..

1. MODERATE diarrhoea in every ftage of the fever.-2. Spontaneous evacuation of bile from the ftomach and intestines, followed by a free perfpiration over the whole body.-3. Deafnefs.-4. Rheu matic fwellings of the limbs, or abfceffes in thefe parts.-5. Intermiffions of the teftian, type. Unfavourable fymptoms.. A hot dry kin during the first feven days.-2. Vomiting without diarrhea. 3. A comatofe ftate in young perfons when not relieved by ftools and blifters.-4 Much pneumonic affection.-5. A pulfe eafily raifed or depreffed by the ftate of the mind.-6. An intermitting pulfe. 7. Inceffant vomiting and hiccup.-8. Bloody ftools in the laft ftage with a jaundiced condition of the body.

Termination. This fever terminated on the second or third day after a fpontaneous evacuation of bile from the stomach and inteftines, or it terminated on the 11th or 14th by an expectoration of frothy phlegm or fharp mucus, or paffing that period it showed, previous to a favourable termination, evident remiffions, and, at leaft, affumed the teltian type. When it terminated fatally the patient funk under debility from profufe diarrhoea, dyfentery, or hemorrhage; died from the accumulation of mucus in the trachea or bronchi; of inflammation or gangrene in the liver, ftomach, or inteftines. In young perfons it terminated often in hydrocephalus, and if the patients were phthifical in hectic,

The treatment indicated was to cleanse the prima viæ-to promote perfpiration-to fupport the fyftem and to counteract occafional fymptoms as inflammation and fpafm. In cleanfing the prima via, cathartics and emetics were often found fufficient to remove the fever in its mildeft forms; for this purpose calomel, and tartarized antimony with ipecacuanha were employed.

The cutaneous difcharge was promoted by the aqua ammoniæ acetate and pediluvia. The tone of the fytem was preferved or reftored by the columbo root, a light infufion of the anguftura bark, and fome other bitters; in feveral cafes myrrh, joined with foda in folution, answered better than columbo. The Peruvian bark disagreed. All the fever was reduced to a true teftian, or till nothing but mere debility remained.

Inflammatory fymptoms were counteracted by blifters, by wathing the hands and face with cold water; by pediluvia, by general and fopical bleedings, though, in general, bleeding was generally dif penfed with in cafes of children, infants, aged perfons, and of those who could not afford a nourishing diet. Phthifical and gouty perfons it was likewife remarked bore the lancet ill. And general bleeding, with very few exceptions, was feldom adviseable after the 5th day. Spafmodic affections of the ftomach and inteftines, accompanied with head-ach and vomiting, were relieved by opiate glyfters, or by glyfters compofed of an ounce or two of vinegar added to ten or twelve ounces of gruel or chamomile tea; by draughts of peppermintwater, and fome drops of the fpirit of hartfhorn. Opiates by the mouth, after the 7th or 8th day, feldom failed to increase the reftleffnefs and disturbance of the head. Spafms, with chillinefs and deli

gum,

quium, were relieved by peppermint-water and the volotile alkali, by every fpirituous liquor diluted with water, by rubbing and fomen tations of the legs with hot flannels. Night fweats by the tincture of cinctiona, joined with the vitriolic acid. Profufe diarrhoea, by tef taceous powders joined with mucilages and fmall quantities of ipecacuanha. Apthæ and ulcers of the tongue by washing with the common infufion of rose petals, acidulated with the vitriolic acid, port wine, or lemon juice.

ART. XI. Letters from Dr. William Kentifch, Nephew of Smellie, to Citizen Baudelocque, on fome Paffages in his Syftem of Midwifery.

THESE Letters are written in French, and with a confiderable degree of fpirit, but are not calculated to produce the effect which the author feems to have intended. He betrays the motives by which he is actuated too foon. His infinuations, upon the authority of mere report, that Baudelocque is a plagiary, that he borrowed all from his mafter Solayres, and that he had not even the merit of reducing his master's opinions to a fyftem, are apt to ftartle the reader, and lead him to expect, from fuch a writer, rather a captious invective than a candid criticifm. The reader, therefore, is more difgusted than furprised, when he sees him catching at any opportunity to expofe Baudelocque, and employing not only arguments but quibbles, and irony, and popular opinions in oppofition to experience and facts. For two thousand years an opinion had prevailed, that there was a dilatation of the Symphyfis Pubis in the time of labour. This opinion, venerable it would feem from its antiquity, has been adopted by Dr. Kentisch, who maintains that a dilatation always takes place in the first labour. Baudelocque, however, after examining about twenty subjects, and not perceiving any figns of a dilatation, naturally concluded that this dilatation was not fo common as had been imagined. What are the arguments of Dr. Kentisch to the contrary? The parts, fays he, might have contracted between death and the time of examination. This argument is a mere hypothefis, and fo very abfurd that it does not merit a moment's attention. According to him the dilatation continues a confiderable time in the living body after delivery; and yet here he afcribes to these organs, in the dead state, an active power which he will not allow them to poffefs when alive. He had feen preparations where a dilatation had taken place; and Baudelocque had feen the like too. What is the inference? Surely, nothing more, than that fuch circumstances occafionally happen. A fact, we believe, which was never denied. But how will Dr. Kentisch account for the fymptoms which he has been hitherto accustomed to explain upon the hypothesis of dilatation? Let the gentleman fee to his own concerns; the world is not to reject facts because they chance to oppofe his theories. So little is the temporary enlargement of the Pelvis understood, that Accoucheurs are not agreed about the manner in which it takes place, Dr. Kentifch afferts, that it is owing to a natural

natural and gradual thickening of the cartilages. Baudelocque to a violent feparation of the cartilages from the bones; the latter had feen this feparation, but never a thickening of the cartilages; the former is content to found his affertion upon an old obstetrical creed. They differ likewife about the form of the Pelvis, and the relative lengths of its different diameters. Here Kentifch again appeals to authority rather than measurement; but did they examine the fame Pelvis, or measure the diameters between fimilar points.

Another fubject of cavil is the Uterus. Baudelocque believes that it retains its ufual thickness in a state of pregnancy. Dr. Kentisch afferts that it becomes thinner, as it is diftended, in every place except where the Placenta is attached. The truth is, anatomifts have found it fometimes thicker and fometimes thinner after its enlargement by impregnation; fometimes retaining the fame thickness that it had in the unimpregnated state; and fometimes thinner in every part except where the Placenta was attached. Much depends on the state of the veffels: if they be turgid at the time of examination, the Uterus appears thick; if emptied of their blood it appears thin; this opi nion of Haller is confirmed by the accurate Tables of Albinus, in which the veffels of the impregnated Uterus are very much enlarged. See Haller's Elements cf Phyfiology, Book XXVIII. § ix.

Baudelocque fuppofes that the Uterus acts partly by its elasticity in expelling the Fætus. Dr. Kentifch maintains that elafticity is a property only of a dry fibre; and that elasticity and irritability cannot exift in the fame body. We should like much to see a demonstration

of his two hypotheses.

The defcent and obliquity of the uterus are the next fources of difference. Baudelocque imagines that the defcent is partly occafioned by the preffure of the vifcera, and by the action of the abdominal muscles. And Kentisch quotes Winflow to prove that the mefentery prevents the vifcera from preffing on the uterus, and thinks that the uterus at that period, cannot be affected by the action of the muscles. Winflow was right, in afferting that the mefentery limits the movements of the intestines; but he knew the structure and fituation of the parts too well to think that the vifcera did not prefs on the uterus. He defcribes the ligaments by which the uterus refifts this preffure, and the action of the mufcles. If Dr. Kentisch entertains any doubts concerning the action of these muscles on the vifcera of the pelvis, he may eafily remove them by examining the mufcles during the expulfion of fæces and urine; or if, as ufual, he prefers teftimony to the evidence of sense, may consult Winflow, and read fome furgical cafes of Hernia,

In the obliquity of the uterus, it inclines more frequently to the right than the left fide; becaufe, fays Dr. Kentifch, the placenta is more frequently attached to the right than the left fide. But this inclination is fometimes found where the placenta is attached to the left fide; and, therefore, fays Baudelocque, must be owing to fome different caufe, a caufe which he fuppofes to be the figmoid flexure of the colon..

We agree with Dr. Kentifch, in thinking, that Baudelocque

Should

fhould have had ftrong evidence before he afferted, that the hymetty might be destroyed by acrimonious humour or depraved febaceous fecretion. If the chafte female should not be rafhly accused, neither fhould the wanton and lafcivious be officiously furnished with the masks of innocence. Baudelocque's recommendation to examine, by the touch, the impregnated and unimpregnated female wherever an opportunity occurs, is not only reprehenfible but infamous. The profeffional knowledge that can be acquired in this way is triflings the chance of contracting habits of depravity, and propagating ima morality, is great. Some Frenchmen of late have had the peculiar honour of eftablishing iniquity by law, and, if there be any merit in wickednefs, Baudelocque is certainly entitled to a fhare for fanctioning a vice by his approbation. That the fecundines are feen prior to the fætus is acknowledged on all fides; that they exift, prior to the fætus, is to us incredible; in what way is the fatus to enter them after they are formed. Dr. Kentifch goes farther, and upon the authority of Ruyfch, believes that the umbilical cord is formed prior to the fætus; if he here allude to the Decas Secunda of Ruysch, we would recommend to him a fecond and more careful perufal of that work. Dr. Kentifch ridicules the idea of the fetus being hit nourished by a fecretion, and then by blood; it is not uncommon to fee men laugh moft, at what they leaft understand. A fatus has been found without any umbilical cord. See Haller's Element Phyfiolog. Lib. xxix. §. 31. The fecundines of the mare fow are not attached to the uterus in the first months of pregnancy and the young of the viviparous blenny have no organic confection with the uterus to the laft, nor any fecundines. He feems to think in letter xxvi, that the head of the fetus would not preponderate in the liquor amnii, unless it outweighed the reft of the body. A very flight knowledge of hydroftatics would have informed him, that whether it outweighs the reft of the body or not it must preponderate in water if it has a greater specific gravity than any other part of the body.

30

The above fpecimens of this Author's mode of reafoning are fuf ficient, we hope, to give our readers a tolerable idea of thele letters. We decline following him through the reft of his trictures which relate to fubjects of lefs importance. }

ART. XII. Some Obfervations on Vaccmation, or the Inoculated Cous Rex. By Richard Dunning, Surgeon, Plymouth Dock. 8vo. 5 Pp. 122.5 Cadell and Davies. London. 1800.

お

VACCINATION is the conceited title of a very conceited work, interlarded with the needlefs repetition of technical and other ex traneous words. The idea of beftiality, which the author declares his exprefs determination to oppofe, must certainly be propagated by a term which evidently implies Cowifying. The idea is too nu gatory and abfurd to be regarded. At T5, cafe is related where the Keine inoculation appears to have corrected a ichroe phulous

phulous diatheræ, as Dr. Jenner has afferted; and could fo important an object be attained, how pleafing the profpect, how defirable the end! The author appears to attach much importance to his own Infama Amabilis (p. 22.) and from P. 33, we thall extract as fpecimen of chis ftyle; to read which a long breath is neceffary. "It is now time to advert to the fubject of Vaccination. But truly the whole affair of that abforption and paffage of the Vaccine aura, through the human body, affecting that inexplicable, immaterial, and indeliable fiat or orgafm, which affures to it complete invulnerability to every poffible future attack of Small Pox, and, indeed, of every circumftance preparatory and fubfequent to it, is altogether a tranfaction fo trifling in itself, fo like a mere nothing, as far at leaft as it is cognizable to fenfe, and in the way it has hitherto happened to me in every cafe under my own immediate obfervation, (and thofe have now been numerous) that I am almoft at a lofs, where to begin the defcription of it."

In P. 46, we have an ingenious letter from Mr. Little, furgeon, of Plymouth-dock, containing fome important obfervations, ppong the erroneous idea that has prevailed, of the Cow Poc being an eruptive difeafe, by ftating the eruption on two children in one family, to be the Chicken Poc, fo diftinctly marked as not to be miftaken by the moft fuperficial obferver." This, we believe, has been the canfe of all thofe mistakes which have been urged against the Cow Poc. Mr. L. adds his teftimony to that of many others, that the genuine Vaccine difeafe, in as far as puftules are concerned, is confined to the place of infertion, producing fpecific fever in a given time. (This is, however, fo flight as frequently to be fcarcely diftinguishable.) And, at P. 50, where inoculated Small Poc would be hazardous, from conftitutional difeafe, "the Vaccine may be fubftituted with fafety, often with advantage," by producing a beneficial change in the habit. This is the more worthy of attention from the writer's having added, "fhould I at any future time have reafon to change that opinion, I will communicate it," &c. At p. 63, Dr. Pearfon's report is inferted, that of SIX THOUSAND Vaccine patients, only one died; (and that was from anotber difeafe.) Dr. P. alfo thinks, that the chance of life is greater under Vaccine inoculation, than under ordinary circumftances. At P. 70 and feq. fome "general reflections" are hazarded on the poffible origin of the Cow, Small, Swine, and Chicken Pox, Meafles, &c. being beftial, as their names appear to indicate; which we think not improbable. The author recommends (P. 79) an attention to the origin, &c. of the difeafes of brutes. We allow him to "plead guilty to the charge of much tedioufnefs (P. 55.) and think Mr. L's letter the beft part of the publication We cannot omit adding our own teftimony in favour of the VACCINE inoculation, which is certainly fuperior to the va

Dr. J. Simms has CONTRADICTED the teftimony which he Originally gave against the Cow Poc, and acknowledged he was taken, Loung