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a very juft fufpicion, that an author is rather writing from his imagination, than copying from nature. We have many bulky volumes in medicine, which would be reduced to a very narrow compass, were they ftripped of all their ufelefs prefaces, apologies, quotations, and other tawdry ornaments, and confined to the few facts they contain, and to close inductive reafoning. We have every thing here but the apologies.

This work is divided into three parts; of which the first treats of inflammatory diseases, the second of putrid fevers, and the last of diseases which partake both of a putrid and inflammatory nature. As the first of these articles is only a superfluous repetition of the practice of almost every author who has wrote on the subject, we shall pass over it. But before we proceed to the fecond part it will be neceffary to premife a few obfervations which will unravel the principles on which it is founded; and, by tracing them to their genuine fource, difcover with what propriety Dr. Millar can arrogate to himself the invention either of the opinions or practice exhibited in this production.

It is many years fince phyfical writers began to explode the multiplicity of distinctions with which the hiftory of fevers had long been extremely incumbered. The judicious Dr. Freind in particular, who favoured the world with an excellent commentary on the epidemics of Hippocrates, which were formerly regarded as fevers of a very different and anomalous nature, declared, that in his opinion they were not diffimilar, but had been the fevers of all former ages, and would for ever remain the epidemic difeafes of future times. This obfervation he evinced more clearly from a comparison of the fevers delineated by Sydenham with thofe of Hippocrates and each other, from which it appears, that, notwithstanding the great diverfity between the climates of England and Thafos, there is fcarce the fmalleft difference to be perceived among the fevers of the two countries; and that all the fevers described by Sydenham as diffimilar, the petechial perhaps excepted, differed not fo much in kind as in degree. This doctrine is still farther afcertained by Dr Lind, at Portsmouth, who, in his Effay on the Diseases incident to Europeans in hot Climates, has fhewn that the remitting fever is the most predominant and univerfal disease over the world, and the grand epidemic in every country: Tiffot, likewife, is fo explicit on this subject as to affirm, that all the primary fevers may be reduced to

* Obfervations on the Duties and Offices of a Physician.

four

four claffes, namely, the inflammatory, putrid, intermittent, and fuch as are compounded of those and if we include the putrid and intermittent in one class, as all fevers which are cured by the bark are fuppofed to proceed from a feptic caufe, we shall reduce the catalogue of fevers into three divisions, the inflammatory, putrid, and thofe which are compounded of both. After fuch an explicit declaration of the above-mentioned phyficians, not to produce Cleghorn and others, in regard to the divifion of fevers, what reader can peruse the following paffage in this author without indignation and contempt.

In my early practice I endeavoured, with care and attention, to investigate the fymptoms by which the various fpecies of fevers were to be diftinguished, and attributed my want of fuccefs to a defect of penetration; but having had many opportunities, in a very extenfive practice, of obferving their different appearances, and finding a strong resemblance in all of them, I was at length perfuaded, that many unneceffary and perplexing divifions had been affumed, which are not founded in nature, but contrived to decorate or fupport a favourite hypothefis. After the ftrictest enquiry, I could only obferve three kinds of fevers; one, of the putrid class, attended with remiffion and intermiffions; another, which is the concomitant of inflammation; and a third, in which the fymptoms of inflammation and putrefaction are combined. But this being matter of fact, and not of opinion, I did not fuppofe that either the experience by which I had been convinced, or any arguments which might be advanced, could gain credit to an affertion fo oppofite to prejudices, established, almoft without contradiction, from the age of Galen to the prefent time. I was therefore refolved, by fearching the records of antiquity, to endeavour to trace these errors to their fource.'

It was eafy, indeed, to difcover from the records of antiquity, and to pretend to afcertain by experience, what had already been discovered and afcertained by the repeated obfervation of others: and it is no lefs eafy, though flagrantly falfe and ridiculous, to infinuate an almoft total inattention of phyficians to this doctrine, which is attempted, with unparal leled effrontery, in the fubfequent paragragh.

But though a moft intricate divifion of difeafes hath hitherto obftructed the progrefs of medicine, yet the fimilarity, which univerfally obtains, hath not altogether escaped the obfervation of several learned and judicious phyficians, whose concurring teftimony may be deemed a fufficient proof of any

fact,

fact, however oppofite to theories and fpeculative opinions, unwarily adopted without an accurate hiftorical exanimation.'

But, to crown the abfurdity of this author's pretenfions, we are afterwards prefented with the teftimony of those very writers who have afferted the fimilarity of fevers, which, unfortunately for him, it was impoffible entirely to conceal. As a farther fpecimen of this great inventive genius, we fhall produce another of his discoveries, in which, however, he has been no less foreftalled than in the former.

An opinion hath prevailed, that inflammatory fevers are extremely frequent, not only in this country, but all over the world. The practice of physic hath been greatly influenced by this fuppofition, and it hath become an almost universal rule to bleed and ufe other evacuations, in the beginning of all acute diforders. This opinion I had also adopted, and on it my early practice was chiefly founded. Captivated with the beauty and ingenuity of Boerhaave's fyftem, which I had been early taught, and in which I implicitly believed, I never doubted of its being confiftent with truth, and founded on the moft accurate and faithful obfervations. By that system I modelled my practice, and formed the most fanguine expectations of fuccefs, by following precepts founded on a theory fo plaufible and engaging. The event, however, difappointed my hopes; experience led me to doubt, and afterwards to reject the doctrine of obstruction and inflammation: and I am now firmly convinced from the refult of a careful attention to difeafes, during the courfe of an extenfive practice, that inflammatory diforders are extremely rare, and that there are very few fevers, in this country, in which the antiphlogistic method of cure can be used with fafety. Such cafes, however, do fometimes happen, and the feldomer they occur, the more neceffary it becomes that they fhould be accurately defcribed, fince a mistake in the beginning of these acute disorders can feldom be retrieved, and often proves fatal.'

In the next chapter, this extraordinary author appears, likewife, to claim the merit of a practice introduced above an hundred years ago, and is the method of curing fevers by the ufe of the Peruvian bark. It is unneceffary to inform our medical readers, that ever fince the first importation of that invaluable medicine into Europe, it has been the great refource in the cure of all difeafes of a putrid, remitting, and intermitting kind; and its encomiums are celebrated by all phyficians. Among those who have carried the use of it to the greatest height, and are alfo the moft lavish in its praises, are the fa

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mous Sydenham and Dr. Morton; the evidence of both which phyficians, however, in favour of the exhibition of the bark in acute difeafes, ftrong and explicit as it is, though limited, the author of this production has moft unwarrantably exaggerated, in notorious contradiction to their own express declaration. The judicious Dr. Sydenham, fays he, was so much convinced of its fuperiority to every other medicine, that after it had been profcribed by unworthy mifrepresentations, he again introduced it, and, after further experience of its efficacy, became more fanguine in its recommendations of it; and in his later practice, not only used it fuccefsfully in all fevers, which were not accompanied with inflammation, but alfo in many other diseases.' So far is it from being true, that Sydenham ufed the bark fuccefsfully in all fevers, which were not accompanied with inflammation, that we challenge this author to produce one inftance where that great phyfician gives the finallest encouragement for adminiftering the bark in any continual fever, except fuch as had originally been of the intermitting kind, and which he clearly defcribes, not as true continual fevers, but remittent, and only approaching to a continued form by a prolongation of the paroxifms. For a proof of which, we refer our readers to his anfwer to Dr. Brady concerning the epidemic difeafes from the year 1675 to 1680.

This author mifreprefents the practice of Dr. Morton no lefs than that of Sydenham. Dr. Morton, as he informs us, a phyfician of found judgment and extenfive practice, fully convinced of the advantages which would accrue to mankind, from the extenfive application of this powerful remedy, exprefies his gratitude to God for fo valuable a difcovery, and endeavoured to place its merit in a juft point of view. He not only adduces a number of examples, which afford the moft convincing teftimony of its great efficacy, but also endea voured to trace to their fource the falfe opinions which had been circulated concerning it. He collected all the arguments advanced on both fides of the queftion, and clearly demonftrated the errors of thofe writers by whom it was rejected. He not only used it fuccefsfully in remitting, intermitting, and continual fevers, but prefcribed it in many other cafes which would, by the generality of physicians, be reckoned of a very oppofite nature, and treated in a very different manner.'

Whoever will perufe the cafes related by Dr. Morton, will find that he never gave the bark but during the remiffion of fevers; in teftimony of which we fhall here produce his own direct authority.

• Quo

• Quocircà, miffa hac methodo rationali curandi febrem Zuvex, quippe longa ac incerta, totus me demum accingam ad modum exhibendi corticis, in Eurexei tam spuria quam legitima defcribendum, unde earum caufa, venenatum fcilicet fermentum, modo magis compendiario tuto cito fubigitur & deletur. Quid opus autem multa verborum ambage, ubi natura potius quam arte res agenda fit? Siquidem antidotus quocunque modo exhibita (modo exhibeatur) venenum delet. Fomite autem fubtracto flamma fponte extinguitur, atque ubi natura a venenato fermento non amplius laceffitur, lubens quiefcit. Ut totam rem paucis abfolvam, fimplex hujufce febris natura nihil præter antidotum forma ægrotanti gratiffima exhibendum exigit; idque partitis vicibus, & durante remiffione, ut fpirituum regimini magis fubje&ta vires fuos felicius exerceat. Indeque, quotiefcunque ad ægrum advocor, fimplici Zuvex laborantem; ubi nullum infolitum fymptoma, aut gradum fymptomatis folito vehementiorem deprehendo, fi exacerbationes & remiffiones ftatis ac certis periodis fe invicem excipiant abfque pompofo quocunque apparatu præcedenti, prima fcilicet remiffione opportuna, illico cortic. Peru, elect. in fubtiliffimum alcohol. reduct. 5j. 5B. 9j. B. pro ætat. forma boli, bauftus, pilul, vel electuarii (prout æger ipfe maluerit) exhibendum jubeo, repetendumque tertia vel quarta quaque hora extra paroxyfmum, dum opus fuerit. Atque, ut veram dicam, vix aut ne vix unquam memini fimplicem Zuvex poft 3j. antidoti exhibitam, fuperftitem fuiffe.

Sin adventus meus differatur donec fibris hæc in augmento fuo adeò provehatur, in continuam tam vergat, & paroxyfmi ferè aboliti fuerint, aut faltem periodos fuas ac ftatas ob cephalalgram laffitudinem ulcerofam, aut fymptomata aliquod aliud folito vehementius fubortum penè amiferit; poft clyfteris (modo indicetur) rejectionem, fanguinis 3 vj. viij. x. pro ætate, & fymtomatum exigentiâ in ipfa exacerbatione illicò e brachio detrahendas jubeo, atque deinde bolum theriacalem cum haufti julapii cordialis exhibendum, qui ad libitum repetatur, ad fpiritum elafticitatem refufcitandam. Et veficatorium unum vel alterum, in eundem finem ad nuchum vel carpos internos applicandum prefcribo: unde, uti vigiliarum, dolorum, cæterorum. que fymptomatam diminutionem ferè femper fubfecutam effe memini, ita infuper inducias remiffionum magis certas ac protenfas obfervavi; qua occafione data, antidotum incun&anter exhibeo, atque ejus repetitionem, durantibus remiffionibus, jugiter renovandam, cum felici fucceffu & optato eventu impero. Quid quod fpatio bidui, fcilicet quamprimum corticis zvj. vel 3j. æger devoraverit, dwupor fere femper inveVOL. XXIX. May, 1770. Z ni.'

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