nerally followed by an augmentation of the dyspnoea and cough, with pains in the chest. Digitalis purpurea. The very great power of this plant has shewn itself in some cases, where half a grain has produced those serious effects well known to arise from an over dose, and soonest removed by brandy, or other spirit, diluted with a small portion of water; in others, one grain at a dose in the first instance, has not produced any sensible effect. Dr Hamilton's remarks on digitalis well merit attention. He is of opinion that digitalis is inefficacious in the early stage of all' diseases purely inflammatory. He considers it very useful in phthisis, and a complete specific in the early stage of dyspnoea aquosa and hydrothorax, but strongly recommends long intervals between the doses. This ought to be strictly observed; a proper dose given at long intervals, is attended with much greater advantage than a small dose often repeated. It is nevertheless highly necessary to commence with a small dose, and carefully increase it, preserving the intervals until some marks of its efficacy appears. Great attention should be paid to the drying of this plant. It is better kept in leaves, excluded from the air, and reduced to powder by a small portion at one time; by which means it does not lose any of its power. It is much to be regretted, that since this plant was brought into practice, there have been so many receipts for the preparation of the infusion and tincture; the latter has been varied at the whim of every physician. There is now a formula in the Edinburgh New Dispensatory, which affords a medicine of equal strength. It is a matter of much importance that such a one should be generally followed, to prevent those disappointments and serious evils which have occurred. In this town it is prescribed by different receipts, one not above half the strength of another: this example, it is to be hoped, will be sufficient to call the attention of practitioners to so important a subject. Hyoscyamus niger is a very desirable addition to the class of narcotics. It is often employed where opium cannot be taken; it acts as an aperient, and is on this account advantageously combined with opium. But it is likewise a remedy of the greatest utility in irritable constitutions, where opium would produce dry tongue, thirst, headach, pervigilium, and fever; but the inspissated juice of this plant acts in these constitutions like a charm, removes morbid irritability, and produces refreshing sleep. Extractum papaveris albi, may very often be substituted for opium. The price to which this drug is now advanced, renders it desirable * Essay on Digitalis. desirable to lessen the consumption in public charities as much as possible, and to direct the attention of medical men to this useful substitute. By careful cultivation, the poppy in this country may be brought to yield an extract, if not an opium very little inferior to the narcotic juice of the Asiatic plant. This has been attempted with success; but the variable state of the weather in our climate, about the time of the poppy harvest, when the ripeness of the plant is such, that one wet night, it is said, will materially damage, if not destroy, the whole crop, is so much hazard, that few men are found speculative enough to cultivate it to any extent. Those that are engaged in this species of agriculture, too often pay no attention to the plant during its growth, having so repeatedly been deprived of the just reward of their attention, by an accident which they cannot obviate, or, at the present price of opium, a successful harvest of poppies would prove a lucrative concern. Humulus lupulus, although not so powerful as the poppy, is yet by no means insignificant, and very serviceable in cases where it is wished to combine a tonic with a narcotic power, as in the second stage of pertussis, &c. Corbonas ferri præcipitatus. This tonic possesses very great advantages over the sulfas ferri, which sometimes, even in small doses, produces griping pain in the bowels, probably from being carelessly prepared. The precipitated iron forms an elegant and safe medicine, and is willingly taken by children, when mixed with treacle. Oxidum bismuthi album requires very little comment; its virtues have already been fully consideredt. It is only necessary to remark here, that it completely supports the favourable opinion already advanced of its efficacy in gastrodynia and asthenia, and must be considered a very valuable addition to the Materia Medica. Phosphas ferri et phosphas ferri oxygenatus have been much extolled by Mr Carmichael and others, in cancer. They have been tried in one case, very favourable for the experiment, but without success; on the contrary, they were quite inert, the ulcers, which much resembled the fungus hæmatodes, was cured by the application of the oxyd of arsenic, combined with the oxymuriat of mercury; yet it would not be fair to draw any conclusion of the result of a practice from a solitary case. Tinctura * Duncan's Edinburgh New Dispensatory. Edinburgh Medical and Surgical Journal, Vol. IV. p. 12. Tinctura cantharidum has been in many instances, successfully prescribed in eneuresis; and since Mr Roberton's remarks or its efficacy in gonorrhoea pura, or gleet, and leucorrhoea, it has been found in some few cases very useful in removing these obstinate affections. Nottingham, February 10th 1808. HI. Memoire sur la Mortification de la Cornée. Par J. P. MAUNOIR' de Genéve. Translated and communicated by Dr de Roches. AMONG the strongest objections that can be urged against the operation of the cataract by extraction, we may consider that dreadful inflammation which takes place on the next day after the operation, unattended at first with violent pains, but which, nevertheless, announces to an experienced practitioner, that the eye is lost, whatever means he may employ to the contrary. That singular species of inflammation, which has been observed by the most skilful oculists, in cases where the operation had been apparently well performed, and the patient's general constitution was good, has justly puzzled them; since hitherto nothing could teach them how to foresee it, much less how to find out a remedy. A pretty certain sign of its existence, is a copious flow of a watery fluid through the eye-lids, which are closed and tumefied, combined with inability on the part of the patient to distinguish night from day, (whereas every one knows, that an eye operated for the cataract, which is to recover its sight, is able, though entirely closed, to distinguish light from darkness); the patient also frequently feels pain in the temple, or along the eye-brow of the operated side. Upon examining the eye itself, the conjunctiva is found red and swelled, being elevated above the cornea, which is itself opaque, and of a yellowish white, much approaching to the colour of pus, so as to induce a belief, that that colour is communicated to it by an accumulation of purulent matter in the interstices of its laminæ, or in the anterior chamber of the eye. The Baron de Wenzel seems, indeed, to be of opinion, that this circumstance is a constant attendant of the complaint; Remarks on the Use of Cantharides in Gleet. complaint. He expresses himself as follows: "The most formidable accident in the operation of extracting the cataract, is a violent inflammation of the globe of the eye, during the continuance of which the conjunctiva becomes considerably inflamed, and the eye immersed in a large quantity of acrid matter. In consequence of this, the cornea not unfrequently becomes opaque, and purulent matter is collected behind it, the matter being sometimes found in both chambers of the aqueous humour ; and from this cause, the patient suffers excessive and incessant pain. If the remedies that are usually directed in cases of inflammation, both those which are more general, and those which are particularly adapted to such cases, be insufficient to produce an absorp tion of the matter, (which indeed too often happens), the case is hopeless, and the pain will not cease until the suppuration is complete, and the eye sunk and lost. I am not aware of any assignable cause for this melancholy accident, unless it be owing to a vitiated state of the humours in the patient's general habit, or to some local defect in the original structure of the eye. But be this as it may, I am happy to subjoin, that it very seldom occurs in the course of our practice." (Ware's Translation.) As the inflammation advances, the conjunctiva increases in size; the eyelids cannot contain the whole eye-ball, and remain half open; the pains become every day more intolerable, and the disease terminates at length in the sinking of the eye, with scarcely any appearance of suppuration. The size of the cornea is always reduced to 1-4th or 1-3d of its original extent; but that small portion which has escaped destruction, generally preserves its transparency, and part of the iris may be seen behind, serving it as a resting-place. The patient seldom recovers the power of distinguishing night from day; when, however, that happens, an artificial pupil may be tried. I do not know, whether any author has considered this inflammation under a different point of view from that of the Baron de Wenzel, all seeming to look for an hypopion. Richter says, "Inter hæc artis auxilia benè administrata rarò hanc operationem sequitur hypopium; sique 1 sequitur, periculum quod adfert tantùm non est ut omnem spem recuperandi visum extingut, modò tempestivum et dexterum auxilium feratur: Annunciant ortum hypopii dolorum vehementiorum remissio, albus ponè corneam color, aut sensus pressionis in oculo sensim molestissimus. Eas vel in camera oculi anteriori vel in posteriori hæret." So violent an inflammation may, no doubt, occasionally terminate in the suppuration of a part, or even of the whole of the eye-ball; but I cannot think, that, in the commencement of the complaint, when the cornea assumes a colour, as if it covered purulent purulent matter, that matter does actually exist, and experience seems to support this opinion; for pus, under these circum. stances, is never poured out, as in the case of the true hypopion. "Factâ cornea incisione," says Richter, "guttula puris cum pauxillo humori aquei spontè plerumque statim prodit quâ elapsâ oculum confestim obtego," &c. He lets out another drop after an interval of six hours, and so forth; but notwithstanding the egress of those drops of pus, mixed with the aqueous humour, the cornea does not recover its transparency; all the circumstances continue, the progress of the malady being nowise altered. Such a small drop of pus is a very trifling circumstance in the history of so formidable a complaint; it is an inconsiderable effect of a great efficient cause. The opacity and whitish colour of the cornea, which are observed so early as next day after the operation, the complete insensibility of that membrane, the remarkable diminution of its size, after the termination of the disease, while the sclerotic coat remains entire, are so many concurring proofs, that the inflammation, which now occupies our attention, is produced by the gangrene of part of the cornea; that the duration of that cruel complaint, is owing to the tenacity and strength of that tunic, the mortified portions of which se parate slowly, and with difficulty, from the living; that it is consequently very useless to make an incision through that membrane, since the reunion of the lips of the original wound cannot take place; and lastly, that the drop of pus, which is so difficultly obtained, comes from the ulcerated margins of that living portion of the cornea, which separates from the dead. I therefore think, that when the hypopion has been cured by an incision through the cornea, the complaint could not be considered as a consequence of the operation of extracting the cataract, since it took place when the lips of the wound were already perfectly united, many days therefore after the operation; whereas, I am here speaking only of the formidable inflammation which follows it almost immediately. If the progress and result of that inflammation leave no doubt as to the reality of a mortification in a portion of the cornea, and no means have been devised to shorten the complaint which it occasions, let us endeavour, at least, to find out the cause of the accident, either in the habit of the patient, or in the manner of performing the operation. In October 1799, I operated on the right eye of Monsieur D. T. C. aged 70. The incision through the cornea was well made and regular, but rather small, if we attend to the rules laid down in the best books of surgery; it included 5-12ths only of the circumference of the cornea; crystalline came out slowly, and with a well marked friction the against |