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itself in the abdomen, though, as ne hadsaid, he suspected that the mischief was inthat region. He was not satisfied now thatinflammation was present, but thinking thesymptoms did not call for bloodletting hegave mercury in small quantities; and asthe redness of the tongue showed great irri-tation of at least some part of the mucousmembrane, he prescribed prussic acid also.A few days after this, he was sent f or to

see her; she had been seized with a severepain in the abdomen, which was followedby five or six stools. The same symptomfollowed by the stools, he had since ascer-tained, had occurred on the previous day,but had gone off, and he was not sent foruntil the present attack. He found the ab-domen excessively tender all over. Eigh-teen or twenty leeches were applied, thepulse being weak, and on the following dayshe was free from all pain, and said she feltquite well, but the tongue still remained inthe same state, and the thirst continued.He saw her two days afterwards; she hadthen had no stool for forty-eight hours, andshe was vomiting up a large quantity ofgreen matter. The vomiting continued forthree days and nights incessantly, neithermedicine nor drink came up, simply the

green fluid, as often as it had accumulatedin much quantity. The red, dry, and hotstate of the mucous membrane, forbad theuse of creosote, except in quantities toosmall to be efficient; and, indeed, it couldnot have been beneficial in any quantity, asthe stomach was not irritable, but merelygot rid of the green fluid, when it, not beingable to pass downwards, accumulated in thatorgan, and there was no motion during thattime, though powerful purgatives, such asscruple doses of calomel, croton oil in largedoses, and turpentine injections were em-ployed. The pulse rose to 160, the pain inthe abdomen, which had been present duringthis last attack, had not returned, though alittle tenderness existed in the region of thecoecum. The patient lay on her side well,talked well, and moved with great strength,yet was evidently dying; she was bedewedwith a cold sweat. Of course lie had exa-mined as to the presence of external hernia,in every situation in which it could occur.When the purgatives and injections failed totake any effect on the bowels, he (Dr. E.)imagined there was rupture of the intestinesin some part, which had produced peritonealinflammation, as there was not the recurrentspasmodic pain present, which generallyprecedes or accompanies intussusception,and there was no hernia, nor the pain andtenderness of enteritis.On a post-mortem examination, the peri-

toneum contained a quantity of a dirty, darkfluid, such as was contained in the intes-tines. The ileum, in its lower portion, con-tained several ulcers, of various sizes, someas large as a silver penny, others not more

than a fourth of that size. Not very farfrom the junction of the ileum with the co-lon, one of the ulcers had so attenuated thecoats of the intestine, that they had givenway. The case might be called one of acuteulceration, the patient having been indis-posed for three weeks only. A writer inthe "Transactions" of the Medical and Chi-rurgical Society,hadstated,that in. these casesthe patient was seized,at the time of the rup-ture, with a very acute pain, which conti-nued till the time of death. He (Dr. E.)had published a case in the same work, inwhich this symptom did not occur, and thepresent case was another instance againstthe experience of the writer in question. Inthis case, the pain went away completely.the patient thinking herself nearly well.So, too, the pain of the peritonitis, whichhad come on afterwards, was, in a greatmeasure, subdued by the leeches. Thiscessation of pain occurred in many cases,also, which were on record. The inflam.mation of the peritoneum of the intes-tines, was sufficient to account for thegreat constipation ; there was no obstruc-tion in the bowels themselves, but theywere completely paralyzed. The interest-ing points in the case were, that acuteulceration of the intestines could go on with-out marked symptoms of inflammation; itwas rather a slow ulceration of an acutekind ; then the giving way of the intestinein one part, producing the great depressionand constipation ; then the pain all going,at one period, under the use of the leeches,notwithstanding the hole in the intestines,and the violent peritonitis, which went ontill death, with scarcely any pain.

CHILDREN’S HOSPITAL, PARIS.

HOOPING-COUGH IN A YOUNG CHILD EM-

PLOYMENT OF BELLADONNA.—SLIGHT CERE-

BRAL SYMPTOMS.—DEATH.—AUTOPSY.

if PIERRE PICARD, a boy two years of age,was admitted into the hospital on the 7th ofJune, 1836, under the care of M. Jadelot.The mother had remarked that the child hadcoughed, more or less, for the last threemonths; but for six weeks past the fits ofcoughing had become very violent. Onsome occasions the accesses of cough wereso severe as to bring on convulsive fits, ofwhich the mother says she counted as manyas six within fifteen davs. The child hadpreviously enjoyed good health, and hadbeen a strong-looking boy. Both parentshave been healthy, never subject to any con-vulsive disorder. The child has never la-boured under diarrhoea, passing one or, at

most, two stools in the twenty-four hours.Never suffered much while teething.June 8. The boy now presents a pale,

weakly appearance; the eyes light blue;

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the eyelashes very long and dark. He hashad several severe fits of coughing since hecame in ; however, the intervals betweeneach fit are passed quietly, without anysymptoms of febrile excitement. Pulse

102; respiration 34 ; performed without anydifficulty or uneasiness; abdomen soft, notdeveloped ; no trace of pain upon pressure;no diarrhoea ; the boy has passed two stoolssince his admission.

Infusion of violets; mucilaginous draught,3xi. Sulphur bath. The chest to be rub-bed with Fiorazenti’s halsazn (a balsam con-taining turpentine and ammonia).

9. The child sleeps well at night; appetitegood; no fever; bowels opened once with-out diarrhoea; respiration nearly natural,30 ; pulse calm, 96. The fits of coughinghave been frequent, and attended with anevident whoop : no vomiting after the fit;no expectoration of any kind. The cervicalglands are not enlarged. Continue reme-dies. Broth three times a day.

10. Cough not diminished; has had threefits this morning; each fit lasts about a mi-nute and a half; no vomiting after; no diar-rhoea; eats well ; skin moist, but free fromfever. Infusion of mallows; cataplasms ofbelladonna over the chest. Three soula inthe day.During the llth and 12th no change wor-

thy of notice took place; ou the 13th wefound that the violence of the cough hadmuch increased ; the fits were now followedby a discharge of the contents of the sto-mach ; no epistaxis ; no diarrhoea; abdomen Itumid, but free from pain ; skin now warmand moist. The child has an exacerbationof fever towards evening. He is now socross that it is impossible to count the

pulse. Respiration not diflicult or oppress-ed. Infusion of coquelicot; gum mixture;catapkzsms of belladonna to chest. Twoleeches to the right side of the chest. Weakbroth three times a-day,

16. The child has had since yesterday se-veral slight convulsive fits, during whichthe head was thrown back, and the eyesrolled about; they lasted, however, only afew seconds at each. The child now lies ina state of tranquil sleep. The face is mode’rately and equably flushed; respiration natu-ral, 36; pulse 132. The cough is very violent;the child has had already (ten o’clock) twofits, and has eight or ten during the day.He vomits up everything which is takeninto the stomach. Skin warm and moist;no diarrhœa; no epistaxis.—Coquel. Sina-

pisms to the legs ; two leeches behind eachear; three light soups.

17. The child lies on its back; is doll-looking and oppressed; the face is flushed ;eyes half closed. There has been no cou-vulsive fit this morning, hut the mother,whom we have just seen, says he was sub-ject to them when at home. Respiration isoppressed and difficult, 40, each expiration

being accompanied with a low, moaningsound. The skin is moist and very warm ;the cough is as violent as ever, though thewhoop is not now well marked. The leasttouch brings on a fit of coughing. No (iiiir-i-lioca. One or two liquid stools a-day.The child was agitated, and cried all night.Pulse small, 140. Chest sounds well onpercussion in front; but the little patientlies too uneasily to permit our auscultatinghim. The pupils are large and dilated ; novomiting; no epislaxis.-Coqucl. Sinapismsto the legs. Three soups.

18. The child has suffered under the sameagitation. Sleeps very little at night. Thefits of coughing are not so long, nor is thewhoop so well marked as before. Thecough, however, is very distressing still, forthe little patient thrusts his hand into thebottom of his month at each fit, as if to re-move some obstruction. He lies stupidlyin bed, and every now and then utters alow moan. The skin is warm and dry;pulse very small, 135 ; no convulsive fitsince; no vomiting; respiration is unequal,oppressed, 48; the chest is equally sono-rous at both sides, and nothing is heard onapplying the earexcept a large mucous rale.-Infusion of tnalloms. Extract of belladonna,1 g)’.; sugar, 6 gr.; to make six pills, to betaken during the day. Sinapisms to theright side of the chest.The belladonna was continued for a

couple of days, during which time thesymptoms continued without any great alte-ration. On the 21st we found the childlying in bed, half asleep, and much reducediu strength, the face excessively pala andthin ; eyes dull. The cough has not abated,but the infant is now unable to congh out,through feebleness. No vomiting or diar-rhœa. He had again one short convulsivelit. The skin is excessively warm and dry;the respiration deep, but not much oppress-ed, 50; pulse rather hard than feeble,160 ; no diarrhoea; abdomen not painful.Child is very dull, takes no notice when itis touched. There is bronchial respirationat both sicies of the chest ; the sound, how-ever, is but little diminished ; no ditferenceof sound between the two sides ; has passedtwo stools under him in bed. Continue re-medies.

22. Since four o’clock this morning thechild has become asphyxiated. At thattime the nurse observed that he began tosquint, and had small convulsive movementsof the face. He now lies on his back, nearlyinsensible, with the eyes wide open. Theleft pupil is greatly dilated, the right is of amoderate size; as we observe them theychange in form, and have contracted ; theleft is very small ; the right pupil is now notbigger than a pin’s head. The respiraãionis excessively rapid; pulse imperceptible;skin of body warm; extremities gettingcold.

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In half an hour after the above report waswritten the child died, without a struggle,or convulsions. The nurse assures us thatthe evening before death the child sat up inbed, and put both hands to suplxtrt the ves-sel from which he drank. She did not ob-serve any paralysis of the limbs during theten hours which preceded death.Body examined on the 23rd at ten o’clock.On removing the skull-cap the dura mater

is evidently distended by a quantity of serumunderneath, the fluctuation of which is

easily felt. When the dura mater is divid-ed, a little serosity escapes through somelacerations accidentally made in the upperpart of the arachnoid.

Brain.—General aspect of brain supe-riorly.—The whole surface of the brain iscovered with an infiltration of serous fluid,equally diffused on both sides. The ap-pearance of this fluid is troubled ; its seatis in the subarachnoid cellular tissue. Thevessels of the pia mater are a good deal in-jected, and numerous small capillaries runover the surface of the brain in alt direc-tions. Neither arachnoid nor pia mater ad-herent to one another, nor to substance ofbrain ; the pia mater, indeed, carries awaywith it a very small portion of cortical mat-ter, but this seems to arise from the greatsoftness of the brain.The base of the brain exhibits exactly the

same appearances, with an abundant iufiltra-tion of serum, between the membranes. Thearachnoid has not lost its transparency atany point. There are a few fine granula-iions about the fissure of Sylvius, at eachside, and a very evident aud elevated patch,about eight to ten in number, at the poste-rior and inferior surface of the right hemi-sphere. The membranes in the neighbour-hood of these granulations are not thickenedor adherent ; do not contain any yellow,lardaceous deposit; in a word, they do notexhibit the least trace of having been theseat of inflammation.The substance of the brain is very soft, and

has lost a great part of its elasticity. Itcontains a great deal of serum, which maybe extracted from it by pressure. It is onlymoderately injected. The lateral ventriclesare but slightly dilated, and coutain abouttwo tea-spoonfuls of reddish serum. Atthe posterior part, near the floor of the ven-tricles, we observe a lacerated appearance,as if produced by accident, or by distention.The septum lucidum and fornix are very re-markably softened ; the other central partsare in a normal state. The pineal glandis infiltrated with serum. The cerebellumand fourth ventricle are normal ; its sub-stance, like that of the brain, is soft, butmuch less infiltrated. The membranes arefree from adhesion or granulations, and nor-mal throughout.

Lungs,—No adhesion at either side of thechest, no effusion into its cavity. The ante.

rior surface of both lungs is marked bya number of miliary granulations. Theparenchyma, of the lung itself is much con-gested, but no actual inflammation has ex-isted, except at the inferior lobe of the leftlung, which is solid in some places ; givesway easily under the finger, and is of a deepred colour. The lining membrane of thebronchi is moderately injected ; they do notpresent any appearance of dilatation, notubercle in the substance of the lungs, norin the bronchial ganglia.The pericardium contains a small quantity

of serum. Tissue of heart normal, firm,valves healthy ; the right side is filled witha large clot. Transverse breadth of bothaorta and pulmonary artery, when laid openopposite the valves, one inch and five lines.

Abdomen.—No effusion into its cavity.The intestines are distended with gas ; liverbrown, firm, four inches high, 2.2 thick, fivebroad ;’ no tubercles in liver, or under itsperitoneal lining. Spleen 3 inches high,one thick, two broad; some miliary tuher-cles in, none on its surface ; it is of a darkchocolate colour, and firm. Coats of sto-mach normal ; it contains a small quantityof greyish matter. The intestinal canal ishealthy throughout. The subperitonealtissue contains, however, a small number ofvery fine tubercular granulations. The otherviscera of the abdomen are healthy.

VOMITING. DIARRHŒA. CREOSOTE.

To the Editor of THE LANCET.SIR:—Cases of diarrhoea with vomiting,

cramp, the rice-water-like dejections, pros-tration of strength, cold and blue extreiiii-ties, and other the usual symptoms ofcholera morbus, have, during the last month,been frequent in this neighbourhood. Some,I think about eight, have fallen under myobservation, in all of which, I have givencreosote with the most gratifying results.T would give publicity to one case (whichI suhjoin), and from which I was led to

adopt the practice of giving this medicinegenerally to allay the vomiting in this dis-ease. I am, Sir, respectfully yours,

C.C. E.Turnham Green, Aug. 29, 1837.

Mrs. Bridport, a housekeeper, aged 81years, was seized with violent vomiting andpurging, and with cramp 1)f the lower ex-

tremities, on the morning of the 7th inst.At eleven, A. JII. I found her suffering se-verely;—her pulse 60, and feehle; counte-nance shrunk ; extremities cold and of blneappearance; her stools liquid, opaque, andcolourless, with excessive prostration of

* These form a portion of a series of measure-mests made to ascertain the normal dimensions ofcertain organs at different ages.