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intestines; in flight infammations of the glans penis, we have observed a similar, thin, membranous coat, formed between the prepuce and the glans; practical writers mention a number of cases, in which it has been coughed up in greater or lesser portions from the aspera arteria and bronchice. The epidermis or interior membrane of the trachea is destroyed and renewed, fays Haller, and is sometimes coughed up in the form of a thick, white membrane; the mucus of these parts is in like manner thrown up in some diseases, and retains the form of the cavity from which it was rejected. This membrane, however, has but a slender claim to be considered as the cause of the croup. The proximate cause of every diseafe we apprehend to be such an alteration in the solids or Auids of the system, as to interTupt the natural and regular motions of fuch fystem: hence a variety of unusual sensations and appearances; thefe constitute the symptoms; and a particular enumeration of fuch symptoms forms the history of the disease. From the histories related by our Author, the membrane seems to be rather an effect, than the cause of the disease ; this too is confirmed by Dr. Home, who, in one of the fubfequent corollaries, divides the fuffocatis Airidula into two stages, the infiammatory and the purulent. In the latter he says the membrane is compleatly formed; he fufpects it is not fo during the inflammatory state; nay, in another paffage, he even queftions whether the membrane is not a sequel to the purulent state. 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 shows such a tendency to assume a solid form.'-The natural progrefs of things, therefore, according to Dr. Home, is as follows: there is a fever; a quick, difficult respiration; a degree of inflammation affecting the glands and coats of the aspera arteria ;-confequently a fow of mucus upon thefe parts. This mucus is changed into pus; and this pus is converted into that membrane, which is the true cause of the croup:-or, in plain English, after the disease has run through its first stage, and is come to the close of the laft, there is then formed the true and genuine cause of fuch antecedent disease. Good logic ! found philosophy! and the most penetrating acuteness in physiological difquisitions !
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 subject are certainly a little outré. Pus is not formed, he fays, as is generally supposed, by the vellels of the ulcer; it exiits in the blood, and is probably the
* Vid. Hailer Elem. Phyfiol. lib. 8. p. 148. 150.
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 secreted mucus ; and in a third, from the ferum, by an evaporation of the watry parts and the fubfiding and inspislation of what remains :-in short, pus is this or that, any thing or nothing, as best suits our Author's ready knack at drawing a conclusion. We should be glad to know from what pus is formed, when in a large ablaess the whole folids and fuids of the part are dissolved down into one homogencous mass of matter. · Corol. 5. contains our Author's account of the different stages of this disease.-Cor. 6. his ratio fumptomatum. --Cor. 7. his prognostics.-Cor. 8. some 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 conclusion. The facts, we hope, will appear curicus, exact, and sufficiently numerous for eur purpose; the method such as is used in mathematics and natural philosophy, for discovering unknown truths; and the conclufions new, surprising, and naturally arising from the facts. . If we have not brought this inquiry to that degree of perfection, in every point, that we could have wished, we have the fatisfaction, at least, to think, that, fo far as we go, our discoveries are certain, as they are built on the foundation of nature. Shunning, 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.' · The first paragraph of this little piece is almost as extraordiFary as the last. The science of medicine has been, gradually, advancing for these two thoufand years by paft; and is now brought to a degree of improvement; perhaps to as great a de. gree, every circumstance confidered, as the difficulty of the art, the limitation of the human faculties, and the continual at. tempts to further refinement, too o ten conducted merely by fancy, will admit of.'—We hope and trust, however, that Dr. Home will prove a false prophet; that from a judicious attention to fact and experiment, many discoveries will yet be made in the physiology ; that from a more accurate hikory, of difeases, their characters will be more strongly marked; and that medicines may be prescribed with a greater degree of certainty, from their virtues being more exactly ascertained. We are the more surprised at this piece of foreknowlege in our NORTHERN SEER, as the metropolis in which he refides, contains one of tho beft colleges of medicine in Europe:-a college, in which this mixed science is cultivated with the greatest success; in which a nunerous set of pupils have the best opportunities for prosecuting their studies ;-and from which, still many improvements may reasonably be expected.
Remarks on the Disease commonly called a Fistula in Ano. By Per
cival Pott, F.R.S. and Senior Principal Surgeon to St. Bartholomew's Hospital, London. 8vo. 25. 6d. sewed. Hawes and Co.
THERE was a time, when our good neighbours the French
1 were generally believed greatly to excel all other nations in the art of surgery. Whatever might be the case in the last age, it is evident, on comparing the present practice in Paris with that of London, that we are now infinitely before them in point of fimplicity of operation, and consequently in rational surgery. To this truth, the treatise now before us bears fpecial testimony.
Mr. Pott's first intention is to inform those of less experience, that a real fistula in ano is a much more uncommon disease than is generally supposed; and that what is frequently mistaken for such, is a mere abscess, or collection of matter, without fiftula or callosity. He proceeds, in his second section, to consider the disease under its various appearances with regard to aspect, situation, and symptoms : but as these are generally known, we shall pass on to Sect. 3d, in which our Author delivers his method of treating the patient before the maturation of the tumour. Here we find him, in two instances, advising, from experience, a method of proceeding very different from the usual practice on fimilar occasions. Speaking of that species of tumour in which the skin wears the yellowish tint of the erysipelas, « This kind of inflammation, says the Author, generally makes its attack with nausea, vomiting, slight rigor, heat, thirst, and restlessness. The quickness of pulse, and heat of skin are indications for some degree of evacuation, and indeed sometimes render it requisite; but it is a very prevailing opinion with many practitioners, that these evacuations should be freely made, and frequently repeated : in short, that the cure of this kind of inflammation is safely to be effected by them; which is so far from being true, that the practice has proved fatal to many.' This observation, from a gentleman of Mr. Pott's experience, deserves particular attention; especially as it applies equally to erysipelatous inflammations in every other part of the body.
The other instance in which, in the first stage of the disease, the Author, most judiciously, steps out of the beaten path, appears in his method of relieving the patient in a total suppression of urine; a symptom frequently attendant on the formation of àn abscess near the re&tum and bladder. “They who have not often seen this case, generally have immediate recourse to the catheter ; and for this they plead the authority of precept: ut the practice is so effentially wrong, and I have seen such die rible consequences from it, that I cannot help entering my peo test against it: the neck of the bladder, from its vicinity to the parts where the inflammation is feated, and from its being involved in the same common membrane, does certainly participate, in some degree, of the said inflammation. This will in some measure account for the complaint; but whoever confiders the extreme irritable state of the parts composing that part of the urethra, (if I may be allowed so to call it) and will at the same time rcflect on the amazing and well-known effects of irritation, will be convinced that the principal part of this complaint arises from that cause; and that the disease is, strictly speaking, spasmodic.'. - The true, safe, and rational method of relieving this complaint, is, by evacuation and anodine relaxation : viz. venesection, gentle cathartics, femicupium, bladders of hot water applied to the pubes and perineum, glysters composed of warın water, oil and opium.' . There may have been cafes, subjoins our Author, which have resisted and baffled this method of treatment, but I have never met with them.' all that is between the edge of the knife and the verge of the anus.' The operation being performed, a soft doslil of fine lint must be introduced between the lips of the wound, and the rest of the fore drest with the same. - Whoever compares this simple operation with those in similar cases of former times in this kingdom, and even of the present age in other countries, will immediately be convinced of the value of this treatise. The latter part of the work is chiefly employed in demonstrating the absurdity of the usụal method of treating this disorder, particularly in France, in which the Author reasons candidly, judiciously, and, we think, convincingly to unprejudiced readers.
Suppose the matter already formed fo as to require being let out, he advises the use of the knife or lancet in preference to the caustic, the latter being neceflarily attended with loss of substance, and, instead of cramming the wound with a large quantity of escharotic dressings, to introduce such only, as, by their small quantity and emollient quality, will permit and encourage a gradual suppuration. If, upon opening the abscess, it should appear, either from the rećtum being perforated or denuded, that there is a neceflity of laying the two cavities into one, he advises the operation to be immediately performed in the following manner:
• The curved probe-pointed knife with a narrow blade (of which there is a plate given) I have always found to be the most useful and handy instrument of any : this introduced into the finus, while the surgeon's fore-finger is in the intestine, will enable him to divide all that can ever require divifion; and that with less pain to the patient, with more facility to the operator, as well as with more certainty and expedition than any other inArument whatever. If there be no opening in the intestine, the Imallest degree of force will thrust the point of the knife through, and thereby niake one; if there be one already, the same point will hud and pais through it: in either case, it will be received hy the finger in ano, will thereby be prevented from deviating, and being brought out by the faid finger, muft necessarily divide
Rev. Dec. 1765.
An Effay on British Ijinglafs: Wherein its Nature and Properties are · compured with the foreign Sorts; with the best Methods of con
verting them into Fining, Glue, and Starch, for the Use of the · Brewer, Vintner, Paper-stainer, &c. comprehending á succinēt
Analysis of Isingless, and Rationale of its Action in clarifying Li. quors. Interspersed with Hints for the further improving of Malta · ing, Brewing, Fermenting, and for preventing the Waden Appa
ratus in the Brewery from speedy' Decay. By H. Jackfon. 8vo. - 1 s. 6d. Newbery.
THE home-manufacture of an article which is imported at
1 an exorbitant price, and forms a disadvantageous balance in the way of commerce, is a subject of great importance ; and the inventor of a method by which we may be supplied with such article from our own labour and our own materials, is entitled to the countenance and patronage of the legislature.-The preparation of Isinglass hath been long kept a secret by the Russians. Neuman, indeed, and others, have given a description of the fish from which this particular species of glue is extracted, and a fort of hearsay account of the process by which it is made: che Rullians; however, were the first inventors of this art, have continued to be the sole manufacturers, and from them all Europe bas been supplied. : In Mr. Jackson's essay we meet with the following interesting particulars :--that the art of making Isinglass in England from British materials, after a moft rigid scrutiny into its merits, has been adjudged a new and useful invention; that several tons weight of this manufacture have been confumed and inconteftibly proved in a court of judicature, to answer the purposes of the toreign; and that all sorts of Ifinglass may be manufactured at home, as soon as we receive a due supply of materials from our