effected in the ftate of the nerves, by the intervention of any power whatever. We will not however dwell on defects, where the difcuffion cannot be rendered advantageous. On the fubjects which follow, we may at least expect fomething more interefting; but we muft neceffarily obferve, that the execution feldom deserves a better character.

The prefident has endeavoured to give the outline of a new system of fevers, which, as we have read with more than com mon attention, we shall endeavour briefly to analyse. Fevers are derived from cold, from miafma, and contagion, or from inoculation. Fever from cold, though not the fimpleft, is yet the most common and obvious, form. It does not arife, in our author's opinion, from the ftoppage of petfpiration, but from the ftimulus of cold on the nerves of the furface. This change is, by fympathy, conveyed to the glands of the bronchiæ and ftomach, fo as to vitiate their fecretions, and produce the feveral diforders of thefe organs. Confequently, though there be a materies morbi, it is not originally received ab extra, but formed within the body; and, though its evacuation may become of confequence in the progress of the disease, yet its very existence may be prevented in the commencement. In the fecond kind, the fever is prodticed by a fpecific caufe, viz. the miafma and contagion: the tendency of the first, is to produce the remittent fever; of the second, the jail and hospital fever. In both inftances the poison, by its being blended with the air, is conveyed to the faliva, and, with it, fwallowed into the ftomach. The remittent tendency of the miafma is fometimes leffened by its being combined with cold, which causes fevers of a more continued form; but the combination of cold is not fo diftinctly perceived when it occurs with contagion. Dr. Gardiner feems to hint, that the miafma is lefs noxious, in its effects, than the contagion; and that the difference, in the fevers produced, is owing to the comparative mildnefs only. He does not exprefsly fay whe ther the contagion may be produced by a number crowded together, without the affiftance of any poifon originally derived from the marsh effluvia. The third mode of infection by inoculation is well known.

If there be any novelty in this fyftem, it is in the caufe of fevers by cold; though we think that the origin even of this opinion might be detected, if the crude ideas of every fyftem-builder could be eafily retained. But the corner-ftone fails, and that is fufficient for the destruction of the building. The chief and almoft only argument to deftroy the common opinion, that colds arife from a fuppreffion of perfpiration, is Keil's aphorifm, that perfpiration is not fuppreffed in catarrhs.

He means, and can only mean, that as much weight is infenfibly loft during the continuance of the complaint, as in an equal period of health; for he had no method of afcertaining the comparative evacuation of the fkin and lungs. But the common fyftems always fuppofe that the lofs of one evacu. ation is fupplied by the other. We are afhamed of fuch trifling; but, when prefidents of colleges become authors, their rank demands our particular attention. Some indeed might expect to find, in a new theory, the connection between the remote and proximate caufe, and again, between that and the fymptoms; but our author is filent on the subject. The change produced by cold is flightly paffed over; the fhiver⚫ing and rigour are fcarcely mentioned; and, though Hoffman is quoted, even his fpafmus periphæricus is overlooked. Our author feems to walk in fear he looks with horror on either fide; for, while he avoids debility,' by the general term of change,' he is always in danger of falling into spasm.' Words have indeed little power; and Dr. Gardiner is not aware, that his Theory very much refembles, in this imperfect outline, the more finished picture of Dr. Cullen. In the former part, he has inadvertently dropped the excitement' of the brain,' which is a much more exceptionable term than either debility or fpafm.

In the practice of our author, we meet with little that is remarkable. In general, it is fufficiently accurate and juft: we fhall only mention one circumftance, fince it is the confequence of his theory. In the means of preventing fevers from miafmata, he ftrongly recommends an emetic, because the matter has been taken into the ftomach, but overlooks the ufe of a blifter, which Dr. Lind, from whom he has copiously borrowed, thinks equally neceffary. This remedy had no connection with his general fyftem.

We have preferred a general analyfis to extracts, from Dr. Gardiner's work, that we might have room for one that may appear more interefting. Phyficians have regretted that fir John Pringle locked up his annotations in the hands of the college; but the prefident has partly unlocked the door: we have a peep only at the treafure; though, if it be a just specimen, our regret will be diminished. Many of the extracts are very trifling; and unless under the fanction of a great name, would not be attended to. We are told, for instance, that Dr. James allowed his fever-powders to be chiefly useful as evacuants; he has repeatedly told us the fame. 'Dr. Huck Sanuders and fir John Pringle cured chronic agues by laxatives; Senac has already ftrongly infifted on the neceffity of a fimilar plan. Mr. Sutton told fir John, that the day after

inoculation, a needle dipped in the puncture, would communicate the difeafe; a proof, fays Dr. Gardiner, that the matter first acts as a topical ferment: but this has been the opinion of almost every practitioner fince the publications of baron Dimfdale. The following extract is more useful.

Dr. Saunders (formerly Huck), whofe correfpondence with fir John Pringle forms a confiderable and valuable part of the above annotations, and who, in his obfervations on the nature and cure of diseases, difcovers an uncommon fagacity, informs, fir John, in one of his letters from the West Indies, "that he had obferved a relation between the bilious, yellow, and intermitting fevers, apt to double, and the bloody flux, for they were distempers which prevailed at the fame time, and very often changed one into the other, at least, in the West Indies.' And Dr. Turnbull, late phyfician to the factory at Smyrna, informed fir John Pringle, that the epidemic fever at Smyrna, of a bilious, putrid, or malignant nature, begins towards the end of Auguft. They have the fame at Conftantinople, but milder, and approaching more to the nature of a regular intermittent. At Smyrna, this fever remits at firft, but, if left to nature itself, ends in a continued fever. The paroxyfms begin in the evening, and early in the morning there is a remiffion with a little fweat. The first paroxyfm begins with a pain in the back and rigour, but afterwards none of the acceffions begin with any cold fit ;" and farther obferved, that the defcription fir John had given of the autumnal bilious, remitting, and intermitting fevers of the camp, and that of marshy countries, anfwered nearly to theirs of Smyrna. He added, "that the diftemper difappeared generally about the end of September, but fometimes ran into October, and by that means continued about two months. In fome cafes the fever began in a tertian form, but more generally in a quotidian; and, if no proper means were ufed, they all ended in a continued fever. The duration of each incidental cafe is uncertain, there being no critical days. Some grow yellow about the fifth or fixth day, and that is accounted a very bad fign, as are worms, and the coming on of the fever with a vomiting of a greenish or yellowish bile. If the usual vomit of emetic tartar, in the advanced ftage of the disease, has no effect, it is a mortal fign. In this fever the hypochondria are commonly inflated, and an uneafinefs is felt by the patient when they are preffed. The cure of this fever was chiefly effected by fuch medicines as cleared the primae viae, as tartar emetic, laxatives, and clyfters. When the fever remits, the cure is carried on by the bark in the following manner: K mellis zi, camphorae zi, fimul probe terantur ad folutionem camphorae, dein adde cort. Peruv. pulv. 3i m. f. maffa, et e fingulis drachmis: formentur pilulae N°. xv. capiat aeger omni bihorio, remittente febre, pil. x. If the patient had time to

B 3

take

take fifty fuch pills before the acceffion of the next paroxyfm, it was always an eafier one than any of the preceding; but if he could, in that fpace, take one hundred pills, the fit never returned. When there was a more than ordinary difpofition to putrefaction, and the pulfe was low, he doubled the quantity of camphire, and with a good effect. He feldom had occafion to ufe more than one ounce of the bark, or an ounce and a half he cured common intermittents in the fame way. The eating of meat or fish was apt to bring on a relapfe with the convalefcents,'

Thefe authorities are undoubtedly refpectable; but they almoft vanish into nothing, when compared with the numerous obfervations, in different fituations and very diftant periods, which converge to the fame point. Many of these are collected by Dr. Cullen, in his Synopfis Nofologiæ.

Though we cannot recommend this work in general, yet, in the practical part, we find fome exact defcriptions of difeafes, and obfervations which, though common, are useful. The difeafes particularly described are catarrhs, catarrhal fevers, cholera, the bilious remittents, and the more genuine intermittents.

Medical Cafes, with Occafional Remarks. By R. W. Stack, of Bath, M. D. Evo. 25. Johnson.

HIS little collection will be highly ufeful to the practitioner who wishes to improve his art: the descriptions are seemingly faithful; and the practice is judicious. But we appre hend Dr. Stack attributes too much to his medicines, and fometimes to the reputed caufes. The changes happen fo often on those days which are ufually diftinguished by a falutary termination, that we are led to attribute a great share of the cure to the exertions of nature alone.

The kermes mineral, which is greatly recommended by our author, we know to be a very valuable remedy; and we have trufted it with advantage. Yet in the cafe, which Dr. Stack defcribes, the expectoration came on the fifth day, though in apparently defperate circumftances. It is however probable, that his judicious treatment had a great share in the event. The next cafe is a relation of what feemed to be nephritic fymptoms, arifing from a four ftomach. In all nephritic cafes, the ftomach is affected; and the fympathy may be reciprocal : in this the return was conftantly relieved by a vomit. The third is an inftance of the bad effects of fuddenly checking a bleeding from the nofe. Indeed, the officious interference of medicine is in no cafe fo injurious as in ftopping an evacu

ation ;

ation: the most careful attention cannot always difcern, when it becomes neceffary to check any difcharge. In the fame patient, a little blood, trickling down into the ftomach, during fleep, caufed the moft alarming symptoms. We fhall select a very juft and useful practical diftinction.

⚫ I think I do not err in faying, that long filent infpirations, and fhort fonorous expirations, may be confidered, pretty generally, as diftinguishing marks of debility, proceeding from a difordered ftomach. In fuch cafes, a cordial medicine might afford a momentary comfort, but expulfion of the oppreffing load is neceffary to permanent relief."

t

The fifth Cafe is an history of a fever, with fome remark. able symptoms, from a worm in the ftomach. The fever was indeed peculiar; but, though its appearance may have been affected by the worm, we do not think that it was the caufe. Our reason is, that the fever abated on the 14th day; and it feems to have remitted before the worm was evacuated. In the fame patient, a remarkable diffolution of the blood followed. This disease is called by the Germans morbus petechialis fine febre,' and is no very uncommon occurrence. The seventh and eighth Cafes are proofs of remarkably rapid putrefaction in the living body. In both, the vital principle was very much weakened by the depreffing paffions, grief and fear. The ninth is fufficiently curious. A nervous atrophy, which refifted every medicine, was brought on by jealoufy. The patient's husband, by accident, gave her an improper medicine, which, in effect, cured the complaint; not by means of the remedy, but from his diftrefs, on account of the mi take this convinced the lady that she was yet dear to him. The tenth is a cafe of dropfy, from unfufpected biliary concretions. Dr. Stack thinks that these calculi are more frequent than we commonly fuppofe, and often a remote caufe of very different difeafes.

In the following hiftory, afthma, anafarca, with a pain and ftiffness of the knee, feemed to arife from a tænia; but we wish to transcribe the following remark, that it may be more generally known, and the diftinction, if the fymptom be really of fervice in that view, better eftablished.

A medical gentleman, to whom I communicated this cafe, informed me that he had attended a young gentleman, who, at different times, was affected with pain, fiffness, and fwelling in one of his knees, which did not, at any time, yield to the applications made ufe of, until he happened to void a round worm. Soon after, the pain used to quit him very fuddenly, and the fwelling and stiffness to go off gradually. Can the doctrine of fympathies help us to explain this phenomenon?'