ten drops of the ol. succini every two hours. I found, on visiting him the next day, that he had not taken the ol. succini, as regularly as was prescribed: the convulsive affection having very much increased, with great difficulty both of respiration and deglution, I ordered him immediately forty drops of tinct. opii, and a tea-spoon full of vit, æther; put him into a warm bath for about ten minutes, with directions to repeat the laudanum and æther, every two or three hours, till the convulsions abated, unless a degree of stupor was produced. In the evening I found the convulsions rather less frequent and violent than in the morning. He had now taken between two and three hundred drops of the tinct. opii, and æther in the same proportion. Ordered the tinct. opii and æther to be continued, and likewise the valerian root tea.

Next morning, at 8 o'clock, he was perfectly quiet and comfortable, and I found he had been so since 12 o'clock. He lay in a quiet sleep, and, upon being waked, did not complain of any uneasiness in his head or stomach. Anticipating its return, about 9 o'clock, he was ordered sixty drops of tinct. opii, and a tea-spoon full of æther, immediately; but, notwithstanding which, it supervened about nine, with all its previous violence. The tinct. opii and æther were continued in large doses, and he took five drops of the arsenical solution every two and three hours. In the evening, there being but little alteration, all were continued as before he had taken about five hundred drops of the tinct. opii, through the day.

Upon seeing him the next day, I found he had taken the arsenic pretty regularly, as likewise the tinct. opii, æther, and valerian root tea; but there had been no intermission since the last visit. As he had taken in the

course of the last day about seven hundred drops of laudanum, I thought it best to try the effect of some of the other antispasmodics, and accordingly ordered him camphor and castor, each seven grains, every two hours; to continue the laudanum and æther, but not so often as before. The arsenic was the next day omitted, at the particular request of the parents.

Several days now elapsed, without any particular alteration. All the medicines were continued in larger doses, except the camphor and castor, which he refused to take, after the second day of its exhibition. He now took from ten to twelve hundred drops of the tinct. opii, in the course of the day. Frictions with æther and laudanum, hot brandy, and fomentations of the latter, were frequently made. As the medicines appeared to have very little effect upon him, I prescribed two grains of the oxyd of zinc, every three hours, at the same time to continue the tinct. opii. But little of the oxyd of zinc could be given him, as he refused to take any thing but the tinct. opii, which was now continued in smaller quantities, as the affection seemed on the decline. Before it entirely left him, he only took between two and three hundred drops in the course of the day.

During the whole course of the complaint, his bowels continued very regular, nor was his stomach or pulse affected, notwithstanding the large quantity of tinct. opii which he took.

A state of coma succeeded the subsultus, which was of several days continuance: though frequently he would open his eyes and ask for drink, and continued now to eat

very freely of his berries and milk. It was evident now, that the power of motion of the left side was entirely lost.

About the sixth day, after the convulsive affections ceased, his eyes appeared for the most part fixed, now and then staring about in a very wild manner: his pulse was much sunk he did not ask for drink, and, for the most part, refused it when offered, as there appeared to be great difficulty in swallowing. By the use of strong wine-whey, and spiced wine, as freely as it could be got down, he was in a day or two considerably revived, so that he ate and drank more freely again. The diabetic symptoms still continued, in proportion to the quantity of injesta. For several days he was unable to turn himself in bed, and as he lay upon his back, kept the well knee drawn up. A day or two after this, he was seized with great oppression in breathing, from an effusion of mucus into the bronchiæ, which he was unable to expectorate, and terminated the scene, about three weeks after the convulsive affection left him.

V. MOTT.

VII.

OBSERVATIONS on the beneficial effects of MERCURY in TYPHUS, which occurred on board the frigate Constellation, on her passage from the Mediterranean; in a letter to Dr. W. CURRIE, from Dr. ED. CUTBUSH. Communicated to the Editors, by Dr. CURRIE.

DEAR SIR,

Philadelphia, April 25th, 1804.

WITH pleasure, I communicate to you, the good effects of mercury in the treatment of typhus, on board

the United States' frigate Constellation. I would have performed my promise ere this, but my baggage, which contained my notes, did not arrive in Philadelphia, until a few days since. I shall not intrude on your time and patience, by tracing the origin of the disease; neither do I think it necessary to enter into a minute description of the various symptoms, as they occurred in various constitutions: the outline, I presume, will answer your purpose.

This disease commenced with more or less chill, alternating with heat, accompanied with an inactive, listless disposition; pain in the orbits of the eyes and forehead; giddiness, with great prostration of strength; pains in the back and limbs, particularly the lower extremities: some complained of acute pain in the thorax, with anxiety: the eyes were of a muddy, red, appearance, and suffused with tears; tongue furred and tremulous; pulse small and frequent; in some cases, a fullness was felt on the first and second day. As the disease advanced, the prostration of strength encreased; the stomach became extremely irritable, with some pain; the most bland fluids were ejected; the tongue changed to a leaden hue, in some it was black; the teeth were also covered with a dark coloured crust. The skin and eyes became yellow on the third or fourth day: the voice was so low as scarcely to be heard; deafness; subsultus tendinum; hiccup; convulsions; swellings of the parotid glands, with dark coloured blisters in the mouth: petechiæ appeared on several; and there was a hemorrhage from the ear and bowels of one man; in two, the discharge from the stomach resembled coffee-grounds. In many cases, the bowels were obstinately costive: more or less delirium

commenced with the disease. Some, after their recovery, were attacked with violent ophthalmia. In some instances, the pain complained of, in the extremities, continued many days, after a complete recovery from all febrile symp

toms.

The mode of cure, which I adopted, I conceive new, having never met with any authority recommending the mercurial treatment in Typhus, or Ship-fever. I remembered to have read a passage in Clarke, on long voyages, advising the trial of mercury, in the advanced stage of this disease, “when an engorgement of the brain takes place." I therefore determined, instead of waiting for this generally fatal state, to commence the cure by administering mercury in the place of the usual remedies, bark, wine, &c. &c. As soon as I was applied to, five, ten, or fifteen grains of calomel were given, combined with a sufficient quantity of tart. emetic, or ipecacuanha, to ensure a copious discharge from the stomach and bowels. The calomel was repeated at night, combined with opium, or pulv. Doveri : during the day, it was given in doses of two or three grains, every two hours, (care being taken to prevent it from running off by stool) until the mouth became touched, which, excepting in three or four cases, never exceeded the fifth or sixth day; in some instances, it was sore on the second. To effect this as soon as possible, I directed the body and extremities to be sponged with cold vinegar, or spirit and water, which seldom failed to determine the mercury to the salivary glands: in a few instances, I found it necessary to employ mercurial ointment. Blisters, when any were applied, were also dressed with it.