An Abstract by James Douglas, M. D. Med. Regin. & F. R. S. of a Book, Entituled, A Short Account of Mortifications, and of the Surprising Effect of the Bark, in Putting a Stop to Their Progress, &c. By John Douglas, Surgeon, F. R. S. London, Printed for John Nurse, at the Lamb without Temple-Bar. 1732

The other Draught is of a prodigious Swelling of the Eye of a Subject of the aforesaid Princess. This Swelling was occasioned by Hail; and it daily encreases and grows hard, except at the Place marked by the Letter \(a\), Fig. 5. This Circumstance is very singular, that the Optic Nerve and the Tunicles have stretched so much, that the Eye quitted its Socket, and fell down to the Beard, Letter \(b\). The unhappy Man is still living, and can move this Eye, which weeps, but, as is no Wonder, cannot see with it. The Tumour is not painful, but it is very troublesome to him about his Nose. If these few Curiosities be acceptable to such inquisitive Philosophers, as the Gentlemen of the Royal Society are, I have my Wish. I am, &c. Dantzick, July 4, 1730. IV. An Abstract by James Douglas, M.D. Med. Regin. & F.R.S. of a Book, entituled, A short Account of Mortifications, and of the Surprising Effect of the Bark, in putting a Stop to their Progress, &c. By John Douglas, Surgeon, F.R.S. London, Printed for John Nurse, at the Lamb without Temple-Bar. 1732. This short Account of Mortifications, &c. which contains Forty-eight Pages in a large Octavo, is dedicated to Ambrose Dickins and LII Glau- Claudius Amyand, Esqrs. Serjeant Surgeons to his Majesty, and divided into three Parts. In the first our Author treats of Mortifications in general, from Pag. 1 to the 6th. What he says upon this Head is collected from some of the most experienced Physicians and Surgeons, who all affirm, that a Mortification from an internal Cause is always incurable; and when it proceeds from an external one, it can never be cured but by Amputation, or separating the Part affected from the Sound. In the second Part he gives a very remarkable Observation of his own, which proves to a Demonstration, that a Gangrene, even from an ill Habit of Body, may be cured, contrary to the hitherto received Opinion. In the third Part, which begins at the 30th Page, he makes some Remarks on the present Case, and adds some parallel Observations from Mr. Rusworth, a Surgeon in Northampton, who had the good Fortune of making the first Discovery of the great and surprising Effects of the Peruvian Bark in checking the Progress of Mortifications, which he says has been likewise confirmed by the repeated Observations of that incomparable Surgeon Mr. Serjeant Amyand, who had often used the same Medicine, in the same Case, and with the same Success with Mr. Rusworth. Our Author says further in this Place, that it is only by taking off the Fever that the Bark produces all these good Effects. But to return to the Observation itself, which he has given us with a great deal of Judgment and Accuracy from Page the 6th to Page Page the 30th. He says, that April 22, 1732, he was sent for about fifteen Miles out of Town to visit a Gentleman near fifty Years of Age. Upon Examination he found the Back of his right Foot mortified, near the middle Toes, about the Breadth of a Shilling; his Pulse quick, and his Tongue dry. There being no Sign of any external Hurt, Bruise or Wound, his Physician, Apothecary and himself were all of Opinion, that it must proceed from some internal Cause residing in the Mass of Blood. The necessary Dressings being got ready, he scarrified the mortified Part, and cut to the very Bones without being felt by the Patient, having afterward carried his Incisions through the Skin as high up as the Knee, before ever he began to complain of the least Pain. His Limb was at the same time stuped with a proper warm Fomentation, and the Wounds dressed up, as usual, with Pledgets dipp'd in hot Oil of Turpentine, and over all a Poultess, or Cataplasm, was laid on of Theriac. Londin. Oatmeal and Stale-Beer, the Physician prescribing what Alexipharmicks he judged most proper upon the Occasion. April 23, Serjeant Dickins and Mr. Chefelden being called in, directed the same external Applications to be continued as before. April 24, The Mortification did not seem to spread. April 25, His Fever was high, his Tongue very dry, and the Mortification began to spread a little. He then scarrified again, and deeper. April 26, The Mortification seemed to be at a Stand. April 27, The Mortification spread across the Toes towards the Ball of the Foot, which he scarified deeper, and dressed as before. The Fever grew higher. April 28, He was forced to use the Actual Cautery, the Mortification getting Ground in spite of all he had done. April 29, He found no Benefit from the Cautery, though applied wherever the Part was corrupted. April 30, The two Surgeons that had been consulted before, the Physician, the Apothecary, and the Author, were all of Opinion, that even the taking off of the Limb could not save him, but that in all Probability he must die in twenty-four Hours, his Symptoms being worse than ever; that is, his Fever was very high, his Tongue dry enough to grate a Nutmeg, his Visage wild, he had a great Drought upon him, was very restless, the Mortification spread as far as the Tendo Achillis, and besides, the Patient complain'd of a Pain and Hardness in the Side of his Belly. In this deplorable Condition the Jesuit's Bark was proposed by Serjeant Dickins, and agreed to by the other Surgeons present, and half a Drachm was ordered to be given that Evening, and repeated every four Hours. May 1, This Morning he found a very surprising Alteration for the better, with regard to the Fever, and the other Symptoms complained of the Day before; the Patient had a good Night's Rest, and the Mortification had made no further Progress. May 2, There was a small Discharge from the Sore. May 3, He found two large Abscesses on each Side of the Ankle. The Violence of the Fever being taken off by the use of the Bark, Nature was enabled to form these Abscesses, and from that he concluded, that the Progress of the Mortification was effectually stopt. He observed upon giving the Bark but once in six Hours a small Return of the Fever, with a worse Digestion, which obliged him to give it every four Hours as before, and continued in that Dose for twenty-eight Days in all; and then every six Hours for five or six Days longer, though the Fever had quite left him all that time. The whole Quantity of the Bark given to this Gentleman amounted to ten Ounces. May 5, His Pulse was regular, and the Digestion plentiful and laudable. The Muscles and Tendons on the Sole of the Foot being all mortified, before the Bark was given, separated in Process of Time, and fell off very kindly, leaving the Bones of the Toes, Metatarsus and Tarsus bare and carious, which he afterwards cut off one after another, as he found Occasion, and could be done with Safety. About the Middle of November following the Ends of the Tibia and Fibula were almost covered with a firm Cicatrix; the Patient at this time was well in all other respects, and was able to walk about by the Help of a wooden Leg, and from that time has continued in perfect Health.