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 ... By William Rowley, M.D. Rowley, William, 1742-1806. 75 600dpi bitonal TIFF page images and SGML/XML encoded text University of Michigan Library Ann Arbor, Michigan 2012 November 004797766 T26358 CW106803399 K032087.000 CW3306803399 ECMS 0059501400

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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 ... By William Rowley, M.D. Rowley, William, 1742-1806. [2],ii,72p. ; 8⁰. printed for F. Newbery, London : 1779. Reproduction of original from the British Library. Roscoe, A472 (1) English Short Title Catalog, ESTCT26358. Electronic data. Farmington Hills, Mich. : Thomson Gale, 2003. Page image (PNG). Digitized image of the microfilm version produced in Woodbridge, CT by Research Publications, 1982-2002 (later known as Primary Source Microfilm, an imprint of the Gale Group).

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eng

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

The Schirrus, Cancer, and Ulcers of the BREAST and WOMB. Scrophulous Swellings and Ulcers about the Neck and other Parts; commonly called the King's evil. The Specks and Opacity of the Cornea of the EYE; in which Sight hath been reſtored, by internal Medicines only. 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.

Harley Street, Cavendiſh Square, May 10, 1779.
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 1767A Treatiſe on the method of curing ulcerated legs without reſt, proved by a variety of Caſes. The doctrinesSee Sharp's Surgery. 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 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.A treatiſe on the diſeaſes of the breaſts, and methods of managing women during childbed, &c. &c. 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 defectsA Treatiſe on the ancient and modern methods of curing diſeaſes of the Eyes, with new improvements.. External applications to the eyes, particularly poultices, were in general condemned, with the reaſons aſſigned; the inflammatory indiſpoſitions were reduced under four heads;St. Ives makes a number of uſeleſs diſtinctions. 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 formerUpwards of ſixty caſes have already been publiſhed in the treatiſes.; 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. 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 neutralisThe difference is very conſiderable between this ſalt and that prepared in the common manner..

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 preparationsA number of experiments on theſe preparations, with the manner of detection if they ſhould be ſophiſticated, may be the ſubject of a future eſſay., 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 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; 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 ſoreHalf a pound of a well prepared white lead, boiled gently for an hour in one pound and a half of hog's lard., 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 kindA diſtinction ſhould be made between indurations, ariſing in child-bed, and thoſe of the cancerous kind; theſe laſt ſeldom make their appearance before the age of 36, and 〈◊〉 ſcarce happen to breeding women., 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 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 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 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, 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 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 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 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 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 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 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 uteriUterine complaints cannot be comprehended, but by thoſe who are ſkilfully verſed in the theory and practice of midwifery. 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 timeWhoever conſiders the ſtructure of the uterus, and the conſequences of the leaſt injury in delivering preternatural births, will not be ſurpriſed at the doubts I entertained on this occaſion.. 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, 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. Oct. 26, 1772.

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.

November 6, 1772. 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.

Nov. 23, 1772. 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. 24/11 1772.
〈…〉

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. 26/xi 1772

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 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. 29/xi 1772

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. 7/12 1772.

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. 10/xii 1772

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 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. 14/12 1772

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 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 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.In complaints of the breaſt and womb all rough aſtringents are commonly injurious, eſpecially if they be of the ſchirrus kind. The giving bark, elixir of vitriol, tincture of roſes, &c. &c. which is a common practice, frequently does irreparable miſchief in thoſe floodings that are the forerunners of cancerous complaints, and happen between the ages of 35 and 50. Some obſervations will hereafter appear in a regular treatiſe on theſe ſubjects, as proofs of what is now advanced.

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 eminenceNothing, certainly; can be more irrational than the uſe of injections in uterine complaints; though the moſt approved authors and practitioners recommended them. The os uteri, or mouth of the womb, when the uterus is in an unimpregnated ſtate, will ſcarce admit a hog's briſtle; how then is the pipe of a ſyringe to be introduced? or, ſuppoſing the introduction of a pipe poſſible, what vac ity is there in the uterus capable of receiving an injection? If the parts ſhould be cancerous and ulcerated, an aperture is ſometimes diſcoverable, and in that caſe every hard ſubſtance would irritate; therefore could the pipe be conducted through the aperture, which every man-midwife knows to be next to impracticable, ſuch a ſubſtance would only injure the parts, and increaſe the patient's miſery; and if any ſharp or corroſive matter is injected, it bids fair to haſten death. Hence may be ſeen the neceſſity of examining into the merits and defects of the common modes of practice, and to depart from them, when they are demonſtrably proved to have their origin in ignorance; for every one who has a preciſe idea of the anatomy of the uterus, muſt be ſtruck with conviction of the impropriety of adminiſtering injections in the ſchirrus or ulcers of the womb, unleſs merely for cleanſing the vagina., both as 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.Whoever would wiſh to know the direful effects of hemlock may read the ſecond letter to Dr. Hunter, where reaſons are given, why this deſtructive poiſonous drug ſhould never be adminiſtered. See likewiſe De Haen's Epiſtle De Cicuta, where it is proved that Storck had been guilty of the moſt flagrant impoſitions in recommending that deleterious remedy; for out of the 36 perſons ſaid to be cured by hemlock, 30 died miſerably, and the remaining ſix were incurable. 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 injectedCertainly no practitioner who underſtood the anatomical ſtructure of the inteſtines, or who reflected on their irritability, would have adviſed ſuch a violent heating remedy to ſuch nervous parts, already in a ſtate of inflammation.; 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; 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 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 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;Whoever perfectly comprehends the anatomical ſituation of the parts affected, it is hoped will not condemn this concluſion; it muſt be confeſſed the caſe did not admit of demonſtration. ſome hopes were ſuggeſted that what had 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 herſelf, moſt probably produced the ſchirrus of the wombLight cooling regimen and remedies will often effect a cure, when aſtringents are ineffectual and injurious. In ſome inſtances it is beſt to leave ſuch caſes to nature., 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 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 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 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 poxI have ſeen ſeveral inſtances where inoculation has produced the king's evil; therefore we ſhould be very cautious what ſubject we take the matter from., 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 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 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 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 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 caſeIn this diſeaſe abſceſſes, deeply ſeated, repeatedly form about the upper part of the thigh in various parts; puſh out their matter externally; and in a number of years, after giving th patient inexpreſſible miſery, prove fatal, in general.. 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 bonesMalleus, incus and ſtapes., 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 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 nitroſaHalf an ounce of pure nitre to a quart of water. 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 continued; but as the inflammation had ſubſided, the doſes of nitre were only given every three hours. No application whatever was uſed outwardlyFor the objections to external applications ſee the Treatiſe on the principal Diſeaſes of the Eyes. Numbers have been blinded by poultices, &c. &c., 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. CrouchAnother child in this family was formerly cured of the ſame diſorder. Vide Treatiſe on the Diſeaſes of the eyes. 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 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 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 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 appliedNo ill ſucceſs can induce ſome to depart from this practice; there methods are too violent for parts already irritated. See the objections in the Treatiſe on the Diſorders of the Eyes. 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 eyeThis white appearance ariſes from the cornea opaca, for the conjunctive membrane itſelf is almoſt tranſparent. 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,There are many inſtances of inflammations of the eyelids happening from the eye-laſhes growing in an improper direction. 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 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 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 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 mannerThe common modes of treating ulcers may be ſeen in the Treatiſe on that ſubject, with the objections., 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 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 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 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 healedThere has been diſcovered a ſafe and agreeable external application for the gout, which with certainty gives immediate eaſe in the moſt violent pains, and draws the diſorder from the nobler parts towards the extremities. The gouty matter is attracted, deſtroyed, and carried off by gentle perſpiration and urine in a few days. Some extraordinary facts of this ſort will be made public. This laſt patient, who is near 60, is one, who has experienced the happy effects, and can now walk better than he has been able to do for ten years.. 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 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.