ten far beyond the worth of their services, and in part by the medical profession. So soon as a woman determines to become a nurse, she should put herself under the instruction and direction of some respectable physician till he can say that he deems her to be well qualified and disposed to perform the important and responsible duties of her office. A woman so qualified and disposed would not want employment. This recommendation of the physician should be revoked the moment the agent is found to be unworthy of it. Physicians should speak of nurses as they find them, and of course should recommend no one of the many who are either incorrigibly stupid, selfish or unprincipled. They should not be employed till somebody who is intelligeut and honest can and will recommend them. The bad should not be tolerated, they should be dismissed; and the faithful, kind and attentive nurse should be treated with kindness and approbation; not caressed till she is spoiled by her own imaginary importance, but like a rational being who has done well and is entitled, in the proper manner, to know that she has the approbation and good wishes of those whom she has faithfully served in a trying and oftentimes difficult and responsible occupation. We have seen a worthy nurse in tears because she had been unkindly and severely blamed and chided, where she deserved only approbation and encouragement. No family should employ a physician who is not worthy of the respect and confidence of his patients, and these should consult him as a friend, seeking the information they need, making known to him all their doubts, wants, and complaints. This would afford the best practicable security against quacks, officious neighbors. and assuming, selfsufficient nurses. This would break up that practice which too many mothers fall into, of secretly consulting the nurse respecting a number of little ailments for which the nurse always has a remedy, and is permitted to use it without the knowledge of the physician. Thus these little complaints, by mismanagement not unfrequently become, as every physician has seen, serious, if not fatal maladies. We feel that we have but just entered on this subject, which might be pursued much further, we are admonished, however, to stop, and can only refer the whole matter to the consideration of those concerned in the correction of existing evils and abuses. NOTICE. The 5th volume of the Medical Intelligencer will close with the third quarter, No. 39, February 12, 1828; this will make a book of 624 octavo pages, one sufficiently large and of more convenient size than the entire Index will be furnished to subscri52 numbers, would have made. An bers. Those who have recently be back numbers so as to complete the gun to take the paper can obtain the volume for binding if desired. Some copies of the 4th volume, bound or unbound, may be had at this office. A physician writes from New York catarrh was becoming frequent, on that the weather was cold, and that the 15th instant. ADVERTISEMENTS. MEDICINES AND SURGICAL THEODORE DEXTER offers for sale SELLERS & ROSE, CUTLERS AND SURGICAL INSTRUMENT 344, Washington St., opposite Avery St. A cutlery are made, ground, repaired, polished, honed, &c., with the finest edge for use. New penknife blades are fitted to old handles. S. & R. make the needles for Acupuncture, of any size, agreeably to order. MEDICINAL PLANTS. A LARGE supply of Herbs, Extracts &c. has been lately received, as prepared in the best manner of the Shakers. Among these are Rose Flowers, Poppy do. Sweet Marjoram, Balm, a small quantity of Liverwort, Slippery Elm Bark, pulverized for internal and external use; Mockerson Root, &c. &c. Constantly for sale, at Wholesale and Retail by Joseph Kidder, 70 Court Street. EPHRAIM L. ELIOT, most strict and personal attention to their orders. Black Currant Wine of superior quality, constantly for sale.-Also, Swain's Panacea. Medicine chests for ships and families, put up and replenished at short notice with directions suitable for their contents SURGICAL INSTRUMENTS, &c. AMUEL N. BREWER & BROTH SERS have just received a large in voice of Surgical Instruments, which they will sell on the most favorable terms at their Store,-Sign of the Good Samaritan, 90 and 92, Washington St., where is also for sale a large assortment of Drugs, Medicines, Chemical and Electrical Apparatus, and other articles that are usually kept in Druggists' stores. A few pounds of the genuine Lin erwort, Hepatica triloba, for compure THE laft6t. VACCINE MATTER. HE subscribers having received frequent applications for vaccine mat ter, which they were unable to supply have now made arrangements to keep s constant supply of it, taken from select and healthy patients. They will receive it fresh, daily; and all had of them may be relied on. SAMUEL N. BREWER & BROTHERS, At the sign of The Good Samaritan, 9 NEW APOTHECARY'S SHOP. R. W. BRADFORD, finding the prac 271, Washington St. corner of Winter St. Die of Physic injurious to his health, FFERS for sale a general assortment among which are Calomel, Tartar Emetic, Blue Pill, and Calcined Magnesia, imported from Apothecaries' Hall, London, expressly for physicians' prescriptions; as he confines himself principally to the retail business, very particular attention is given to the preparation of all compound medicines, and no articles delivered but of the first quality. Physicians and families may depend on the has relinquished it, and opened an Apoth head of Poplar where he will keep the best of Medicines Medicines may be obtained in the night Published weekly, by John Cotton, 184, Washington St. corner of Franklin St. -The price of this paper will vary with the time of payment. If paid on subscribing, or within 3 months after, the price will be 3 dollars per annum; if paid after 3 months but within the year, it will be $ 3,50; but if not paid within the year, it will be 4 dollars. No paper to be discontinued till arrearages are paid.-All communications relating to the present or future concerns of this paper, to be addressed, always postpaid, to John G. Coffin.-Advertisements, 1 dollar a square. MEDICAL INTELLIGENCER. JOHN G. COFFIN, M. D., EDITOR. DEVOTED TO THE CAUSE OF PHYSICAL EDUCATION, AND TO THE MEANS OF PREVENTING AND OF CURING DISEASES. VOL. 5. TUESDAY, FEBRUARY 5, 1828. DISEASES OF THE SKIN. Drs. GRAVES and STOKES have published in the fourth volume of the Dublin Hospital Reports, some highly interesting observations on the efficacy of the physiological treatment of cutaneous diseases. We hope in our next, or in the subsequent number, to present some cases successfully treated on this plan, by our coadjutor, Dr. Jackson; at present, as the treatment of these diseases in this country, is very generally empirical, we shall give a full analysis of the observations of Drs. Graves and Stokes. Case 1.-A young girl was admitted the 25th of October last into the Meath Hospital, laboring under the severest form of psoriasis, affecting not only the scalp, face, and extremities, but almost the whole surface of the body. A most abundant desquamation of silvery white scales was constantly taking place,--skin almost universally of a bright red color and very itchy, pulse 100, strong, complained of thirst, but had good appetite, and in other respects appeared healthy. By bleeding twice, low diet, the repeated application of leeches to the most inflamed parts of the surface, and the use of a pint of the decoction of sarsaparilla with two drachms of supertartrate of potash daily, the cutaneous inflammation was sub 38 -- ΝΟ. 38. dued; recourse was then had to the use of sulphur internally, and warm baths containing sulphuret of potash. For some time the disease seemed to diminish under this treatment, but it afterwards appeared stationary. Recourse was then had to tar ointment, and afterwards to a mixture of tar and citrine ointments. which the ointment was applied "The parts to were well cleansed every day, either by means of diligent washing with soap and water, or with water containing a solution_of caustic potash, as directed by Dr. Duffin. The warm baths and the internal use of sulphur have been continued; she uses a diet consisting chiefly of bread and milk, and is now almost completely well.". "In squamous diseases, more limited in their extent, we have successfully used a similar method of treatment; except that in such cases general bloodletting may be often dispensed with, as the repeated application of leeches to the affected parts is sufficient to subdue the active inflammatory stage of the disease. The only difficulty which occurs in the treatment of squamous diseases, is to determine the proper period for leaving off the local antiphlo gistic applications, and changing them for stimulants. The latter, if applied too soon, will aggravate the disease, and when this is found to be the case, they should immediately be laid aside, and the application of leeches, poultices and cooling lotions be again resorted to." As yet Drs. G. and S. have met with no case of scaly disease which has resisted the above method of cure. Drs. G. and S. have also employed this treatment in chronic pustular and tubercular diseases. Case." John Knowlan, aged 16, was admitted into the hospital early in December, 1825, covered with the most aggravated form of general porriginous eruption. The head, face, elbows, hands and wrists, were particularly affected; on the hands there was the most enormous accumulation of scabs, arising from the discharge of numerous pustules. The nails were thickened, contorted and split. A continual steam arose from his arms and hands, and the odor of the body was most disgusting. Indeed it would be difficult to convey in words a proper idea of his loathsome appearance. The eruption chiefly affected his scalp, face and extremities; on the trunk there were but few pustules. The skin of the trunk was how ever red, rough with papulæ, and the cuticle fell off constantly in dry scales. The skin of the extremities was red and hot. He had occasional rigors and constant thirst, but was not emaciated. Under these circumstances it was determined to treat him on the antiphlogistic plan. He was, in consequence, bled twice to a considerable amount, freely purged, and used several warm baths; by these means he was greatly improved, the skin of the body had lost much of its inflammatory red ness, but the hands were stil loaded with the dried scabs, red. and constantly exhaling a dense vapor. They were leeched, and warm poultices applied over the recent leech bites. He continu ed using the warm bath, and took an electuary of the supertartrate of potash, with sulphur. In the course of a week the bleeding and leeching were again repeated with great benefit; so much indeed had the inflammatory symp toms subsided, that it was thought advisable to order him small doses of the arsenical solurias Under this plan he continued for some time, but the symptoms not yielding, this medicine was omitted, and he took the infusion of dulcomara without any percep ble benefit. The antiphlogis plan was then recurred to, # head was shaved and poultice he was freely purged, and took several tepid baths; by this treatment every inflammatory symptom subsided, the head became clean, and the skin lost its red color, but was still covered with small white scales in such abundance, the. when he took off his shirt, a cloud of them would rise around him The hands were still covere with thick scabs, but had lo their inflammatory appearance The pulse was slow, and the borels freely open. The phlogist diathesis being thus somewhat subdued, he used the s bath, and an ointment cossisting of equal parts of the dilute citrine and tar ointments was applied to the hands and head, with the greatest benefit; the scabs fell off, and a fine new cuticle cover ed the palms of the hands. Thus he continued for about ten days during which time he had been put on a more generous diet. He now experienced a return of the course, in the treatment of all eruption over the whole body, es- cases of porrigo, "must be cutpecially on the breast; it came ting the hair, and the diligent use out in the form of minute pus- of emollient poultices, alkaline tules, which quickly dried, leav- lotions, &c. till the scabs are softing the surface covered by thin ened and removed, after which scabs. The skin was hot and the head should be shaved. Even red, and the pulse indicated great in cases of long standing, we have activity in the circulation. He found the greatest benefit to arise was ordered to be bled, and was from leeching the head, and now again freely purged. The blood almost always commence the was buffed and cupped. Great re- treatment in this way. Recent lief followed this operation. The cases however require a more skin lost its red color and itchi- frequent repetition of the leechness, and the pulse was reduced es, and a stricter antiphlogistic in strength and frequency. He general treatment than chronic was ordered to take no animal cases. In several cases of scald food. The baths were repeated, and his bowels kept freely open by the electuary of cream of tartar and sulphur. Under this treatment he rapidly improved, and after some time was even enabled to recur to the use of the tar and citrine ointments, which, together with warm baths, completed the cure in a few weeks. He is at present, December 15, 1826, in good health, and quite free from the least trace of cutaneous eruption." Drs. G. and S. have found a similar treatment efficacious in a case of sycosis menti, and have also used it with very marked success in porrigo of the scalp, or scald head. "Recent cases of porrigo yield readily to the application of leeches to the head, and poultices, repeated till the inflammation of the scalp is subdued." The formation of these pustules, be the case chronic or recent, are the result of inflammation, and their developement will cease, with the removal of their cause; the cure may then be easily completed by the judicious use of the tar and citrine ointments. The first step, of head, where circumstances prevented our having recourse to leeches in the first instance, we have substituted, with advantage, poultices, with an ounce or two of liquor acet. Plumbi. In children this will often succeed in reducing the high inflammatory action. In one case only did the continued use of the acetate of lead produce symptoms like colica pictonum." In The constitutional treatment must vary with the patient's peculiarities as to health. strong healthy children cooling aperients and a spare regimen will much facilitate the cure. In the weakly and emaciated, change of air, attention to the bowels, a more nutritious diet, and a judicious use of tonic remedies, may be combined advantageously with the local antiphlogistic plan, and in such the cure of the cutaneous complaint, by removing a constant source of irritation, will materially tend to restore the health. "There is no doubt that the sudden drying up of cutaneous diseases has occasionally produced dangerous internal complaints. |