Extract of a Letter from Mr. John Latham, Surgeon and Midwife, at Dartford, in Kent, to Mr. Warner, Fellow of the Royal Society, and Senior Surgeon to Guy's Hospital. Communicated to the Royal Society by Mr. Warner

XXXVIII. Extract of a Letter from Mr. John Latham, Surgeon and Midwife, at Dartford, in Kent, to Mr. Warner, Fellow of the Royal Society, and Senior Surgeon to Guy's Hospital. Communicated to the Royal Society by Mr. Warner. Read Nov. 7, 1770. Mr. A.B., about 55 years of age, was an healthy man till about 20 years since, when he was first seized with a fever; at which time he followed the trade of a miller, and maker of French barley. This last business, he tells me, is attended with very great heat to the operator, and exposes him to a continual cloud of dust. As soon as he began to work, his breath grew oppressed with a sensation of his body being puffed up all over; from which symptoms he was relieved by occasionally leaving off his business. On the first cold caught after his entering on this kind of employment, a fever attacked him; which has generally returned sometimes once, and sometimes twice in a year, chiefly in autumn; but sometimes in spring likewise: though he once missed being ill for two years together. After carrying on this trade for four or five years, he left it off; as he attributed his disorder chiefly to the effects of the meal dust. Be that as it will, the fevers have not been so violent since, as while he followed that occupation: though the cuticle, or outer skin, has come off, the same as before. As to the particulars of his illness, they are nearly as follow: The disorder begins begins with a violent fever, attended with pains in the head, back, and limbs, accompanied with continual retchings; he sometimes vomited up much bile, at other times little or none; the skin was dry, the tongue much furred, together with great thirst, costiveness, and the urine highly coloured. At the beginning of the fever he was generally let blood; this evacuation afforded some relief, and by keeping his body open, and taking cooling medicines, the retchings abated in about five or six days: the whole surface of the body became yellow, though this circumstance did not always happen. Afterwards it became florid, having the appearance of a rash; on which he felt a great uneasiness for several days, with a numbness and tingling all over him: when the urine grew turned, and deposited a thick sediment. About the beginning of the third week from the first attack, the cuticle appeared elevated in many places. In eight or nine days afterwards it became so loose, as to admit of being easily removed in large flakes. The cuticle of the hands from the wrist to the fingers ends came off whole, bearing the resemblance of a glove. He never was disposed to sweat in any part of his illness, and when sweating was attempted by medicines, he grew worse for it; nor was he much at ease till his urine deposited a sediment, after which he felt very little inconvenience, but from the rigidity of the skin. The nails of the patient, whose case you communicated to the Royal Society, are mentioned to have come off after the illness; I did not find that ever was the case in this person. As to your communicating the above account to the Royal Society, I beg that may be as you think proper: though, I should suppose it would not prove unacceptable to the medical members of that learned body; as it may shew, that the case already recorded in the Philosophical Transactions of last year is not a singular one. I wish the glove, I send you, was as perfect as I have seen some of them; but, as it is, I beg your acceptance of it. With the human glove, you will receive a curiosity, which I think not inferior to the glove; to wit, a very small foetus, brought into the world at the same time with a live child at its full growth. The woman was delivered before I came to her: on examining the placenta, a substance appeared somewhat unusual; and on washing it clean, I discovered the foetus abovementioned. It had no visible communication with the placenta, but was squeezed flat, though not in the least putrid, and seemed shrivelled. I don't remember a case like this mentioned, except in Smellie's, vol. ii. p. 85, where he relates one from the Academy of Sciences at Paris, nearly similar to this. May we not suppose the woman to have been with child of twins; and that this, dying, was not discharged, as was most likely to happen, but remained till the time of the natural birth, when they were both expelled together? I am, very respectfully, Gentlemen, Your most obedient, and very humble servant, Joseph Warner. XXXIX.