under my preceptor's notice, it terminated favourably. Gentle purges, blisters, camphor, opium, &c., were the remedies he employed.

The winter diseases are pneumonia, rheumatism, different forms of cynanche, &c. Several cases of cynanche trachealis occurred this season (1804), so late as July. Dysentery has been the predominating disease, during the present season. The first cases occurred in the first week of July. Many of the first patients had a diarrhoea for several days, before either pain or fever made their appearance. Some had neither of the last-mentioned symptoms. Occasionally, the disease was ushered in with vomiting; and it was not unusual for patients to be costive for several days, with pain before the lax appeared. The fever and pain were seldom so severe as I had seen them in former years. It was generally confined to children. Tenesmus was a troublesome symptom. The treatment differed little from that of 1799 and 1800. Kino and other astringents were, I think, used with more safety, as the disease occasionally ran again into diarrhoea. There have been a few cases of remitting fever. Adults were more generally affected.

VI. Supplement to the Preceding Paper.

AS supplementary, in part, to the preceding paper, I shall introduce, in this place, a notice of an epidemic disease, which prevailed in the neighbourhood of Bristol, many years ago.

Dr. John Abraham De Normandie informed me, in the year 1789, that he well recollected an epidemic disease which prevailed two different times at Bristol, viz. in the year 1749, and again in 1753.

In both of these years, the disease made its appearance in the month of November. It began with a pain in the side. In the beginning, the pulse was generally full; but it fell so greatly by a single bleeding, that my informant did not venture to repeat the operation, and a different mode of treatment was adopted.

Genuine carbuncles were often observed in this disease. But they were not remarked to have much connection with particular crises of the disease.

In the progress of the disease, a putrid diathesis (as it is improperly called) generally prevailed.

This disease was extremely local, in different parts of the country, at the same time. Thus it was very common at Bristol, and for about four miles round that town, but it was unknown at Burlington, on the opposite side of the Delaware. In other parts of Jersey, however, it was extremely common, particularly at Allen's Iron-works, where of 130 persons, 80 were seized with the disease; all of whom died. It was also very common at Salem, and at Gloucester.

In the treatment of this disease, Dr. De Normandie found nothing so beneficial as the Virginia Snake

root (Aristolochia Serpentaria of Linnæus), exhibited in decoction. At first, he gave the medicine in such large quantities that it excited vomiting. But he depended more upon the diaphoretic operation of the medicine.

This disease, of which a more ample account is a desideratum in the medical history of the UnitedStates, is noticed by many of the medical writers of Europe. It seems to be described by the learned Sauvages, under the following names, viz. Peripneumonia putrida, Peripneumonia maligna, Peripneumonia typhodes, Pleuritis biliosa, Pleuritis erysipelatosa, Pleuritis putrida, Pleuritis pestilens, &c. It is the Pleuritis biliosa of Bianchi.

THE EDITOR.

MS. Medical Journal, for the year 1789.

VII. On the medical virtues of the Warm and Hot Springs, in the county of Bath, in Virginia. From the MS. journal of the Reverend Dr. A. GREEN, of Philadelphia. 1800.

THESE Springs are chiefly useful in the cure of rheumatism and gout, and other local affections of the nervous system. They are also highly useful in a number of cutaneous eruptions, and are frequently beneficial to persons of a bilious temperament.

The cures they have performed in the gout and rheumatism are almost incredible. A gentleman, by

the name of man of science, and apparent candour, assured the company, that he had been for fourteen years incessantly afflicted with rheumatism and gout, and had but little expectation of ever obtaining relief. That the year before he made this communication, he was induced to try the Warm-Springs. He used them nearly two weeks without getting any sensible benefit, and for some time even with an aggravation of the symptoms. At the end of a fortnight, however, he was surprised with a cure almost instantaneous. All his pains left him at once, and they had never returned; nor had he experienced any inconvenience from his complaints, till the time he gave this narrative (in 1800). He had then come to the Springs, for a few days, to use them, as a preventative, but did not need them as a remedy for any sensible complaint.

whom I saw here, and who is a

'An instance of cure, nearly as wonderful as this, I saw myself. A certain Mr. S-, a gentleman of respectability in Virginia, had long been tormented with the chronic rheumatism, the principal seat of which was in his loins. He used the waters at the same time with myself, and for nearly two weeks, he complained, that he rather grew worse than better. At length, however, his pains left him so suddenly, that he could scarcely believe they were gone; and, for a day or two, he was constantly putting himself in such attitudes as he thought would make him feel his former complaint, if any of it remained. It did not, however, return, and he went away well.

Ꭰ .

In using these waters, considerable care is necessary. They should not be drunken in large quantities at first; and in drinking them it is a precaution which should never be neglected, by those who have a weakness of the stomach or bowels, to cool them before they are used. This is easily done by filling a bottle with them at the spring, corking it closely, so that the gas cannot escape, and then placing it in cool water, till its temperature is such as not to relax the stomach.

From inattention or disregard to this caution, considerable inconvenience has been experienced by many. A few glasses may be taken warm in the course of a day, especially by those of a bilious habit, or those who are subject to costiveness: but, in general, it is of much consequence to cool the water, before it is taken into the stomach.

In using the water as a bath, great care must also be taken. At first, a person should not remain in the water more than a few minutes, and perhaps never beyond a quarter of an hour. By degrees, the time of remaining in may be increased, till, at length, it may be continued to forty minutes; and may be used twice a day by those who have a firmness of the muscular system, or who are affected with obstinate rheumatism, or gout. But as the use of this bath is one of the greatest luxuries in nature, there will always be a call for caution and self-denial, that it be not used to excess.