appearance every thing is going on well, cicatrization even commences and bids fair to continue to the completion of e cure when, however, suddenly a nail, black as the first, changes entirely the condition of the sores, and in a few days it looks as badly as at any time previously. Remove this nail and it goes through the same course as before, which will continue for weeks and even months, in spite of every effort, local and Constitutional, to bring the sore into a healthy state. Nor are hese the worst of this kind of ulcers, for in many cases they never show a disposition to heal from the time the nail has been removed until it reappears, and during the time be extremely offensive. Practitioners who have met with many of these cases, will not be suprised at my dwelling so long upon a matter apparently so unimportant. It is in these cases particularly I would recomend the extract of Belladonna. The following are very similar to many others in which I have used the article.

CASE I.

Master S. æt. 7., bruised the end of his thumb in

May, 1842. In June I was consulted, and found the dorsal side of the thumb ulcerated for three fourths of an inch from the end, including absorption of most of the nail. The excavation much deeper in the space previously occupied by the nail. The nail was divided into two portions, which were short, curled backwards, and jet black. The sore had been in that condition three weeks.

I removed the nail, and applied calomel with lime water, and lint, and as the patient was debilitated I gave Columba and Sarsaparilla in decoctiou.

July 1st. Ten days since I saw the patient-Ulcer the same as before, patient's health somewhat improved, sore very offensive, bleeds when touched a little roughly, considerably painful-Added one fourth grain of Ox. Mur. Mercury to a pint of decoction and continued it, applied Ox. Mur. Mercury to Ulcer, also lint, and covered with oil silk.

4th. Surface of Ulcer pale and secreting considerably,

very offensive, continued decoction as before. Mur. Mercury with bals. fir, lint, and oil silk.

Applied Ox.

Sth. Still very offensive and pale as before. Discontinued Ox. Mur. Hyd., both externally and internally, continue decoction. Applied Nitric Acid Solution with lint and oil silk. 12th. Ulcer about the same, continued the treatment. 16th. Considerably painful last night, discharges largely, and is very offensive. offensive. Ordered blue pill and opium at night. Applied Carb. Ferri and Acet. Plumb. and, instead of oil silk and lint, used linen merely.

This was continued for near a week when a new nail appeared, or rather two portions of nail, one on either side, which were attached at the root. This also curled as the first, and was black. I removed it and afterwards used various articles trying first lotions, then ointments, afterwards simple lint, and continued for four weeks when a third nail appeared. This I dissected out, with the gland which produced it, from which I hoped to derive some benefit, but to my utter chagrin six weeks passed, and although no appearance of nail to pre. vent a cure, the sore seemed obstinately the same, and during the time I had tried many articles which are recommended and some not recommended, and at last applied extract of belladonna, more for experiment as I had tried many others, with out any particular hopes of its proving beneficial.

The patient had suffered much pain in the arm at times before the use of this artcle which was occasionally so severe as to prevent sleep, but after its application for two or three days he suffered no pain, and in two weeks florid granulations had arisen a little above the surrounding surface, and in four weeks cicatrization was completed. The use of the article was not intermitted from the commencement, until the cure was effected. The extract was moistened a little and spread into the form of a covering, which was reapplied twice per week, and was all the dressing the ulcer received. It appeared alike effiecient in allaying the pain of the part, and reducing the sore to a healthy condition.

j

CASE II. I was consutled in January 1845, in reference to an ulcer on the index finger of Miss M. t. 11, who had it inred six months previously by a strike from a hmmer.

It

hud been sore two in nths when a physician was called who applied a blister which removed the nail, give the patient some blue pill, and applied mercurial o'ntment, which soon brought the sore into a healthy state, sm ill florid geanul.tons covered the surface and a speedy cure was anticipated which was, however finally interrupted, by the growth of the nail, which was black. thin, and curling. This was taken away with forceps having apparently but slight attachment, and the wound afterwards treated with the application of Sub. Mur. Hyd. and Aqua Calc., which appeared to have a good effect, and the Sore looked to be in a good condition as before, which cont'nued until the appearance of the nail again. It then assumed its former unhealthy aspect, the granulations become absorbed, and the excavation became deeper than before including part of the bone. But the nail was permitted to remain some weeks before its removal this time, which, how ever being finally effected the sore became healthy again, and remained so until the reappearance of the nail. After which it became as ill-conditioned as before. And it was at this time I was consulted.

Remembering the former case, after removing the nail, I made the application of extract belladonna as before and with like result. The gland not being dissected out the nail was reproduced but instead of the black color, it was of the redish hue which marks newly reproduced cuticle, and which afterwards remained a shade redder than the balance of the nails.

Several other cases have occured in my practice, similar to these and although the good effects of the belladonna were not so striking they were sufficient to convince me that it was superior to most or all other articles with which I was acquanted in ill-conditioned ulcers. One advantage it certainly does posess over other applications to sores viz., it never loses its in

fluence, the sore never becomes accustomed to its action, and I have witnessed its good effects for weeks in allaying the pain of malignant mammary ulcers, after the disease was so far advanced as to exclude all hope of cure. I have never known an ndividu il complain of severe pain in an ulcer to which it was applied.

ARTICLE V.

Influence of Disordered Functions of the Skin in producing Fevers. Extracted from a paper read before the Union Medical Society of Northern Indiana. By JOHN JACKSON, M.D.

Investigations with regard to the remote and proximate causes of fover have, at all times, engaged the attention of the medical profession. Malaria, according to the prevailing opinion, is a specific agent, capable of producing the class called bilious, intermittent, and remittent fevers. But have we not other agents to which to ascribe the production of fever without assigning unknown and doubtful causes? Are not the different electrical conditions of the atmosphere, moisture, cold, etc., agents active enough to disturb the equilibrium of the circulation and with it that harmonious action of the nerves so necessary to perfect health? Have we not, during the winter, a season unfavorable to the production of malaria, fevers presenting precisely the same phenomena as those called intermittent and bilious? and are they not treated successfully by the same kind of medicine.

We know that during winter as well as summer, if the functions of the skin are disturbed so as to suppress perspiration, large quantities of carbon are retained in the blood, as

is evident by its being found in excess, combined with other substances in the excretions.

Superabundance of carbon in the system, as is well known to medical men, is deleterious in its effects.

This redundance of carbon in the blood may, at any time or season, be occasioned by the quick closing of the pores of the skin-especially is this the case during warm weather; for, during the summer and fall, the skin is most active, and the lungs less so, for the reason that the quantity of oxygen in the inspired air is less in warm than in cold weather. In summer, therefore, the carbon cannot be carried off by means of the lungs in anything like the same proportion as during winter.

Again, all writers upon the subject of fever say it is the effect of irritation, seated, as most of them believe, in the capillaries. Allowing it to be in the capillaries, we would ask why may not fever-especially intermittent and bilious-be produced simply by an excess of carbon in the blood keeping up a coastant irritation in the capillary nerves.

Upon the first onset of most disease, patients exhibit all the symptoms of fever; that is, they present an irritability of pulse, congested vessels, and preternatural heat. These are the constant symptoms of fever; but if the action of the skin is restored, all the alarming symptoms quickly disappear, and with them the fever.

Fevers are always ushered in by a sense of nervous depression. A chill never occurs until the blood recedes from the surface. We consider, therefore, that the disturbed functions of the skin, produced by cold may be a frequent cause of fever, and that the proper treatment is to arouse its healthy action and allay nervous irritability. In the early stages this can be done by the application of heat alone; its constant effects being to stimulate the skin to action. Moreover, every practitioner knows that many of the fevers called bilious are cured by rest alone; or in other words, the patient gets well when the cause-a superabundance of carbon-is carried off