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The author purpofes to publifh by degrees, the more remarkable cafes of his Hofpital practice; and in order to enable the reader to compare more properly the courfe and fymptoms of the difeafe with the eftedis of the remedies that have been employed, he com-, municates a feries of cafes of each principal difeafe. The remedies that are made'ufe of are the moil fimple and the lead expenftve.
When emetics are indicated, he ufes, inftead of ipecacuanha, 15 grains of gratiola, fometimes mixed with 5 grains of rhubarb. In the gangrene, he applies, inftead of the bark, the cortex Hippocaftani and falic ; inftead of farfaparilla he gives the carex arenaria. In intermittent fevers he has fuccefsfully employed the cortex Soimydae ; in the fluor albus he found the faba pichurim, half a drachm pro dofe for three times a day, very efficacious. For blifters he recommends a mixture of wax, turpentine, and the powder of Spanifh fiies. In contufions, equal parts of vinegar and water are Serviceable. After confiderable wounds or operations, he gives a fimple tin dure of opium every two or three hours, confifting of op. crud. dr. j.fpir. vin. reftific. unc.j. He employed the cortex caribous in intermittent fevers without fuccefs, but with fome ufe in the lumbago ; he never remarked any emetic quality of that remedy during its ufe. Such, and fimilar remarks, are contained in this work, which deferves the attention of hofpital phyficians, and of thofe who are obliged to have recourfe to cheap and fimple remedies. The greateft part of this volume, however, is devoted to the lefions of the head, of which 217 cafes fell under the author's care, from the ift. of November 1795, to the lft. of March 1800, 127 of which ended fatally. The method of treatment confifts of cold fomentations on the fhaved head, of venefettion, leeches, and the internal ufe of camphor; but he recommends, above every thing, the timely application of cold fomentations, of the ufe of which lie is fo much perfuaded, fhat in moft cafes the fatal event might be attributed to their being neglefted; but .they ought always to be kept properly cold, by the addition of ice, fnovv, &c. Thefe are the contents of this ufeful publicafon, the continuation of which we heartiiy approve. The Author of the work before us has been favourably known to the public as an acute reafoner, an able controverfialift, and a very zealous defender of thofe theoretical {peculations on various difeafes, which proclaimed the genius of the late John Hunter.
In his " Obfervations on Morbid Poifons," (publilhed in 1795>) Dr. Adams has taken great pains to eftablifli a very lingular opinion concerning the origin of carcinoma, which had been merely hinted at by Dr. Hunter, and which is again urfued at confiderable length in the treatife before us.
There are few difeafes in which the utmoft length of conje&tire, and the greateft latitude of experiment, are more to be allowed and encouraged than in cancer.
A melancholy conviftion of the extent of its ravages, and of the inability of artto^check it progrefc by any certain rules, hat been lately evinced by an inftitution in this metropolis, for the exprefs purpofe of inveftigating the nature of this dreadful calamity 5 and we feel difpofed to give a confiderable fliare of attention to the conje&ures advanced by the ingenious author of the prefent publication. As this is to be confidered as a fequcl to the chapter in the Observations on Morbid Poisons, juft alluded to, we fliall beg to prefent our Readers with the fum and fubftance of it in as few words as pofiible.
Schirrus, Dr. A. obferves, or the early ftage of carcinoma, is always compofed of certain cysts, which, he thinks, constitute its true charafter, and which are filled with fluids of different completions. Mr. Hunter has fpoken of the cylls as being cancerous hydatids, and this is the opinion which Dr. A. follows up in his fubfequent obfervations, and which conftitutes their originality. Thefe cyfts have fome peculiarites in their appearance and progrefs; the one, that their increafe is not towards the furface, like matter in a common abfcefs, but in every direttion ; another peculiarity in the difeafe is a difpofition to fungate even before the fkin is broken, and in a very high degree after it has become an open fore. After this period the progrefs of the difeafe is uncertain, fometimes with a rapid ulceration of the fungus, which, in floughing away, expofes feveral roundifli fovcoli, which are the cyfts with their contents, changed from their original appearance to that of an opake pale, refembling half diflolved leather. This alternate progrefs, namely, of the extenfion of thefe cyfts, of the formation of fungus around them, of the floughing of this fungus and the confequent difcharge of the contents of the cyfts, and of the attempts at granulating Dr. Adams, on the Cancerous Breast. milating which are made by the furrounding parts, forms the principal phenomena of this difeafe.
We fliall not further purfne the arguments of the Author in his Obfervations on Morbid Poifons, in order to eftabliih his opinion on the origin of cancer ; but he concludes the fubjeft by propofin^ a fet of queries, wherein are the following : Is the fimple hydatid the firft form of carcinoma? Have thefe hydatids a life independent of the fiibjett in which they grow, excepting as parafites? &c. &c. The anfwer to feveral of thefe queries is given by the Author in the work which we are now to confider, and to which it is high time to revert. This volume confifts of correfpondence between the Author and Dr. Baillie, Mr. Cline, Dr. Babington, Mr. Abernethy, and Dr. Stokes; in which Dr. A. ftates pretty fully his peculiar opinions, and his correfpondents fome of the obje&ions which may be urged againft them, and other very valuable illuftrative fa&s. Perhaps it would have affifted the reader in forming a clearer idea of th? Author's theory, if the fads on which it is founded had not been prefented in fo defultory a form ; but the authenticity which is attached to original correfpondence may make amends for this defeft.
Almoft the whole of our knowledge on that curious -parafitical animal, the human Hydatid, is contained in an excellant paper by globules being found of various fizes floating in the liquor, feems to prove.that they aie originally formed there, and not in the coats of the hydatid, upon which they.are afterwards depofited. The number of thole that had young ones in them, was few in proportion to the others.. : ; " The hy datids "in their growth and decay appear to pnfs through various ftages"; the'y are firft found floating in the fluid that fills the hydatid, and afterw ards attached to its coats. The hydatid thus pregnant with ycvn g, if the expreflion may be allowed, adheres to the neighbouring parts, increafes in fize, and becomes itfelf a fac, containing numerous fmall hydatids. Thefc, after a certain time, decay, and the fkins or empty bags are fqueezed together into a fubftance like ifinglafs. It is probable they ftill undergo a further change; two fmall bodies of the fize of the common bean, of a cheefe-like confiftence, and covered with a {kin, were taken notice of adhering to the bladder, near its neck; it may be a queftion whether thofe were not the remains of hydatids ? but that mull be determined by future obfervations." The hydatids of fheep differ from the human hydatid, in poffefiing befides a more mufcuiar bag filled with a tranfparent liquor, a mouth or longitudinal aperture, and a neck compofed of rings.
Thefe hydatids are contained in the abdomen of the animal; others are fometimes found in the brain, which again want the mouth and rietk above defcribed, and give the difeafe called the Jtaggers. Each'kind'of hydatid, when put in warm water, moves about brifkly, with a kind of periilaltic motion of the whole body, though it has'been taken out of the fheep for feveral hours.
??'The firft letter contained in this volume is addreffed to James Pitcairn, Efq. in .which Dr. A. makes fome obfervations on the ftrufture of the hydatid, and obferves, very juftly, that " the moil *f fimple idea of animal life we can well form, is that of the hytf datid, confifting only of a membranous bag containing a tranf-** parent -fluid. Thofe  ferved, I fhould be inclined to believe, that cyfts are only fometimes formed in a fcirrhous ftrudture, but are not cffential to itln this, however, I may be miftaken ; and it may be found by a more minute observation, that trie formation of" cyfts always conftitutes a part of a fcirrhous ftrudture. If you fhould be able to eftablifn this or any other general obfervation about the nature of fcirrhus, it will give me real fatisfa&ion. " I have known a fubftance which pofiefled the common characters ?f fcirrhous ftrufture to be converted into a kind of bony matter.
In this, I believe, that the earthy part will be generally found to be in a larger proportion to the animal part than in common bone. Mufcular and membranous parts I have known to be affetted with fcirrhus, as well as thofe which are ftridtly glandular. A fatty membrane I have feep affefted with the Hjme difeafe. The fat was almoft as hard as a piece of griftle." In the fourth letter, (from the author to Dr. Baillie) he explains more at large his opinion on the nature of hydatid, and the proofs of its exiftence in carcinoma. In this part of the fubjedt the author is fo clear and precife, that our readers cannot form a better idea of it than in his own words. " By the term hydatid," he obferves, " I mean an animal, confifting only of a cyft and its contents, incapable of exifting but in living animal matter, having the powers of fecreting or abforbing from its nidus the food which fills its whole cavity, and of producing an offspring fimilar to itfelf by no generative organs that can be traced. If  Dr. Adams, on the Cancerous Breast fhould be objefted that the etymology of the word would confine it to thofe cy{Is which contain a watery fluid,^ I would remark, that fuch is not the cafe with the common hydatid, the contents of which are coagulable, and fometimes tinged with red particles of blood. For this and other reafons, I fhould divide thefe into hydads lymphatica, and hydatis cruenta." *' That which is the fubjeft of our prefent enquiry, I fhould call hydatis carcinomatofa, which, befides the difference of its contents, has alfo the property of ftimulating the part in which it lives to form a kind of fungus, for purpofes I fhall endeavour hereafter to point out: my firft bufinefs is to prove, if poffible, the animalcular exiftence of carcinoma ; for this fungus, though in the cancerous breaft it is ufually confidered as the whole of the fcirrhus, appears to me only an appendage to the carcinomatous hydatid." " As you have been lefs converfant with the cancer in the breaft: than the vifcera, you may, perhaps, not have examined with your Hfual accuracy a quantity of apparently difeafed fat; which, when the part'is very much enlarged, is found inclofed in different portions of the fcirrhus, and of which the whole pofterior part of the tumour, as well as the fpa.ce from that to the axilla is ufually made up. This difeafed fat, as it is fometimes called from its appearing thinner, more tranfparent, and of a greeniih yellow hue, I have found to have all the properties afcribed to the hydatid in the human fubjedt." Dr. A. then reverts to the proofs of the feparate exiftence of the common hydatid given in Dr. Bailiie's Morbid Anatomy. The chief is, that the hydatid of the fneep, when taken out of the body and put into warm water, lias been feen to move. This, indeed, has not been obferved with the hydatid of the human liver; but as Dr. B. obferves, the reafon may be that the body is feldom examined till many hours after death. In the cafe given by Dr. Hunter, which we have juft alluded to, he found likewife that the hydatids when opened, retained a ftrong ccntratfils farce fo as to roll themfelves up in part. This power of contraction, Dr. Adams obferves, if not dependant on elafticity, is a fufficient proof of the life of thefe hydatids. If, therefore, the fame property, unconnected with elafticity, be found in the cancerous breaft, it will be fufficient (Dr. A. imagines) to eftablifh the point of the hydatid-life of this difeafed part. This he de-mon# rates in the following manner. exhibits this appearance, nor is it poHible in this ftage to dif~ tinguifh at firft light what I call carcinomatous hydatids frofti common fat. By this it appears that the yellow-green, tranfparency of the fat, and the contractile power of the inclofing tunics could only arife from life, and the degree of heat with which that life was attended." The next point on which Dr: A., exercifes his conje&ures, is oa the ufe of the formation of cartilage before ulceration, afid of the fungus after it, which fpring up round the ulcer; calling in aid of his explanation that principle fo well laid down by Hunter, that living animals lodged within another living body, do not whilfl alive ftimulate to fuppuration the parts which form their nidus; but that when dead they a?t as mere extraneous matter, aYid caufe this procefs to take place: Dr. A. thence explains the ufe of the carcinomatous fungus in the following terms: " Now, if carcinomata pafs through the fame ftages as Dr. J. Hunter has remarked of the common or lympahtic hydatid, is it not probable that on the death of any of them fuppuration will follow, and that this fuppuration may expofe the living hydatids in fuch a manner that many of them may die from not being furrounded by living animal matter? To prevent this, I conceive 3. fungus is formed, which inclofes individuals or clufters of them in feparate compartments, fo that the death of one fet produces no effeCt on the reft." " As far as my obfervation extends,' this fungus grows in every dire&ion where it is neceffary to preferve the hydatids. When z clufter of hydatids dies, the fungus between it and the furface ulcerates, or floughs flowly, till the compartment containing them is expofed. By this time, if the progrefs has been very flow, ali the tunics of the hydatids are detached, and the furface being clean will make an attempt at healing. If no dead hydatids are in the neighbourhood, it will often, for a time, fcab, or even fkin over.
But if, when the cavity is expofed, fome of the tunics of the hydatids retain their attachments, the attempt at healing will only produce an exuberance of fungus with retorted edges. This will continue till all the tunics or fragments of them are detached; after which, if no new impediment arifes, the edges will take a different direction, and the part heal for a time." The fifth letter, (from Mr. Cline to the author). The writer obferves, that he has often met with the cells in cancerous tumours, containing a greenifh yellow liquor, as mentioned by Dr. A. but they did not give Mr. C. the idea of being living hydatids. The writer alfo gives the following valuable practical directions concerning the removal of encyfted tumours.
" When an encyfted tumour is fmall, it may be cured by an opening that will difcharge its contents; and then by applying lapis fepticus to the internal furface, fo as to deftroy the cyft. But when they are very large, this praCtice muft be dangerous, becaufe the fuppurating furface might be greater than the conftitution is able to fupport. The removal or dcftruCtion of the cyft is generally Dr. Alams, on the Cancerous Breast? generally neceffary, for it rarely has any difpofition toheal. Evc? the leavinoa very fmall part of the cyft will be fufficicnt to prevent the complete healing of the wound." In the fucceeding letter, (in anfwer to the former,) Dr. Adams endeavours to explain the nature of the various cavities or cylts conne&ed with carcinoma. He fuppofes three kinds. The firlt is the common hydatid, in which, after the contents have been walhed away, on throwing the amputated part in water, the cyft Hill preferves its figure, and remains an empty cavity, or only filled with ferum. The fecond kind of cyft is a cavity filled with a gelatinous fubftance, which the author fuppofes to be carcinomatous hydatids, which have gone through their various ftages of birth, growth, and decay, and are retained in the enclofed fungus.
A third fpecies is a cavity compofed of cells, filled with a dark bloody fluid, to which the author gives the appellation of Hydatis Cruenia.
In the eighth letter, (which is from the author to Mr. Aberr nethy,) Pr. A. explains more at large the final caufe of the generation of fungus. This is in a great meafure a repetition of what we have'given our readers from the fourth letter; but the following paffages will include all the moll material fubftance of the author's hypothefis, which therefore we fhall quote. " In examining a carcinomatous breaft amputated in an early period, we meet with little or no fungus. By an early ftage I mean, before the difeafe, how long foever it may have exifted, has made any confiderable progrefs. If the progrefs has been fufficient to exhibit any fuperficial marks, by a circumfcribed puckering of the fkin, we find the fungus ufually confined to the fpace between the carcinomatous hydatids and the furface; but if the difeafe has made confiderable progrefs, fo that the whole breaft is much enlarged, it is then that we find various compartments in the fungus filled with hydatids in different Hates of their progrefs towards maturity and death. <c Hence it feems as if the hydatids'had a period of exiflence lhort in proportion as, their powers of multiplication are greater. Till they multiply (fuppofing them in a fituation that affords them a nidus for it) they appear more or lefs in a torpid ftate, occafion-. ally growing, and at other times ftationary. But the death, or perhaps even the approach towards death, of any individual or number of carcinomatous hydatids, inftautly becomes a fiimulus to the furrounding parts to generate this fungus, which, by feparating the dead from the living, produces in different parts of the fame breaft two different adtions at the fame time. One is a kind of ulceration, or more commonly continual iloughing of the fungus which inclofes the dead hydatids; the other is the formation of new fungus to protect the living hydatid, and in many inftarices, if not in all, the fungus becomes itfelf a nidas for the -generation as well as proteftion of future hydatids. That it does io for hydatis cruenta, when fuch are the contents of a cancerous breaft, we have every proof that our fenfes can furnilh. For in thefe cafes the gg ttie fungus is always much fofter and fpreads fafler, if the integuments are removed by the knife, cauftic, or ulceration, and the whole appearance when removed is fimilar to the defcription of thofe hydatids which have efcaped from the uterus, adhering to a fpongy fubltance refembling or fcrving as a placenta." In a private letter to the Editors, Mr. C. complains that his Statement, which appeared in our laft Number " was not intended to tie obtruded upon the public in fo crude and incomplete a form, nor with the verbal errors it contains. He does not think his opponeiit juftifiable in fending what was inteiided for a fmall circle, before the public at large, without the knowledge and conferit of the writer." In the prefent pamphlet, Mr. C. has given that Statement of the Cafe which he wiflies to be eonfidered the only one intended by him for general infpe&ion. It does not differ materially in fafts or opinions from that given in the Journal. 'A fecond Cafe is added, very (imilar to the firft, which was attended by Mr. C's friend, Mr. Davey, who gives the following i-elation of-it. " When I firff faw her, which was riot lefs than two-hours and a half from the conimendement of the attack, fh? was juft recovered from a fit, which, from its fymptoms,' (defcribed to me by the perfons prefent) I judged to be apopledtic, arid of that kind which is termed by writers of the moil refpeftable authority, the nervous apoplexy.

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She was now perfeS^ly colle&ed in her fenfes, but hiid a difficulty in articulation, with a want of recolleftiori'. To explain which I muft obferve, her ideas of things were perfectly accurate, though Ihe had forgotten .the words which exprelTed them; I fay collected, becaufe when {he was at a lofs for a proper word,' if you mentioned.it, fhe direftly ufed it. " She complained of head-ach, itcknefs, naufea, nuffibrfgfs ^ all over her right fide/ with want of power to riiove that arm, thigh and leg, without the greateft exertion, and then could merely drag them after her.
For fome days previous to this attack flie had , been troubled with vertigo, naufea, general uneafinefs, pain in the head, and drowfinefs. .The bowels had been regular.