caufe certainly occafions an eflential and specific difference, for a venereal or fchrophulous ophthalmy is very diftinct from one occafioned by cold or irritation. The fecond diftinction our author confiders as the leaft important, though in a practical view, it is of great confequence; for no one would give the purgatives in peripneumony, which are abfolutely effential in phrenitis, or the opium in hepatitis, which is fo particularly adapted to enteritis. The third divifion we fufpect is not an accurate one. The inflammation of the skin is ftyled eryfipelas, of the cellular membrane phlegmon; the inflammations of the diaphanous membranes, as the p', ura, peritoneum, &c. are fuppofed to be different from thofe of the mucous membranes, or the mufcular fibres. That the eryfipelas is a peculiar difeafe of the fkin, may be admitted to a certain extent; but there are inflammations, which in their symptoms come fo near to eryfipelas, though the feat is different, that by common confent they have obtained the name. Thus, the peritonæal inflammation in puerperal fever, is ftyled eryfipelatous: the peripneumonia typhodes has had a fimilar appellation. We mean not to affert that this is correct; but thofe who have attended the progrefs and termination of thefe complaints will be prepoffeffed in its favour. There are, however, facts on the other hand; and a peripneumony, decidedly from cold, has fometimes, under our own eyes, affumed a putrid appearance, when a putrid fomes has been present in the system. The eryfipelatous fore throat is on a more certain foundation, though, while the ephelion is a continuation of the skin, it can fcarcely be adduced in oppofition to our author's fyftem, which we mean not to oppofe: we have only fuggested these doubts for future elucidation. That cryfipelas is always the effect of acrimony, another of the pofitions which Dr. Smyth oppofes, may alfo occafion fome difficulties. Heat and cold will undoubtedly induce it; but restrained or hurried perspiration may be as certainly accounted acrimonious as any poison introduced. In the third article of this volume, eryfipelas came on, by the puncture of a tendon; and though we suggested doubts of its caufe, we thought, if our recollection was not inaccurate, that other inftances of a fimilar kind might have been adduced. We ought however to add, that, on tracing the fuppofed facts, we have not been able to difcover them; and the inftance which occurred to us may have been a folitary one; or symptoms of general irritation, with which the fkin will occafionally fympathife, may have been the foundation. That there is generally an acrimony, may be shown from the fpreading nature of the disease, and the utility of dry powders. Our author's conclufions, with the answer to one 5bjection, we fhall felect.

Do not the preceding facts naturally lead to the following conclufions? ft. That the eryfipelas is an inflammation of the fkin only. adly. That the peculiarity of this inflammation depends folely on the nature and texture of the fkin. 3dly. That acrimony, though a frequent caufe, is by no means the only one capable of producing it. And 4thly. That though the difference of the cause cannot in this inftance alter the nature, yet it has confiderable influence on the appearance and fymptoms of the disease.

To the first conclufion it may be objected, that as the eryfipelatous inflammation fometimes recedes, or is repelled from the skin, and attacks other parts of the body, particularly the brain and lungs, thofe parts, as well as the fkin, must be fubject to this affection. The obfervation is certainly juft, but not the inference. I admit, that the fame caufe which produced inflammation of the fkin may equally excite it any where elfe: but it does not follow, that those inflammations, though arifing from the fame caufe, fhould be of a fimilar nature, when the part affected is fo extremely different. I affirm on the contrary, that there is not the smallest refemblance between the fymptoms of the eryfipelas of the head, and the delirium or coma which is brought on by this inflammation receding and affecting the brain: nor, to invert the propofition, is the peripneumony occafioned by the retroceffion of the meafles (an inflammation analogous to the eryfipelas) in any refpect different from the fame disease produced by other causes.'

These cafes of retroceding eryfipelas are different from the eryfipelatous affections we just now mentioned. Dr. Smyth is ftrictly accurate in his remarks; but it may be questioned how far thefe inftances are truly metaftafes. We have often feen delirium fupervene on erysipelas, as well as peripneumony; but they have either feemed new attacks, accidentally varied, or concomitant affections. In the other parts of the paper our author is fufficiently correct; and, if he fails in explaining the nature of critical abfceffes and their connection with fever, he fails with every other pathologift; and no one will fucceed, till the nature of fever is better afcertained.The acute rheumatism is probably not so much a disease of the mufcular fibres, as of the coats of the veffels.

XX. A Cafe of Inverfion of the Uterus. By Robert Cleghorn, M. D. Profeffor of Materia Medica in the University of Glasgow. This unfortunate woman furvived the accident, and the uterus remained inve d. Dr. Cleghorn's remarks on this and fimilar cafes are judicious and practical. His reading on the subject is alfo extenfive. The following circumstances are very properly pointed out, as neceffary to be kept in view.

ift. The quantity of blood discharged. Whenever that is uncommonly copious, especially when the ftrength finks fpeedily,

the patient ought to be examined most carefully without losing a

moment.

zdly. The nature and degree of the pains which remain after delivery. Fatigue, diftention of parts, and other obvious, caufes, always do, and always must leave a fenfation of foreness after the pains of labour. This fenfation, however, which often gives way to a gentle fleep, is not only inferior in degree, but is' different in kind from the horrible pangs which accompany the inverted uterus. The back, the loins, the fore-part of the belly and the thighs, are all exquifitely painful, while the uterus is' thrown into convulfive contraction, fo that the patient imagines fhe is about to bear a fecond child, or to lofe fome part of her bowels. Her ftrength finks apace; the extremities grow cold; a clammy sweat bedews the forehead and breaft; the pulfe ftops; excefs of fatigue procures no reft; the patient falls into a fyncope, from which the is never roufed, or roused only by convul. fions and delirium.

If, therefore, after the delivery of the placenta, violent expulfive pains, equalling or exceeding in feverity thofe which attended birth, shall attack the patient, the ought to be examined inftantly. Such an examination, unless the operator be deficient in skill or tenderness, can do no harm, and it may fave life. That it is fo frequently neglected in the beginning of fuch melancholy cafes, is unpardonable: for, when the bottom of the uterus at first falls through the os uteri, it can be for the moit part eafily replaced, if no fpafm has come on.'

XXI. The Hiftory of a Contraction of the Fore-arm and Fingers, with fome Remarks and Reflections on Bleeding in the Arm, By Mr. Henry Watfon, F. R. S. Senior Surgeon of the Westminster Hofpital.-The contraction arofe from the irritation of the tendinons fafcia, and was removed by dividing the biceps longitudinally, and continuing the divifion from the flesh into the tendon, below that part where it fends off the fafcia. The relief was almoft inftantaneous.

XXII. A fingular Cafe of Abfcefs of the Liver which terminated favourably. By George Sandeman, M. D. Physician to the General Difpenfary.-The cure was not effected by art: the abfcefs burst into the intestines or into the ducts, and the matter was discharged by ftool. The recovery was rapid and complete. If the application of a blifter had occurred, it would have faved much trouble, for, in that way, the matter might have been perhaps drawn off.

XXIII. A Cafe of a Rupture of the Bladder, from a Fall. By Mr. Charles Montagu, Surgeon of the Weftern Difpenfary. The accident was occafioned, as the title imports, by a fall, probably when the bladder was diftended. It is how

ever furprising, that though the rupture would admit the hand to pafs through, eight ounces of water were drawn off by the catheter the morning after the accident, and, at another time, a pint of urine of the natural colour.

XXIV. A Cafe of Hydrophobia. By Mr. John O'Donnel, Apothecary in London.-An inítance of a dreadful disease, but in no refpect a peculiar one.

XXV. On the Medicinal Properties of the Muriated Barytes. By Adair Crawford, M. D. F. R. S. Physician to St. Thomas's Hofpital. - Muriated barytes, probably a metallic falt, in a large dose, is certainly injurious: in a small one, it promotes a flow of urine, warms and apparently stimulates the ftomach, and feems to be a powerful alterant. When any fever is prefent in the fyftem, it is found to be injurious. The beft effects were produced by it, in doses of from three to feven drops, in fchrophula, incipient cancers, and fchirri. In the laft ftages of cancer, and in confumption, it did no fervice. Dr. Smyth defcribes the method of preparing the medicine, and afcertaining its purity; but thefe directions cannot be given in an abridgment. The barytes of Stronteam in Scotland, feems to be an earth, in fome effential refpects different from the earth commonly distinguished by this name in chemical authors.

XXVI. A Cafe of Dropfy, in which the Water. has been twice drawn off by tapping the Vagina. By Sir William Bishop, Knt. Surgeon at Maidstone in Kent.-The operation, in the way prefcribed, was peculiarly easy, as the vagina was protruded by the weight of the water.

XXVII. Two Letters from John Collins, Efq. of the Island of St. Vincent, addreffed to Benjamin Vaughan, Efq. of London, on the Subject of a Species of Angina Maligna, and the Ufe of Capficum in that and feveral other Diseases. --In these inftances, as well as in fome epidemics, when the disease prevails in Europe, the affection of the throat was the primary complaint. The recipe we fhall transcribe :

Take two table spoonfuls of fmall red pepper, or three of the common cayenne pepper, and two tea fpoonfuls of fine falt, beat them into a paste, and then add to them half a pint of boiling water. Strain off the liquor when cold, and add to it half a pint of very sharp vinegar. Let a table spoonful of this liquor be taken every half hour, as a dofe for an adult; diminishing it in proportion for children.'

From the earliest period of our practice we have seen common pepper eaten with great advantage.

XXVIII. Account of an Exfoliation of the internal surface

of

of the Tibia, removed by the Application of the Trephine. By Mr. Thomas Whately, Surgeon. This account is not very fingular in any refpect, nor does the operator's address deferve any very particular encomium.

XXIX. Some Account of the Invention and Ufe of the Lever of Roonhuyfen. By Robert Bland, M. D.-Dr. Bland's hiftory of the lever is curious, and his directions for the ufe of this inftrument are judicious and proper. It is an unfuitable fubject of difcuffion in a popular work; nor will the directions admit of an analyfis. We do not, however, perceive the advantages which Roonhuyfen's lever poffefles over the fingle blade of Dr. Leake's forceps.

XXX. An Account of a very uncommon Blindness in the Eyes of newly-born Children. By Mr. Samuel Farar, Surgeon at Deptford.-A fingular occurrence, where the three fucceffive children of the fame parents were born with the cornea opaque, but gradually acquiring pellucidity. In the last child the recovery was very flow.

XXXI. Three Inftances of fudden Death, with the Appearances on Diffection. By James Carmichael Smyth, M. D. Fellow of the College of Phyficians, and of the Royal Society; and Physician Extraordinary to his Majefty.-In the first in ftance, there was an occafional pain of the stomach, though flight: the death was fudden, by the internal coats being corroded, and the peritoneal coat at last bursting in confequence, probably, of the exertion of vomiting. There was an inflammation of the peritoneum feemingly occafioned by the ftimulus of the fluids efcaping through the wound. In the fecond cafe, the fudden death was fubfequent to a fever with aphthæ, in which there had been some affection of the lungs : it was owing to a fudden effufion of blood, or of bloody ferum, into the lungs: the blood was in a diffolved state, and hæmorrhages after fevers had not been uncommon. The third was an inftance of croop, lefs acute than the usual disease of children, owing to a humour in the back part of the larynx, seemingly of a conglobate gland, which had partially and incompletely fuppurated.

XXXII. Of the Danger of wounding the epigastric Artery in the Operation of Tapping for the Afcites. By the fame. The accident of wounding fome confiderable branch of the epigaftric artery feems not be fo uncommon as has been fuppofed. Perhaps the inflammations in the bowels, and other unexpected accidents, which fometimes happen after tapping, may be owing to the artery leaking internally.

XXXIII. Of the Aphonia Spafmodica. By the fame.In the three cafes of aphonia fpafmodica here related, the two laft are feemingly paralytic or apoplectic, That the disease

fome