frequently, fatal inftances of the difeafe. In one inftance, only, did I fee thofe fcyballa which the celebrated Cullen has supposed the proximate cause of dysentery.

Having fully embraced the practice of Sydenham and Sir John Pringle, principally, becaufe both were much verfant in this disease, and wrote more with a defire of improving the science of medicine than of fhining as authors, the method of cure I first attempted was to cleanse the prime viæ, directing moft of my attention to the ftate of the ftomach and bowels. With this view I began the cure with an emetic given in divided dofes and at long intervals, fo as to infare its purgative effects. The discharge was commonly a vitiated bilious matter of a greenish colour: the fickness, however, was in no cafe alleviated; on the contrary, the ftomach was always left in the fame or even a greater state of disorder. In one or two of

the earliest cafes, from an idea that the continuance of this fymptom might be the effect of impurities ftill remaining, I repeated the medicine, but the fuccefs did not justify the reafoning; the debility of the ftomach was evidently increafed by the medicine.

After the emetic I gave fome mild purgative, in the choice of which I was allowed no very great variety, for, from the beginning of the disease, the stomach was unable to bear either Glauber's falt or the fal cathart. amar. though the taste were ever fo artificially covered: caftor oil was almost equally offenfive to the ftomach, and very seldom remained long enough to be of any use. Calomel, united with a fmall proportion of rhubarb, and the vitrum antimonii ceratum, were the only medicines I could avail myfelf of with any tolerable certainty. In the first cafes I refrained almoft wholly from the ufe of opium, depending principally upon "purging affiduously employed." It is with the utmost pain I am obliged to fay that this method, fupported as it is by the authority of the greatest, and I believe, moft candid writers in medicine, though conducted with all poffible circumfpection, always dofing the medicine fo as to act in the most lenient manner, produced little or no advan

tage. Emetics deftroyed the tone of the ftomach, and laxatives haftened the progress of the disease by increasing the patient's debility.

Foiled in this mode, I adopted a new one which, though it did not fucceed to my wishes, was more fatisfactory than the former. I now treated the difeafe as a typhus fever, directing but little attention to the state of the bowels, which I began to confider as a preffing symptom only, to obviate which, I tried the force of injections, compofed of fome demulcent, with a liberal quantity of opium, but they were either discharged immediately upon the withdrawing of the pipe, or, at best, were never retained above a minute: in two cafes, I repeated them half a dozen times in each, in hopes that the opium might moderate the irritability of the rectum, and that perfe verance would at length obtain the end defired. The tenefmus was increased by every attempt, the parts being so much excoriated as to occafion the most acute pain in the operation, to which caufe, principally, I attributed the failure of fuccefs.

If I were to judge from my own particular experience, I fhould either condemn as pernicious, or difregard as ufelefs, the application of blifters. In four cafes in which I used them, I could difcover no fenfible benefit, and they certainly muft add fomething to the fufferings of the fick. The blifters were in all these cafes applied to the hypogastric region.

Believing it unneceffary to give you a detail of every particular remedy, I here conclude this account, but not without affuring you with what warmth of affection,

I am, esteemed Sir,

Your much obliged, and very humble Servant,

FRANCIS BOWES SAYRE.

DR. BENJAMIN RUSH.

Crofwicks, 20th December, 1792.

On the Efficacy of Olive Oil as a Purgative, after the ineffectual Trials of more active Remedies.-Alfo, an Account of an Intermittent, cured by nasal Hamorrhage; and of a chronic Intermittent fufpended by a Scald. By Dr. JOHN VAUGHAN.

I

SIR,

WILMINGTON, February 4th, 1805.

F you deem the following cafes worthy of a place in the Medical Museum, they may, probably, not be uninteresting to your readers. Though theories entertain and instruct, we are often, in practice, disappointed in the operation of medicines. Peculiar ftates of fyftem, frequently preclude the use of remedies which would otherwise promise the most success.

Mr., aged 50, has, for ten years, been fubject to occafional attacks of the cholic, with obftinate conftipation of the bowels. On the 15th ult. I was called to him, and found him exceffively distressed with flatulency and tormina, and frequent vomiting. He had, previously, taken two ounces of fulphate of foda, an ounce of caftor oil, and a confiderable quantity of manna and fenna, without effect. His pulfe being rather full, and apprehending inflammation, I drew a few ounces of blood, and commenced the use of purgatives and active injections. In the course of the following night, a dark coloured matter, of a fufpicious appearance, was discharged by vomit, and my patient expreffed himself fenfible of inverted peristaltic motion, commencing low in the left hypogastrium, which excited apprehenfion of introfufception or iliac paffion. The alarming condition of my patient, produced the most unremitted diligence in his attendants. Cathartics of different kinds and in varied forms were affiduously given, and enemas of falts and fenna-of affafoetida-of carminative teas with ol. ricini-of tobacco, &c. were frequently exhibited, and fomentations applied to the abdomen, with but little effect. A respite from the more urgent symptoms was, however, obtained for two days, when the tormina and vomiting returned.

Medicine feemed only to irritate the primæ viæ and increase his distress; and, while pondering on the use of quickfilver, it occurred to me that, perhaps, olive oil from its bland taste and aperient quality, might not offend the stomach, and, if given in frequent doses, might eventually glide through the intestines. Accordingly, half an ounce of fallad oil was given every hour, alternated with injections of fennel-feed tea and caftor oil. In fix hours, confiderable relief was obtained and feveral difcharges procured. For two days my patient appeared convalefcent, but incautiously taking three of Fothergill's pills, as a fimple laxative (though composed of colocynth, aloes, fcammony, and calx of antimony) he suffered a return of tormina and vomiting; but two ounces of olive oil, at one dofe, and two or three injections, effectually cured him. The oil paffed through the bowels unmixed with feculent matter, and he was fpeedily restored to health.

It is, at the first view, fomewhat irrational to fuppofe that fo mild an aperient as olive oil should prove cathartic, when the routine of active purgatives have failed; but it was fuggefted by the circumstances already mentioned, and its utility was proved by the event. I should certainly have given the quickfilver, had it not been for the unpleasant reflections of the relatives, in cafe of an unfavourable event. Though no confideration fhould counteract the ufe of remedies, offering, even, a probability of fuccefs, in defperate cafes; yet if the object can be attained without aggravating the diftreffes of relatives, already great enough, the more agreeable alternative should be chofen.

If quickfilver operate only from its weight, it is an inoffenfive remedy, in cafe it pass the bowels; but the fame weight, which would overcome ferious obstruction in the intestinal canal, might, in cafe of infuperable resistance, force its way through the coats of the bowels. Whether the olive oil would prove equally fuccefsful in a fecond cafe or not, is difficult to determine, and though the ufe of any article, in a single cafe,

is not to be relied on as a general remedy, yet it is worthy of future trial.

Cafe of Intermittent Fever cured by Nafal Hamorrhage.

Mrs. while labouring under an obftinate intermittent fever, in the feventh month of pregnancy, was attacked with nafal hæmorrhage, which refifted all the usual remedies, and was finally stopped by spunge forced up the nostri!, so as to prefs on the mouth of the ruptured veffel. In five days, fhe was fuppofed to have loft four pounds of blood, which effectually cured her previous disease.

Bloodletting is often useful in intermitting fever, but it was the exceffive discharge in this case, inducing a different difeafed action, which banished the febrile diforder.

Cafe of Chronic Intermittent, suspended by a Scald of the Foot.

A girl, who had had a chronic periodical fever for several weeks, accidentally fcalded her foot, which remained fore for two weeks, and during this period fhe was freed from fever; but, when the ulcer healed, her fever returned. It is not improba le, but if the ulcer had been kept open a fortnight longer, or an epispastic added, in this cafe, the cure would have been completed.

I am, Sir, refpectfully,

Your Friend and humble Servant,

JOHN VAUGHAN,

DR. JOHN REDMAN COXE.