a general idea of this work; and we shall add nothing further, but that the tranflator appears to have exerted himself, in doing juftice to the original.

II. Obfervations on the prevailing Difeafes in Great Britain: together with a Review of the Hiftory of thofe of former Periods, and in other Countries. By John Millar, M. D. 4to. Pr. 128. Cadell. Concluded.

IN

our laft Review, we obferved that this author had attempted to arrogate to himself the invention of opinions refpecting fevers, which had been previously and repeatedly fuggefted by other writers. That it might have been poffible for Dr. Millar, or, indeed, for any other perfon, who was ignorant of the prefent ftate of medical knowledge, to stumble upon the doctrine of the fimilarity of fevers, we do not dispute: but can any thing be conceived more prepofterous than such an affectation of novelty, when the very infinuation of it is a proof that the author, long, for aught we know, after commencing practitioner, was unacquainted with the writings of the moft eminent physicians? In this claim Dr. Millar must be still less entitled to the attention of the public, when it is confidered, that, at a period even pofterior to that wherein his pregnant genius was teeming with profound difcoveries, he appears to have been fo little acquainted with the remitting fever, as never to prefcribe the bark to a patient, who was labouring under it, and whofe life might poffibly have been preferved by the use of that febrifuge; as will be evident from the fequel of this examination. We observed also, in our former Review, that this author has mifreprefented a fact of a ftill more important nature, in pretending that Sydenham and Morton used the bark in continual fevers, and the exacerbations of the remitting. The contrary of which is evident from Sydenham's answer to Dr. Brady, formerly referred to, and from the paffages extracted from Dr. Morton; where the practice of thofe authors is either exprefly or indirectly declared: and this point is yet farther confirmed by Dr. Morton's cafes. But we now proceed to thofe of the author before us,

CASE I.

• A clergyman in Berwickshire, aged forty-five, was feized, on the ad of May, 1761, with coldness and fhivering which was fucceeded by ardent heat and a profufe sweat. The feverish paroxyfm was accompanied with delirium, and a quick full pulfe, he had a diftinct remiflion, but of fhort duration

the

the intervals between the fits were only fix or eight hours, and the feverish paroxyfm continued thirty. He was blooded and purged in the beginning by his apothecary, who had also given him nitre and the faline julep. On the 9th, at four in the afternoon, I vifited him. He had a confiderable remiffion about mid-day, but the feverish paroxyfm returned in the afternoon; his pulfe beat 112 in a minute, and his skin was moift. The faline julep was continued, a blistering plaister was applied between the fhoulders, and the following draught and bolus were prescribed:

R Gummi guaiaci (foluti) grana decem. Theriaca Veneti, femidrachmam. Salis ammoniaci volatilis, grana quinque. Syrupi balfamici, q.. F. bolus, octava quaque kora exhibendus, fuperbibendo bauftum fequentem.

B Aqua cinnamomi fimplicis, fpiritus Mendereri, ana drachma duas. Syrupi facchari drachmam unam.

He had a copious diaphorefis all over his body, and on the morning of the 11th the fit terminated in a distinct remiffion; but at noon the fever returned with violence, and was exceedingly high in the afternoon, when I vifited him for the fecond time. His pulfe was low and feeble, and beat 120 in a minute; he had a cold, vifcid fweat, was quite infenfible, and frequently attacked with violent fartings, and fubfultus tendinum. These complaints increased, and he died on the morning of the 12th.

A man in Berwickshire, aged thirty-five, fix feet high, and of a robust make, was feized on Tuesday the 7th of June, 1762, with a pain in his head, and complained of laffitude and flying pains. He did not, however, think these complaints of fuch confequence as to ask any advice, but went about his business till Wednesday night, when he was obliged to take his bed. He was then blooded by his apothecary, and took nitre and faline medicines. He was again blooded on Friday morning; on the evening of that day, when I first faw him, his face was much flushed, his fkin extremely hot, with a little moisture, but no fweat; he had no thirft; his pulfe beat 110 in a minute, and feemed full; he was quite fenfible, and gave a distinct relation of his illness.

As he had been coftive fince the beginning of his diforder, a laxative clyfter was immediately injected, which operated well. A blifter was afterwards applied between the shoulders; cataplafms were laid to his feet, and fixty drops of the antimonial wine were prescribed ever two hours, with a tablespoonful of the following julep :

& Aqua

R Aque cinnamomi fimplicis, fpiritus Mindereri, ana uncias duas. Syrupi balfamici, drachmas duas.

On Saturday morning, at three o'clock, I was defired again to visit him, His fever was greatly increased, and he was delirious. Eight ounces of blood were immediately taken, and the decoction of fnake-root was given in place of the julep. The fever increased, and he died in the afternoon.'

On these cafes Dr. Millar has this obfervation:- Had the lancet been withheld, evacuations made more sparingly, and the bark early administered, is it not probable that both of them might have terminated favourably ?'-Highly probable : and Dr. Millar is inexcufable for not having prefcribed it: who knows not, that the bark has been recommended in the remiffions of all fevers, by every physician who has wrote within thefe hundred years paft? But perhaps Dr. Millar's practice has been rather too early to have been fufficiently informed. The affirmative answer which we have given to this author's interrogatory, is to be applied to the firft of the above cafes only; for though Dr. Millar's very ingenuous question includes the fecond case likewise, there is not the smallest evidence that it was a remitting fever.

• A gentleman in Roxburghshire, aged about fixty, of a ftrong habit, and good conftitution, but wore out by ferving in a military capacity during several hard campaigns, and subject to the gout, had complained of laffitude and weariness for feveral days; and these complaints increafing, I was defired to vifit him on Friday the 11th of June, 1762. He then had a giddinefs in his head, great drought, was extremely hot and reftlefs, his pulfe was full, and beat 110 in a minute, and he was coftive. Sixteen ounces of blood were immediately taken, and fixty drops of the antimonial wine were prefcribed every two hours, with a spoonful of a Mindereri julep. His pulfe became calm in the evening, and beat only 64 in a minute. He had a copious universal sweat, and refted well in the night. A clyfter was injected in the morning of the 12th; it operated well, and he continued easy till seven at night, when he grew hot and reftless. Thefe fymptoms increased for twenty-four hours, when he was again relieved by a copious fweat, At eight in the evening of Monday the 14th the paroxyfm again returned, and was not only attended with more giddiness and uneafinefs than formerly, but with fqueamishnefs and pain in the ftomach. Sixteen ounces of blood were taken, and a blister was applied between the thoulders, but this paroxyfm

was

was much more fevere than the former. The pain in the ftomach and fqueamishnefs increased, and at fix in the morn ing he vomited. His pulfe ftill appeared full, and beat 100 in a minute. In the evening he again had a remission, and his pulfe beat 72 in a minute. On Wednesday the 16th, at eight in the evening, he grew hot and reftlefs, and the feverifh paroxyfm feemed to be approaching. A vomit was then prescribed; his feet were bathed, and cataplafms were applied. He had a very violent fit, which was carried off, as formerly, by a copious fweat. As every paroxyfm had been more fevere than the preceding, I apprehended great danger from the continuance of the fever, and therefore determined to prevent another exacerbation. Two table-fpoonfuls of a ftrong tincture of the bark were given every two hours, with a small quantity of the tincture of rhubarb; and weak camomile tea was used for ordinary drink. The paroxyfm came on feveral hours later than ufual, and was milder; the bark was given in fubftance, as foon as the fever remitted, and he was foon restored to perfect health.'

On this cafe we are prefented with the following obfervation: The third cafe was more violent than either of the two former; and while the fame measures were pursued, the fymptoms became more and more alarming: but upon altering the plan, giving the bark, and defifting from the antiphlogistic method, a happy change was speedily brought about, and the cure afterwards went on profperously. Would this have happened if the antiphlogiftic method had been purfued? Or would the event have been the fame as in the two preceding cafes ?

In the fequel it appeared, that whenever brifk evacuations were purposely made, or happened accidentally, the fever increased; but an early ufe of the bark either reftrained, or entirely removed it.'

Never was any observation more abfurdly drawn, than that of the cafe laft quoted. Though the first bleeding had evidently been beneficial, and procured a remiffion of the fever; yet, as an improper repetition of it had increased the violence of the paroxyfm, that operation must be reckoned injurious. This is reasoning against the use of a thing, from the abuse of it. The bark, which any phyfician would have prescribed to this patient on the 11th day of the month, was delayed to the 17th, which this author, by a mifapplication of words, calls an early use of it; a declaration which at once overthrows the whole fyftem of practice which he has been labouring to erect.

The

The diftin& remiffion mentioned in Cafe IV. is no more than frequently happens from the application of a blistering plafter, independent either of the bark, or antimonial wine. The Vth Cafe proved fatal.

The VIth was a malignant fever, where the use of the bark was never queftioned.

The various revolutions of the disease, in the VIIth Cafe, feems to render the effects of the bark, in the cure, extremely problematical.

The VIIIth Cafe proves nothing to the purpose, as the bark was not administered, till after a remiffion appeared.

The IXth Cafe affords the fame obfervation with the preceding.

The Xth likewife the fame: but as the author has drawn an improper observation from it, we shall give it at full length.

CASE X.

• The uncle of the young man, whose case is above related, (No. IX.) having attended him conftantly during his illness, complained, on the 11th of Auguft, of laffitude and pains all over his body. On the 14th, being prevailed upon to drink a quantity of fpirits, he was feized with coldness and shivering, which were fucceeded by ardent heat and thirst. On the 15th, his complaints increafing, I was defired to vifit him. His pulfe beat 100 in a minute; he was extremely hot, and had no perfpiration. An antimonial vomit was immediately prefcribed, and a draught of guaiac & theriac was given at bedtime. The vomit operated well, he flept in the night, and had a gentle perfpiration. On the morning of the 16th his head and back were eafy, his thirft was moderate, and his pulfe beat only 72 in a minute. The bark was then given, but finding himself quite well, he did not perfift in using it. On the 25th, when walking in the fields, he was again seized with coldness and fhivering, and suffered a fevere feverish paroxyfm, which went off without any perspiration. He continued much diftreffed during the remiffion, and had a return of the paroxyfm on the 26th and 27th. On the 28th I was again defired to vifit him. His pulfe was low and irregular, but not quicker than natural. He complained much of ficknefs, had no appetite, made little water, was extremely coftive, and the perfpiration was obftructed. The following antimonial medicine was prescribed; and barley water, acidulated with fpirit of vitriol given for common drink:

K Manna, uncias duas. Tartari emetici, grana tria folve in aquæ fortunæ unciis octo. M. Capiat cochleria duo fingulis femiboris,

He