tent fever continued; and Mr. Reay perceiving some tendency to squinting, began to dread that it would terminate in hydrocephalus, and I was called in on May 14th, when I found the child very hot, with a rapid pulse; the alvine discharges ill digested and extremely offensive; the abdomen, though not tumid, felt doughy or inelastic; the tongue was furred; there was no marked impatience of light, the pupils regularly contracted, but the child occasionally screamed without apparent cause, and the urine was scanty. He had cut all the incisors, the canine teeth, and four of the first molares; smart doses of calomel and jalap, with a mixture containing squill, were prescribed, while the head was ordered to be kept cool by an evaporating lotion. 15th. Bowels freely moved, fever diminished, stools improved. 16th. At one this morning I was summoned, and found the child in a severe convulsive fit. Gums immediately freely divided, over the concealed molares. Leeches to the temples. Enemata. The warm bath. Dose of castor oil.

17th. To day decided symptoms of cerebral affection were present; impatience of light; frequent screaming; convulsive twitches of the limbs. Leeches again applied, and a large blister between the shoulders, reaching to the nape. Cold evaporating lotion to be kept constantly applied to the head. Calomel and jalap in repeated doses. 18th. Blister rose well, the cuticle was removed, and the raw surface dressed with unguentum hydrargyri 19th. Symptoms unchanged. The action of the bowels kept up by small doses of hydr. c. creta three times a day. To day there is strong strabismus: pupils much

dilated, and nearly insensible to light. Yesterday and to day all the other bad symptoms were increased; screaming more frequent; left side seemed paralytic, while the limbs on the right side were frequently and convulsively agitated. 20th. No improvement; cont. medicamenta. 21st. Repeat the blister as before, and again dress it with the mercurial ointment. Give a dose of castor oil to purge the bowels. 22nd. Bowels active; omit the hydrarg. c. creta: if necessary, give an enema. In the evening castor oil. Pulse, which had been rapid, generally, now between 70 and 80. Omit the cold applications to the head. 23rd. No improvement; urine nearly suppressed; eyes quite insensible to external objects, but he can swallow easily; calomel and jalap purge; enemata; nitre whey. 24th. Moaning and screaming very distressing; urine very scanty; one side quite paralytic, the other constantly agitated by convulsive twitches. Repeat the blister and dress it as before. Bowels rather costive. Castor oil and enemata. Omit the purgative powders. 25th. The child begins to be under the mercurial influence: blistered surface highly inflamed; simple cerate substituted for the mercurial ointment; enemata as before; convulsive motions less violent. 26th. Less convulsion. Cont. omnia ut heri. 27th. Urine considerably increased. Cont. 28th. Some undoubted signs of improvement; urine passed freely; twitching of limbs and screaming less violent; one of his front teeth loose; gums swelled; bowels freely open; some griping. Omit the castor oil. A few drops of tinct. camph. comp. to be occasionally given. 29th, 30th, 31st. Improvement pro

gressive, but slow; twitching and screaming much less frequent; nape of neck much inflamed and discharging freely; bowels open; some griping; urine copious; the paregoric appears to soothe him; anodyne at bed-time. June 1st. Favourable symptoms continue, but the eyes appear insensible to light, and the strabismus continues; pulse below 70, rather irregular. Conceiving that the inflammatory stage had subsided, but that the ventricles were still loaded, diuretics were continued, and a small blister was applied to the vertex, over the fontanelle, in the hope of promoting absorption. The bowels open, but much distended with flatus; for which a fœtid enema was given with relief. 2nd. Seems relieved; an opiate was given to-day, which allayed the convulsive motions of the limbs. 3rd. Repetantur enema folidum el haustus anodynus. h. s. 4th. Strabismus much diminished; urine in large quantity. Cont. omnia. 5th. Blister on vertex repeated. Bowels bound. Castor oil. 6th. Evident improvement in every respect. He now can distinguish external objects. The loose front tooth was removed by the fingers from the lower jaw, without pain to the child; its root was long, white and hollow. 8th. Eyes and limbs gradually recovering; urine very copious. 11th. Child so far recovered, that I discontinued my evening visits. An astringent lotion was prescribed for the mouth: the bowels being sluggish, a dose of castor oil was recommended every second day. After the 18th I only saw him twice professionally; Mr. Reay ceased to attend him on the 11th July, and he was soon in vigorous health. The boy remains quite well, and has no mark of having

suffered from disease, except the loss of the two front teeth of the lower jaw; the second having been shed in the end of 1830. His countenance is naturally pale, but he has a healthy look; his limbs are strong and muscular; his habits active and lively; his intellect very acute.

Dec. 1832.

THOS. STEWART TRAILL.

VOL. I.

N

A PROPOSAL

TO ESTABLISH

COUNTY NATURAL HISTORY SOCIETIES,

FOR ASCERTAINING THE CIRCUMSTANCES, IN ALL LOCALITIES,

WHICH ARE

PRODUCTIVE OF DISEASE OR CONDUCIVE TO HEALTH.

BY J. CONOLLY, M. D. WARWICK,

Late Professor of the Practice of Medicine in the London University, &c.

AMONG the objects contemplated in the formation of the Provincial Medical and Surgical Association, next to that of promoting the courteous feelings and that interchange of opinions which are alike honourable and advantageous to persons of a liberal profession, there appears to me to be none more important than one which provincial practitioners seem to possess peculiar opportunities of advancing. At the same time, it is one so comprehensive, as to be only fully expressed in three out of the five heads under which the objects of the Association are stated, in the tenth page of the Introductory Address. To this object, therefore, I beg leave to draw the attention of the readers of the Transactions, in the hope that the suggestions with which I mean to conclude will be found both practical and conducive to many extremely useful ends.