am informed that during many weeks, her cafe was confidered as fever and ague.

To this fucceeded a deep yellow fuffufion all over the body; an habitual costiveness her fæces being like putty, and much harder too. When I first faw her, the fever was remitting, . and fhe experienced by times a great want of food. Had all these last symptoms marked the beginning of her complaint, it had been justly inferred that she had worms; but all the aforefaid circumstances, and various appropriate remedies which had been reforted to, rendered that fuppofition very vague,, yet, it was again indulged in, but without the leaft relief. Other physicians thought that bilious concretions had interrupted the flowing of the bile. To this I observed, that children might be fubject to any kind of limy concretion, but that the rapidity of their circulation and digestion must always oppose those of the bile. No ground whatever, no indication could open any favourable profpect; while her fymptoms were daily growing more alarming; when the little unfortunate, who was groaning under excruciating pains, which she traced to the region of the stomach, fell delerious, and shortly after expired.

This certainly was an anomalous cafe.

The body exhibited no marks of emaciation, but on diffecttion, the liver was found almost destroyed, not by decay or suppuration, but by tubercles, which appeared on the surface like circular contractions, which fucceeded to each other, while the parenchyma was wafting or absorbed.

The little mafs remaining, about one third of the common fize, offered no fhape of great or fmall lobes; it was darker

than natural. Its contracted pori-biliarii contained black blood, and the gall-bladder affixed to it, was half wrinkled. The stomach was not much altered, but the whole intestinal canal and omentum appeared in the most complete ftate of inflammation. The whole colon was difeafed and confiderably strictured; the pulmonary veficles were filled with dark blood, and not otherwise diseased.

Dr. Matthew Baille, in his morbid anatomy fays, " that the common tubercles in the liver, are hardly ever met with in a very young perfon; that it is likewise more common in men than in women, that it seems to depend upon the habit of drinking."* The above cafe is in every point fubverfive of his doctrine; the life of a man, is not fufficiently long to embrace as many facts, as would be neceffary to circumfcribe causes and effects in the history of human diseases: whoever writes a book, finds it very convenient thus to form arrangements and claffifications, which if not very correct, will one day perplex our judgment, when we are called upon to relieve or remove a complaint.

New York, Nov. 12, 1807.

* Vide, page 214, Lond. cdit. 1807.

Cafe of Hepatic Affection. By DR. J. L. STRATTON.

SIR,

Burlington, (N. J.) July 14, 1807.

F the following statement of a fact shall be confidered of fufficient importance to merit an insertion in

If atace to an your Museum,

it is at your service.

Near the close of December last, a negro man who had formerly refided in the West-Indies, applied to me for medical aid, affected with cough, fhortness of breath, and fever. On examination, a protuberance was to be felt directly under the umbilicus, of the size of the head of a full grown foetus, and to the touch as hard as iron. Apprehending his complaint to be a schirrus in fome of the abdominal viscera, after taking away eight ounces of blood, and opening his bowels with calomel and jalap, I gave the nitrous acid, and directed a blister to the part diseased, which, after raifing, was to be dreffed with mercurial ointment. While perfifting in the above course of medicines the fymptoms were mitigated, but he could not be prevailed upon to continue them any length of time.

He was constantly affected with a moderate cough and difficult refpiration, accompanied with a discharge of limpid phlegm. He never experienced severe pain, but what pain he felt was feated in the unfound part; he always denied having pain in his shoulder, which is frequently a symptom of that disease, and was feldom prevented from pursuing his business, (which was that of a barber) more than one or two days at a time.

On the 10th inftant, he was fuddenly seized with delirium, and ran into the street naked. On taking away eight ounces of blood

he became rational, until the next morning at five o'clock he underwent a fimilar paroxyfm of infanity, that lasted about the same space of time as the preceding one, and then left him rational.

On the 12th, at five o'clock in the morning, he became speechlefs, and continued fo until 10 o'clock the 13th, and then expired apparently from fuffocation.

In the presence of Drs. E. Shippen and Cole, I opened the abdomen; the liver presented an appearance truly astonishing; it was greatly enlarged, and in a complete state of schirrofity, except a very fmall part of the concave fide of the leftlobe, and weighed 123 pounds. The gall-bladder perfectly natural and contained a quantity of dark coloured vifcid bile.

After raifing the fternum the lungs appeared but little dif ferent from the common ftate, with the exception of a few fmall pellicles on the right lobe filled with extravafated air.

I was informed by him that it was five years fince he became diseased, and that the affection was at that time about the fize of an egg.

He was not remarkably costive, and the ufual quantity of aperient medicines would operate upon his bowels. His appetite and digestion were generally good, and he was not emaciated.

What might have been accomplished by the powers of medicine at the commencement of the disease, I cannot say; but at the stage of the complaint in which he was when I first faw him, I am acquainted with no remedy that I think could

have restored him to health. I believe he was for the most part temperate, and eat but little animal food.

I am, fir, yours,

DR. JOHN REDMAN COXE.

JOHN L. STRATTON.

Cafe of Flores Zinci taken by mistake for Magnefia, in large quantities without any effect. By DR. M. WENDELL.

SIR,

New-York, August 1807.

BSERVING in the laft number of the Medical Museum,

a case of epilepsy, "highly alarming," and threatening immediate deftruction, in which the "flores zinci were given with empiric boldnefs," and apparently to the complete eradication of that diftreffing disease, I am induced to offer a few remarks on the efficacy of this fuppofed powerful medicine.

From repeated trials of the flor. zinci in epilepsy, and other fpafmodic affections, and from its never having the exclufive claim of curing either; being generally preceded by venesection, cathartics, &c. or accompanied with fome powerful tonic or aftringent, I have adopted the opinion of the celebrated Cullen, who fays-"The flor. zinci were introduced into practice by the late Dr. Gaubius, as an antifpafmodic, or as I confider it as an aftringent or tonic. In epilepfy they never answered with Dr. G. himself; nor have they that I know of, though given in much larger dofes than he seems ever to have employed. In my own practice, (fays Dr. C.) I have not found them of remarkable benefit, nor do I find my fellow practitioners giving a more favourable report."