evacuations, for which he had been under treatment for several months. The remedies which he had employed, consisted principally of mercurial preparations, with dietetic regimen. He commenced the bath at about 104 degrees, and sweated profusely, each time augmenting the temperature, till it reached to between 115 and 120 degrees. His liver was much benefited; his stools became more natural; the eruption much faded, and his general health decidedly improved. He was in the habit of taking several tumblers of cold water while in the bath; and neither in his case, nor in any other in which this usage was followed, did any bad consequences result. The whole system was highly excited, more heated perhaps than in the height of summer; and yet no prostration, no pain, no inconvenience of any kind, was the result. Whether the perfect safety of drinking cold water under these circumstances can be attributed to its being unconnected with fatigue and intemperance, which are generally associated with those terrible cases of cold drinking in the summer season, we will not undertake to decide. It may be proper also to mention, that this gentleman's hair, which of late had fallen out considerably, became under the use of the bath strengthened and thickened. The same effect was observed in other cases.

but here the benefit terminated. Indeed, in one case, the inhalation of so much warm vapor seemed to excite too much phlogosis in the stomach, as the patient was worse after taking several baths, and attributed to them this effect. It is probable, that benefit might be derived from a partial bath. For instance, a dyspeptic invalid might be enclosed as high only as the epigastrium, thereby avoiding the inhalation of the vapor; at the same time the abdomen might be freely rubbed with a flesh brush.

A robust Irishman was attacked with violent inflammation of the kidneys, and sympathetic spasms about the heart. Several bleedings, large doses of laudanum, external applications, and pediluvia succeeded in moderating the symptoms; but there remained a distressing dysuria, the urine being voided by a few drops at a time, mixed with blood, and a considerable flatulence and tumefaction of the abdomen. Nothing made any impression on these symptoms, till he took the vapor bath at as high a temperature, and as long as his strength would permit. He afterwards urinated freely and without pain, his bowels became regular, and he was soon convalescent. A slight fever was developed after the bath.

A case of hemicrania of some standing was perfectly cured by six baths.

the system. A physician of Charleston informed us, that salivation was induced by the bath, in a patient who was at the time taking Swaim's Panacea, strengthening the supposition, that, sometimes at least, mercury, in some shape, is contained in this nostrum. Erysipelas was one of the diseases which yielded readily and kindly to the influence of the vapor bath, and some cases of much interest presented themselves to our notice; but fearful that we have already entered too much into detail in this paper, we shall ouit any particular mention of these, as well as of other cases, and hasten to draw our remarks to a close.

The cases we have mentioned were generally of those, who inhaled the vapor in addition to having the surface of the body exposed to its influence; and the peculiar odor of some of the articles, through which the steam passed, was not unfrequently perceived in the urine of the bathers after coming out of the bath. This was the case with myself, after placing a sponge filled with balsam copaiba in the receiver.

It was customary to enter the bath at a low temperature, and afterwards gradually to increase its heat. One physician, however, for the sake of experiment, allowed the temperature to rise as high as 120 degrees, before he entered; and he describes his sensations as similar to those, which he had experienced when taking a cold bath.

In conclusion, it may safely be asserted, that the vapor bath, as a remedy, is possessed of uncommon powers, and that by not employing it more frequently, our

physicians deprive themselves of a most valuable adjuvant. The preceding account, with the few interesting cases noticed, will, we hope, attract their attention to it, and we are satisfied they will never regret the time spent in investigating its merits.

We are glad to see and publish so good a report on the character and effects of the vapor bath, for as a remedy vapor bathing is far less

known and esteemed both by physicians and the people than it ought to be, and soon will be. From considerable attention to the subject, we cannot agree with this intelligent reporter, that the inhaling of the va por causes inflammation of the stomach, or that it has any tendency of this kind. So far as we may be permitted to form an opinion after nearly two years' attention to its operation, we are fully persuaded that when the bath is properly taken for any other complaint, its influence on dyspepsia is always more or less beneficial. As to temperature we are also fully satisfied that to produce any good result the heat never need be carried so far as to be unpleasant. Enter the bath at about 90 of Fahr. and let it gradually rise till it comes to be of the most pleasant degree of warmth, and a more or less copious perspiration, and every other good effect will be secured which the process is capable of effecting. This is the general rule, to be varied so as to suit particular cases. Some persons are warmer and perspire earlier and more freely than others, and there are other circumstances of individual peculiarities. In catame

Dial obstruction, and in difficult, painful, and insufficient menstruation, the vapor bath, impregnated with camphor, often affords immediate and complete relief.

DISEASE OF THE KNEE JOINT.

By J. SUMMERS, Esa. The following case may be regarded as interesting, in as much as different opinions were advanced, and various remedies were employed for its improvement without success. For the particulars in the treatment I am indebted to Mr. Rule, an eminent surgeon of Guernsey.-It appears that Captain Mansell, R. N., applied to this gentleman respecting a lameness in the knee joint, in August, 1821. He had been, however, under the care of another gentleman in the same place, previous to this period. But, it appears, that the abstraction of blood was the only remedy employed by the individual in question. Under these circumstances, Mr. Rule was induced to adopt the following plan of treatment, namely.-The application of friction, with the soap liniment and opium, which was continued for forty minutes, night and morning; and a pill, composed of blue pill and colocynth, every night. Some advantage was supposed to be derived from this plan of treatment, soon after its adoption; but this gentleman candidly admits that it was discontinued on the 29th of May, as "little good from the practice then appeared." He, consequently, "reversed the plan," and applied a lotion of ammonia, with vinegar and rosewater till the 4th of June. The result was, however, by no means

favorable. A large blister round the joint was next applied, and the effect of this remedy appeared at first, to be productive of great benefit; so much so, as to induce this gentleman to suppose, that a continuation of the same plan would be sufficient to produce the desired effect. Consequently, a second blister was applied on the 12th, when the symptoms of improvement beforementioned entirely disappeared; and the "puffy enlargement of the joint returned with rather increased violence." The blister was, however, kept open till the 24th. On the same day Mr. R. had recourse to friction a second time, with mercurial ointment and camphor. This plan was pursued till the 2d of July, when emetic tartar was used in addition to the former. These remedies were continued till the 16th, when a soap plaster and a bandage were applied till the 7th of August; after which time a mercurial plaster and bandage were prescribed. As these remedies failed in producing the desired effect, Captain Mansell consulted Mr. Scott, of Bromley. The plan this gentleman pursued was different from the former, as blood was abstracted, by means of cupping, and the knee bandaged, without the least advantage to the patient. Captain Mansell being apprehensive that the injury of which he complained might prove to be of serious consequence to him, requested the opinion of Sir Astley Cooper, who declared it to be his opinion, that the tumefaction complained of, was the consequence of disease of the capsular ligament; and the learned baronet was likewise of opinion, that the

only remedy calculated to effect a cure, was a perpetual blister for a month. Instructions to this effect were accordingly given in writing. But this distinguished officer, having minutely observed the effects produced by blisters, when under the care of Mr. Rule, and having recollected his observations respecting them, resolved not to adhere to this advice, notwithstanding the high authority from which it emanated. In consequence of this determination, Captain Mansell favored me with a visit, the object of which was, to have my opinion of the case. At the same time this gentleman furnished me with a statement of the opinions and practice of those who had previously seen and attended the case. After the perusal of which, I was convinced that every endeavor had been used for the removal of the malady, according to the system generally pursued; but that there was an exciting cause in existence, which rendered such powerful measures useless,was equally certain. The only course, therefore, which I resolved to pursue, was minutely to inspect the joint, and thereby endeavor to ascertain whether any change in the position of the joint had taken place, which might be regarded as a source of irritation; though little doubt can be entertained that distortion does take place in extensive disease of joints. It is, however, equally certain, that a trivial injury, occasioned by walking exercise, has proved to be a source of irritation; and consequently, resisted every remedy which was directed for the removal of the tumefaction occasioned by it. This case proved to be one of this description. As

I observed, on examination of it, that the knee was slightly everted, and the patella displaced, and that there was contraction of the biceps muscle, which contributed to maintain the knee in the position already mentioned. The tumefaction was considerably increased by the displacement of the patella, inasmuch as the powerful ligament, which connects it with the tibia, appears more prominent. Under these circumstances, I resolved to ascertain how far the injury before described would influence the tumefaction, which had occasioned so much anxiety. I dispelled the contraction of the flexor muscle, in the manner described on a former occasion; and also accomplished the replacement of the patella, which caused a diminution of the swelling in this part. A bandage was likewise applied, in order to afford support; and in some degree, to maintain the joint in a favorable position. Under such circumstances, I have occasionally used them, but I have not perceived any other advantage derived from bandaging, notwithstanding the unbounded applause which has been conferred on the advocates for this plan of treatment in diseases of the joints. Captain Mansell had been in the habit of taking a considerable portion of walking exercise previous to the appearance of this injury; and though he is not conscious of meeting with an accident, it is by no means improbable that the injury referred to originated from this cause. This circumstance becomes more evident, when it is considered, that in proportion as the position of the limb was improved, a diminution of the swelling took place; so that at the ex