of individuals. 4. Patients were not a second time attacked by the contagion. 5. It is by another author represented as an ulceration attracting or draining out humours, and attended with an offensive smell. (pp. 5, 6, 7.) Now it is very doubtful whether any of the several characteristics above specified will apply to the pestilential Bubo; certain that most of them will not; and equally certain that the aggragate will not correspond to the description of any other complaint except the small-pox: but that it will, with great fidelity, coincide with the most accurate accounts of the small-pox in its confluent form. Dr. Willan therefore concludes, and the conclusion seems to be irresistible, that the disease distinguished so frequently under the name of the spreading or herpetic Anthrax from the common Loimos, was the confluent small-pox." xv. In the 2d chapter Dr. W. continues the inquiry through the writers of the first and second centuries. Philo Judæus, about the middle of the first century, describes a Loimic disease which agrees very nearly with Eusebius's account of the herpetic or spreading anthrax, and exhibits the mode of diffusion, and the circumstances of the confluent small-pox. * Herodotus, a physician of Asia Minor, describes, in the reign of Domitian, a febris loïmodes, without noticing buboes or carbuncles, but adverting to the existence of ulceratice, anthrax-like, herpetic exanthemata on the face and the rest of the body; "and observations present themselves in all the writers on small-pox, from Rhazes to Sydenham, similar to those made by Herodotus on these eruptions." Rufus, of Ephesus, says nothing of buboes or carbuncles in Loimos; but he states that" besides other evil ulcers, the all-dreadful Anthrakodea may take place in the Loimos, as well on the rest of the body as on the face and tonsils." Galen has not left us any distinct history of Loimic discases; but there are numerous scattered observations in his works respecting them-especially respecting a pestilential disease introduced into Asia Minor by the army of Lucius Varus, about the year 164, in which no mention is made of buboes or other glandular swellings; consequently Dr. Willan refers it to epidemic small-pox of the confluent kind, and also measles. * We confess, however, that the Jewish philosopher's ætiology of this disease leaves an impression on the mind that it was not small-pox. He says" the cloud of dust suddenly falling on men and cattle, produced over the whole skin a severe and intractable ulceration, &c." All these statements, too, must be taken cum grano salis; for even so late as the 14th century, a writer, after describing an epidemic smallpox, as Dr. Willan supposes, informs us that the Bishop having anointed a person, in this disease, with oil taken from the lamps burning at the tomb of Saint Marcellin, the pustules subsided, and the patient's skin became more polished than it had formerly been. "1. When the disease was about to terminate favourably, numerous exanthemata appeared over the whole body, which in the greater number of patients were ulcerative or pustular.-2. The disease was occasionally attended with roughness and hoarseness of the voice.— 3. A distinction is carefully made between two species of the exanthemata, which is precisely answerable to the long-recognized and universally known difference between the eruptions in small-pox and measles. (pp. 38, 45, and notes to 46.)-4. The sudden retrocession of pustules or tubercles efflorescing from within, rendered the case highly dangerous.-5. Almost all who perished, died of colliquative diarrhoea.-6. So great was the deformity produced in the persons of the sufferers by the ravages of the epidemic Anthrakes in Asia, that they were compared by the spectators to apes, rather than men." Pref. xix. Dr. Willan thinks that, from a passage in Dion Cassius, (Rom. Hist. lib. 62,) there is some reason to believe that an attempt at inoculation had been made in the reign of Domitian, A. D. 92,) and revived under the Emperor Commodus. After mentioning the great pestilence, (A. D. 189,) Dion Cassius adds-" many died in another way, not only at Rome but over nearly the whole empire, through the practice of miscreants who, by means of small pointed needles, communicated, for a reward, the horrid infection so extensively, that no computation could be made of the numbers that perished."* In the fourth chapter, Dr. Willan endeavours to trace evidence of the existence of small-pox in periods anterior to the Christian æra. He thinks that Hippocrates' account of the Anthrakes applies more strictly to small pox than it does to carbuncles. His words are- The Anthrakes appeared at Cranon, in a very hot and rainy summer, mostly with a south wind. Ichors collected under the skin, and, being This is pretty analogous to the calumnies circulated against our early inoculators. In one of the first pamphlets published here on inoculation it is said-"not only physicians make havoc of mankind for the satisfaction of their judgment in physic, and increase of their experience, but every quack now may be a hireling to the Devil, and, like that banditti in Italy, be ready to do the drudgery of removing heirs, and other obstructing incumbents of many kinds, and to do this under the mask of a cure, inoculating death instead of disease, and making use of an art never before practised, in a manner not foreseen, and by the laws not yet sufficiently guarded against."-See Woodville's History of Inoculation, p. 126. These specimens of medical logic, indeed, have been quite equalled by the early antivaccinators themselves, in our own times. We think we may venture to predict, that medical controversies in this style have now ceased for ever. The profession will never again disgrace itself by permitting the introduction of JOHN BULL ribaldry in their discussions. confined, they became hot, and excited itching. Then there arose phlyctænides, such as are caused by fire, and they seemed to burn under the skin." 53. But we confess that we can see little in this passage to support the design of the author in antiquatising small-pox. From the Grecian, Syrian, Jewish, and Egyptian records our author naturally has recourse to those of Rome in its regal and republican states. Here our sole guides are, of course, the historians and poets. Among the former the terms pestis and pestilentia were used in the same extensive signification as Loimos and Loimiké by the Greeks, comprising every contagious epidemical disease. It is therefore contended that, if diseases are found recorded in Roman history under these denominations, and with epithets and characters not appertaining to the pestilential bubo, or epidemics caused by famine, but descriptive in different degrees of the confluent small-pox, we are justified in presuming that the diseases so described were, in some instances, at least, the confluent small-pox. The intrepid Seneca-a poet and philosopher, is introduced by Dr. Willan as describing a disease, the Loimos at Thebes, bearing a striking resemblance to small-pox. "O dira novi facies leti! Gravior leto!-Piger ignavos Senec. Edip. Act. I. Dr. Willan points out the coincidence between this eruptive disease and small-pox or measles. He does not think the circumstances attending these last eruptions are better described by any of the Arabians or other medical writers prior to Rhazes, than in the above extract. The fourth chapter of this learned essay is dedicated to the purpose of shewing that small-pox was prevalent in the British Isles and on the Continent of Europe, prior to the supposed origin of the disease in Arabia, being described by literary men under the terms pusula-pustularum morbus, and morbus dysentericus cum pustulis. Gregory of Tours states that, about the year 580, A. D. almost every district of France was occupied by a dreadful plague (Lues) in which the patients were affected with violent vomiting, fever, head-ache, and excruciating pain in the loins. This epidemic was particularly fatal to children. King Chilperic recovered with difficulty himself, but lost two of his sons. Austrigilda, Queen of Orleans, sank under this disease; but not until she had exacted a promise from the king that her two physicians should be put to death if they did not save her! The physicians were accordingly executed! We live in better times now. A queen may die, and her physicians may still hold up their heads-even "within the verge of the palaces." The following passage from the same author, must, Dr. Willan thinks, remove all doubts that the smallpox existed in France long before the Arabian æra. "Last year, the state of Tours was desolated by a severe pestilential sickness (Lue Valetudinariâ ;)—such was the nature of the infirmity (languor,) that a person, after being seized with a violent fever, was covered all over with vesicles and small pustules (vesicis ac minutis pustulis.) The vesicles were white, hard, unyielding, and very painful. If the patient survived to their maturation, they broke, and began to discharge, when the pain was greatly increased by the adhesion of the clothes to the body.-In this malady, the medical art did not avail without the assistance of Saint Martin; for many were restored, who sought a benediction from his holy temple. Among others, the Lady of Count Eborin, while labouring under this pest, was so covered with the vesicles, that neither her hands, nor feet, nor any part of the body, remained exempt, for even her eyes were wholly closed up by them. When nearly at the point of death, she received some of the water, in which the tomb of the blessed saint had been washed at the Lord's Passover.This having been taken as a drink, and applied to her sores, the fever abated, the discharge from the vesicles was made without pain, and she was soon after healed.'” 92. We confess that this is a very strong document, and nearly decisive of the question. In the British Museum there is a miscellaneous manuscript of the eighth or ninth century, partly Saxon, partly Latin, in which it is said that Saint Nicaise, Bishop of Rheims, A. D. 453, had been affected with a species of variola, and was at that time favoured with the privilege of emancipating his worshippers from the disease by means of a talismanic inscription to be suspended about their persons. "Sanctus Nicasius habuit minutam variolam, et rogavit dominum, &c. &c." The Treatise concludes with a description from Adomnan, a learned Hibernian Scot, of an eruptive epidemical disease in Ireland, attended with purulent ulcerations which raged cotemporaneously with the pustular lacs in France. It is evident that Dr. Willan has not contented himself with consulting the ordinary sources of information on the subjects under investigation-the writings of medical anthors. He has taken, in fact, a comprehensive view of the works of historians, poets, and ecclesiastical writers of antiquity. From these authorities he has accumulated a mass of probable evidence that the small-pox, measles, and scarlet fever, have existed in almost every age of the world, of which history or tradition has furnished us with any records. Such an inquiry is certainly very interesting, and only subordinate to an accurate investigation of the nature and treatment of these diseases at the present moment. Such inquiries, too, cnlarge the mind, and thus invigorate the understanding a due proportion of them is therefore to be encouraged in modern medical literature; on which account we have entered into the analysis of Dr. Willan's posthumous essay, somewhat farther than the able editor himself. The notes and references appended to this part of the volume by Dr. Smith are creditable to this gentleman's erudition; and we cannot help anticipating something important from the same pen, when time shall have matured his judgment, and experience supplied him with ample materials whereon to exercise it. Of the "Reports on the Diseases in London," we need not speak, as they were first published in the periodicals of the day, and afterwards collected and republished in a separate volume, with additions by the author himself. In the present edition, however, there are notes appended by Dr. Smith, which tend to enrich these very valuable reports. The detached papers on medical subjects collected in this volume, are five in number, viz. a remarkable case of abstinence-a case of obstruction of the bowels-singular termination of dropsy-observations on the use of arsenic in intermittents-and cases of Ischuria Renalis in children. It is a common observation that we want facts or materials in medicine, on which to raise the superstructure of theory or science. But time buries facts in oblivion almost as fast as they are recorded. Who in the present day has time or inclination to toil back through the innumerable volumes that have been written, or the myriads of cases that have been put upon record by our predecessors? Very few indeed! A retrospective review in medicine is the greatest desideratum in this intellectual age; and we are perfectly satisfied that such a work would confer more benefit on medical science than all the other periodicals put together. It |