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

The prefident has endeavoured to give the outline of a new fyftem of fevers, which, as we have read with more than common attention, we fhall endeavour briefly to analyfe. 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 stoppage of perfpiration, but from the ftimulus of cold on the nerves of the surface. 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 exiftence may be prevented in the commencement. In the fecond kind, the fever is produced by a fpecific caufe, viz. the miafma and contagion: the tendency of the first, is to produce the remittent fever; of the fecond, the jail and hofpital fever. In both instances 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 diftin&tly 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 whether 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 ino culation is well known.

If there be any novelty in this fyftem, it is in the cause of fevers by cold; though we think that the origin even of this opinion might be detected, if the crude ideas of every sys tem-builder could be easily retained. But the corner-ftone fails, and that is fufficient for the deftruction 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 am equal period of health; for he had no method of afcertaining the comparative evacuation of the skin and lungs. But the common fyftems always fuppofe that the lofs of one evacu ation is fupplied by the other. We are ashamed 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 cause, and again, between that and the fymptoms; but our author is filent on the fubject. The change produced by cold is flightly paffed over; the shivering 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 resembles, 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.

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In the practice of our author, we meet with little that is remarkable. In general, it is fufficiently accurate and just: we fhall only mention one circumftance, fince it is the confequence of his theory. In the means of preventing fevers from miafmata, he strongly 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 disease; 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 Dimsdale. The following extract is more useful.

Dr. Saunders (formerly Huck), whose correfpondence with fir John Pringle forms a confiderable and valuable part of the above annotations, and who, in his observations on the nature and cure of diseases, discovers 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 first, 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 firft 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 used, 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 stage 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 : R mellis 3i, 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

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take fifty fuch pills before the acceffion of the next paroxyfmr, 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 disposition 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 fifh was apt to bring on a relapfe with the convalefcents.'

Thefe authorities are undoubtedly refpectable; but they almost vanish into nothing, when compared with the nu merous obfervations, in different fituations and very diftant periods, which converge to the fame point. Many of thefe 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 descriptions of difeafes, and obfervations which, though common, are useful. The difeafes particularly defcribed 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. 8.v0. 25. Johnson.

THIS little collection will be highly useful to the practitioner who wishes to improve his art; the defcriptions are feemingly 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 thofe days which are usually distinguished 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 fhare 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 instance 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

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ation: the moft careful attention cannot always difcern, when it becomes neceflary to check any discharge. In the fame patient, a little blood, trickling down into the ftomach, during fleep, caufed the moft alarming fymptoms. We shall select a very juft and ufeful practical diftinction.

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

The fifth Cafe is an hiftory of a fever, with fome remarkable fymptoms, 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 feventh 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 distress, on account of the miftake this convinced the lady that he was yet dear to him. The tenth is a cafe of dropfy, from unfufpected biliary concretions. Dr. Stack thinks that these calculi are more fre quent than we commonly fuppofe, and often a remote caufe of very different diseases.

In the following history, 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 established.

• 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, fliffness, 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 ufed to quit him very fuddenly, and the swelling and ftiffnefs to go off gradually. Can the doctrine of fympathies help us to explain this phenomenon?"