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orginal warm and generous love of the yeoman, he even spends his life and dies in the hope of restoring him to his rights. Of the subordinate characters, the two Greek women are drawn with the classical chasteness of a sculptor of antiquity : we well remember all Mr. Godwin's portraits of female loveliness; his women are angels and might have been painted by one; they are unhumanized by a single earthly passion; they are sweetness, they are tenderness, fidelity, beauty, but beauty as cold as moon-beams, and if we love them it is with only a fraternal glow. Such is Irene in Cloudesley, such is Marguerita in St. Leon. Mr. Godwin's character will be a curious subject for the biographer when it comes under critical discussion. He has had the reputation of an incendiary, when he was breathing nothing but brotherly love to all mankind : his moral reputation has been blasted because he was purer in his aims than other men, and when perhaps his main fault has been a want of passion, he has been held as the prophet and precentor of licentiousness. After the beauty and innocence of woman, Mr. Godwin dwells with most delight and success on the beauty and innocence of childhood. Now a day, nothing would seem to gratify this Nestorian author so much, as watching the little ways and registering the little thoughts of the third or fourth generation, whose budding he is spared to witness. Men return in some respects to the state of childhood ; but there is also a time when some men combine the wisdom of age, and the simplicity of infancy.
We had thought of giving a long and touching passage, in which the wicked uncle, as the story of the Children in the Wood would call him, speaks of the infancy and the death of his offspring; but we must refrain, for such an extract, in truth, would be scarcely a fair specimen of a story which moves uniformly and regularly forward to its development, and does not offer any very prominent and striking portions. Enough has been said to invite the reader to the enjoyment of the work itself.
Art. XVI.-1. A Treatise on Fever By Southwood Smith, M.D.
Longman and Co. London. 1830. pp. 436. 2. Pathological Observations on Continued Fever. By W. Stoker,
M. D. Hodges and Co. Dublin. 1829. pp. 267. IN pursuing the Review of the Works of Drs. Smith and
Stoker, we address ourselves as directly to the public in general as to the medical profession. The controversy which now agitates this country upon the subject of Fever, is of equal importance to every class of society, and its issue must be looked for with anxiety by all who value the health and happiness of the community. The property of the country is of some importance, and, by revealing the dangers to which it is exposed, we have, in more instances than one, endeavoured to protect it; but the lives of the public are of still greater consequence, and we are now solicitous to prove our concern for their safety and preservation. Fever is a pestilence, as deadly in its action as it is migratory in its habits; neither rank nor fortune, neither youth nor vigour, can shield from its influence; but the healthy and the young, the helpless and the old, the rich and the poor may be alike its victims; and we can derive no consolation from the belief that this terrible malady is either generally understood or scientifically treated. The arguments about to be urged in the hope of elucidating its real nature can be understood by any person of sense, and, if they are sound, it deeply concerns every one to be acquainted with them. In too many instances the medical practitioner is called upon to perform a mental operation for which his habit and education have but ill prepared him. He has to deduce an inference on the state of diseased organs which are concealed from his observation, by signs which are appreciable by his senses, and there passes not a day in which hundreds of lives do not depend upon the skill with which this mental operation is performed. Now, the important object is to show how these signs can be successfully interpreted in fever, what dreadful consequences follow their misconception, and how easy it is to trace to this single source the rise of almost every controversy upon this subject, whether it refer to the nature or to the treatment of the disease.
In our last number many of these errors were examined with some minuteness, in the present instance it is our purpose to review a few others; and, as the points about to occupy attention are more immediately concerned in the treatment of fever, we are anxious that the public should look with their own eyes into the consequences of the errors we shall endeavour to expose, that they may see the exceeding hazard which their continuance must occasion. Were the extent of disputed territory limited to a few inches or a few feet, the value of conquest might be of little importance; but it is a wide and spacious interval which is the subject of contention. The grand point at issue is not a verbal difference, or a conventional technicality, it is an important practical doctrine. It is whether a disease, which is never absent from our cities and our villages—which
spares no age, nor sex, nor constitution—which comes into our families unseen and unprovided for-which creeps from house to house with noiseless progress, and covers entire countries with death and desolation-it is whether such a monster can be more effectually killed by being starved or fed. Surely this is a wide difference, and merits some consideration. It may be put to the good sense of the public if it can be a matter of no moment whether, in the selfsame disease we bleed and leech and purge; or support and strengthen and excite. These modes of treatment sadly differ, and neither of them is inert.
Each must either effect good or harm-and in many, very many, instances must save or destroy life. If fever be an inflammatory disease, or a disease so akin to inflammation that the difference resolyes itself into a mere matter of degree, it is a serious affair to nurse and fondle it with wine and cordials; and, on the other hand, if it be really a disease of weakness, every one must allow that bleeding, purging and starvation are no children's toys. •To bleed or not to bleed'is a question which, in this instance, can find its counterpart only in the soliloquy of Cato; and if the great national distress, under which we are now labouring, have not induced the public to regard life as less estimable than formerly, 'to be or not to be ought to be their inquiry when fever enters their dwellings, and calls for the interference of the faculty.
In studying this disease the safest ground for the erection of medical doctrine is Pathology. The character of exciting causes may deceive, the nature of existing symptoms may deceive, the peculiarities of the affected constitution may deceive, but it is utterly impossible for the results of disease after death to prove deceptive; they do not change, they cannot be equivocal. During life there may be pain; acute and stinging pain, and this pain may be as far from the seat of action, as it often is from being an honest representative of the nature of this action; but, after death, both the seat and nature of this action inspection will generally disclose. This pain may be moderate or severe, constant or intermittent, alleviated by one remedy, and aggravated by another; yet the same action, and even the same amount of action may be present in all these instances. We may have pain without inflammation, and inflammation without pain ; acute inflammation while the pain is trifling, and triAling inflammation while the pain is acute. Symptoms may be present indicating one stage of action, while the disease, which they indicate, exists in another, and there may be destructive, deadly disease without a symptom or a sign.
If a knowledge of external symptom were sufficient to impart a knowledge of internal action--if like parallel linen the symptom and the action ran, pari passu, in company, so that the extent of the one were the measure of the other, then it would be as easy to pronounce upon the presence and progress of the most insidious malady as to point out the north pole by examining the needle, or to ascertain the direction of the wind by looking at the weather-cock. But it must be admitted that any such comparison is loose, if not inapplicable to every form of disease, and that, as regards fever, it is perfectly fallacious. If the bowels may be inflamed and ulcerated, yet pressure over the affected organs, occasion neither pain nor uneasiness—if the touch of a finger, or the weight of the bed clothes can scarcely be endured over the region of the stomach, in which nothwithstanding there is neither ulcer nor inflammation—if the brain may be floating in water, without any corresponding warrant of disease-if deep and spreading abscess may be lurking within the very organ of sensation, without a warning voice, or yet a whisper, to discover its retreat, who can say that fever
may be taught and treated through its symptoms, or that the language of fever is unequivocal, or even articulately pronounced. If the symptoms which do appear cannot bcentirely depended on, and if important and leading symptoms ought to appear, which are wholly absent, then where is the far-famed light of symptomatologists, the infallible guide to certain treatment? If fever may be dealing destruction on the organs it assails, if it may be preying upon life, and yet if the path of its progress over the constitution can only be traced by the relics it leaves behind, is it not foolish and fruitless to take mere symptoms for our guide ? The experiment has been made, and upon a scale of fearful magnitude; its progress has been patiently observed for many years, it has been variously modified according to the taste of the experimenter, and it has been brought to work upon every form of case, and every type of constitution ; yet discomfiture has been the general result, and it is certain that nothing will, and that nothing can, ever be the result but discomfiture. Amid a sea of such doubts and difficulties the only ground for anchorage is pathology. Practical doctrine can take hold in no other bottom. If rested elsewhere it will yield-it will neither give support nor direction; but if grounded upon this foundation a clue will be found to rescue us out of every labyrinth, and a guide which, by conducting us to the source of evil, will lead us to a plan of cure. When we can have an honest guide, in the name of prudence, why should we choose a faithless one. When we can see into the very arcana of the real and inward action, why should we still regard only what is a mere
consequence of this inward action. A heated skin, an excited thirst, a general malaise restlessness during the day, and sleeplessness during the night, are not the constitutional elements of fever. These are not what we have to physic, and what we have to fear, any more than the vane at the mast-head is what the sailor dreads when the wind and the thunder-clouds foretell the storm. No man
ever yet died of symptoms, no man ever can die of symptoms, and if fever be only a congregation of symptoms, then no man has ever yet died of fever.
If it be found upon inspection after death that vessels are gorged with blood, tissues are altered in structure, organs are inflamed, that pus and lymph, ulceration and effusion, and in a word, all the ordinary results of a disease which must during life have possessed some activity, and been characterised by some excitement, can there remain ground for doubt as to what fever is, or as to the general principles by which its treatment should be conducted ? These fruits of action are accents of disease which it is neither difficult to hear, nor, when heard, to understand. Many external signs may not, but these internal monitors must, exist; not all in every case, nor always to the same extent; but some of them do invariably exist in the present fever of this country, and each of them is decisive of the same truth which all, if present, could do nothing more than confirm. Feeling earnestly, because knowing that fever has not been generally studied under this view, and that the neglect, if not contempt of pathology has been the chief cause of the errors with which its history is observed, we are anxious to obtain from those who support opposite opinions, the results of their pathological information. If it be, that fever is weakness, that weakness stands in need of wine, and that wine cures by infusing strength; then let them adduce the proof in the fruits of fever as they are exhibited after death. 'Let us see the operations of this monster debility upon
he invades. Let us see fluids dissolved and watery, solids relaxed and putrid, a vascular system paralyzed and powerless, and that general atomy which indicates privation of strength. Let it be shown that no product of activity is met with; that we never find gorged veins, nor loaded arteries, coagulated lymph, nor extravasated serum, structures thickened by new deposits, membranes freshly formed, nor ulcers in all stages of progress. Let all this be shown, and then these symptoms, which may be adduced in favour of debility, will prove something. No indications of weakness, which symptoms alone may exhibit, entitle us to characterise fever as a disease