to be the likely means of putting a stop to expectoration. All this appeared much more plausible when taught in the schools of physic, than probable when I attended to fact and experience. The unquestionable safety and acknowledged use of the bark in the worst stage of an inflammation, when it is tending to a mortification, affords a sufficient answer to the first of these objections; and I have several times seen it given plentifully in the confluent small-pox, without lessening in any degree the expectoration. An asthma, which seemed to be near its last stage, became very little troublesome for several years, during which the patient took two scruples of the bark every morning and night. If great care be taken not to give it in such a manner as to load or oppress the stomach, every reasonable objection would, in my judgment, be removed, to the giving of it in any distemper whatever. For the purpose now under consideration, its efficacy is the same with any other bitters; but some preference may perhaps be due to this simple on account of its friendly powers to the human body, manifested in its being a specific remedy for intermittents: but if any one cannot quiet his own or his patient's apprehensions of some lurking mischief in the Peruvian bark, any other mild bitter may be used for the same purpose of enabling nature to struggle successfully with the malady, by invigorating the principle of animation in the stomach.' P. 11.

The remarks on the different circumstances in which the abdomen is distended, independently of water, flatulence, or scirrhi, are curious and just; but little is added to our resources. Some curious facts are recorded under the heads of abortus' and 'alvus.' In the latter are some singular instances of habitual diarrhoea and constipation. For great pains in the anus, sometimes exasperated, never relieved, by stool, a blister kept open on the thigh for two or three months has succeeded. When inflammation and suppuration came on, healing the abscess has been succeeded by broken health and pulmonary consumption. The same remark is repeated under fistula ani;' and we mention it with more anxiety, because we have seen the most dangerous consequences arise from operating hastily and inconsiderately, before an attention has been. paid to the constitutional complaints. The general health should be first amended, and the operation followed by substituting some other discharge. In very few instances are abscesses of the anus or fistula a local complaint.

Scarlatina and malignant sore-throat are, in our author's opinion, the same or very similar diseases; but they are never epidemic at the same time, nor do they ever run into each other. To this may be added, that the scarlatina is sometimes inflammatory, and generally attended with delirium; while the angina maligna is uniformly putrid, and the mind is scarcely ever affected. Patients are torpid and stupid, but, when spoken to, commonly answer rationally, or only wander foolishly. It ought to remarked, that in the angina maligna the local affec

tion is often unnoticed, no difficulty of swallowing being observed. In some instances we perceive Dr. Heberden confounds the cynanche trachealis with the maligna; and, in one or two remarks, probably the croup is confounded with both.

Dr. Heberden's observations on gout are peculiarly valuable, though different from the common opinions. We believe them, however, to be well founded; for experience has led us to distrust the latter, and look for views somewhat more consonant to observation. The following remarks deserve to be very generally known.

Though the toe be the usual place in which a regular gout first fixes itself, yet it will not very unfrequently prefer the instep, the heel, or the ancle: but if the first attack be felt in any other part beside these, the continuance of such a pain, the returns of it, and its consequences, will differ so much from those of the ordinary gout, that it is either to be called a rheumatism, or should be distinguished by some peculiar name from both these distempers. For, besides those cases which no one would scruple to call rheumatic, similar pains have been found to come on, and have not only, like the common rheumatism, continued for two or three months attacking by turns all the limbs; but have in their first year returned two or three times, and have continued to do so for some succeeding years. These pains are less violent than in the common gout, though the swellings are much greater: but the remarkable circumstance is the great and lasting feebleness which they occasion; so that the limbs have been more weakened by them in two years, than they usually are even by severe fits of the regular gout in twenty. The late Dr. Oliver of Bath told me, that he considered this disorder as partaking of the nature both of the rheumatism and palsy. In the cases which I have observed of this malady, whatever it be named, when the pain does not first attack the foot, and when its returns are so frequent, it has more usually come on after the sixtieth year, than before that age: yet there have been instances where young men have been made cripples by it long before they were thirty.' P. 33.

The fashionable fondness for gout, and the idea that it will carry off other diseases, are justly reprehended; and Dr. Heberden has probably explained the foundation of the delusion, People in general will not admit their constitution to be breaking; and the common treatment of gout when present, or the means of inducing it when latent, are such as flatter too strongly the palate.

If we ask what reason there is to consider the gout as a critical discharge of peccant humours, more than a rheumatism, palsy, or epilepsy, we can only be referred to experience for the proof; and some indeed in the first attack of the gout congratulate themselves upon the completion of their wishes, and, during the honey-moon of the first fit, dreaming of nothing but perfect health and happi ness, persuade themselves that they are much the better for it; for

new medicines, and new methods of cure, always work miracles for a while. Of such we must not inquire, but of those who have had it their companion for a great part of their lives. Now, among those gouts which I have had an opportunity of seeing, I find by the notes which I have taken, that the patients in whom they have supervened other distempers without relieving them, or where they have been. thought to bring on new disorders, are at least double in number to those in whom they have been judged to befriend the constitution; and it has appeared to me, that the mischief which has been laid to their charge, was much more certainly owing to them, than the good which they had the credit of doing. Other disorders will indeed sometimes be suspended upon an attack of the gout; and so they will by palsies, fevers, asthmas, small-pox, and madness, of which I have seen many instances; but then the gout has often come on when persons were labouring under vertigos, shortness of breath, loss of appetite, and dejection of spirits, without affording the least relief, and sometimes it has manifestly aggravated them; nay, these complaints have in some patients always come on with the gout, and have constantly attended it during the whole fit.'

P. 39.

The same reasons, as we have just now hinted at, have induced patients to consider other inflammations as misplaced gout, and to treat them with a warm regimen. In this part of the subject Dr. Heberden steps beyond us; but we believe him very near the truth. His principle is, that evacuations suit better with gout than has been supposed; and that we do less injury with these in gout, than with a warm regimen in the other complaints, should we have mistaken their cause. Bath waters, and other remedies employed for latent gout, should not, he thinks, be given if they would be improper, should the complaints arise from any other cause. As the credit of the Portland powder had been raised too high, so it has now sunk, in our author's opinion, too low. If adapted better to the difference of constitutions, and the state of the stomach, he thinks it might be useful. The palsies and apoplexies attributed to it are the common effects of gout, and every instance ought not to be considered as owing to the medicine. Rheumatism and gout are carefully distinguished; but as evacuations in the former are not now required in so great a degree, and as the latter may admit of cooler treatment, the apprehension of error need not be so considerable.

Some very curious facts are collected respecting that very peculiar Protean disease, the asthma; but we find little respecting its remedies. Opium is a powerful remedy in some asthmas, when all other means have failed. Is it not useful in all?' In our experience it has, we think, been often detri mental. Of the Bath waters our author speaks with some disrespect, confining their internal use to complaints of the stomach chiefly from hard drinking, and supposing them injurious in

such cases, when connected with hysteria and hypochondriasis. In palsies and contractions he prefers cold bathing, and can scarcely find a period for their use in the Poitou colic, which he thinks always arises from lead. Of the Bristol waters, and their medicinal virtues, Dr. Heberden speaks also with little respect.

Under the title of 'calculus vesica,' Dr. Heberden offers some just distinctions between calculus and a disease of the prostate. He seems to depend, perhaps too securely, on the solvent power of lime-water and soap-lees. Their effects we have in general found inconsiderable and transitory.

Head-achs, he remarks, continue often for years without injury to the constitution, and they arise, or are influenced, by very unsuspected circumstances. We find only the most trifling remedies mentioned for their relief; and it is singular that, under this title, and the following one (intermittent head-achs', the electuary recommended by Grant, or the metallic tonics, are not noticed. Each medicine approaches as nearly to a specific, in all nervous intermitting pains, as the bark in agues.

We must pass over several less important sections, where the practice is trifling, and the distinctions of less importance; nor do we perceive much that merits attention in the more extensive remarks on cutaneous eruptions. The most experienced observers, with the microscope, contend that they never could distinguish animalcules in the pustule of the itch. The scaldhead our author does not think infectious. We suspect we have found it so; but the remedies he employs are by far too mild for the worst kinds. There is a very acrid mercurial ointment in Banyer's Pharmacopoeia Pauperum, which usually succeeds, though, in general practice, it must be rendered more lenient. We have seen the same disease in the beard, and have cured it by the same remedies. It is a disease in the bulbs of the hair, and can only be removed by accelerating the circulation through them; while at the same time the morbid crust is thrown off by this increased action. We were surprised that Dr. Heberden does not mention the remedy recommended by Dr. Mead-the tincture of cantharides. In the herpetic eruptions of old people it often succeeds, especially when they can bear a moderately large dose of it. We once saw a herpetic eruption alternate with a sweet taste in the mouth-a salivatio mellita.

On the subject of diabetes,' our author offers little novelty of remark, and none of practice. He thinks it by no means an organic disease of the urinary organs. Diarrhoea, it is observed, may continue for many years without injury. We have more than once found this to be the case, till about the middle of life, when it has ceased, and some chronic unaccountable discase supervened, which a restoration of the diarrhoea would not relieve. It is singular, also, that diarrhoea will often continue CRIT. REV. Vol. 36. September, 1802.

D

some weeks, particularly in fevers, without evacuating the of fending cause. This has been discharged at the end of the fever, or on the exhibition of any laxative, which powerfully excites the action of the intestinal tube. Under the title of pains, and wandering pains' we find no very satisfactory information, and under that of dysenteria' little more than a recommendation of neutral salts. In the long section of 'epilepsy' we meet with nothing that should particularly detain us. Indeed medicine is here often useless, as the disease arises very frequently from organic affection. A medicine lately recommended, viz. camphor with white vitriol, gradually increasing the dose of the latter, has succeeded, when owing to, or continued from, irritability. Dr. Heberden mentions a clyster of five ounces of wild valerian root, with a drachm of musk, given every eight hours for three days, as apparently successful.

We have been led, by the character of Dr. Heberden, to notice his remarks somewhat diffusely, and perhaps to indulge a little of our own garrulity. Our intention, however, was an honest. desire to add to the stock of useful information, with a view, at least, to relieve what we may not be able to cure. We shall therefore request the reader's indulgence to pursue the subject

in another article.

ART. VI.—Memoirs of the different Rebellions in Ireland, from the Arrival of the English: also, a particular Detail of that which broke out the 23d of May, 1798; with the History of the Conspiracy which preceded it. By Sir Richard Musgrave, Bart. Third Edition. 2 Vols. 8vo. 1l. 1s. Boards. Stockdale. 1802. VII.-The Reply of the Right Rev. Doctor Caulfield, Roman-Catholic Bishop, and of the Roman-Catholic Clergy of Wexford, to the Misrepresentations of Sir Richard Musgrave, Bart. With a Preface and Appendix. 8vo. 1s. 6d. Keating and Co. 1801. VIII. Part of a Letter to a noble Earl; containing a very short Comment on the Doctrines and Facts of Sir Richard Musgrave's Quarto; and vindicatory of the Yeomanry and Catholics of the City of Cork. By Thomas Townshend, Esq. 8vo. 1s. 6d. Booker. 1801. IX.-Observations on the Reply of the Right Reverend Doctor Caulfield, Roman-Catholic Bishop, and of the Roman-Catholic Clergy of Wexford, to the Misrepresentations of Sir Richard Musgrave, Bart. and on other Writers who have animadverted on the "Memoirs of the Irish Rebellions." By Sir Richard Musgrave, Bart. 8vo. 25. Stockdale. 1802.

IT is sometimes advantageous to the public to postpone the consideration of a subject to a distant period beyond the time