have no liking for their principles, by the skilful exertion of that familiar and attractive quality, which, as it never fails to brighten the beft characters, fo it ferves to fhadow and disguile the worlt.' In fome of these difcourfes, the author's principal design, and the tendency of his arguments, are not fufficiently obvious; for want, perhaps, of the old methodical arrangement. In other refpects, there is merit in thefe compofitions; and the author appears to be a man of ingenuity and learning. Obfervations on the Theory and Cure of the Venereal Disease. By John Andree. 8vo. 3. in boards. Davis. Notwithstanding the many treatifes which have been written on the venereal disease, we find in the one now before us fo great a variety of useful obfervations, as juftly intitles it to particular attention. The author begins with giving a concile account of the hif tory of the disease in this country; whence it appears that the lues venerea was known in Britain before the epoch of its fuppofed importation from America. In confirmation of this remark, Mr. Andree obferves, that in the original manufcript of the ancient Customary of the diocese of Winchester, for the regulation of the public ftews, or brothels, in the reign of Henry VI. the difeafe is mentioned as a common, and not a new one. Mr. Andree diftinguishes the disease into three states: the first is the gonorrhoea, and its effects: the fecond, chancre, its immediate confequences, and fome other symptoms; and the third is the confirmed, or conftitutional lues venerea, the ftate when the symptoms feem to be occafioned by the action of venereal virus, generated in the patient's body. The author, having formerly treated of the gonorrhoea, and its effects, proceeds to the fecond ftage of the disease, or that of a chancre, which he defcribes with great exactness. The parts on which they ufually happen, fays he, are the glans penis, the corona glandis, the prepuce, the frænum, the fkin of the penis, the outer and inner labia pudenda, the clitoris and its prepuce, and fometimes the vagina, in women. The number of chancres which arife in confequence of an unclean connection, varies confiderably (which happens from caufes unknown), being from one to ten or twelve; the most common cafes are from one to about four and I have obferved, that, in proportion as they are more numerous, they have a lefs degree of venereal malignancy, are more eafily cured, and are the less liable to produce the conftitutional lues; whereas a fingle chancre is most commonly either very difficult and tedious of cure, or heals too foon, which gives rife to other symptoms of the venereal disease. • The next circumstance to be confidered, is the time of the appearance of chancres after the infecting virus has been applied. It is usually from about thirty hours to three or four weeks; the most common time is about five or fix days. I have been told of a cafe, in which it was near feven weeks before they appeared. But no material affiftance, in forming a juft prognoftic of the future progrefs of chancres, feems deducible from the time of their appearance, farther than that, in general, the earlier they arise, the greater is the tendency to inflammation; and that the later they are, there is more reafon to be apprehenfive of the disease having entered the conftitution. It is a common opinion, that the earlier the disease is in its appearance, the greater is the de4ce of virulence of the matter which communicated it, and confequently that the fymptoms will be the more virulent; but experiments which have been made on this fubject tend to prove, that the malignancy of the fymptoms is entirely independent on the degree of virulence of the infecting fluid; and from analogy, by comparing this disease with fome others, we have farther reafon to adopt this opinion: for example, in the small pox, the violence of the disease depends on the conftitution, and the method of treatment; for (experimenti gratia) people have been inoculated from the worst kind of the disease, which has produced as mild and good a fpecies of the fmall pox as matter from the best kind; and I have obferved, in thofe who have had the ve nereal disease many times, that the fymptoms have afually ap peared nearly at the fame diftance of time after the infecting fluid was applied; alfo, that fome people are much more liable to catch the disease than others: which circumftances tend ftrongly towards proving that the time of its appearance depends principally upon the tendency of the conftitution to be affected by the venereal virus.' After delivering a general account of chancres, in respect of their fituation, number, and other circumftances, Mr. Andree introduces a detail of the various preparations of mercury, and the method of ufing them. He obferves, that the general and almost constant action of mercury upon the body, is to increase its irritability, which renders it more difpofed to refift every injury inflicted on it. On this principle it has been remarked, that a person who is under the ufe of mercury cannot bear fo ftrong an electric shock as at another time. On the fame principle, it is found to be peculiarly injurious in the hæmoptoe, and fome other diforders: and, Mr. Andree obferves, it seems to be on the fame theory, that it is apt, in gouty people, to bring on a fit of that distemper. In confequence of this remark, our author hints at the propriety of trying a gentle course of mercury in those cases in which the object is to bring on a fit of the gout. Mr. Andree afterwards treats, with great precision, of the methods of curing chancres, and alfo buboes, with the phymofis, paraphymofis, &c. H 2 Ulcers Ulcers of the ton fils or uvula, when apparently the confequence of a chancre improperly treated, have generally been confidered as a certain symptom of the conftitutional lues; but Mr. Andree fufpects the juftness of this opinion, from the following circumftances: 6 First, because it ufually appears in a much fhorter time than a constitutional lues venerea does; fecondly, that the chancre, on the appearance of this fymptom, lofes much of its virulency; and laftly, that the difeafe is confined to this part. From thefe circumstances, I think it may be rationally inferred, that the disease has removed from one part to the other, without infecting the conflitution. It muft, however, be confeffed, that it is difficult to afcertain whether the conftitution is infected with the difeafe by this change of fituation, or not yet, in favour of my opinion, it must be observed, that in fome cafes of abfceffes (not venereal) the matter has been abforbed, and another abfcefs appeared in fome diftant part of the body, and in a less space of time than feems neceffary for the tranflation of the matter, by the circulation of the blood, from one part to the other. And farther, fome parts are more prone to be affected by the venereal virus, at its removal from the genitals, than others; and the throat feems to be the most fo of any diftant parts.' The author next treats of the last stage of the disease, or that which is properly diftinguished by the name of Lues Venerea. This, he obferves, is frequently caused by the unskilful management of fome of the fymptoms proceeding from chancres. Sometimes, however, it is the immediate confequence of a chancre; and, in other more rare inftances, it appears without any previous venereal fymptoms; the virus having probably been abforbed from matter applied to the external parts of generation, without producing any disease of them. Mr. Andree informs us, that, from his own obfervations on a great number of cafes, thofe cures are feldom found to be permanent, which are performed with lefs than fourteen dofes of mercury; and he is of opinion, that mercury, when it does not produce - any apparent effects, has in very few cafes even the power of ftopping the progrefs of the fymptoms, in this ftage of the disease. Previous to the author's treating of the fymptoms of the conftitutional lues venerea, we meet with the following general obfervations on the use of mercury. It should be a general rule to introduce as much mercury at each time as the patient can bear, without its producing any violent effects. It is not, however, yet afcertained, whether it is best to give, or rub in, the mercury in a double quantity every other day, or half the fame proportion each night. In obftinate cafes, and ftrong conftitutions, the first of these methods should be tried; but in common cafes, and in all weak conftitutions, 8 any any attempts to get a large quantity of mercury into the body in a fhort time, will be attended with danger of its bringing on a diarrhoea, a violent falivation, or fome fuch diforder as would retard the cure. The mercury, in curing this ftage of the dif eafe, is to act principally by the quantity introduced into the body in a diffolved ftate; therefore one of the mild class of its preparations will, in moft cafes, be the most eligible: but if fuch are found not to act upon the conftitution in a proper way, that is, when a great quantity has been introduced without producing any effect, one of the acrid mercurials may be given to advantage, to excite the mercurial ftimulus in the conftitution, and cause it to diffolve the mercury; thus a few grains of calomel, given every night, will, in fome cafes, foon bring on a ptyalism, after half a drachm of crude mercury has been taken, or rubbed in, every day for two or three weeks, without producing any fuch symptom: if this method does not produce the defired effect, a large dose of one of the acrid preparations fhould be given. This peculiarity is in fome cafes conftitutional; but in others it feems to be owing to the long-continued ufe of mercury, by which it loses the power of ftimulating the body; juft as ftrong liquors, or an unwholefome air, cease to produce any bad effects upon those who have been long accustomed to them. In one cafe of this kind, the unhappy patient had fuch a caries of the right orbit, that the eye was protruded out of the focket: he had, by the advice of his furgeon, rubbed in a drachm of ftrong mercurial ointment, and had taken three quarters of a grain of corrofive fublimate of mercury, night and morning. Another furgeon, being confulted on this cafe, advised that the mercurial courfe fhould be left off, and that the patient should take no other medicine for three weeks, except a laxative potion every other day. He was then put under a gentle courfe of mercurial inunctions; and, in ten days after, a kindly fpitting enfued, though only half as much mercurial ointment was rubbed in every night, as had been used in the former courfe. In the other ftate, when the mercury does not produce any of its ufual effects upon the patient, and that circumftance cannot be accounted for from the caufe above mentioned, it is to be regarded as a conflitutional peculiarity in these cafes, the dofes fhould be increafed as fuddenly as can be done with prudence, and fome of the ftimulating preparations tried perhaps electrification might be used to advantage in fome cafes; which, by increafing the irritability of the body, might render it more fufceptible of the mercurial itimulus. From fome inftances of this kind which have come under my infpection, and others which I have been informed of, this difpofition does not feem to be peculiar to any conftitution or form of body, but occurs in all.' The whole of this treatife is clear, judicious, and practical; and contains many valuable obfervations refpecting both the history and cure of the difeafe, in the ftages of chancre, and the conftitutional lues venerea. Ode, infcribed to John Howard, Efq. F. R. S. Author of The State of English and Foreign Prifons. By William Hayley, Efq. 410. 1s. 6d. Dodfley. OUR UR favourite poet has here refumed his prolific pen, to pay a deserved tribute of applaufe to one of the most worthy and benevolent characters this age has produced. To a mind like Mr. Howard's, the free-will offering of fuch a Mufe muft afford more pleasure and fatisfaction than all the honours and emoluments which fortune could bestow upon him. It is well known that this humane traveller vifited every loathfome dungeon in this kingdom, fearlefs of the dreadful confequences which he might naturally have expected from fuch a dangerous enterprize; but the fame Providence which faved and protected the good bishop of Marseilles extended its care over this equally bold and pious adventurer. This refolution our poet has finely expreffed in the following elegant stanza. • What precious drug, or ftronger charm, In fcenes, whence, muttering her alarm, Her cryftal cup from Nature's pureft rill; Chief nourisher of life! beft antidote of ill!' His generofity in vifiting foreign prifons, as well as our own, is mentioned in terms of the warmest approbation, Mr. Hayley's apoftrophe on this fubject is truly poetical. Ye nations thro' whofe fair domain Our flying fons of joy have past, Philanthropy outftript keen Pleasure's pace, Princes his fupplicants became : He feem'd the enquiring angel, fent To fcrutinize their fecret fhame. Pope has immortalized him in the fe lines: Why drew Marfeilles' good bifhop purer breath, alluding to his conftant vifitation of the fick in his diocese during the time of the plague. See Pope's Essay on Man. 師 Cap |