button about the size of a bean, rest on the inferior side of the tongue in the returning angle which it forms by its union with the inferior side of the mouth.

This instrument is scarcely fixed in its place, when, as I have said above, a confused and embarrassed voice is heard, very analogous to that which characterises the erosion or congenital division of the veil of the palate; but, what is remarkable, quite free from stuttering. The most difficult syllables are painfully articulated, but by no means repeated; and this favourable change still continues, even when the organs of speech, accustomed to the instrument, have recovered the freedom of their motions, and can pronounce sounds clearly articulate. However, if this mechanical support be too soon removed, the stuttering comes on as before; it must, therefore, be kept on a long time, and, when it is necessary to remove it, as for eating or sleeping, silence must be rigorously observed. I cannot precisely say how long it is necessary, being able to cite only two instances of a cure by this method. One was a young man twenty years of age; he kept this sort of bit in his mouth for a year and a half, and found it so little troublesome at last, that, during some months, he did not even take it out to eat. The perseverance with which he bore this apparatus arose from a motive which, at that age, will make one undertake and support any thing,-the hope of pleasing a young woman with whom he was violently in love, and whose coldness he attributed merely to his unfortunate stuttering. His complaint, indeed, was very bad, and subjected him to convulsive exacerbations of the muscles of the mouth, nose, and eye-lids, which made speaking both painful to himself and unpleasant to the company. His success was complete; but I never heard whether he obtained the object of his wishes.

The second object of my observation was a boy eleven years old, who could not feel the same motives for perseverance. He was very impatient with the instrument, and took it out of his mouth whenever he was not watched. Notwithstanding which, when he was brought to me after eight months, the stuttering was considerably diminished; and, though I have heard nothing more of him, I am almost certain that a few

months more would have completed a cure. At the moment I am writing this, a young man, passed thirty, who one day or other will take his hereditary seat in the Chamber of Peers, has subjected himself to the same treatment with a constancy and strength of mind inspired by the most noble motives. A sensible improvement, within a few weeks, gives me reason to think, that I shall not have undertaken his case in vain. The instrument which I have had made for this young man is much more perfect than those which I previously employed. I am indebted for it to the skilful hand of Pernet, the dentist. Moveable branches, shorter or longer, more or less divergent, allow the pressure on the muscles of the tongue to be increased, and the resting points to be varied. I have seconded the effects of these mechanical means by tonic gargles, made with an alcoholic tincture of bark, cantharides, and other stimuli.

There are few cases of stuttering in which this last method might not be used with advantage. I must, however, except that sort of stuttering (very rare indeed) in which the organs of the voice, much more than those of speech, appear to be the seat of that spasmodic hesitation which suddenly suspends the formation of words. It is perceptible from the sounds appearing, as it were, to be stopped in the larynx; and it becomes evident, if, on attempting to pronounce with some haste a long series of vowels, the difficulty still recurs. In this case, most advantage will be derived from the practice of vocal music, and particularly from that exercise of the voice which consists in stringing sounds together. These means may be seconded by some local tonics. Moxa, on the sides of the larynx, and the os hyoides, might have the happiest effect. I recommended it once in a stuttering of this kind; but, the patient taking alarm, it was not employed. In prescribing this mode of excitation, I was guided by the good effects which I have often observed from it in chronical aphonia, essential dumbness, and other lesions of the voice and speech, which will form the subject of another memoir.

Case of Varicella.-By Dr. M'Arthur, M. D. F. L. S. Walmer, Kent.

[From the Medico-Chirurgical Journal and Review, for January, 1818.]

THE frequently alleged failure of vaccination, in preventing small pox, is a matter of deep regret, because these reports prevent some parents from submitting their children to vaccination, since it does not promise them absolute security; and, therefore, in many parts of the kingdom, partly from this cause, and partly from the want of agreement amongst the medical practioners themselves, inoculation for small-pox is occasionally practised; and thus, a disease continues to be perpetuated, which the friends of humanity had hoped would have been banished by this time from the catalogue of human ills.

Within the last nine years my attention has been directed towards the supposed cases of small-pox which had succeeded vaccination, and many instances have been pointed out to me, but the disease in every case proved only a severe degree of chicken-pox; and I should have been led to suppose, that small pox as rarely occurred in a person that had been properly vaccinated, as after the inoculated small-pox itself, were it not proved to the contrary by the evidence of men of the first talents and respectability.

It is a trite observation, that diseases occurring during the prevalence of any epidemic, partake, in a considerable degree, of its nature and severity; and I have often remarked varicella to be more severe, when it has occurred at the time a bad kind of small-pox or measles has prevailed.

The preceding observations are intended to introduce a Case of chicken-pox, which for some days had deceived me; and had I quitted my patient on the fourth day of the eruption, I should have left her, persuaded that the disease was a case of legitimate small-pox; although some of the symptoms appeared earlier than common. I subjoin the Case in the ipsissima verba of the memoranda I took at the time.

VOL. VIII.

3 L

No. 32.

"I was this day, the 17th of June, 1816, requested to visit Miss M'K-, aged about 13 years. Had been vaccinated ten years ago at the Naval Hospital, and a cicatrice is evident on her right arm. Mr. Howell, a surgeon in the royal navy, and a friend of the family, states, that on Saturday last, the 15th instant, she complained of a loss of appetite, with pain and uneasiness in the region of the stomach; skin hot and dry; head-ach, anxiety, thirst, and some difficulty in swallowing, but unattended with pain. On Sunday the 16th, the febrile symptoms had increased; there was much delirium; pulse 150. Mr. H. abstracted ten ounces of blood from the arm, and opened her bowels with the sulphate of magnesia. This day delirium was less; heat of skin abated; pulse 150. An erythrematous inflammation occupies the face, neck, arms, and particularly the abdomen; but has not extended to the lower extremities. To be kept cool, and her bowels to be opened with the sulphate of magnesia. Tuesday the 18th, a crop of small pustules appears on the face and neck, and a few are appearing on the arms; the inflammation extends to the lower extremities; delirium gone. Wednesday the 19th, the eruption on the face and upper extremities very full; a considerable number has appeared on the lower extremities; no pustules on any part of the abdomen; the efflorescence has nearly disappeared on the face and arms; on the abdomen it is of a less vivid colour, and very much resembles the red-gum in children; pulse 100; tongue clean; some enlargement of the tonsils, and pain in swallowing. Thursday the 20th, pustules every where increasing in size, and more elevated; eye-lids swollen; soreness of the throat, and increased flow of saliva; pulse 96. Friday the 21st, pustules still increasing, and filling with a straw-coloured fluid; confluent on each side of the nose; eyes closed; pulse 100. Saturday the 22d, pustules on the face depressed and beginning to blacken; on the extremities they are stationary, containing a whey-like fluid; face less tumid; soreness of the throat abated; can open her eyes, and seems altogether better. Sunday the 23d, pustules on the face dry and shrivelled, those on the arms depressed; on the lower extremities they continue much as before: neither ptyalism nor soreness of the

throat. Monday, the scabs on the face are already nearly dropped off, leaving a horny elevation occupying the centre of each pustule; the eruption on the extremities disappearing. In a few days after this period, the scabs had entirely dropped off, leaving her in perfect health. The erythrematous inflammation which preceded the eruption of the pustules disappeared as the latter increased in size. It is singular, the pustules did not extend to any part of the abdomen."

Walmer, Deal, March 30, 1818.

On the Medicinal Properties of Stramonium; with illustrative Cases. By ALEXANDER MARCET, M. D. F. R. S. Physician to Guy's Hospital.

[From the Medico-Chirurgical Transactions, Volume VII. Part II.]

HAVING seen, within the last few months, several instances in which Stramonium, or the Thorn-apple*, taken internally in the form of extract, has appeared to relieve acute pains of various kinds, more effectually than any other narcotic medicine; and the properties of this plant, as an internal medicine, not having, to my knowledge, been yet particularly investigated or described by any English medical writer, I have thought it my duty to submit to the Society the result of my observations on this subject.

The inhalation of the smoke of the Datura Stramonium for the relief of asthma, a practice introduced within these few years, is, I believe, in some instances attended with unquestionable benefit, and is frequently resorted to in that disease. Indeed this plant, which grows wild in this and many other countries, and is more especially met with in dunghills and among rubbish, is now cultivated in some English gardens for

Datura Stramonium of Linnæus. An herbaceous plant, with a thick branched stalk, two or three feet high, large sinuated indented leaves, and long tubular white or purplish flowers succeeded by large, prickly, green, fleshy seed-vessels, which open at the end in four divisions, and disclose numerous black seeds. It flowers in July.