lized in the lungs, and venalized in the course of the circulation. It also shows how, under particular circumstances, the arterial blood may be venalized without leaving the arteries, and the venous blood arterialized without leaving the veins. It accounts for the gradual evolution of caloric in the capillary vessels, during the course of the circulation, by the union which takes place between the oxygen and the carbon, whereas in the other hypothesis, this union is entirely completed in the lungs. It allows a considerable space of time in which this union may be accomplished, and likewise supposes the constituents to remain in perfect contact for an indefinite period. My hypothesis also explains, how the oxygen is disposed of, which is not consumed in the formation of carbonic acid, and likewise possesses the advantage of supposing the existence of a surplus quantity of this agent, which, being carried along the circulation, may be expended on a variety of useful purposes, in the different parts of the animal economy. It shows how the supply of matter, which is poured into the blood by the absorbents, is gradually incorporated with the mass; and after the separation of that portion, which is necessary for repairing the waste of the different organs, the remainder is united to oxygen, and keeps up the temperature of the body, and, having afterwards no farther useful purpose to serve, it is discharged by the lungs. This hypothesis may be said to point out the appropriate use of the pulmonary system, and to show why the blood is dispersed through such a number of small channels, and so intimately intermixed with the air. Had there been nothing more to accomplish except the mere excretion of carbon, this might have been done with a less compli cated apparatus of blood-vessels; nor would it have been necessary to employ so much contrivance to bring the air and the blood into contiguity.

All the arguments which I have here adduced in favour of my hypothesis of repsiration, are such as apply to it exclusively, as I have purposely avoided bringing forwards any which are equally favourable to both opinions. If I mistake not, they afford a mass of evidence, which is rarely to be found on subjects so intricate as the internal operations of the animal economy.

VI.

* It may be necessary for me to observe, that the term, " my hypothesis," is used merely to avoid a long periphrasis. I claim neither invention nor origi mality; the only alteration which I make in Mr Allen's modification of the hypothesis of Messrs Lassange and Hassenfratz, is that I suppose the matter discharged to be carbon; Mr Allen, a mixture of carbon and hydrogen,

VI.

The following History of a Case of Hysteralgia was read at a Meeting of the Medical Society of Liverpool, By JOHN RUTTER, M. D. Physician at Liverpool.

S. the subject of this history, enjoyed good health in the earpart tary kind. Her constitution occasionally exhibited a disposition to hysterical affections; but they did not proceed to any great degree, nor did they continue long. In January 1758, in the 27th year of her age, she married. In her pregnancy, which took place in the following year, nothing unusual occurred. She went to the full period; but her parturition, which happened in her 29th year, in the month of January 1760, was extremely difficult, lingering, and laborious, although natural. She was young, and well formed; and there was no apparent impediment to her speedy and safe delivery, but what arose from excessive terror, to which, in the opinion of the gentleman who attended her, the late Mr Antrobus of this place, her protracted labour was to be ascribed. At length, after much severe suffering, she was delivered in convulsions of a dead child. A short time after her delivery, she was attacked by miliary fever, which greatly reduced her strength, and retarded her recovery. About a year after her delivery, that is, in the year 1761, she felt a hard lump, seated deep in the pelvis, and in the left side of it, and complained of pain in that part on leaning forwards or stooping. The lump increased very gradually in size, and, in the sequel, rendered exercise very painful to her. Some time elapsed before the lump could be felt through the integuments, but when it was perceivable by the touch, it was hard, firm, and circumscribed. The swelling continued to increase for several years, until at last it rose out of the pelvis, and pushed outwards the integuments of the left side of the abdomen; and, when it had acquired its largest bulk, appeared to the touch to be about the size of a child's head. In the beginning of March 1770, in the 39th year of her age, and after a period of nine years had elapsed from the time when she first perceived the hardness, the swelling burst internally, and discharged its contents by the rectum. This event was preceded by a smart attack of fever. The fluid discharged daily during the first few weeks was thin, fœtid, of the colour of coffee grounds, and in large

quantity.

quantity. It then assumed a purulent appearance, and the fœtor of it was intolerable. As the discharge proceeded, the external swelling subsided, and at last disappeared altogether. The discharge continued to flow in undiminished quantity for many months, and then began to abate. It occasioned an extraordina ry degree of emaciation, and such debility that, for some time, she was attacked daily with syncope, from which it was often difficult to recover her. The medical gentlemen who attended her, the late Dr Robinson of this town, and Mr Antrobus before mentioned, finding their long continued efforts to restore her by medicine altogether fruitless, resigned her to the care of her connections, by whose incessant and persevering attention for several months, she very slowly regained a considerable share of strength. The discharge, however, returned at different periods for several years afterwards, and was in every instance of such return, preceded by an attack of fever. She suffered also, during this period, from repeated attacks of colic.

So far my information, with respect to the progress of her complaints, has been received, from her sister, who attended to her very closely, particularly during her dangerous and alarming situation, after the abscess had burst; and upon whose mind the circumstances have made such an impression, that little doubt can be entertained of the correctness of the statement which Į have here given. The dates have been ascertained by reference to different documents,

Amongst her papers, which it was my lot, as her executor, to examine after her decease, I found a great number of letters written to her by the late Dr Hillary, (then a resident in London) from the year 1758 to 1763, and one from the late Dr Fothergill in the year 1765, entirely on the subject of her complaints. From these letters it appears, that during the whole of 1758 and 1759, that is, two years before her delivery, as well as during several years after it, she had been affected with leucorrhoea to an uncommon degree. The effects of this disease on her general health, are thus described in a letter of Dr Hillary's, dated July 4th 1761: "The continual drain and discharge is the cause of all the other complaints: the pain in the breast, shortness of breath, fluttering and surprise from little things, pain in the side, great sweatings, hectic heats, great weakness, faintness, sickness, pain in the back, beating and trembling at the heart, and noise in the ears, and all the other symptoms, are caused by, and are the produce of that disorder," viz. the leucorrhoea. The whole of this correspondence is confined to the consideration and relief of that disease alone; and, although many of the letters were written two years after the hardness and pain had been first

felt

felt in the pelvis, there is not the slightest allusion to this complaint in any of them; for she had concealed the knowledge of it not only from these gentlemen, but also from her medical friends in Liverpool, for some time after this correspondence had ended.

On the cessation of the catamenia, in her 50th year, a new symptom was superadded. She was seized with a very acute pain, which she always referred to the region of the uterus, and which she carefully distinguished, from a sense of internal heat and soreness, under the integuments of the abdomen, in the former seat of the abscess; both of which symptoms continued during the remainder of her life. That sensation of heat and soreness was always increased on motion, particularly on walking or riding in a carriage: it was increased on any, even the slightest, exertion of her arms. The pain in the uterus, on the contrary, was relieved by motion in a carriage. The pain in the uterus was her daily companion for not less than twenty-six years. It began early in the morning, and frequently waked her out of her sleep, and continued to increase until noon, when it appeared to have acquired its utmost violence, and, towards evening, gradually abated; but I never heard her say that, when awake, she was altogether free from it. Its exacerbations were generally preceded by extraordinary agitation of the heart and arteries; the heart throbbed, and the pulse beat with great rapidity; as the pain increased, the countenance became flushed, and was expressive of great anxiety; her spirits were depressed, with a sense of great faintness; her whole frame was agitated and restless, and she was often harassed with loud and violent eructations. When the pain abated, these symptoms subsided. The pain was also greatly increased at the periods of new and full moon. She first directed my attention to this circumstance, and I observed it, for many years afterwards, to recur with a degree of regularity which leaves no room to doubt the fact, to whatever cause it is to be ascribed. In her 52d year she was seized with spontaneous ptyalism, which continued two years; during which time she discharged daily from one to two pints of saliva; but the ptyalism at last suddenly ceased on swallowing her saliva, by the advice of a gentleman who then occasionally attended her. Of late years she frequently complained of severe palpitation of the heart, which was accompanied with irregularity and intermission of the pulse. In her 72d year, she was attacked with hemiphlegia, which distorted her features, affected her speech and respiration, and deprived her totally of the power of motion of the whole of her left side. By the remedies which were employed, she recovered her speech and the power

of

of motion in about three months; but her respiration was ever afterwards occasionally more or less difficult. It is however remarkable that, during the continuance of the paralytic affection, the pain in the uterus was considerably diminshed, as well as the other symptoms which usually accompanied it; but, after the powers of speech and motion were restored, the pain returned again with its accustomed, or rather with increased violence, and continued so till her death. It was the last symptom of which she complained, whilst she was capable of utterance. In May 1806 she was affected, without any apparent cause, with an uncommon degree of restlessness, agitation, and depression of spirits. These symptoms continued four or five months, and were relieved by nothing but the occasional use of opium. During the last 12 months of her life, she was confined to her bed. In this confinement she complained frequently of great pain at the extremity of the rectum; and, a few weeks before her decease, a purulent discharge took place from that part. Whilst she was thus confined, the kidneys were affected with great torpor. The urinary secretion was not supported without the frequent use of diuretics. It was discharged at long intervals, and in small quantity; a state very different from that to which, during all the preceding part of her life, she had been accustomed, for, before that time, the discharge of urine had been very frequent and copious, and the colour pale.

Death put a period to her sufferings on the 23d of August 1807, in the 77th year of her age.

I am aware that the preceding narrative contains but a very imperfect history of morbid affections, which, from their commencement to their termination, occupied nearly half a century. It is however, I believe, correct with regard to all the material circumstances of the case. Of the views which were first formed of her complaints, and of the means which were employed to relieve her, I can obtain no satisfactory information; for the gentlemen who attended her in the commencement of her illness have been long since removed from the scene. I can only learn, that the tumour, when it was first made known to them, was supposed to be of a scirrhous nature, and that cicuta was prescribed freely; but, as might be expected, with no advantage. Before I had an opportunity to make any observations on her state, she had almost entirely abandoned the aid of medicine. She had recourse to opium occasionally for the relief of pain; but as its effects were merely temporary, and as it disordered her stomach, lessened her appetite, and increased the depression of spirits, she did not continue the use of it for any long time together. The bark always disordered her bowels, and medicines

of