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tations from scripture fcornfully termed, A Number of Wonderful Things, and this fcrap of fcripture, there be gods many, judged by the R. R. Author to be a stronger text against the unity of the godhead, than any this learned writer has produced for his opinion. The late worthy Dr. Taylor of Norwich is called Another of thefe Sleepers,' and a very fenfible quotation from him has the following decent reflection paffed upon it: This is the old exploded trash of Coward, Toland and Collins,' And yet, I dare fay, his Lordship will think this writer as honourably claffed, in point of authorship, with Coward, Toland, and Collins, as the Bishop of Gloucester would be, fhould fome one, illnaturedly pleasant, and availing himself of his Lordship's decent expreffion, clafs his performance on this fubject, with the old, popular-traf-of Goddard, Steffe and Fleming.

An Inquiry into the Nature, Caufe, and Cure of the Croup. By
Francis Home, M. D. his Majefty's Physician, and Fellow
of the Royal College of Phyficians in Edinburgh.
Is. Kincaid, Edinburgh. Sold by Millar in London,

8vo,

R, Home, who has already given the world feveral proofs

DR of the useful application of his genius and abilities, pro

poses, in this little piece, to afcertain the hiftory, nature, cause, and cure of the croup; a disease which he looks upon as hitherto undefcribed, and entirely, he says, unknown as to its nature, cause, effects, and cure.-The croup, from our Author's hiftory of the disease, we apprehend to be a species of catarrh, attended with an inflammatory fever; and, fo far as it is local, chiefly affecting the mucous membrane and the numerous glands of the trachea or windpipe. He obferves that it is peculiar to children ;-that he never faw or heard of one, above twelve years of age, affected by it; that it is local, and rarely found at any great diftance from the fea-fhore ;-that it likewife only attends certain seasons of the year, appearing from the month of October to the month of March. Our Author gives twelve cafes or hiftories of the disease, with the diffections of those bodies in which it proved fatal; and from these he deduces a number of corollaries. We fhall tranfcribe one of thefe hiftories; which appears the leaft complicated with any fimilar disease.

September 29th, 1760, I was called to a boy of feven years of age, who had been fome days fick. He lived on Leithbridge, had been ill of the chin-cough the preceding winter, and had recovered of the meafles about fix weeks before this. He had been frequently purged, and had been tolerably well,

excepting

excepting a flight cough, till he was feized, four days before I faw him, with fever, heat, thirft, and the fhrill croupy voice. When I faw him his pulfe was quick, with a little degree of hardness, but not ftrong. He fwallowed eafily; but complained of a pain in the trachea, when he spoke, or when I preffed it with my fingers. His face had been fwelled. Great drought. Breathing high, but not very quick. He fometimes expectorated, and had often frothy faliva upon his lips: the urine had a white ouzy sediment: his fenfes and his head were quite clear and diftinct. He was immediately blooded, and at night had leeches applied to his throat, and a blifter round it: the next day his pulfe was weaker, and beat 175 in a minute: breathing quicker, and often altered: diftinct in all his fenfes: died that night.

On laying open the parts, there was no appearance of any inflammation on the fauces: but to my great furprize, the whole fuperior internal furface of the trachea was covered with a white, foft, thick, preternatural coat or membrane, easily separable from it, and generally lying loose upon it, and purulent matter lodged below, and around it. The fubjacent parts were red; but no great degree of inflammation. As we fearched downwards, the fame appearances continued through the ramifications of the afpera arteria, though the membrane seemed here fofter, thinner, and to become of a more purulent nature. All the branches of the windpipe and bronchia were filled with puFulent matter; and we could easily squeeze it out, in great plenty, from all thefe pipes. The fubftance of the lungs was quite found, and in a natural state.'

From this and the other hiftories and diffections related by the Author, he deduces his corollaries.In the first corollary, are pointed out the pathognomonic fymptoms of the croup: a peculiar, fharp fhrill voice, not eafily defcribed, and which can be refembled to nothing more nearly than the crowing of a cock; a remarkable freedom from all complaints when in imminent danger; a quick, laborious breathing; frequent pulfe, ftrong at first, but foft and weak towards the end; little difficulty in deglutition or inflammation in the fauces; often a dull pain, and fometimes an external fwelling in the upper part of the trachea; the fenfes quite diftinct to the last; and all the fymp toms most rapid in their progrefs:-fufficiently characterize this difeafe. From the fhrill voice and difficult breathing, which our Author fays are the leading symptoms, he calls it the fuffocatio fridula; but whether it can with propriety be called an unde feribed difeafe we pretend not to determine: thofe who will turn to Boerhaave's account of the angina inflammatoria when it attacks the trachea; or to Sauvage's Cynanche trachealis; will find the ox acuta, clangofa, fibilans, firidula; refpiratio parva, frequens,

erecta

erella cum molimine; of which, our Author's leading symptoms, the fharp, fhrill, ftridulous voice; and the quick, difficult, high breathing, would not be a bad translation.

In Corol. 2, Dr. Home obferves, that as the fuffocatio Aridula is peculiar to a certain age, as it is local with refpect to its fituation, fo it is likewife particularly connected with the cold/ and moist weather of winter.

In Corol. 3, our Author endeavours to ascertain the feat of the fuffocatio ftridula: it is not placed in the muscles of the glottis;-nor in the lungs ;--nor in the coats of the trachea ;but in the cavity of the trachea.-We profefs we cannot fee with what propriety this difeafe can be faid to be feated in the cavity. of the trachea independant of its coats. It is true, indeed, the membrane which is found on diffection, and which is deferibed by our Author, is feated in the cavity of the trachea; but then this membrane is only to be confidered as a fymptom or effect; and is produced by an encreafed fecretion from the mucous membrane, or the glands of this organ, which are in a preternatural, difeafed ftate: and Dr. Home fo far forgets himself as foon after to observe, that this distemper ought to be confidered as originally feated in the mucous glands which are in great abundance in the coats of the trachea. The airy cavity of the windpipe is to be fure a very uncommon place for the feat of a difeafe; but our Author's fprightly imagination may poffibly have catched the thought from a circumftance not unfrequent in his part of the world; the houses there confift of a great number of ftories; and a perfon may have property in the upper parts of fuch a building, but none in the foundation :-now property fo fituated may be justly termed a tenement in the air: and why may not Dr. Home be indulged in fixing the feat of the croup in a manner alike fanciful and aerial ! ·

The obfervations and conclufions concerning the cause of the Croup, in Corol. 4, are equally wild and unphilofophical, and quite unbecoming that gravity, foundnefs, and referve, which are generally affociated with the word COROLLARY.- Various, fays he, have been the theoretical opinions of people, who never had the opportunity, or gave themselves the trouble, to fearch into the real caufe of this diftemper. But from the inspection of the morbid body, that true fource of knowledge, we learn, that the cause of this disease is a preternatural, white, tough, thick, membraneous cruft, covering, often for many inches, the infide of the trachea.'This wonderful membrane feems to be our Author's hobby horfe; mounted on which, he with the greatest eafe bounds over every difficulty relative to the nature, fcat, and caufe of the croup.-But the obfervation of this membrane is not fo very nouvelle as Dr. Home may imagine: it has been feen lining the back-parts of the fauces, the ftomach and

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inteftines; in flight inflammations of the glans penis, we have obferved a fimilar, thin, membranous coat, formed between the prepuce and the glans; practical writers mention a number of cafes, in which it has been coughed up in greater or leffer tions from the afpera arteria and bronchia. The epidermis or interior membrane of the trachea is deftroyed and renewed, fays Haller, and is fometimes coughed up in the form of a thick, white membrane; the mucus of thefe parts is in like manner thrown up in fome diseases, and retains the form of the cavity from which it was rejected*. This membrane, however, has but a flender claim to be confidered as the cause of the croup. The proximate cause of every disease we apprehend to be fuch an alteration in the folids or fluids of the fyftem, as to interfupt the natural and regular motions of fuch fyftem: hence a variety of unusual fenfations and appearances; these constitute the fymptoms; and a particular enumeration of such symptoms forms the hiftory of the disease.From the hiftories related by our Author, the membrane feems to be rather an effect, than the cause of the difeafe; this too is confirmed by Dr. Home, who, in one of the fubfequent corollaries, divides the fuffocatio fridula into two ftages, the inflammatory and the purulent. In the latter he fays the membrane is compleatly formed; he fufpects it is not fo during the inflammatory ftate; nay, in another paffage, he even queftions whether the membrane is not a fequel to the purulent ftate. Dr. Home fuppofes, that mucus, by heat and ftagnation, may be converted into pus; and perhaps, fays he, this change from mucus to pus happens before the membrane is formed, as pus fhows fuch a tendency to affume a folid form.'-The natural progrefs of things, therefore, according to Dr. Home, is as follows: there is a fever; a quick, difficult refpiration; a degree of inflammation affecting the glands and coats of the afpera arteria;-confequently a flow of mucus upon these parts. This mucus is changed into pus; and this pus is converted into that membrane, which is the true caufe of the croup:-or, in plain English, after the difeafe has run through its first stage, and is come to the clofe of the last, there is then formed the true and genuine caufe of fuch antecedent difeafe.-Good logic! found philofophy! and the moft penetrating acuteness in phyfiological difquifitions!

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But our Author proceeds to inquire, whence there is pus, or true matter, without ulceration?. -That pus is formed without ulceration we know and believe from experience; but Dr. Home's thoughts on this fubject are certainly a little outré. Pus is not formed, he fays, as is generally fuppofed, by the veffels of the ulcer; it exifts in the blood, and is probably the

Vid. Haller Elem. Phyfiol. lib. 8. p. 148. 150.

true,

true, nutritious, coagulable part of our fluids. In one place we are told that pus is formed from the lymphatic part of the blood; in another, from the fecreted mucus; and in a third, from the ferum, by an evaporation of the watry parts and the fubfiding and inspissation of what remains :-in fhort, pus is this or that, any thing or nothing, as beft fuits our Author's ready knack at drawing a conclufion.We fhould be glad to know from what pus is formed, when in a large abfcefs the whole folids and fluids of the part are diffolved down into one homogeneous mass of matter.

Corol. 5. contains our Author's account of the different stages of this difeafe.-Cor. 6. his ratio fymptomatam.-Cor. 7. his prognoftics.-Cor. 8. fome general rules with regard to practice, -Dr. Home in his conclufion is a little upon the PARADE: We have now, fays he, brought our inquiry to a conclufion. The facts, we hope, will appear curious, exact, and fufficiently numerous for our purpofe; the method fuch as is ufed in mathematics and na-tural philofophy, for discovering unknown truths; and the conclufions new, furprising, and naturally arifing from the facts. If we have not brought this inquiry to that degree of perfection, in every point, that we could have wifhed, we have the fatisfaçtion, at least, to think, that, fo far as we go, our discoveries are certain, as they are built on the foundation of nature. aing, with all imaginable care, fruitless and deceitful fpeculations, however entertaining, we have conftantly kept our facts and experiments in view, as the only road to the improvement of medicine, and the good of mankind.'

Shun

The first paragraph of this little piece is almoft as extraordinary as the laft. The fcience of medicine has been, gradually, advancing for these two thousand years by paft; and is now brought to a degree of improvement; perhaps to as great a degree, every circumftance confidered, as the difficulty of the art, the limitation of the human faculties, and the continual attempts to further refinement, too often conducted merely by fancy, will admit of.'-We hope and truft, however, that Dr. Home will prove a falfe prophet; that from a judicious attention to fact and experiment, many difcoveries will yet be made in the phyfiology; that from a more accurate hiftory of dif eafes, their characters will be more ftrongly marked; and that' medicines may be prefcribed with a greater degree of certainty, from their virtues being more exactly afcertained. We are the more surprised at this piece of foreknowlege in our NORTHERN SEER, as the metropolis in which he refides, contains one of the beft colleges of medicine in Europe:--a college, in which this mixed fcience is cultivated with the greateft fuccefs; in which a numerous fet of pupils have the best opportunities for profecuting

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