MEDICAL REPOSITORY,

FOR

MAY, JUNE, AND JULY, 1808.

REMARKS on the FUNCTIONS of the STOMACH, and on the singular Case related by JACOB HELM, Physician in Vi enna, &c. in a LETTER from Professor WATERHOUSE to Professor MITCHILL, dated Cambridge, March 5, 1808.

IN pages 16 and 17 of my lecture "On the general doc

gene

trine of Chronic Diseases," and particularly "on the evil tendency of the use of TOBACCO upon young persons t more especially of the pernicious effects of SMOKING CIGARS, with observations on the use of ARDENT and VINOUS spirits," I inserted a note which excited considerable notice, and gave occasion to some good-humoured raillery among my friends, who would frequently enquire after the good woman "with a hole in her stomach!" The note stands thus: "Opportunities of looking into the stomach of a living subject are very rare indeed. I remember but two instances on the records of medicine. One was a woman in the ral hospital at Vienna, in 1798. She had her stomach perforated by a wound, which could not be closed up. Through this wound her food might be seen. When any indigestible food created uneasiness, as sour-crout, she took the oppres sive food out with her fingers, and washed her stomach with water, and this always relieved her, and revived her appetite. Milk was observed to curdle instantly, except when she had carefully rinsed out her stomach: in this case, says Dr. Jacob Helm, whose patient she was, the coagulation did not take place till after some time, for want, he supposes, of gastric liquor. The coagulation could be expedited, by irritating the inner surface of the stomach with the finger. Ass's milk was longer in coagulating than cow's milk. The last coagulated in a few moments. Eggs and cheese were quickly digested, but not so soon as flesh meat. flesh meat. Vegetables in general were longer undergoing this process; of these, potatoes and carrots passed off soonest." My credulity in giving Vol. VI. A

place to this singular narrative in my publication, has repeatedly occasioned a little merriment at my expense. My only defence was, that I had taken the case from some British publication; that I found it in my book of extracts; but I had neglected to notice what publication. When a new impression of the lecture was spoken of, some of my friends seriously advised me to leave out the German woman "with a hole in her stomach." I said but little; nevertheless I went on believing; and determined to write to my correspondent, Dr. De Carro, at Vienna, who has rendered himself famous by his successful transmission of the vaccine virus to the vast regions of the East. My first letters, via England, never reached him; my second, through France, had a better fate, and procured me a full and highly satisfactory answer to my queries respecting a woman who could give visible proofs of the powers of her digestive organs. This gentleman says, "There is not the least doubt of the truth of the fact, which you have mentioned in pages 16 and 17 of your Lecture. Several of my medical friends have invited this woman to dinner, in order to see that extraordinary patient. I know Dr. Helm perfectly well, and you may rely entirely upon the accuracy of his report. In the supposition that the original publication of this case has not reached you, I here send it to you from the author." The book is in German;† and I

* He fent vaccine matter from Vienna to Bagdad, and may be said to have laid the foundation of the oriental vaccination.

Tranflation and Abftract from Dr. JACOB HELM's Zwey Khranken Geschickten, published at Vienna in 1803; ein weib mit einem loche in dem magen, &c. &c. by S. L. M.

Therefa Petz, of Breitenwaida (a village feven miles from Vienna) is fiftyeight years old, the mother of feven children, and had fortunate labours, though they lafted from twenty-four to thirty hours. Her father, a greyheaded man of seventy-three years, was obliged for the last seven years of his life, to keep his bed in confequence of fevere pains of the gout, although he had before enjoyed the most perfect health. Her mother's health had been lafting, for the reached her feventieth year. Our patient continued in fine health until her twentieth year, and with the exception of the fmall-pox, never fuffered any of the diseases incidental to children, and ftill lefs had fhe any marks of fcrophula. In her twentieth year, her menfes occurred and returned every month without remarkable inconvenience. She connected herself, in her thirty-third year, with Paul Petz, a blacksmith, and was very healthy in her marriage; fhe did not perform field-labour only, but also that of the fhop, in the fociety of her husband, without remarkable fatigue. However, the had borborygmi, which were not accompanied with pain. From 1782 to 1796, she had several fits of cholic, vomiting, and fearlet fever, with violent burning and stitches in the fide. She was attacked by fome of these diseases almoft every third week, which, however, during her pregnancy

am mortified in confessing that I am ignorant of that language, seeing I had so good an opportunity of learning it, during the four years I resided at Leyden. The engraving

were much less fevere, but never wholly abfent. In 1787, fhe felt, whene ver the stooped to the ground, an itching pain, which was frequently as violent as if a dog was gnawing her ftomach. It was believed to be a cramp of the ftomach, and feveral remedies which were employed, feemed to give relief from time to time. A plaifter that was applied to the region of the ftomach, freed her a whole year from the pain. She fuckled her children herfelf, but none reached their twelfth year; the most of them died a few months after their birth. For five years the had no menftrual evacuation without producing a remarkable relief from her pains; and when the menfes returned in 1790, but one day, she was big with her feventh and laft child. While pregnant, all her complaints were confiderably diminished; and when half of her time was over, the perceived a fwelling on the fide of the ftomach of the fize of a nut, of a colour like that of the fkin, which produced great pain whenever touched. After fhe lay in, all the circumftances were as before, except the vomiting, which had ceafed. Whenever chilly weather was at hand, the pains of the ftomach became fo violent, that the patient was obliged to roll herself upon the ground. Her appetite was always very good, only fhe dared not fill the ftomach with too much food and drink, because they augmented her pains. The tumour now began to enlarge in fize and hardness, and in 1796 extended as far as the navel. All the phyficians confulted upon the cafe, unanimously declared it was an induration of the fpleen, and prefcribed different external and internal remedies; but all proved useless. The only remedy which gave relief, was a mixture

of which the took a spoonful now and then. In 1796, she was attacked with anafarca. She was then very weak, and expected foon to be relieved from her miferable and painful fituation. But as the fwelling, in April 1797, broke by incautious preffure, and a pint or a pound of a thin and yellowith matter discharged, her pains were diminished, and also her dropfical effufion diminished from day to day, and wholly disappeared in a fortnight. The opening of the tumour was at that time of the fize of a lentil, and there iffued from it already fmall particles of the food fhe had taken, as the patient herfelf related. The author then begins his own obfervations: When he was called he found her very weak and emaciated. Under his prefcriptions the opening grew larger and larger, and by the month of July he could introduce his finger into her ftomach. The back part of the ftomach advanced, and was more plainly difcernible through the opening. He often introduced a catheter as far as the upper and lower orifice of the ftomach without giving the leaft pain to the patient, or provoking the fmalleft difpofition to vomit. During the five years he attended to this cafe, he made the following obfervations: She always attended to her domeftic employment, and was mostly in good fpirits. Her food was fimple, as is generally the cafe with poor people. She would fometimes take milk and water to wash out her ftomach through the orifice, and relieve herself from the furplusage of food by the fame way. After washing it out and putting on the dreffing, fhe was obliged to take food to relieve her diftrefs and uneafinefs. The opening was two inches in diameter; the margin was callous and almost as hard as gristle, and being deftitute of cuticle, was painful when touched. When the rode in a waggon, or was fubjected to confiderable motion, the bile came into the ftomach and iffued from the orifice; it tafted very bitter; did not mix with the gastric juice, but inftantly curdled the milk mixed with it. In 1800, she was able to walk to Vienna, and fhew herself to phyficians and other curious perfons, and alfo to do her field labour, &c. &c.

at the end of the book represents, I perceive, the aperture through the muscles into the stomach. To remove all doubts from my mind respecting this singular case, Dr. Helm has sent me the identical perforated tubes of wood, and of metal, and also the identical little linen bag, which he had used to ascertain the powers of this woman's stomach upon various articles of food, which were put in and taken out of her stomach, as you would biscuit into an Oven! I am not a little gratified in finding this doubted case so amply confirmed. My correspondent informs me, that my lecture on the evil effects of tobacco, was soon to appear in a German translation, in which my notice of this extraordinary case would be adverted to. He says the aversion to smoking was extreme among the French, but that among the evils of the revolution was the disgusting habit of smoking; he hoped, however, that as they re turned to courtly manners, they would leave their pipes in their camps and guard-houses. They have given, I am also informed, a French translation of this trifling publication at Geneva, where, I learn, they have not been dis pleased with the compliment paid them in page 21: viz. "Cannot wisdom devise a plan of social intercourse inde"pendent of the stimulus of the bottle? It is said such plans existed in the city of GENEVA, before the French "inflicted the benefits of their liberty on that philosophic ❝ people."

On the subject of vaccination, he gives a very satisfactory account. It is practised at Vienna, and other cities of Germany, without opposition; while I find, by letters just received from Dr. Jenner, that it is obstinately opposed by some in England. He tells me that there are some prejudices so deeply rooted among the common people, that a long time must elapse before they can be eradicated. This distinguished German, who is a botanist and an agriculturist, has taken great pains to introduce the Chinese, or dry rice, into Germany; and has sent me a few seeds to make a trial in the soil of New-England. It is the mountain rice, that is cultivated in various parts of the peninsula of India and in China. It grows in dry soils, and does not require natural or artificial marshes. If we could introduce this mountain rice, or a rice that will grow not in a fever-andague soil, but in a dry and healthy region, we should have reason to bless the name of the introducer of it. It was carried into the Isle of France from Malabar. He received

250 grains of it from China by the means of the Russian embassy, and it has ripened at Vienna. He has sent me. some of the original seed, which I value equal to so many diamonds. As soon as the season admits, I shall commit them to the fostering care of our mother earth, and the re sult shall be communicated to you by your friend,

BENJAMIN WATERHOUSE.

Description of the INFLUENZA or EPIDEMICAL CATARRH, which spread over the United States in the year 1807; as it appeared at NASHVILLE in WEST-TENNESSEE. In a letter to Dr. MITCHILL from Dr. THOMAS G. WATKINS of that place, dated April, 1808.

GREEABLY to my promise I send you my ideas on the Influenza as it appeared at Nashville, Tennessee, in November last. Previously to entering on the subject, it is, perhaps, proper to premise that a long, dry, and sultry course of weather preceded the appearance of it through. out the district which contains Nashville, situated about the thirty sixth degree of north latitude. This drought continued so late that the Cumberland river, on which Nashville lies, was said, by old settlers, to be lower than they had seen it except once; others did not admit one exception. Salt, which is brought here entirely up the Cumberland, rose to from two to five or six dollars in consequence of the difficulty of ascending the river in boats, for which it is gene rally navigable all the year. Grass and corn blades were suddenly parched up early in August, and continued so through autumn, and a great many constant springs were dried up entirely, or sunk from their usual level so as to fail. This state of things continued until a short time before the first of November. About the first or second day of this month, the sudden arrival of the Influenza, ushered in by cold north-eastern winds and rain, was universally announced; it seemed to fall upon all at once, but most believed they had it first, for few had time to hear it from their neighbours before they felt it themselves.

The superior or district court was sitting about this time in Nashville, which is near the centre of Mero, the western