the fick, whether white perfons already affimilated to the climate, or people of colour, having univerfally remained free from the disease; newly-arrived Europeans being alone fubject to its ravages. Medical writers inform us that this is by no means a new disease, but the fame to which Europeans have always been liable in a greater or lefs degree, on their first arrival in the Weft Indies. That it has been unusually prevalent and fatal in Jamaica fince the year 1793, is certain; but this must be referred to fome particular constitution of the atmofphere, which induces endemics more at one time than another and it is to be observed, that when this disease was so fatal in 1793, and the three fubfequent years, there was an unusual influx of European ftrangers, particularly of the army and navy, occafioned by the war. But, although the mortality during thofe years was exceedingly great, yet it was confined to the towns, and particular situations on the plains only. In the mountain parts of Jamaica, even among the newly-arrived Europeans, this complaint was scarcely known; and, although I had an opportunity of attending fome hundred young men in their first indifpofition, in the diftrict where I refided, I do not recollect ever meeting with a case of the true tropical continued fever. A disease of a very different nature is faid to have been brought to Jamaica with fome Irish regiments in the year 1796; this was the common typhus, jail, or hofpital fever, and was highly contagious: it carried off a great number of the foldiers before their arrival, and continued its ravages for fome time after. The two regiments of Irish brigade alluded to, buried in feven months more than one-half of their officers and privates. Perfons of every defcription connected with the shipping, and lately from Europe, were fubject to this disease, which was much more rapid in its progrefs, and more generally fatal than the tropical continued fever. It gradually, however, difappeared, and by the end of the year not a cafe of it was to be seen. The negroes are liable to a much greater variety of diseases than the white inhabitants; as, befides thofe before enumerated, they fuffer from yaws, coco

bay, Guinea-worms, ulcers, king's evil, and dirt-eating: they are alfo, either from accidents or cold, peculiarly liable to tetanic affections; from the former caufes, this complaint is univerfally fatal; from the latter, it generally yields to a combination of the ufual remedies. The trifmus nafcentium or locked jaw, alfo makes dreadful havoc among the negro children, from the 7th till the 9th day after their birth, and by which one-half of thofe born in the courfe of the year, are not unfrequently carried off, although I do not remember an inftance of its occurring in a white child.

In Jamaica there are feveral vegetable poisons which perhaps may not improperly be mentioned, viz. the manchineel apple, night-shade, dumb cane, the bark of the cabbage tree, and bitter caffada. It is well known, that although the farinaceous part of this last root forms excellent bread, the expressed juice is a most deadly poifon; a certain antidote is, however, now, fo univerfally known, that death, from its being accidentally swallowed, feldom occurs: this was discovered in rather an extraordinary way; it being obferved that hogs, though immediately poisoned upon eating the roots after their being previously washed, fuffered no injury from what they turned out of the ground, and eat with the furrounding earth; when therefore it is known a perfon has eaten bitter caffada, a quantity of common earth is immediately mixed with water, and fwallowed, and repeated every ten or fifteen minutes, till all the effects of the poifon have ceafed a few hours after, a dofe of castor oil, or Glauber's falts, is given to empty the stomach and bowels of the earth; and the perfon next day is perfectly free from complaint. Though there is no doubt any alkali would be equally efficacious as earth, yet, it, being always the most acceffible, is made ufe of, and never fails in its effect. I have met with fome hundred cafes of perfons poifoned with this root, and on fome of whom it had produced the most alarming fymptoms, fuch as violent convu.fions, cold VOL. I.

B b

fweats, intermitting pulfe, with every appearance of approaching death; yet, in less than half an hour, a few draughts of the earth and water, have removed every complaint.

Defcription of DR. PHYSICK's improved Gorget. In a letter from R. B. BISHOP, Surgeon's Inftrument-maker, to Dr. Coxe, (with a plate.)

SIR,

FIND

INDING that the Gorget conftructed according to a plan communicated to me by Dr. Phyfick fome time ago, has met with much approbation, I take the liberty of fending you a drawing, together with a defcription of that inftrument.

In all gorgets (even the most modern), much difficulty is experienced in forming a fine edge contiguous to the beak: and, as I understand it is defirable, that that part of the instrument should be very keen, because with it the section of the foft parts is commenced, and continued through the whole of the parts to be divided; it will therefore appear that this inftrument poffeffes every advantage that could be derived by obviating that difficulty, and enabling, not only the instrumentmaker, but the furgeon himfelf, to form an edge with complete ease, on the whole of that part of the inftrument which is intended to cut. It has alfo the advantage of being more portable and less expensive than the common fets of gorgets.

Fig. I. A perspective view of the inftrument; the blade a little open to fhew in what manner it is connected to the stem and fecured by the screw.

a. The blade.

b. The stem.

c. The screw.

d. The beak.

e. The cutting edge.

Fig. II. The stem of the inftrument, comprehending the haft and beak.

f. A groove, gradually deepening to admit the point of the blade, fig. III.

g. A perforation in the direction of, and to admit the peg k, as a further fecurity, and to prevent injuries to the point of the blade by the upper part of the groove f.

b. The opening in the handle admitting the blade.

Fig. III. A back view of the blade as relieved from the stem. It is common to furnish each instrument with five or fix blades of different fizes.

i. The point.

k. The peg.

1. The cutting edge-the curved line fhewing the manner of grinding it away to form the edge.

m. The female screw.

Fig. IV. A fection of the gorget of the natural size, describing the angle formed by uniting the blade and stem.

The fize and angle of the blade and haft of this inftrument, are the fame with Mr. Cline's gorget. The drawing reprefents it of little more than half its fize.

I am, Sir, with respect,

Your most obedient Servant,

PHILADELPHIA, November 1ft, 1804.

R. B. BISHOP.

Defcription of DR. HUTCHINSON's improved Splints, in a Letter to the Editor, (with a plate.)

SIR,

THE

HE difficulty of managing fimple oblique, and compound fractures of the leg, where both the tibia and fibula have been broken, every furgeon has experienced. It has been my lot to have feveral fuch cafes: I foon found that a flexed pofition of the limb was not the most favourable to infure fuccefs. The method of Deffault appeared to be more fa

tisfactory than that of Pott, but even it will admit of fome improvement.

In thofe cafes of fracture which came under my own notice, it was evident, that the common fplints, which I then ufed, kept up no extenfion whatsoever, though they were applied with great care. The most trifling action of the muscles was fufficient to difplace the broken ends of the bone, notwithstanding my patients had been bled repeatedly.

Thinking that thefe difficulties might be avoided, by the application of an apparatus capable of keeping up a powerful extenfion, fuch a one was conftructed, and made use of in the next cafe which I attended. The following is a defcription of it. The patient being placed on his back, with the fractured limb refting on a pillow, two pieces of tape were bound on each fide of the leg about three inches from the knee, by a common roller; the ends of the tape projecting fome diftance above and below the roller. As near as convenient to the ankle, another bandage is to be applied, having under it two pieces of tape, one on each fide of the leg. The splints are next to be fixed on. A good idea of them can be obtained by examining the plate. Fig. I. reprefents a limb with the fplints, bandages, and tapes applied; a, the bandage near the knee; b, the bandage at the ankle; c c, pieces of tape under the bandage, and on the inner and outer side of the leg. Fig. II, reprefents one of the fplints feparate from the limb; a, points to four holes at the upper end of the splint, through which the pieces of tape, fecured to the fides of the leg by the roller, near the knee, are to pass, and be tied as feen at d, in fig. I.—b, is a hole near the lower end of the splint, through which the piece of wood, fig. III, is passed, as represented at e, in fig. I, and to which the pieces of tape under the roller at the ankle are tied, as in f, fig. I, for the purpose of extending the limb.

In the apparatus of Deffault, the fame parts of the leg are ufed for keeping up extenfion and counter-extenfion, as in the one just now defcribed; but his fplints and bandages are trou