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The 12th and 13th Cases show that sometimes by accident, sometimes from more certain causes, the eruption of the inoculated small pox may be retarded. In the first instance, the delay was owing to worms. Some remarks on inoculation foilow, which seem to have been written in the infancy of the operation. They are not, at present, very interesting. The use of the warm bath, on the repulsion of the small pox,
is now well established : the Cases, in this pamphlet, were subjoined to the author's Thesis, printed at Leyden, in 1764.
The Appendix contains the history of a lady who was affected with an obftinate coftiveness, and some anomalous symptoms. The cause seemed to be an enlargement of the stomach, and a scirrhus on the inferior part of it. Dr. Stack suspected a tænia; but we think every symptom may be fatisfactorily explained, from the weight and pressure of the tumour.
We must dismiss this little work with our approbation; and can only with, that the author's health and avocations may permit him to enlarge it. Twenty years of practice must furely have furnished a much greater variety.
Medical Communications. Vol. I. 8vo. 6s. in Boards. Johnson. SINCE the principal supports of the 'Medical Observations'
are removed, we may probably consider this work as a phænix arising from the ashes of its predecessor. If so, our regret will be, in some measure, diminished; for, though the fucceffor follows its parent with unequal steps, yet it fol. lows at no great distance. We see, with pleasure, the aspiring attempts of those who laudably aim at being distinguished; and if they are, in a few instances, crude or less correct than we wished, they exhibit striking proofs of diligence and attention, frequently of learning and genius. In this new undertaking, it will be no useless talk to trace the outlines by which, in our opinion, their future efforts may, be most successfully directed.
The great object of these occasional authors, seems to be the accumulation of cases, new, extraordinary, and surprising. It is an old observation, that histories of this kind are more curious than useful; and, if they are ever admitted, it should be only where a very accurate history of the preceding complaints can be collected, and where they can be ultimately connected by the fubfequent appearances on diffection. This connection has been seldom attended to in Bonetus and Lieutaud : we have occasion to regret the want of it sometimes even in Morgagni. In general, it is preferved in the present
volume. volume. It has been frequently wished, and indeed it would be desirable, that physicians would record their unsuccessful cases; we may add also, that they would mention their mif. takes and the causes of the error ; but, though a work of this kind would be useful, it can hardly be expected : physicians muft indeed sometimes err; yet self-love always extenuates the error ; and an anxiety, which we all feel, to conceal our faults, prevents the best practitioners from mentioning them. As histories of diseases are now written, we think that they are by no means useful ; detached facts appear extraordinary, merely because they are not connected with others.; and the most surprising events would, in some instances, fail of fixing the attention, if the collateral circumstances were known. Single cases, however, have frequently an advantage of which the author is scarcely aware. He who brings them to support the credit of a new remedy, or the use of a former one, in new circumstances, frequently explains to his reader what in the ardour of improvement he bad overlooked. Facts speak different languages to different eyes ; and, though we would not wish to accumulate them without necessity, yet, on some occasions, they are of service, if not to the cause of the author, to that of truth. Those facts are particularly advantageous, which elucidate the distinction of diseases frequently confounded.
The effects of new remedies, and what is of much more cunfequence, the circumstances which extend, limit, or correct the use of those already employed, is an important part of fimilar collections. On this subject, almost every one can furnith obfervations ; it is only necessary to guard against the warmth, the enthusiasm, of an inventor or improver. He will be best secured from the effects of prepossessions, who is most aware of their existence. On this account, as well as many others, the reigning epidemic should be always attended to ; and there can probably be no articles more important than a short relation of the nature of those which have occurred since the last publicaton, and how far they influence the effect of remedies. Few medical men can be ignorant how feldom intermittents, a few years since, yielded to the bark, long before the continued fevers assumed an appearance so decidedly bilious. We attributed much to the red bark; and it was undoubtedly more efficacious than the common; but, before it was generally employed, the fevers had appeared in a very different form, and the common bark was again successful. We therefore strongly recommend a series of obfervations of this kind : if properly digeited, they would not be very extensive; but, unfortunately, those who are beft able to furnish them, have least leisure for the tak. The fiatural history of those remedies, which we receive in the form of preparations, would be also highly useful.
We have premised these few reflections, from a conviction of their utility; and shall now, as usual, attend to the several articles in their order.
Article I. An Account of the Epidemic Catarrh, of the Year 1782 ; compiled at the Request of the Society. By Edward Gray, M.D. F.R.S.The very different accounts of the induenza are brought, by Dr. Gray, into one connected Sarrative ; but, on this subject, we need not be diffuse. The fum of the whole is, that from May to Auguft, 1782, a catarrhal complaint was almost universal in this kingdom, evidently traced from the north east, and, in some places, called the Russian cold. It was distinguished, from other catarrhs, by its being a very general epidemic, and by the great debiJity which attended it. If patients were irregular in thei conduct, or improperly treated, it then, and then only, became inflammatory; but we have seen this change in putrid fevers, and even in the true ulcerated fore throat, from the same foarce. Its cause we muft at present leave to the pathologift. Dr. Gray enquires, at some length, and, in our opinion, unneceffarily, how far it might be owing to contagion ; for, though contagion was the general mode of communication, yet the miafmata were certainly conveyed also by the air. One fact, not fingular, proves this mode. A family, convened in a focial meeting, in perfe&t health, have before their separation univerfally been infected. If it should be supposed that any one brought it in their clothes, we may reply, that he would probably have been as susceptible of infection an hour before, as at that time : on the contrary, there seems to have been one general cause, so strong as to be irresistible. The fact is, that, like all other epidemics, the poison seems to be contained in the atmosphere ; but frequently, though not universally, to require some exciting cause, before it exerts its peculiar deleterious powers. We cannot very critically examine each account; hat, in fome instances, we perceive inaccuracies and contradictions, though, on the whole, the compilation merits our commendation. It seems to have been generally agreed, that consumptions were less frequent after the epi. demic catarrh, than after usual colds. To us, indeed, there seemed little difference : even at this moment we meet with consumptions, which are easily traced to that period. Our author mentions the circumstance which annually occurs at St. Kilda. This fecluded ifland fees only an annual vificor, the steward who collects the rents ; but immediately, on his ar
rival, all the inhabitants are affected with the epidemic cold. The fact is curious, and certainly true, though not new; it is mentioned by Martin, in his account of the Weftern Islands, and seems to Thew, that the particular cause of the epidemic, is more generally diffused than we suspect. In smaller degrees, we probably elude its forse, in consequence of its being habitual.
II. Remarks on the Influenza of the Year 1782. By James Carmichael Smyth, M.D. F.R.S. This account came too late to be incorporated into the general one. It is apparently accurate, and written with ease and propriety : indeed all Dr. Smyth's communications show him to be an intelligent practitioner, and a careful observer.
III. An Account of a gouty Body, dissected by Henry Watson, F. R. S.-This paper might require a large commentary: even the soul itself, if it indeed resides in the pineal gland, became goaty, or, at least, had an uneasy feat, since this celebrated protuberance was changed into a chalky matter: this appearance seems to support the opinion of those who consider the gland as of the lymphatic kind. The brain was hard and dry ; and this change will affift the arguments of Dr. Cullen and others, who think that mental diseases are connected with an organical affection of the encephalon; for the patient had funk into a fecond childishness fome time before his death. In short, not only the joints were stiffened by the earthy depofition, but it even appeared between the skin and the periosteum of the tibia. The glandular parts were particularly affected. fall insert our author's opinion on the nature of the chalk, which will at leaft afford fome comfort to the gloomy atbrities and, though we wish that this opinion had been supported by a chemical analysis, yet we can add, from practical observation, that we have not seen the gout combined with calcylous complaints, except when, in confequence of the patient having been confined, for some weeks, on his back, the blad der has been prevented from entirely discharging its contents."
• It has been, I believe, a pretty common opinion, that those who have gouty concretions in their joints, are very li. able to the stone in the bladder and kidnies; as if the one disease were generally productive of the other.
• Is not this pronouncing rather too much for of sil the patients cuc in our hospitals, men, women and children, how few do we meet with that have any the flightest indications of gout about them?
• Both the gout and the stone are morbid secretions, and may pollibly exit together, in one and the same subject; but differ effentially in their material principles, and have very different tendencies,
• The calculous matter is formed in the urinary passagesthe gouty deposits itself generally on bones, cartilages, membranes, and lymphatic glands.
• The gouty seems to be a kind of earth different from that which generally forms a stone in the urinary bladder ; for it never appears lamellated, or to have any kind of nucleus, but is white, soft, and uniform throughout; it may be diffolved, and being ground down by the motion of a joint, readily mixes with the synovia, forming a smooth creamy fluid.
• The gouty earth is then a kind of greasy bole, which may easily be made to mix with oil and water, which, in general, the calculous cannot be made to do; so that in every respect, in colour, form and consistence, it seems to differ essentially from that which lays the foundation, and causes the increase of the stone in the bladder.'
IV. A Case of Proptosis. By Edward Ford, Surgeon.The most material fact, in this article, arises from the diffece tion. The cause of the difease in the left eye, was an enlargement of the left thalamus of the optic nerve its progress, it pressed on the right nerve, so as to deprive the patient of the fight of that eye, which had been hitherto unimpaired. It has been imagined, that the nerves of the eye arise from the side of the brain opposite to that on which they are finally diftributed ; and, even those who doubt of this total change of distribution, as Monro and others, yet allow that the fibres decussate in their progress. But, in this case, a considerable disease of one nerve had not the smallest effect on the other.
V. A fingular Case of Hydatids. By Samuel Foart Simmons, M. D. F.R.S. -The sac containing the hydatids, or rather the habitation of the tænia hydatigena seems to have been the gall bladder, which was diftended so as almost to fill the whole abdomen. It then perforated the diaphragm, and, contracting a little in its paffage through that muscle, again expanded and filled nearly the left side of the thorax : in the substance of the liver was also a large fac containing ten pints of hydatids. This case is indeed surprising, but it surprises rather from the vast bulk, which originally arose from the Small cyst usually containing the bile, than from the nature of the contents. Similar sacs are more commonly from the ovarium. but the destructive animal, which causes so great devasiatica, may appear in any glandular part. We once faw it arise from the spleen.
VI. Obfervations on that Species of Hæmorrhage which is occasioned by an Attachment of the Placenta to the Cervix Uteri. By Andrew Douglas, M. D.-Every one, who has practifed Midwifery, knows the distress which this mode of