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restlessness, and even other symptoms, which, under other circum, stances, I would have deemed counter-indications of wine.' --pp. 128-9.
What it has been our anxious effort to prove is, that all such cases constitute the exceptions and not the rule, and that while the exceptions should be studied with as much attention as the rule, such importance only as exceptions ought to have, should be ascribed to them. The rule is, that the general and abstract character of the Fever of this metropolis is excitement, that şuch measures are necessary for its treatment as are opposed to excitement, and it matters not in what climate or constitution, in what stage or under what circumstances, this excitement appears, when it does appear it should be assailed with an energy proportioned in its degree, that those doleful consequences -helpless debility and hopeless disorder—which ever follow it when unsubdued may be effectually avoided. The various remedies which may be employed for this purpose, it is not our intention to detail. To state how often the lancet must be unsheathed, how many leeches must be applied, or how many purgatives must be administered would be entering into minutiæ of no interest here. Our business throughout has been with prominent principles. If they can be settled it will not be difficult to adjust the detail, and those who wish to extend their knowledge into minute statements, will find in the work of Doctor Smith every necessary particular, and to its careful perusal would we earnestly recommend them. Again, let the disciples of Brown produce their facts, their arguments, their cases.
General statements, vehement assertions, abstract deductions will not do: individual descriptions, minute particulars : symptoms of every case from first to last; the daily results of daily treatment in different constitutions at different stages of disease, the circumstances which show the marked evil of early and judicious depletion, contrasted with those which establish the inarked good of early and general stimulation, and, finally, a description of the relative appearances of those who die after such modes of treatment, this is what we ask. Such information has been given on the other side, and it is now again given in the fullest manner in the works of Doctor Smith. Again, those who say to the disciples of the school of Brown, explain it to us, why our bleedings are almost invariably followed by relief, when we are intrusted with the management of the first symptoms ? inform us why the pulse does not sink, why the functions are not weakened, why the powers are not impaired? Tell us why the blood which we draw, is in nine cases out of ten, inflamed, why the pain which we draw it to relieve is in nine cases out of ten relieved, and why, in very
many instances, the symptoms are so moderated after depletion, performed at the proper time and prosecuted to the necessary extent, that little is afterwards left for the physician to do, beyond preserving by prudence the vantage ground which his activity has procured? Explain to us all this, and when your commentary is complete then take it to our dissections, and make it harmonize with all that is there revealed. Make it account for our coagulated lymph, our adhesions, our new membranes, our spreading ulcers, and our loaded vessels. And after you have satisfied yourselves that your harmony is made out, then require of us why we bleed; and if we cannot show cause, we leave you at full liberty to tax our practice as unscientific, and our language as intemperate.
If we are to follow the directions of Doctor Stoker, and never employ our lancet in any case, in any constitution, in any cli, mate, under any circumstance, and by any chance-if we are to look upon leeches as upon lions, with fear and trembling-if we are to regard " disappointment generally, and irreparable injury sometimes, as the result” of free purgation, it is only fair to give us something in the form of argument, with the weight of truth. We maintain that this something of proof and argument has not yet been given. If in the treatment of the Dublin-fever we are to be hedged in by such precautionary death-warnings, be it so ; but we would recommend it to the doctor to watch over the firstlings of his own flock, for in the persons of Mills and Cheyne and a few other unbelieving bleeders, we verily believe him to have wolves in the centre of his own fold. Let his admonitions be directed towards them, and, in as far as in him lies, let him protect the lives of his devoted countrymen from the consequences of their frightful sytem of depletion. As for this metropolis it. must needs, we believe, select its creed from another liturgy, and until the evidence of sense shall cease to outweigh that of testimony, we must not only persevere in heterodoxy, but be per. verse enough to enhance our guilt by endeavouring to conyince others we are right. We must believe that the London-fever requires both leeches and the lancet-that moderate purgation is always necessary and free purging often beneficial--that a total removal of all stimuli from all cases is incomparably safer, as a general rule, than that the lancet is inadmissible in anythat every mean, which Doctor Stoker would employ against an ordinary attack of inflammation, may be employed to a certain extent in the present fever of this metropolis--and the only reason we can advance for the faith that is in us is, that a very similar action is going on in both, and very similar consequences are to be feared from both. The action and consequences of both differ
we believe, principally in degree, and the means necessary to cure both must differ nearly in the same respect. All this we believe in nine cases out of ten, and he, who requires more argument than the limits have suffered us to advance in support of this opinion, has only to consult Doctor Smith's work to procure it. We solicit the attention of the public as well as of the profession to this work. If it advocate error, the error is of such magnitude that it ought to be exposed, and the earnestness and plausibility with which it is advocated arms its intrinsic evil with tenfold mischief. But, if the doctrines it contends for be founded in nature, and be derived from the study of nature, the author merits the reward of a double service-by arriving at important truth amid much popular error, and by laying this truth before the world in a diction, and with a demonstration which most powerfully recommend it to the judgment. It brings forward the opinions of conflicting sects with equal candour and perspicuity—it subjects to the ordeal of reason what experience cannot reach, and it tests with experience what reason has approved—it neither devotes itself to empty speculation on the one hand, nor to abstract dogmatism on the other. Its business is with practical truth. Where novel opinions are hazarded, the arguments which convinced the writer are laid before his reader—where old opinions are impugned, the reasons for objection are fully stated, and whether its theme be the exposure of error or the support of truth, no doctrine, however roughly handled, is condemned by merely brandishing the wand of magisterial authority, and no assertion, however feasible, is suffered to go forth unsustained by evidence. And when the mass of information which the work contains, is considered with relation to the source from which it has been obtained, it can scarcely be said that the inferences to which it arrives are rashly drawn or feebly advocated. The London Fever Hospital has been the principal field of observation. Into this valuable establishment no disease is admissible but fever, and no other hospital exists in the metropolis, which gives indiscriminate admission to this disease. It is obvious, therefore, that if the amplest opportunities for observation can give weight to the results of experience, it is from such an institution that the most authentic knowledge should be looked for. If anything can be certainly known of this pestilence-if seeing it in every form of constitution, in every stage of progress, in every change of atmosphere, and under every variety of cure-if watching it daily and carefully from its commencement to its close, where every medicine can be seasonably prescribed, and every prescription judiciously administered – if attending the sick under the salutary discipline of a rigid police, where every in
jurious influence can be effectually removed, every promising remedy advantageously applied, and every direction implicitly obeyed--a well-conducted hospital for the cure of fever, like the Fever Hospital of London, is the fountain from which the purest information should be found to emanate. Upon such neutral ground nothing may be omitted which it is desirable to do, nor any thing done which it were better to omit. symptom can be carefully traced, every change of symptom instantly noticed, medicines can be exhibited with a precision and surveillance which the ignorance of attendants cannot frustrate, nor the prejudices of the patient counteract. The diseased are thus rescued out of the baneful influences of vulgar prejudices, the disease is rooted up out of its disadvantageous localities, and the constitution is placed upon a vantage ground, which infinitely multiplies the chances of recovery by adding to the efficacy of the remedies employed. Such establishments, when ably conducted and amply endowed, are productive of advantages which can be adequately appreciated only by the poor; but were their usefulness even limited to the important benefit which we have already specified, their value, as schools for the initiation of the profession into the mysteries of fever, were more than a sufficient recompence to the public for the expenses they incur. It appears strange that London, so overgrown, so overpeopled and so obnoxious to fever, should consider a hospital, containing no more than between sixty and seventy beds, sufficiently spacious to answer all the purposes of such a charity; and it must appear stranger still, that this little solitary hospital, which admits
upo wards of six hundred patients annually, and annually expends a sum no greater than two thousand pounds, should be annually obliged to appear as a petitioner before the public, for the means of support. It is a duty which the affluent owe to themselves as well as to the destitute, to place this benevolent institution above the influence of poverty, that the sphere of its usefulness may not be unnecessarily contracted by any pecuniary disabilities for let them be assured that the most effectual mode of preserving their own families from the scourge of fever is to facilitate, by every means in their power, the speedy removal of the destitute poor from their crowded and filthy habitations into the wards of a comfortable and well-conducted hospital.
There still remains one other point connected with the works of Doctor Smith, which it was our intention to have included within the present paper-namely, the subject of contagion as connected with fever ;- but the very great importance of the points in which we have been engaged has tempted us into a miputeness, which was not originally contemplated. We hope, however, at no distant period to take up this question, when we shall attempt to establish two positions the first of which is, that it is 'as much unsettled as it ever was; and, in the second place, that it may be for ever set at rest by some such plan as shall be then detailed.
Arr. XVII.--Le Représentant des Peuples. Hebdomadaire de la Politique
et de la Littérature étrangères. No. I. pp. 36. Ridgway, Piecadilly. IȚ is not easy to translate the title of this weekly publication
into English with conciseness and effect. It is not The Representative of the people ;' for that would be understood as applying to the people of some particular country, or else to the people in all countries, considered in the light in which they may be assumed to form a single aggregate, And to say • The Representative of the peoples,' would not be understood at all. Such, however, is the idiom of the original ; and the unlearned Englishman will have no difficulty in comprehending on being told, that it means the Representative of each of the several peoples' of the civilized world, considered as forming distinct and several aggregates, as they really do in point of fact.
Unlearned Englishmen are at this moment enduring so much suffering, for the folly of their predecessors in allowing themselves to be made a cat's paw for imposing aı bitrary government on foreigners, that they ought to receive with great gratitude any foreigner, who will endeavour to extend the knowledge of the interests which are in common to the people of all coun, tries, and which can never be injured in one without bringing a corresponding harvest of mischief on the others. Let the unlearned Englishman, for example, attend to the struggle which is at this monient carrying on between the people and arbitrary power in France. Let him view a monarch, imposed upon the nation in the same manner as would have happened if the Pretender had been brought to London by a victorious French army ;- let him see him unceasingly persisting in all plans for restoring the power of the supporters of ancient abuses, and insisting, as a preliminary, on the appointment of a ministry composed of men who have been educated in inveterate hostility to the French people, and of deserters from their army,--and above all, let him view the tone and spirit in which the contest is looked on by the friends of arbitrary power at home-their longing hope for the success of the despotism, their insulting language to all that stand up for the people's