conclusion does not follow the premises in the common logical form, but is drawn in direct contradiction to the premises. This may appear strange at first sight, but the reader shall have the sample of an argument in the common form, and one in the modern medical form: e. g.

The plague is a contagious disease. It has been and may be imported; therefore quarantines should be established, though at a considerable expense, to prevent the importation of that terrible disease. This is the old form of reasoning; and people in France and England reasoning in this manner, and acting accordingly, have long been exempted from the visitations of that disease. Here follows a specimen of the modern form of reasoning: viz. The yellow fever is a native disease. It is not contagious; it is not, and cannot be imported; therefore a host of officers should be kept up, at a great expense, to prevent it from being imported. In other words, to prevent the thing from being done which cannot be done. Would any man seriously advise that we should build a large fort and support a garrison at Albany, to prevent that city from being battered by ships of the line, when he knew that no such ship could come within fifty miles of the place? If such a man expected the command, his advice would be the more easily accounted for. But if he should get the command of such a garrison, he would hardly lose much of his sleep by watching.

Besides the circumstance mentioned, of medical men drawing their conclusions somewhat different from the common form, we have another reason for presuming that the question of the yellow fever being importable or not

importable, may be the subject of long debate. Gentle. men who say that the disease is not contagious, and cannot be imported, allege that it is generated among us like common bilious fevers, and from a similar source. Hence it follows, that if the fever breaks out, as it constantly does, in the neighbourhood of a ship that is just arrived from an infected port, or in the place where that ship is landing her cargo, or in the place where some of her passengers are lodged, we are not to infer that the disease has been imported in that ship, for it is not importable. We have only to search for some puddle or heap of manure that lies in sight of the ship, which is to be taken for the legitimate cause of the disease. Now, since there can be no difficulty in finding such objects or causes in every port, it will readily be perceived that the dispute may be perpetual.

AN OBSERVER.

V.

CASE of ENTERITIS, accompanied with a PRETER-NATURAL FORMATION of the Ileum. Communicated to the Editors of the American Medical and Philosophical Register, by JOHN W. FRANCIS, of New-York.

THE writer of the following paper was an eye-witness to most of the facts which he relates. They are taken from memoranda made at the request of his preceptor, Dr. David Hosack, in whose practice the case occurred. Should the editors of the Register consider it deserving a place in their journal, they are at liberty to insert it.

On the morning of December the 22d, 1809, Dr. Hơsack was requested to visit a Captain D—, aged about thirty-five; of a slender habit of body; who was represented to be in an alarming condition. At the first view of the patient, it was perceived that he was afflicted with all the symptoms characteristic of enteritis, accompanied with those of ileus; viz. an acute and constant pain in the whole abdominal region, particularly about the umbilicus : the abdomen greatly distended, hard, and extremely sensible to the slightest touch, or whenever he attempted to move: vomiting of stercoraceous matter, and constipated state of the bowels: pulse small, tense, and frequent; respiration hurried and anxious; countenance livid; heat of the body increased somewhat beyond its natural temperature; and excessive thirst. These symptoms were attended with a great prostration of strength, and an extreme degree of restlessness.

Upon inquiring into the history of his complaint, it ap peared that he had been first attacked while at the theatre, on Wednesday evening, the 20th. On the morning of the day following he was visited by an eminent physician, who directed an antispasmodic mixture, the symptoms of his disease being, at that time, but slight. Deriving no relief from the medicine prescribed, Dr. Hosack was called upon on Friday morning, the 22d, between the hours of eight and nine, when he found him labouring under all the symptoms above described.

From the best information that could be obtained, it was rendered highly probable, that the exciting cause of his complaint was cold. He had repeatedly been subjected to attacks of this kind, though less violent than the

present, for several years past; at which times he was relieved by the ordinary method of treatment.

1

Immediate recourse was now had to the lancet, and he lost blood to the amount of eighteen ounces. A cathartic, composed of the pulv. jalap. and sub-muriate of quicksilver, each ten grains, was directed to be given, which was rejected in about an hour after he had taken it; and a similar one repeated with the same result. Blisters were applied near the umbilicus; fomentations of vinegar and water over the whole abdomen; and enemata of the oleum ricini and tinct. assafœtid. were administered. These were partly discharged by vomiting; which afforded abundant proof, that an inverted action of the whole intestinal canal had already taken place. In the afternoon, the several applications to his surface were repeated; and during the remainder of the day he took, in divided doses, no less than two scruples of the sub-muriate of quicksilver, combined with opium and camphor; which, however, were rejected by vomiting shortly after they were taken. The enemata, rendered more active, were again given, but with no advantage. At this time Dr. Miller visited the patient, in conjunction with Dr. Post and Dr. Hosack. They united in recommending a continuance of the same mode of treatment that had been pursued. In this condition he passed the night; the constipation of the bowels obstinately resisting every means used to obtain an evacuation.

On the morning of the 23d, the sub-muriate of quicksilver, combined with opium, was again directed, in doses of fifteen grains every two hours. The warm bath was

at the same time employed. It produced a temporary mitigation of his symptoms; but left him still more enfeebled. His fate, which for some time had been probable, now became almost certain. The vomiting, which, within the first thirty hours from the commencement of his disease, had become stercoraceous, and which had continued, with but little intermission, to the present time, was now renewed. Attempts were made to allay it by the free use of the tincture of opium, and other remedies usually indicated under similar circumstances. The effect was an aggravation of all the symptoms. At 10 o'clock, P. M. his dissolution was momentarily expected, his pulse scarcely perceptible, and his extremities cold.

He expired on Sunday morning, the 24th, at 6 o'clock, the vomiting having been incessant until about twenty minutes before his death.

MORBID APPEARANCES ON DISSECTION.

At 2 o'clock in the afternoon, the body was examined in the presence of the attending physicians, and several other professional characters. The abdomen was tense and greatly distended: upon making a longitudinal incision into it, a considerable quantity of serous fluid issued out. Having completed the division, the intestines were found in a highly inflamed state, and of a dark red colour: the peritoneum lining the abdomen was also much inflamed, and covered with coagulable lymph. A remarkable deviation from the ordinary structure of the parts was now discovered to exist: a portion of intestine, attaching itself to the umbilicus, formed a union between it and a part of the intestinal canal. Upon further exa