« ForrigeFortsæt »
ART. V. Medical Communications, vol. 1. 8vo. 6s boards.
of his great work, Haller has borne an illuftrious teftimony to the merit of English physicians. Their indifference to hypotheses, and attention to the operations of nature, obtained this eulogium. And the publication of collections like the present will most effectually serve to spread and perpetuate their reputation.
The two first papers treat of a disease, which likewise oc-. cupies no inconsiderable part of the last volume of the Medical Observations. In the former we have the narratives and opinions of the correspondents of the society, exhibited at one view by Dr. Gray. The fame variety of symptoms the same gradual diffusion from place to place, and in general the same mode of cure and termination appears in the descriptions of both societies. That which we now have under our inspection, seems to hold forth venæsection in a light rather less favourable. Dr. Gray is also struck by a remark which the Medical Observations suggested to us; while those who mention emetics ascribe 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 still more than by the sensible qualities of this body. At the same time we wish that the reports of the crews of ships at sea, having been seized with it, were properly inquired into. At the conclusion of this article, we meet with a moft fingular and anomalous appearance in the natural history of the luman species, 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 rest, named St. Kilda. It rises like a rock in the ocean, about 16 or 18 leagues west of the Lewes islands. This place is inhabited by 20 or 30 poor families, who subsist chiefly on the flesh and eggs of sea fowls, which they have in prodigious quantities. They have besides a small quantity of barley, and a considerable number of sheep. The open and boisterous sea around them, together with their distance from every other land, exclude these poor islanders from the rest of their species ; and they scarcely ever see a human being, except once in year,
when they are visited 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 steward always refides in the latter place. He makes his annual voyage to St. Kilda Eng. Rey, Yol V. May, 1785,
in the month of June, when the day is longest, and the season most temperate. His retinue confifts of ten or a dozen men, fufficient to manage a large open boat, such as are in common use in these islands. The inhabitants meet him on the beach, and prompted by a desire of intelligence, as well as a respect for his perfon, all assemble round the strangers. But behold the consequence! "The next day the steward has hardly a St. Kilda man at his levee. They are universally seized with a catarrh or cold, as they call it, which rages so fast, that in twenty-four hours every individual on the island is generally laid by. The symptoms are a cough, head-ach, sneezing, and coryza; from which they recover in a few days by drinking largely of water-gruel, and other diluting liquors that promote pertpiration. This is so invariably the case, that it is considered as the natural and infallible confequence of the steward's visit, 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 strongest grounds of authenticity."
Dr. C. Smith seems to have seen rather more violent cases of the influenza than had occurred to others. What be fays of the bark is remarkable: “In cases" he says, “where the great lowness and apparent putrid tendency feemed not only to justify, but even to demand the use of the bark, I never was so fortunate as to see one single instance where it produced any fenfible good effect, either in moderating the fever, supporting the strength, checking the disposition to gangrene, or preventing the fatal catastrophe that ensued."
In the 3d article, Mr. Watson relates the appearances which the body of a man who had been violently afflicted with the gout, exhibited on diffetion. While we are instructed by the author's anatomical observations, we fee with concern that he has ventured far beyond his depth in what he says concerning the nature of calculous and
gouty concretions. In one paragraph we are told, that the deposition of matter caused by the gout is chalk; in another passage he concludes, that " the gouty earth is a kind of greasy bole.” It were to be wished, that Mr. Watson had put chefe concretions into the hands of a chymist before he had entered into any speculations on the nature of them. In this article we are likewise displeased with the term gouty matter; if it means the efficient cause of the gout, it involves an improbable, not to say, absurd opinion; if it has a different import, it is at best ambiguous.
Mr. Watson's strictures on the common opinion, that those who have gouty concretions in their joints, are very liable to the stone in the bladder and kidnies, as if one dis
disease was generally productive of the other, appears to us very pertinent.
The next paper is a cafe of proptosis of the left eye, and affords a strong presumption, that the nerve of each eye does not arise wholly, as fome anatomists have supposed, from the opposite fide of the brain.
It deferves likewise to be remarked, that in both these instances, there was a partial disease of the brain. In Mr. Watson's case, the medulla oblongata, and spinalis were indurated. And Mr. Ford found a swelling larger than a hen's egg, formed by the enlargement of the thalami on the left side,” and “ the disease extended backwards almost to the medulla oblongata.” Those who are not so immediately called upon to examine the state of the brain as the ingenious author of the present paper, will yet, we hope, pay attention to it, since a theory has been partly founded on the partial morbid condition of this principal organ.
Dr. Simmons has justly stiled the case of hydatids, which he relates in the 5th article, singular. What human saga-' city, aided by all the lights of the medical art, could ever have conjectured the state of the patient's viscera ? The great quantity of hydatids in the abdomen, the fize of the liver, which extended from the spine of the ilium to the 4th rib, the hydatids lodged within it, the change endured on the gut bladder, the compression of the right lobe of the lungs, the perforation of the diaphragm on the left side, and the suppuration of the left lobe of the lungs, are all circumstances which, taken together, must render this case highly interesting to the pathologist.
Of Dr. A. Douglas's Observations on the Hæmorrhages, occasioned by the Attachment of the Placenta to the Cervix Uteri, we are ready to acknowledge the propriety; and we also think his inferences just; but we owe it to former writers, to observe, that little new is advanced by the present 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 persuaded to comply with Dr. Douglas's advice. When however we consider, how few of those who practice the obstetric art, exclusive of women, whether old or young, enter into the class of learned readers, we are willing to believe that the paper, which lies before us, will have its use.
The case 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 compressing the vena cava.
remarks with which he concludes on the diagnosis of this difease, deserve to be considered.
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 circumstances led Dr. Keir and others to treat this as an obstruction of the colon, by indurated fæces; but diffection shewed, that the kidnies were the only diseased parts. Hence Dr. Keir is led to con clude, that there exifts a closer and more extensive fympathy between the stomach and kidnies, than has been generally imagined. And that “the facts he stated, may help us to distinguish between diseases of the intestinal canal, and those of the kidnies. If fickness and violent vomiting should occur without pain or any sign of inflammation, the cause of the disease, even if constipation should attend, might with more reason be fought for in the kidnįes than in the intestines; because the nature and the structure of the intestines hardly admit of the supposition, that a cause confined to them should occafion violent vomiting, without affecting the part where it is seated in a violent manner ; which it can hardly do without producing a painful contraction, or an inflammatory ftate ; and I know no instance of an obstinate vomiting produced by a disorder of the intestines without pain ; whereas we are now possessed of two cases, where vomiting appears to have been supported with uncommon obstinacy, by a disease in the kidnies, with. out any mark in them either of pain or inflammation."
The succeeding paper treats of the efficacy of spir. 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 :
Day. Cafe 1. Case 2. Case 3. Cafe 4. Cafe 5.
921 78 • 130 1
Zij. M. Capt. Zij. fecundâ q. hora. The prescription, as will readily be conceived, was occafionally varied.
Of the effects produced by this medicine, besides that which the table exhibits, sweating was the only one that appears from the five cases related by Dr. Smith to have been at all sensible. In the fifth case, indeed, it produced no permanent diaphoresis, and did no service, which also happened in another case, not particularly related.
These trials were made feventeen years ago ; and we are assured that the author, as well as others, have experienced the beneficial effects of this medicine, since 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 cases, the advantage derived from it is trifling or doubtful; that in the remittent and common putrid fevers, it has been prescribed without advantage, but also without bad confequences; that when joined with small doses of emetic tartar, it has been productive of the beft effeéts.
" I may likewise with truth affirm,” adds the author, " that in the low state of putrid fevers, (where cordials are wanted), it is one of the best medicines of the kind, and I think greatly affits the bark in resisting the septic tendency of the disease. But the cases of all others, to which it seems to me the most peculiarly adapted, and where I have seen it produce the moft sudden and surprising effects, are those fevers occafioned by contagion, or what are commonly called the jail or hospital fevers. In these, as its cordial powers are more immediately neceffary, so they are in general more evident and striking ; its operation also as a diaphoretic, is here of the utinost consequence: for by promoting a perspiration or sweat, it promotes the only method, in my opinion, by which these fevers, (unless at the very beginning) can possibly be cured. Upon the whole, I esteem the dulcified spirit of vitriol a medicine of great utility in the cure of putrid fevers in general, and more particularly so in 'thole arising from contagion; nor do I know, (excepting perhaps emetic tartar, or some similar antimonial) any one medicine to be preferred to it; not even the peruvian bark itself, though so strongly recommended by Sir John Pringle, an authority in phyfic to which I shall always pay the highest deference and respect."
The fix following papers, though the cases related in them are highly deserving of attention, and especially Dr. Keir's, in which there was a communication between the sophagus, trachea, and substance of the lungs, in conse, quence of ulceration ; and still more, Mr. Watson's cafe of ascites, in which the water was drawn off by tapping; we are obliged to pass over, in order to make room for matter of more general importance, or greater curiosity.
[To be continued.]