriol, vinegar drinks, &c. &c. After recovery, the discharge from the ear was remarkably more offensive than before. This circumstance was communicated to me. A fumi­gation of cinnabar factitium and aethiops minera­lis p. e. was used, by means of a proper tube every other evening to the part. Internally twice in the day was taken the pulvis mineralis, to which was added a larger portion of the aethiops, and some aethiop. antim This plan was continued for near three months, during which time the dis­charge gradually decreased, and entirely lost its offensive smell. The powders were then directed without the fumigation; the ulcer was soon after entirely healed; the wax was secreted; and the [Page 53]hearing perfectly restored. No return of this complaint hath since happened.

Some other instances of the same sort have oc­curred, where the fumigation has been very effi­cacious, as it commonly is in foul ulcers, unat­tended with inflammation.

CASES IN SPECKS AND BLINDNESS, CURED BY INTERNAL MEDICINES ONLY.

CASE XLVII.

MR. Whittaker, No. 2, Mercer Street, Long Acre, was seized on August 1, 1773, with a violent inflammation and pain of the left eye. Conserve of roses was applied at first, and a purge taken; then a lotion was used of the vitriolic kind until the 10th; when the pain and inflamma­tion continuing, he was advised to apply alum powdered, with the yolk of an egg; and on the following day he found he had totally lost his sight. What made his misfortune truly melan­choly was, he had lost his other eye in his infancy. On the 15th in the morning he was led to me: the cornea was opake, and of a pale bluish co­lour; nor could he perceive the least glimmering of light. Bleeding was first ordered to twenty ounces. The pilula alba was given every night, ad gr. ss. and a cupful of the solutio nitrosa* was taken every hour in the day-time. In three days there appeared to the patient some little light; and though the cornea did not seem to have the least transparentcy in any part, yet the remedies were [Page 54]continued; but as the inflammation had subsided, the doses of nitre were only given every three hours. No application whatever was used out­wardly*, and the patient, who is now living, had the inexpressible pleasure of being perfectly res­tored to sight in three weeks.

CASE XLVIII.

MISS G—, Richmond, applied the 29th of April, 1774, for relief in a disorder of the eyes. The case was the cataracts in both eyes; one con­firmed, the other incipient. The sight was great­ly impeded; and threatened a total loss of vision. The pulvis mineralis was given, and the pilula ru­bra for between three and four months: the sight was restored, and has remained well ever since.

CASE XLIX.

A child of Mr. Crouch St. Ann's, Soho, had been blind for above 4 months, occasioned by a num­ber of irregular specks on the transparent cornea, which prevented the rays of light forming a point in the chrystalline lens, as likewise an inflammation so violent, that the lids were enlarged; thickened; and had almost lost their muscular motion. The lips of the child were swelled and puffed up: the cer­tain marks of a scrophulous affection. This child was restored to sight, and the scrophulous symp­toms were entirely removed, in less than four months, by the pulvis mineralis.

CASE L.

A CHILD four years old, daughter of Mrs. Williams, recommended by the overseers of St. Giles's in the year 1773, had lost her sight one year, from an inflammation in cutting her teeth. When the child was but eighteen months old, an inflammation of the eyes proved very troublesome; for which a physician, reputedly skilful in the cure of childrens diseases, was consulted; but no benefit was received from his prescription. A very emi­nent practitioner was consulted in the present in­stance; who ordered a fomentation of white rose leaves, to be used two hours in the day, and a powder to be blowed into the eyes. This plan was continued three months, and a lotion was used. Six leeches were applied to the inner angles of the eye, and repeated twice; but no relief was obtain­ed. Application was then made to a celebrated foreigner; who ordered an issue in the arm, and an ounce of magnesia to be taken in a week. A physician at an hospital ordered a blister and an emetic. Finding no good effects from his pre­scription, he declared the disorder to be the king's evil, and that no relief could be expected until the girl reached her fourteenth year. When I first saw the child, she had been blind above nine months; the cornea of both eyes was opake, but there was no discharge. The pulvis mineralis was given for six weeks every two hours in the day-time, without any apparent benefit. On the 9th week the cornea seemed to be nearly transparent; but the child could not bear any light without ex­quisite tortures: the same remedies were con­tinued one week longer. Perceiving then that no­thing could impede the rays of light, in passing [Page 56]through the cornea; and that the chrystalline lens was perfectly clear, I concluded that extreme re­laxation alone prevented the patient from being susceptible of external objects. The bark in substance was prescribed, which had excellent ef­fects: for in nine days the sight of both eyes was perfectly restored.

CASE LI.

MRS. P—, a lady from Guernsey, aged be­tween 40 and 50, had been long afflicted with an inflammation of the eyes, with specks on the cor­nea; which greatly impeded vision, and was the cause of the eyes being covered, to prevent the agonies which the light produced. This case was cured in about three weeks by the pulvis minera­lis; though it had been troublesome many years,

CASE LII.

MISS W. in the city, aged four years and a half, had scrophulous swellings on the lips, with a violent inflammation of both eyes, and specks on the cornea. The rays of light were broken, so that they could not form in the chrystalline lens, and strike on the retina any figure of the external ob­jects which presented themselves. The light al­ways caused misery, if strong. There were crus­ty eruptions behind the ears; about the up­per lip and nose. This child was restored to perfect sight; the swellings in the lips were perfect­ly resolved; and the eruptions removed in the course of three months by the pilula alb. ad gr. ss. twice in the week, and the pulvis mineralis four times in the day.

CASE LIII.

MISS R—, at — W—, Esq. Wimpole Street, had suffered for a long time under a complaint in the eyes. One eye was blind from an opacity of the cornea, in the other the sight was imperfect, owing to two small specks in the immediate direc­tion of the pupil. The light occasioned great distress, therefore the eyes had been long covered by a green shade. The pilula alba was given in the dose of gr. ss. every night, and the pulvis mi­neralis ad ʒss. quater de die. In six weeks this young lady was perfectly restored to sight, and has continued without the least indisposition of the eyes ever since.

CASE LIV.

A child of J. Egleton, servant to a merchant in the city, had been deprived of sight by an opa­city of the cornea and specks; they were intirely removed by the pulvis mineralis taken four times in the day.

CASE LV.

MRS. P—, Argyle Street, in 1772, had an inci­pient cataract of both eyes, which occasioned a great defect in vision, every thing appeared in a cloud. There was evidently an affection of the christalline humor. This patient was perfectly restored in a few weeks, by the pilula alba and solutio nitrosa.

CASE LVI.

MR. Roberts, St. James's Street, was suddenly struck blind on Easter-eve, 1772, and went under the care of an eminent oculist for some time, but [Page 58]received no benefit. The case was the gutta se­rena, for the coats and humors of the eye were per­fectly sound. There was a palsy of the retina, the contraction and dilatation of the pupil was de­stroyed. The pilula alba and the solutio nitrosa perfectly restored this patient to sight in about two months. He is well known to several inhabitants in Holborn; and some years after the cure, I was present when he read in a book with a very small print.

CASE LVII.

THE servant of a foreign ambassador in 1774, applied with a disease in the cornea and inflamma­tion, which greatly impeded his sight. Various methods had been used to remove the complaint without any advantage. The pilula alba ad gr. ss. omne nocte, and the solutio nitrosa taken six times in the day, perfectly restored the sight, and radi­cally cured the inflammation.

CASE LVIII.

A child about three years old had an inflammation of the eye for above nine months, which prevented her bearing the light. Several practitioners had been consulted; lotions, purges, and various re­medies had been administered. The last person consulted had bound up the eye for six weeks, af­ter applying some liquid daily. After this, the in­flammation became very violent, and according to description was what is known by the name che­mosis; the lid was affected, and the cheek swelled. The eye was then poulticed with white bread and milk, and the sight was entirely lost; the part was in the greatest agony. When I first saw the case, the distention was so great, that I expected no­thing but the bursting of the eye, with the loss of the humors. No time was to be lost; and though [Page 59]it was evening, at least eight ounces of blood were immediately taken away from the arm: this saved the eye. The pulvis mineralis was given to gr. xv. every two hours, the sal neutralis was likewise occasionally united with it, and the methods suc­ceeded; for in about three weeks the inflammation was perfectly cured, the opake cornea of a blu­ish color when first I saw it, had become quite transparent, sight was restored, and in one week after, no shade whatever was necessary to enable the eye to bear the strongest light.

CASE LIX.

MR. L—, in the City, had been many months afflicted with a disorder in the eyes; the sight of one was intirely destroyed by a large opa­city, so confirmed as to be incurable. A large speck covered the other in the direction of the pupil, with the inflammation called chemosis. A very eminent surgeon had attended him, and had ordered the calomel in the dose of two or three grains every night, a powerful cathartic every other morning, and a poultice had been applied* This common rough treatment greatly relaxed the patient, but produced no good effects in the cure of the disease. I ordered him, after bleeding, ten grains of the aethiops mineralis, joined with some camphor and confect. damocr. three times in the day, and a so­lution of nitre with the sal neutralis after each bolus. In one week the inflammation had sub­sided, and in a fortnight after he was restored to the sight of the left eye. He was afterwards di­rected to continue these remedies for a few weeks longer; with the addition of the pilula rubra.

CASE LX.

A YOUNG gentleman had been two years and half suffering great misery, from a violent dis­order in the left eye. The whole cornea was opake, and of a bluish color, the conjunctive membrane exceedingly inflamed and thickened; the lid of the eye and the lips were considerably swelled; there were likewise several little ulcera­tions behind the ear. A surgeon of great merit, high in the public estimation, had attended the case for a long time, he had ordered calomel. in the dose of two grains at night, cathartics, and a poultice of linseed, and fomentations. Sometimes the dis­order was better, but on any slight cold broke out again. The pilula alba ad gr. ss. was given twice in the week; the nitre was ordered in the dose of twenty-five grains four times in the day. The in­flammation soon subsided, and the eye was restored to sight in about six weeks. On leaving off the remedies too soon, a slight relapse happened two or three times within the year, but by having re­course to the nitrous medicine, joined with the sal polychrestum, the cloudy appearance has been removed.

CASE LXI.

A GIRL at Battersea, sent by the Lady at Richmond, mentioned in case XLVI, had been many years distressed with scrophulous tumors and inflammation and specks in both eyes, so as to deprive her of sight; some of the swel­lings had broken, and discharged an acrimonious matter, but could not be healed. The pilula ru­bra and the solutio nitrosa, with a laxative occa­sionally, removed both these complaints in the course of foul months.

CASE LXII.

A YOUND gentleman of fashion, had been many years troubled with an inflammation in the eyes, occasioning a sharp discharge, and such irritation, that any strong light of the chandeliers in the night, excited the most disagreeable sensations, and could scarce be endured. This was caused by an affec­tion of the conjunctive membrane which lines the lid, but it communicated its effects to that part of the membrane, which forms what is called, though improperly, tunica albuginea, or, vulgarly, the white of the eye* The vessels in this last part des­tined in a natural and healthful state to carry lymph, were all filled with red particles, and consequently in a state of distension. On examination it ap­peared, that several of the eye-lashes which were inverted, long and bristly, occasioned all these symptoms. These were carefully extracted by for­ceps with a very small point, and the symptoms were in a few days removed; a lotion, with a small portion of the saccharum saturni was order­ed. This operation was four times repeated, and there has not appeared the least complaint in the eyes since *.

CASE LXIII.

A YOUNG Lady had an excrescence, which was ulcerated in the cornea of the right eye; the ves­sels of the conjunctiva were much distended and red. The whole of the transparent cornea was co­vered, [Page 62]and the patient suffered extreme pain, ow­ing entirely to inflammation; the removal of which was the only object in view, for the restoration of sight was impossible. The pulvis mineralis was given in considerable doses four times in the day. In fourteen days the inflammation subsided, and the excrescence, which made a very disagreeable ap­pearance, in the form of a cone, pushing itself beyond the lids, gradually wasted. In about four weeks after it was removed, without any ex­ternal application.

CASE LXIV.

A WATCHMAN in Westminster, in the depth of winter, caught a violent cold, which produced an inflammation and opacity of the cornea; the sight of the other eye had been lost many years before; and from the present misfortune he was quite blind. He took, after bleeding, the solutio nitrosa four times in the day, and the pilula alba every other night. He was restored to sight in less than a month. The inhabitants during his cure humanely contributed to his support.

CASE LXV.

A CHILD of Mr. C—, Spital Fields, had inflammatory eruptions on the face; scrophulous swellings in the neck; and both eyes were blinded by specks and inflammation in the cornea. The eye-lids and lips were much tumified; the pain was inexpressible. Bleeding was first pre­scribed, and the pulvis mineralis was taken four times a day, in the dose of gr. xxv. The pi­lula alba gr. ss. was given every other night, and a [Page 63]nitrous decoction was used as common drink. In six weeks the child was restored to sight, and the swellings reduced.

CASES OF OLD ULCERS IN THE LEGS, CURED IN PERSONS ADVANCED IN YEARS.

CASE LXVI.

MRS. B—, Marybone, aged 78, had been for between thirty and forty years, experien­cing great misery from an ulcer of the leg, si­tuated a little above the ancle. It was not large, but the surrounding parts were callous, itched in­tolerably, the discharge was acrimonious; there were several scorbutic eruptions in different parts; the pains were acute, and almost constant. Various had been the means used to cure, or to relieve this complaint. Sometimes by rest and medicine it had been healed; but, as is common, on exercise soon broke out again. For several years the pa­tient had been advised to bear patiently the pain­ful disorder, under the specious pretence of its being necessary, as a drain for all bad humors. To cure a person so far advanced in years, might make the disorder fly to the head, and destroy the senses; or bring on a fever, or a cough, which would prove fatal. By such artifices, which are too commonly practised, when surgeons cannot cure an ulcer, was the patient persuaded to suffer in­expressible misery for so many years. The pulvis [Page 64]mineralis was given three times in the day: to the wound was applied the saturnine ointment, and proper dressings. In six weeks an evident altera­tion for the better was produced, the itching be­ing allayed, and the eruptions cured. The pilula rubra was then taken, as the callosity was stubborn, The ulcer still discharging an a­crid matter, a fumigation was used every other night. By these means the cure was effected, and the patient remains in perfect health, using as much exercise as that advanced age will admit.

CASE LXVIII.

THE Lady of — L—, Esq. aged 64, had been lame for fifteen years, from a number of ulcers in her leg; sometimes they were rather better, at other times worse, according to the changes of the seasons. Different practitioners had been con­sulted, rest, purges, and various means had been prescribed by some of the first practitioners in town. After many fruitless attempts, agreeable to the common modes of practice, to cure this case, it was gravely asserted, that it would be the lady's death, if the wounds were healed. When first I inspected the case, there were at least forty ulcers in different parts of the leg, foul, offensive to the smell, discharging a very acrid matter. There were swellings and inflammation, and the pain was ex­quisite, constantly depriving the patient of rest. At first the pulvis mineralis was given three times in the day, and proper dressings were applied; which, in the course of a few weeks, produced very favourable appearances. The plan was continued, but the disorder seemed to be at a stand, neither growing better or worse. The pulvis mineralis was then omitted, and the pilula rubra three times in the day given; and in about three months all [Page 65]the ulcers were healed. When this cure was ac­complished, it was maliciously insinuated, that per­haps sudden death would be the consequence. It is now four years since the cure has been con­firmed; no relapse has happened; neither diarrhoea, fever or asthma have attacked the patient; but, on the contrary, she has better health than had been experienced for years. If these methods had been discovered, and applied at first, fifteen years of in­expressible torture most probably might have been prevented.

CASE LXIX.

Mr. N—, aged 64, formerly in the ser­vice of her late Royal Highness the Princess Dowager of Wales, had been a long time suf­fering from a disease in his leg. He was of a remarkable full habit, very corpulent, and his leg, which was swelled to an enormous size, was almost one continued ulcer; livid in color, and resembling the bark of an elm tree; being full of innumerable fissures, from which is­sued a very great quantity of acrid serum. Conti­nual acute pains, itching and irritation made him extremely miserable; for no rest could be procured. He had been treated in the usual man­ner*, by a very eminent court surgeon for nine months; but received no alleviation from his mi­sery. When I first saw him he was exactly in the situation described. He was ordered the solutio nitrosa, with the vinum antimoniale and the pilula rubra, three times in the day. The disorder proved obstinate; but the cure was effected by a perseverance in the above remedies, with proper [Page 66]dressings, in eight months. It is now near four years since the cure; the patient remains in perfect health, walks many miles every day, and has bet­ter spirits than he had experienced before for many years.

CASE LXX.

A LADY of rank recommended a poor woman who had ulcers, about the eighth of an inch in di­ameter, in her leg, from the knee to the foot; the limb was exceedingly swelled, had a livid appear­ance in many parts. The smell was extremely of­fensive; there were scaly scorbutic eruptions all over her body; and the misery she suffered from pain was inexpressible. She had applied to an hospital, and no relief had been obtained; but a proposition had been made to amputate the limb, as the only means of a cure. The solutio nitrosa, with merc. corros. sublimat. were given in this case after a gentle laxative. The sal neutralis was administered occasionally, and the medicines were continued for two months; during which time the disease had been mending, and the cure was accomplished. The ulcers were all healed, the leg was reduced to its natural size, and the scaly eruptions had entirely disappeared.

CASE LXXI.

MRS. B—, aged 40, for near twenty years had been tormented with an ulcer, which had been often healed, and as often became bad again. It was situa­ted above the ancle on the inside; was not large but exceedingly painful, as is often the case in very small deep ulcers. A great hardness sur­rounded the sore, for a considerable space; there were likewise several scorbutic eruptions, which itched much, and were very troublesome. The [Page 67]pulvis mineralis was given, and for about two months seemed to have excellent effects; for the eruptions and irritation were cured, and the cal­losity greatly resolved; but the ulcer did not heal. The bark and elix. vitriol. acid. was taken for some time. At first the ulcer seemed to be forming gra­nulations, and in a disposition to incarn, but a second disappointment happened. The pilula ru­bra was then given without any other medicine four times in the day, and a perfect cure was in about nine weeks after effected. This lady re­mained well for four years, but having a scarlet fever, a superficial sore was produced. The pilula rubra was given, and a cure was soon the con­sequence.

CASE LXXII.

Mr. B—, St. Paul's Church-yard, who had suffered much misery from the gout above twenty years, had the additional mortification to be af­flicted with a small ulcer near the ancle. I was consulted, and was dubious, whether it would be proper in a gouty patient to attempt any method of cure, and only then recommended a palliative dressing. In about six months the ulcer had so spread itself, as to cover half the foot, and sur­rounded the greatest part of the ancle. Half a pint of a very sharp humour at least was discharged in a day; the pain was exquisite, had reduced the patient exceedingly, and he seemed to be in an alarming situation. I ordered the pilula alba to be taken every other night ad gr. ss. and the part was dressed with ung. album. The ulcer was bet­ter; a sit of the gout came on, the discharge and irritation increased. The gout seemed to have no connection with the ulcerous indisposition, nor the ulcer with the gout; for the discharge, though considerably increased, did not in the least al­leviate [Page 68]the pain. The stomach was attacked with the gout, a draught was prescribed of the camphor, tinctura stomach. and tinct. sacra. which removed it to the extremities. The knee, ancles and hands were affected. When the fit was over, the pill, which had been omitted during the paroxysm was returned to, and the sore parts were soon perfectly healed*. A spirituous tincture of hiera picra, in the dose of a tea spoonful in a little water every day, one hour before dinner, has been recommended, and fifteen grains of the aethiops mineral. every other night. By this simple me­thod, and a proper diet, has the gout, and rheu­matism, in some instances, though inveterate, and even in the stomach, been radically cured. A striking proof of this sort has happened to a mem­ber of the house of commons; who has had no re­turn of this disorder for above three years, and has enjoyed a perfect and uninterrupted state of good health.

CASE LXXII.

MRS. C—, aged between 40 and 50, of very full corpulent habit, had been many years dis­tressed with an ulcer of the leg near the ancle. No advice or remedies had cured the case; and the old story of the danger attending a cure, when it was found impossible by the common means, was strongly inculcated. The patient, under these ap­prehensions, raised by a practitioner, in whom she had the utmost confidence, supported with great [Page 69]fortitude a miserable life for such a length of time. Every dishonourable artifice was used to prevent my being consulted; but the lady mentioned, Case LXVIII. having been cured, was the means of my being called. The cure was undertaken; the pilula rubra, and the pulvis mineralis, removed this disorder in about ten weeks. The lady remains in perfect health since the cure, which is now above three years.

CASE LXXIII.

MRS. G—, Doctors Commons, of a full ha­bit, had seven ulcers in her leg; four were situa­ted immediately below the knee, the others about the ancle, and a little below the calf. This lady had been at different times under the care of seven surgeons, and some of great eminence in the city; but no relief was the consequence; every method proved fruitless. The pilula rubra and the pulvis mineralis perfectly cured this case in about nine weeks; after it had been declared by many practi­tioners incurable. This lady has been cured above a year and half, and remains perfectly well.

CASE LXXIV.

MR. B—, had for ten years a foul ulcer on the inside of the right leg, the veins of which were all enlarged; he had been under the care of several eminent surgeons, and had, at different times, by rest, &c. received a temporary cure; but on using exercise it broke out again. The pi­lula alba and the solutio nitrosa, cured this case in four months, during which time the patient used exercise, and has remained well ever since, which is now near five years.

Amongst the variety of cases which have oc­curred, I have found two instances, which I could not cure, of persons, whose customary drink had been cyder.

IT is now sincerely hoped, that mankind will be no longer persuaded, that it would be injurious to cure old ulcers; so erroneously considered a drain for peccant humours. It is highly proba­ble, in these complaints, that some part of a scor­butic, or putrid acrimony, issuing from the sore, is daily absorbed and conveyed to the blood and other juices by the lymphatic vessels, and the whole habit is, by these means, contaminated. A bad constitution is the general cause of the ul­cer, this afterwards becomes the cause of a worse constitution; and while this reciprocal ac­tion is in force, the ulcer will be in no disposition to heal. Whatever can gradually and impercep­tibly restore the fluids to a mild balsamic state, and regulate the secretions and excretions, will be found beneficial in removing these scorbutic dis­tempers, so predominant in this country. It may be a matter, perhaps, worthy the consideration of the surgeons of hospitals, whether such rational methods of cure should not be embraced, which would save those public charities a large annual expence. Experience confirms, that ninety five at least out of a hundred may be radically cured as out-patients, at the same time obtain their livelihood by industry. A moderate exercise is so far from retarding the cure, that it facilitates it, and renders the afflicted less liable to a relapse.

THE CONCLUSION.

SOME may possibly imagine, that the common unsuccessful modes of treatment have been too freely censured; but, let it be considered, that until erroneous systems are exploded, no new discoveries, however important, can be established.

It gives me inexpressible pleasure to find, that several eminent practitioners, and some at the pub­lic hospitals, have adopted these new modes of treatment, and have candidly acknowledged, that considerable success has attended their endea­vors. The opposition the modes have experienced from others, may have arisen from their being strongly prepossessed in favour of the practice they have been accustomed to. The facts here pro­duced, it is presumed, will convince them of their errors, and be the best answer to whatever may have been advanced against the doctrines.

Though the hasty adoption of novelties has fre­quently been productive of evils in the healing art; yet, an inflexible adherence to erroneous maxims, has proved a check to philosophical en­quiry; a bar to every useful improvement. The cases here related, the result of many years appli­cation, are respectfully submitted to the public consideration, and particularly to the unprejudiced and learned practitioners in medicine; who will best determine, whether they merit attention. The curative methods are, still, it is presumed, capable of much improvement, and the same dis­position which gave rise to the discoveries, shall not be wanting to prosecute so desirable a purpose.

The ulcerated legs, the opacity of the cornea, partially, or totally impeding vision, scorbutic, and schrophulous cases, are proved, in general, to be curable. It could be ardently wished, that the same might be asserted, with equal confidence, in confirmed cancerous diseases. These ravaging complaints, however, if not too far advanced, can frequently be removed. When poisonous re­medies have been administered, or other violent practices adopted, little success can be expected; and often the cure is as impossible, as in the aneu­rism of the aorta. The barbarous use of escha­rotics, and the unfeeling and improper use of the knife, have been condemned, in all ages, by every physician of integrity and experience; as they have hastened the progress of the cancer, and the dis­solution of the patient.

FINIS.

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