«The lassitude and depression of spirits, with restless nights, harass the patients for many days after the decline of the fever; which indeed, in several instances, does not go off after the fifth day, but becomes intermittent, the patient feeling himself worse every other day." These symptoms were modified in various ways; in some there appearing a violent headach, and in others a sore throat, a peripneumonic disposition, or a disorder of the stomach and bowels. As the author considers the fever to be the essence of the complaint, his plan of cure is principally directed to the use of such remedies, as are capable of acting upon the system at large. Hence he recommends, at first, emetics, cathartics, and diaphoretics, and afterwards gentle opiates and the squill. Blisters were beneficial for the relief of the cough and dyspnoea, and when pneumonic symptoms appeared early, blood-letting was necessary, Great debility had remained after the symptoms had gone off, which was rather to be removed by bitters or myrrh, than bark or mineral acids. The infectious nature of this disease, the author thinks is hardly to be doubt ed; but his opinion on this point appears to be rather derived from general reasoning, than the consideration of particular facts. Nothing but facts can justify a decided conclusion upon this subject; for though the origin of the complaint may not be referable to any perceptible change in the state of the air, yet it by no means follows from hence, that it is necessarily propagated by personal com. munication. It must still be admitted to have arisen from an unknown cause, the operation of which differs exceedingly from that of any contagion with which we are acquainted, and until it is une quivocally shewn that it has been conveyed only by personal intercourse, and has been confined within the limits to which still remain on this subject. In the com this has extended, many doubts must munications from which the author gives abstracts, there is considerable difference of opinion with regard to the contagious nature of the complaint. Most of the correspondents consider it as an infectious disease, but one of them who is of this opinion, Mr. Du Gard, of Shrewsbury, mentions an instance of a boy, who was seized with it at a grammar school, on the 20th of February, was ill a week, and did not communicate the complaint to his bedfellow, nor any of the boys in the same room, who amounted to 20: "-nor did any one in the house become attacked with the disease till this boy had been well eleven days, at which time, five or six were taken ill, and the same number daily till four fifths of the school were affected.” In general, the observations and prac tice of the author's correspondents pretty much agreed with his own. The disease very seldom assumed an inflammatory disposition, and bleeding was rarely necessary. ART. XVIII. A Plain Discourse on the Causes, Symptoms, Nature, and Cure of the prevailing Epidemical Disease, termed Influenza. By JOHN HERDMAN, M. D. Fellow of the Royal College of Surgeons of Edinburgh. pp. 76. THE author has entered upon the consideration of influenza, with hypothetical ideas on the general nature of diseases, unsupported by, and frequently repugnant to the inductions of the most cautious and attentive observation. He is a Brunonian, but his principles do not always accord with those of his master; for while the latter admitted the existence of discases of excitement, requiring blood-letting and other evacuants, the former denies that such a morbid state of the system can ever occur; and hence concludes, that the debilitating plan of cure must, in every circumstance, be improper. The extent to which Dr. Herdman carries his speculative notions on the practice of medicine, which, it may however be remarked, are not novel, may be appreciated, from his determined reprobation of blood-letting in the most violent pneumonia. The more violent the inflammatory symptons are, the greater, in his opinion, is the degree of debility which has occasioned them, and the less, therefore, are the usual means for removing inflammation, adapted to the cure. A doctrine so extremely repugnant to the universal experience of medical practitioners, might do a great deal of harm, if it were not so evidently in contempt of every well established fact, and so clearly the result of a narrow and unphilosophical view of the subject. The author possesses, however, a great deal of self-complacency, and entertains no doubt of the firmness of the basis on which his reasoning and practice are built. His doctrine and treatment of influen za (which has given rise to a long exposition of the principles which guide him in the practice of medicine) are simple; he considers it a disease of debility, produced by debilitating powers existing in the atmosphere, and to be cured by keeping the patient quiet, and by warmth; but should nature require more to relieve the complaint, you may then, says he, administer "your stimulant medicines and your warm cordial drinks, your opium, your warm wine, and your warm spirits and water." ART. XIX. On the Influenza, as it appeared in Bristol and its Vicinity during Part of February, March, and Part of April 1803. By JOHN NOTT, M.D. pp. 25. THE symptoms here described, and plaint, the author is adverse to the opithe method of cure recommended, do nion of its being contagious, and thinks not materially differ from those which it ascribable to some peculiarities in the are mentioned in the other accounts of air, which elude all medical research. the epidemic already given. Bleeding The reasons which he adduces against was never necessary when the complaint its contagious nature, are the following, appeared in its simple form; but when viz.-That two or three persons of a nuit was combined with peripneumonic merous family have had the disease, symptoms, as was frequently the case, a without any others being affected by it, corresponding mode of treatment became till a fortnight after their recovery; that necessary. A full dose of opium has its propagation in public seminaries has sometimes suspended the disease, but in been unfrequent and uncertain; that peogeneral this medicine was found to be ple who slept together frequently did not improper, for in such cases the complaint take it from each other; that it often atafterwards returned with increased vi- tacked all the individuals of a large faolence. Syrup of poppies was a good mily at almost the same instant, which anodyne; but opium itself, contrary could hardly argue the progression of to the experience of Dr. Falconer, seemed the contagion from one to another; and to do harm, by checking the expectora- that remote villages, and solitary houses, tion. The author's experience of blis- have been affected at the precise time of ters differed from that of most other me- its appearance in large cities. The last dical men he found them to be of little stated fact, it may be observed, is at vaor doubtful efficacy. riance with those which, Dr. Falconer mentions on the same subject. : With regard to the nature of this com ART. XX. Observations on the Epidemical Diseases now prevailing in London, with their Divisions, Mode of Treatment, Sc. By ROBERT HOOPER, M. D. resident Physician to the St. Mary le-Bone Infirmary, &c. DR. Hooper describes the late epide. mic as assuming a considerable diversity of forms, and as having its origin in causes which exist in the atmosphere. The forms under which the epidemic appeared, were peripneumonia vera, peripneumonia notha, catarrh and acute rheumatism. The symptoms of each of those species of the complaint, and the treatment required by them, are given under particular heads; but previous to their being thus separately considered, the author gives the remote causes, which seemed to him to dispose to their attack; and the general symptoms by which they were accompanied, together with the treatment which each of them seemed more especially to require. These symptoms are particularly referred to the head, chest, limbs, skin, pulse, tongue, bowels, and stomach, and the nature and ANN. REV. VOL. II. pp. 43. degree of them a good deal depended upon the form of the epidemic with which the patient was attacked. The author describes the appearance of the tongue as having been very uniform. "From the beginning of the disease," says he, "to the termination, it is white in the centre, and its edges are red, and studded with very florid papillæ. "In some instances, the line which separates the red edges from the white centre is very distinctly marked, and frothy, while in others the whiteness is gradually lost towards the sides. The whiteness of the tongue appears to arise from change of colour in the papille of the tongue, and not from inspissated mucus covering that organ, though in some this has taken place. "In many instances several of the papilla are of a florid red colour, and distinct in the midst of the white papilla. This appearance 3 B ART. XXI. Hygeia: or, Essays Moral and Medical, on the Causes affecting the Personal State of the middling and affluent Classes. By THOMAS BEDDOES, M. D. 8vo. Three vols. 6 AMONG the multitude of writers on the art of preserving health, there are few who merit any particular attention. They have in general copied from each other, and detailed the common notions and prejudices of the age in which they lived, apparently with no object in view but to announce themselves to the world, as the proper guardians and dispensers of the blessings of health and longevity. Catalogues serve to record the books which they have written, but posterity is not in possession of any proofs of the good which they have done, or the benefits which they designed. When an author appears endowed with superior abilities to lay before the public a body of popular information on health, his writings have many claims to be studied with all the care and consideration required for so difficult and delicate a subject. Such is the author of the work now before us. The name of Dr. Beddoes must be familiar to all readers. The number and variety of his publications, the novelty and boldness of his views, and the peculiar originality of many of his speculations, have contributed to raise and to sink his fame in the scientific and literary world. For conveying instruction from the shrine of Hygeia, he has shewn himself possessed of talents of no common and ordinary cast. One of his most striking characteristics as a writer, is the power of drawing fine pictures of diseases; he delineates the most trivial complaints in the strongest colours, which fix the attention and captivate the imagination. He has proved himself a great enthusiast in whatever he undertakes, though in the present instance his ardour and zeal may by some persons be considered as misplaced. This work is divided into eleven essays, which were published separately. These essays are written in a bold energetic style, yet there is too much frothy declamation, and frequently a careless or wanton forgetfulness of the subject. It is to be regretted, that they did not receive the form as they contain the substance of a general treatise. Much obscurity and useless prolixity would have been avoided, if the trifling and tempo rary topics had been placed in a subor dinate digression or wholly omitted, instead of being interweaved with more interesting and general inquiries. This work, however, is only a prelude to a more comprehensive one; it is selected from a general treatise of physiology, which the author promises soon to bring forward, for the use of all to whom their own nature is interesting. We shall attempt to give an abstract view of the principal contents of these volumes. The first essay, on personal prudence, and on prejudices respecting health, con tains the greater part of the author's opinions on the means of avoiding habitual sickness and premature mortality. He tells us his intention, with regard to preventive medicine, in the following passage: "What I could wish then, and what every one, who has taken serious pains to follow up man sufferings to their origin, will agree the most irreparable and most regretted of huwith me in wishing, is, that reasonable care should be taken to provide each individual with a set of ideas, exhibiting the precise relation in which his system, and the several organs of which it is compounded, stand to external agents, particularly to those with which he is likely to come most in contact; that these sets of ideas be so placed in his head, that he may refer to them with as little difficulty as to the watch he wears in his pocket; and that as by the one he adjusts his business to his time, so by the other he may be always able to accommodate his actions to his powers. "The distance at which we at present stand from such a consummation is no reason why future generations should, like the tion of the animated machine to the powers past, be abandoned to their fate. The rela by which it is put in motion, is unhappily not enough understood for the purposes minute medical philosophy; but so far as it of is understood, it constitutes, as I hope to shew in the sequel, a doctrine rich in lessons for common life." Personal prudence is only to be acquired by an acquaintance with the struc. ture and functions of the human body. For this purpose, Dr. Beddoes proposes, that lectures on select subjects of anatomy, adapted for a mixed audience, should be established in all our large towns; that one of the medical profession in each place should undertake the office of lecturer, or that travelling professors should engage in such an employment. The deep interest excited by a teacher of chemistry, when he treats of respiration, is adduced as an example to enforce the importance of this proposal. And precedents are produced from the success of a popular course of anatomical lectures at Bristol, and the lectures on an thropology, which are given in some foreign countries. To supply the want of lectures, books and engravings are recommended, and clinical lectures, to teach the method of applying physiological knowledge to domestic use. This consideration will be better illustrated by an example than by any general assertion. Let us then refer to our universities; let us enquire, whether hypochondriasis be not very common among medical students? According to Dr. Beddoes it ought not, but we will venture to assert, that among no class of menit more frequent. Every student almost in the beginning of his studies is harassed by groundless apprehensions; through his want of more extensive knowledge and experience, he often has every disease in succession as he reads Cullen's First Lines, and where a constitutional tendency to low spirits has existed, some young men have appeared to die, not from any one particular disease, but from Cullen's Nosology! If such be the case with those who must be supposed to have acquired more information than can be derived from a few popular lectures, what must be the condition of a large portion of the community, when every person shall be taught in his youth a smattering of anatomy, and physiology, and diseases? The aim and object of this popular instruction is highly laudable, if it could be attained within certain limits. It would lead men to avoid those things which gradually undermine the consti tution, and might enable them to check diseases in the first stages; it would teach them when to call in medical assistance, and enable them to select rational and judicious practitioners. These good ef fects seem more likely to be counterba lanced by the bad, which have been already stated, and of which Dr. Beddoes seems fully aware. For he deprecates the custom of living by rule, and condemns very justly the methodists in meat and drink. His plan, however, seems calculated to increase the number of fa natics in physic, though in his second essay on the prevention of mischief he very properly sets forth the folly and absur dity of making private practitioners. The lady and gentlemen doctors, the hoarders of single infallible cures, the pedlars and hucksters in medicine are very ably and judiciously exposed. Alluding to the absurdity and evil tendency of books on domestic medicine, he expresses himself thus: Many objections present themselves to this general diffusion of medical knowledge. The arguments adduced in its favour by our ingenious author are not very consistent or convincing. There can be little doubt, that the ascertainment of causes has scarcely been more beneficial in preventing real danger, than in banishing false alarms; but it is the difficulty of ascertaining the causes of diseases, which renders a superficial knowledge of medicine or physiology more likely to induce, than to banish false fears. Medicine at present is imperfect, whether considered as an art or a science; it requires to be deeply studied, to be well practised and understood. Since it ought to be our first concern in the art of living, to ensure a continued succession of agreeable feelings, this general acquaintance with the human body and its complicated disorders, may be productive of more harm than good. It will render persons alive to sensations, trifling in themselves, that would otherwise escape attention, and imaginary and exaggerated complaints will form a more conspicuous part of the evils of life. We shall see people constantly swallowing pills to clear the prima via, supposed to be deranged; and nobody will travel without a tourniquet to stop hæmorr- tical affairs of the easiest kind. No one has, hage, or caustic and a scalpel to prevent I suppose, yet come forward with pretensions the mischief from the bite of a mad dog! to teach the coarsest handicraft by à book. the power and proviuce of mere rules in prac "Here let me beg the reader to consider But in the tumult of literary projects, amid which we live, scarce any absurdity being impossible, let us imagine some adventurer, sufficiently intoxicated to undertake to communicate the capacity for exercising one of our humblest, and most useful trades, without apprenticeship, by a tract on domestic shoe-making. Should any one, after studying this tract, conceit himself qualified to handle the awl and the paring knife, I leave it to be imagined by the reader, how unmercifully the leather would by pricked and at shed, and what would be the condition of the poor toes, condemned to be lodged in the receptacle, prepared by these learned hands. Does common sense spurn at the idea of efficacious instruction in such an art by such means? Are the qualities, then, of feather more complicated than those of the living body? Does the art of managing the former to most advantage require a long apprenticeship, and not that of managing the latter? Are the tools that lie within the compass of the shoemaker's bench, more easy to employ properly, than the articles of the materia medica? I see, indeed, one essential difference: the incompetent mechanic will soon be marked; no cluinsy workmanship of his can pass: whereas, in inedicine, bunglers may go on, I know not how long, without disgrace. This chance of escaping detection is, no doubt, an encouragemnt for private practitioners, such as nothing can countervail, if they be agitated by the same restless dæmon that possessed Lord Chesterfield's blood-letting peer. But I have no hope of effecting any thing, except with active, but misguided benevolence. Insanity must be differently dealt with, and wrong-headedness is scarce to be reclaimed by plain dictates of prudence. Otherwise, a consideration, yet untouched, would be decisive! For the defect of the artisan, who leaves his work imperfect, can be afterwards supplied. But an amending hand may be vainly applied in case of omis sion during sickness, where it is often just as fatal to leave undone what is right, as to do what is wrong. What then shall we think of the defence, which conscious incapacity is so apt to set up by anticipation: very simple my advice is: you may be sure if it does no good, it can do no harm? Oh, yes, but if does no good, it can do harm all possible harm, provided in killing there be harm. It can arrest the rescuing hand, till the silent, but progressive finger of fate move from time is, to time is no more. There are plenty of occasions on which watergruel, upon the harmless principle, will do a man's business just as effectually as laurel And what, I pray, does it signify to the killed, whether they come to their water. end by the saucepan or the still? To the killer, the difference, we know, is all in all. Yet he who simply thrusts his ignorance between the sick, and the means of recovery, will really have done more mischief, inas much as he will have more largely accumu lated pain upon death. And surely, where law cannot interfere, the call is so much louder for public censure. It is by far too unequal a game to be allowed in society, where one party stakes empty professions of good-will against the other's existence." To many persons the study of physiology must be well suited, as an interesting branch of natural philosophy. An inquiry into the structure of animal bodies, an investigation of the beautiful adaptation of different parts, and of the most wonderful effects produced by the simplest means, will be deemed far more interesting than the history of butterflies and cockle-shells. But the latter of these pursuits is less liable to abuse, and therefore better adapted for general readers; inasmuch as medical reading excites groundless anxieties, especially on hypochondriacs, which have so often been exhibited with exquisite humour. Some acquaintance with the general principles of medicine might be useful to the clergy, especially those residing in the country, as they may be called upon to judge of the propriety of sending for medical aid, and can enforce the regulations necessary for the preservation of health. The third and fourth essays include a variety of curious and important observations on schools. Many of the instances of errors, mentioned in the fourth essay, might have been omitted with great propriety. Common decency and decorum require such omissions. The remarks on girls' schools appear just and well-founded; the lady abbesses of our temporary nunneries will blush at such a public declaration of the truth, It is to be hoped, that the faults are not so general or so enormous as detailed. The condition of children, with respect to food, is said to be improved, and there was room for improvement, as a curious fact is stated in another part of this work, of forty girls at a school who fed for two successive days upon a single leg of mutton! The second volume commences with a series of useful details relating to animal temperature. Then follow two essays on scrophula and consumption, which include many excellent remarks, well deserving an attentive perusal. Did our limits permit, several interesting passages might be selected from these two impor tant dissertations. In the last volume, our author comes to treat of what is generally understood by the appellation of nervous disorders; |