Extract of a Letter from Andrew Cantwell, M. D. Monspel. to Dr. Stack, Dated at Montpellier, June 23. 1732. N. S. Containing an Account of a Large Glandular Tumor in the Pelvis; and of the Pernicious Effects of Crude Mercury Given Inwardly to the Patient

IX. Extract of a Letter from Andrew Cantwell, M.D. Monspel. to Dr. Stack, dated at Montpellier, June 23. 1732. N.S. Containing an Account of a large Glandular Tumor in the Pelvis; and of the pernicious Effects of crude Mercury given inwardly to the Patient. On the 7th Instant, I was called hence to Balleruc, to visit an English Gentleman, who was ill there. In the House where he lodg'd, was one P—r M—n, born in France, but settled in Cadiz. This poor Gentleman, having been very ill these two or three Years last past, had lost the Use of his Left Leg and Thigh, was subject to frequent Head-achs and Pains in his Bones, but more especially in his Legs: For which, because he had been given to Women, his Physicians in Cadiz salivated him twice, sent him to several hot Waters, and gave him all the Remedies they could imagine, but to no Purpose; for his Illness increasing, he had from time to time great Difficulty of making Water, and going to Stool. In this Condition he came from Spain to Marseilles, and from thence was sent to the Waters of Balleruc, of which he drank a great Quantity. But as they did not pass, his Physician there order'd him strong Purges, with Clysters of a Decoction of Tobacco, and the like. He then began to vomit his Excrements; upon which the Physician to the Marquis of C———'s Regiment in Spain, who happen'd to be there, order'd him half a Pound of crude Mercury by the Mouth, which made him suffer the most exquisite Pains; and his Belly swell'd, and became as stiff as a Drum. Here Dr. Montagne was sent for, who soon discover'd the Error in the preceding Practice, by feeling a solid Body near the Rectum, which obstructing the Passage, hinder'd the Clyster-pipe from entering far enough into the Gut. After his Departure, the Patient was again order'd Clysters, which were injected with a crooked Pipe, and several Purges; till at the End of eight Days he died, having his Belly bigger, stiffer and harder than ever. Though I arriv'd the Day before his Death, I saw him not till after he expir'd. His Physician having invited me to open the Body, I willingly consented, curious as I was to find the solid Resistance or Tumor, which he could give no Account of. I sent for the Surgeon of the Village, who with a Bistouri (the only anatomical Instrument he had) open'd the Abdomen by my Directions, which was fill'd with a whitish Liquor of some Consistence. The Epiploon was all dissolv'd, and swam in this Liquor like so much Pus. This Water pour'd out, I examin'd the Intestines. The Colon was burst under the Stomach, and in three other Places at its lower Part; and so was the Coecum; the Ileum all inflam'd, and in one Part gangren'd. The Lips of the Ruptures were plaister'd with Excrements, all beset with a prodigious Number of Globules of Quicksilver; and when the Intestines were disengaged and taken out, the Quicksilver fell from them in large Drops. The other Viscera were in the natural State, except the Liver, which was gangren'd. As I was very solicitous about the Tumor, I look'd into the Pelvis, where I found an Excrescence of of a prodigious Size, which fill'd all its Left Side. I took the Knife, and clear'd all round the Tumor; whereby I found the urinary Bladder close pent up between the anterior Part of the Tumor and the Os pubis, which occasion'd the Strangury the Patient had been tormented with: The Rectum, which lay upon the Middle of the Os sacrum, was also vastly press'd on by the Tumor, which seem'd to take its Rise from the Holes that are in the Left Side of that Bone. The Surgeon was so unluckily impatient, that while I laid down the Knife, in order to separate the Os pubis with a Hatchet, he cut out the Tumor. I then examin'd the Os sacrum, which was so very soft, that my Fingers enter'd it every where on the Left Side. The Tumor is of an ovoide Figure, cover'd over with several Membranes: Its Weight is two Pound and an half; its longest Axis is five Inches and somewhat more than three quarters, French Measure; its shortest four Inches three quarters. At first Sight I took it for a Parenchyma; but, upon Dissection, found it analogous to the Liver in Substance, Colour and Consistence. Its Artery, Vein and Nerve are very big, and are distributed through its whole Substance: Wherefore I really take it to be one of the conglobate Glands of the Pelvis, whose Vessels yielding to the Blood impell'd thither with greater Force and in larger Quantity than usual, on account of the violent Exercises of Dancing, Jumping, &c. which the Patient very much practis'd, gave Room to its Increase to that enormous Size. Upon opening, I remark'd three very apparent Divisions in it: And where the Psoas lay over it, and one of the Pyramidales beat upon it, it was ossified. I preserve it in Brandy, and find that the small Vessels, that were most fill'd with Blood, press it out into the Interstices of the neighbouring ones. The Weight the Patient constantly complain'd of at his Left Hip; the Difficulty he had in going to Stool, and that of thrusting a Syringe far enough into the Rectum to give him a Clyster with any Success; the Tumor itself, which was easily felt upon putting the Finger into the Anus; together with the Palsy of the Left Leg and Thigh, might, I think, have given other Indications to the Physicians, than those they took. And, in my humble Opinion, the Frictions and other heating Medicines the Patient was ply'd with, contributed to augment his Illness. In fine, the crude Mercury he swallow'd, the vast Quantity of Balleruc Water he drank before it, with the strong Cathartics taken by the Mouth and Anus, seem to have cut him short of some Months, which he might have liv'd, had he used no other Remedies than a slender relaxing Diet. Printed for T. Woodward, at the Half-Moon, between the Two Temple-Gates in Fleetstreet; and C. Davis, the Corner of Pater-noster-row, next Warwick-lane; Printers to the Royal Society. M.DCC.XXXIX.