A Remarkable Case of the Efficacy of the Bark in a Mortification. In a Letter to William Watson, M. D. F. R. S. from Mr. Richard Grindall, Surgeon to the London Hospital

XLIX. A remarkable Case of the Efficacy of the Bark in a Mortification. In a Letter to William Watson, M.D. F.R.S. from Mr. Richard Grindall, Surgeon to the London Hospital. Austin-Friars, Dec. 7th, 1757. SIR, Read Dec. 8, 1757. The following case being very singular has induced me to lay it before the Royal Society, and beg the favour to do it through your means. Although numerous instances are related in the records of medicine, of the great danger in interrupting nature in her operations, there is not one (so far as I know), in which more violent and extraordinary effects have been produced, than in the following. It may happen also, that this instance may be of service in ascertaining the virtue of the medicine in intermittents, when in the hands of men of judgment. On the 28th of June 1757, Mary Alexander, aged 31 years, of the parish of Whitechapel, was brought into the London hospital, having a mortification in both hands, which reached about an inch and half above the wrists. All her toes, and about an inch of one foot beyond the last joint, were mortified; her nose was also intirely destroyed by a mortification; and all these happened at the same time. Upon inquiry into the cause of this misfortune, I found, that on Monday the 30th of May she was seized with a quotidian quotidian ague, which usually began about three of the clock in the afternoon, and lasted near two hours; which was succeeded by a hot fit, and then a violent sweat. And in this manner she was afflicted for seven days without any material alteration; when, being informed by a neighbour, of a person, who had an infallible remedy for the cure of an ague, she applied to him. He brought her two phials, containing about an ounce and half each, of a pale yellowish liquor; one of which he directed her to take directly, promising, that she should have no return of the fit of consequence; and that, if she had any small return, the second bottle should cure her effectually. In consequence of which, she took one dose, which was at the time the cold fit had been on about a quarter of an hour: she had no sooner swallowed it, but, as she says, her stomach was on fire, and felt as if she had swallowed the strongest dram possible. The cold fit left her instantly; but she was immediately seized with so violent a fever, as to make her burn, and be extremely thirsty, all the following night; much more so than ever she had been before, till the next morning, when a sweat a little relieved her from the violent heat. When she rose in the morning, she was much troubled with a great itching in the hands, feet, and nose; and soon after all those parts began to feel numbed, or, as she describes it, as if her hands and feet were asleep; which she took but little notice of, till the evening of that day, when she found the nails of both hands and feet were turning black, and, at the same time feeling great pain in both, as also in her nose, and that they appeared of a darkish red colour, like the skin in cold weather. Upon Upon which, at nine o'clock that night she sent for an apothecary, from whom, I have since been informed, the person before mentioned had bought the medicine, which he gave her. The apothecary was not at home; his journeyman went, and finding the woman had a difficulty of breathing, ordered her a mixture with sperma ceti and ammoniacum to be taken occasionally. The apothecary did not see her himself till the 16th of June, when finding her in a very bad condition, that her hands, and feet, and nose, were entirely black, and had many vesicles or small bladders upon them, filled with a blackish bloody water; he opened them, and let out the fluid, and dressed them with yellow balsamicon; and in this manner continued treating her till the 20th of the same month, when, finding no material alteration for the better, he ordered her a brownish mixture, of which she was to take four spoonfuls every four hours; which, he informed me, was a decoction of the bark; and says, on taking this, she was better, as the mortification seemed inclined to stop. But as it was a bad case, he advised the woman to be carried to an hospital: and in this condition was she brought in, when she was immediately put into a course of the bark, taking a drachm of the powder every four hours; and in 48 hours taking it there was a perfect separation of all the mortified parts. She was then ordered to take it only three times in 24 hours; and pursuing this method for eight days, there was a very good digestion from the parts above the mortification. The mortified part became now so offensive, that the poor woman pressed me much to take off her hands, assuring me she would go through the opera- tions with good courage, being very desirous to live; though in this miserable condition. On the 12th of July I took off both her hands: I had very little more to do, than saw the bones, nature having stopped the bleeding, when she stopped the mortification. In a day or two after, I took off all the toes from both feet, and now discontinued the bark, the parts appearing in a healthy and healing condition; which went on so for five weeks, when, on a sudden, the parts began to look livid, her stomach failed her, and she was feverish; but, upon taking an ounce of the bark, in 36 hours her sores began again to look well. She was not suffered to leave off the bark so soon this time, but continued taking it twice a day for a month. She is now almost well: that part of her face, from whence the nose mortified, was healed in seven weeks; the stumps of both arms are entirely healed; and both feet are well, only waiting for one piece of bone scaling off, which I believe will be in a very short time; and she is now in good health. The person, who gave her this medicine, is a Barber and Peruke-maker at Bow. I applied to him several times, to inform me what it was he had given her. The affair was talked of so much in his neighbourhood, and the man threatened by the woman's husband, that for a long time I could not get him to tell me, till I told him, I had been informed where he bought the medicines; and the time of the day, that he had them, corresponding with the time of his giving them to the woman, and that I knew it was tincture of myrrh, he at last told me, that he had frequently given the above quantity of an ounce and half of of it in an ague; that it had never done any harm; and hardly ever failed to cure. Upon which information, I carried some tincture of myrrh to the woman, who tasted it, and is well assured it is the same liquor the barber gave her in her ague-fit. I am, with respect, Your obliged and obedient Servant. Richard Grindall. L. A Letter to the Rev. Tho. Birch, D.D. Secret. R.S. from John Pringle, M.D. F.R.S. inclosing Two Papers communicated to him by Robert Whytt, M.D. F.R.S. Pallmall-Court, St. James's, Dec. 10. 1757. SIR, Read Dec. 15. 1757. ABOUT three weeks ago I put into your hands an extract of a letter, I had then received from Dr. Whytt, containing a postscript to his Observations on Lord Walpole's Case; and slightly mentioning some doubts he had then about the justness of Dr. Springsfeld's experiments with lime-water, from some trials he himself had made, upon reading that gentleman's curious treatise on the extraordinary lithontriptic quality of the waters at Carlsbad in Bohemia. Within these few Days, Dr. Whytt having favoured me with a full account of those experiments, I have herewith sent you his paper, in order, if you please, to lay it before