« AnteriorContinuar »
eligible for answering this indication. He begins with the difcharge by perspiration.
Perspiration in some degree, he obferves, is common to every kind of small-pox, particularly in the period of eruption; commencing generally with the eruptive-fever, or soon after it. It is insensible in the mild kind, copious in the contiguous, and, for the most part, moderate in the confluent, especially if diarrhoea occurs. When perspiration is altogether wanting, the fever and other symptoms are more violent, and the crop of small-pox more numerous; an evident proof that it contains a . portion of the contagious fluids. Our author observes, that if gentle perspiration does not occur after bleeding, in this early Itage of the disease, it affords an unfavourable prognosis, and, with other circumstances, points out the neceffity of more blood being taken away. In this case, a few grains of James's powet der, according to the age and habit of the patient, or other antimonial preparation, in small nauseating doses, may be given at proper intervals with good effect. The medicine which Dr. Walker has found to be more certain and effectual than any other, for an adult in this case, is the saline julep, with the pro. portion of one-eighth of a grain of emetic tartar to the dole (two table-spoonfuls, or one ounce), given once in two or three hours, according to circumstances. But however salutary this excretion may be, in carrying off a part of the contagious fluids, yet, as it seldom continues longer than the complete eruption of the puftules, our author thinks that little dependence can be placed upon it, for giving any effectual relief to the patient, by disa charging fuch an accumulated load of contagious matters as are generated in the system.
Dr. Walker next considers the salivary discharge, which occurs in all bad cases of small-po:, and is generally, though not always, connected with swelling of the head, face, and fauces, By medical writers the ptyalism is usually regarded as a favourable fymptom ; Sydenham considers it even a necessary discharge, which ought to be promoted and kept up. Dr. Walker, how ever, is firmly persuaded that it is merely the effect of an extenfive assimilation, and that the excess of the contagious Auids may be more advantageously reduced by diverting them into another channel. For the ptyalism being commonly accompanied, as before observed, with tumefaction of the head, face, and fauces, there ensues not only an increase of cephallagia and delirium, but an almost insuperable impediment to the swallowing of drink, and even a danger of suffocation.
Our author observes that the continuance of fever, after the complete eruption of the puftules, plainly thews the presence of the irritating cause in the system ; but if, in the commencement
able fymhought to persuadech at the end
of the disease, a reduction of the proximate cause can be ob. tained by diminishing the excess of the contagious fluids, the fever will be moderated, and of course the impetus upon the vessels of the head will be considerably weakened, the salivation will proceed more equably and moderately, and the morbid saliva continue in a fluid state. On the contrary, if the quantity of contagious Auids is not reduced, the fever goes on even after the eruption is completed, with very little abatement, and the faucial glands being incapable of secreting the saliva in proportion to the quantity of Auids hurried on to these organs, a very slow circulation, or a total stagnation, must necessarily follow, by which they are thickened, and rendered more unfit for secretion. Dr. Walker therefore concludes that, though ptyalism is a resource of nature to free herself from an excess of contagious Auids, and though this secretion evidently tends to diminish some part of them, yet the manifest danger that attends it in every bad cafe of small-pox, does more than counterbalance any advantage that can be acquired by supporing it.
While our author maintains, however, that ptyalism, considering the inconveniencies and danger which attend it, is not the most eligible way of discharging the contagious fluids, he means not to recommend any undue resistance to that evacuation, where it has already commenced. On the contrary, he specifies the means of promoting it in cases of particular exigency.
The effects of the urinary discharge come next under our author's consideration. He observes that, in every case of extensive assimilation, or where the vital fluid is strongly impregnated with contagious matters, the different fluids, secreted from it, will more or less partake of its peculiar quality. On which account it is of importance to promote the urinary discharge through the whole progress of the small-pox, but especially in its first stages; though we cannot, in the opinion of our 'au. thor, expect from it any considerable reduction of the proximate cause.
The remaining evacuation, the effects of which our author examines, is that of diarrhea; which, as it forms the basis of the doctrine inculcated throughout the work, he appears particularly solicitous to establith upon the firmest foundation. In general, the various testimonies which he adduces from writers on this subject, tend to shew that physicians have proceeded with great caution in the use of purgatives in the small-pox; while some have even entertained the opinion, that, in this difease, any recourse to them was accompanied with danger. This caution of some, and timidity of others, our author ascribes to their not having a distinct view of the proximate cause of the diftemper; and he remarks that the successful examples which
occur in authors, of such treatment, though not founded on any just principle, are sufficient to fortify the mind against the dread of purging in the worst cases of small-pox.
In the tenth chapter our author proceeds to the treatment of inflammatory small-pox, under which head are comprehended both the contiguous and simple confluent kinds of the difease.' But before he enters upon this part of his subject, he premises a Short account of the reasons which induced him to adopt the me. thod of cure so strongly recommended in the present work. He had found that in treating the various kinds of bad fmall-pox, with all the advantages of the cool regimen, besides évacuation, by bleeding, and a laxative clyfter from time to time, he never was fenfible, by the strictest attention to this regimen, of the crop of small-pox being lessened; for the pustules were often as numerous as the skin would admit of, with little or no remission
of the eruptive fever. After many disappointments, obfervaition at last taught him what was farther necessary to render more
complete the success of the cool regimen in this disease. In
The subsequent, chapter is allotted to the treatment of para ticular symptoms, viz. swelling of the head, face, and fauces; cephalalgia, deliriuin, coma, phrenitis, angina, dyspnea, pain in the region of the stomach, lumbago, swelling of the hands, fuppreffion of urine, and convulfive fits. The treatment of these various symptoms is intelligently and usefully detailed; and, in general, besides other means of cure, an attention to early purging is mentioned as highly advantageous.
In our next number we propose to conclude what farther we :: have to observe on the work before us.
Art. XV. Chaubert; or, The Misanthrope: a Tragic Drama.
Svo. 25. 6d. Cadell. London, 1789.
-HE modeft author of this maiden production pleads very
hard for mercy, and acknowledges his piece is unfit for representation, which he imputes to the nature of the fable; complains much of the difficulty he found in compressing scenes of so great a length of time, even into the state in which they now appear; and after observing that neither the unities of time or place are observed, tells us that the deficiency in incident and effect arising from the constitution of the story, prevents the thoughts of its ever passing beyond the limits of the closet.
We would with this young gentleman to recollect that he is as much an offender for choosing a fable he could make so little of, 'as he would have been for ill-managing a good one. ..
Cui leEta potenter erit res
Nec facundia deserit hunc nec lucidus ordo. But our author has more to plead :
" There remains somewhat to be offered in extenuation of the many faults that will here be conspicuous; it is a first and a juvenile production ; it was composed under many and unavoidable disadvantages--only during the interval of necessary duties, and for the short space of an hour at a time ; interrupted by continued circumstances, and confused by numberless dillractions ; amidst the chat of females, the noise of children, and the thrummings of a harpsichord.'
As we are unacquainted with these chatting females and noisy children, we cannot be expected to call them to account for lo frequently interrupting their poet's best thoughts. We are glad, however, to find by the necessary duties hinted at, that he has some other profession besides writing, or he might be too frequently interrupted by still more unpleasant intruders.
After these friendly hints to the author, we shall introduce our readers to the work, which, in many parts, discovers marks of ENG. REV. VOL. XY, MARCH 1790.
genius, a lively imagination, and some talent at embellishment.
The following description Chaubert gives of his mistress is anzmated and pleasing enough:
"O! fhall I paint to thee her peerless charms,
Blushing in beauty, and without a thorn.' Nor is the conversation between Valois and his patron destitute of point:
• Valois, Yes--as a friend, the warmest, truest friend,
• Valois. What! must I not enjoy the poor reserve
• Chaubert. Valois, thou ow'st me nothing.What am I?
T’ave been the instrument of gracious Heav'n