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an enema of starch with tincture of opium. From this time she failed rapidly, her diarrhæa continuing, until the 15th, when she expired.
On the morning after death I examined the cavities of the thorax and abdomen, The lungs were healthy in their appearance, but the left lobe adhered extensively to the pleura costalis. The heart was rather small, but healthy; the pericardium contained a little more fluid than usual.
On viewing the viscera of the abdomen in situ naturali, the following circumstances were noticed. The omentum was small, and destitute of fat. The small intestines were of their natural colour, and bad their usual polish. The large intestines appeared more dark-coloured than usual, particularly certain parts. These were, the cæcum; the first portion of the colon, in extent, about five or six inches; and its latter portion, in extent, about three or four inches. In these parts the vessels seemed filled, as if by injection; but the peritoneal coat had its usual polish. The liver was larger than nátural, and extended quite into the left hypochondrium. Its' right lobe was thickened, and was both hard and more dark-coloured than the left lobe. The galla bladder was full, and of its natural form: its duct, and those connected with it, were pervious. The spleen and pancreas appeared in all respects sound.
The alimentary canal was laid open through its whole ex. tent, except the gullet. The stomach contained air with a. dark-coloured fluid, not offensive in smell, and in quantity about half a pint. The small intestines contained a fuïda not very dissimilar to that in the stomach, except that in the
of the ileum it had more consistence, and resem. bled dark moist clay. Through the small intestines there was not any vestige of disease, except that the valvulæ con. niventes were preternaturally pale, and destitute of mucus, On Jaying open the large intestines, there were evident marks of disease. These were seen in the cæcum, and in the first and last portions of the colon. In these parts the mucous membrane was very red, and much swollen; the surface was rough, but did not exbibit any appearance of ulceration. The diseased portions of the intestines felt nearly as thick again as the healthy portions. The inflammation extended all around the bowel, and terminated abruptly. The large intestines contained a' dark-coloured matter, similar to that which the patient had voided for some days previous to her death. One of the mesenteric glands was enlarged and indurated. It is worthy remark that there was not found, in any сс 9
part of the alimentary canal, any thing resembling, in the smallest degree, the peculiar substances which the patient lrad discharged so abundantly during life.--New-England Journal.
For the London Medical and Physical Journal. On the Author of the Theory concerning the Secretion of Pus;
by JAMES CURRY, M.D. FOR your being the first in communicating to the British
faculty the ingenious and candid critique, by the NewEngland Journalists, upon Caldwell's Notes, &c. on Cullen's First Lines, accept my grateful acknowledgment. I equally approve of your candour respecting the disputed claim to the Glandular theory of Suppuration, and trust that the opinion which I have taught in the medical school of Guy's Hospital for sixteen years past, will, when explained, not be found to call for more than the “regret" you express“ at hearing of such doctrines being promulgated in one of the London schools” (Med. and Phys. Journal, No. 222 for July 1817, note *, on p. 103), viz. that Dr. Morgan of Philadel. phia, and not Mr. John Hunter, was the first who affirmed that pus was a secretion. Now, sir, I am proud thus publicly to avow, that, in the doctrines I have taught, and, God willing, shall ever teach, I have never been guided by any other motive than a sincere belief of their being well founded ; and that, although not devoid of national partiality, where that is justifiable, I have never yet sacrificed truth to national attachment. On this ground alone I bave always followed the precept of detur digniori, and awarded praise where praise was justly due, without a moment's considera. tion of the claimant's æra, or country: “Tros Tyriusve nuhi nullo discrimine agetur'.” Although, perhaps, in a practical view, the question respecting the formation of pus is of little consequence, yet I have always been impressed with a conviction, that what many hold to be mere speculative questions in science, are, nevertheless, worthy of notice, upon this principle, that, in natural knowledge, every fact has a bearing, however remote, upon some other and more important ones, which, perhaps, yet remain to be discovered, but which this seemingly insulated one will serve to illustrate and confirm. Thinking so, I could not pass over unnoticed a point which had been successively laboured on by Boerhaave, Grashius, De Haen, Quesnay, Pringle, Morgan, and John
Hunter; and, allowing any merit to the glandular theory, I could not avoid giving that merit to Dr. Morgan, who discussed the question with great ingenuity in his Inaugural Dissertation, on taking his degree at Edinburgh in 1763; whilst I could find no proof that Mr. Hunter bad taught, or even adopted, such opinion, until a considerably later period: for Sir Everard Home, who, in 1788, published a “ Dissertation on the Properties of Pus,” and claims the merit of the doctrine as entirely belonging to Mr. Hunter, has altogether forgotten to support his claim, by stating at what time it was first formed and promulgated by him. It is, indeed, very possible, that Sir Everard did not think such a step at all necessary; for he never once notices Dr. Morgan's Thesis, and inight not even know that any such thing existed. It is often said, and, in certain things, I think it true, that we grow fond of early opinions, and more tenacious of them as we become older ; but I shall feel sincere gratification in being set right, if I am wrong, upon this point, and shall not fail to make the amende honorable to the memory of John Hunter, by transferring from Dr. Morgan to our British Machaon the exclusive claim to originality. I may here remark, by the way, that the first hint of this doctrine will be found in Dr. Simson's "Tractatus de Re Medica," published in 1740, in which he asks, “may not an issue be considered as performing the office of a gland?" and I think it not improbable but that Dr. Morgan took this hint, as Simson's book, though now little valued or read, was then common in the hands of students at Edinburgh.
After having said so much upon this question, it may seem odd that I should wind up by stating that I believe the doctrine itself untrue, nay more, that it is even completely overturned by the very experiments which have been adduced in its favour. The detail of arguments, however, to prove what I here advance, would take up much more time than I can at present allot to it; but, should the question be thought worthy of farther discussion, I pledge myself to inake good the conclusion I have drawn. Bridge-street, Blackfriars;
August 1, 1817.
We shall feel extremely thankful to Dr. Curry by the honour of a further communication on this interesting subject; and we trust Mr. Hunter's friends will not be backward in defending their master.-EDIT,
ANECDOTES, FACTS, EXTRACTS, ILLUSTRATIONS,
QUERIES, SUGGESTIONS, &c.
RELATING TO THE
History or the Art of Medicine, and the Auxiliary Sciences.
Quicquid aguut medici,
nostri farragó libelli.
Account of Medicine and Surgery in the Islands of Tonga in the
Pacific Ocean. (From Dr. MARTIN's Account of those Islands,
collected from Mr. MARINER, a shipwrecked sailor.) THERE are a few particulars in this account worthy of notice,
principally their amputations and extirpation of the testicle without a ligature to stop the bleeding.
The Author's Account of Tetanus, &c. We have observed in the before-mentioned case that the wound was not washed, and it may here be noticed, that in all cases of considerable wounds produced by pointed instruments the patient is not allowed to wash himself till he is tolerably well recovereil, por: toʻshave, cut his hair, nor his nails: for all these things they say are liable to produce gita (tetanus), unless the wound be of such a nature, and in such a situation, that it may with safety be first laid completely open, then there is no danger. Mr. Mariner never witnessed a case of "tetanus produced by these means; but he met with many who said they had seen it in persons who had got nearly well of their wounds: but, happening to wash theniselves too soon, spasm supervened, and death was the consequence. They notice that wounds in the extremities, particularly in the feet and bands, are liable to produce tetanus; also, in persons already wounded, sudden alarms, or even any :sudden' noise that calls the attentiou abruptly, is liable to produce this complaint. They never allow females to be near men thus wounded, lest the mere stimulus of venereal desire should induce this dangerous complaint. As to cutting the hair and nails, they positively assert that the mere sensation of these simple and common operations has not unfrequently been productive of these dreadful consequences. The man whose case we have just mentioned was eight months without being washed, shaved, or having had his hair or nails cút.
Gita is a disease very common among the Tonga people; but still more common among the natives of the Fiji islands, who, froin their warlike habits, are more frequently in the way of it: they adopt, however, a remedy which the Tonga people have borrowed
of them, and consists in the operation of Locolósi, or passing a reed first wetted with saliva into the urethra, so as to occasion a considerable irritation, and discharge of blood; and, if the general spasın is very violent, they make a seton of this passage, by passing down a double thread, looped over the end of the reed, and when it is felt in the perineum they cut down upon it, seize hold of the thread, and withdraw the reed, so that the two ends of the thread hang from the orifice of the uretira, and the doubled part from the artificial opening in the perinænm; the thread is occasionally drawn backwards and forwards, which excites very great pain, and abundant discharge of blood. The latter operation Mr. Mariner has seen performed several times; but only twice for tetanus, arising in both instances from wounds in the foot: in these cases the spasıns, but particularly the convulsive paroxysms, were exceedingly violent, extending to the whole body, neck, face, trunk, and extremities: but in neither case was the jaw permanently locked, though on every accession it was violently closed for a few seconds. A native of the Fiji islands performed one operation, and Hala A'pi A'pi the other: they both happened at Vavaoo, at different times. In either case the disease caine on suddenly, three or four days after the wound was received, which was from an arrow not barbed. The moment the symptoms became evident, tocolosi was performed. In the short space of two hours one of them was greatly relieved, and the other in about six or eight hours. The following day the one on whom Hala A'pi A'pi operated was quite well, and afterwards had no other attack; consequently the thread was withdrawn: but the other on the second day was not quite free froin spasmodic symptoms, and, a paroxysm coming on, the seton was moved frequently, which iu two or three hours gave him great relief, and he afterwards had no other attack: it was thought prudent, however, to keep in the seton till the fourth or fifth day, when it was withdrawn. The effect of this operation was a considerable pain and tumefaction of the penis, but which gradually subsided (in about five or six days): the artificial openings in both cases healed spontaneously, without any difficulty.
These are the only two cases of tetanus in which this operation was performed that Mr. Mariner can speak of with certainty, having been an eyewitness of them. He heard of several others at the Hapai islands, at the island of Tonga, &c. some of which were equally for tunate. From what he has heard and seen of the success of this operation at the Tonga islands, he is disposed to believe that about three or four in ten recover by the aid of it. The Fiji islanders, however, speak of the happy effects of this singular mode of cure with much more confidence than the natives of Tonga; but, as they claim the merit of the discovery, they are probably rather too profuse in praise of it.
Tetanus is not the only disease for the cure of which the operation of tocolósi is performed: it is adopted also in cases of wounds in the abdomen, upon the mistaken notion that any extravasated blood in the cavity of the abdomen is capable of passing off by the discharge from the urethra, Mr. Mariner saw the operation per