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right as to the nature of hydrocephalus, that it is at first dependant upon inflammation, or congestion; and that the water in the ventricles is a consequence, and not a cause of the disease; the curative intentions ought to be extremely different in the first and the last stages. It happens very rarely that I am called to patients at the beginning, but in two instances wherein I was called at first, the patients were cured by repeated topical bleedings, vomits, and purges. Some years ago I mentioned these opinions, and the success of the practice resulting from them, to Dr. Quin, now physician at Dublin. That gentleman had lately taken his degree, and had chosen hydrocephalus for the subject of his thesis in the year 1779. In this very ingenious essay, which he gave me the same morning, I was much pleased to find that the author had not only held the same ideas relative to the nature of the disease, but had also confirmed them by dissections. In the year 1781, another case in the first stage demanded my attention. The reader is referred back to Case LXIX for the particulars. I have not yet been able to determine whether the Digitalis can or cannot be used with advantage in the second stage of the hydrocephalus. In Case XXXIII. the symptoms of death were at hand; in Case LXIX. the practice, though successful, was too complicated, and in Case CLI. the medicine was certainly stopped too soon. When we consider what enormous quantities of mercury may be used in this complaint, without affecting the salivary glands, it seems probable that other parts may be equally insensible to the action of their peculiar stimuli, and therefore that the Digitalis ought to be given in much larger doses in this, than in other diseases. HYDROTHORAX. Sec. 18. Under this name I also include the dropsy of the pericardium. The intermitting pulse, and pain in the arms, sufficiently distinguish this disease from asthma, and from anasarcous lungs. It is very universally cured by the Digitalis. Sec. 19. I lately met with two cases which had been considered and treated as angina pectoris. They both appeared to me to be cases of hydrothorax. One subject was a clergyman, whose strength had been so compleatly exhausted by the continuance of the disease, and the attempts to relieve it, that he did not survive many days. The other was a lady, whose time of life made me suspect effusion. I directed her
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