Jenner for the vaccine vesicle. To Dr. Hume we are indebted for the first discrimination of croup, as it appears in infants. The same disease, in more advanced life, has now been ascertained, with no other difference than such as we might expect from the difference of age. For the discovery of the disease in infants we are not indebted to nosological tables, but to the observation of the unlearned, insomuch that the vernacular names are still retained in Britain and in America. The disease in advanced life, though accurately described by the ancient Greek and Roman writers, and spoken of by Sydenham as by no means uncommon, seemed almost unknown in our own nosological age when we had to lament the loss of two most respectable physicians. Was it by nosological tables that Dr. Heberden, even without the assistance of morbid anatomy, first taught us to distinguish angina pectoris from other forms of asthma; and afterwards, with a modesty characteristic of the man, placed it alphabetically as pectoris dolor, thus making the pain, as it is the most prominent, so the leading, character of his disease.

When we first viewed Mr. Good's performance, we expected, indeed, to meet with every disease in the organs, in the order he has arranged them. But we flattered our hopes also with a renewal of the important division of diseases into chronic and acute, and in the subdivision of each organic disease, with a detail of those symptoms which require the most immediate attention. This induced a wish that he had commenced with inflammation, because the general treatment would be similar in all such cases, though the sympathies, as well as symptoms, often vary. When inflammation is accurately defined, its progress traced, and its consequences pointed out, the first and most urgent part of medicine is accomplished. This is a grand desideratum in fevers, and it is truly astonishing that no nosologist before Dr. Young should have seen the necessity of placing inflammation anterior to fevers. In Boerhaave's days, morbid anatomy had not been sufficiently cultivated to teach us how much was to be apprehended from inflammation in fever of every description, and of every name. The same may

our remarks were very copious; and, as we could not compress them, we have omitted the whole, excepting one piece of justice which we cannot withhold from Mr. Hey. With what astonishment will the reader learn that only a single name is referred to in the division B spongiosus, or fungus hæmatodes, and that the name is not Hey. We omit its insertion, because we are sure it must offend the modesty of the person named, and that Mr. Good must regret his own inattention,

be

be said almost to the time of Cullen, before which we had only the solitary facts which Pringle and a few others afford us. But later information taught Dr. Young that, in fevers, inflammation is the first consideration. Not only in fevers, but in all local diseases, especially if attended with heat and pain. By an inattention to this, Mr. Good has overlooked the most formidable, and, probably, the most remediable, of all the complaints in his first genus of Odontia, though he had the example of Mr. Hunter for his guide. After a general view of the peculiarities of the teeth, and of the diseases to which they are liable from that peculiarity, the attention of his "discriminating mind" is directed to inflammation, its symptoms, and mode of treatment, from a conviction, that, when extended to any great degree, it is productive of mischief which we have afterwards no means of relieving.

The mention of pain in Dr. Heberden's Nomenclature, leads us back to Mr. Good's preliminary dissertation. In the early part, he tells us that the only method for a nosological system worthy of attention is built on distinctive symptoms, and afterwards symptoms, if not the disease, are considered as algebraical characters leading to a knowledge of the disease... Yet, in a subsequent part, "the family of DOLORES, or LOCAL PAINS, is," we are told, "entirely suppressed, and the genera or species of which it has ordinarily been composed are distributed, as mere symptomatic affections, under other heads.". In this manner, it is added, Cullen found it necessary to conduct his system; and Dr. Parr, after asserting the necessity of an order, at least of DOLORES, abandons it when describing his method. And what is the consequence? That "Cullen makes Odontalgia a species of rheumatism," and Parr " omits all notice of Cephalalgia, or even of Hemicrania."

We shall not venture into the inquiry whether DOLOR is consistent with an artificial order, but no one will doubt its physical existence, or that, in a practical point of view, it is the first thing to be attended to. Even its absence is often an important consideration: but, when present, can a practitioner be excused if he does not direct his first attention to its degree, its probable seat, and, most of all, to its relief. It may be said that the part of which our patient complains is often mérely sympathetic. Does not that very circumstance prove the high importance of studying pains? It is enough to remark, that, wherever we have pain, we have reason to apprehend inflammation, and such we shall see, if not the opinion, was the practical inference, of writers whom we affect to venerate. To a modern nosologist, or NO. 224. writer

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writer of systems, it may seem strange that Celsus should, in his second book, give a chapter concerning the treatment of ' diseases (de morborum curationibus), and afterwards that his 3d book should commence de morborum generibus. But nothing, in our opinion, can be more judicious than first to make us aware of those indicia or symptoms which, he observes, are common to many diseases, and indicate immediate agenda. Among others, his rules for blood.letting are so well marked, that we are forced to regret how often they have been overlooked since the introduction of nosological systems. "Ergo vehemens febris, ubi rubet corpus, plenæque venæ tument, sanguinis detractionem requirit: item viscerum morbi, nervorumque resolutio, et rigor, et distentio: quicquid denique fauces difficultate spiritus strangulat; quicquid subito supprimit vocem; quisquis intolerabilis dolor est; et quacumque de causa ruptum aliquid intus atque collisum

est.

In these comprehensive lines we have, in our opinion, instructions more important to the young practitioner, and more serviceable to mankind, than are to be met with in volumes of nosology. The symptoms of fever in any stage-visceral diseases, whether attended with pain or not-apoplexy-the severe forms of quincy, be the seat of the disease in whatever part of the throat-and violent pain, from whatever cause,-demand the immediate use of the lancet. Such aphorisms are, indeed, practical; but we have yet to learn what are the practical advantages of nosology.

Such, then, is our opinion of nosology, and such appears, sometimes, Mr. Good's opinion of all nosologies excepting his own. He must not, therefore, take it amiss if "future nosologists (should the present work have any pretensious to futurity)" amuse themselves as he has done. We have already, without design, extracted several passages in which Mr. Good is very pleasant on his predecessors. Another obtruded itself upon us, whilst, under the article Inflammation, we were searching for a methodical arrangement of Tracheitis or Laryngitis. It shows how easy a thing it is to make nosology ridiculous, so that we cannot help advising any future undertaker of this modern art to reflect on Horace's caution

cr

Quid rides? mutato nomine, de te
Fabula narratur.

"Dr. Cullen (we are told) is said to have prided himself upon having grouped an extensive natural family of diseases under the term cynanche. Parr, art. ANGINA stridula, denies that he has done so; and adds, that self-complacency had never so baseless a foundation. The species,' continues Parr, agree in no one princi

..ple

ple but affection of the parts connected with the neck. This remark is too sweeping: it may apply to Cullen's species of c. trachealis (croup), and c. parotidea (mumps); but the rest must be exempted from its severity. And it is not a little ludicrous to observe Parr, after passing this censure in his article Angina, under which he considers the disease in its different bearings, completely altering his views by the time he reaches the article Nosology: for here we find, in the first place, the term angina banished, and that of cynanche adopted in its stead; and secondly, croup and mumps, which are chiefly objected to in the preceding quotation as divisions of cynanche, not only made divisions, but sunk from species, in which they occur in Cullen, into varieties. The present arrangement follows the Cullenian as far as, perhaps, it ought to do, and only quits it where the latter seems to demand a change."

All this is very entertaining; but we must leave those to enjoy it who consider physic a joke, and who can so soon forget the names of Pitcairn and Macnamara Hayes. That Mr. Good is an able practitioner and a profound scholar, we cannot question. His good sense, his age, and the department he has chosen, must have entitled him to the first character; and his quotations from all languages satisfy us concerning the second. But either we are much mistaken, or he has attempted what cannot be accomplished in the present state of medicine, and, though we have given him credit for the diligence he has shown in correcting our nomenclature, yet we conceive that his attempts at simplicity have sometimes deceived him. When we expressed our satisfaction at not meeting with pseudos or oïdeses among the affixes or suffixes, we little expected to meet with syphilòdes used in a sense similar to the syphilöides of other writers. Whether these suffixes are both from the same root, it is not our province to inquire; but that they are used in meanings not precisely the same, will not, we suspect, be questioned. Oides is well known to be formed from ados, forma, and is often convenient in anatomy and other branches of natural philosophy when used with great caution: odes, on the contrary, when joined to a Greek substantive, makes an adjective, which may be used in the more general sense expressed by "of or belonging to." In this manner Mr. Hey has named the disease so accurately described by him, and, with equal propriety, often called "bloody cancer. But, had he called it hæmatoïdes, it would be likening a thing to itself. We know not in what way to treat Mr. Good's syphilodes. An ulcer, "indeter minate in its character, irregular in its symptoms and appearances, usually yielding spontaneously, and variously affected by mercury," can never be like, or have any kin to,

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an

an ulcer of a determinate character, "yielding to mercury and not known to yield spontaneously." The only kindred is locality, which is scarcely less consistent with profes sional gravity" than psora and broken bones, or the other locales of Dr. Cullen. (See p. 213 and 214 of our last Number.)

Many other instances have occurred in which Mr. Good appears to us to have sacrificed accuracy to simplicity.. Let us refer to the specimen transcribed from the prelimi nary dissertation into the beginning of this article (see. page 218, which we request the reader to re-peruse). Here we are told that marisca,-in Latin, hæmorroides, and ya in Greek, are the same thing. That the root is Arabic (-Khazan) or Persian, or both, to us it signifies little which. But we shall take the liberty, if not to set Sauvage and Mr. Good right, at least to differ from them.

These marisce have been well known from the time of Astruc by the name of fici, and very probably each name is derived from a similar property. Martial, Mr. Good informs us, speaks of them as figs: the Greek term is, we believe, συκωμα or συκωσις. Homer, in his account of the garden of Alcinous, tells us that figs grew in such succession that some were constantly ripe-συκον επι συκω γαράσκει. This constant succession, with a spongy, succulent, and sticky property, it is supposed gave rise to the term ouиopavz sycophant; at least it helped Aristotle to his pun on quitting Athens, whilst the citizens were rejoicing at the death of Socrates. Thus, gentle reader, you perceive that we, now and then, venture to stray as far as Aristotle; but we pretend not to know whether his gaze were marisce, or whether either or both were hemorrhoides: nor do we venture to dispute with Hesychius, or Scaliger, or Mr. Good, whether yala is a Persian word, and means treasure, or whether it is rather an Arabic than a Persian term-whether it signifies redness, blushing, fulness, or autumn, &c. &c. Yet we may be allowed to remark, that, though podix and anus are sometimes used in a very general sense, each had its appropriate meaning. The poets, when speaking to the first of these terms, never refer to the latter. These mariscæ were on the podix, not growing from the extremity of the rectum. We shall not refer to the Latin derivation of mariscæ given by some commentators on the poets, any further than to shew that in those days an idea of the inoculation of morbid poisons seems to have prevailed (see Juvenal, as cited by Mr. Good).. Martial, however, imputes the disease to the chafing of those parts from riding without a saddle. This can never refer to piles. In short, the marisce of the poets, the fici

and