620

which is at a distance of seven miles, andthat, immediately after the application ofthe instruments, he was driven back again.This proves how little inconvenience wasoccasioned bythe operations. I am inclinedto think, however, that these drives pro-duced the slight attacks of rigors whichfollowed the last examination.

CASE OF

BLUE SPASMODIC CHOLERA (?)AT KNIGHTSBRIDGE.

SIDNEY R. ENSOR.

To the Editor of THE LANCET. SIR,-Cholera having during the last

few months engaged the attention of the

public and the medical woild, I am inducedto forward you a case which I conceiveto be in its symptoms strongly analogous tothe reported cases of the blue spasmodiccholera of India and this country; it ishere, however, necessary to remark, thatthe patient had been afflicted for twelvemonths with hypertrophy and chronic rheu-matism.

I am, Sir, your obedient servant,SIDNEY R. ENSOR.

43, Dorset Street, Portman Square.CASE.

The patient, a youth about thirteen yearsof age, residing with his parents at Knights-bridge, having been previously indisposedwith the complaints above stated, was at-tacked on Sunday the 1st of January, withslight diarrhoea and vomiting ; the matterejected having the appearance of a mixtureof water-gruel and chalk. The pulse wasat that time 73 and soft, the lips livid, andthe countenance dejected. These symp-toms manifesting themselves at the com-mencement of the attack, I considered it

necessary to mitigate the action of thebowels, and relieve the vomiting, by order-ing’ the patient an aromatic draught, with20 drops of tinctura opii, to be repeatedevery two hours, should the intes!inal ac-tion continue. On Monday, the followingdav, he appeared to have rallied ; the vo-

miting and purging had ceased, and thelips had regained their colour. The patientat this time felt himself decidedly improved.Towards the evening of the same day, Iordered him a draught composed of cam-phor mixture, and 30 drops of tinctura

opii. On Tuesday, during the early partof the morning’, he complamed of cold andshivering, with considerable uneasiness inthe epigastric region. His bowels hadacted once since the day previous, but nourine had been passed. He complained ofpain in his stomach with a degree of ex-haustion, which indicated the approachingstage of collapse. I then prescribed a table-

spoonful of brandy, with ten drops of theopiate mixture, to be repeated every halfhour, until reaction should take place ; -,likewise I recommended continual frictionwith flannel, and diluted spirit of ammonia.In two hours the body had regained its ha-bitual temperature, and the patient appearedmuch relieved. Throughout the day hecontinued to improve, taking at intervals20 drops of the aromatic spirit of ammonia,and 10 drops of tinctura opii. On the

Wednesday he appeared to be fast ap-proaching a state of convalescence, not hav.ing had a motion -since Tuescl,-y, when,towards four o’clock in the alternoon, hebecame suddenly cold ; the tongue, whichhad been furred, warm, and moist, since thecommencement of the attack, was at thisperiod clammy and quite cold ; the abdomi.nal spasms increased, the skin became dryand corrugated, and the pulsation almostextinct. No urine had been passed sincethe second day of the attack ; the intellectwas unimpaired. He continued taking thespirit of ammonia with opium ; sinapismswere applied to the feet, stomach, and chest,accompanied with friction; at eight o’clockpulsation ceased in the extremities, the

spasms increased, prostration became moreevident, and the patient expired at fouro’clock on the following morning. Themind remained unaffected until within halfan hour of his decease, when a slight deli.rium supervened.

THE "NEW STYPTIC."

To the Editor of THE LANCET.SIR,-As the fate of the poor animal ex-

perimented on by M. Halma-Grande, at

the hospital, may be still more interestingto your readers than the mere experimentitself, I have to beg you will inse rt the fol-lowing particulars :-The day after the ope-ration on its carotid, M. IL visited it; hestated " everything was going on favour-ably," and declared he had " removed all theplugs." The animal, however, never re-

gained its natural vivacity ; its breathing was extremely quiclc, and its appetite veryfar from aldermanic. Eight days after theoperation haemorrhage returned, and it ac-tually bled to death. On examination, itwas found the styptic had no effect on the

artery, and that a very large consecutivaaneurism was formed; furthermore, time

plugs remained. Now, Sir, 1 think you andevery other person will agree, we ought nolonger to " suspend our judgments," butdeclare this to be, at least, a great piece ofhumbug, practised with consummate effron-tery. I am, Sir, your obedient servant,

A PUPIL OF THE LOND0N HOSPITAL.Jan. 15th, 1832.