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The benefit that has arisen from establishing literary and scientific societies, has not operated to a greater extent in any branch of human learning, than in the medical art. In 1808, we endeavoured to point out the advantages of such institutions, though in a manner confessedly inadequate to describe their extensive utility. Our attention is again called to the subject by the Medical and Chirurgical Society of London having published the first volume of its Transactions. In the year 1805, several physicians and surgeons of the metropolis of the British Empire, "held a meeting for the purpose of considering the best means of ob viating the acknowledged want of a Society founded upon liberal and independent principles, and conducted with pro priety and dignity." The result of this meeting was the formation of the Medical and Chirurgical Society of London, composed certainly of a most respectable portion of the medical talent and consequence of the metropolis Several papers in the volume published by this Society, have already been noticed; the remainder are of a practi cal nature generally, and are indebted for their utility more to the quantum of their facts, than to the plausibility of their theories.

The writer of this Annual Historical Sketch of the Progress of the Medical Art, has occasionally added his mite of information to the subjects that came under his notice, by such remarks and short details as the subjects themelves suggested; and especially while giving a history of pass ing events, has he believed it proper to strongly impress the value of veracity, and to inculcate an unbiased study of Nature. "THE VOLUME OF NATURE IS THE BOOK OF KNOWLEDGE; AND HE BECOMES MOST WISE WHO MAKES THE MOST JUDICIOUS SELECTION."

Princes Street, Cavendish Square,
June 15, 1810.

the sensation of quickening? If this explanation of a singular fact in the female economy should hereafter be ascertained to be false; still, as our present uncertainty on the subject gives occasion to much physical or me❤ taphysical jargon; and especially as the laws recognize the circumstance to mark the line of division between the legal innocence and criminality of certain actions, it is not undeserving inquiry.

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Case of Tetanus. By Mr. R. JONES, Surgeon.

MRS. MARTIN, residing at No. 4, Bowl and Pin Alley, aged about 52 years, in going through Old Boswell Court, on Monday the 23d of April, was wounded in the left cheek by an arrow, shot by a little boy; which was formed of a stick sharply pointed. The point of it, about half an inch in length, remained fixed in the cheek, and had penetrated the masseter muscle, but not deeply, being rather in a slanting direction. She called upon me about ten minutes after the accident. I extracted the portion fixed, and a little blood issued out. I dressed it simply, and desired her to call upon me the next morning. She however returned the evening of the same day a little agitated; described herself as feeling much pain in the wound, and a dimness in the sight of the left eye, of which, she feared she should lose the use. I told her to poultice the wound, and to call upon me in the morning; and solaced her with the hopes of no such disagreeable consequence happening. I heard no more of her till Wednesday evening about ten o'clock, when she sent for me. I found her suffering under very violent attacks of tetanus, and a great degree of trismus. The flexors of the lower extremities were quite rigid; abdomen tense; and whenever the spasms came on, which was every five or ten minutes, the actions of the diaphragm and abdominal muscles seemed particularly to distress her. She often laid hold of my hand and applied it to her abdomen, and a loud gurgling noise was heard, as if from the undulation of water. The muscles of the neck and face were rigid, and sometimes contorted, particularly on the left side, and an efflorescence suddenly appeared and disappeared. As she had no evacuation since Monday, I ordered her a glyster; also a mixture, containing ninety drops of tinct. opii, to take a fourth part every two hours, and opening pills, composed of calomel, gr. x. Ext. coloc. c. zi. Opii purif. gr. iij. ft. pil xij. Cap. iij. 6ta, quaque hora.

Thursday 26. I was this day informed by her attendants, rather imperfectly, of the progress of this disease from Monday to Wednesday evening. It appears she was attacked a few hours after I saw her on Monday night, with what they called cramps, &c. She immediately sent for me, but from some cause or other, the messenger went elsewhere. When I called this morning, I found her suffering under an aggravation of all the symptoms; sensible

to

to every thing that was said to her, but speechless; she took a part of her medicine with difficulty, but could not be persuaded to have the glyster. I endeavoured to get down some medicine; and after much difficulty, she swallowed a pill of five grains of calomel, and about eighty or ninety drops of tinct. opii. I also ordered her neck, chest, and abdomen to be fomented. She retained the greatest part of a glyster, that was administered this day. When I saw her again in the evening, every symptom was aggravated; and every attempt at deglutition was as distressing as it was unavailing; all I could hope for, was to get down the five grain pills of calomel, to each of which I now united one grain of antim, tart. with directions to take them every six hours, and to wash theta down with about a drachm of tinct opii. diluted with each dose. She had had no stool to day, but passed her urine freely.

Friday 27. The patient had in the course of last night and this morning vomited up some black mucous substance, and passed a stool of the same appearance. The tetanic symptoms, though very violent in the night, are certainly not so now. We were able to get down the medicines with tolerable ease. In the evening she wrote down, that she should like some collared eels, and a little porter.They were introduced in the same manner that her medicine is administered, through the vacancy left by the loss of her upper front teeth. She was able to take a little, and it was the only nourishment she had taken for three days. Her jaws were completely locked these two days, except when they were forced open by the spasms, yet she appeared to all about her better this evening.

Saturday 28. When I visited her this morning she was in a most profuse perspiration, with the affected muscles as rigid and contracted as ever. Her lower extremities were drawn up towards her body. She attempted to take some tea but could not; though at particular times, I was told, she swallowed with tolerable ease; but whenever I saw her attempt it, the spasms of the fauces and throat were very distressing, and much resembled that of a person suffering from hydrophobia. When I saw her again this evening, she perspired freely, and made signs that she was better. Her medicines are continued, but with less calomel, and the antim. tart, is entirely omitted.

Sunday 29. She is this morning better; has had no severe spasms since Friday night. She articulates more distinctly. Her attendants are able to introduce the point of a tea spoon through the vacancy left by the loss of her upper

front

front teeth, and in that manner she has sucked about twothirds of the yolke of an egg, and some porter; but the most promising announcement of this day is, the absence of those distressing spasms that accompanied every effort at deglutition. Her sight is also much recovered, but as the calomel did not act upon the bowels, I ordered this morning a cathartic mixture. About two o'clock in the afternoon, she experienced a most violent attack of spasms, commencing in the wounded cheek, and instantaneously attacking the left side of the neck and arm, down to the fingers. In the course of a minute or two they became inflamed, and in about fifteen minutes after were completely black. This blackness seemed to proceed in the course of the nerves of the left brachial plexus, the first or axillary nerve of which had been so affected the day before; but the whole body seemed writhed with the spasms. She be came tranquil again in the evening.

Monday 30. The blackness in the arm is gone off, but around the left eye and cheek a similar affection took place; which terminated in the same manner. She has had three copious evacuations during the night; has taken nourishment, and feels considerably better. She can now distinctly describe her wants and feelings, as ber tongue seems now completely released. We could not prevail upon her to take her medicines regularly these two days, as she has discovered that laudanum is given to her; to which she has a particular aversion.

Tuesday, May 1st. Continues better; has had more eva cuations, and also vomited once. For these two days she has complained of a pain extending from the wound, which is completely healed, to the mouth, and of a disagreeable smell. Her jaws remained closed, although she has attempted to separate them by a variety of instruments.

Wednesday 2. She was by no means so well this morning; had been much troubled with spasms last night, which partially attacked her throat. The pain in the wounded cheek was, at times, very acute; and like nothing, as she said, that she could describe. She felt pain also in the other side, proceeding along the upper lip, and over the arch of the nose; but by no means of equal violence, She vomited once, and had several motions. I thought proper to persist in the exhibition of mercury; but from the state of her stomach and bowels, preferred the friction. A drachm of ung. hydr. fort. with ten grains of camphor, was directed to be rubbed inside of the thigh every night and morning. The left hand was last night so clenched,

that

that her nails had penetrated the skin; but I could move the first and second joints of the fingers this morning.

Thursday 3. She was, upon the whole, better to day, but felt much pain at the soles of her feet.

Friday 4, Still better. Tive ointment is readily absorbed, and she has had no severe spasms since Wednesday night. The trismus continues, and her extremities much in the same state. She has taken some rice milk and porter, to which she is very partial; and though she swallows with a great deal more ease, yet there is still a difficulty.

Saturday 5. Much the same as yesterday. The quantity of calomel she had before taken, with the subsequent inunction of the ointment, has brought on a ptyalism. Her gums do not appear much affected, but as she feels a soreness about her mouth, and her tongue is swelled, I have desisted from the friction. The only amelioration that I could mark to day, is a greater freedom in the knee joints.

Sunday 6. Better in respect to the tetanic symptoms, but had been several times sick, and rejected the slight nourishment she had taken within the last twenty-four hours. Complains more than usual of the pain in the left hypochondrium; and whenever she closes her left eye, the most horrid objects present themselves to her. A large blister applied to the nape of the neck.

Monday 7. She was much harrassed all this day with purging and vomiting, and appears completely under the influence of mercury.

Tuesday 8. Much better this morning. The rigidity of the flexors of the lower extremities is sensibly less. She complains of considerable pain about the umbilicus, and has now quite a sore mouth. There is still much irritability of the stomach.

Thursday 10. The sickness now and then recurs, with some irritation of the bowels; but the acute pain which she felt at the umbilicus is going off. The whole of the body is this day covered with an efflorescence, and the mouth exhibits the mercury in full force. She has now the perfect use of both her arms. It may not be amiss to remark, that the eyes, during the whole of this attack, never twinkled, and the eye-lids could only be brought together by the fingers.

Saturday 12. My patient had been a great deal better the last three days, was even able to sit up in bed, and talked of getting up to have her bed made; but last night she was exposed to a current of air through a broken

pane

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