Having inquired rather minutely into the contents of the preceding chapter, we fhall not fuffer ourselves to be long detained by the next; in which we are informed that the ichor, which is fuppofed to be generated in the blood-veffels, and to cause the disease, is afterward expelled into the puftules: but as these puftules do not always contain the whole of the ichor, the part which remains in the blood, keeps up the fever, &c. after the eruptions; and hence is feen the excellence of the Eastern practice, which, by evacuating the matter in the puftules, gives room for more of the ichor to drain into them! Hence too, to continue this ftrain of arguing, it must be evident, that they who have the greatest number of puftules, muft have the disease in the mildest way, because thus the offending ichor is more fully thrown out from the blood. As it is certain also, that one large puftule will contain more matter than several small puftules, occupying the fame space, fo it will be moft happy for the patient when the difeafe proves confluent! This is a comfortable theory, and certainly ought to be true; yet according to Dr. Walker's obfervation, it follows, that where the puftules are feweft, the whole noxious ichor is determined to the fkin: but in the confluent fmall-pox, where perhaps the whole fkin is covered, there the noxious ichor is not all determined to the fkin.-How happens this? Because in thefe cafes a greater quantity of ichor is generated in the blood. How is this known? By the appearance of a greater number of puftules! We afterward meet with fome fimilar information with refpect to perfpiration. Perfpiration, we are told, evidently contains a portion of the contagious fluids, and of courfe tends to moderate the eruptive fever, and certainly leffens the number of pimples. How comes it then to be least in the mildeft difeafe? Because in the mildest disease there is leaft of the contagious ichor generated. -How is that ascertained? Because there are fewest puftules.-We thank the author for his information: but it is enough to make our heads giddy, from thus continually pacing round the fame circle! In defcribing the fymptoms of this difeafe, Dr. Walker evinces a confiderable fhare of accurate obfervation: we are not certain, however, whether there is not fomething fanciful in the remark, that we judge of the eruption being completed, from the ceffation of fneezing." We next arrive at the method of cure; and we are informed, amid a great deal of ufelefs theory, that the indications of cure are two: to moderate the inflammatory fever; and to diminish the excefs of the contagious fluids.' U 4 Under Under the first of thefe heads, the ufual antiphlogistic plan is recommended for it happens luckily, that however wild the theory may be, the practice which has been beneficial is generally retained. We expected, however, to have found Dr. Walker a warmer advocate for the lancet, than he appears to be; fince, if the proximate caufe of the difeafe be the presence of contagious ichor in the blood-veffels, why not open the fluices, and evacuate it?-but our endeavours, it feems, will be fruitless, however rational the treatment under the first indication may be, while we leave the proximate caufe unfubdued: we muft, therefore, have recourfe to the fecond indication, and evacuate the contagious ichor. Now, Nature, who is always fo wife, and who yet is always fuch a fool; who knows the means of curing every difeafe, and always fets about them, but who, like a bungler, fails in her mode of employing them; Nature here very properly directs her chief aim to the expulfion of the morbid particles,' but then, fillily, the employs the common fecretory organs of the machine for that purpose.' She tries to evacuate the ichor by perfpiration, by difcharges from the falivary glands, by the kidnies, &c.; by fome of which endeavours he does harm, and by others but little good, for they are infufficient to discharge the great load of morbid Auids,' The outlet for thefe is by the intef tines, and the chief art in conducting the cure, depends on the conftant exhibition of purges. It is for want of thefe, adds the author, that fo many patients are loft by our late phyficians,' who are under a rooted prejudice against early purging in small-pox. Nor does Dr. W. confine this practice to the inflammatory difeafe; it is equally recommended in the putrid. kind, while the frength is to be kept up with wine, &c. He here likewife recommends bark, becaufe, among other properties, it promotes the diarrhea. This is.certainly rather novel; and though it is endeavoured to be established by a profufion of reafoning which may tire us indeed, but can never convince us, ftill fome cautious practitioners will entertain doubts of its efficacy. To keep the body foluble throughout the disease, to throw up glyfters, and occafionally to adminifter purgatives, would probably form a part of their plan of treatment: but this by no means anfwers Dr. Walker's intention: his business is not to evacuate fæces, or, by purging, to leffen the pulfe, or diminish the strength of the body; his aim is fo to stimulate the arteries which furnith a difcharge to the inteftinal tube, that they fhall freely pour cut the contagious ichor which floats in the blood. How it happens that this ichor feparates from the rest of the circulating fluid, and is directed to the intef tines, we are not informed: nor fhall we puzzle ourselves with feeking for the information; we fhall be contented with hinting, that to us the evacuation of contagion, like its multiplication, is rather an obfcure doctrine.-Fortunately, however, as we obferved before, Dr. Walker is not fo much at variance with us in his practice, as in his opinions; and if we may judge from the few cafes which he relates, his purgatives were neither more active in their operation, nor more frequently repeated, than thofe which have been recommended by Sydenham, Boerhaave, Huxham, Freind, &c. Huxham particularly fays, that "nothing has fucceeded better with him in removing the fecondary fever, than repeated purgatives, with the addition of calomel occafionally, and interpofing opiates between whiles." In the chapter on the fecondary fever, we have a repetition. of the fame unfatisfactory theory. Dr. Walker first attempts to prove that this fever is not occafioned by the absorption of the variolous matter from the puftules: nor do we affert that it is but this we do affert, that his reafons why it is not fo are futile. If it arofe from this caufe, fays he, the puftules would be emptied, which is not the cafe. Has he not himself told us, that if we were to empty the puftule with a needle or lancet, it would again be filled; and this perhaps for five or fix times: what then is to hinder this fame refilling in cafe of abforption? The fact appears to us, that abforption and fecretion are both going on in the puftule; though the fecretion. may not be in confequence of a fuperabundant quantity of contagious matter in the blood,' nor the abforption be the caufe of the fecondary fever. The author next propofes his own theory; which is, that the fever depends on the excess of contagious ichor in the fyftem; and that it comes on in confequence of the puftules being full, and admitting no more of the affimilated fluid. We need add nothing more on this fubject: fimilar doctrines have been already advanced, and, we truft, confuted. We shall now briefly notice the author's opinions on the cause and prevention of pits; and, probably, with regard to thefe being formed in the face by the drynefs and hardness of the puftules, in confequence of expofure to the air, Dr. Walker's fentiments may be juft. Still this appears to be not the only caufe; fince in the hands, which are alfo exposed to the air, we fee few or no pits; and in inoculation there is always a confiderable mark where the matter was inferted, though that part is defended from the air. The variolous eruption feems, from fome caufe or other, to be particularly determined to the face; more puftules being generally collected in it than in any other part of the body of an equal furface; hence from clustering, clustering, as at the place of inoculation, and from being more liable to be inflamed from fcratching, &c. the cutis probably becomes ulcerated, or more fo than in other parts: ftill this drynefs and hardnefs of the furface affift in continuing the irritation, and in caufing the fear. How far the impreffion of a feal on melted wax' illuftrates 'this fear, we are in doubt: certainly our faces are not like wax, which being ftamped when hot, retains the impreffion when cold. Indeed what is faid about the tumefaction of the face being favourable to receive the impreflion, appears fanciful. On the whole, our opinion of the caufe of pits is, that they are the confequences of ulcerations in the cutis, which are allowed to heal, while a hard unequal body, (the dry and condensed matter and cuticle,) is preffing on them: confequently, they heat unequally. Dr. Walker's mode of preventing this deformity, is by the application of a mafk:-but we will give his own words: As the condenfation of the maturated puftules upon the face appears to be folely owing to the influence of the external air, my firit intention is, to prevent the accefs of air to the part. This is done, by the application of a mask, compofed of old fine cambrick, thinly fpread with the following liniment: R. Ol. olivar. opt. unc. iv. Ceræ alb. utr. femunciam. Liquefcant fimul leni igne et agitentur donec refrixerint. I first apply a triangular piece of cambrick, fpread with the liniment over the nofe, which is not intended to fhut up the noftrils, but fnipped in different parts at its bafe, and thefe fnips a little turned up within the nostrils: a fuitable opening is cut in the mafk, to admit the nofe already covered, and another opening for the month, a little fnipped, for its better application upon the lips, though it is unneceffary and inconvenient to bring it too far within the lips. The mask is fpread with the liniment in the fame way, as the triangular piece for the nofe, and is kept on with tapes, or narrow ribbon, that faftens behind; its circumference reaches to the hair on the forehead and temples, covers the cheeks, and turns under the chin, being fnipped at the bottom for that purpose. If the above defcription is not readily understood, the intention of it being merely to exclude the accefs of the external air from the faee; this end may be obtained, by covering the whole face with feparate pieces of old fine cambrick, fpread over with the liniment, leaving apertures for the mouth and noftrils.' The mafk is ufually applied on the seventh day, and is continued, renewing it three or four times in twenty-four hours, till the puftules are perfectly emptied. reprefenting the pre The volume clofes with an appendix, fent ftate of the fmall-pox, with remarks on its frequency and mortality, mortality, and on the expedients ufed for reducing thefe:" fome means also are propofed of ftill further reducing the number of deaths.' Thefe means, which confift in establishing regulations to prevent all communication between found and infected perfons, might be useful in small societies: but to fuppofe that every individual in a large city, or in a whole country, is to be guided by them, is mere fpeculation. It is curious, then, to find Dr. Walker afferting, that to fuch as perfevere in obferving the rules, it is impoffible they can catch the diftemper'! We fhall here clofe this article, (though we have paffed over many particulars which we intended to notice,) by remarking, that though Dr. Walker's practice appears to be judicious, as it feems, in general, to be the common established practice, yet we cannot applaud the fallacious reafoning, and the unfounded affertions, which fill fo large a portion of his book; and by which the author has plunged us into theories that we hoped were forgotten, and has obfcured the science which he profeffed to elucidate. ART. VI. A View of England toward the Clofe of the Eighteenth Century. By Fred. Aug. Wendeborn, LL. D. Tranflated from the original German, by the Author himself. 8vo. 2 Vols. pp. about 460 in each. 12s. Boards. Robin fons. 1791. WE have already noticed this entertaining work in the ori ginal, and have exhibited a general view of the heads into which it is divided, and under which our national character is confidered; and we have, in fome measure, enabled our countrymen to judge of the execution of Dr. Wendeborn's defign, by tranflating particular paffages from his performance. The prefent publication comes with a two-fold recommendation to the English reader; the tranflation has been performed by the author's own hand, and he has thereby adhered to the old English precept, of not faying behind our backs what he will not fay to our faces +. * See Rev. vol. lxxvii. p. 229. and vol. lxxviii. p. 568. + When this idea, however, is farther confidered, we may object to the author's having omitted, in the tranflation, many paffages which he had inferted in the original, because their contents are well known to Englishmen.' On this principle, the whole work might have remained in its original language, if an Englishman is prefumed to be acquainted with all that he ought to know on the subject: but if we wish to fee what a learned foreigner fays of us, and to judge whether his account be accurate; that curiofity fhould be gratified, and that judgment allowed to exercife itfelf, in every part of the work, The |