the aid of medicine than small-pox, hooping-cough, and measles.

Treatment.

The preparatory measures advised for measles should be resorted to. Emetics should be given twice or three times every week; leeches and blisters frequently applied to the sternum, and along the course of the trachea; and the cough quieted by the judicious use of syrup of poppies. When the inflammatory symptoms run high, venesection will be requisite. After the disease has subsisted for a few weeks, a change of air will be of service.

CHAPTER VII.

Variola.

Synocha contagiosa cum vomitu, et, ex epigastrio presso dolore.

Tertio die incipit, et quinto finitu eruptio papularum phlegmonodearum, quæ, spatio octo dierum, in suppurationem et in crustas demum abeunt, sæpe cicatrices depressas, sive foveolas in cute, relinquentes.

Species sunt,

1. Variola (discreta) pustulis paucis, discretis, circumscriptione circularibus, turgidis; febre, eruptione facta, protinus cessante.

2. Variola (confluens) pustulis numerosis, confluentibus, circumscriptione irregularibus, flaccidis, parum elevatis ; febre post eruptionem perstante.

Cl. i. O, iii. G. xxvi. CULLENI.

THE treatment of small-pox must be very similar to that recommended for typhus. In the confluent species of it, when the pustules look pale and flaccid, wine or some other cordial must be freely administered. The preparation for this disease was formerly carried to an extravagant extent; it was however an error on the right side. In the present times it is too much neglected.

The day will, I hope, arrive when this loathsome disease will be known only by name; but this day is far distant, unless the Legislature will compel all those who

delight in the murder of their offspring, and in entailing misery upon mankind, to erect the altar of Moloch in a place remote from the habitations of Humanity.

CHAPTER VIII.

Variola Vaccina.

WHEN groundless prejudice shall cease to operate; when private emolument shall be sacrificed to the general good; the name of JENNER will be pronounced with rapture by a grateful world. I would rather be Dr. Jenner than any man who has been born during the last* thousand years.

My observation furnishes me with nothing to add to the many valuable works upon this disease which have already appeared.

CHAPTER IX.

Syphilis.

Morbus contagiosus, post concubitum impurum et genitalium morbum, ulcera tonisllarum; cutis, præsertim ad marginem capillitii papulæ corymbosæ, in crustas et in ulcera crustosa abeuntes; dolores ostocopi; exostoses.

Cl. iii. O. iii. G. lxxxv. CULLENI.

THE remedy for syphilis is well known. Mercury, judiciously administered, is an invaluable medicine, but if given improperly, or in too great quantity, it is frequently productive of greater evils than it is intended to

remove.

In a work professedly a "Compendium," it cannot be expected that I should enter into the history and description of a disease, which it would require volumes properly and sufficiently to detail. I shall therefore content myself with a few general observations.

Mercury is the only certain remedy for syphilis: but I feel persuaded that ten times as much of it is frequently given as is necessary for the cure of the disease in any form. If we excite and keep up a slight mercurial action for a sufficient length of time, the disease will be certainly cured, without any injury to the constitution. Violent salivation is never nccessary, is often prejudicial, and not unfrequently destructive. In scrophulous habits, more particularly, we ought to be very guarded in our exhibition of it. On some persons, a small quantity of this metal will produce very violent effects. As we are not in possession of a knowledge of the peculiarity of constitution upon which this susceptibility depends, after having slightly affected the mouth, we ought to lay it aside for a few days, till we have ascertained that it will not produce these powerful effects upon the person under our care, before we venture to proceed with it.

One of the most common injurious effects of too much mercury, is ulceration of the throat; with destruction of the palate, and of the bones of the nose. I believe these parts are more frequently destroyed by mercury than by the venereal virus. Unfortunately, a syphilitic ulcer in the throat, and an ulcer produced by the excessive use of mercury, bear a very strong resemblance to each other. I know of no decisive marks of distinction. As a general rule, if an ulcerated throat of long standing presents itself, where mercury has not been given in excess, we may conclude that it is of venereal origin; on the other hand, if we meet with it after mercury has been largely and repeatedly used, we shall be justified in suspending its further exhibition for a sea

son.

I have one remark to add, with respect to the use of mercury. Children will take an immense quantity of it, without the salivary glands becoming affected; we ought

not, however, on this account to give it incautiously; for it will sometimes happen, that, without salivation, the parotid duct will be excited by it into violent inflammatory action, in which the parotid gland and the whole cheek will be speedily involved, and sphacelus, or a rapid ulceration, will be the consequence. I have seen both cheeks entirely removed by this process. Nothing with which I am acquainted has the slightest tendency to check its progress.

CHAPTER X.

Erysipelas.

Synocha duorum vel trium dierum, plerumque cum somnolentia, sæpe cum delirio. In aliqua cutis parte, sæpius in facie phlogosis erythema.

Species sunt.

1. Erysipelas (vesiculosum) erythemate. rubedine serpente, latum spatium occupante, et locis ejus quibusdam in vesiculas magnas abeunte.

2. Erysipelas (phlyctanodes) erythemate ex papulis pluribus, trunci corporis partes præcipue occupantibus, et protinus in phlyctænas, sive vesiculas parvas abeuntibus.-Cl. i. O. iii, G. xxxi. CULLENI.

THIS Hospital has, during nearly five years, been occasionally infested with an erysipelatous inflammation, of a very malignant description. In some cases it arises without any assignable cause, and a few patients have been admitted with the disease upon them; but by far the greater number were attacked with it in the surgical wards after admission. The patients most liable to its attack are those who have recently undergone operations: those with ulcered legs, or any open wound or ulcer, are, however, liable to it. Patients in the medi. cal wards are sometimes attacked with it after venesection, bleeding from the temporal artery, making of setons or issues, and the application of leeches. I believe the

The medical and surgical patients are kept perfectly distinct from each other in this Hospital; an arrangement so judicious, that it is to be regretted it is not universally adopted.

first cause occurred in a medical ward. The subject was a young woman, by the name of Grace Hansford, who was bled in the temporal artery. This girl was removed to a surgical ward, for the purpose of being trephined*, and very soon afterwards the disease made its appearance among the surgical patients.

The course which the disease usually observed is the following. Two or three days after an operation, the edges of the wound became thickened, and slightly elevated. From these edges a dusky erythema spreads with great rapidity, and speedily covers the whole limb, or the greater part of it. This redness is accompanied by an intense degree of heat upon the surface of the body, and great swelling of the whole limb. When the disease proceeds from an incision made for the purpose of opening the temporal artery, the whole face is in less than twenty-four hours, completely disfigured by it. The parts upon which the inflammation is seated feel harsh, hard and unyielding. Together with the local inflammation, great constitutional irritation is experienced. The pulse is full, hard, and rapid; the tongue becomes brown, and thickly coated; and towards evening, and during the whole night, there is delirium. This symptom is almost uniformly present when the inflammation is upon the face, scalp, or neck.

The most common terminations of this affection are, resolution; a fever resembling typhus; gangrene and internal hydrocephalus. In a few cases it has ended in suppuration. Vesicles rarely form.

Examination after death shews that the inflammatory process is not confined to the cutis. It involves not only the cellular membrane surrounding the limbs, but passes with it between the muscles. The muscles are in fact dissected by it, and can be lifted from their nidus without the assistance of a scalpel. The brain always exhibits

*This is the case alluded to when treating of Affections of the Scalp.