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ART. V. Medical Communications. vol. 1. 8vo. 6s boards.


IN N the preface to one of the volumes of the new edition of his great work, Haller has borne an illuftrious teftimony to the merit of English phyficians. Their indifference to hypothefes, and attention to the operations of nature, obtained this eulogium. And the publication of collections like the prefent will most effectually serve to spread and perpetuate their reputation.

The two firit papers treat of a disease, which likewise occupies no inconfiderable part of the laft volume of the Medical Obfervations. In the former we have the narratives and opinions of the correfpondents of the fociety, exhibited at one view by Dr. Gray. The fame variety of fymptoms the fame gradual diffufion from place to place, and in general the fame mode of cure and termination appears in the defcriptions of both focieties. That which we now have under our infpection, feems to hold forth venæfection in a light rather lefs favourable. Dr. Gray is alfo ftruck by a remark which the Medical Obfervations fuggefted to us; while those who mention emetics afcribe beneficial effects to them, they were but rarely exhibited. The reflections of the compiler, upon the origin of the 'disease, seem just and pertinent; and we cannot but coincide with him in opinion, that it was propagated by contagion rather than excited by any matter floating in the atmosphere, and ftill more than by the fenfible qualities of this body. At the fame time we wish that the reports of the crews of fhips at fea, having been feized with it, were properly inquired into. At the conclufion of this article, we meet with a moft fingular and anomalous appearance in the natural hiftory of the human fpecies, now for the first time well authenticated, for it was not totally unknown before.

Dr. Macqueen relates it in the following terms :


Amongst the islands on the western coast of Scotland, there is one very remote from all the reft, named St. Kilda. It rifes like a rock in the ocean, about 16 or 18 leagues weft of the Lewes iflands. This place is inhabited by 20 or 30 poor families, who fubfift chiefly on the flesh and eggs of fea fowls, which they have in prodigious quantities. They have befides a fmall quantity of barley, and a confiderable number of sheep. The open and boisterous fea around them, together with their distance from every other land, exclude these poor iflanders from the rest of their fpecies; and they scarcely ever see a human being, except once in a year, when they are vifited by the steward, who receives the rent in feathers, wool, and mutton.

"St. Kilda being an appendage to that part of the Lewes called Harris, and the property of Mr. Macleod, the fteward always refides in the latter place. He makes his annual voyage to St. Kilda

Eng. Rev.Vol. V. May. 1785.



in the month of June, when the day is longeft, and the feafon moft temperate. His retinue confifts of ten or a dozen men, fufficient to manage a large open boat, fuch as are in common ufe in these iflands. The inhabitants meet him on the beach, and prompted by a defire of intelligence, as well as a refpect for his perfon, all affemble round the ftrangers. But behold the confequence! The next day the steward has hardly a St. Kilda man at his levee. They are univerfally feized with a catarrh or cold, as they call it, which rages fo faft, that in twenty-four hours every individual on the island is generally laid by. The symptoms are a cough, head-ach, fneezing, and coryza; from which they recover in a few days by drinking largely of water-gruel, and other diluting liquors that promote peripiration. This is fo invariably the cafe, that it is confidered as the natural and infallible confequence of the fteward's vifit, and the poor people are prepared accordingly. I remember Dr. Cullen mentioned this circumstance in his lecture on the catarrh, about fix years ago, when I attended him; but I have still better opportunities of knowing the matter in its full extent than the Doctor; and my connections in that part of the country enable me to give it on the ftrongeft grounds of authenticity."

Dr. C. Smith feems to have feen rather more violent cafes of the influenza than had occurred to others. What he fays of the bark is remarkable: "In cafes" he fays, "where the great lownefs and apparent putrid tendency feemed not only to juftify, but even to demand the ufe of the bark, I never was fo fortunate as to fee one fingle inftance where it produced any fenfible good effect, either in moderating the fever, fupporting the ftrength, checking the difpofition to gangrene, or preventing the fatal catastrophe that enfued."

In the 3d article, Mr. Watfon relates the appearances which the body of a man who had been violently afflicted with the gout, exhibited on diffection. While we are instructed by the author's anatomical obfervations, we fee with concern that he has ventured far beyond his depth in what he fays concerning the nature of calculous and gouty concretions. In one paragraph we are told, that the depofition of matter caused by the gout is chalk; in another paffage he concludes, that "the gouty earth is a kind of greafy bole." It were to be wifhed, that Mr. Watson had put thefe concretions into the hands of a chymift before he had entered into any fpeculations on the nature of them. In this article we are likewife difpleafed with the term gouty matter; if it means the efficient caufe of the gout, it involves an improbable, not to fay, abfurd opinion; if it has a different import, it is at beft ambiguous.

Mr. Watfon's ftrictures on the common opinion, that those who have gouty concretions in their joints, are very liable to the ftone in the bladder and kidnies, as if one dif


difeafe was generally productive of the other, appears to us very pertinent.

The next paper is a cafe of proptofis of the left eye, and affords a ftrong prefumption, that the nerve of each eye does not arife wholly, as fome anatomists have supposed, from the oppofite fide of the brain.

It deferves likewife to be remarked, that in both these instances, there was a partial disease of the brain. In Mr. Watson's cafe, the medulla oblongata, and spinalis were indurated. And Mr. Ford found a fwelling larger than a hen's egg, formed by the enlargement of the thalami on the left fide," and "the disease extended backwards almost to the medulla oblongata." Thofe who are not fo immediately called upon to examine the state of the brain as the ingenious author of the prefent paper, will yet, we hope, pay attention to it, fince a theory has been partly founded on the partial morbid condition of this principal organ.

Dr. Simmons has justly stiled the cafe of hydatids, which he relates in the 5th article, fingular. What human faga-` city, aided by all the lights of the medical art, could ever have conjectured the ftate of the patient's vifcera? The great quantity of hydatids in the abdomen, the fize of the liver, which extended from the fpine of the ilium to the 4th rib, the hydatids lodged within it, the change endured on the gut bladder, the compreffion of the right lobe of the lungs, the perforation of the diaphragm on the left fide, and the fuppuration of the left lobe of the lungs, are all circumftances which, taken together, muft render this cafe highly interesting to the pathologist.

Of Dr. A. Douglas's Obfervations on the Hæmorrhages, occafioned by the Attachment of the Placenta to the Cervix Uteri, we are ready to acknowledge the propriety; and we alfo think his inferences juft, but we owe it to former writers, to obferve, that little new is advanced by the prefent writer; and in particular, he who has not been convinced of the propriety of attempting delivery by the arguments advanced in the tenth chapter of Van Dolveran's Specimen Obf. Acad. will scarce be perfuaded to comply with Dr. Douglas's advice. When however we confider, how few of those who practice the obstetric art, exclufive of women, whether old or young, enter into the clafs of learned readers, we are willing to believe that the paper, which lies before us, will have its ufe.

The cafe of an aneurism of the aorta, related by Dr. Simmons, has this peculiarity, that it did not prove fatal by bursting, but as he thinks, by compreffing the vena cava. The

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remarks with which he concludes on the diagnosis of this difease, deserve to be confidered.

The late Dr. Keir, a man not more remarkable for a truly scientific genius, than for amiable manners, has bequeathed to the public, in the next article, an account of a fatal vomiting, apparently brought on by a disease of the kidnies. Several circumftances led Dr. Keir and others to treat this as an obftruction of the colon, by indurated fœces; but diffection fhewed, that the kidnies were the only diseased parts. Hence Dr. Keir is led to con clude, that there exifts a clofer and more extenfive fympathy between the ftomach and kidnies, than has been generally imagined. And that "the facts he stated, may help us to dif tinguish between diseases of the intestinal canal, and those of the kidnies. If fickness and violent vomiting fhould occur withoutpain or any fign of inflammation, the cause of the disease, even if conftipation fhould attend, might with more reafon be fought for in the kidnies than in the intestines; because the nature and the structure of the inteftines hardly admit of the fuppofition, that a caufe confined to them fhould occafion violent vomiting, without affecting the part where it is feated in a violent manner; which it can hardly do without producing a painful contraction, or an inflammatory ftate; and I know no inftance of an obftinate vomiting produced by a diforder of the inteftines without pain; whereas we are now poffeffed of two cafes, where vomiting appears to have been fupported with uncommon obftinacy, by a difeafe in the kidnies, without any mark in them either of pain or inflammation."

The fucceeding paper treats of the efficacy of fpir. vitrioli dulc. in the cure of fevers, by Dr. Carmichael Smith. The following table, together with a few additional remarks, will put the reader in poffeffion of this ingenious phyfician's ideas:

Cafe 4. Cafe 5. 1 Pul. 120 Pul. 100 Pul. 120 Pul. 120 Pul. 130




78 130







Day. Cafe 1. Cafe 2. Cafe 3.

123+50 78






62 65







The fpirit was exhibited in the following form:-
Spirit. vit. dulc. 3iij.



Sacch. alb. 3ij. M. Capt. 3ij. fecundâ q. horâ. The prefcription, as will readily be conceived, was occa fionally varied.


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Of the effects produced by this medicine, befides that which the table exhibits, fweating was the only one that appears from the five cafes related by Dr. Smith to have been at all fenfible. In the fifth cafe, indeed, it produced no permanent diaphorefis, and did no fervice, which also happened in another cafe, not particularly related.

These trials were made feventeen years ago; and we are affured that the author, as well as others, have experienced the beneficial effects of this medicine, fince its first exhibition. We are further told, that in the various forms of inflammatory fever, it would be extremely improper; that in the hectic and pulmonic cafes, the advantage derived from it is trifling or doubtful; that in the remittent and common putrid fevers, it has been prefcribed without advantage, but also without bad confequences; that when joined with fmall doses of emetic tartar, it has been productive of the beft effects.

"I may likewife with truth affirm," adds the author, "that in the low state of putrid fevers, (where cordials are wanted), it is one of the beft medicines of the kind, and I think greatly affifts the bark in refifting the feptic tendency of the difeafe. But the cafes of all others, to which it feems to me the moft peculiarly adapted, and where I have feen it produce the most fudden and furprising effects, are thofe fevers occafioned by contagion, or what are commonly called the jail or hofpital fevers. In thefe, as its cordial powers are more immediately neceffary, fo they are in general more evident and striking; its operation alfo as a diaphoretic, is here of the utmost confequence: for by promoting a perfpiration or sweat, it promotes the only method, in my opinion, by which thefe fevers, (unless at the very beginning) can poffibly be cured. Upon the whole, I efteem the dulcified fpirit of vitriol a medicine of great utility in the cure of putrid fevers in general, and more particularly fo in thote arifing from contagion; nor do I know, (excepting perhaps emetic tartar, or fome fimilar antimonial) any one medicine to be preferred to it; not even the peruvian bark itself, though fo strongly recommended by Sir John Pringle, an authority in phyfic to which I fhall always pay the highest deference and refpect."

The fix following papers, though the cafes related in them are highly deferving of attention, and efpecially Dr. Keir's, in which there was a communication between the fophagus, trachea, and fubftance of the lungs, in confequence of ulceration; and ftill more, Mr. Watfon's cafe of afcites, in which the water was drawn off by tapping; we are obliged to pafs over, in order to make room for matter of more general importance, or greater curiosity. [To be continued.]



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