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The three summer months have exhibited very little of that character this year; as there has scarcely been one hot day during the whole of that period, and very few without more or less of rain: the season, in fact, having been latter by at least a month in all its productions than is usual, and the thermometer uniformly low.
Whence the diseases, which have presented themselves at the Dispensary, have been also of a mixed character. The derangements of the digestive organs, and the diseases principally depending upon them, have therefore been rather more numerous than in the winter months; whilst the occurrence of upwards of fifty cases of rheumatic affections, and twenty of acute attacks in the chest, indicate a state of atmosphere rather ungenial. Among the diseases that are principally referable to gastric derangement, not only the large proportion of vertiginous cases and cephalæa, but the long list of cases under the head of Febris are also chiefly to be enumerated; for most of them assumed the type of slight fever, accompanied by disturbed abdominal function, with little disorder of the head, and were of slight duration after a proper regulation of the chylopoetic organs. A small number of them, however, which occurred in the very filthy courts about Saffron Hill, occupied almost exclusively by Irish labourers and their families, assumed a typhoid character, and spread, apparently by contagion, so that twelve patients were removed from that quarter to the House of Recovery in I i
VOL. XII. NO. 48.
Gray's Inn Lane in the course of a fortnight in the early part of the present month. By this speedy removal, assisted by the white-washing and fumigation, which that institution practices in the habitations of the patients when removed, the progress of the fever appears to have been completely arrested. T. B. London, Aug. 31, 1816.
Letter from Mr GRAINGER, giving an account of a Ball found in the Heart of a Buck.
On August the 31st past, a buck that was remarkably fat and healthy in condition, was killed in Bradby Park, and, on opening him, it was discovered that, at some distant time ago, he had been shot in the heart; for a ball was contained in a cyst in the substance of that viscus, about two inches from the apex. The surface of the cyst had a whitish appearance. The ball weighs 292 grains, and was beat quite flat. What led to the discovery of the ball was the unusual circumstance of a firm adhesion of the heart with the pericardium to the ribs of the left side. One of the ribs at the place of the adhesion, bore marks of having been fractured. Mr Richardson, the parkkeeper, who opened the animal, and communicated the account to me, is of opinion that the ball had struck some hard substance before entering the body of the deer, as it could not otherwise have become so flat. In the Second Volume of the MedicoChirurgical Transactions, is published an extraordinary case of a soldier who survived 49 hours after receiving a bayonet-wound of the heart; but the above particulars of a gunshot-wound of the heart will afford a still more striking example of the great extent to which this vital organ may sustain an injury from external violence, without its functions being immediately destroyed, or even permanently impaired. The recovery from an accident of this nature having happened to an animal of an inferior order to that of man, can in no respect materially vary the physiological import of the fact; therefore this authentic statement of it may be worthy of a place in that department of your Journal allotted to compendious articles of intelligence. Burton-upon-Trent, September 7, 1816.
Observations on some Causes of Deafness, with the Means of Removing them. By Professor AUTHENRIETH of Tubingen.
THE closing of the Eustachian tube, which at last causes loss of hearing, so difficultly removed by syringing the tube, and so imperfectly remedied by piercing the tympanum, almost always arises from a catarrhal cause. Twice I have seen this closure occur so frequently at the same time, that one would have been
almost justifiable in calling it epidemic. After moderating the determination of blood to the head, and the catarrhal affection, by the usual remedies, the best means of obviating the permanent closing of the tube, even after the hearing has been lost for some weeks, and the forcing of air into the tube by expiring strongly with the mouth and nostrils shut, has been tried in vain, is to excite and maintain for several days, or even weeks, an artificial inflammation of the pharynx, attended with a great discharge of mucus. It acts as an evacuant remedy upon the neighbouring mucous membrane, still turgid with the stagnant fluids produced by the catarrhal inflammation.
Two or three drachms of mezereon bark, boiled down with two ounces of honey and enough of water, to ten ounces of decoction, to which as much caustic ammonia is added as to give the mixture a biting taste upon the tongue, which requires generally from half a drachm to a drachm, is to be used as a gargle every two hours, so as to excite slight inflammation very slowly. If, therefore, upon the first trial, it should seem to act too quickly, it must be diluted with more water, and employed less frequently. In old people, still greater caution is requisite, as in them the inflammation excited is more obstinate, and is apt to be unexpectedly aggravated.
The hearing is frequently not restored until after the inflammation has again ceased.
In the bodies of almost all old people, there is found in the innermost part of the meatus auditorius externus, a firmly attached lump of indurated ear-wax, which, in old age, acquires a disposition to crystallize partly in an earthy form. The earpicker only scratches off its outer surface. This lump is the cause of the dulness of hearing which occurs slowly in healthy old people. We have as yet no very convenient method of removing it.
The tympanum of the car is frequently destroyed in consequence of the suppuration of the external meatus auditorius ; and of the small bones of the ear, the stirrup only is left which continues to shut the fenestra ovalis. But the entrance of the cold external air into the cavity of the tympanum, stimulates the membrane lining it. Moist air swells it hygroscopically. Then undulations, which would have excited vibrations in the internal parts of the ear, even without the tympanum, or small bones, are suffocated in it, and such patients become at that time perfectly deaf. The wearing of cotton within the ear, during such weather, preserves from pain, but, on the other hand, renders the feebly observed sounds still more obscure. At these times, it is of use to wear in the meatus an artificial tympanum, consisting
of a short tube of lead pressed into an elliptic form, upon the inner end of which the membrane of the swimming bladder of a small fish had been previously stretched when wet, and varnished over after it had become dry.
Extracts from a Letter from a Physician in London.
Mr CARPUE, who succeeded so admirably in the brave Captain Latham's and another officer's cases, has produced a great sensation among the unprofessional as well as professional public. Trials are making, and more are in contemplation, to supply the loss of other parts besides the nose. To what extent the art of engraftation may be practised, is not yet definable; but in the meantime, applications are made from defective persons for the supply of parts; of course they must be second-hand organs, which it would be ludicrous at present to mention.
2. Fatal Hamorrhage from Drawing a Tooth.
A man had a tooth extracted in I believe the usual circumstances; a considerable hæmorrhage ensued. The discharge was attempted to be stopped by the well-known means, but in vain. The actual cautery was next employed; it succeeded for a time only; the repetition failing, the carotid artery was next tied. This measure also failed under the hands of one of the most skilful surgeons in London, from whom every thing to be accomplished by art was to be expected, but the patient died from the discharge. Was the blood in this case coagulable?
3. Fatal Hæmorrhage from Scarifying.
On scarifying and cupping between the shoulders in the usual way, the bleeding did not stop as was expected. The discharge continuing, the known measures were taken, but without success. It was found that the blood did not coagulate, and this uncoagulable state was the cause of the subject dying from the evacuation.
4. Inflammation of the Interior Coat of Vessels.
I have seen the disease seemingly of the vasa vasorum of the interior coat of the large blood-vessels several times like inflammation described by Mr Hodgson; but it attended other wellknown diseases, and I could not distinguish any peculiar symptoms referable to this inflammation-like state of the blood-vessels. Is it a species of erysipelas ?
5. Eau Medicinale.
The evidence of the infusion of colchicum in wine being the
renowned nostrum eau medicinale, is increasing, but not the evidence of its efficacy. It will, in a few years, be a most curious piece of history to account for the present evidence in its favour, when its fame shall be buried (as I believe) in the tomb of all the Capulets.
6. Mr SAMUEL YOUNG continues to practice in cancerous cases, upon the principle of pressure, in many cases with great relief, and in some with entire success; at least more benefit has been produced by his than former modes of treatment.
On the 1st August, the Senatus Academicus of the University of Edinburgh conferred the degree of Doctor in Medicine on the following gentlemen, after having gone through the appointed examinations, and publicly defended their respective inaugural dissertations:
Geo. Hume Weatherhead,
Moses Stephen Buchanan,