The phosphate of iron (first recommended by Mr. Carmichael, an eminent surgeon of Dublin), I have found to answer this purpose better than any other topical application. The best method of using this composition is to form it into a thin paste with water, and to apply it, by means of a hair pencil, to the surface of the ulcer every morning, over which a cataplasm of fine charcoal powder and oatmeal (in the proportion of one ounce of the former to four ounces of the latter) should be placed, of the temperature of the body. The poultice should be regularly changed twice a day.

The strictest care should be paid in this stage of the disease to support the general health by a strengthening medicine, as the Tonic Mixture (A), p. 115; to each dose of which from five to fifteen drops of the Solution of Acetate of Morphine may be added. If the system be free from fever, and the countenance pallid, from five to ten grains of the oxphosphate of iron may also be administered two or three times a day.

Before decomposition has taken place, or the skin has ulcerated, preparations of iron are manifestly hurtful.

Wine should be allowed in such quantities as to support the system, but not to excite heat or fever; and the Solution of Morphine should, at the same time, be occasionally employed to mitigate pain. The mind should be soothed, and kept in a cheerful state, as nothing is so apt as peevishness and despair to produce irritation in the system.

These methods of treating this disease I have found to succeed in several desperate cases, in which the operation of extirpation had been urged as and dernier resort.

Compression of incipient cancers by rollers, &c. has lately been recommended by Mr. Young, of London. I have never met with a case in which it proved of any advantage, but with many in which it evidently aggravated the disease, and materially injured the general health.

Dr. Sully and Mr. Farr speak very highly of the Infusion of Corsican Moss, in cases of scirrhous tumours. The dose is from a wine-glass to an ale-glassful three times a day. — (See INFUSION OF CORSICAN Moss, p. 134, and ANTISCROPHULOUS CATAPLASM (B), p. 120.

PRACTICAL REMARKS. By the foregoing account of cancer, it appears that it is not a disease of the constitution, as generally imagined, but a local complaint, arising from diseased absorbent vessels; that on its first appearance, means should be employed to rouse the action of the absorbent vessels for the removal of the accumulated mass of glandular matter; that the progress to ulceration is the consequence of the absorbent vessels being too diseased to act effectually, in which case the tumour should be

removed by the knife. That when the disease has advanced to suppuration, it may be cured by the application of preparations of iron, and by attending to the general health of the patient. That anodynes, as laudanum or hemlock, are serviceable, by allaying the morbid irritation of the part, and in procuring

rest.

OF CATALEPSY.-This very extraordinary disease attacks in fits, at irregular intervals, which generally last only a few minutes, but sometimes continue two or three days, when it is termed by the ignorant a trance. It is seldom succeeded by any derangement of the system; the patient falling suddenly down, and remaining senseless and motionless. The limbs readily admit of being moved, and continue in the position in which they are placed till the termination of the fit. Although all the senses seem entirely suspended, the patient will swallow with avidity any liquid put into the mouth. The countenance is florid, the eye-lids remain open, and the eyes seem fixed on some object. Sometimes there is a grinding of the teeth, and discharge of tears. The fit, sooner or later, terminates by sighing.

Dr. Cullen observes, that he never saw a case of catalepsy but what was counterfeited; and the same has been said by others. When it is not feigned, he thinks it must be a species of apoplexy; but there is a very evident difference between a fit of catalepsy and apoplexy.

CAUSES. It may be brought on by passions of the mind ; as fear, anxiety, and anger; by intense thought, worms, and excesses of any kind.

TREATMENT. If the patient be of a plethoric habit, or the face red and bloated, or the blood-vessels of the head and neck distended, eight or ten ounces of blood should be taken from the arm, or from the back part of the neck, by cupping. The Purgative Mixture (A), p. 118, and Antispasmodic Clyster, p. 106, will also be necessary, and the Mustard Poultice applied to the feet. The Antispasmodic Mixture, p. 110, should like

wise be administered as there directed.

The smelling salts, or the camphorated acetic acid, may be frequently placed to the nostrils.

If the disease should continue notwithstanding the employment of these remedies, the head should be shaved, and well rubbed with the following liniment :

Take of Oil of Amber,

Spirit of Hartshorn,

Oil of Rosemary,

4 drachms.
ounce.

2 drachms.

Slight electric shocks passed through the head have, in some instances, been of service in weakly subjects. Blisters have not been attended with any beneficial effect. The Galvanic fluid,

passed from the head to the feet in the direction of the spine, has in some instances been found very beneficial.

Dashing a pail of cold water over the body, once or twice a day, has proved more beneficial than electricity or galvanism. Practical Remarks. Catalepsy is a disease of the nervous system, occurring in opposite states of the constitution, viz. in the plethoric and robust, as well as in the debilitated and reduced. Like epilepsy, it depends on a peculiar state of the nervous system; and like it, is brought into action by whatever disturbs the general health, either by increasing the vigour of health, or by reducing it. The treatment must, of course, be regulated by the state of the constitution. Where plethora prevails, bleeding and purgative medicines are the principal remedies; and when the system is in a debilitated state, stimulants, as the mixture of assafoetida, electricity, &c. may prove beneficial. This disease, however, like epilepsy and hysterics, is often aggravated by officiousness, and especially by frequent exhibition either of medicine or food. A few gallons of cold water, poured suddenly over the body, is the most effectual remedy, often suddenly terminating the disease.

OF CATARACT. - This is a species of blindness, occasioned by a diseased state of the lens or its tunic, preventing the transmission of the rays of light to the optic nerve. If the retina (the expansion of the optic nerve in the interior of the eye) be not discased, vision may be restored, by either depressing the diseased lens, or extracting it entirely.

With respect to the advantages of depression over extraction, there is a great difference of opinion. Many respectable surgeons give a decided preference to depression of the lens, an operation certainly less painful and hazardous than extraction. If the lens happens to be too soft to allow of being wholly depressed (which cannot always be predetermined), it is afterwards frequently removed by absorption, which may be promoted by the exhibition of a little mercury. The only objection to this operation is, that the lens will sometimes rise again to its former situation; but this is a very rare occurrence. Some of the first oculists recommend the extraction of the lens; but it must be allowed that the intention is too often frustrated by the inflammation and consequent thickening of the tunics of the eye and it not unfrequently happens, that after the patient has gone through the pain of the incision, the lens is too soft to be removed entirely. The depression of the lens, on account of the operation being more simple, less painful, attended with little or no risk, and of succeeding as often as extraction, is entitled to the preference. Mr. William Hey, of Leeds, after thirty-three years' practice in diseases of the eye, states that experience has

led him to prefer the mode of depression, and very ably and satisfactorily confutes the arguments adduced by Baron Venzet and Mr. Ware in favour of extraction.

So many well-authenticated instances of the absorption of opake lenses, by the internal use of mercury combined with hemlock, having been published by respectable practitioners, the operation should in no instance be recommended till these medicines have had a fair trial. The following is the usual form for their exhibition:

Take of Extract of Hemlock,
Prepared Calomel,

1 drachm. 15 grains.

To be well mixed, and divided into twenty pills. One to be taken three times a day.

Of all the preparations of mercury, I have found the oxymuriate to answer best in this disease. Eight grains of this preparation may be dissolved in an ounce of spirit of wine, of which ten drops may be taken in a wine-glassful of barley-water twice a day after taking this solution a week, the dose may be increased to twenty, or even thirty drops, if the stomach will bear it. In the course of three or four weeks, the patient will be enabled to determine whether it be likely to prove of any utility.

The asarabacca snuff, by increasing the secretion from the nostrils, and exciting sneezing, may likewise prove very beneficial; but if sneezing occasion head-ache, or pain in the head, it should not be provoked.

To the state of the general health of the body attention should be paid. If the digestive organs be disordered, the treatment recommended for Indigestion should be adopted. If the patient suffer from a determination of blood to the head (producing head-ache, redness of eyes, or giddiness), the loss of blood either by cupping or venesection, or a blister to the nape of the neck, will also be proper.

Electric sparks may likewise be applied to the ball of the eye once or twice a day.

The following remarkable case of the gradual disappearance of a cataract, is an evident proof that the diseased lens may be removed by absorption, or that the structure may undergo a change by keeping up a degree of irritation in the part.

Admiral Henry having a cataract in each eye, consulted Mr. Ware, who recommended extraction. The admiral submitted to the operation on one eye, and in case it answered, he promised to allow him to perform it on the other. The operation having failed, the admiral resolved to have recourse to his pommcling system and friction, which he had found to succeed in numerous cases of rheumatism and chronic gout. After rubbing the ball of the eye, and at times gently beating it with a small

wooden hammer (the eyelids being closed), in a few weeks he found that he could discern a luminous body, and by continuing the practice, the diseased lens was so totally absorbed, that the gallant admiral was enabled to read small print. Since the publication of the last edition of this work, I have met with cases in which a similar treatment completely succeeded in removing the diseased lens. In the 11th and 12th numbers of the Monthly Gazette of Health, this practice is illustrated by Dr. Balfour of Edinburgh. A representation of the instrument used for rubbing the eye and other parts is given in the chapter on Rheu

matism.

Practical Remarks. The loss of vision in this complaint, arises from diseased structure of the lens, which, in consequence of becoming opake, mechanically obstructs the rays of light to the optic nerve. In this case, the lens may be considered as an extraneous body, and in order to restore sight, its removal is absolutely necessary. This may be done by mechanical means, and by nature. The mechanical means are two. The most simple, and not least successful, is that of depressing the diseased lens to the bottom part of the eye, from whence it seldom ascends, and, in course of time, is frequently absorbed, and in case it should rise again to its natural situation, after the cyst has been punctured in the operation of depressing, it is more likely to be removed by the absorbent vessels. The other method is, by making an incision through the coat of the eye, and removing the diseased lens entirely. This operation is much more painful, and more hazardous than depression, the object being sometimes frustrated by subsequent inflammation, and thickening of the transparent coat. The removal by nature is by means of the absorbent vessels, in which she is to be assisted by rousing their action by mercury, by friction, by sneezing, and by putting the system in a state of health.

OF CATARRH. Catarrh consists in an inflammatory excitement of the membrane lining the nostrils, fauces, and often the windpipe, attended with slight fever, and sometimes with cough. It generally begins with a sense of stoppage in the nose, a dull pain, and a sense of weight in the forehead, and stiffness in the motion of the eyes; and soon after a discharge of a thin fluid from the nose, and often the eyes, which constitute the complaint termed coryza. When the symptoms run high, and the disease is very prevalent, it is named influenza.

CAUSES. This disease is generally produced by sudden exposure to cold air, or by exposure of the head or chest to a current of air, sleeping in a damp room or bed, sudden changes from a warm dry air to a cold humid one, &c.