Imatges de pàgina
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facts from Dr. Caldwell, one of the physicians who attended her after she was taken ill, with a uterine hæmorrhage, at about the seventh month of what she supposed to be a pregnant state. The flooding continued more or less nearly six weeks, when pain supervening, supposed to be that of labour, the assistance of Mrs. Morrell, a midwife, was requested. The old lady not being able to satisfy herself with respect to the actual situation of her patient, solicited the aid of a physician. The result of a further investigation of her case, was a belief, that she in all probability was not pregnant. Under this impression medicine was resorted to, the principal of which she supposed to be mercury, and after the lapse of some time she in a great measure recovered her health. After the abdominal swelling which the patient had imputed to pregnancy had subsided, while on the use of medicine, she very plainly discovered a very hard tumour in the region of the uterus, which, by assuming different positions of the body, would move from one side to the other. This tumour never occasioned much uneasiness, excepting when a sudden motion would be given to it, or at the times of her being pregnant, and then it would sometimes give her slight pain. She continued to carry this singular enlargement the period of about eleven years, during which time she enjoyed an ordinary proportion of good health, and became the mother of six children. In the last of these six births I extracted from the uterus this tumour, which proved to be the remarkable fœtus before alluded to. I now beg leave to introduce Dr. Caldwell's letter.

"Dr. Caldwell has a perfect recollection of the case of Mrs. B, to which Dr. Klapp has reference in his note of this morning. It occurred, he thinks, in the year 1804. That lady having previously had several children, supposed herself again in a state of pregnancy, accompanied however with several

⚫ It will be observed that this statement does not appear in Dr. Caldwell's letter, as well as a few other circumstances alleged by the patient, which must be attributed to the difficulty of retaining in the memory events which had occurred so many years ago.

VOL. V.

3 A

No. 19.

unusual and unpleasant symptoms, which did not fail to excite in her mind considerable apprehension. At the request of Dr. C. she engaged the late Dr. Church to be with her at the time of her confinement.

"Some time in the spring, perhaps in the month of March, of 1804, labour pains came on, and continued with considerable severity for two or three days.

"There being no appearance of delivery, and Dr. Church becoming uneasy, and somewhat doubtful as to the issue, requested Dr. C. to attend with him in consultation. The pains were now evidently on the decline, and in a few days afterwards, without producing any birth, or as far as Dr. C. now recollects, any unusual discharge of fluids, went off entirely.

"The abdominal enlargement still continuing, and Dr. C. suspecting the case to be dropsical, recommended the use of calomel and digitalis. He thinks, but is not certain, that he pushed the remedy to the extent of ptyalism. In a few weeks the tumour disappeared, if not entirely, at least so far as not to be perceptible to common observation, but many months elapsed before the perfect re-establishment of the patient's health. At length however all complaints ceased, certainly none were spoken of, and in the course of the following year Mrs. B. was delivered of a healthy and vigorous child. Dr. C. thinks she had one or two more children during his attendance in the family, which terminated perhaps in the beginning of the year 1808. Subsequently to her false confinement in 1804, Mrs. B. menstruated regularly when not pregnant, and enjoyed, as far as Dr. C. recollects, tolerable health.

"Touching the case in question, the foregoing is the amount of all that Dr. C. is able to communicate. He is sorry it is not better calculated to shed light on the subject, and to subserve the inquiry which Dr. K. may have in view.

"March 16, 1815."

A description of this singular fatus.

Its colour is a light red, it is very destitute of all the exter

ual soft parts of the body, excepting an indistinct appearance of muscle on the lower extremities; all the rest of the exterior. of the body consists of bones covered with a fine, transparent membrane. The greater part of the bones are of the usual form, yet many of them are thrown into unusual situations. The object viewed as a whole exhibits a figure extremely irregular, in short it is a shapeless mass of bony matter. The head and inferior extremities are somewhat bent towards each other, in consequence of which its back at, and just below the scapulæ, is formed into a considerable convexity. There is no sternum: at the place where it should be there exists a depression, within which may be perceived a quantity of soft substance apparently consisting of viscera; on each side of this depression are placed the anterior terminations of the ribs; these are destitute of cartilages, but are successively arranged aside of each other in the natural order, eight or ten of which can be easily pointed out. The left scapula has the usual form, the right is indistinct, neither of which are in their proper places. The os humeri of the right side passes down over the ribs in a direct line from the glenoid cavity of the scapula, to the hip joint, and the bones of the corresponding fore-arm are reflected upwards from the elbow joint along the humerus to the extent of their length, so that the joints of the wrist and shoulder are nearly in contact with each other. No appearance of a hand can be found on either side, but something similar to five metacarpal bones are attached to the cubitus of the right side. The head is turned round to the left, so that the face is nearly on a line with the left scapula. The left upper extremity is differently disposed of from the right; the bones of the fore-arm are bent back on the humerus, similar to what is observed in the other extremity; but instead of hanging down over the side as the other does, it is thrown immediately forward, so as to run nearly in a direct line from the shoulder joint to the spot where the upper end of the sternum should have been. By this arrangement the right side of the head and face rests on the left upper extremity, so that

the chin is attached to the shoulder joint of this side. The general figure of the head is nearly natural. The frontal, parietal and occipital bones, are easily distinguished; also the sagittal, coronal and lamdoidal sutures. The temporal bones are entirely wanting. Something similar to an ear can be distinguished on the left side, but no trace of an ear can be discovered on the other side. The different parts of the face are not very obvious at first sight, but by a little attentive inspection nearly all of them can be recognized. The cavity of the head appears as if it might be occupied by something similar to brain. No trace of an umbilical cord can be detected. The lower extremities are bent in a way similar to the upper ones, the bones of the leg pass up along the back part of the femoris, so that the ancle and hip joints are nearly in contact with each other. The thigh bones are somewhat covered with a soft substance resembling muscle. The feet are absent. The greatest circumference of the head is eight inches. From the top of the head to the ancle joint is eleven inches and a half. The weight of the object is eight ounces and a half.

TO THE EDITORS OF THE ECLECTIC REPERTORY, GENTLEMEN,

THE following communication, which I send you for the Eclectic Repertory, on a disease too much neglected by preceding practical writers in medicine, will, I hope, receive that attention, which one, so formidable in its aspect, and so fatal in its consequences, necessarily demands.

On Mania à Potû.

BY ISAAC CLARKSON SNOWDEN, M. D.

From the familiarity which my late residence in the Medical Department of the Philadelphia Alms-House, has furnished me with this disease, I shall endeavour to present, from

personal observation solely, a concise view of the cause, a correct delineation of the characters, and the most successful method of treating the disease in question.

In the animal system, there is known to exist a principle, denominated variously, principle of vitality-excitabilityvibratility, &c. &c. according to the opinions of different theorists. Rejecting all specious display of hypothesis, and strictly adhering in this, as I shall throughout the communication, to fact, and the most obvious inductions, I merely state, that this principle, in whatever it may consist, or whatever name it may assume, may be diminished, augmented, impaired, destroyed. The first effect produced by ardent spirits on the animal system, is an universal and preternatural excitement. When the excitement is urged to a high degree, the functions of the brain, and of most of the systems, become impaired. Nor does this elevated condition of the system continue long; for, by a rapid decrement the excitement falls, not to its original level, but far below the natural, healthy standard. When the practice of drinking spirituous liquors to excess has been long pursued, the vital principle, or, (to use a more general expression) the system, which, for a certain period, was able to resist in some degree the force of such a stimulus, loses, by being so frequently and so powerfully operated on, (when the cause itself ceases to act) the power of rising from the state of depression into which it was thrown. This I consider to be the state of the system in Mania à Potû.

The SYMPTOMS which attend this disease are the following. I will sketch them as nearly as possible in the order in which I have usually observed them to approach. The countenance becomes dejected; the eyes are red and furious, never fixed, but incessantly wandering from object to object; the tongue is dry and hard; the skin, though occasionally dry, is more frequently moist; the bowels are almost always costive the stomach much disordered and affected with frequent vomiting. The patient complains of violent pain in every part of his head; he is unable to retain aliment of any kind; and even

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