knowledgment of the infectious nature of the inoculated smallpox. For which purpose, he says in his " Account of inoculating the Small-pox vindicated from Dr. Wagstaffe's Misrepresentations," p. 25, second edition, 1722, "I own that it seemed probable that the six persons in Mr. Batt's family might have catched the small-pox of the girl that was inoculated: but it is well known that the small-pox were rife, not only at Hertford, but in several villages round it, many months before any person was inoculated there." He then enumerates several families who had the small-pox, and goes on to say; "besides all these, there were a great many more whose names I cannot at present call to mind, both in [the] town and [the] country about it, who had the small-pox, and several died of it, the summer before I began this practice. To charge then the spreading the infection and the consequences of it, through that town, upon two single boys who were inoculated in a court in a manner separated from all the rest of the town," [by the bye, he says in the first account, p. 28, that one of these boys could not be kept within doors] which was fuller of the small-pox before than after the inoculation, is not agreeable to that ingenuity which the Doctor (Wagstaffe) seems to demand of his adversaries."

Afterwards, p. 34, he says, "I think it is hard to exclude men from the means of securing themselves from a great pestilence, upon a mere suggestion," from all which it seems probable that Mr. Maitland would have been very glad to have it believed, that the persons in question catched the small-pox from some other source, rather than from the inoculated disease. If, however, there were no other evidence that Mr. Batt's servants catched the infection from the inoculated child, (which Mr. Maitland now finds it convenient to admit to be only probable) the mere circumstance of their being "all seized at once," would go far to establish the fact.

But there is more complete evidence. An absurd suspicion was entertained, arising from the mild symptoms of the inoculated small-pox, that inoculation did not produce the genuine disease. To subvert this suspicion Mr. Maitland published the following certificate, as a complete proof that the real small-pox was given by inoculation, because from this identical mild small-pox, six persons had catched the genuine disease in its several varieties by casual infection.

"These are to certify, that Mr. Charles Maitland, Surgeon, did, about the beginning of October last, inoculate the smallpox upon my daughter Mary, aged two years and a half, who had but few of them, and perfectly recovered in about fifteen days. I do declare that six of my domestic servants

were

were seized with the small-pox, which, I believe, was owing to their carrying about and conversing with my said daughter, they having had no correspondence during that time with any person or family who had them, which inclines me to think my child had the true small-pox."

This certificate is not only signed by Mrs. Batt herself, but attested by the marks of " two servants who received the small- -pox from the child," and who state that they know the contents to be true." A certificate to the same purport signed by Mrs. Heath was likewise published.

This

These extracts fully prove, that the mildest inoculated small-pox is infectious; and that Mr. Maitland and others were not aware of this fact, till it was forced upon their conviction, by the most indubitable evidence, and the sacrifice of at least one poor woman to the variolous scourge. I think will lead us to acknowledge, that Dr. Douglass is worthy of credit, when he says, that the friends of inoculation at Boston "first gave out that it was a method not infecting," and that when "many had died of the infection received from the inoculated, they gave up this point." (To be continued.)

I

To the Editors of the Medical and Physical Journal.

GENTLEMEN,

LATELY sent you the history of a case of fracture of LATEL the vertebræ, in which the mode of treatment there detailed was, in a great degree, successful.

I have now a few remarks to offer on the subject of fractures of the thigh, which, as they are the result of further experience, may be useful to my professional brethren and their patients; and, not the less so, for their being sufficiently obvious when pointed out, if they have escaped particular notice before.

It has long been the established practice, I believe, in fractures of the thigh (except in those cases where the fracture has been supposed to be within the capsular ligament at its upper extremity) to keep the limb in a bent position, whether the patient lay upon his back or upon his side. This has been my own practice: but there is a circumstance, which I am about to explain, of considerable importance, and which, I believe, has not hitherto been observed.

The objects of the Surgeon in setting a fracture of this limb are, of course, as much as possible to prevent the twisting of

the

the bone, if I may be allowed that expression, and to preserve its length. To secure the latter object, the plan first proposed by Mr. Pott, of placing the limb in such a position as to relax the muscles, generally, surrounding it, has been adopted.

Now, supposing the fracture to be within a few inches of the knee joint, the success of this treatment will materially depend upon the direction of the fracture; for, if the fracture be transverse, or if oblique, and the direction of that obliquity be not such that the lower fractured portion may rest upon the upper fractured portion, when the knee is bent, as much as it usually is on these occasions, the large body of muscle attached to the patella, will, by its communicated action upon the extremity of the bone, occasion a very material depression, and consequent separation of the lower frac tured portion from the upper,

Let the parallel lines A. B. C. D. represent the os femorisA. B. its anterior, C. D. its posterior surface when in an erect position; A. C. its upper, and B. D. its lower extremity. Let the line E. F. represent the oblique fracture of that bone in the direction (still in relation to its upright position) upwards and backwards. Let the dotted line from A. to B. represent the extensor muscles of the leg attached to the patella at B; and let the dotted line D. G. represent the direction of the resisting power, as applied to the calf of the leg, when bent at the knee, to prevent the shortening of the distance between A. and B.-the result of the action of the muscles of the dotted line A. B. and the resistance in the direction of the dotted line D. G, will be a sort of vertical rotation of the lower portion E. B. and a material depression of it at the point F.

There are two modes of ascertaining this state of the case, if the patient be laid upon his back; one is by comparing the patella with each other, (if there be a fracture of one thigh only) the patella of the fractured limb will be found, in proportion to the proximity of the fracture to the joint, to be evidently less prominent than the other. The other mode is, by passing the fingers along the under surface of the frac ture, when the depression will be evident to the touch. If, however, the patella of the fractured limb be as prominent as the other, the Surgeon need make no farther in(No. 150.)

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quity, as he may then depend upon the under portion of bone being properly supported by the upper.

Having pointed out this distinction, it is scarcely neces sary for me to remark that, where the fracture is transverse, or where the obliquity, as represented in the diagram, is upwards and backwards, the limb must be very little bent at the knee, and the rectus muscle would be still more relaxed if the body could be in some degree bent upon the thigh. I am not aware of any mode of preserving the proper length of the limb, where some resistance to the contraction of the muscles is not made by pressure upon the calf of the leg, and, when patients are placed upon the fracture machine, this is the only part which suffers pain. The cushion must therefore be made of the softest materials; ease may be fre quently obtained by lessening the pressure upon particular points, insinuating for that purpose small portions of wool on each side, upon the end of a spatula; and the less the knee is bent, admitting that it is sufficiently so to answer the purpose, the less will the patient suffer from the pressure.

A new, but untried expedient occurs to me, which I am disposed to think may answer the purpose, and would deserve trial in the event of failure of the plan I have just mentioned-it is this-Let there be a band of stout buck skin, or buff leather (which last has the united qualities of firmness and softness, and might, if requisite, have a padding of wool on its inner surface.) Let there be a band of this description, about two inches broad, buckled, moderately tight, above the knee at the usual gartering place, with the buckle on one side, and the skin beneath it protected by a prolongation of the strap made rather wider than the buckle. To the front edge of this band, immediately above the patella, let the end of a strap be fixed.

Then let an iron A. somewhat in the form of a spur, be projected from the knee extremity of the fracture-box B (see the plate in vol. XV facing p. 16.) to which it may be fixed, when wanted, by its also sliding into the staples C C, and what corresponds with the shank of the spur D should be curved upwards and have a loop at the extremity E, to which a buckle should be fixed for the strap from the band to be led through;

through; by which means a moderate degree of extending power might be employed, so as to counteract the injurious action of the muscles attached to the patella.

It must be remembered that, as only a moderate degree of extension in this way could probably be borne, this must be considered only as an auxiliary power, and employed when the action of the muscles is almost prevented by the limb be ing but little bent at the knee.

I am, Gentlemen,

Your humble Servant,

ROLD.

E. HARROLD.

Cheshunt, Herts, May 14, 1811.

To the Editors of the Medical and Physical Journal.

GENTLEMEN,

I AM concerned to find, by the perusal of your last Number, that my former observations have produced little change on the language and sentiments of your correspondent A. H. He remains equally hostile to the Medical Bill, and, as I think, is highly and unjustly prejudiced and intemperate. In order, however, that your readers may be enabled to judge and decide between us upon a question of such importance to the whole profession, I shall be glad to see a corrected sketch of the Bill published in your Journal, together with the clauses, which I repeatedly stated to have been omitted, from motives of prudence, in the present sketch, through the recommendation of the Members, who had engaged to introduce, and support the Bill in Parlia

ment.

A. H. has, it is true, retracted two material objections, on which he formerly laid great stress, and to wihch I now desire to call the particular attention of your numerous readers. He asserted, that the Bill would subject the faculty to a pecuniary payment. He now admits, on further consideration, that it will not so affect the present Establishment. This is an important concession, and will, I trust, make a due impression on the minds of the regular Profession. To them I desire to be understood as asserting, that the Bill will in no way be productive of expence or inconvenience in practice. They will be left as much at liberty to exercise their. skill and talents under the projected Act as at this moment. No practical restrictions of any kind were ever intended to be

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