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The view of Dr. Priestley's political works and opinions, contained in the third appendix, shews that he was no revolutionist. While he remained in his own country, he uniformly wrote in support of the British Government by King, Lords, and Commons; and though we are told that he became a republican in the new world, yet it was evidently with some limitations. His wishes and his conversation always tended to impress the idea that improvements in each country should gradually progress, according to the respective situations of each, and in conformity to the previous ideas respectively prevalent on the subject of government, among the better informed classes, and the spirit of the times.'

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In the observations on Dr. P.'s miscellaneous writings, a long analysis is given of his Lectures on the Theory of Language and Universal Grammar, printed (not published) for the use of the Students at Warrington; and notice is taken of his letter to Dr. Wistar, in reply to Dr. Darwin's observations on Spontaneous Vitality, in order to introduce some very free remarks in favour of Atheism. I cannot see, (says this annotator) how the belief of no God can be more detrimental to society, or render a man less fit as a citizen, than the belief of the thirty thousand Gods of the Pagans, or the equal absurdities of trinitarian orthodoxy.' The best answer to the writer, in this case, will be found in the words of Dr. Priestley, extracted from his paper signed A Quaker in Politics, which is the most valuable portion of the 4th Appendix: Where there is no sense of religion, no fear of God, or respect to a future state, there will be no good morals that can be depended upon. Laws may restrain the excesses of vice, but they cannot impart the principles of virtue.'

The remainder of this Appendix includes a letter by Dr.P. in vindication of the character of Dr. Franklin from the charge of being an incendiary, while he lived under the protection of the British Government.

As Dr.Priestley's religious opinions are well known, we shall excuse ourselves from quoting any part of the Summary at the conclusion of the volume, which furnishes an accurate delineation of his character and merits: but which would have been more generally acceptable in this country, if the features of republicanism and infidelity, betrayed in the appendices, had been concealed.

The printer has made an error in filling up the blanks left in the copy for the Greek and Hebrew quotations, see p. 410, where, in speaking of x as answering to in Hebrew, he should have put a .

χ

This writer mentions Hare's "Difficulties and Discouragements" as a melancholy letter. Did he not know that the whole is a fine piece of irony?

ART. V. Description and Treatment of Cutaneous Diseases. Order 3. Rashes. Part I. containing the Varieties of Rubeola and Scarlatina. By Robert Willan, M.D., F.A.S. 4to. 18s, sewed.

Johnson.

A$ s the commencement of Dr. Willan's elaborate work on cutaneous diseases has already fallen under our review, we have at present to notice the publication of a 3d number, containing an account of the measles and scarlet fever. These diseases compose the first part of his 3d order, Exanthemata; a term which he translates by the word rashes, and describes to be a redness of the skin, varying as to extent, continuity, and brightness of colour, and occasioned by an unusual quantity of blood distributed to several of the cutaneous veins, in some instances with partial extravasation.'

Our medical readers will perceive that the term is here applied in a new sense, and that the definition is limited to the character of the eruption, independently of any general affection of the system. Dr. Willan's arrangement is confessedly artificial, founded not on any supposed resemblance or analogy between the nature of the diseases, but merely derived from their external appearance; and therefore we cannot be surprised to find that the present order consists of a different assemblage from those which have been usually allotted to it. The other affections classed as exanthemata, besides the measles and scarlet fever, are urticaria, roseola, iris, purpura, and erythema. -We shall postpone our remarks on the system in general, until we arrive at the termination of the work, when we shall have a better opportunity of comparing its different parts with each other.

Dr. Willan's account of the measles is full and satisfactory: but the symptoms and progress of this disease are well known, and have been so accurately described by preceding writers as to leave little room for offering any new information on the subject. The disease is highly contagious, particularly to children; yet the author supposes that some previous state of the body is requisite, in order to render it susceptible of the infection. Infants, he observes, are less liable to it than children at a more advanced age: but he has never met with any individual who is wholly unsusceptible of it, as is the case with the small-pox. Three varieties of the disease are pointed

out;

out; the rubeola vulgaris, rubeola sine catarrho, and rubeola nigra: the first of these varieties, as the name implies, being the common form of the disease. Dr. W. remarks that, in addition to the usual exanthematic eruption, a few miliary vesicles occasionally make their appearance; and he says that the fluid from these vesicles has produced the disease by inoculation, but it does not seem that the symptoms were milder than in their usual form. He is decidedly of opinion that it is improper to check the eruption, when it has become visible, by cold or by purgatives; an opinion which is sanctioned by the concurrent testimony of all writers. He does not appear to have experienced the effects which would result from repressing the fever at its commencement; a practice which, although of doubtful success, probably would be less injurious than repelling the eruption when once formed. The constitutional symptoms and the eruption generally disappear about the same period, and leave the patient nearly free from complaint; sometimes, however, the pectoral affections return with increased violence, and are either immediately fatal, or prove ultimately mortal by inducing pulmonary consump tion.

During the first period of the disease, little medical treatment is necessary, except an attention to diet and temperature. When the symptoms become severe in the latter stage, the most active practice is to be adopted; bleeding is frequently necessary, and should be employed where the oppression of the chest is considerable. It was formerly the custom, in all cases, to bleed at the commencement of the disease: but in modern times, when the antiphlogistic plan is pursued with more caution, and we are less influenced by systematic views, the lan cet is not employed until particular symptoms indicate its use.

Rubeola sine catarrho is described as a complaint in which the eruption exhibits the usual features of measles, but is unattended by fever. It is with difficulty distinguished from other cutaneous eruptions, and appears not to secure the constitution against the feverish measles; whereas the author never met with an instance in which this latter affection occurred twice to the same individual.

Dr. W. closes his observations on measles with some remarks on the cases described by Sir W. Watson, under the title of "putrid measles," as occurring among the children at the Foundling Hospital in the years 1763 and 1768. supposes these to have been, in fact, the scarlet fever; a con. clusion which he draws from considering the symptoms as related by Sir W. Watson, the titles under which he entered the cases in the Hospital books, and the unsettled state of medical

opinion

opinion at that period respecting the nature of the scarlet fever, and its connection with the measles: a point which is more fully illustrated in the subsequent section. After an interval of so many years, it is perhaps impossible to form a decided opinion on this matter; but we think that Dr. WilJan's reasoning is at least extremely plausible; and until we shall have an opportunity of again observing the symptoms described by Sir W. Watson, we must consider the existence of the putrid measles as very problematical.

We next proceed to the Scarlatina. Dr. Willan, disposes the varieties which this disease assumes under three heads, to which he gives the specific names of simplex, anginosa, and maligna. In the first, a moderate degree of fever prevails, which continues for three or four days, attended with an exanthematic eruption, but without any swelling, inflammation, or ulcer of the throat. Its general appearance is not very unlike that of the measles; and, as we afterward learn, they have been very frequently confounded together. The diagnostics are, however, for the most part, sufficiently well marked; and they are very accurately laid down by Dr. Willan, as consisting in the different period at which the eruption becomes visible, in the appearance of the efflorescence, in the accompanying symptoms, and in the manner in which the disease declines. In the scarlatina anginosa, (which is perhaps the most usual form that occurs in this country,) besides the fever and efflorescence, the tonsils are considerably affected with swelling and inflammation; which frequently proceed so far as to produce slight ulceration and sloughs in the throat. The symptoms of this species are admirably detailed; and we regret that our limits will not permit us to quote them at full length.--With the exception of the state of the throat, the symptoms of the scarlatina anginesa resemble, in every respect, those of the scarlatina simplex, but exist in an aggravated form.

Scarlatina malignu presents an appearance materially different from the two others, and is altogether a much more formidable complaint. Its peculiarities are thus stated by Dr. Willan :

It's symptoms on the first day are nearly the same as in the Scarlatina anginosa; but some of the following peculiarities are af terwards observable :

1. A small indistinct, and irregular pulse; a brown or black incrustation of the tongue, teeth, and lips+

2. A dull redness of the eyes, a dark red flushing of the cheeks, deafness, delirium, or coma alternating with fretfulness and violente:

3. Breath extremely fetid; a rattling and laborious respiration, partly occasioned by a thick tough phlegm 'clogging the fauces; a

constriction

constriction of the jaws, and painful deglutition; a fulness and livid colour of the neck, with retraction of the head:

4. Ulcerations on the tonsils, and adjoining parts, covered with dark sloughs, and surrounded by a livid base the tongue is often so tender that a slight touch produces excoriation:

5. An acrid discharge from the nostrils, causing soreness, or chops, and even blisters, about the nose and lips, the fluid discharg ed being at first thin, but afterwards thick and yellowish:

6. The rash is usually faint, excepting in a few irregular patches; and all of it presently changes to a dark or livid red colour. It appears late, is very uncertain in its duration, and often intermixed with petechiae. In some instances the rash suddenly disappears a few hours after it is formed, and comes out again at the expiration of a week, continuing two or three days: in one case numerous patches of it appeared a third time, on the seventh day from the second eruption; these remained for two days.'

It is a curious fact that in this which is the most violent • form of the disease; the characteristic efflorescence is seldom so considerable as in the other varieties, and sometimes is entirely wanting. This circumstance led to much uncertainty in the nosology of scarlatina; and from this cause, until within a few years, the identity of the different species was not acknowleged. On this subject, Dr. Willan observes:

It is truly singular, that the slightest of all eruptive fevers, and the most violent, the most fatal disease known in this country, should rank together, and spring from the same origin. Experience, how ever, decides that the simple Scarlet Fever, the Scarlatina anginosa, the Scarlatina (or angina) maligna, and the scarlet ulcerating Sorethroat without the efflorescence on the skin, are merely varieties of one disease. That all of them proceed from the same source of con. tagion, is evident; because, under the same roof, in large families, some individuals have the disease in one form, some in another, about the same period. According to the state of the air, the soil, climate, or season of the year, one form predominates over all the rest, and gives the general character to every epidemic Scarlatina."

Another point respecting scarlatina, which has been the ground of much controversy, is whether the disease can occur twice to the same person. The affirmative was formerly adopted by many eminent practitioners, and is still maintained by some men of respectability: but the contrary is the position most commonly received, and that which is supported by the greatest authorities. Dr. Withering, whose experience and judgment were so well known, was decidedly of this opinion; and the same was also maintained by the late Dr. Currie.

Perhaps the history of no disease of modern times, cer tainly of none so important, is involved in so much obscurity as that of scarlatina. Dr. Willan has taken particular pains

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