Imatges de pàgina
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self, in vain. But finding the tumour very hard, as well as the pulse, I went home in search of my lancets, having previously administered a dose of ol. ricini. On my return, however, after keeping the muscles relaxed for some time, the hernia was almost immediately reduced. The patient soon felt relieved, the pain had disappeared, and not the least vestige of the tumour remained, when I left him dosing.

A couple of hours afterwards the symptoms of strangulation were renewed, and continued the same as previous to the reduction of the hernia. No evacuation having taken place, a second dose of ol. ricini was ordered, but almost immediately vomited. A third cathartic, which he kept down, produced no effect whatever. It was then deemed necessary to take ten ounces of blood from the arm, which however failed to procure any relief. At twelve in the forenoon no abatement of the pain could be perceived, although the pulse was softer, but the vomitings and hiccups had disappeared: no passage had yet been procured, a dose of calomel and jalap was therefore prescribed. Having seen him a third time in the afternoon, and no amelioration being visible, the abdomen becoming painful to the touch, and tumefied, and still no evacuation, a second dose of calomel, with emollient injections were recommended, and the patient was bled a second time. The same situation manifested itself in the evening, when the patient was again bled for the third time. Although the reduction of the pulse was considerable, yet it procured no relief. The vomitings had occurred twice in the afternoon. Fomentations on the abdomen were ordered with the injections, but with the exception of a little relaxation in the tension of the abdomen, no effect was produced. An infusion of senna was administered also in vain.

I visited him early on the morning of Sunday the 12th, and found that his sufferings had not increased, although he had experienced no relief. He had not slept any during the night. The abdomen continued painful and tumefied, but he complained much more of pain in the groin on the right side than at any other point; no passage; the injections, fomentations, and the infusion of senna, were directed to be continued. The pulse had become tense and tremulous.

The case proving obstinate, I requested the advice of my friend and neighbour, Dr. Povall, who called to see the patient with me, and agreed in opinion that the symptoms of strangulation most probably arose from a stricture of the hernial sac, that had been reduced with the intestine. It was determined at his suggestion to apply a large blister on the abdomen, and to insist upon the injections of large quantities of warm water, with the hope of overcoming the obstruction which existed. The blister did not produce on the skin or system any effect whatever, and the other remedies made use of were equally ineffectual. A copious bleeding was ordered in the afternoon, owing to the hardness of the pulse. The night from Sunday to Monday was equally restless. On Monday, his situation continuing the same, it was agreed between Dr. P. and myself that a dose of gum gamb. and calomel should be given, and cold water poured on the lower extremities. No effect whatever from either. His sufferings as great as the day previous. The vomiting and some hiccup had occurred, but gave way to the camphorated mixture which was now recommended.

On Tuesday morning his pulse was considerably depressed, the tension of the abdomen had subsided, and it was much less painful, but the extremities were cold, accompanied by clammy sweats. The voice had undergone some alteration, constant anxiety and restlessness were also observed. The injections were continued during the day, and a decoction of tobacco was also added. Notwithstanding the treatment the inflammation maintained its ground. No passage could be procured. Several medical gentlemen saw the patient in the course of this day, and agreed with me in the opinion that very little hope could be entertained. At the suggestion of one of the gentlemen, quicksilver was administered in the proportion of an ounce, but also in vain: it was repeated equally in vain. Dr. Parrish was called to see the patient in consultation on Wednesday, and concurred in opinion with VOL. VI.

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No. 24.

Dr. Povall and myself as to the probable cause of those very dangerous symptons.

The pulse continued to sink, and, with some remissions, when it would rise in an unaccountable manner, gradually lost both its strength and regularity. Vomitings, but more especially the hiccup, became very troublesome, and the least motion produced fresh pains. The camphorated solution was of service in relieving him from the hiccup. In this situation, when every remedy had failed, he kept lingering until the night of Thursday to Friday, when he expired—the seventh day of his disease.

I proceeded the next morning to the opening of the body, accompanied by Dr. Povall.

On opening the abdomen we found the whole mass of the intestinal tube, commencing at the strictured part and extending upwards, distended with air: the vessels of the omentum, as well as those of the mesentery, very much injected with blood, and the greatest portion of the intestines bearing evident marks of inflammation. The seat of the disease, however, was confined to the jejunum, which for the length of twelve inches had lost its colour and was in a complete state of sphacelus. A portion of this intestine was confined in the inner portion of the abdominal ring, where the herdial sac formed a stricture round it, which having also participated in the general mortification, was totally disorganized, and could easily be torn away by the nail. So complete had been this adhesion, that when it was ruptured by a very slight effort, a hole in the intestinal canal, about the size of a shilling, was produced. We also noticed another hole near it, of the same size, having all the appearance of an ulcer. Having cut open the intestine at its most diseased point, for a few inches, pus, and a remarkable black appearance on the internal coat, were observed. Several black spots here and there were also noticed in this vicinity. A remarkable spot about the size of a half dollar, attracted our attention. It was situated about the mid. dle of the transverse portion of the colon. It was very evident to us that the intestines contained in the right side of the abdomen, but more particularly in its lower region, had been the

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seat of a more extensive and acute inflammation than those situated on the left. The inguinal ring, which was diseased, as we have already noticed, on the left side, had protruded in the abdomen as much as an inch, by the increase of its volume.

Philadelphia, August, 1810.

OBITUARY NOTICE.

[From the Edinburgh Medical and Surgical Journal, for July, 1816.]

Died, on Tuesday the 18th instant, (June) in the 82d year of his age, Mr. Thomas Henry, President of the Literary and Philosophical Society of Manchester, Fellow of the Royal Society in London, and Member of several other learned Societies both in this country and abroad. As a practical and philosophical chemist, he had obtained a high and merited reputation. His contributions to that science, besides a small volume of Essays and his Translations of the earlier writings of Lavoisier, which he first introduced to the notice of the English reader, consist chiefly of Memoirs, dispersed through the Transactions of the various Societies to which he belonged, and relating both to those parts of chemistry that are purely scientific, and to those which have a connection with the useful arts. On a subject intimately connected with the success of the cotton manufacture, (the employment of Mordants or Bases in dyeing,) “Mr. Henry was the first," to use the words applied to him by a subsequent author, “who thought and wrote philosophically.” In the introduction, too, of the new mode of bleaching, which has worked an entire revolution in that art, and occasioned an incomparably quicker circulation of capital, he was one of the earliest and most successful agents. In addition to the acquirements connected with his profession, he had cultivated, to no inconsiderable degree, a taste for the productions of the Fine Arts: he had obtained a knowledge of historical events remarkable for its extent and accuracy; and he had derived, from reading and reflection, opinions to which he was steadily attached, on those topics of political, moral, and religious inquiry, which are most important to the welfare of mankind. For several years past, he had retired from the practice of medicine, in which he had extensively engaged, with credit and success, for more than half a century; and, from delicate health, he had long ceased to take an active share in the practical cultivation of science. But possessing, almost unimpaired, his faculties of memory and judgment, he continued to feel a lively interest in the advancement of literature and philosophy. Retaining, also, in their full vigour, those kind affections of the heart, that gave birth to the most estimable moral qualities, and secured the faithful attachment of his friends, he passed through a long and serene old age, experiencing little but its comforts and its honours, and habitually thankful for the blessings with which Providence had indulged him.

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