us to the fact. I have also seen since, though not in the tropics, this self same effect exhibit itself in fever cases, treated by mercury, when the individual appeared evidently under the influence; from this I am led to imagine, if Dr. Stevens's hypothesis has any foundation in truth, its proper proof rests on the perceptible effects of his saline remedy on the living fluid, contained within its own proper vessels, and not by an admixture of salt and blood in a porringer. There can be no difficulty, I imagine, in testing, at least its colouring powers in disease, by adopting this saline treatment; and when the cases are presumed to be sufficiently saturated with this allrenovating and all-colouring remedy, the lancet will then demonstrate the truth or error of the statement, with the concomitant of bona fide convalescence. To me, something of this kind seems imperative to be done, if the system has really a foundation to rest on; for the ablest chemists heretofore could throw no light, by experiments on the blood, on the nature of different diseases; and although some of our first and best chemists contend that it is on a peculiar animal principle the colour of the blood depends, many, however, equally eminent, assign it to another cause: but the Stevens Sidus has "clearly elucidated the truth by the greatest discovery ever made," and fixed it on the immutable principle of sea-salt!! which we call on him now to substantiate equally by experiments on the living, as he has attempted to do on the dead fluid. I shall now finally state, in answer to all Dr. Stevens urges in his communication, and to shew the profession generally of how much value in practice his doctrines were and are yet considered in the treatment of tropical fever, that, as far as I could learn, throughout all the following islands, which I lately visited on duty, there is not one convert to his opinions, and that the practitioners generally throughout them, respectively, cry pshaw!" both to his writings and pretensions at Antigua, Dominica, St. Lucia, Barbados, Tobago, Trinidad, Grenada, St. Vincent; in the next place, for the last fifteen months that I had been stationed at Antigua, not one particle of his "sodaic mixture" was administered to a single fever case, and yet our practice had been equally as successful there as at Trinidad; and, although it must not be disguised but that there is a very material difference in the two stations, as regards either the frequency or intensity of fever, yet I believe "English Harbour," which was my immediate residence, is as well known amongst the medical profession, particularly the navy, for furnishing as heavy a mortality, both amongst strangers and natives, as any other part, be it where it may, amongst the Tropics. "The Ridge" is considered the most healthful situation; this part of the garrison is occupied by the 86th Regiment, nevertheless, from amongst these we have occasionally as heavy and severe cases of fever as I have ever witnessed at Trinidad; having premised thus much, I shall now quote from surgeon Cunningham's (of that corps) last report, as the means of disabusing the community of the twaddle, wilfully or ignorantly attempted to be imposed on them. Let me remark, Mr. Cunningham is an old and most respectable medical officer, and not likely to be swayed, as hinted at by the learned gentleman in respect of Mr. Greatrex, contrary to his judgment by any man; he has now been upwards of five years in the command, a portion of which he served in Trinidad, therefore may be considered no despicable authority in the present affair. "Five cases of remittent fever were treated in the Regimental Hospital during the quarter. Two cases were also treated in quarters, of peculiar severity, viz. one officer, Major Gibson, of the 86th-the other the wife of the Serjeant-Major. These were, in particular, aggravated cases, attended with intense degree of gastric derangement at the commencement of the attack. In the whole of these cases, the beneficial effects of the croton oil, in suddenly and effectually arresting the violent irritability of stomach, and in alleviating the urgent febrile symptoms, were particularly apparent; the quantity administered was four drops for the first dose, assisted by active purgative enemata and warm bathing, or the cold shower-bath-the latter was found the most beneficial; a second dose of the oil, to the extent of one-third to two drops, was in some of the cases found necessary. The sulphate of quinine, in doses of from 10 to 12 grains daily, was had recourse to at as early a period as circumstances would permit. Venesection was in none of the cases had recourse to; no instance of protracted convalescence occurred. There is every reason to conclude that, had the excessive irritability of stomach not been arrested by the use of the croton oil, and had the symptoms been combated, as formerly, by the use of other remedies, &c. black vomit, with exhaustion, must have soon supervened, with a fatal termination." I shall here detail a case, given also in my Quarterly Report, not only corroborative of Mr. Cunningham's opinion, but strikingly illustrative of the almost, let me say, miraculous powers of croton oil in the worst forms of tropical fever. "I was solicited, by message from his medical attendant, to visit the parochial schoolmaster of English Harbor; being occupied, I could not attend. In about an hour, I received a second pressing message from the man's wife, to entreat I would see her husband, as the doctor declared, on departing, that he could do no more than what he had already done for him; she herself adding, "if he did not get speedy relief he must die.' On going, I found the man had been ill of fever for three days, and, for the last fourteen hours, had laboured under irritability of stomach and almost incessant vomiting; the bowels were torpid, though purgatives and lavements had been given, and, indeed, in justice to the Doctor, I must say, the usual routine in tropical fever had been in no way neglected; there was great exhaustion-no pain-no complaint, but of constant vomiting the skin was moist and clammy, from the violent exertions the patient was obliged to make. Here was the exact case I ever found croton oil pre-eminently useful in—1 gave four drops immediately in a tea-spoonful of syrup: in a little time this seemed to increase the irritability, which is ever the case; but this soon subsided. A large bucketful of lavement was made, of salts and ol. ricini, of which four large syringes full were given promptly, and as quickly in succession as they could be administered. No operation took place, although a respite was now given the patient for about a quarter of an hour. Four more syringes full, similar to the former, were now given, when the bowels began to act; the effect produced astonished all around, both as to the excretion and quick relief obtained; suffice it to say, in about two hours the severity of its effects began to subside, the irritability of the stomach was nearly gone; the patient became tranquil, complaining only of great weakness. As we advanced (the irritability of the stomach having for some hours subsided), a ten-grain dose of quinine was given, and repeated the following day. Convalescence was now established; in a few days, health was restored." I recapitulate this merely as Trinidad practice:-Away, then, with the most groundless and unfounded assumption of Dr. Stevens, in his "Observations on the Blood," that we cured fever in that garrison by the soda combination, forsooth, of his recommendation. Still further corroborative of what I have advanced, as regards the confidence reposed in croton oil and quinine, I herewith send you a few letters received from medical friends at Trinidad, to whom I addressed myself on the subject. You will be pleased to give to these such publicity as you may deem necessary. I shall now take leave of Dr. Stevens and this controversy altogether, declaring "I'd rather be a dog, and bay the moon, and shall take no further notice (except it comes in a more tangible shape than assertion, for assertion and proof seem synonymous in the Doctor's vocabulary), of whatever his singular self-sufficiency may again prompt him to state to the public. In taking leave, however, of this gentleman, I cannot, I conceive, do better than give him the following theme, taken from a modern writer, for his cogitation and application. "There is nothing better known to those who are conversant in medical practice, than that the most ignorant and the most shallow, those of the least learning, nay, those of no learning at all, are the most addicted to hypothetical reasoning-the most infested with presump tion and conceit." Should Dr. Johnson do me the favour to publish this communication, the whole statement will then be before the profession generally throughout Europe and America; to the candid and liberal of whom, in both countries, most willingly do I submit the cause of truth, which, and a sense of what is due to them and the public, could alone, I assure them, have induced me thus to come forward (however feebly, perhaps, I may have executed my task) in its advocacy; and should I in any manner seem to have exceeded the bounds of courtesy, beyond what the novel peculiarity of the subject demanded, I confidently claim their indulgence, and would intreat them to consider it in its true light -the natural consequence arising from an highly-exciting cause. I have the honor to be, Sir, Your most obedient Servant, To Dr. James Johnson, &c. W. HACKET, M.D. Printed by G. HAYDEN, Little College Street, Westminster. Cholera, Mr. Lizars' letter on.. 229 Convulsions, puerperal, Dr. Rams- 304 Cholera, importation of Cholera at Paris Cholera at Ely Cholera, Baron Heurteloup on Cholera in Cork. ..... .... .... 234 Convulsions, puerperal, cases of... 305 ...... 330 Cholera, saline injections in 544 D. .... 545 Cholera, circular of the Board of Delirium tremens, case of 173 .... Cholera, moveable commission for.. 547 548 Diabetes mellitus relieved .... 439 Cholera, saline injections into the Diseases of the spine, Mr.Stafford on veins 550 Doctrine homoiopathique.................. 132 Epilepsy with scrofulous disease of Heart, purulent cysts in the 182 .... 406 .... 464 ........... 550 Heart, dilatation of the cavities of.. 183 21 1. Fractured sternum Fractured scapula... 537 14 214 Fungus of dura mater and cranium, 483 483 |