There have been since the last year's report, nine amputations, `and three cut for the stone. The average number has been 49

in-patients, and 326 out-patients.

There has been always an inaccuracy in the auditor's report of the Charity, which is partly rectified in the foregoing; for under the admissions, the out-patients made in-patients, and the inpatients made out-patients, were always introduced. Although a patient thus changes his designation, and is moved from one book into the other, yet he forms but one admission to the hospital, and can be considered only as one patient. The full force of this error will be seen on referring to the report in the third volume of this Journal, page 315, where no less a number than 3152 more are entered on the table than actually applied for relief. This mistatement is not peculiar to Nottingham; it is to be observed in the reports from other hospitals. The Norwich has carefully avoided this error; and very properly explains by a note the apparent difference between the admissions and discharges, which is even a more satisfactory method than the one adopted in this paper. The erroneous statement just pointed out, precludes the possibility of making any thing like a correct comparative estimate of the expenses of the Charity, or in fact any other calculation, for which it may be necessary to specify the actual number of individuals admitted on the books.

The table of diseases which closes this report, may be divided in three heads of practice.

Cases of Apparent Paralysis of the Lower Extremities removed, by the Patient being attacked with Hepatitis and Gout. By Mr MELLOR, Surgeon, Stafford.

AY 23.-Mrs H

aged 40, full habit of body, menses regular; has been unwell a month or five weeks; complaining of general debility; great weakness and numbness of the lower

extremities; has now much pain in the lower part of the back, sacrum, and pelvis. On examination of the spine, she complained of great tenderness of the sacrum and back; she cannot walk, or even stand, without being supported, nor can she turn herself in bed, or move the lower extremities. The bowels are very costive; the bladder appears to be paralytic, as she does not part with her urine oftener than once in 24 hours, and then in the quantity of two quarts; the skin is cool; tongue clean; pulse 80, and soft.

She was ordered to take six grains of calomel immediately, and a purging mixture every four hours afterwards, composed of sulphas magnes. infus. sennæ, and pulv. jalapii. This procured several large evacuations. She was then directed to take a mixture with gum guaiacum; also to rub the spine with lin. volat., to use the warm bath every day, and to apply a blister to the sa→

crum.

May 30th.-Complains of much pain in the epigastric and right hypochondriac regions; is completely jaundiced; has a short troublesome cough; the skin hot; tongue parched, and loaded with a yellow fur; great thirst; pulse 110, full and hard. An inflammation of a rose colour has attacked the outside of the right foot, which extends towards the toes, attended with swelling and great pain; the urine is in small quantity; makes it more frequent than she did, and it is very yellow; stools of a dirty white.

I bled her to the quantity of sixteen ounces; put her upon the antiphlogistic plan; gave her saline medicines with nitr. and vin. antim.; purged her smartly every day with calomel and infus. of senna, and pulv. jalap. The blood was highly inflamed; she was bled again on the 31st; also on the first of June, and on the fifth.

June 2d. The gout has attacked the other foot.

June 4th.-The inflammation has attacked both hands, and even extends to the fingers; the feet are better; has more feeling in her legs, and can move them a little; in other respects much the same. Ordered to continue her present plan.

June 6th.-Feels much relieved by the last bleeding; the pain and inflammation of the feet gone; has more feeling in her legs, and can move them better.

June 8th.-Is in every respect better.

June 12th-Is in a convalescent state; the numbness of the lower extremities gone; and she is able to walk with a little assistance.

June 20th.-I saw her; found her well in every respect, and able to walk as well as usual; the bladder has recovered its tone,

and she has the inclination to part with her water three or four times within every twenty-four hours. The pain and tenderness of the spine, sacrum, and pelvis, and also the numbness of the limbs, are entirely removed.

If she had not been attacked with this violent inflammatory disease, would she have become paralytic ?

Case of Hæmorrhoea Petechialis, successfully treated. July 20th.-ANN MOORE, 7 years of age, has been unwell near a fortnight; complaining of lassitude and great debility; has gradually lost her flesh; her appetite is good; tongue rather brown; great thirst; skin cool, pulse 90, but rather feeble; belly open. Five days ago, there appeared petechiæ upon the face, neck, arms, and every part of the body; the petechiae were as thick in the skin as the eruption of the measles; she has bled for several nights frequently at the nose, and for an hour or two at a time; her shift is stained in spots all over with pale blood; there is also a spot on the inside of the knee, about the size of half a crown, as if it had been bruised, and of a yellowish colour.

Ordered to take a decoction of bark, with the muriated tincture of iron. To eat fresh animal food; ripe fruits; vegetables; to drink half a pint of port wine, diluted with an equal quantity of water, every twenty four hours; and to sponge the body every four hours with cold vinegar and water.

August 1st. Has bled a great deal from the nose; appetite good; sleeps well; petechiae and hæmorrhage from the skin much the same. Ordered to continue her medicines.

August 5th.-Appears better; has had no return of the hæ morrhage from the nose; that from the skin less; tongue moister; thirst less; appetite good; petechiae are beginning to change colour, from being livid to a yellowish appearance; says she is stronger, and is able to run about and play with her companions as usual. Medicines continued.

August 12th.-Petechia have almost disappeared, and she is in every respect perfectly well. The bark and tincture are recommended to be taken three times a-day for a fortnight longer.

Two Cases where Bleeding, so as to produce Syncope, cured the Disease immediately, without the aid of Medicine.

MISS NEEDAM, aged 18, apparently of a full habit, pale complexion, but delicate constitution, short chest, has for the last two years been subject to violent attacks of spasmodic asthma, and an incessant, short, and irritable cough.

October 15th-Was attacked after dancing with the cough, which is incessant, recurring every second of time, and which VOL. VII. NO. 26.

K

appears to arise entirely from irritation; she has no pain or difficulty in breathing; pulse soft, but frequent; she has been coughing without intermission thirty-six hours; has taken opium, æther, camphor, assafoetida, and inhaled the steam of warm water, and also the vapour of æther, but without the slightest good effect. I bled her from a large orifice to the quantity of twelve ounces, until she fainted; she was very sick, and vomited a good deal. The cough immediately ceased, and did not return in the slightest degree again.

Mrs S, aged 36, spare habit, had been subject to attacks of acute rheumatism; complains of violent and acute pains in her knees, ancles, elbows and wrists; is unable to walk without the support of two persons; skin cool; tongue rather white; pulse 80, but full, and rather hard; urine high-coloured; joints not swelled or inflamed.

I bled her from a large orifice, to the quantity of sixteen ounces; she fainted, and vomited, and was near an hour in recovering. I called upon her the next morning; found her busy in her domestic affairs; said she had had a very good night; was entirely free from pain, and could walk as well as usual; and has had no return of her disease.

III.

3.

1. Case in which the Larvae of an Insect were voided in the Urine. 2. Cases of Poisoning by Foxglove and Corrosive Sublimate. Remarks on Enlargement of the Heart. In a Letter to Dr DUNCAN, jun. from WILLIAM HENRY, M. D. F. R. S. Physician to the Manchester Infirmary.

I

HAD intended to send you an account of the first of the following cases, and had transcribed it from my notes for the purpose, before the number of your Journal fell into my hands, which contains Dr Bateman's valuable communication on a similar subject. As it does not appear, however, that any instance: had occurred within the experience of that writer, in which larvæ were discharged from the urinary passages, I have not relinquished my intention of transmitting the case, along with some