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the action of measles has been suspended by this new action, that is, the catarrh, after the impression has been received from the contagion; and that when this action from the supervening catarrh has been completed, that of measles commences, and goes through its usual progress ? We are led to offer these suggestions to our ingenious author from the following very valuable history.. u I inoculated about the same time three children with the fluid contained in these vesicles, but no effect was produced by the ino?_ culation. A similar trial at the Inoculation Hospital proved more successful.
Richard Brookes, aged eighteen, was inoculated by Mr. Wachsell, with fluid from the miliary vesicles in mealsesj and with vaccine virus, January 6, 1S00. On the 10th there was some redness and elevation of the cuticle at both the inoculated places. ? 15th. The redness round the part where the lymph of the measles was inserted had disappeared, while the vaccine pock was vivid. 18th. The vaccine disease was over. 22d. He had severe cough, sneezing, and watery eyes, with cold shiverings and fainting. 28th. The measles appeared; his eyes we're inflamed, and the lids swollen. 2.9tn. The efflorescence was diffused all over the surface of the body; frequent cough ; violent fever. Feb. 1, Efflorescence disappeared ; cough and fevGr much abated. From that time he recovered gradually, and was dismissed in health on the 12th of February." , We have copied this passage not only as an instance of successful inoculation for measles, but also as an illustration of our opinion concerning the causes of the protraction of the disease after the contagion has been received. Here we find the subject susceptibly of the two contagions at the same time; and as long as the diseased actions were local, both went on at the same time. i$ut as soon as the constitutional action from vaccination commenced, the local action of measles ccased.
When the vaccine process was completed the rtibeolous recommenced, and in four days afterwards the cough, sneezing, and other symptoms previous to the eruption^ came on.
In six days more the eruption appeared, and in four more disappeared; making in the whole twenty-six days, a fair allowance fer the two diseases. We would not be supposed in this . . examination S64; Di\ Willan> on Cutaneous Diseases. examination to question Dr. Willan's accuracy or his abilities, .we. have fairly stated the question as it appears to us, and leave the decision to our readers.
After a very accurate description of the disease in its most usual progress} the author enumerates some of the anomalous appearances remarked by himself and other writers. We shall transcribe his. own, not only on account of their importance, but because they lead to,the solution of a difficulty which no one has ventured to, touch upon with so much boldness before. " Some other appearances which occasionally succeed the measles likewise demand attention. These are, 1st. Small hard tumours, like, boils, being'in the beginning very much inflamed, and sometimes of a livid colour, afterwards suppurating with great pain,, and a sanious discharge. They appear mostly on the back, loins, or lower extremities, and are not readily healed. In children there is an analogous eruption of inflamed pustules (Phlyzacia Def. X. 1.) on different parts of the body, but particularly on. the feet, legs, thighs, and scrotum. " 2dly. An eruption roui\d the chest, about the mouth, temples, &c. of watery vesicles, in clusters, with an inflamed base, producing much heat, pain, and tingling of the skin. " 3dly. In infants aphthous ulcerations of the tongue and fauces,.
" 4thly. Soft pustules containing a viscid, straw-coloured fluid, (Achores & Favi, Def. X. 3.) on the head, face, breast, and thighs, succeeded by ulcerations at the corner of the mouth with, tumour of the upper lip, sore eyes and ulcerations of the tarsi, discharges from behind the ears, enlargement and tedious suppuration of the submaxillary, occipital, axillary, and inguinal glands,, sometimes with pain and swelling of the joints. " 5thly. In some cases where no eruption of pustules, nor superficial ulcerations have preceded, the lymphatic glands of the neck and other parts become considerably enlarged; this appearance is succeeded by a swelling and tension of the abdomen, with hectic fever and emaciation., " I never saw the rubeola terminate by gangrenous ulcers of the throat, cheeks, gums, &c. or by caries of the jaw-bones, as stated in several respectable authors. Those dreadful symptoms more especially belong to another disease of the present order," We shall pursue this important enquiry without interruption. " It may be proper," says our author afterwards, "to notice the ' Putrid Measles,' observed by the late Sir William Watson among the children at the Foundling Hospital, in 1763 and 1/68; see Med. Observ. vol. 4. In this disease there was a cough and watery inflamed eyes, but ' the eruption appeared, over nearly the whole body, on the second day;' the fauces were of a deep red colour ; the pulse was very quick, but low; the patients complained of extreme weakness, and could not bear bleeding; their oppressed and difficult breathing was attended with great restlessness and anxiety, but,with scarce any expectoration throughout; some died under Dr. Willan, on Cutaneous Diseases.
?Under laborious respiration, more from a dysenteric purging.; several were so debilitated that they refused to take almost any nourishment, and sunk quite emaciated, one so late as six weeks aftex the attack; some aases terminated in mortification of the rectum, pudenda, cheeks, gums, &c. others with caries of the jaw-bones/ These circumstances do not belong to the rubeola, or measles generically considered; they are, indeed, ranked otherwise in Sir W.
Watson's own statement respecting the disease, which he refers to the morbilli maligni, or epidemii, described by Morton. Now it must be observed, Dr. Morton expressly maintains that the measles and scarlatina are the same disease, with no more variation in ?their form than there is between the distinct and confluent smallpox; he has therefore conjoined their principal symptoms (cap. iii.) pnd wishes t? banish the distinction, and the very name of scarlatina from medical language. In this wish Dr. Morton has not succeeded; hence those readers who attend, not to the names of things, but to the things themselves as described, will find that the morbilli maligni, morbilli epidemii, morbilli spurii, and febris morbillosa, pestilentialis, in his writings, have no relation to the measles, but constitute the disease, to which other writers have given have occurred between April 21 and May 4, are not entered in the written books under the denomination of 'measles;' one is termed 'eruptive fever,' the other 'scarlet fever.' From these sources one hundred and eighty children were soon affected with the disease in question, every case of which -is termed 'eruptive fever/ no mention being made of measles in the .report-book till the latter end of November, when ten cases aie entered under the name of ' morbillous fever/ This, however, -had no connexion with the preceding ' eruptive fevers/ which, according to the printed account, (p. 137) wholly ceased on June 9.* " * Sir W. Watson's statement lias led several persons to suspect, that, tfrom the virulent svmptoins of a disease alvvav reputed inflammatory, there Biust be something amiss in the state of the air, the.diet, or general nia-?W?einent of the children at the Foundling Hospital. For  4 measles and sore throat' or ' measles and ulcerated sore throat,' and measles with ' putrid fever/ The denomination 'scarlet fever and sore throat,' first occurs in the weekly report, Sept. 1, 1/87. About the same time, in the prescription "book appropriated to the measles, a separate entry is made of scarlatina, this generic title being at length applied, when the disease, after a dreadful ravage during two successive years, had fully ?impressed the inhabitants of London with a knowledge of its distinctive character, and peculiar virulence." We shall make no apology for this long quotation on an enquiry leading to so important a discrimination. Dr. Willan's arguments seem almost conclusive, and it is impossible not to admire his industry in following the question so closely. But we cannot help also expressing our surprize when he tells us, that measles have not been fatal at the Foundling beyond the usual proportion ; when by the register, it appears, that at two periods taken collectively, about one in thirteen died. Surely, such a mortality as this iw b'eyond the common ratio in this disease. The question is carried much further than our limits will permit us to pursue it, but not further than every diligent enquirer will wish to accompany our author. This part of the work concludes with some short but . pointed remarks on the low state of Saracenic or Arabian medicine, even when in its highest reputation. The next genus in the order of exanthemata or rashes, according-^ ?frequently occurring there, that they have not been fatal beyond the usual proportion. Thus, in the year 1798, twenty-five boys, and forty-four girls, had the measles, six of the latter died. In autumn 1800, twenty-nine boys, thirty-seven girls were affected, and four boys died of the disease, or its consequences. In 1794, twenty-eight had the measles, and all recovered.
In 1802, one died out of eight children affected. Particular cases may occur wherein symptoms of putrescence appear during the latter stages; (p. 237). Of such cases I have only noticed five, in a practice of twentyfour years; many practitioners who have been established fifty years, have not seen them in a greater proportion; I never yet conversed with any uae ->vho had noted putrid .measles occurring epidemically." Dr. Willan, on Cutaneous Diseases. U may be distinguished from measles. As this is connected with an enquiry in which we have hitherto followed our author with so much caution, we shall do him the justice to transcribe the passage. ' " Although the measles and scarlatina are now known to arises from different modes of contagion, yet so many authors have considered them as varieties of the same disease, that it may be allowable in this place to recapitulate their diagnostic characters. " 1st. The efflorescence in scarlatina generally appears on the second day of fever; in the measles it is seldom visible till the fourth.
? " 2dly. It is much more full and spreading.in the former disease than the latter, and consists of innumerable points and specks under the. cuticle, intermixed with minute papula?, in some cases forming continuous, irregular patches, in others coalescing into an uniform flush over a considerable extent of surface. In the measles the rash is composed of circular dots partly distinct, partly set ia small clusters or patches, and a little elevated, so as to give the sensation of roughness when a finger is passed over them. These patches are seldom confluent, but form a number of crescents, or segments of circles, with large intervening portions of cuticle, which retain their usual appearance. The colour-of the rash is also different in the two diseases, being a vivid red in the scarlatina, like that of a boiled lobster's shell; but in the measles a dark red, with nearly the hue of a rasberry. " 3dly. During their febrile stage, the measles are distinguished by an obstinate harsh cough, forcing up, in repeated paroxysms, a tough, acrimonious phlegm,?by an inflammation of the eyes and eye-lids, with great sensibility to light,?by an increased discharge from the lachrymal gland, sneezing, &c. The scarlatina is frequently attended with a cough, also with redness of the eyes from an extension of the rash to the tunica albuginea, circumstances which render the distinction between this complaint and measles particularly difficult, if other symptoms be not clear and decisive. On minute observation, however, it will be generally, perhaps always, found, that the cough in scarlatina is short and irritating, without expectoration ; that the redness of the eye is not attended with intolerance of light, that the ciliary glands are not affected; and that, although the eyes appear shining and watery, they never overflow, " 4th. Most writers on the subject, in distinguishing scarlatina from measles, and other eruptive complaints, observe that there is a peculiar sensation of anxiety, depression, and faintness? in all cases of it which are attended with fever. " 5th. When the rash appears on the third or fourth day, being scattered, and of a dark shade of colour, as frequently happens ia the two latter varieties of scarlatina, the disease may be distinguished from measles by ths appearances in the throat, by the rigi-3tzw&iitQ ... , ?& ditjr \36S <D;*. Willan, on Cutaneous Diseases.
?dityof the muscles of the neck, and other peculiar symptoms ?hereafter to be described." We have next very accurate descriptions of the two other species of scarlatinas viz. anginosa and maligna. In both these we 'liieet with the caution and minuteness which might be expected from Dr. Willan. Next follow some enquiries, whether the disease can attack a person more than once during life. Amidst the contradictory evidence, the author seems disposed to the negative side ?of the question, but unwilling to decide. This introduces an his-* ?torical detail ot the different periods at which the disease has been described in different countries throughout the world. The author -conceives it was originally introduced among'us from the Levant or .?Mediterranean.
It is highly probable that the country first peopled, the most populous and most abounding with the children of poverty, may have been the first among whom a contagious disease was discovered in such full force, and so generally extended as to attract the attention of physicians. The uniformity and fatality of its symptoms would force upon them a conviction that something more was to be described than was met with in Galen and Hippocrates, and that a mode of treatment was to be pursued different from any authorized by these celebrated oracles. With submission however to the great diligence and ingenuity of our author, we cannot help doubting whether the disease described by Aretceus Aetius, and even by Tournefort, can fairly be called scarlatina. No mention is made of a scarlet eruption, and it does not seem, ?unreasonable to impute all the symptoms to the malignant fever .with sore throat, generated in the abodes of poverty, especially when we consider how much this disease is increased in proportion to its inciting causes.
In tracing the disease, from a later period, Dr. Willan stands on very firm ground. Its milder form he shows satisfactorily to have been described by Ingrassia in Italy, in the beginning of the six-?teentlr century, and its malignant form-by Wierus in Lower Germany, in the years i6'54! and 16'55, From this period we meet -with equal learning and diligence in tracing the disease to our own .times. The superficial-reader will perhaps fancy this long detail 'tedious; but the true pathologist, who knows how necessary the .greatest accuracy is in ascertaining the true character of every disease,-will be aware that nothing which relates to. it can be indifferent.
He will follow with pleasure his learned instructor in the .'Variety vof forms aild''synonyms under which he detects a disease, ? sometimes traced back to Hippocrates, and at others considered as .a now phenomenon. From thi? mass of evidence he .will with delight perceive the uniformity of nature, even in her deviations from /the healthy actions of life, and find new proofs, if any aria wanted, -of the necessity of uniting in practice a sound judgment, and a -bold, if well founded decision, to the most laborious research. ? We offer the following extract not only from the interest it has excited in our own mind, but because it contains a kind of summary Dr. Willari, on Cutaneous Diseases. 369 inary of the arguments that Dr. Fothergill's ulcerous sore throat, as it was at one time called?, was only another form of the mild innocuous scarlet fever* which Sydenham describes almost without proposing a method of treatment. " The ' sore throat attended with ulcers/ which was prevalent in London during the years 1747?S, and of which an accurate account was given by Dr. Fothergill, appears to have been an epidemic scarlatina* like the anginose fever* and ulcerated sore throat described by Huxham. Although many of Dr. Fothergill's cases were certainly of the malignant kind, and he thought proper to insist generally on the putrid tendency of the disease with a view to combat the mode of treatment then employed, yet it is evident from his treatise, that he frequently saw the disease in its mildest form. The rash, of which he has given a full description* coincides exactly with that in the scarlatina. It appeared on the second day of the disease, and began to decline on the fifth. He further observes, that there were ' in general symptoms of recovery on the third, fourth, or fifth day, and that, " some grew easier from the first day of the attack." With respect to the affection of the throat, he says, " The disease terminates in a superficial ulceration of some of the parts about the fauces, with little appearancc of sloughs if the disease is very mild; and with large and deep ones, of a white, cineritious, livid, or black colour, if it is more violent." In another place he says, " Where the disorder is mild, a superficial ulcer appears in one or more of these parts, which may easily escape the notice of a person unacquainted with it, as it can scarcely be distinguished from the sound part* but by the inequality of surface." He adds, that under a proper mode of treatment, " it seldom happens, but that the febrile symptoms disappear, the sloughs come off, and the ulcers are disposed to heal in a few days, unless it be where mismanagement at first, malignity of the infection, or an unfavourable constitution, have one or all contributed to increase the disease, and'to render its consequences more lasting and mischievous.' " The disease described by Dr. F. was attended with hemorrhage from the nose, mouth, and ears, also from the uterus; such discharges of blood take place in every variety of scarlatina, and in the two latter species are often fatal. He has noticed a circumstance peculiarly attributed to the scarlatina anginosa by most writers on that subject; 4 Another symptom which requires our attention in the cure of the disease is an excessive faintness, of which they generally complain soon after they are taken ill, and continue to do s-o, if they are sensible, till the distemper begins to abate.' " The doctor has elucidated his observations by two instances (p. 52, 56) in which slight cases of scarlatina anginosa, scein to have proved fatal from an imprudent use of bleeding and purgatives. One of the cases so treated, he says, 'was apprehended to be a common scarlet fever/ Dr. Willariy on Cutaneous Diseases. " He remarks, in concluding, * Thus much, however, seems to be true in fact, that in some cases* the disease appears to be of so mild a nature, and so benign, as to require but little assistance from art. Persons even recover from it under the disadvantages of unskilful and injurious management; whilst in others the progress of the symptoms is so rapid, and the tendency to corruption so strong, that nothing seems able to oppose it. Just as it happens in the small-pox; the benign and distinct sort bears ill treatment without injury; in the malignant flux kind,, the utmost art and experience aie too often insufficient to conduct the distemper to a happy issue. Whether this diversity in the sore throat we arc N speaking of, is owing to a difference of constitutions, or of seasons, to the different quality or quantity of the contagion, or the manner of receiving it; or whether thereare in reality distinct species, may perhaps hereafter be more certainly determined.' * " affords an opportunity of comparing its appearances in the couatrv?
with its form in a crouded metropolis." A number of writers follow in order, from the descriptions of most of whom it is shown that the three varieties of the disease ar? from the same source. The most remarkable among these is Dr. Pelham's two sons, on the same day, by a malignant sore throat, (Gent.. Mag. vol. sxvii. Nov. 1739.) and afterwards kept up through reports of the appearance of this supposed pestilential distemper in other parts of the kingdom, occasioned Dr. Ps account of it to be read with the utmost avidity. The title and tenor of his publication so far coincided with current opinion, that he soon attained the highest professional emineace. Dr..
Cotton's treatise on the same subject had perhaps equal merit with regard: to stile and precision; hilt as he gave an old appellation to a disease certainly not new, his work attracted little attention, and produced him no emolument. The Doctor was, however, consoled by the visitation of his muse, and by the comforts of his rural 'Fire-side/ He declined an invitation to practice in London, considering ' the metropolis as a dangerous and stormy ocean;'?If we can trust the muse, his 'search after happiness,* among calme* sceHes, was not ineffectual.
Dr. Willan, on Cutaneous Diseases. 371 tracing the progress of the disease in the extensive seminary cf ( Ackworth, place the question beyond all doubt.
Having settled this most important point, the author " proceeds to make some observations on the method of treament in the different forms of scarlatina." However pleased we might be with the result of the former enquiry, and with the general uniformity of description discoverable in various writers, making only a moderate allowance for the difference of climates and season, it is impossible to read the present section without some melancholy suggestions on the uncertainty attending our practice in acute diseases.
One most important fact seems to meet with general confirmation, that bleeding has been gradually disused, or employed with greater caution. If the subject were less serious, we might smile at the confidence with which other remedies are extolled or condemned by their different advocates and impugners: Emetics, particularly in the early stage of the disease; seem to meet no opposition. Blisters are a doubtful and uncertain remedy in the opinion of many respectable writers. Our author however does not scruple to recommend them, when the throat is so much swelled as to occasion painful deglutition. He proposes also such a temperature of the chamber as is most agreeable to the patient's feelings, and such as is the common temperature of the season when the disease assumes its mildest form. Very gentle purgatives, administered with caution, are not without respectable advocates ; but it is difficult to collect our author's opinion of them, as well as of bark and wine.
Probably, he has not found either of them necessary. We shall consider his remarks on acid drinks hereafter.
On the subject of gargles, we meet with nothing very new. In the last division of the disease, scarlatina maligna, our author seems to join in the general objection against blisters. No one can dispute the great disposition to gangrene in the worst form of this disease. Bleeding and purging he considers also as qoiistantly hurtful. On this occasion, a just tribute is paid the late Dr.
Fothergill, as " among the first to discourage this destructive practice,"*?in England we presume our author means, for after tracing the practice of blood-letting through Spain and Italy, he adds, " It is extraordinary that after so dreadful a mortality, no phy-A a 2 sician * The following note attends this passage.-?"Dr. Huxhain persevere 1 blood-letting till the vear 1750, though he says,' It will be constant y ou that the pulse as well as the strength sink vastly after the secon or 1 bleeding, and truly very surprisingly after the first-' ^)r. Grant was a o an advocate for bleeding in angina maligna in 1770," See. , . We should have been glad if our author could have settled a doubt which was often started by the last race of practitioners, viz. whether or no Dr. Leatherland had any share in reforming the practice in this disease. The only, printed document that occurs to us on the subject is contained 1 Chandler's " Treatise on the Disease commonly called a Cold, a pamphlet #f which, probably, few have heard more than the title.  Dr. Willan, on Cutaneous Disease*. sician should have thought of instituting a different mode of practice. None of them, however, would recede from the plan or maxims they had adopted; to that the honour of arresting the progress of this disease, and of effecting its cure, was claimed by a bold empiric, who attracted general attention by advertising a specific remedy, which was merely a cretaceous earth, or bole, said to be the Samian earth recommended by Galen for ulcers of the mouth. We cannot now impute Charamonte's success, which was certainly very great, to an inert powder, but must refer it to collateral circumstances. A principal one seems to have been, that when tJie Neapolitans and Sicilians were induced to confide in a specific, they no longer submitted to the usual purging and bleedings, which, in opposition to the whole faculty of Naples, Charamonte decidedly reprobated as the causes of the preceding mortality. The event was by no means in favour of medical science at that periodj for, soon after the trammels of regular practice were shaken off, we find that the disease became less frequent, and less fatal, though its name impressed terror through many succeeding generations." By a note, it appears that Charamonte wrote in 1637-Dr. Fothcrgill's first edition is dated about 1748. We have, as our author Observes, no reason to doubt that Huxham continued bleeding till the year 1750. Ilis Dissertation on the' Ulcerous Sore Throat is dated 1757-In this he shows how much trouble he had to con-' vince his neighbouring practitioners, " though in general as careful, capable, ami judicious as in most parts of England," that the disease was altogether putrid or malignant. Perhaps, had he produced authorities in addition to argument and demonstration, he might have been more successful-When will the professors of a liberal ' Science, and an art altogether practical, direct their whole views to the improvement of that art, or to the encouragement of all the means by which it can be improved ? To empirics we owe the bold use of mercury. To empirics,It now appears, we owe the improved method of treating scarlatina maligna. To a female, the introduction of inoculation ; and to empirics the improvement of the practice. It is to be admitted that the ignorant boldness of empiricism requires some controul, but it is also entitled to fair enquiry ; and it bccomes the business of the enlightened practitioner to profit by the errors as well as success of .his more hardy antagonist. But it were well if this jealousy were directed only against empiricism ; unfortunately we have too many proofs that eminence and usefulness, if they lead to the temple of Fame, conduct us by so steep, so rugged a path, that few arrive there but to leave their ashes. Who is ignorant of the jealousies which Hervey encountered ? Who can misunderstand the little querulous hints of Sydenham I Which of us has not witnessed the ignorant petulance which every, where attended Hunter ? And who can see, with indifference, the constant puny attempts to blast the laurels, or to intwist thorns" in the wreath of Jenner. We -Dr. Willan, on Cutaneous Diseases.

37S
We know it will be urged, that men conscious of their own rectitude and usetulness should view with contempt the malice of their inferiors. This is certainly true. But superior abilities are too often attended with a peculiar delicacy of feeling, which is much increased by the perpetual well-meant adulation which by degrees becomes habitual to them. We must therefore consider theL.e inconveniencies as inseparable from the nature of man, and only rejoice that as civilization improves, a sense of decency restrains most of us from the expression of passions which are held in universal abhorrence, and which recoil with tenfold severity on those who indulge them. But to return to our subject. Hie next remedy suggested by Dr. Willan, on the authority of the best practitioners and his own experience, is emetics. ? Of these he speaks in very favourable terms. The subject of gargles is fairly and amply discussed. Tepid bathing and cold affusions are next considered. Again, our author shows the same caution, in recommending the exhibition of bark and wine, but with his usual candour produces all the evidence on each side. For some time past, acids have been considered as the principal remedy in this disease. The number of authorities quoted in their favour exceeds those which have recommended any other remedy excepting bark, against the admission of which, at some periods, many objections occur.
In scarlatina anginosa, acids seem the only remed}' after emetics, <an which our author relies during the early stage of the disease;; and for this same disease Dr. Withering recommends alkalies. We do not find any objection made to acids in scarlatina ijialigna ; the bark and other remedies are said to be necessaTy in other stages and circumstances of the disease: and here again we have a quotation from an author, who describes "universal efflorescence, extremities swelled, foetid ulcers, particularly about the parts of generation, throat swelled, inflamed, often ulcerated, and respiration almost prevented, scorching fever, raging delirium, situation horribly alarming; yet, continues this fortunate-practitioner, in all these variations of the disease, the volatile alkali was my specific., which 1 administered to between two and three hundred patients successively and successfully!" Who e-k&ll decide, &c. However, as Dr. Withering recommends alkalis on account of their diuretic quality, and as acids have this property in common with .them., why should we not insist on a greater attention to the urinary secretion ? lluxham remarks,-that the " urine was often in small quantities;" and in another place, that " if the animal salts are not duly and constantly carried oft by urine, they are highly destructive/"' It is true, he expresses many objections to the use of alakaline salts in this disease, yet this might be owing to the imperfect knowledge of chemistry in those days. But perhaps^ we shall be told that it is more the business of reviewers to attend to the suggestions of others than to offer their own. 'I he rest of this number is occupied in considerations concerning a preservative from the contagion of scarlatina for persons within Dr. Smyth's JLpitomc of Iufahtile Diseases. its influence, and still more concerning the means of preventing the spreading the disease whenever it is found to exist. On this last point we find our author, as usual, veiy full of useful information.
A valuable history is given of the progress of scarlatina in the school at Ackworth, of the inutility of all preservative means from fumigations, or any thing less than a most careful separation, li is highly probable that the economy of this school, like whatever is managed by this class of the English public, is peculiarly exact as to cleanliness and good order. If this is the case, though such a caution may prove the means of keeping out infection, and a complete preservative against typhus fever, it will also render the inhabitants of the seminary more susceptible of effects from a most slightly tainted atmosphere, inasmuch as they are accustomed only to breathe a purer. That such consequences follow from such causes all'analogy teaches us. The impropriety of sending children from school, who are already infected, is warmly insisted on, and Dr. Blackburn's valuable remarks on that subject are properly enforced. Several quotations as well as observations of our author show the progress of infection in certain instances, and the manner hi which it might and ought to have been prevented. Lastly, a few of the clauses concerning quarantine, are quoted, to show that the proposed restrictions are less oppressive than laws which have long since been sanctioned and sumbitted to without murmur. Such is this performance which it is unnecessary we should recommend to our readers. It must find its way into every library, should be carefully perused by every practitioner, and must become a standard authority in ascertaining the true character of the diseases it undertakes to describe. We wait with anxiety but not with impatience for the succeeding numbers, well aware how arduous the undertaking is, and how anxious the author must be to do justice to the reputation he has already acquired. Aware likewise of the readiness with which true merit meets reproof, we take the freedom to hope, that on future occasions we shall see more of the author and less of his authorities. Nothing can be more unsatisfactory than to read accounts of never failing remedies, implying indiscriminate censure on every other practice. Pleased as we may feel with the candour 111 which our author recapitulates what has been done by his predecessors, we should gladly have admitted more decision from one who has enjoyed so many advantages, and improved them so well.
Dr. Smyth's Epitome of Infantile Diseases. 375 derived from the original 'publication, through a wider circle, ani to furnish parents in particular with the fund of practical knowledge which it contains. These, it will be allowed, are motives strong enough to justify the author's undertaking, and the work itself it is presumed will be found a useful compendium of the kind, and worthy of the notice and attention of such persons as may be entrusted with the health of infants. Though the work scarcely extends through eighty pages, there arc no fewer-than sixty-three chapters, each chapter containing a succinct account of the cause, symptoms, and approved treatment of one particular disease. Three new chapters, viz. the forty-fifth, forty-sixth, and sixty-third, on the nettle-rash, the state of the pulse, and the ^stula lachrymalis, are added, and also several notes, chiefly containing results of the translator's practice, together with a copious extract from the works of Dr. Jenner, relating to the cow-pox. Upon the whole, however, this epitome is better calculated for the use and reference of professional students than of common readers, and it may surely be reasonably questioned whether parents in general, or an)' who have not made the profession their study, are qualified to undertake the management of diseases so superficially noticed as they necessarily are, within these narrow limits."; indeed it is evident, had the original work been designed for popular use, it would have been conducted on a very different plan.
As far as the translation goes, there is no doubt but it is faithful; the language is correct and intelligible ; extremely literal ; and in professional treatises, what would we have more ? But when Dr. S. speaks for himself, as he does in his dedication and preface, he cannot be said to have wielded the pen, as it is not to be questioned he wields the pestle, like an experienced general. In the dedication, while he is urging his motives with proper and due solemnity to the President and Fellows of the Royal College, he bursts forth into this sublime and unaccountable phraseology: Dr. Adams's Anszcers to Objections against  ?deed, Mr. Birch writes for the nurseries, which he is so anxious po reclaim, he may probably succeed ; as those foolish' old women _do, who alarm children into good behaviour by stories of hog-goblins. Indeed, from the general tenor of the letter, and particularly from the boldness of the last quotation, we should have considered the whole rather directed to nurses than to the gentleman whose address it bears. After an exordium, in which he expresses his surprise, that the objections to vaccinate should be so frequent in England, though unknown in every other part of the world ; he /comprehends these objections under three general heads.
1st, That the cow-pox is no security against the small-pox. 2dly, That it is only a security for a time ; and, 3dly, That it introduces other humours into the constitution. The first is considered as so completely answered by every concurring fact, as to be now given up by all reasonable people.
That it is only a security for a time is admitted to be urged by a very well intentioned author. But even this Gentleman, it is added, is now " led to believe that vaccination in the hand may be a security for life, though in the arm only for a time." However, the Doctor admits that small-pox may occur after yaccination, without any impeachment of the practice, in one of the three following ways.
1st, By imperfect vaccination. 2dly, By the constitution being under the influence of some other disease at the time of vaccination ; and, Lastly, By the person being liable to the small-pox twice. The first can only be detected by the most accurate examination of the pustule during its whole progress by a person well acquainted with the appearances to be expected. ? For the second, the author refers to those papers published hy Dr. Jenner and himself in our Journal.
That the same person may have small-pox twice, he proves by well authenticated cases, resting on unexceptional authority, and recorded before vaccination was introduced. These he shows were sufficient to convince him, when he published his Morbid Poisons in the year 1795, not only that small-pox might occur 3, second time, but also that a certaiu period would be necessary before the susceptibility to the disease should return. Respecting the last charge of the inoculation of humours from iho cow, Dr. Adams remarks, that it would be absurd ?o suppose no no children had breakings out after vaccination, though it will be found, that by it, many more have been cured of their eruptions. But cutaneous diseases following cow-pox have been always temporary, and ceased without any remedies ; whereas, those which have followed small-pox have been much more serious, and often fatal. This he imputes to the greater violence of the disease in small-pox, and not to any effects from inoculation. To prove this, he shows, that the most dreadful consequences have occurred from the natural-small-pox. But, adds our author, whence can these humours proceed, which are imputed to vaccination ? Is it from the cow, or the person from whom the matter is taken ? If from the latter, we are not likely to fare better under small-pox inoculation ? If from the cow, let us, at least, recollect who are ?the subjects in whom the cow-pox was first discovered, and who receive it, though with less violence, sometimes, two or three times in their life. These are the plump English dairy-maids ! celebrated through the world for their rosy cheeks, their sleek arms, and stout constitutions. This, he adds, may be enough to do away all the nonsense which has beon promulgated about the danger of inoculating humours from an animal, whose milk makes the principal part of our children's food ; whose flesh is the source of old English courage, and whose breath is not only fragrant, but salubrious.
Such are the arguments contained in this pamphlet, which we have endeavoured to compress as much as possible. Those who wish to see them more at large must consult the Tract itself, which concludes with a general advice on the score of our duty to others; that we should no longer continue to inoculate a disease, which may spread by effluvia, when we may not only secure our children without danger to others, but with no hazard and little inconvenience to themselves.
An Appendix is added, giving several well authenticated instances of small-pox after inoculation for that disease.