causes which first produced it might produce it again, although it had entirely disappeared; or the disease constantly existing may be of so mild a character as to escape attention, awaiting favourable circumstances to render it active.

You consider that local causes alone might revive it annually?—I should think very probably, under favourable circumstances, in the Levant; but in Europe the disease is only spread by contagion, for the separation of the healthy invariably preserves them.

Do you consider it very similar to small-pox contagion ?—I cannot draw a comparison; I consider the two diseases as so different.

Is the contagious quality of it so likely to communicate the disease as small-pox?—I can conceive the plague existing, and yet not very contagious; and I can conceive it existing and extremely contagious; and precisely the same with the small-pox.

Do you not consider the small-pox contagion as more diffusible than the plague?—I should think it difficult to institute the comparison.

To what do you attribute our not having had any plague-case in Great Britain for so long a period? Having had notice only last night, I have scarcely had time to give it a thought. I conceive, when a cargo is shipped in any part of the Levant, the sailors of the ship are necessarily employed in taking in the cargo. Under these circumstances, if the plague existed, I do not suppose the ship would arrive in England before the disease had made its appearance; and I suppose, when the plague breaks out on the voyage, the vessels put into the nearest port where quarantine can be performed, and are there subjected to the usual precautions. This may be only one reason among others.

Do you consider goods equally communicable of the disease as persons?-From all I have heard, inquiring of those who have seen the plague very repeatedly, and what I have read, I conceive equally.

How do you account for the expurgators of goods in Great Britain at the quarantine establishments never having taken the plague?—I should suppose the plague makes its appearance before the ships arrive in England, and I conceive the goods liable to give the plague have undergone purification in foreign lazarettos before their importation into England; and we frequently find a typhous fever, probably from this cause, in a lazaretto: of this I had examples during my attendance on the sick in the quarantine establishment at Naples.

Do you know that the goods are promiscuously shipped at Smyrna, whether or not the plague rages there?-With that I am not acquainted.

Assuming that to be the fact, how do you account for those goods, upon their arrival in Great Britain, not communicating the disease at the quarantine establishments?—I should suppose the plague makes its appearance before the ship arrives, and consequently the necessary precautions have been employed.

The fact being that goods are shipped at Smyrna, even in times when the plague rages furiously, and those goods arriving at the quarantine establishment in Great Britain, how do you, in those cases, account for the expurgators of goods not having the infection?-Although we have authentic accounts of the plague existing at nearly every temperature,

still we find it is less virulent at one temperature than at another: perhaps other causes may conspire with temperature to increase its destructive effects. The degree of temperature, and other favourable circumstances for the propagation of plague, not existing at the time the affected goods arrived in England, may have prevented the dissemination of the disorder. But, should such circumstances exist, we may again be visited by the plague, and even a typhous fever may have been produced in this country by such goods; for we know that a mild case of plague resembles much typhous fever.

It appears from the Custom-house return, that nothing of that kind has appeared at the quarantine establishments ever since their origin: from that circumstance would you not conclude the infection did not arrive? To give a satisfactory answer to that question would require more reflection than I have been able to give to this subject.

Do you consider the plague of 1665 to have been imported into Great Britain?-I feel unequal to answer that question.

Do you consider the quarantine establishments as useful?-As very useful: but I should conceive, from what I have seen in the quarantine establishments here, at Venice, Naples, Malta, and other ports of the Mediterranean, that considerable modifications might take place: amongst many other examples, I might instance a circumstance which occurred to myself. I arrived at Dover from Naples in seventeen days, but neither myself, luggage, or carriage, underwent any-where quarantine; whereas my other luggage, which I left at the saine time, came by sea, and arrived in England a considerable time after me, underwent the usual quarantine. Couriers, who travel with the greatest expedition, do not perform quarantine; although ships, which have taken a long time to perform the voyage from the same place, are frequently obliged to undergo it.

You consider that the regulations might be modified, both with respect to persons and goods?-With respect to goods, I am unable to give an opinion; but I should assuredly think so with respect to

persons.

[The extracts already produced from the Minutes of Evidence comprise the examination of the whole of the Physicians who have had opportunities for actual observation: we shall conclude with transcribing the General Report of the Committee.]

The Select Committee appointed to consider the validity of the doctrine of Contagion in the Plague; and to report their observations thereupon, together with the minutes of the evidence taken before them, to the House ;-have considered the matters to them referred, and have agreed upon the following REPORT:

Your Committee being appointed to consider the validity of the received doctrines concerning the nature of contagious and infectious diseases, as distinguished from other epidemics, have proceeded to examine a number of medical gentlemen, whose practical experience or

general knowledge of the subject appeared to your Committee most likely to furnish the means of acquiring the most satisfactory information. They have also had the evidence of a number of persons whose residence in infected countries, or whose commercial or official employments, enabled them to communicate information as to facts, and on the principle and efficacy of the laws of quarantine. All the opinions of the medical men whom your Committee have examined, with the exception of two, are in favour of the received doctrine, that the plague is a disease communicable by contact only, and different in that respect from epidemic fever; nor do your Committee see any thing in the rest of the evidence they have collected, which would induce them to dissent from that opinion. It appears from some of the evidence, that the extension and virulence of the disorder is considerably modified by atmospheric influence; and a doubt has prevailed whether, under any circumstance, the disease could be received and propagated in the climate of Britain. No fact whatever has been stated to show that any instance of the disorder has occurred, or that it has ever been known to have been brought into the lazarettos for many years: but your Committee do not think themselves warranted to infer from thence that the disease cannot exist in England; because, in the first place, a disease resembling in most respects the plague is well known to have prevailed here in many periods of our history, particularly in 1665-6; and further, it appears that, in many places and in climates of various nature, the plague has prevailed after intervals of very considerable duration.

Your Committee would also observe, down to the year 1800, regulations were adopted which must have had the effect of preventing goods infected with the plague from being shipped directly for Britain; and they abstain from giving any opinion on the nature and application of the quarantine regulations, as not falling within the scope of inquiry to which they have been directed; but they see no reason to question the validity of the principles on which such regulations appear to have been adopted.

14th June, 1819.

CRITICAL ANALYSES

OF

RECENT PUBLICATIONS, IN THE DIFFERENT BRANCHES OF MEDICINE AND SURGERY.

"I would have men know, that, thongh I reprehend the easie passing over of the causes of things by ascribing them to secret and hidden vertues and properties; (for this hath arrested and laid asleepe all true enquiry and indications;) yet I doe not understand but that, in the practical part of knowledge, much will be left to experience and probation, whereunto indication cannot so fully reach: and this not only in specie, bat in individuo. Yet it was well said, Vere scire esse per causas scire."-BACON.

A Treatise on Indigestion, and its Consequences, called Nervous and Bilious Complaints; with Observations on the Organic Diseases in which they sometimes terminate. By A. P. W. PHILIP, M.D. F.R.S. ED. &c. 8vo. pp. 363. T. and G. Underwood, London, 1821. [In continuation from page 148.]

THEC HE author, in conformity with his pathology, treats of the means of cure of what he regards as the first and second stages of indigestion, respectively, in a distinct manner. We have already shown that he considers "indigestion" to be essentially a disease from debility, which is accompanied in the second stage with inflammation. His mode of treating it agrees with these principles. The medicines he recommends for the first stage, are of the stimulative kind: his prophylactic measures are directed with the view of averting the supervention of irritation. His remarks on the diet and regimen proper for those purposes are, for the most part, judicious and interesting, especially those on diet; and, as we always endeavour to support our assertions by cited evidence, we shall adduce some of the most remarkable of them, as we pass them in review in a particular manner. Before we commence, we should however observe, that we regard the remedial measures proposed by the author for the "first stage," in a favourable manner only as they are applicable to indigestion from debility, when inflammation of the stomach is not present. That indigestion sometimes, and not unfrequently, originates with chronic inflammation of the mucous membrane of the stomach, we suppose no one will be adverse to acknowledge: Dr. Philip must be aware of this fact; and we do not conceive why he has neglected to notice it in a precise manner. The whole tenor of his history of the first stage of indigestion, and of the means of treating it, would imply that it arises only from debility of the stomach. He does not, it is true, profess to give a complete history of indigestion; but, with this reservation, it would, we think, have been prudent to have stated more precisely that one species of indigestion alone was the subject of his consideration.

Having noticed, in a general way, the importance of due exercise of body and mental quietude, both in a remedial and prophylactic point of view, the author considers the subject of diet. The objects to be kept in view in regulating the diet, he says, are "that it shall tend as little as possible to produce either morbid distention or morbid irritation of the surface of the alimentary canal." Although these matters may appear so simple, and are so well understood by brute animals, a great deal may be said about them, that daily experience proves to be of much importance. This we think ourselves, though we are not much disposed to conform to the fashion of the day, and pretend to be very knowing in what is and what is not good for a stomach, or think that the caprices of this organ, above all others in the body, are to be humoured with so much condescension as is generally showed towards them. We have a friend, who, tired of consulting them in vain, for they varied incessantly, resolved that his stomach should digest what he chose to put into it, or serve him as a stomach no longer, and, after two or three squeamish fits and a week's starvation, managed somewhat like that of Governor Sancho Pança, the organ would do its office very well, and has since served him in a becoming manner. We suspect that the cases of indigestion are not few that might be cured by similar measures; and we recommend them as worthy of a place with the advice of MONTAIGNE for the management of the still more vexatious caprices of another organ.

"All undigested food," the author says, "however small the quantity, is a cause of irritation. Thus, the whole train of symptoms which constitute a fit of indigestion, may arise either from too large a quantity of food, particularly if carelessly masticated, or from food of difficult digestion; most readily, of course, from a combination of these causes. It is therefore of great consequence, in regulating the treatment of this disease, to ascertain what kinds of food are most easily changed by the gastric fluid. This is sometimes influenced by peculiarities of constitution, to which no general rules will apply; but it is not difficult to perceive what kind of diet is generally best suited to a weak stomach.

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"Acescent and oily articles of food, with a large proportion of liquid, compose the diet most difficult of digestion. It would appear, that a feeble gastric fluid, as indeed we might à priori suppose, does not admit of being greatly diluted, without having its powers much impaired. The diet opposite to this, then, is that which agrees best with dyspeptics. In the first stage of indigestion, a diet composed pretty much of animal food and stale bread is the best."

If we except beef and veal, the author adds, the flesh of old, is generally more easy of digestion than that of young, animals, on account, he says, of the greater quantity of mucilage in the latter; and all mucilages are of difficult digestion."