home, I was requested to defer it again to the next day, that he might give his approbation.

On the roth, I vaccinated her four children, and finding then that the eruption was going on pretty faft with the mother, I defired the children to be kept from her room; but feeing afterwards, that no attention whatever was paid to comply with my repeated request, and two days being already elapfed, without the leaft appearance of the vaccine infection, I inoculated them all with variolous matter taken from the mother.

Mrs. B- was fo well that I did not vifit her until the 14th, when I found that the variolous infection had produced the defired effect upon her children, and, to my great furprise, that Betsey B, the eldest daughter, about nineteen years. of age, who had been, from the beginning, nurfing her mother, exhibited an evident mark of vaccine infection.

Defirous to have a full view of the contest between the two diseases, and anxious to know which would gain the victory, I vifited my patient every day, flattering myself with the hope, that the insertion of the vaccine virus having been made two days previous to that of the small pox, the areola would appear before the time of the eruptive fever of the fmall pox, and counteract the variolous infection.

The 19th, no fign of the areola.

The 20th, fever, pain in the arm-pit, faint appearance of the areola. Her brother with the eruptive fever of the small pox.

The 21ft, beautiful areola, continuation of the fever, pain much increased, and fwelling of the glands in the axilla. I was then struck with a very fingular and unexpected phenomenon. An areola, fimilar in colour and fize to the vaccine areola, was furrounding the variolous pimple, and continued as long as the other. Another phenomenon, no lefs worthy of remark, was, that although the variolous and vaccine pimples were scarcely one inch and an half diftant from one another, there existed a line of demarcation, with the natural colour of the skin, between

the two areolæ, their circumferences being flattened instead of intermixing with one another.

These phenomena were fo unexpected, that I called several times at your house, to have you an eye-witness of the cafe, but unfortunately never met you within. Meeting with Doctor Pascalis, and relating the cafe to him, he defired me to let him fee this patient, and found it a very curious and interesting cafe.

I shall now remark, that all the other children who were inoculated for the small pox at the fame time with B. Bunderwent a regular course of the disease, and she escaped it, although fhe had the nurfing of the whole of them.

Not feeling fatisfied of the refult, without tefting the matter of this vaccine, on the 22d, I took matter from both pimples, vaccine and variolous.

With the vaccine, I vaccinated three children, who received a very genuine kine-pock, without the leaft fymptom of variolous infection.

With the variolous, I alfo inoculated three children, every. one by a double puncture, but none of them received any infection. One of these three laft children was inoculated afterwards with other matter of the small pox, and took it immediately.

A young boy was lately inoculated by me, with variolous matter four days after vaccination, the fmall pox produced no effect but for a few days.

Leaving any one to make his own remarks, I conclude by expreffing the most carnest wish, that every one would exert his utmost endeavours to extend the benefits of fuch a bleffing as vaccination.

To J. REDMAN COXE, M. D.

Yours, fincerely,

J. C. ROUSSEAU.

On the Cure of Chronic Diarrhea, &c. in a Letter from DR. WILLIAM HAYES, of Dorchester County, Maryland, dated January 8th, 1801,

SIR,

NOW present you with a few remarks on our late epidemic.-I found several under the most profufe fweats, with out obtaining any relief. On Hooper's Island, they had more rain than where I live; their fevers higher; the discolouration of the skin but flight, and no black vomitings; the alvine discharges of many were black bile. Where there was lefs rain, there were feveral inftances of the coffee-ground vomiting; efpecially after it assumed the form of dysentery.

I tried the effect of the shower bath on two patients under this form of the epidemic, (being baffled in other remedies), the effect was, a natural stool before they could be got to bed, They were laid in blankets, a perspiration enfued, and the tenefmus vanished for the day. At night the tenefmus, &c. returned; the next day the bath was repeated with the fame good effect; the third day the bath was objected to. On the third or fourth day after, they died; one with the coffeeground vomiting. The fyftem was well loaded with mercury, at the time of ufing the bath, yet no evil enfued. bath ought to have been used at least twice a day.

The

In the year 1792, a Mr. Henry Travers, with chronic diarrhoea of two or three years standing, applied to me after trying feveral other gentlemen; I recommended the bath with anodynes, which in a few weeks reftored him to perfect health. In 1798, a fimilar cafe occurred, but not of fo long standing the fame remedy had the defired effect.

:

In fact, the shower bath is my principal remedy for the cholera infantum, diarrhea, and intermittents in children.

DR. BENJAMIN RUSH.

Your most obedient, and

Very humble Servant,

WILLIAM HAYES,

Cafe of a Luxation of the Thigh-bone, forward, and the Mode of Reduction. By P. S. PHYSICK, M. D.

Philadelphia, 12th April, 1805.

'N February 1805, a man was brought to the Pennsylva

IN

nia Hospital, in confequence of a dislocation of the thighbone at the hip-joint, which had taken place the day before, in the following manner. As he was riding on a fled which was drawn rapidly along, with his legs extended over its fide, the foot of his left leg became entangled in the gears of a team of horses ftanding in the road. A great abduction of the leg and thigh was thus fuddenly made, by which the head of the bone was forced out of its focket, and lodged on the os pubis, directly before the acetabulum. In this fituation it formed a tumor, plainly to be feen and felt in the groin, under Poupart's ligament. The foot and knee were turned outward, the thigh was extended with the leg bent backwards. By a very particular examination it appeared that the dislocated limb, was a little longer than the other, though the difference in length was very inconfiderable.

After an unfuccefsful attempt, which it is unneceffary to describe, the head of the bone was replaced by the following

means.

i

The patient being laid on his back on a table covered with a mattrafs, a firm ftrap was paffed between his thighs, and the ends of it being carried upwards, before and behind his body, were fastened to a staple oppofite his left shoulder, for the purpose of fixing the pelvis, and making the counter-extenfion. This ftrap was applied in fuch a manner, as to act as much as poffible against the injured fide of the pelvis, and was carried, therefore, between the dislocated thigh and the fcrotum, and then over the tuberofity of the ifchium of the fame fide. A ftrong towel was then fastened with a roller upon the leg just below the knee, and the leg was bent to a right angle with the thigh.* The ends of this towel were tied together, and a

* In the first attempt, two towels had been fastened on the thigh just above the knee, one on each fide, but they were foon obferved to flip.

pulley was hooked to it for the purpose of making the extenfion.

In order to draw the head of the bone directly outwards, a firm ftrap was paffed over the pelvis below the crista of the ilium of the injured fide, and the ends of it faftened to a ftaple oppofite the found fide of the patient's body. Another ftrap was applied over the upper part of the dislocated thigh, the ends of which were fastened to a pulley oppofite the injured fide of the patient.

After the application of this apparatus, before commencing the extenfions, the man was copiously bled, with the intention of causing him to faint, an effect, however, which was not fully produced, though he loft a confiderable quantity of blood, by which he was much weakened. In this ftate of debility the extenfions were repeated, and, at the fame time, the leg being bent, was moved inwards and outwards fo as to rotate the thigh-bone as much as poffible, and thereby to affift in diflodging its head. To prevent the abduction of the thigh by the strap over its upper part, the knee was pressed inwards by the hand of an affiftant applied on its outside.

In this manner feveral attempts were unfuccefsfully made, but, added to the bleeding, they exhausted the patient's strength fo much that his body became covered with a cold fweat. In this state of weakness the extensions were directed to be again repeated with greater force than had before been employed, and by these the head of the bone was fuddenly reduced to its natural fituation. The patient in a few minutes recovered fufficiently to move his thigh in every direction, suffered very little pain afterwards, and was discharged from the hospital, cured, in three weeks.

In order that the mode of reduction may be more easily understood, the enclosed sketch is herewith fent.

Reference to the Plate.

. Represents the ftrap paffed between the fcrotum and thigh, and over the tuberofity of the ifchium, fastened to a hook, for making the counter extenfion.