but seldom; so that the quantity and frequency of its exhibition was gradually diminished to thirty drops twice-a-day, and at last discontinued. Saturday, we found him in every respect better, as he had made shift to take some food, but complained sorely of his tongue and teeth; he had slept pretty well for the first time since the Saturday before. The spasms being much diminished, we thought that the affusion might be dispensed with, as it was a measure that carried with it such an air of severity; we advised him to drink plentifully of good Madeira wine, and take as much nourishment as he could. Sunday morning, we found him quite merry, having drank two bottles of wine, and slept tolerably well, except when the attendants plied him with wine. He began to walk about with a little support, but he yet cut a ludicrous figure. No medicines were ordered, and the wine was continued. Monday, the appearances were yet more favourable, and he could make a better use of his limbs; his jaw was relaxed sufficiently to eat a little bread and biscuit, but his tongue was sore yet; his features were gradually assuming their wonted appearance. He had drank two bottles of wine since the last report, and staggered about rather better than yesterday Finding matters go on so favourably, we recommended the same plan, which he continued with little variation for twelve or fourteen days, when there was no rigidity of consequence remaining, and he gradually returned to health, lessening the quantity of wine by degrees. I have stated the above case merely as a succession of facts, which you are at full liberty to make what use of you please, and have forbore making any comment of the treatment; but I am strongly inclined to think, that the benefit to be expected from the cold affusion will be very little, unless it is carried to the length of producing a suspension of the vital principle, as the spasms were very markedly dissolved on the deliquium taking place, and their recurrence with the reaction, with an evident abatement. He had taken, in the course of ten days, besides the frictions, nearly three ounces of the thebaic tincture, without inducing the least stupor; nor did we perceive any bad effects from the cold, although very much under the influence of mercury. There was nothing in the discharges by stool that might indicate any irritation in the alimentary canai, either as to quantity or quality, as his evacuations were natural, excepting the solitary lumbricus, which could hardly be suspected of having created so much disturbance. The wound on the toe never exhibited any appearance of inflammation, nor could we perceive that it gave VOL. IV. NO. 13. D him him any unusual pain on pressing strongly on it. His pulse was not disturbed during the whole course of the disease, except from the effects of the affusion. At this date, which is upwards of a year since his illness, he has enjoyed an uninterrupted state of health, has got fat, and was married eight months ago. While drawing out this sketch, he informs me that he recollects having had a diarrhoea which lasted a day, a few weeks before his illness; in his stools, he noticed several small worms, but never observed them before or since. It may be worthy of remark, that the weather was very sultry during the latter part of June, and all July; and there was very little variation in the thermometer, night or day. Montreal, August 12th, 1807. VII. By Mr A Case of the Cancer of the Penis, extirpated with success. IN 1806, Mr Thomas Foster, 65 years of age, of emaciated constitution and slender make, requested my assistance in a discase of the penis. On my first visit, I found a large irregular excrescence, extending from three quarters of an inch of the pu bes to near the extremity of the yard; its resemblance was that of a full blown red rose; a small part of the prepuce, at its extremity, remained entire, and was firmly contracted over the glans penis, forming a complete phymosis. The anterior part of the urethra was wholy obliterated, and the urine passed with excruciating pain through four apertures at the sides and centre of the ulcer. I afterwards found the fungus had originated in the gians penis, and measured one inch and a quarter from base to apex. This blended mass of cancerous flesh, in its growth, caused a separation of the prepuce anteriorly, the edge of which was much ulcerated and thickened, forming a sort of margin, which circumscribed a third of the circumference of the fungus. The surface assumed the same irregular granulated appearance as the rest of the sore; the prepuce could be separated from the other part of the fungus by forcibly pressing with the fingers; both edges were smooth, and of a duskish colour, which was : owing to a fetid ichor constantly exuding from the surface of the sore this foulness, together with the urine, made his linen continually moist, which perpetually gave out an intolerable fetor. From his history of the case, it appears he was never able to denude the glans. About eight years ago, he first began to feel a little uneasiness on discharging his water, which, after the space of two years, came away with great difficulty. This he attempted to remedy by introducing the head of a common pin. Not long after he observed an ulcer, the size of a small pea, near the end of his yard; this, in the space of five years more, had increased to such a bulk, that it was with difficulty he could walk. The pain he felt on voiding his urine, and which continued a long time after, was beyond description. Notwithstanding every distressing circumstance he laboured under, he firmly refused to comply with an operation which at that time I thought myself justifiable in proposing. About two months after, I was desired to attend again, and found him considerably shrunk. He complained of night sweats, great prostration of strength, with other symptoms of extreme debility. The rapidity with which the disease now advanced was become, to himself, evidently dangerous; for that part of the integuments of the penis, between the fungus and pubis, had turned livid, and was perforated in three places, since the time when I last saw it, and endeavoured to enforce on him the necessity of an operation, which he then firmly refused. Being now made sensible of the event if the disease was suffered to go further, he consented to the operation. That part of the penis which is covered by the scrotum felt hard and knotty, so that I found it impossible, in extirpation, to get beyond the diseased part without taking away much of the scrotum ;—this I hesitated to do, as no case had occurred to me of so formidable a nature. Thus circumstanced, I solicited the assistance of a neighbouring practitioner, who readily agreed in the propriety of extirpation; but in what manner to proceed with safety to the patient, as well as a due regard to our own reputations, was difficult to determine. Here was combined inveterate disease and impaired old age, fast approaching to natural decay. At this crisis, however unfavourable, he urged, and we determined on extirpation. Having cut through the common integuments of the 'penis and scrotum, on examining, I found the disease to extend as far as the pubes, and I next detached the whole diseased penis; the hemorrhage was very profuse, there being no possibility of applying a tourniquet. I ordered my assistant to keep a firm pressure with his finger and thumb behind the bulb of the urethra, by which means he was able to bring the remaining part of of the penis into view, which, after extirpation, had shrunk considerably within the perineum; he was also enabled, in a great degree, to moderate the hemorrhage until I secured the vessels. I took up an artery in each corpus cavernosum, and one in the dorsum penis, but still finding a running from the smaller arteries, I tied six of these, then brought together the lips of the divided scrotum by the conimon suture, when, waiting the result of a few minutes before I proceeded further, to my surprise two small vessels began to bleed, which I immediately secured, and again desisted a sufficient time to prove the safety of the part. Having applied the dressings, through which I introduced a silver canula, for the purpose of conducting the urine over them, I suspended the scrotum in a bag-truss. He was put to bed, and, considering his feeble state, felt to erably easy. I administered an opiate and left him. On the morning after, he complained of the most distressing pain in discharging his water. On examining, I found that the urine had penetrated the dressings at the orifice of the urethra, and, remaining in the scrotum, it excited the most grievous degree of pain. The very lax state of the scrotum, the urethra retracting so considerably within the perineum, and the heat of the urine, made it a task of the greatest difficulty to retain the dressings in their proper situation. After repeated trials, I found the canula, when introduced, sufficiently tight to prevent the escape of urine by the side, gave the patient constant and severe pain, causing convulsions of the right limb; and when it was too small, the other evils were produced, and those so frequently, that I began to despair of the success of the operation. For the space of two days, the part was little assisted by every means I had devised of applying the dressings. At length I discovered that a piece of tin-foil, spread with adhesive plaster, answered the purpose extremely well After laying a slip longitudinally, I applied other slips transversely around the scrotum, which kept the lips of the wound sufficiently well together, and stood the washing of the urine without being in the least injured. I was enabled to accommodate a part of this plaster close to the orifice of the urethra, which made a sort of groove or channel for the conveyance of the urine. In whatever form this plaster is modelled, it retains its shape so firmly that, by its use, I was better able to convey the urine over the scrotum than by any other means whatever. My patient assured me, * Since I first used this plaster, in Forster's case, I have formed it of tin-foil doubled, and of sheet-lead of various thicknesses. In a case or two of old ulcerated legs, I have found it remarkably useful applied in a spiral form I discharged the contents of the sores from two or three small openings made in the plaster. Those dressings were longer continued, and kept the parts cleaner and han the plaster in common use. me, that the urine which washed the wound before this mode of dressing was used, produced as much pain, on every occasion to void, as he suffered during the operation. The evil was sufficiently remedied by the above method; the part took to cicatrize readily; and, in the space of two months, my patient got completely well. I saw him half a year after his discharge, at which time he looked well, and, besides being free from pain in the part, possessed a good share of general health. Extirpation in this case was surely carried to the utmost extent, and the benefit derived from it, even at the latest moment, was evidently great, for he assured me his sufferings in one day, before the part was removed, were more than he experienced during the operation. Walsingham, 4th Sept. 1807. VIII. Biographical Sketch of Dr PERCIVAL. THOMAS PERCIVAL, M. D. F. R. S. and A. S. F. R. S. and R. M. S. Edinburgh, late president of the Literary and Philosophical Society at Manchester, Member of the Royal Societies of Paris and of Lyons, of the Medical Societies of London, and of Aix in Provence, of the American Academy of Arts, &c. was born at Warrington, in Lancashire, on the 29th of September 1740, and died at Manchester the 30th of August 1804, at the close of the sixty-fourth year of his age. He was descended from a respectable family, but had the misfortune to lose both his parents when he was very young, to which circumstance, perhaps, some parts of his character may be traced, as the loss of parental instruction was supplied by the able and affectionate care of his eldest sister, who furnishes another instance of training up an only pupil to the foremost station in society by unremitting solicitude and attention. Most of our celebrated men seem to have been indebted to their mothers, or to some kind female superintendent, for their fondness for study, and their habits of application. Dr Percival received his classical education at the free grammar-school at Warrington, and afterwards at the academy established in that town. His predilection for medical studies manifested itself very early; and his choice of the profession was partly owing to the pleasing associations excited by a remembrance of his uncle's virtues and attainments, and partly because medicine appeared most congenial to his feelings, as being more allied to his favourite pursuits in moral and phy sical |