21st. Pulse 166; has been delirious since the early part of the night; had two motions; condition same in other respects. Ordered sulph. quin. grs.vi. at 8 o'clock, to be repeated at 12 o'clock. Decoction serpentaria continued.

Evening. Condition same. Ordered sulph. quin. grs.iv., pulv. opii gr.4th. M.-to be repeated at intervals of four hours.

22d. Same condition; pulse 166; passed a restless night, starting, incoherent talking, &c. Quinine continued. At 11 o'clock, A.M., she was enveloped in a mustard poultice, allowed to remain fifteen minutes, and after being placed in a warm bath and washed, was removed to bed. Applied a blister of flies to the scalp; gave subm. hydrarg. grs.v., and continued the quinine. While she was in the poultice her forehead became moist, and on counting her pulse immediately after she was removed to bed, it was found to be reduced to 154.

Evening. Pulse reduced to 134; skin soft; more rational and calm. Quinine continued.

23d. Pulse 120; she is perfectly sensible; rested tolerably well through the night; countenance cheerful, and expresses herself as feeling much better. Quinine continued, and ordered ol. ricini 3 vi., which produced several consistent, bilious evacuations. She continued to improve slowly; desquamation commenced on the 30th and was general.

In this case there were many other remedies used, but the commencement of convalescence was marked by the salutary impression of the poultice, which was observed during its. application.

CASE IV-October 6th, 1843. J— W—, a bank of ficer, æt. about 27 years, was attacked four days ago with a chill, succeeded by nausea and vomiting; dry tongue; excessive thirst, great oppression about the epigastrium; pain in the head and back, and frequent pulse; skin moderately warm and dry. The treatment during this time consisted of mild mercurial and other laxatives, which produced moderate alvine evacuations, one bloodletting, sinapisms to the epigas

trium, and quinine when it was thought advisable. This morning, pulse 126, and small; excessive vomiting; surface generally cool; extremities very cold, the lower ones to within a few inches of the groin; copious diaphoresis about the head and face; countenance pale and somewhat sunken, and speaks but little above a whisper. Everything given by the mouth is thrown up almost immediately. Enveloped the extremities, and covered the thorax and abdomen with mustard poultices. About an hour after their application the system appeared to rally considerably, and as the stomach had become quiet, he was ordered to take sulph. quin. grs.iv., sulph. morph. gr.4th, made into a pill, with the ext. taraxaci q. s. The poultices were allowed to remain on about four hours, when, at his earnest request, they were removed. His pulse by this time had fallen to 92; surface generally warm; vomiting had ceased; expresses himself much relieved; says he felt a great oppression about the praecordia which is now entirely gone. Quinine was continued in six grain doses, and occasionally combined with gr. 4th morphine, for the succeeding 24 hours, which produced extreme restlessness. This, however, subsided a few hours after the discontinuance of the remedy-from which time he continued to convalesce without taking any more medicine.

In this case, the excessive irritability of the stomach precluded the use of internal remedies, until the most urgent symptoms had greatly subsided.

CASE V.-Wade, a lad, æt. about 7 years, has been sick for several days, and in the absence of Dr. Henry, the attending physician, I was called, Oct. 7th, 1843, at night. Found him with pulse 146, small and weak; deep coma and insensibility; surface generally cool; extremities very cold; clammy perspiration about the head and face. The friends had applied sinapisms to the extremities before my arrival, which, however, had failed to redden the skin. Ordered the extremities to be enveloped and the abdomen to be covered with mustard poultices. Nothing was given the patient by the mouth-he was left with the poultices on for about an hour

when he spoke. A little while after, he complained of the burning caused by them, and cried to have them removed. They were, however, allowed to remain on about two hours, when they were taken off; his pulse had by that time declined to 124; the patient was rational, and the surface of his body generally warm.

In the meantime, Dr. H. arrived, and we made the following prescription for the night:-sulph. quin., hydrarg. c. creta. ää grs. xxiv. M. in chart. xii., div., one to be given every second hour. They did not extend the poultices as high up on the extremities as I ordered, or as I generally do.

I did not see the case again, but was informed that he continued comparatively comfortable through the night, and convalesced slowly, the greatest subsequent annoyance being sores on his legs, which were occasioned by the poultice having been made too strong with mustard.

In a case of congestive fever, treated successfully, but which is too tedious to detail at length, I kept the extremities enveloped, and the chest and abdomen covered with the mustard poultice, for forty-eight hours-reapplying them every four or five hours.

In the treatment especially of those diseases which depend upon a want of balance in the circulation, and when the structural lesion is not very extensive, the mustard poultice used as I have recommended it, if not in itself a curative remedy, will, at least, frequently be found a powerful adjuvant.

October 23, 1844.

ART. II-A Case of Emphysema. By E. W. HARRIS, M. D., of Cape Girardeau county, Mo.

The report of Dr. Girdner's case of Emphysema induces me to publish the particulars of one similar to it in every respect.

Mr. C ง aged 40 years, received a gun-shot wound in 1841, the ball passing through the upper arm, and fracturing a rib, the lung being wounded by a spicula of bone.

I was called 24 hours after the accident occurred, and found him under the care and management of a German, who called himself doctor (one of the cold-water tribe). I found the patient enveloped in sheets-sheets, bed and all, deluged with cold-water; almost pulseless; the whole surface cold, and of a leaden hue; every part of the body enormously distended, the scrotum being swollen to the ordinary size of the adult head; every portion of cellular membrane seemed to be filled with air, the crepitus of which was distinct and audible.

The wet clothing was speedily removed, dry warmth applied, and diffusible stimulants given; under which, reaction was established in about six hours.

My German friend said to me, that "it ish de dhropsies; you must tap him." To the latter I assented, and punctured the scrotum, and the skin in some half dozen other places, from which punctures the air could be heard to escape with considerable force. The German, offended that it was not water, left. The patient, much relieved, set out in two days. for his home, in Illinois, and in a short time recovered perfectly.

An old hunter, who saw the above case, enquired of me the cause of the swelling, stating that he had frequently seen the same in deer when shot in the 'lights.'

November, 1844.

ART. III. Observations on Erysipelatous Fever, as it occur red in Memphis, Tennessee, in April and May, 1844, with a report of eight cases. By LEWIS SHANKS, M.D.

Preliminary to the observations we design making on the character and type of the erysipelatous fever, together with a report of the cases which occurred here, some general re

marks on the character of diseases as modified by the seasons, by the clearing up and improvement of the country and the city, and the change in the habits of the people, might be interesting and useful, and necessary to a clear understanding of our views of the nature and treatment of this disease.

When the diversity of opinions both in Europe and America, of the nature and proper treatment of erysipelatous fever is considered, it must be attributed, either to the blinding influence of prejudice, or to the influence of season, climate, local atmospheric causes, or the difference in the constitutional tone and vigor of the subjects of the disease in different places and countries. If to both causes, and especially to the latter, this difference of opinion among highly distinguished members of the profession, may be attributed; an additional reason is afforded for tracing up the influence of the causes, that may have operated in determining the type of the disease, and indicating the proper treatment in the cases that occurred here. So full and complete are the general descriptions of this disease and its treatment furnished by the most able medical writers, &c., especially by Dr. Nunneley of Leeds, that little seems left to be done, except the investigation and explanation of local and epidemic influences, which modify the type and violence of the disease in different places and at different times, requiring a corresponding difference in the treatment.

Though we have proposed this extended consideration of the causes, which tended to make up the medical constitution of the atmosphere the present year, in this region of country, and to give character and modification in some degree, to all diseases, as being interesting and useful; we do not design more than a brief reference to these causes, and to their effects, as manifested in the general character of diseases.

We have not only been constantly impressed with the observation ourselves, but we have frequently heard the remark made by intelligent and observing physicians, that disease is more or less inflammatory-that there is more or less tendency to disease of particular organs-that depletion is more