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subject to wind in their stomach, and a swimming of the head, who, by looking into a mirror that was kept constantly moving before them, became so giddy, as to be in hazard of falling. Others upon the sudden opening of a door, or any other unexpected noise, have been liable to be seized with convulsions. Nay, there have been some, whose brain and organs of sense were so susceptible of impression, that they could scarce abstain from imitating every motion and gesture they saw performed by others.'

Soon after, our learned Author thus finishes his discussion of the causes of this

genus

of diseases : To conclude our observations on the causes of nervous direases, it may be proper to take notice, that although it appears from the diffections of those who have died of them, that the ftomach and intestines, liver, fpleen, omentum, mesentery, or uterus, have frequently been found obstructed, schirrous, or otherwise unsound; yet as in many other cases of the same disorders, no such morbid appearances have been observed in the body after death; it follows, that these symptoms may frequently proceed from causes, which, eluding our senses, are not to be discovered by dissection. Nay, obstructions, schirri, and other disorders of the viscera, observed in those who have died after long suffering from nervous ailments, seem, sometimes to have been the consequences of a long state of bad health, rather than the causes of it: particularly, by the frequent attacks of that arthritic or other morbid matter which is often the cause of these disorders; and, by the pains and spasms atteriding them, some obstructions may at length be formed in the small vessels of the stomach or neighbouring parts; to which every new return adds a little, just as new infammations of the cornea always increase fpecks on that membrane.'

The sixth chapter is thoroughly replenished with observations on some of the most remarkable symptoms of the diseases professedly treated on. These he distinguishes into, 1. An uncommon sensation of cold or heat in different parts of the body. 2. Pains in different parts of the body, suddenly moving from one place to another. 3. Hysteric faintings and convulsions. 4. A catalepsis and tetanus. 5. Wind in the stomach and bowels. 6. A great craving for food. 7. A black vomiting. 8. A sudden and great flux of pale urine. 9. A nervous atrophy. 10. A nervous or spasmodic asthma. 11. A nervous cough. 12. Palpitations of the heart.

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The pulse often varying in quickness, strength and fulness. 14. Periodical head-achs. 15. A giddiness. 16. A dimness of fight, without any visible fault in the eyes. 17. Low spirits, melancholy and a mania. 18. The incubus or night-mare. Rey. Aug. 1765. K

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As this chapter is confiderable, both for its length and ima port, we fhall give a specimen of our Author's reasoning in it, principally from the first and last articles, which are not the least curious, and are also new. On the first he says,

· The senfe of cold and shivering in the beginning of most fevers and inflammations, seems not to be owing, as Tome have imagined, to viscid Auids ftagnating in the finall cutaneous vefsels, but to a spasmodic contraction of these vessels, in confequence of that irritation which the nervous system suffers from the febrile stimulus, or the beginning infiamnation. However, although all fevers proceed from irritation, and consequently from an affection of the nerves, and many fevers of the low kind have had the name of nervous peculiarly bestowed on them; yet a regular intermittent seems to deferve that appellation better than almost any other species of fever ; for its paroxysms, like those of the epilepły, or other convulfive diforders, are owing, not so much to any fixed obstruction in the vascular system, or general acrimony, or vifcidity of the mass of fluids, as to an irritation or affection of the nerves of fome particular part, such as the stomach or inteftines; whence the whole fyftem fuffers by fympathy, and a shuddering is produced, which is fucceeded by a hot fit and a sweating, that, for the time, removes the cause of the disease. And as an intermittent agrees with epileptic and other convulfive disorders as to its caufe ; fo its returning paroxysms, like theirs, may be often prevented or weakened, by raising, a short time before the approach of the fit, an acute pain or any great commotion in the body.'

This plainly opposes the doctrine of that morbid lenfor, or viscid fate of ihe blood, which has generally been fupposed an efficient cause of intermitting fevers, to which it is not improbable many ftill may adhere; though we confess Dr. W.'s account of them is more plausible to us : the frequent degeneracy of inveterate intermittents into drcpfies, inducing us, as it has done others, to doubt considerably of this supposed viscidity of the buinours in intermitting fevers.

After an accurate description of the incubuis, or night-mare, our Author, having (on the credit of some strong arguments) diffented froin the received opinion, that this disorder arises from a starnation of the blood in the finufles of the brain, or in the vessels of the lungs, or from too great a quantity of blood being sent up to the head, proposes his own opinion in the following terms:

« We know, that certain medicines or poisons, worms, and even corrupted bile or other humours, by disagreeably affecting the nerves of the stomach, produce an oppreson about the precordia, wild imaginations, frightful dreams, raving and infensi

bility : bility: and there is no doubt, that low spirits, melancholy, and difturbed sleep, often proceed from a disordered ftate of the stomach. Is it not probable, that the night-mare has its seat chiefly in the same organ? If epileptic fits often proceed from the stomach, why may not the incubus, which has been considered by Galen as a nocturnal or flighter epilepsy, have its feat in that part? People troubled with nervous or hypochondriac ailments, and who have delicate or fatulent stomachs, are more subject than others to this disorder.- A heavy or fatulent fupper greatly increases the night-mare in those who are pre-disposed to it. The sympathy of the stomach with the head, heart, lungs, and diaphragm, is lo remarkable, that there can be no difficulty in fuppofing the several symptoms of the incubus to arise from a diragreeable affection of the nerves of that organ.

When my stomach, adds he, has been out of order, and troubled with wind, I have perceived a flighter incubus seize me before I was fully alleep, the uneasiness of which would make me get up suddenly. As soon as I was quite awake, I was generally sensible I had been affected with a weight and unealiness about my stomach, attended with a faintness, and some sort of oppression or suffocation about my breast, as if the circulation in my lungs had been a good deal obftructed. While I sat up in bed, or lay awake, I felt nothing of these symptoms, except, perhaps, some degree of uneasiness about my stomach; but when I was just about to fall asleep, they began to return again. In this way, I have often gone on, for two hours or more, in the beginning of the night. At last, I found, that a dram of brandy after the first attack, kept me easy the whole night. This remedy has never failed to succeed with me, the few times I have had occasion to try it; for of late, since my stomach has been pretty sound, I have seldom felt in my sleep any of those uneasy sensations which resemble the night-mare.'

In the sighth article of this chapter-on a sudden and great Aux of pale urine-he observes by the way, p. 250%. That he has met with several instances of a great and long-continued Aux of urine, from an arthritic humour turned to the kidneys.? We were the more ftruck with this affirmation, from a positive experience of an arthritic person, turned a little of fifty, who never had the gravel, nor any nephritic complaint, passing with a *sudden and considerable irritation, a large quantity of urine, with a very copious calcarious sediment, which quickly precipitated. This discharge was continued for at least two days and nights, and a considerable quantity of this sediment was faved by filtring, which being kneaded, when of a due consistence, into Imall mafies, like levigated crabs-eyes, was much of the same colour with gouty chalk-stones, and would score like .chalk. This was a plain effect of the natural separation and ex

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pulsion; pulfion; as no complaint had preceded it, no medicine had been taken ; and the perfon, to whom it happened, concluded it had saved him froin a gouty paroxysm, a few of which he had pretty regularly experienced.

The eleventh article of this chapter-a nervous cough-employs 20 pages, and contains a very particular account of a most extraordinary cough of the truly nervous, or sympathetic kind. The case annexed to it was so uncommonly rare and curious, that it engaged our Author's strictest attention and vigilance : and the cough, after a long investigation, was finally cured as compleatly as it was possible to expect, from a cause, that being inherent in the original constitution, was not entirely to be removed : for we are told, that, since September 1762, the patient has been very rarely affected with the disorder in any confiderable degree. Dr. W. found the justeft occasion, from this extraordinary case, of magnifying the efficacy of a pediluvium of leg-bath of warm water, which inftantaneously removed the cough, that was not prevented, nor even appeased, by half a grain of opium, and three grains of aja fætida given morning and evening for several days. He adds, that from January 20 to March 25, vomits, blisters, an issue between the shoulders, bark, powder of tin, rhubarb with calomel and boluffes of Vea nice treacle, with camphire and valerian, were equally ineffectual. This is a circumstance our most candid Author scarcely ever omits, and may not be the least practical hint he affords us. He judges, with great probability, that warm water affects our nerves very differently, not only from a dry heat, but also from warm fteams, or cloths wrung out of warm water. We find thcle pediluvia also, though without any theorising about them, are very strongly recommended by Dr. Tifiot, in different acute difcales, and particularly upon their invasion. [To be concluded in our next.]

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An Account of the Incculation of the Small.pox in Scotland. By

Alexander Monro fenior, M. D. and F. R. S. Fellow of the Royal College of Physicians, and Professor of Medicine and of Anatomy in the University of Edinburgh. 8vo. 19. Longman, &c.

TH

HIS account was written in consequence of five queries

sent to the Author by the Dean and Delegates of the Faculty of Medicine at Paris, with respect to the practice of Inoculation and its consequences in Scotland. And though the dean and delegates, to whom it is addressed, had made their re

port

port on Inoculation, to the faculty, before Dr. Monro had received all the information contained in this pamphlet, yet as several members of the philosophical society at Edinburgh, to whom it has been read, thought the public should be acquainted with the result of that enquiry the Author had made, by establishing a pretty general correspondence on this occasion throughout Scotland, he determined to publish it.

As this subject is very trite with us, and the practice is become popular, in consequence of long cxperience and plain calculation, we lhall be very concise in any cita : un from this small treatise, selecting only what is strictly material, or new. The five questions are as follows:

1. Has Inoculation been long practised in your country? and with what success?

2. Did some of the Inoculated die ?

3. Did some who had undergone Inoculation take the natural Small-pox afterwards, and at what time?

4. Do you know that other diseases have been ingrafted with the Small-pox, by Inoculation ?

5. Whether did many, after Inoculation, labour under va. rious diseases, which seemed to be owing to that operation ? and whether did this happen more frequently, or seldomer, than from the natural Small-pox?

In the course of our Author's circumstantial answer, to the first query, it appears, that from the year 1744 to -53, both included, one tenth part of all the deaths in Edinburgh, and St, Cuthbert's parish adjoining to it, were occasioned by the Smalle pox, when Inoculation was but little used : and in the ten immediately succeeding years, from 1754 t0–63 inclusive (during which term Inoculation was more frequent) the total number of deaths was 1096 less than in the first ten; and the number of deaths by the Small-pox were 71 less.

In answer to the second and most important query, our Author gives a list of 5554 inoculated in different parts of Scotland by a great number of physicians and surgeons. Of which five thousand hve hundred and fifty-four, 72 died; fo that scarcely one died out of 78. In this answer he also details the arguments used by the friends of the Inoculated, in order to deduct from the num. ber of those dying after being inoculated, as dying less from that practice, than from an abuse or misapplication of it.

Dr. M. declares, in answer to the third query, that almost all his correspondents agree in affirming, they never saw any attacked by the genuine Small-pox, after they had truly received it, whether by accident or art.

In answer to the fourth query, Dr. M. affirms, he never saw other diseases communicated by Inoculation; in which negative his correspondents agree with him. He gives an instance from .

one

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