3804.) 
ait, with regard to thd matter, cannot 
fail to be of ferious, and perhaps fatal, 
injury to his patient. 
Since the publication of the laft Report, 
the writer was called, in the middle of the 
night, toa lady one was feized fuddenly 
with the fymptoms of an apoplectic pa- 
roxyfm. ‘Though there was in her habit 
an evident predifpofition to the difeafe, 
the immediate caule feemed to haye been 
the having eaten the evenirg before a 
very hearty fupper ; a meal in which, by 
medical prefeription, the {carcely ever had 
indulged. It, is often mentioned in the 
public papers, as remarkable, that a per- 
fon has been found dead in his bed after 
having partaken, with a more than ufual 
appetite, his evening repaft; a circum- 
fiance avhich, fo far from making the 
event curious, fufficiently accounts for its 
premature occurrence. Emetics are often 
given, but are never proper in a fudden 
attack of this difeafe, as they inevitably 
produce a violent determination to the 
head, at the moment when its veffels are 
already dangeroufly diftended ; even bleed 
ing is fometimes of dubious utility. The 
partial accumulation more rarely arifes 
from a fuperabundance of blood than 
from a want of power in the veflels to 
diftribute it ree searly end impartially 
through the trunk and all the extremi- 
ties of the frame. Jn many cafés, there- 
fore, we ought to have recourfe to ftimu- 
lation rather than to evacuation. 
Inftances of this difeafe occur where 
brandy would cure, and bleeding infaili- 
bly deftroy. When it arifes, as it often 
doées, from a burden on the ftomach, or 
retention of matter in the inteftinal canal, 
the fymptoms are more fafely and as ef- 
fe&tually relieved by the adminiftration of 
a glyfter, or other modes of gentle purga- 
tion, than by thofe remedies which aét 
_ more imniediately and violently upon the 
ftomach. 
Another cafe in the private practice of 
the Reporter has recently occurred, which, 
by the patient himfelt and former Waedical 
_attendants, was confidered as hydrotho- 
yax, or what is more commonly called wa- 
fer in the cheft; but, after due examina- 
tion, and reflecting at leifure on the nae 
ture of the fymptoms, there appears every 
reafon to believe that it is not a difeafe of 
the lungs themfelves, but of the fomach, 
which, unnaturally ditended by a habit 
af inordinate imgurgitation, prefles upon 
Lift of Di tfeafess 
493 
the diaphragm, and. thus contracts the 
thorax, and prevents the free exercife of 
the pulinonary organs. If it were an 
idiopathic difeafe ef the lungs it would 
have been chronic, and without fatermi 
fioi, whereas it occurs only after imter- 
vals of different duration, and in general 
at periods when the flomach had mtn too 
copioufly replenifhed, Ass it generally oc- 
curred in the evening, the’ Cay fancied 
that it was produced by the evening air, 
but, in fa&, it arefe merely from the cir- 
cumftance of the evening being after his 
dinner, the only meal which he relifhed, 
and after. which he was in the habit of 
indulging in liberal and fometimes ine- 
briating potations. 
In two inftances of intermittent fever, 
which have of jate occurred within the 
province of the Difpeniary, opium in lieu 
of bark has been made ufe of with de- 
cided efiicacy and advantage. The em- 
ployment, however, in ague of this in- 
eftimable drug is not abjolutely a novel 
ractice. 
What at the prefent time furprizes us 
as difcoveries in medicine, will, upon en- 
quiry, be found in more inftances than 
one to have been familiar to the practi- 
tioners of former periods. Pe im~ 
provement in this region of se fical {ci- 
ence is perhaps more likely to arife from a 
diligent refearch into what has teen al. 
ready done, than by the utmoft and mot 
fucceisful exercife of modern imagination 
or ingenuity. 
In a melancholy cafe, where there was 
no chance of li'e, the Reporter fcrupled 
not, at the requelt of the p.tient, to de- 
clare the exatt nature of his fituation. 
The fear of death, no doubt in many 
cafes, accelerates the event; but this cir- 
cumitance, although it ought to regulate 
the time and modiiy the manner in which 
the truth fhould be told, caonot juftify ia 
any inftance a direét viclation of veracity. 
That princip'e may be compared to the 
principle of gravity ; the latter fometimes 
may kill, and frequently occafions im- 
portant mlilehiet but unlef$ we felt an 
entire reliance upon the invariable agtion 
of that principle, it would ber epaiiie 
for us to reafun with Certainty, or to fir 
a flep in life, without unceafirng anxiety 
and alarm. 
J. Rep. 
Southampton-row, Rufél-[quare, 
May 26, 1804, 
ALPHABETICAL | 
