19

tained inviolate, or destructionto the society ensues. But wemay add, by way of exculpation,

Quid quisque vilet, nunquamhomini satis,

Cautum est in laoras.

MR. REED’s INSTRUMENT.

We have been informed thatMr. Reed’s Instrument was late-

ly tried, in a case where arsenichad been taken into the stomach,but without snccess. The gen-tleman who performed the ex-periment is, we understand, Mr.Gurney, the Author of Lectureson Chemistry.

HOSPITAL REPORTS.

ST. THOMAS’S HOSPITAL.

CASE OF CHRONICHYDROCEPHALUS.

The following- is an extreme-ly curious case. We have usedthe Latin language on this oc-casion, because some of the de-tails of this case are of a naturewhich, though interesting in aphysiological point of view,miht perhaps be objected to byfastidious readers.

J. Cardifial, annos viginti no-vem natus, in hoc Nosocomium,admissus est, mense Aprilis, an-no 1822, hydrocephalo chronicoaffectus, Mater ejus dicit, caputfilii vel die natali majusculumesse quam infantibus comnure

sit, idque panlatim increvisse,donee annum ?etatis quintum at-tigerat, quo tempore caput taliserat magnitudinis qualem hodioinspicere licet. Corporis exiguiest ægrotans ; statura quinquepedum, et quinque pollicum ; fa-des macilenta, oculi subfusci,vox actita, membra extenuata,sed nulla, ut videtur, organorum! de’iclentia. Caput ejus magni-tudinis mirabilis; eircnmferen-tia 33 pollicum ; spatium adextrema utriusque auris 20½ pol-licam; a tullerositate occipitisad apicem nasiemetitum 21 3x pollicum: Summo capitis depressioest quam nctatissima; os frontissatis promiuens; tuberositas oc-cipitis projecta. Circa duos pol-lices snnra tuberositatem crani-um valde projectum. Infra quin-qtie fere proximos annos Coiwul-sionibus epilepticis laboravit,qniblls maxime affligi solet, ubianimus aliquo modo iritatur.Convulsiones qnoque fere menserecurrunt; signa paroxysmunipræcedentia sunt torpor posteri-oris partis capitis prope os pari-etale dextrum, dolorque acutissi-mus in regione occipitis. Di-gestio haud mala; alvus vero

aliquando torridus, iisqtie tem-pnribus rectirrit epilepsis. Nonpotest plusquam pauca spatiaambulando conficere, quoniamcaput ejus enorme cito-vertiginecorripitur. Appetentia cibi na-turalis ; interdum qttoque sto-machum geniali cerevisiae haus-tu reficit. Capilli capitis rigidi,nulla barbae sigl1a; ipse vero

affirmat sibi -ter quaterve annoopus esse tonsoris auxillo. Con-gressum venerum nunquam ini-vit ; erectiones verohabet Patu-rales, coitusque voluptates vehe-mentissime desiderat ; interdum

20

poscit, efflagitat. Prorsus singu-laris est hujus hominis status

physicus, quum de his rebus in-terrogaiar. Color certus in ge-nas alioqui pallidas ruit; oculimicant, os semihiulcum cachin-no distenditur, totumque corpusnescio qua pectur batione agita-ri videtur. Nescit an semen us-quam noctibus emiserit; benedormit, salusque generalis, utdicitur, minime prava. Nonnun-quam lectione animum recreat,necars scribendi ei prorsus ig-nota; quæ legere solet baudequidem memoria tenet, sed li-

ris religiosis maxime g-audet,Satis sorte contestus videtur di-citque se nunquam velle e noso-

. comio egredi.

, OCT. 25. —Half-past 8, a.m.— ,

Edmund E-, aged 42, waggon-driver, Merrywith, Kent, wasadmitted into St. Thomas’s Hos-pital (Luke’s ward), under thecare of- Mr. Tyrell, at three- o’clock this morning, with a

wound of the head and a frac-ture of the right os humeri;; says that yesterday- morning,(October 24th) at nine o’clock,whilst driving- the waggon, hewas thrown from the seat-boardon the ground: when it hap-pened, he was asleep, which wasowing- to some spirits and por-ter that he had taken that even- ’,ing. The upper arm is much ,,

swollen, and fractured oblique-ly in the centre ; there is a

slight extravasation on the in-side of the middle of the arm,and a depression. On the

rightside, -just at the top of the tem-poral- fossa, is a wound of thescalp, which extends from aninch above the helix, and a little

posterior to it, obliquely upwards.

and outwards, to about 3 inchesabove the right external angularprocess of the os frontis; andfrom near the termination of this

anteriorly proceeds another, witha widened base, to the anteriorand superior angle of the pari-etal bone.. The pericranium isdivided to the extent of half acrown, and the upper part of thetemporal muscle is wounded;the skull is not fr’actured.

The patient is 5 feet 5 incheshigh ; ’; stout ; plethoric -- inthe habit of living, freely, anddrinking plentifully of spirits-Lying on his back in bed, in adrowsy state; when asked anyquestion he answers it coherent-ly, and then falls in a doze again- Countenance flushed—Eyes,when exposed to the light, ac-tive—Pupils small.—Skin hotand dry—Tongue, red. at theextreme edges, then of a palewhite in the outer half, and alight brown in the inner half-dry.--Has no desire to eat but is is

very thirsty.—Bowels open oncesince the accident.—Has notmade any water since he was atstool, 3 o’clock this ,morn,ing.- Respiration 22, laborious:breathes by the whole chest andabdominal muscles.-Can take afull inspiration without pain.-Pulse 96, full, but may be easilycompressed.-Heart’s actioilcor-responds to that of- the pulse.-Abdomen full, but not painful ;complains of pain only in thehead and arm, and in those partsto’ no great degree.—Has notbeen sick since the accident.-11. a. m. pulse 96, full, pain in theright side of the head.—Breathsmelling strong of spirits; ,

Y. S, ad xviii, ’

21

Towards the termination ofthe bleeding became pale, andslightly faint.

½ p. II. a. m.-Very thirsty,- pulse more frequent thanbefore the bleeding, but lessfull, more compressible, 112,still pretty full. - Respiration30. - Had some buttered rolland tea for breakfast.—The headwas shaved, and the partsbrought as close in contact as

possible, by means of adhesiveplaster, but at the extremity ofthe wound anteriorly, a portionof the scalp was wanting, andcorresponding to this the bonewas denuded--Head bandag-e wasapplied, and a poultice over.-The arm was placed on a pillowand the fore arm bent on the

body ; spirit wash applied.R Extract. Col. Comp. gr: x.

Hydrarg. Subm: gr v: . M. capt.statim.

8. p. m. Has been dozing eversince the morning, complains ofa numbness in his head, and

smarting in his arm.-Respira-tion more general, 22.-’-pulse 80.not so full.-Bowels not openedsince 3 a. m.—not so thirsty.Tongue moist and of a palewhi’e.R Olei Ricini jHas taken some milk and

bread since the morning. ’

N. B. Blood buffed and cupped.. Oct. 20. 10. a. m. Bowelsopened 5 times since yesterday.- Passed a restless night, onaccount of lying in an uneasyposition, and disturbed his arma good deal.—Breathing a littlesonorous,24.—Complains of painno where except in his back,

which aches a little.-p. 96. full.no pain on pressure in the abdo-men. -Tongue red at the tip andedges.-Has taken a basin ofmilk for breakfast.-Pupils na-tural.

8. p. m. Wound was dressedthis afternoon, edges rough, andseparated considerably.-Feels

comfortable.—Bowels open oncesince the morning.—Pulse 84,soft.R Infus. Rosee, cum sulph :

mag:, cochl : jj. mag : ter die.

Oct. 27. p. 8. Passed abetter night; cheerful, says thathe thinks- the head bandagewas applied too tight, as he feelsa numbness in the head; thearm has not been disturbed dur-

ing the night; lying on a paddedsplint, in a half-extended posi-tion, with the fore arm inclinedtowards his body, and his hand

resting on a small pad. -Tonguenot so moist as yesterday, butnot more furred -Respiration24, easy.-Breathing not so son-orous.-Pulse 78, soft.

4. p. m. Has complained ofuneasiness in his head duringthe day.—Wound was’-dressedthis afternoon, begins to dis-

charge imatter offensive ; rednessand swelling down the rightside of the neck.-Bowels openonce during the day.-Pulse 96,rather hard. Has taken nothingbut a little milk and some rice

pudding.—Respiration 26, moresonorous.

V. S. ad viii.28. Was disturbed in the night

by a noise in the ward.-Heedpainful in the night.- - * Red bin hdown the other side of the neck.Feels easy at present.—Pulse 96,

22

easily compressed. - Bowelsmoved once in the night.—Res-piration 24, sonorous.—Skin na-tural--Dry cough.--Blood slight-ly buffed.—To the swelling’ onthe sides of the neck, spirit washis applied.

,

’

Oct. 29. The wound wasdressed yesterday with a simplebit of lim, and enveloped with alinseed meal poultice ; dischargesa good deal of thin plirifornimatter.—Passed a very goodnight, disturbed his arm a little.—Skin comfortable.—No.t thirs-ty.—Pulse 78, full.—Tonguepale white. Bowels moved

twice since yesterday.’ Pain attimes in the head.—Milk diet.--Continues the rose mixture.—Wound discharges a good dsal.,30. Did not sleep well last

night, from pain in his back.Tongue red at the lip and edge.Pulse 96 and soft. Skin cool.

Splints were applied all roundthe arm to-day.31. Slept well: » Free from

pain. Tongue cleaner. Pulse90, soft. Bowels open once

ince yesterday. Appetite riot

very good. Still thirsty. Gra-nulations beginning in one part.Healthy pus - copious, —Red-ness of the sides of the neckless.—Poultice, and openingmixture to be continued.

,. ,.

Nov. 1. Bowels open twicesince yesterday--Tongue cleanerPulse 72, fuller—Wound just thesame

e

Sunday, Nov. 2. Slept prettywell—Tongue moist, furred atthe- root) clean at the tip—Pulse96, soft—Bowels open twice

since yesterday’s report—Flatu-- lent—Still -on the milk diet-.’ Wound itches a little,and painful’ at times ; dressed twice a-day—Arm bound by four splints, wellpadded, placed on a pillow in ahalf-extended position—Swett-ing’ very much reduced.

Nov. 3. Slept very well lastnight—Bowels open once, copi-ous—Tongue much cleaner-Wound and arm doing- well--Pulse 72, soft.

’

Nov. 4. Sat up to-day forthree hours--Slept well--Bowelsopen once since yesterday-Tong’ue, appetite, &c. as yester-day—Pulse rather quick, 108.

Nov. 5. -Slept very well--Sitsup great part of the day--Woundbeginning to granulate, except-ing where the bone is denuded—Tongue covered with brown furat the root - Pulse 98, ratherhard - Arm disturbed in the

night—Bowels open once.Nov. 6. Disturbed m the night

by noise in the ward—Bowelsopen once-Other symptoms asyesterday.

’

,

Nov. 7. Tongue red at the

edges, furred in the middle—Pulse 102, full—Bowels not

open--Where the bone is dividedno granulations from the skinnear that part—Bones of theupper arm still ride.

It was found* that the gettingotit of bed) together with the ex-ercise of putting’ on his clothes,disturbed his arm, and he wasordered to keep iti bed and notget up ; this he did till the latterend of- November, by which timeho was able to get up and walk

23

about, firm union - of- the boneshaving taken place : he was kepton milk diet a little more than

three weeks after the accident,and after this lie was allowedeight ounces of animal food,and a pint of porter a-day. Thewound soon healed up where thebone was not denuded ; in that

pari, exfoliation of the outer tablecommenced, which was promot-ed by the application of piecesof lint wetted with nitric acidwash, and warm linseed mealpoultices, and about the 7th ofDecember a thin piece of bonecame out about the size over ofa penny. Since this, healthygranulations have sprung- tip inthe part, and he is now nearlywell. The right arm is a little sti1f.Up to the present time (January1st, 1824) he has kent his bowelsregular by the infusion of rosesand sulphate of magnesia, andexpects to leave the hospital inabout a week.

Henry Stephenson, ret. five,was admitted into Isaac’s ward,St. Thomas’s Hospital, underthe care of Mr. Tyrrell, Oct.2d,1823, with an affection of the

spine ; he also had strumous

opthalmia. The Following me-dicines were ordered for thechild :-

Hydrarg. subm. gr.j.Pulv. Rhæi gr. x. fiat pulv: se-

conda quaque nocte sumendns.Unguenti Cetacei pauxillum

ad oculos applicandum.Emplast. Lyttæ pone aurem,

which apparently relieved thechild.

On Tuesday evening, Oct. 14,was taken with sickness of thestomach, which continued -till

9 p. m. the next day ; he vomitedoften, but little at a time ; thecontents thrown np at first werewhite, afterwards black andsimilar to coffee grounds. Duringthis time some saline mixturewasadministered to the child; at 9p. m. (October 15th) when thesickness went off, the childbecame thirsty, but was verycheerful, and in an hour’s timeat 10 p. m. was taken in a con-vulsion fit and died. The childhas had none of the diseases in-cident to children, viz.-measles,small pox, &c. but was alwayssubject to great difficulty of

breathing’.N. B. This account- was ob-

tained. from the child’s nurse

after its death.

Inspectio cadaveris Stephen-son, aet. i ve years.

The body was examined thirty-seven hours after death, by Mr.Tyrrell, in’the presence of hisdressers, and some of the pupils.

. External Appearances.—Childthree feet long, stout, head large,countenance pale, slightly sal-low, extravasation under the softpart of the back, legs, arms,sides, front of the chest.

HEAD. -Vessels of the piamater were preternaturally dis-tended with blood’; throughoutthe whole of the cortical sub-stance there were minute redpoints,no water in the ventricles,plexus choroides redder than na-tural, and the pia mater, cover-ing the tuber annulare, appearedopaque. The brain was, of thenatural firmness, -bat- the left-

hemisphere appeared larger thanthe right.

24

CHEST.—On pening the chesta large - portion of the thymusgland’ was seen ort the upperpart, soft and flabby. The lungswere gorged with blood and ofa very livid colour all through,more so posteriorly than in front;of a knobby feel in some parts.Pleura was very red, but therewas no lymph on its surface,nor adhesions of it to the lungs;lower Jialf of -the trachea wasred on its internal surface, andthe bronchiæ were filled with athin, yellowisli .fluid. Bronchialglands on the left side very muchenlarged, and pressing- on thevessels and bronchia of that side.The heart was healthy; theblood in the veins had not coa-gulated ; there was a slight la-teral curve of the spine, and aposterior one ; body of the 10thdorsal vertebræ was nearly ab-sorbed.

ABDOMEN. — Stomach dis-

tended, -removed from the bodyand carfully examined. Con-tained half a pint of dark colour-ed fhlid,;. inner coat, natural ;liver of the natural size, -andonly a little paler than naturalbladder distended with bile ; in-

testines natural and empty, ex-

çêpting in the coecum, whichcontained a little faeces. Nothingelse was ascertained in the ab3o-men. SpinaT cord and mainarteries were not examined.r Jan. 1. An operation for ex-travasation of urine was, perform-ed here at 5 o’clock this after-noon, by Mr. Travers. The pa- .tient was 60 years of age, of astout, full,. plethoric habit, andhas been afflicted with a stricturefor some time past; and in thehabit of takirig large quantities

of porter; in fact, the extravasa-tion of - urine came on immedi-

ately after drinking freely. Theoperation was performed-by mak-ing a complete section of thescrotum, in the line of the raphedown to the urethra, which wasnot opened. By this means thescrotum, which was at the timethe patient was brought into theoperating theatre, of the size ofa very large melon, was nearlyreduced to its natural state; theparts were ordered to be foment-ed with warm water,-,and thenenveloped in a hot poultice., - , °

The accidents which have beenadmitted here this week, are afracture of the tibia, a fracture ofthe fibula, an injury to the thigh,and a, burn.,

’

GUY’S HOSPITAL.

Jan. 1, 1824.- Several acci-dents have been admitted hereduring the past week, some ofwhich are of a very serious, na-ture. The principal are, fractureof the skull, with depression;extensive laceration of the scalpand wound of the face, from thegrasp of a tigress’.- foot ; com-poupd fracture of the tibia,andtibula (slight) ; two cases pfsimple fracture of the tibia and.tibula; fracture of -the tibulaonly;- fracture or the ribs, -withinjury to the diaphragm,; frg-ture of the olecranon, and twocases of lacerated scalp-* ’,’

Fracture of - the Skull with De-a ,

’ pression. .’:’- Robert B.-. set. 14, was sd-mitted into Accident Ward, Sun-day, December 28, 2. p. ?. withan injury to the head. -Hi