the same in color, but less in quantity, menses more or less every fortnight; sometimes mixed with fluor alb. and some times not. June 23, although she is upon the whole better, yet the discharge continues alarming, with dysury, pain in the loins, &c. Chalyb. with cicut. &c. continued. July 15, directed this injection to be used ter die. R. vitriol. alb. j. Alum Rup. 3j. Ferr. vitriolat. gr. v. Aq. hordei 3 vj. M. From this day to Oct. 29, perceiving little alteration, excepting the symptoms of hectic were lessened, and the pulse seldom exceeding S6, but the pain in the loins, region of the uterus, and dysury, still continuing, I prescribed the following mixture. R. Tinc. Canth. 3j. Sp. Lavend. C. gutt. xx. Aq. distillat. viij. M. Sumat cochlear, j larg, ter quoti die, and discontinued the chalybeate. Nov. 1, as the Tinc. cantharid. did not affect the bladder, I encreased the dose to zij in the viij mixture. Nov. 7, encreased the mixture to 3iiss. Astringent injection continued. Nov. 11, encreased the Tinc. canthar. to giv. Nov. 29, less discharge, and not so fetid and painful. Dec. 3, as the Tinc. canth. has not affected the bladder, I ventured to increase it to zvj in oz. viii mixture, cochlear. j, ter die. Dec. 7. R. Tin. cantharid. 3j. Aq. distillat. zvij. M. Cochlear. j, ampl. ter die. This mixture encreased the dysury, brought on a copious purulent discharge with some blood, which was relieved by frequent draughts of decoct. Althææ, and two draughts with Tinc. Opii, gutt. xx in each, immediately, one after the other in nine hours the pains were arrested. The next day the discharge was lessened considerably, and she was relieved in every respect, but she was alarmed to such a degree, that all my.rhetoric could not prevail on her to renew the Tinc. Canthar. in small doses, until the 10th of March, 1807, when she took the following R. Tinc. Ganth. 3jv. Aq. distill. viijss. M. Cochlear. j ter quotidie. March 14, mix ture continued. March 18, increased Tinc. Canth. to zvj. March 19, she was again seized with violent pains, dysury, bloody urine, &c. No relief, with gutt. xl T. Opii in a draught. She fainted several times with agonizing pain; I became myself exceedingly alarmed, fearing she would expire under my hands: I directly dipped a double piece of flannel in the following epithem. R. Spt. Vin. Camph. 3iij. Tinc. Opii 3jss. M. and applied it on the pubis, keeping it continually wet, and gave her a pill of R. Camph. gr. iv, Pulv. Opii pur. gr. jss, every hour. Three of the pills, with the epithem, relieved her of her pains, and me of my fears. March 23, she received so much benefit from the last mixture, in every

'respect,

respect, that I prevailed on her to begin again with 3vj Tinc Canth. in viij of the mixture, as some discharge remained. May 13, as the urinary passage seemed to threaten another dreadful contest, I directed one of the following pills every two hours, until the ardor urinæ ceased. R. Camphor. gr. xxiv, Opii pur. gr. viij, Mucil. q. suff. pil. vij, with plentiful draughts of decoct. Althææ, with Gum. Arab. Two of the pills arrested the symptoms with Dec. Alth. May 22, she was in high spirits, pain of the back, dysury, hectic heats, and scarce any discharge remaining, and that without smell, quite bland: I continued the Tinc. Canth. as follows: R. Tinc. Canth. 3j, Aq. Distill. bj. Cochlear. j ter die. June 24, Tinc. Canth. et Dec. Althææ continued. July 10, deemed it adviseable to continue the Tinc. Canth. as the discharge was not totally arrested. Aug. 18, discharge remaining, and her health so much improved, better than it had been for many years, I took leave of her. She bestowed on me many thanks and great praise, &c. which is due more to that ingenious man, Dr. Roberton, than to me: for, if I had not been encouraged by his publication on Cantharides, I should not have persevered with so much resolu

tion.

N. B. This lady is a tender, weakly woman. I paid her the utmost attention, and staid with her when she was in those agonizing pains until relief was obtained. It was the worst case I ever met with.

I shall say of Drs. Jenner and Roberton, that they are the saviours of millions yet unborn. I have not room for a case of deranged practice, in which zij of Calomel were given to an infant of only 15 months old. Of course the child was poisoned, and expired in excruciating pain and misery. Case CROUP.

Thornbury, Sept. 15, 1810.

J. E. H.

P. S. The menses are now regular every three weeks.

Of Sleep; its Utility, Causes, its Varieties, Perturbances, Defect, Excess; of their Irregularities, and of the Ra tionale, and Cause of Dreams; translated from DR. GREGORY'S Conspectus Medicine, by DR. STAN

CLIFFE.

A man is not always capable of exercising his senses or producing motion at the instance of the will:-it is necessary

that

that either function be exerted by intervals, so that the mus cular and nervous powers being exhausted by exercisé, may be refreshed by repose and quiet.

That state in which our perceptions are distinct, and in which we direct the muscles of voluntary action according to the will, is that in which we are awake that in which we are neither sensible (of external objects) nor capable of produ cing motion by the will is called sleep.

But each of these states has its degrees of perfection, so that, strictly speaking, one may neither sleep nor be able to discharge properly the duty of one awake. Such as are in the most healthy state sleep very soundly, and neither possess voluntary motion nor the use of the external senses; nor do they recollect the actions of the internal organs: but such as are but halfasleep have however some perceptive faculty, and though inaccurately, yet perceive many external things; they call to their recollection many circumstances, exert the powers of the imagination, revolve in mind, and are agitated by various affections of the mind; they frequently talk, sometimes rise, clothe themselves, walk about and exercise the functions of people awake. But the vital as well as natural actions go on most perfectly during sleep, but these are observed to be somewhat slower than when awake.

After the usual labour of the day, a light supper, mode rate venery, a most sweet sleep succeeds, which is aided by the darkness and stillness of night.-Sleep is preceded by a desire of quiet, ease of body and tranquillity of mind, weakness, lassitude, a sense of fatigue, especially in those muscles generally in use, dullness of the external senses, disorder of the internal, distracted attention, inobedient to the will, involuntary recollection, fancy vague and at length credulous, a kind of delirium, lastly entire oblivion of every thing the muscles weary and relaxed, can neither direct or support the particular parts to which they are appropriated, nor on that account the whole body: the eyelids twinkle, and are afterwards shut, the jaw falls, the head nods, every member gently inclined, is at rest, and the body is bent forward, unless it falls down during sleep-The pulsations of the arteries become slower and more full, the respiration more gentle and more profound, and many snore during sleep; the animal heat is diminished as well as several secretions; nor are the accustomed appetites and propensities perceived.

The length of sleep depends much upon age, constitution, habit, and in short the state of the body when sleep had stolen. on. Various stimuli prevent sleep, either applied externally

or

or which occur internally, light, noise, ruder touch, hunger, thirst, and inclination to make water.-At length sleep is broken, yet not so suddenly but that perturbation of the internal senses, dreams, dullness and imperfect use of the external senses, are for the most part observed, and though we frequently remember the dreams of the morning, yet the rest is almost entirely forgotten. At length we awake, yawn, and stretch our limbs which have been for a long time bent, just as if we were going to sleep we begin once more to perceive our natural appetites and propensities, and are shortly alive to every faculty both of body and mind.

The cause of sleep, or at least, its ultimate and proximate cause is at present unknown, and will probably long remain a secret. It is very improperly attributed to a peculiar fluid, with which the nerves are filled and alternately deprived; because sleep is in many instances readily protracted, where the fluid (if such really exist in the nerves and brain) cannot be much exhausted; *and sleep is often continued for a considerable time after the nerves ought to abound sufficiently with such peculiar fluid.

Nor is sleep said with greater propriety to arise from compression of the brain; because no such compression can in general be shewn, nor can, indeed, exist; and a stupor induced by compression of the brain, differs very much from natural sleep; for it neither refreshes, nor can it be so interrupted but that the patient immediately relaxes into the same state as before, on removing such exciting stimulus. But natural sleep is readily repelled by any stimulus, when nothing is employed to free the brain from compression.

Every symptom which accompanies sleep convinces us, that the state of the whole nervous system, and especially the brain, is greatly changed; but leave us altogether ignorant of what such mutation is. It will however be of some use to know the remote causes of sleep and watching, without the knowledge how that state is induced, by the assistance of which physicians frequently attempt, and not in vain, to regulate sleep according to circumstances.

All the senses, external as well as internal, every affection of the mind, each action of the muscles, excite the nervous system, and put man upon his guard, the more readily in proportion to his strength. Thus vivid light, sound, grief, anger, joy, sorrow, fear, anxiety, hunger, thirst, eager desire, motion of the body, a lively memory or imagi nation, intense thought deprive one of rest. There can be no gentler impression upon the organs of sense than the hum(No. 140.)

Y

ming

ming of bees, the murmur of a gentle stream, a dull frigid oration; in short, such an exercise of the memory as is neither sufficiently laborious, nor which rouses the mind, invites and cherishes sleep The too violent force of the blood towards the head, as frequently happens in fever, repels sleep. But a free and equal distribution of the blood throughout the whole body, and especially the extremities, frequently induces sleep. Whatever relaxes the body favours sleep; hence various evacuations, bath, fomentations, sometimes even heat are useful in procuring sleep. After meat and venery sleep readily steals on; a strong appetite being al layed, and the body somewhat relaxed. Intense and continued cold induce sleep not to be readily broken, and which is often fatal. In short, there are substances, which when in contact with the body, or when received internally, not only do not excite the nervous system, but are obviously soporific, and render it less fit for sensation and motion, thus inducing sound sleep. Of this kind are the remedies termed narcotic, opium and the like; among which we may reckon even wine when taken in too great quantity, and certain lethi ferous vapours, as that of burning charcoal. Lastly, watchfulness itself is not uncommonly a cause of sleep; wherefore, during the time we are awake, we exercise our organs more or less, and thus diminish and expend the nervous power. And, indeed, the more laboriously the body is exercised, the greater necessity will there appear for sleep.

The time passed by the foetus in the womb seems to be chiefly consumed by sleep; and premature births, which still survive, sleep away the first months almost entirely. Youths and men who pass a laborious life, more than adults or the luxurious and lazy, also sleep sounder; because they exercise the body properly, which is not oppressed with food, nor their minds distracted by cares. Sweet sleep, the reward and solace of labour, virtue, and temperance, are not readily granted to the undeserving.

Besides, as the body daily increases, more and more sleep is required; since this does not a little tend to refresh and nourish the body. In the middle of life, men require Jess sleep. Habit is however a powerful agent; some require but four hours sleep, others consume more than ten of each day. Some almost worn out with age, drowsy and torpid, sleep the greatest part of their time.

The use of sleep from its effects upon the body is suffi ciently obvious. The mental and corporeal strength, con, sumed by exercise, it repairs; to this, it restores its former vigour and alacrity; it renders the muscles rigid, sore,

tremuloys,