In at Cairo, and that muriatic acid has not always the quality of dissolving stony concretions. Not finding any dissolving medicine that would act universally, I was obliged to effect the cure of stone in the bladder by an operation with the instrument. Syria there were also Arabs, known as stone-operators, who adhered to the old method of Celsus, i.e., to bring the stone down by introducing the fingers into the rectum, and cutting it out through the perinceum; but I preferred the apparatus altus, where the stone is cut out from the bladder, through the pyramidal muscle of the belly, which produced a very great sensation, and obtained for me the name of a skilful operator. The first operation for the stone I made was on Mount Lebanon. Afterwards I performed similar operations at Damascus, Bagdad, Persia, India, and even at Bokhara, as the reader will find. In the year 1822, I began to vaccinate in Syria, with a lymph received from Aleppo, which acted well. Two particular cases which occurred at the villages in the neighbourhood of Tripoli (Syria) deserve especially to be mentioned here. The smallpox raged epidemically in those places, in a horrible manner, killing adults as well as infants, without any distinction. The use of vaccination was as little known in Syria, as it was in Europe before the time of Jenner, and I was just in the centre, or rather in the focus of that epidemical disease. A widow having two children, one son and a daughter, the latter of whom she loved and idolized, insisted upon only permitting the male to be inoculated, and if it should prove successful she would allow the operation to be performed on her fondled darling, the daughter. Accordingly I only vaccinated the son. When I visited him, after a lapse of eight days, I found the mother in despair, her daughter having during the interval died of the small-pox, whilst the boy was quite well, with large pustules like pearls on his arms; she regretted, but too late, not having followed my advice, and looked upon the event as a punishment from heaven. In another village, not far from the above-mentioned, I had to attend a whole family of eight persons, old and young, who were vaccinated all at the same time. After eight days, upon calling on them, I found a young man of about twenty years of age, in agony, in consequence of confluent small-pox, which eruption had taken place on the evening of the vaccination. He was the only person in the house on whom the vaccination had failed, on account of the man having carried on his shoulders a dead body that was infected with the natural small-pox; thus the lymph failed, by the counteragency of the contagion. The rest of the family enjoyed excellent health, and were saved through the medium of vaccination. There is an opinion prevalent, that vaccination will only keep off the small-pox for a period of twenty years. I was (if I am not mistaken) vaccinated in my native country, in the year 1800, with such an excellent lymph (not crust), that I treated a great many cases of small-pox, such as lately occurred in the years 1848 and 1849, at Lahore, without being affected by the disease myself, and that without having been a second time vaccinated. Nevertheless, if the second or third vaccination is of no use, it does no injury to the constitution. In one year I got from English physicians, lymph of quite different qualities, some from Umbala, and some from Delhi; the former was of a good quality, but the latter was of a very bad one, as the pustules sprang rapidly up and vanished in a very short time; neither was the areola of them red enough, which accounted for many of those whom I vaccinated catching the small-pox. I therefore discontinued to vaccinate with the matter from Delhi, after I had received some of a better quality from Umbala. At Tripoli, I met with the then new Governor Barber, who although of very low birth, had managed to get possession of the fortress, and afterwards of the town itself, by fraud and cunning. He was a short-necked man, thickset, inclined to apoplexy (Habitus apoplecticus), and, in consequence of his sedentary life, was troubled with hemorrhoids and obstructions. He consulted me, and when I ordered him to apply a clyster, he measured me wildly with his eyes, as if I had ordered him some dangerous remedy; I repented having done so. I remembered afterwards, that the Arabian physicians, although aware of the efficacy of clysters, as they are recommended in their medical books, seldom apply them, and only in cases where all other remedies fail, as they consider it as a last resource; in a country where pederasty is in vogue, it is disgraceful to acknowledge that fact. At his request for a proper remedy to be taken by the mouth, I prepared for him the well known aloetic dinnerpills, mentioned in the second volume of this work, from which he found great benefit. Besides these pills, I ordered him to observe the following rules: Post coenam stabis, vel passus mille meabis, or— "After dinner, sit awhile; For several years I spent the cold seasons in the maritime towns on the Syrian coast, at Tripoli or Beyrout, where the winters are only rainy; but I passed the hot summer-months in the most agreeable regions of Mount Lebanon. At Araba, not far from Seyda, I made the acquaintance of that original person, Lady Hester Stanhope, who called herself Queen of Palmyra. I was told that she ordered a herd of goats to be killed, and buried, and paid the people who did so, well, only because a few of them were scabby, and she thought by that expedient to prevent epidemical diseases, which might occur by their eating the flesh, or drinking the milk. Not far from Tripoli, there lay at the foot of the Lebanon, in a very romantic valley, a village called Mesrut-ul-Toofah (apple-district), where I was requested to attend some fever patients. My friends advised me not to go there, as in their opinion an epidemical disease was raging at that place; but I did not listen to their warnings, as I wished to be useful to those people who had implored my assistance, and at the same time to extend my experience. When I was near the village, I saw a great many Maronite girls (Christians), coming back from the well, with pitchers on their heads, each of them holding an onion in their hands, at which they frequently smelled. The epidemical disease had the character of a Synochus, and several persons had died suddenly, which caused great alarm among the inhabitants. The silk gathering was just ended, and I found the diseased were located in miserable, low houses, deprived of fresh air; I thought it advisable to cause them to be removed from their habitations, and brought into the manufactories, where previously the silk worms had been; and the result of my treatment was, that none of my patients died of that disease. I was conducted from Mesrut-ul-Toofah, to a place a little farther up the Lebanon, to Aïto, where the former French interpreter, Isaac Torbei, was confined to his bed with Angina, and was unable to articulate, in spite of all his efforts to do so. I examined his throat, and found an abscess therein, which I opened immediately; by which operation my patient was able to talk instantly, and after a few days he entirely recovered. From Aïto, I was brought to Kannobin, to the residence of the Maronitan patriarch, where the Bishop Mootran Seman lay very ill. Kannobin is situated on a declivity, from whence a beautiful view is obtained of the valley. It is by no means a town, as the Dictionnaire Encyclopédique Française (second edition) erroneously asserts, it being merely a convent. There is a curious custom attached to this country, and in most places of Asia. A physician being called on to attend a sick person, it is first arranged as to how much he will require for curing the same; upon that arrangement being completed, the physician receives one moiety of the sum agreed upon, and upon the recovery of the patient, he receives the balance, which includes the cost of medicine. Having arrived at Kannobin, I found the bishop suffering from nervous fever, in a state of insensibility. After a strict examination, I entertained but little hopes of his recovery. His numerous relatives, standing round his bed, appeared to have resigned all hope previous to my arrival. I agreed with the brothers of the bishop as to the amount they were to pay me for my attendance, the half of which I received in advance, for the medicines to be delivered, the other half to be paid after the recovery of the patient, from whose own hands I should receive it, according to the above-mentioned custom. All was legally signed by the parties and witnesses. I caused the troublesome spectators to withdraw, as by their thronging around the bed they occasioned disturbance and confusion, and only permitted four of them to remain as attendants. Then I was able to reflect, and found that the patient had been wrongly treated by his former physicians, and so reduced to a most pitiable condition. They had copiously bled him unnecessarily, and, led by a false diagnosis, they had prescribed him a quantity of decoctions and purgatives. I learned from the attendants, that four days previously the patient was constipated, which occasioned him to fall into a state of insensibility. I found it necessary to commence my treatment with a lenitive clyster, which did not fail to have its good effect; I afterwards ordered the room to be aired, sprinkled the patient's face with vinegar mixed with rose-water, and ordered his feet to be warmed by friction. At ten in the evening I applied a blister on the nape, and administered a compound opiate powder, which was given in a strong dose. I put it into his mouth, rinsed it from his tongue, after which he began to perspire, and passed a tolerably quiet night. The beneficial result was owing to the properly proportioned mixture of the opium, as I afterwards experienced in many cases, whilst a lesser dose (1-2 grains opium) made the malady worse. By this process the patient was saved. On the day of the recovery of the bishop, I had an opportunity to cure another patient, which occasioned a great sensation. The sexton of the patriarch was troubled with a tertian-ague. It was the fever day, and the patient complained of feeling dizzy, want of appetite, a bitter taste in his mouth; he looked very ill, and the white of his eyes was rather of a yellow colour. I ordered him an emetic, he vomited, and a long tape-worm was expelled, which I drew until it broke. On giving him a second dose of solution of tartaremetic, it operated, and caused the ejection of the rest of the worm by an evacuation. I ordered the pieces of the ejected worm to be washed. I measured them afterwards, and they were fifty-two yards long. I found among them three heads, and I |