while venesection, by diminishing the quantity of the fluids, obviates resistance.

"We are often told of the pernicious effects of mercury on the constitution; but if I were to judge from my own experience I would form an opposite conclusion. In cases where mercury was carried to such a length, that the patients have been for two weeks without tasting almost either meat or drink, the cure was most complete. In some instances this was done where the patients were supposed to have suffered greatly from previous salivations; and so far from injuring the constitution, the process appeared to give it new energy, and the most perfect health has been the consequence.

"Several years ago, I treated a person, above seventy, with a course of corrosive sublimate; the mouth in a short time was so much affected, that for fifteen days he neither ate nor drank; his body was much reduced, but he had a rapid and complete recovery, and has since enjoyed excellent health.

"The bad effects of mercury, like those of venesection, are to be attributed to not carrying the process a sufficient length at once. A cure from mercury is not to be expected, while the patient's body remains unreduced, and while he continues to take his usual diet. Venesection contributes to the former of these, and the sore mouth effectually secures the latter."

scope

To these general observations, our author has added some cases and remarks on the history and treatment of asthma, cholera, colic, consumption, chorea, and plethora. The general of these histories and reflections is to show, that a cold stage, or interrupted balance between the circulating and pulmonic systems, always precedes the stage of reaction which properly constitutes the diseases, and to illustrate at once his general doctrine, and method of treatment in all of them. In the case of chorea and convulsions, the boy, aged four years and three months, had been vomited and purged smartly without benefit; purgatives too were continued throughout the cure; but two large bleedings from the jugular vein, the first to the

amount of nine ounces, and the second, four days afterwards, to the amount of ten ounces, had evidently the merit of putting a stop to the violence of the disease. A few grains of calomel at last brought away a large lumbricus, and a number of very hard scybala.

"This case, it is observed,' seems to prove, that the convulsive motions do not depend on obstruction of the bowels, for they were completely removed, even while the hardened scybala remained. I am apt to think that the convulsive motions, the torpid intestines, the chilly state of body, and the peevish irritability of mind are merely symptoms of diseased habit. The bleeding had an instantaneous effect in relieving them; after the system was repaired, a few grains of calomel enabled the intestines to discharge scybala, on which dozes three or four times as large had no effect in the earlier

the treatment."

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We have now done with Mr. Watt, whose book contains many important observations and reflections. The practice, so different from any thing we have been hitherto conversant with, has surprised us much, not less on account of its seeming success, than of the persevering boldness with which it has been followed up in the face of every professional prejudice. Nothing could have carried Mr. Watt through with this, in the sick room of his patients, nor induced him to submit the whole to the public eye, but a conviction of its utility and importance. On subjects which can be decided by observations and experience alone, we forbear to make any further reflections; but we earnestly hope, that the subject started by Mr. Watt will neither be overlooked nor neglected.

REVIE W.

A View of the Nervous Temperament; being a practical Inquiry into the increasing Prevalence, Prevention, and Treatment of those Diseases commonly called Nervous, Bilious, Stomach and Liver Complaints, Indigestion, Low Spirits, Gout, &c. By THOMAS TROTTER, M. D. &c. pp. 338. Troy, re-published, 1808.

DR. TROTTER has undertaken a task in this work, which the most experienced physicians best know to be very arduous. No diseases embarrass our first steps in the profession so much as those of the nervous kind, nor continue to form more anomalous exceptions to our rules of practice. The clue which Dr. Trotter found most successful in leading him through this labyrinth, was the study of the nervous temperament. It results from predisposition, and this may be hereditary or acquired. By the hereditary predisposition he understands an original conformation of body, transmitted from the parent to the offspring; by reason of which, when particular exciting causes are applied, a similar train of morbid phenomena takes place. A predisposition may, therefore, appear long before any symptoms of actual disease has shown itself; as in the phthisically disposed, a person will be easily affected by weather and sudden changes of temperature, and, on slight occasions, liable to cough, hoarseness, tightness, or stitches of the breast.

“The child born of nervous parents, that is to say, persons of weak digestive organs, and irritable nervous system, subject to bilious and spasmodic complaints, &c. will, at the breast, be very liable to bowel affections, such as cardialgia, flatulence, constipation, or diarrhœn, gripes, yellow gum or jaundice, &c. These will be apt to come on from slight occasions, as when the milk of the nurse is affected, either by her passions or improVOL. 1.

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prieties of diet, or when any thing has entered its food that is difficult of solution in the stomach. These causes will frequently operate with such effect, and to such a degree, as to induce convulsions and death.

"In some of the diseases of infancy, such a child will suffer more than other children. At the teething period, it will be more likely to be seized with bowel disorders and convulsions: in the eruptive fever of the small pox, it will be more prone to these fits and in the hooping-cough, as being a spasmodic disease, the nervous infant will be a severe sufferer. Frights of all kinds, that ruffle the temper, and impatience under bodily pain, will be attended with irritable passions. Worms are the consequence of weak bowels and disordered digestion; a child of this description will, therefore, be much troubled with worms, and generally their most troublesome symptoms. These symptoms will sometimes put on all the appearance of a confirmed hydrocephalus internus, even to the last degree of strabismus. I have seen so many instances of recovery from this apparently hopeless state, that I am disposed to refer the whole to their intestinal vermin, or to some aggravated attack of stomach affection, depending on original nervous predisposition.

"At the age of puberty, if a female, it will be liable to be affected with that disease usually called chlorosis; which, besides so many symptoms of dyspepsia, combines with it the emansio mensium. The chorea, or St. Vitus's dance, also appears about this age and in numerous cases which I have seen of both complaints, I am disposed to think, that they never occur without manifest predisposition, and are therefore to be considered rather as symptoms of the nervous temperament, than as distinct diseases. The changes which now take place in the constitution, conjoined to the quick growth of the body at the same. time, will render this a most critical period. At this season, the nervous woman is first affected with hysterics; these added to many painful symptoms of increased irritability, will be apt to recur at distinct intervals, through life, particularly if unmarried. Extreme delicacy of stomach, dyspeptic affections, and what are called bilious, dysuria, leucorrhoea, hemicrania, &c. with other nervous signs, will be the lot of this hereditary predisposition.

The female that is born of gouty parents, comes entirely within this description. The fact is notorious, that what is called regular gout, or gout showing itself in the extremities of the body, seldom attacks the fair sex: and when it happens, the

woman is marked by a more masculine form, or other external signs indicating this peculiarity. But even this will not explain why the female is so seldom affected with arthritick inflammation. Something may perhaps be sought in the generative faculty: the castratos are said to be exempt from gout: regular gout is very rare before the age of puberty; and all the women whom I have known subject to inflammatory gout, except one, had never borne children. Gout, in all its shapes, is preceded by stomach affection; so also is the period. Again, the stomach recovers as the pain and inflammation fix in the joints; and if they prematurely recede, the affection of stomach returns. It is the same with the period: when one goes on properly, the other declines in due time: and if cold, passions of the mind, or other causes, bring on a sudden stoppage, all the complaints of the digestive powers instantly recur.

"But as the dyspeptic symptoms which attend gout are so much alike in both sexes, making allowance for the greater sensibility of the female, they strongly support the idea, that the chylopoietic viscera are the original seat of this disease; and these the primary symptoms of gouty diathesis. The child, therefore, who is born of arthritick parents, has in its constitution. what may be called the predisposition to nervous and bilious diseases. In infancy it is prone to all stomach and bowel complaints from slight causes, as have been described, and these will be its attendants through life. Even the man of the gouty family will not be exempt from this disposition to be dyspeptic and bilious, on every kind of excess or improper indulgence. In both sexes, they show a stronger tendency, as they appear early; for that proves a weaker structure of the digestive powers, and greater debility of frame; just as gout is to be more dreaded in proportion to its attack at an early age. Thus the youngest votaries of Venus and Bacchus will run greater hazards of immature gout, and premature decrepitude as a consequence.

2. The other division of predisposition to these diseases, is the acquired predisposition; or what may be brought on by causes which especially weaken the frame of nerves, and the chylopoietic organs. This predisposition may take root, even during the earliest stages of infancy, in children born of the healthiest parents. The effects of the milk of an unwholesome nurse often lay this foundation. It may happen where the child is not sufficiently nourished; where the nurse is much affected with the disorders herself: if she drinks too freely of spirituous