2

posed to have arifen from any former infection re appearing upon exercife, freer living, &c. and if fo, to learn every circumftance of that infection, of its duration, and former treatment. He fhould likewife fee the ftream in which the urine flows, whether large, fmall, or scattered, in order to be acquainted with the exact state of the paffage; for he may be fure, that old complaints there, lengthened out by the nature of the infection, by the particular habit of body, or by unskilful management, must have more or lefs affected the urethra, by contracting its diameter, or filling Gree with caruncles, which are very fenfible to the touch of the bougie, though feldom feen upon diffection, at least as anatomifts affirm.

If the discharge has manifeftly the appearance of a fresh clap, attended with inflammatory fymptoms, it will be time enough to examine the urethra with a bougie, when, although your method of cure may have removed the inflammation, it has yet not carried off the gleet. In that cafe, it will help to fave your own credit, as well as prevent much anxiety to your patient, if you examine whether any local complaint in the urethra be the cause of its ftubbornness. If the bougie paffes freely, you will do well to fet about the cure by a proper quantity of mercury rubbed on..

This quantity can, I think, be ascertained only by the change brought upon the matter, in refpect of its colour or confiftence. Where fuch change does not take place, as will fometimes happen, I rub on three or four ounces, fo as scarcely to leave the poffibility of a pocky caufe remaining.'

D

The ninth section is occupied by the fubject of bougies. In this part of the treatise, the author obferves, that though almoft all the prefent writers contend, that the common bougie is as good as Mr. Daran's; yet, that the dextrous method of applying them, made ufe of by that gentleman, with his remarkable care and affiduity in conducting the regimen of his patients, feem much better adapted to the nature of the complaint, than any other generally known. In fhort (fays he) I cannot help thinking, that Mr. Daran is entitled to fuperior fuccefs by fuperior merit; at the fame time that I acknowledge, he gives the whole a myfterious air, which favours more of quackery than of found theory, or enlightened practice.'

In the fection of buboes, he tells us, that he has not found the French practice of repelling and purging off thefe tumours fuccefful, although tried with the utmost care. That rubbing the mercurial ointment on the bubo itself, ferves only to repel the difeafe into the habit, let the quantity rubbed on be ever so proper and that ulcers in the throat, or foul bones, are often the immediate confequence. For this reafon, he declares against

all mercurial applications to the difeafed, or ulcerated part, in every cafe, till the general habit is thoroughly rectified by a proper courfe. If the bubo is not attended with confiderable pain, but advances flowly to fuppuration, he advises that the patient fhould not wait for that event, but immediately fet about his cure with mercurials, and fuffer the bubo to take its chance: otherwife, the disease may increase, by delaying the use of the. fpecific. He fays, he has never met with any incurable cancerous buboes. That they have indeed often gone on for many months, but always difappeared, as the habit became better; and takes the opportunity of repeating his encomiums on hemlock, and likewife aconite medicines. To fay the truth, I have, in many cafes where I could give no relief by other means, experienced fuch frequent good effects of Storck's hemlock, and aconite medicines, as convince me, that there has been fome want of candour in crying them down so strongly without fairer trials. I have, for fome years paft, given above ten pound weight of the extract of cicuta annually, in which time, it is certain I have both frequently fucceeded, and frequently failed. I have failed however feldomer in mending the face of cacoëthic fores, than in any other circumstance.'

In the eleventh fe&tion, he confiders a chancre on the præputium, or glans penis, as the moft fimple species of pox; but that it never can be radically cured, without a mercurial courfe.

In the next article, the author affirms, with refpect to the ufe of guaiacum, that he has feen decoctions of that wood given, times without number, in almoft every ftubborn fymptom of the venereal diforder, without the leaft advantage, unless in very phlegmatic, or debilitated habits, or where it has been -combined with the farfaparilla.

Among the remarks in the thirteenth fection, it is obferved, that the venereal disease differs from most others, in having no perfect crifis, except in its fimpleft fpecies. That it is always in a progreflive state, growing worse every hour, and recoiling with double force, if the cure be interrupted by any irregula rity, or entirely given over, before a total ceffation of the complaints. He affirms, as a declaration due to truth, that notwithitanding the boasted powers of noftrums, which have been confidently recommended, he has not found, in any preparation of mercury, used by injection, either a certain preventive, or a certain cure of any venereal taint, at any season, from or before coition, to the most complete and virulent gonorrhoea. For though obftinate gleets have been frequently cured by in jections of calomel, at the end of a proper course, a pox has been brought on feveral people in the clap, by means of that

medicine,

medicine, when ufed in the beginning of a gonorrhoea vi

rulenta.

The problem in the fourteenth fection may draw the attention of phyfical enquirers; though it is a queftion, whether an attempt to the folution of it, can be admitted upon the principles of ethics. If the infection of the venereal virus was communicated by the air, as in most other contagious diftempers, it would certainly be a fubject extremely worthy of invef tigation, to discover a medicine to prevent it: but while this loathfome poifon is only propagated by impure embraces, and that the publication of an infallible method to obviate infection, might be productive of great licentiousness, the most benevolent maxims of philanthropy will fcarcely juftify the prevention of a natural evil, at the hazard of increafing a moral one. 'To me (fays the author) I confefs, the fubtilty of this poifon appears too like that of electrical fire to be prevented. It is well for the human race that it can be cured.'

The next fection is employed on mercury and its preparations. Here, the author remarks of its ores, that the virtues of thefe do not correspond with what has been said of them by moft writers on the venereal diforder. For native cinnabars are, in their effects on the body, either fettered on the one hand by their combination with fulphur, or dangerous on the other by effluvia from the arfenical part of them: and the disappointments he has met with from the use of the factitious, or antimonial kinds, both given inwardly, and outwardly applied, correfpond exactly with the experience of Dr. Aftruc on that head. The author, after treating of the feveral preparations, and methods of applying mercury, gives the preference to the ointment in relation to the quantity of which, neceffary, he refers us to the opinion of two celebrated judges. "It is diffi cult (fays Aftruc) to affert, à priori, what quantity of mercury will, in the whole, be neceffary to cure this distemper completely; fince that depends upon the age, fex, and temperament of the patient; the malignity, degree, and inveteracy of the infection; the number, ufe, and importance of the parts affected. It must be judged of, à pofteriori, from the abatement and ceafing of the fymptoms: but it is found by repeated obfervations, that commonly not less than two ounces of the ftrong mercurial ointment is fufficient, and not more than three or four ounces neceflary."

The other writer, Septalius, who had the care of the great hofpital of Broglio at Milan, for forty years together, where, by his account, he cured of the venereal difeafe near one thousand patients yearly, fays, "That for compleating one cure there

Gg 4

ought

ought to be used, at repeated inunctions, three or four ounces of quick filver; and that the infection fhould not be carried off by purgatives, unless in cafes of the utmoft neceffity." It is the advice of this experienced physician, either not to use mercurials at all, or to use them in a quantity fufficient to enfure fuccefs; "fince by too fparing an application of them, the morbid matter is fet in motion; and the fymptoms being only diminished, not removed, unless perhaps to the nobler parts, the patient is left, uncured and difappointed, to drag out a miferable life."

The following hints, which come from the author himself, deferve the attention of the reader.

Rub a little, fuppofe lefs than a drachm at a time, of mercurial ointment upon a chancre, a beginning bubo, or phy mofis, and repeat it daily for three or four times; and it will remove the appearance of disease from the part, and drive it into the conftitution, perhaps upon the bones, probably into the throat, but always from the part. Every mercurial application to a venereal fore, whether chancre or bubo, is equally improper, till you have conquered the infection.

Rub to the quantity of two, three, or four, and some few times more ounces, in proper dofes, upon any part of the body, except the part affected; and all the fymptoms of the disease, which deserve the name of venereal, will either disappear, and never return, or else be so altered as to give way to diet-drinks of farsa, or bardana, or perhaps of the plants faponaria and lobelia, or the roots of mezereon.

Again, rub a small quantity of the mercurial ointment on any part of the body, in the cafe of a fcrophulous or fcorbutic habit, tainted at the fame time with the pox; and, in many inftances, it will produce a violent falivation, that in spite of all forts of remedies fhall run on for feveral weeks; the patient shall be much reduced in his strength, wafted in his body, and remain tainted with the disease, notwithstanding the falivation has been fo inordinate. Repeat the anointing, and the effect will be the fame.

But first correct this fcorbutic difpofition, then rub on the mercury, proceed to the length above mentioned, at proper intervals, and in proper quantities; and you will generally, even without affecting the mouth, obtain a complete cure. Go beyond this quantity, and, except in a few cafes, mercury fhall feem to have produced no further effect on the fymptoms. Here we may fay with truth, that it has done, both its best and its worft it has faved the conftitution from being ruined by the difeafe, and it has changed a strong into a weak habit.

Upon

Upon the whole, I believe, that purging gently in the inflammatory ftate, at the intervals already fpecified, and inter mixing crude mercury internally, or applying it externally, in juft quantities, as foon as the fymptoms of inflammation are abated, will cure a clap in all its ftages; and that mercurial ointment, used in the proportions above directed, will generally fecure the conftitution against the further progrefs of a confirmed pox, or at least enable you to eradicate it by the affiftance of other medicines before mentioned.'

The last section is devoted to the confideration of the prefent state of the pox. The author is of opinion, that the disease is growing much more general; which he imputes to the ignorance with regard to the quantity of mercury neceffary, and the manner of applying it; to grafts from America, and both the Indies, where the difeafe has been fuffered to lay deeper hold, and produce more ftubborn symptoms, The last cause he alledges is, the conftitution of modern livers; where love of ease, love of pleasure, continual watching, and anxious gaming, have miferably enervated the pofterity of thofe heroes who fought at Agincourt and Creffy.'

The character of this performance cannot be determined without great limitation and reserve. The observations it con tains are juft, but often fuperfluous; and the ftyle, though not inelegant, is fometimes blemished by affectation. It is oftentatious without futility, and critical without novelty.

As the practice recommended by the author is that which is generally established, and what he has exploded was already become obfolete, this treatise, though orthodox, may be regarded, upon the whole, as a work of fupererogation: but though it prove of little advantage to the learned practitioner, it may have a falutary effect in preventing the ravages of empiricism, by enabling patients to judge with more certainty of the rectitude of their treatment, which appears to be the purpofe intended.

VII. An Hiftorical Account of a New Method of treating the Scurvy at Sea: containing ten Cafes, which fhew that this defru&tiese Difeafe, may be easily and effectually cured, without the Aid of fresh Vegetable Diet. By David Macbride, M. D. 8vo. Pr. I s. Cadell.

FIVE

IVE years ago, this ingenious phyfician made a propofal of trying fresh wort, or infufion of malt, as a fubftitute for the juices of vegetables, in the cure of the scurvy at fea; induced into a confidence of the antifcorbutic virtues of fuch a liquor,

from