1827. 1 Biographical Memoirs of Eminent Persons. 3'25 



for his instruction by all the higher nobi- and expression ; nor was the facility with 



lity ; and, for many years, he continued at which he imparted its peculiarities to his 



the head of his profession in the fashion- pupils less extraordinary. Signior Sapio 



able world. The superiority of his style died on the night of the 30th of June, after 



was ascribed to its incomparable feeling a short illness. He was iu his 77th year. 



MONTHLY MEDICAL REPORT. 



CLOUDS, showers, and light winds have prevailed in the metropolis and its neigh- 

 bourhood very generally since the date of the last Report. One or two days have 

 been characterized by a close and sultry heat ; but the usual range of the thermometer 

 has been from 65 to 75. The evenings have been cool, and the nights, in general, 

 cold. With such a condition of the atmosphere, it is not to be expected that any very 

 violent epidemic should reign. The complaints have, indeed, partaken cf that cha- 

 racter which is common at this season; that is to say, they have been bilious. The 

 functions of the liver and upper bowels have been manifestly disordered, and from this 

 source have proceeded many other groupes of symptoms ; but there has been no viru- 

 lence or malignity in the disease, and the mortality from this cause has proved below 

 that of ordinary seasons. 



One important distinction may be drawn among the bilious cases which the last 

 month has presented. Some have been attended with alternate chills, and flushes of 

 heat, and weakness of the limbs in other words, with fever ; while others have been 

 free from all marks of pyrexial excitement. The following may be taken as an instance 

 of the latter, or the simple bilious disorder of the season. A school-boy, aged about 

 thirteen, came under the Reporter's care, on the 2d of August, complaining of the 

 severest pain and stiffness of the lower extremities. He was unable to walk across the 

 room, or even to raise his foot upon a stool. Sleep was totally denied him by the 

 violence and obstinacy of the pain. His pulse, however, was unaffected, his tongue 

 clear, and the skin natural. His appetite was good, and the expression of his coun- 

 tenance unaltered. A moment's reflection convinced the Reporter that this singular 

 affection of the lower extremities could have its source only in sympathy with the 

 stomach and liver, that important centre of healthy and of unhealthy action, where, 

 rather than in the heart or in the brain, the old pathologists fixed the domicile of their 

 archaeus, or governing principle of the animal ceconomy. An emetic was prescribed, 

 which detached from the stomach and duodenum a large quantity of viscid rnucus and 

 of acrid bile. Some amendment followed instantly ; and the cure was completed in 

 forty-eight hours, by the aid of some appropriate aperients. A variety of cases, vary- 

 ing in the character of the leading symptom, but pathologically allied to the preced- 

 ing, have been recently met with. 



. Wherever, from the greater severity of the disease, its more gradual advances or 

 other less obvious circumstance, fever has been superadded to the truly bilious symp- 

 toms, more time has been required for the cure, and more delicacy in the administration 

 of the necessary remedies. The following have been the most usual complaints of 

 patients labouring under the bilious fever of the present season. Alternate chills and 

 flushes; a feeling as if they had been beaten all over the body with slicks; pains of 

 the legs and arms in particular; dryness of ihe mouth and throat ; nausea and disposi- 

 tion to sickness ; oppression at the chest ; head-ache, particularly severe on one side ; 

 great languor ; and total loss of appetite. To the physician's eye, the tongue appears 

 but little affected. The pulse is small, feeble, and, as it were, oppressed. The bowels 

 are sometimes confined, sometimes in a natural state. Piles have been a very frequent 

 concomitant of the other symptoms, and have contributed to shew that the proximate 

 cause of the disorder is a constricted state of the vessels supplying the chylopoietic 

 viscera. The obvious means of relief are the employment of calomel, emetic tartar, 

 ipecacuanha, and Dover's powder, iu doses and combinations suited to the strength of 

 the patient's habit, and the irritability or torpor of the stomach and bowels, but for 

 which no specific rules can possibly be laid down. The treatment thus began is to be 

 actively followed up by a solution of Epsom salts in peppermint-water, or by a mild 

 infusion of senna with aromatics or carbonate of soda, according as languor or acidity 

 predominate. Perseverance in these or similar means, for several days after the 

 apparent cessation of urgent symptoms, is requisite to prevent relapses, which have 

 been, unfortunately, but too frequent. 



. It has not occurred to the Reporter to witness as yet any cases of decided cholera; 

 but he has seen several of very pure dysentery, and he has reason to believe that this 

 disorder is daily becoming more prevalent. It has for its predisposing causes, warmth, 

 with moisture of the atmosphere 3 just as catarrh, the corresponding affection of the 



