guine in my expectation that the pulsation would have ceased, as I have known two instances, one of a wounded radial artery, and the other of aneurism of the anterior tibial, in which the tumor continued to grow by anastomosis, after the arteries had been tied above the swellings.

February 21, 1809.

A case of Exposure to the Vapour of Burning Charcoal.

BY WILLIAM BABINGTON, M. D. F. R. S.

Senior Physician to Guy's Hospital.

From the Medical and Chirurgical Transactions.

A CONSIDERABLE degree of interest having been excited by the melancholy accident which occurred at the Dolphin, a public house, in Honey-lane Market, on the morning of the 24th of November last, I am induced to offer to the consideration of the society the following statement with some reflections on the subject of it.

William Smith, aged thirty-eight, a waiter belonging to the house, and a boy about thirteen years old had, on the preceding night, gone to their bed-room, both in perfect health, and it was supposed under ordinary circumstances. Between six and seven o'clock in the morning, neither of them having been then seen, a person went to the chamber, and on opening the door found the waiter insensible, and apparently at the point of death; the poor lad lying lifeless on the floor, and a chafingdish containing some extinguished charcoal placed at the foot of the bedstead. The one who still exhibited signs of life was removed into a larger and more airy apartment; and Mr. Hingeston, of Cheapside, being called, and finding that with stertorous breathing the countenance was rather flushed, the lips livid, the pulse full and strong, and as he conjectured, about ninety in the minute, was induced to take away eight, or at most ten ounces of blood from a vein in the left arm. At his request I attended to give what assistance might lie in my power. It was little more than seven o'clock when I reached the house, and having been informed of the circumstances under which these unfortunate persons had been discovered, as

the respiration, pulse, and heat of him who had been removed into a cool and pure air were distinctly perceptible, I thought it my duty to determine, by actual experiment, whether any thing could be done for the recovery of his companion. With this object in view, a common sized silver catheter being passed from the mouth into the trachea, an artificial process of respiration was instituted by the aid of my friend Mr. Hingeston, and that of his assistant Mr. Gingell, alternately breathing into the lungs, and forcing out the air so introduced by means of external pressure.

While these gentlemen were engaged in this process, I went to my friend Mr. Allen, in Plough Court, to request his cooperation in the trial of the galvanic influence, as one of the most ready and satisfactory modes of ascertaining whether any remains of life still existed to encourage our further exertions. In this interval the waiter, whom I had visited as I was quitting the house, had evidently become worse, and the artificial respiration having produced no effect on the boy, we passed several shocks from the galvanic trough, which we had previously found to be acting with considerable power, through his chest and head; but these being equally unproductive of any visible excitement we were reluctantly compelled to think that he had in reality passed from sleep to death. As we now perceived that the vital powers were in Smith still further enfeebled, and that unless more active steps were taken, there was reason to think that he also would fall a victim to the accident, we transferred the galvanic apparatus to his apartment, the window of which being open, and there being no fire, the temperature was necessarily that of the atmosphere, about 50 degrees of Fahrenheit. At this time his pulse, instead of being strong and full, as before the bleeding, was weak and quick, and the respirations very imperfect; but the heat of the upper part of the body remained. The power of voluntary motion was suspended, and the slight convulsive twitchings of the muscles which at first prevailed had altogether ceased; ordinary impressions no longer appeared to affect his organs of sense. His countenance was pale, the eyelids closed, the eyes prominent and rolling in their sockets from side to side; the tongue swollen and projected from the mouth, was locked in this position by a spasmodic action of the muscles which raise the lower jaw. At

the corners of the mouth there was a copious discharge of frothy saliva. Having passed a galvanic shock through the chest, he instantly to our surprise, drew his breath deep. The muscles of the abdomen were seen to react, though feebly, while those of the face were slightly convulsed, and the eyelids were raised. At each successive application of this powerful agent the respirations were more forcibly performed, and the stroke of the artery at the wrist rose in the same proportion. Having, between eight and nine o'clock, procured a bladder filled with oxygen gas, we caused it to be inspired, and we thought that it was followed by an increased activity of the powers of respiration and circulation. As the heat of the body was not deficient, we now sprinkled the face and chest with cold water, which also had the effect of rousing the dormant powers of sensation, as the respiratory muscles were uniformly thrown by it into action, though in a more feeble and interrupted manner than when we employed the galvanic influence. About nine o'clock, having received a large supply of oxygen gas, we repeated the inhalation and the galvanic succussions alternately, through the chest and head, every half hour, till twelve o'clock, when the galvanic application was discontinued, as the heart, though uniformly excited by it, seemed in the intervals to act more feebly, and we were apprehensive that by exalting the action of one power continually, we might destroy that equilibrium of forces which is necessary to the maintenance of life. Some volatile spirit of hartshorn was rubbed upon the temples and chest, and the vapour of it inhaled; the latter rendered him uneasy and excited coughing. As the extremities were cold, bottles filled with hot water were applied to his feet, and the trunk of the body covered with the bed clothes. About one the surface became moist, and gradually a warm perspiration was diffused over the whole body. The pulse from this time was uniformly fuller and more equable in strength and frequency, and as the respirations became more free, the inhalation of the oxygen was repeated at longer intervals, and about four in the afternoon was entirely desisted from. The spasm of the jaw having subsided in a great degree, and the tongue being reduced, he was allowed some very weak wine and water, which he swallowed, a tea spoonful at a time, without any apparent difficulty. The pulse had now risen to 120, and was

strong; we, therefore, in the early part of the evening, considered of the propriety of further venesection; but as the apoplectic stertor was evidently not so great, we determined not to interfere with the efforts of nature; accident, however, accomplished what we had hesitated to do, the ligature having slipped from his arm, he lost, before it was noticed, nearly a pound of blood; the pulse sunk, his countenance collapsed, and Mr. Hingeston, who saw him at this period, was apprehensive that he would not survive the debilitating influence of this accidental hemorrhage. At twelve at night he had, however, recovered from this depression; the pulse was 120, full, but soft. Repeated glysters had procured a copious stool, and fomentations of the belly had been followed by a free discharge of urine. He was now very restless, and Mr. Gingell kindly stayed with a relation of the poor man during the night, when the exertions of both were requisite to keep him from injuring himself, and rolling out of bed. On the 25th, he recovered the use of speech, though very imperfectly. The tongue, when put out, pointed to the left, and the muscles on that side of the face were slightly paralysed, as they had been occasionally observed to be on the preceding day; he complained, when questioned, of pain in his left side; referred to the spot where the wire from the galvanic trough had been applied, and also in his left arm and hand, the latter of which was swelled; the orifice in the arm did not, however, exhibit any signs of inflammation. The cough, which had occasionally distressed him the preceding day, was still rather troublesome. His mental powers seemed much impaired, and he cried bitterly when any person entered the room, a state of imbecility frequently observed in cases of ordinary palsy. He did not recollect one event, or one sensation from the time when on lying down between the hours of eleven and twelve, he saw the charcoal burning bright, till the second or third day after the accident, when he became conscious that he was in a strange room, and felt great distress from being in a situation of which he could form no adequate and satisfactory conception. As the tongue was white, the temperature rather augmented to the touch, and the pulse full, he was kept on a low diet, and the bowels regularly purged. He progressively recovered so far as to be removed by his relations in the course of a few days.

On December 15, he called at my house; at which time he only complained of a slight degree of weakness, more particularly felt in his left arm. His appetite was good. No affection of his head, nor febrile symptoms.

W. BABINGTON.

January 7, 1807.

REFLECTIONS.

THE vapour of burning charcoal has, from times of ancient date, been observed to exert a very deleterious influence on the life of animals; but it is only within these few years that its nature has been developed, and its mode of operating fully appreciated. Modern chemistry has clearly ascertained the composition of atmospheric air, and proved that its capacity for supporting life chiefly depends upon that constituent principle which, in the language of this science, has been denominated oxygen. It has likewise instructed us that there are many other aerial fluids which possess the ordinary physical properties of the atmosphere, but differ essentially from it in not being subservient to the purposes of respiration. They have hence been distinguished from it by the general term of irrespirable airs or gases, and are destructive of life either by the exclusion of what is necessary, or by the presence of principles directly injurious to vital energy. Even the atmosphere that we breathe may, by this very process, as well as by various circumstances of chemical combination, be either itself deteriorated, or it may be impregnated with other fluids, and thus be rendered incapable of supporting the function of respiration. We find that the burning of bodies is one of the most common, but effectual ways of producing this change, which analysis teaches us it does by the abstraction or condensation of the oxygenous portion of atmospheric air, and the evolution of new products corresponding with the nature of the inflammable substance which is made the subject of the experiment.

When charcoal in combustion combines with oxygen we obtain carbonic acid gas, and at the same time in proportion to its moisture, more or less hydrocarbonous gas is evolved. The latter is peculiarly fatal to life, and very much increases the danger resulting from exposure to the vapour of burning fuel. The only attempt ever made to breathe it in its undiluted state