16. The malignant carbuncle, or charbon, of animals is characterized by the appearance of a voluminous uncircumscribed tumour, which yields to pressure, crepitates like emphysema, and exhales a peculiar putrid odour. The centre of the swelling is black, as if carbonized, and the circumference is infiltrated with a brownish or yellowish fluid, and distended by a very fetid gas. After death the substance of the heart is softened, and its external surface ecchymosed in the course of the blood-vessels. The blood in the heart and large vessels is generally fluid. In the veins it is very black, sometimes containing clots of a black or yellowish colour. The lungs are covered by small ecchymoses, which are also seen penetrating their substance. The stomach and intestines present black san the veins of the face, and a number of small | and more rapidly fatal tendency than in the latabscesses in the substances of the lungs. Inter; and that the true anthracion or malignant addition to the destruction of the integuments pustule is generally infected by the morbid fluids and adjoining cellular tissue of the affected part, of cattle, &c., and especially by the malignant marks of congestive inflammation with ecchy-carbuncle of animals, or that attacking sheep moses have been observed in the lungs, liver, and other woolly and hairy animals, and which spleen, and digestive canal. M. VIRICEL States, I shall briefly describe. that he found malignant pustules in the colon; and M. LAMBERT says, that the gelatinous serous deposites always found in the adjoining subcutaneous cellular tissue is occasionally also found in the cellular tissue of the mediastinum. A quantity of sanguinolent serum is commonly effused into the serous cavities. The several tissues are more or less softened, and the viscera and blood present the same changes as are found in the malignant carbuncle of animals. 14. III. DIAGNOSIS.-On its first appearance the malignant pustule may be mistaken for the bite of an insect; but it wants the minute central yellowish point of an insect bite, and soon presents the painful indurated base, and the sanious vesicle with which malignant pustule commences, and which, with the diffuse or erisypelatous and emphysematous-looking inflam-guineous ecchymoses, of various sizes, between mation surrounding it, also distinguishes it from furuncle, carbuncle, or anthrax. Malignant pustule in some instances, however, can hardly be distinguished from the more gangrenous form of carbuncle (see art. FURUNCULAR DISEASES, &C., 14, et seq.); and it is most probable that the one affection runs into the other, those cases of sporadic anthracion which have not been traced to contagion being only instances of very | severe carbuncle, the local and constitutional characters of which they have certainly possessed. 15. On the other hand, anthracion may be confounded with phlegmonous or gangrenous erysipelas, and with the gangrenous or sphacelating ulceration of the cheeks, and labia majora vulvæ met with in children, or even with the bubo or carbuncle of plague; and certainly cases of these occasionally very closely resemble anthracion, and if they be not seen at an early stage, or at their commencement, the diagnosis will be difficult, if not impossible in some instances. These, however, do not present the sanious vesicle or the puriform pustule with which anthracion originates; and the gangrenous affection of the cheeks of children commences in the inside of the mouth, and extends to the skin. From pestilential carbuncle and bubo anthracion is distinguished by the absence of the symptoms characterizing plague, and by the several circumstances attending either the one or the other. Cases of anthracion, however, are not so readily distinguished, as M. RAYER supposes, from the carbuncles in cases of sporadic or scattered plague. Indeed, he endeavours to draw distinction, but conceals close resemblances between this malady and those which are very closely allied to it, if they be not altogether identical with it. I would, however, infer, that the sporadic or uncontagious cases of malignant pustule, or the affection described as such, are severe cases of carbuncle (see FuRUNCULOUS DISEASES, 14, et seq.); that the malignant pustule or anthracion, caused by the contact of a poisonous or morbid animal matter, consists of local changes which closely resemble the worst cases of carbuncle, and of a constitutional disturbance often of a more intense the inner coats and under the peritoneum, and variously distributed in different parts of the canal. The liver and spleen are gorged with dark blood. The nervous system is said not to offer any change. 17. The same changes, local and visceral, which are found in the malignant carbuncle of animals are also found in the blood, heart, lungs, digestive organs, and other viscera in cases of fatal malignant pustule in the human subject; and, moreover, the discharge from the disease of the brute produces the same malady in man-malignant pustule or anthracion. The identity of both these diseases cannot, therefore, be disputed, although the spontaneous or sporadic appearance of anthracion in man may be disputed, or may want confirmation. 18. IV. PROGNOSIS.-The first variety may recover of itself, the gangrene terminating spontaneously, or being readily arrested by treatment. The second is much more serious, but it will generally be cured by the prompt and energetic use of caustics. The third variety is generally mortal, and it may end fatally in twentyfour or forty-eight hours from its appearance. The danger is always greater from the second variety, when it attacks the face, head, or neck, than when it affects the extremities. It is also aggravated by extremes of temperature. 19. V. TREATMENT.-M. RAYER states, that as soon as the existence of anthracion is ascertained, the part must be deeply scarified and extensively cauterized. To be effectual, the incisions should extend to all the gangrenous parts, but not beyond them. The vesications on the surface ought to be immediately opened and the fluid absorbed, and the denuded surface covered with a dossil of lint dipped in the liquid muriate of antimony, or with a small fragment of caustic potash, kept in its place by a strip of plaster and a bandage. Five or six hours afterward this application may be removed, and the eschar covered with lint spread with the unguentum resinorum, or some other salve of a similar kind. Instead of the caustics advised by M. RAYER, I would recommend the nitric acid to be freely applied, and to be followed by the usual dressings and the internal treatment pre scribed for gangrenous inflammation of the cellular tissue and for carbuncle. (See articles CELLULAR TISSUE, ◊ 35, et seq., and FURUNCULOUS DISEASES, 20, et seq.) 20. Next day, if it be found that no vesicular areola has been formed around the eschar, and if the patient complains of but little pain, without smarting or pungent heat, it may be inferred that the cautery has included the whole of the disease. If, on the contrary, a hard and deep-seated tumour has appeared around the primary seat of the malady, and symptoms of phlegmous-erysipelatous inflammation are present, the caustic must be applied again, having first removed the gangrenous parts, after dividing them by a crucial incision. This procedure is also necessary when the slough, which forms the centre of the swelling, has already become hard and impermeable like a piece of leather; for it must be removed to admit of the action of the caustic being exerted on parts not yet sphacelated, after which they are to be covered with a stimulating poultice. change of the blood without external gangrene.) — Bland, CLASSIF.2d Class, Nervous Diseases. 3d it is liable to the objections which may be urged against nosological descriptions, namely, that it represents merely a single type or phase of the disease; a single and distinctly characterized form, without any notice of the modifications and gradations which ally it to other disorders of the digestive organs. I shall first describe this affection nearly in the terms used by Dr. CULLEN, and afterward notice such variations as have fallen under my observation. 21. The value of escharitics in the treatment 2. The description furnished by Dr. CULLEN of malignant pustule is incontestable. They has generally been considered as most accurate, are indicated as long as the gangrene shows a his experience of the disease in a country where disposition to spread, or while its limits are un-it is prevalent having been considerable. But defined; but, in order that the constitutional or vital powers should be enabled thus to limit the extension of the local mischief, and to resist the imbibition and absorption of the morbid matters of the gangrenous part-should oppose the general infection and contamination which the peculiar matter of anthracion produces, and the consequent congestions, congestive inflammations, and visceral lesions which are observed in fatal cases, the powerful internal restoratives, aided by the aperients and enemata, that I have recommended in similar states of constitutional and local disease, should not be overlooked, but be promptly and efficiently prescribed. (See CELLULAR TISSUE, Diffusive Inflammation of, 35, et seq.; ERYSIPELAS, 73, et seq.; INFLAMMATIONS, 236, et seq.; GANGRENE, 66, et seq.; and Poisons, § 698, et seq.) BIBLIOG. AND REFER.-Celsus, De Re Med., 1. v., 28. 3. I. SYMPTOMS.-Pyrosis appears most commonly in persons under middle age, but seldom before the age of puberty. When it has once taken place, it is apt to recur occasionally for a long time after; but it seldom appears in persons far advanced in life. It affects both sexes, but more frequently the female. The fits of the disease usually come on in the morning and forenoon, when the stomach is empty. The first symptom is pain at the pit of the stomach, with a sense of constriction, as if the stomach were drawn towards the back. The pain is increased by raising the body erect, and is alleviated by bending forward. It is often severe, and after continuing for some time it is followed by an eructation of a thin, watery, limpid, or nearly clear and often ropy fluid in considerable quantity. This fluid is generally insipid, but it is sometimes more or less acid. The eructation is for some time repeated frequently, and does not immediately give relief to the pain; but it does so at length, and terminates the attack. C. P. de Herrera, De Carbunculis Animadversiones, 4to. Vallad., 1604.-Fournier, Observat. et Expériences sur le Charbon Malin, avec un Moyen assuré de le Quérir, 8vo. Dijon, 1769.-Enaux et Chaussier, Manière de Traiter les Morsures des Animaux enragés, et de la Vipère, suivie d'un Precis sur la Pustule Maligne, 12mo. Paris, 1785.-Thomassin, Sur la Charbon Malin de Burgoyne, ou la Pustule Maligne.-Jemima, in Jour. de Médicine, t. liv., p. 144.G. L. Bayle, Consider. sur la Nosologie, la Médecine d'Observat. et la Médecine Pratique, suivies d'Observations pour servir à l'Histoire des Pustules Malignes, 8vo. Paris, 1802. -Davy la Chevrie, Sur la Pustule Maligne, 4to. Paris, 1807.-Littré, in Journ. Hebdomad. de Med. Sep., 1829, p. 449.-Lambert, Révue Médicale. 1830, p. 481.-Hurtel d'Arboval, Diction. de Chirurg. Vetérinaires, 8vo. Paris, 1826, art. Charbon-Leuret, Recherches et Expériences sur les Altérations du Sang., 4to. Paris, 1826.-Lallemand, in Archives Génér. de Méd., t. iv., p. 242.-Costallat, in Journ. Hebdom. de Méd., t. i., p. 51.-Blandin, ibid., t. iv., 4. I may add to the above, that I have seen p. 417. (Treated by the application of the Acidulous Ni- this affection more than once in males much trate of Mercury.)-Lisfranc, in Journ. Complément. des Sc. Médicales, t. xxxix., p. 304. (Prefers the actual Caubelow puberty, occurring at any hour of the tery to the potential.)-Decaris, Révue Médicale, t. xv., p. day when the stomach was empty, and affect429. (A case cured by phosphorus dissolved in ether.)ing patients with good appetites and rapid di-Schwann, ibid., t. xvi., p. 463.-P. Rayer, Theoretical and Practical Treatise on the Diseases of the Skin, 8vo. Paris. Transl. by R. Willis, 8vo. Lond., 1835, p. 557.J. Bouillaud, in Diet. de Méd. et Chirurg. Pratiques, 8vo. Paris, art. Charbon.-Rochaur, in Dict. de Méd., 2d ed., art. Pustule Maligne.-D. Hoffmann, in Rust Magazine, b. xxi., p. 70.-Marjolin et Ollivier, in Dict. de Méd., 2d ed., art. Charboneuses Affections. (They adduce several instances of the charbon, or malignant carbuncle of animals, having produced malignant pustule in the human subject; and cases of constitutional disease, with visceral lesions, and gestion. I have seen it also unattended and not preceded by any actual pain at the pit of the stomach, but by slight uneasiness only in that situation; and in more than one case the patient complained of the great coldness of the fluid thus ejected. The pain is quite different from that of cardialgia, or heart-burn, when the fluid brought up is abundant, insipid, ropy, and colourless; but when it closely resembles cardialgia, the sensation of constriction, with bending forward of the trunk, is not present, and the fluid ejected is often acid, and less abundant than when the pain is of the constrictive character above described. In no case is the dis-sea or vomiting, and as this discharge may be ease attended by fever, or by nausea or retchings. The fluid is always regurgitated or eructated by a similar inverted action of the esophagus to that producing rumination. It has appeared to me, during a careful observation of some cases, that the constrictive pain, as well as the ejection of the fluid, partly may be referred to the diaphragm. 7. III. PROGNOSIS.-Having once taken place, pyrosis is very apt to recur, and it is often very difficult to cure; but I have not met with an instance of it having passed into serious or structural disease, or been attended with danger. I am intimately acquainted with a gen has digested its contents, and contains nothing but the fluids which it thus ejects. Pyrosis cannot be confounded with simple gastrodynia, inasmuch as the former is attended by the copious discharge of a peculiar fluid, without nauabundant although the pain may be very slight, gastrodynia being only a symptom of several gastric diseases. Dr. WEST states, without, however, adducing his authority, that the secretion of true water-brash is composed of water, albumen, and a trace of sodaic salt, with an excess of soda; and that, when it is acid, this property is owing to the muriatic and acetic 5. Complications.-Pyrosis may be independ- acids. A recent analysis of the fluids thrown ent of indigestion, or be attended by rapid di-off the stomach has been published; but they gestion; it also may be associated with either do not appear to have been the fluids ejected of the forms of dyspepsia or with flatulence. It by pyrosis, as they were mixed with undigestis commonly complicated with costiveness, and ed food, and contained much acetic acid. (SIoften with torpid function of the liver, or even MON's Animal Chemistry, by Day, &c., vol. ii., p. with disease of this viscus. That it is often 393.) associated either with organic or with funetional disease of the pancreas seems probable. Indeed, it has been long supposed, and by various writers, that the fluid thrown off is merely an excessive discharge of the pancreatic fluid regurgitated into the stomach, and thence into the mouth; but, as Dr. KERR has justly remark-tleman who was long subject to this disorder ed, if this were the case, we should expect the fluid to be mixed with some bile. Besides, it could hardly be expected that so large a quantity of fluid could be furnished by the pancreas in so short a time as during a fit of pyrosis. I am not aware of any instance in which organic disease of the pancreas has followed pyrosis, or in which such disease had taken place in a patient who had been at any previous period the subject of this affection. Dr. SEYMOUR adduces a case in which organic change in the liver followed pyrosis; but the cases which I have observed have not been associated with any organic change, excepting in one instance, although various functional disorders have often been present. It is not unusual, especially in northern countries, where pyrosis is most prev-in females than in males, and in the unmarried alent, to observe it in the course of pregnancy, and in both married and unmarried females, complicated with leucorrhoea. I have seen it in one instance associated with disease of the ovaria, and frequently in these countries with chronic rheumatism. when he was a boy residing in the north of Scotland, and who was afterward frequently attacked by indigestion; but he is now well and strong at an advanced period of life. Persons who are subject to it generally are able to pursue their avocations without much inconvenience; and often continue free from it for a considerable time, without any very obvious cause, and then are attacked, owing either to some error of diet, or exposure to cold and moisture. When the complaint is prolonged, the patient frequently becomes pale, considerably emaciated, and debilitated; and when it is protracted in females, scanty, or difficult, or painful menstruation is a common consequence. 8. IV. CAUSES.-A. Pyrosis is more frequent than in the married. It may occur at any age, after six or seven years, but it is most common after puberty and until far-advanced age. It is so prevalent in some countries as to be considered endemic in thein, especially in Sweden, Norway, Lapland, Scotland, and the Isles, 6. II. DIAGNOSIS.-Pyrosis is readily distin- &c. It has been attributed to the diet used by guished from other affections of the stomach the natives of these countries-to the use of by the absence of the usual symptoms of indi- rye, barley, oats, potatoes, &c., and the want gestion; by the appearance of the fluid ejected, of animal food. It has been supposed that the its clear, colourless, generally insipid nature, use of unleavened or unfermented bread may and abundant quantity; by the absence of fe- be concerned in producing it. The share that ver, of nausea, or retchings; by the manner in these causes may have in occasioning it can which the fluid is thrown off; by the mere re-hardly be determined. But it is also prevalent gurgitation without nausea; and frequently by the little inconvenience or general disturbance attending it. The eructations which often accompany cardialgia, or other forms of indiges-siderable quantity, and of dried fish-both the tion, are usually observed during the progress of digestion; the fluid eructated being generally in small quantity, and acrid, always discoloured, and often furnishing indications of the indigestible matters. When the fluid of pyrosis is at all acid or acrid, these properties are much less marked than in cardialgia or the allied states of dyspepsia (see art. INDIGESTION, 13, 14); it furnishes no indications of undigested matters, and is thrown up from a stomach which in countries where not only these causes prevail, but others which may concur with them, as the use of dried and smoked meats in con dried meats and the dried fish being preserved without salt, or with very little. Pyrosis is certainly, also, much more frequent in cold and humid climates than in temperate, dry, or warm countries, and among the poor and ill-clothed than among the wealthier classes; although the latter are not exempt in these climates. LINNEUS states that nearly one half of the population, men and women, living near the mountains in Lapland, were in his time the subject of this complaint, and that in some it endured through their entire lives. 11. V. TREATMENT.-The indications of cure should be based upon sound views of the na9. B. The exciting causes of pyrosis are chief- ture of a disease; but if these views are not ly long fasting, errors in diet, tasting savoury to be found, we must fall back upon the results articles of food, without partaking of them of experience as far as they may be trusted. cold and humidity, especially when their influ- If the above opinion that the disease is generence is prolonged, and the warmth of the body ally produced by a diet requiring a copious seis not promoted by exercise; cold applied to cretion of the gastric juices, but that the atthe lower extremities; powerful mental emo- tack is excited by the want of that supply of tions; a poor and unwholesome diet; the priva- food which is usually furnished to the stomach, tions often contingent upon a laborious life in a or which is required for the quantity of the cold and humid climate; and the want of saluta-juices habitually secreted, or secreted in exry stimuli, or of wholesome beverages, experi-cess under the influence of circumstances, be enced by persons who are thus circumstanced. at all correct, the intentions of cure may be 10. C. The nature of this complaint has been readily devised. Indeed, this view, as well as much discussed. Pyrosis has been viewed as the treatment, or, rather, the no treatment, a form of indigestion, and it is probably allied founded on it, is not infrequently adopted by to indigestion in many instances as it occurs persons subject to this complaint; for they genin this and other temperate countries; but in erally endeavour to prevent long fasting, rather northern countries I have seen instances of it than to cure the attack by eating, when the pain attended by powerful and rapid digestion. Dr. characterizing an attack has commenced; for PEMBERTON Viewed it as a morbidly increased if food were attempted to be taken at that time, secretion from the stomach, analogous to a di- unless in the slighter fits, it either could not abetic secretion of urine by the kidneys. Some readily pass into the stomach, or it would be physicians imputed it to obstruction or conges- rejected along with the fluid which has now oction of the collatitious viscera; and in this casioned a retrograde action of the stomach. light it appears to be viewed by Dr. SEYMOUR. According to this view, a change to a more diOthers have considered it as actually a disease gestible diet to food habitually requiring a of the pancreas; this organ furnishing the fluid less abundant secretion of the gastric juices, which collects by regurgitation into the stom- and avoiding long fasting, will often be sufficient ach, where it causes pain and irritation, follow- to cure the disease. This, in most places, caned by its expulsion. The reasons which mili- not be even attempted; although a popular retate against this opinion have already been no- course to several articles has been recommendticed (5); and the analysis of the fluid is said ed as substitutes for change of diet, and to preto demonstrate that it is not pancreatic, al-vent the ill effects of long fasting or of impropthough this is not a sufficient proof, for the pancreatic fluid may be considered just as likely to be altered in quality as in quantity. I once considered it as not improbable that this fluid partly consists of the gastric juice; for,, having observed it in persons possessed of pow-sons who are subject to this complaint. These erful digestion, and who live on food requiring strong digestive and assimilative powers, I inferred an abundant secretion of this juice, which would not infrequently be continued to be secreted in excess, especially in circumstances favouring the determination of blood to the digestive viscera, and in the very circumstances by which I have observed a fit of pyrosis to be produced, although there existed no food in the stomach to excite the secretion of the gas- 12. Many systematic writers, as well as autric juices; or, in other words, that pyrosis is thors of works on diseases of the digestive orproduced by the continuance of the secretion gans, appear either to have had no experience of the gastric juices after the food taken into of pyrosis, or to have observed it imperfectly, the stomach has passed into the duodenum; for they have confounded it with cardialgia and and that these juices, by irritating or other- other forms of indigestion on the one hand, or wise acting on the stomach, cause the pain at- with the more common occurrences and states tending the disorder, the inverted action of the of gastrodynia or gastralgia and of vomiting on organ, or the regurgitation by which they are the other, and have treated it accordingly. thrown off; the complaint ceasing for a time Doubtless there is a more or less close approxwith the rejection of these juices, and return-imation of cases of these affections to each oth ing only when the exciting causes (8, 9), the nature of the food, or prolonged abstinence from it, or other circumstances which may favour the secretion of these juices, without furnishing food to the stomach on which they may act, are brought into operation. According to this view, the frequent discharge of secretions, so instrumental as they are in the assimilative processes, must necessarily be followed, in protracted cases, by pallor, emaciation, anæmia, and the other complications and consequences mentioned above (§ 5). er food. Thus, opium, spirituous liquors, nux vomica, canabis Indica, tobacco-smoking and chewing, &c., are severally used in some countries with these intentions, and are more or less efficacious in warding off an attack in per substances, by allaying the morbid irritation of the nerves of the organ, diminish or prevent the excessive secretion of the gastric fluids causing the disorder; but, as long as the diet is persisted in that causes the complaint, the continued use of these substances is required to prevent a recurrence of the disorder, and thus the remedy often becomes as great an evil as the disease itself. er; still they are distinct. The pain of pyrosis is different from that of cardialgia, or of the more usual painful affections of the stomach termed gastrodynia, or gastralgia, and it may be so slight as to amount only to uneasiness. The matters brought up from the stomach are either not acid or very slightly so, are unmixed with undigested matters, are clear and colourless, are so abundant, and are so peculiar, even as respects their low temperature, as to constitute the chief feature of the complaint. The substances ejected either by eructations 371, or by retchings, in the ordinary forms of dis- | by NIEMANN and others. LINNEUS recommend- it had been long or often used, in the doses (20 [Pulverized charcoal, blended with carbonate of magnesia and united with ginger, has been successfully given (since 1812) in various forms of gastralgia and pyrosis, according to Dr. FRANCIS.] BIBLIOG. AND REFER.-S. Alberti, De Morbis Mesenterii, Ardore Stomachi, &c., 8vo. Witteb., 1578. In Hallert, Biblioth. Med. Pract., vol. ii., p. 214.-J. Crüger, de Ardore Stomachii, &c. Erf., 1715.-Raven, Beobachtungen, p. 111.-Ranoe, in Acta Reg. Soc. Med. Haun, vol. iv., p. 258.-Henke, in Horn, Archiv. für Pract. Medicin. July, 1809, p. 252.-M. Good, The Study of Medicine, vol. i., 4th &c., vol. iv., p. 13, and Works by Thomson, 2 vols. 8vo. edit., p. 119.-Cullen, First Lines of the Practice of Physic, 1827, vol. ii.-Reydellet, in Dict. des Sciences Médicales, 13. States of disorder quite distinct in themselves, and different in their natures and characters, have thus been confounded with each other; and substances which have been found of service in one or more of these have been recommended as cures for pyrosis, although they are either altogether inappropriate, or only temporarily beneficial. Indeed, unless the chief causes of the disorder be removed-unless many of those who are the subjects of pyrosis live on more nutritious and digestible food, and are better protected from cold and wet than usually fall to their lots-no permanent advantage can be expected from treatment. Most of the remedies which have been prescribed for pyrosis, and have been said to remove it, merely alleviate the attack, but seldom succeed in preventing a recurrence of it. These medicines are generally appropriate in cardialgia, and in most cases of indigestion which are attended by acidity and flatulence, and by the eructation of fluid matters, more or less acid, or acrid, containing undigested, or partially digested substances. But these cases are not cases of pyrosis; and although these medicines are sometimes useful in this latter affection, still they are not permanently beneficial unless they be aided by change of diet, especially by an improved diet. Among the remedies thus recommended, thoset. xlvi., p. 341.-B. Parr, Lond. Med. Dict., 4to. London, usually prescribed for the severer forms of indigestion hold prominent places, especially absorbents, as lime-water with milk; soap with small doses of opium; magnesia with various antispasmodics, and narcotics (RANOE, &C.); the oxyde of bismuth, with aloes or henbane (ODIER, MARCET, &c.); and ammonia in bitter infusions. As pyrosis was thus generally viewed as a form of indigestion, and not as an affection, caused by the nature of the diet and by the influence of cold and humidity upon the surface and extremities, and independent of defective digestive power, numerous other digestive aids were prescribed for its cure; and among these I may mention, as being sometimes beneficial, the mineral acids, particularly HALLER'S OF MYNSYCHT's sulphuric acid-the acidum sulphuricum aromaticum-the preparations of iron, and the balsams, especially the Peruvian balsam. Bitter almonds, with ammonia and the preparations of angelica root, were much praised by several German writers; and inspissated ox-gall,* with asafoetida and soap, It may be mentioned that the or-gall was recommended in several places of the first part of this work, and numer ous formulæ, in which it formed the chief ingredient, were given in the Appendix. These were published in September, 1832; but this medicine was employed by me in practice since 1820, and was not viewed as a novelty, as it had been for centuries prescribed on the Continent; yet has it 1809, vol. ii., p. 492.-C. R. Pemberton, A Practical Treatise on the various Diseases of the Abdominal Viscera, 4th edit., 8vo. Lond., 1820, p. 99.-E. J. Seymour, in Lond. Med. Gazette, vol. i, p. 783.-M. Baillie, Lectures and Traité sur les Gastralgies et les Enteralgies, ou Maladies Observations on Medicine, 8vo. 1825.-J. P. T. Barros, Nerveuses de l'Estomac et des Intestins, 3d ed., 8vo. Paris, 1829.-W. Kerr, in Cyclop. of Pract. Med., vol. iii., p. 578. T West, A Treatise on Pyrosis Idiopathica, or Waterbrash, &c., 8vo. Lond., 1841. (The systematic works of the Franks, Hufeland, and others generally err in confounding this affection with Cardialgia, and with those states of Indigestion which are attended by a discharge of acid, acrid, and undigested substances.) [AMER. BIBLIOG. AND REFER.-Francis, Cases of Morbid Anatomy, in the Transactions of the New-York Literary and Philosophical Society, vol. i., 4to.-Delbee's MidwifeMeigs, Diseases of Females ] QUARTAN FEVER. See FEVER, Intermittent. VER. RABIES.-SYNON. Hydrophobia (from top, La recently been paraded as a discovery by some writers in medical journals. |