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two of mild aperients) with the digitalis, and pursued it under every modification that it has ever been exhibited in, without any apparent advantage; finding this to fail, I turned by attention to the fquills (a favourite medicine with me as you know) combined with fmall proportions of calomel: and here I was equally disappointed; the cellular substance was now so much distended, that I could fcarcely perceive the beat of the radial artery at the wrift; the afcites especially still made a rapid progrefs. Thus baffled in every effort to be of service to my fuffering patient, I applied myself with fresh ardor to the investigating of the nature of this disease; in order to which I attended principally to the pulfe, and by it I was at length conducted to fuccefs. I found on the second day after the last determination an evident intermission, in the beat of the artery, to occur after · the 5th or 6th stroke: from this circumftance I concluded that there existed a latent morbid excitement in the arterial system, fuppreffed by congeftion fomewhere, and determined to have immediate recourfe to the lancet and active purges, confifting of jalap and calomel: the blood that was first drawn (about 15 ounces) was not fizy; that circumftance I did not expect: the day following, in the morning, I bled again, and in the mean time kept up moderate evacuations from the bowels. I now perceived the pulfe to quicken confiderably, and to become more tenfe, corded, and hobbling in its action; in the evening I took away about 18 ounces more of blood, and continued the mercurial purges: At this time, no change could be perceived in her bulk, nor in any of the fenfible fecretions or excretions. When fitting up, although a woman of moderate size naturally, fhe now filled a large chair. I was ftill confident from the change in the pulfe that my ideas were correct, relative to the state of action in the system, and determined to perfevere: with this refolution I vifited her the next morning-but behold! to my great furprise and pleasure, I found her fitting up, reduced to a mere skeleton, there appearing not the smallest symptom of effufion under the skin or in the abdomen. She informed me that fome little time after the last bleeding, a profuse discharge took

place from the fkin; and an aftonishing flow of urine foon followed, which continued till the fwelling had entirely fubfided. The refult of no cafe that ever came under my notice, has afforded me fo much pleafure. The triumph must be given (not to blind chance but,) to a principle in medicine; and, the saving of the patient should be afcribed to Dr. Rush, from whom I derived my reasoning."

II. January 12th, 1805.

"More cafes than usual have occurred within the last three weeks, of general and partial anafarca, and in fome instances combined with afcites. All these cafes occurring in habits previously debilitated by the autumnal epidemic, have induced me, (with a fingle exception) to use the lancet, in connection with evacuants-and in every inftance, the most apparent and unequivocal advantages have refulted from this mode of treatment."

An Account of the fuccessful Ufe of Opium, Cordial Drinks, and Animal Food, in two Cafes of Pulmonary Confumptian. BY BenjaMIN RUSH, M. D. Professor of Medicine in the University of Pennsylvania.

ELIZABETH DAVIS, aged about 25 years, was admitted

into the Pennsylvania hofpital, on the 7th of February, in apparently the last stage of pulmonary confumption, brought on by an attack of fever fix months before. She expectorated pus in large quantities, had a diarrhea, and spoke only in a whisper. She was moreover fo weak as to turn herself with difficulty in her bed. Her pulfe had notwithstanding a small degree of tenfion. As I confidered this tenfion in her pulfe, an obstacle to the ufe of the only remedies that were indicated in her cafe, I directed four ounces of blood to be drawn from her, and ordered a blister to be applied to her breast, and small dofes

of calomel, tartarized antimony and nitre, with a little laudanum, to be given to her every two hours. On the 12th of the month I found her pulfe so much changed into that itate of weaknefs, fuftnefs, and frequency, that characterises a typhus fever, that I directed her to take two grains of opium every night. On the 19th she complained of a fore mouth, and of a difficulty in swallowing her opium pill; I now directed the calomel to be laid aside, and instead of the opium in a folid form, I ordered her to take eighty drops of laudanum at bed-time and fifteen every morning and noon of every day.

On the 26th her diarrhoea returned, for which I prescribed the chalk julep, rendered cordial by an unusual quantity of laudanum. It had the defired effect. On the 1ft of March I found her pulfe evidently flower and fuller than it had been, and without any tenfion. Her voice became ftronger, her cough was lefs frequent, and her expectoration lefs copious than they had been, and the now complained only of pains in her head and back. I confidered this change in her fymptoms as highly favourable, and in order to fecure the advantages thus obtained over her disease, I directed her to take one hundred and twenty drops of laudanum and a pint of wine in the course of a day, and to live wholly upon the most cordial animal food. My tour of attendance at the hospital expiring at this time, I committed her to the care of my fucceffor Dr. Park, who politely continued the use of my prefcriptions, by which means fhe was rapidly restored to health, and discharged cured on the 9th of April.

On the 6th of August, a woman with a full face and rofy countenance, came up to me as I was getting out of my chair to vifit a patient in Fifth ftreet. She expreffed her gratitude to me in ftrong terms for my services to her. I did not recollect her, and asked her name. With equal furprise and pleasure, I learned it was Elizabeth Davis. She appeared to be in perfect health.

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