In respect then to my theory of the disease, and the practice founded upon it, I believe the gentleman will find that, by steadily examining the nature of the one, and the result of the other, he will be agreeably surprised to find simplicity take the place of former confusion, and success of disappointment. I wish the gentleman to understand that it is upon previous rational theory that I conceive it to be possible to establish scientific practice. It is not by wild hypothetical flights, which some men call reasoning, that we are to expect any immediate practical advantage. Hypotheses are less definite than theory, and are, in all instances, the first operation of our minds in the investigation of difficulties in science. Hypothesis, therefore, ought to exist no longer than we can possibly transform it into theory. On this we must build our practice, and this practice will be successful or otherwise in propor tion as we have theorised.

I have no hesitation in asserting, that, previous to the very little I have written on this subject in the works above alluded to, no theory of any kind existed respecting this disease. What was said about it amounted, at least to the thinking part of the community, to very little. The disease. was never till then considered in its first stage, when effusion had not yet taken place, and when alone it was remediable. We do not hesitate to blame any one for allow ing every variety of the most fatal complaints, such as fevers, &c. &c. to go on unchecked till the last stages, and then most feelingly pronounce the disease to be incurable, which in almost every instance could be easily removed by attention to their early stages. Though, however, we do not approve of this, we silently allow the most precious moments to elapse in the disease in question, and when it is really incurable we take, to ourselves the merit of saying so, Nevertheless, not only for this, but, as in No. 131 of this Journal, for my making an attempt to improve the reasoning and practice, in a disease acknowledged by every one, and even by the gentleman himself, to be incurable, I am found fault with.

With regard to the opinion either of the public at large, or any individual of it, in respect to any point in my profession, I pay them equal deference, and hold them in the very highest respect when I conceive it to be right. But when the whole or any individual of it, however high he may stand in the estimation of the world, advances opinions which seem to me erroneous, I never hesitate to state my objections, and, if possible, propose something which I

Q 3

think

think less objectionable. Names I regard not in such matters, nor shall they ever deter me from the investigation of any point. Neither do I wish or expect that they shall either influence or deter others from making the freest and most liberal remarks on any opinions I may have or shall hereafter advance. Names are the stumbling blocks of all improvement, and their influence is always directly in proportion to our want of real knowledge.

I shall then be happy to hear the unbiased opinions of scientific men on any or every opinion I may make public, and, if objected to, 1 shall either openly confess myself in the fault, or, in the same open manner, I pledge myself to defend the doctrines I have espoused or may yet espouse. In the mean time, when your Correspondent has attentively consulted the works I have named, I shall be glad to hear his further observations.

Another paper appeared in your Journal some time previous to the one I have alluded to, but as I have not the Journal at hand at present, I do not recollect either the author's name or in what number it was inserted. The gentlemen seem acquainted with each other; and as the objections there stated were of nearly the same nature as those I have now alluded to, the same answer will do for both. I am, &c.

Princes Street, July 23, 1810.

JOHN ROBERTON.

ON THE DANGER OF CURING CERTAIN DISEASES.

(In Continuation.)

A Young officer, of a hot and sanguine temperament,

who, during a long sea voyage had the itch, produced by the gross and salted provisions he was obliged to subsist on, upon his coming on shore rubbed himself with some. ointment, whose composition I was ignorant of; the itch disappeared, but he was dangerously ill a long time, vomiting up every thing he took, whether solid or fluid; he was troubled also with a constant hiccough and cardialgia; these symptoms were attended by sleepless nights, want of appetite, slow fever, &c. He returned home in this state, and by means of fomentations, of anodynes, of mild purges, and afterwards of baths, he entirely recovered his former health.

A young lady, in the seventh month of her pregnancy, consulted me on account of an eruption which itched a

great

great deal, and occasioned her sleepless nights, without any other inconvenience; I directed her to lose blood and take some cooling drinks, advised a mild and cooling regimen, and desired her to wait patiently for her accouchement, which would certainly cure her of her malady, unless it depended upon some particular cause, and I explained myself no further. The eruption resisted all the remedies I had prescribed, and the lady, impatient to be rid of it, rubbed herself, by the advice of some women, with an ointment sold in the shops as a specific for the itch. The eruption in a few days entirely disappeared, but it was followed by a hard painful tumour, the size of a walnut, within the labia pudendi, just above the meatus urinarius. I was sent for to her, and having heard this account, I did not for a moment doubt the itch having been venereal, and that her husband had communicated it to her. I mentioned this, and he confessed to me his former irregularities, and begged of me to do every thing in my power to cure his wife.

The case was too urgent to wait for the accouchement of this lady, more especially, as a few days after the appearance of the tumour, she was troubled with warts about the anus, so that she could not sit down without great pain, and she voided her urine with difficulty. I determined therefore immediately, notwithstanding her advanced pregnancy, to employ mercurial frictions; having made her lose blood, I ordered her to rub in half a drachm of ointment, containing a third part of mercury; on the following day but one I made it stronger, and thus continued increasing the dose gradually to two drachms, every other day for a mouth, at the end of which time she was delivered of a fine boy, perfectly healthy, and who during five years has not suffered the least inconvenience. The mother had a good getting up; the warts and tumours left her as soon as she was delivered. However, as she had used only three ounces of ointment, we thought it more safe to recur to the frictions after her confinement. perfectly recovered her health, and from that time has felt no other inconvenience but what is common to pregnant women, having since borne several fine strong child-, ren. Her husband, after her recovery, was treated in the same manner, and perfectly cured.

She

The first case is a clear example of the itch arising from an internal cause, produced solely from a vitiation in the humours, brought on by the grossness and bad quality of the food and of the air; in the other, the itch also arose

from a vitiation of the humours, by an extraneous poison, and was symptomatic, and from the nature of its cause may be said to be venereal.

We see in both instances how dangerous it is to attack the disease, and to repel it inwardly by topical applications, before we have removed the internal source of it, which is also confirmed by several examples related by authors.

I knew, says Zacutus Lusitanus, a man of a bad habit of body, who was subject on the approach of spring to an itch, which nature at that time threw out; he anointed himself with a composition of cerusse and litharge, and having by these means repelled the humour, or salutary evacuation, he was seized in the night with a violent dyspnoea, and died.

Amatus Lusitanus relates, that a young Florentine, seeing his body covered over with a filthy itch, would, in spite of the advice of his physicians, anoint himself with a composition containing a small quantity of arsenic, and the next day his servants found him dead in his bed.

The learned Gregoire Horstius makes mention of a young student living at a taylor's, who was attacked with an itch, and being willing to free himself from it, he anointed his skin, without having first used internal remedies; the night after he was seized with epileptic fits, on which account he was called to him with another of his colleagues; they employed the usual remedies, and hẹ recovered.

Daniel Sennert relates the history of a student, in whom the itch was driven inwardly, who was blind for two days; afterwards he had a violent oppression and tightness in the breast, and voided urine of a very black colour, of which symptoms he was relieved by medicines which caused the itch to reappear; he particularises none of them but fumitory. The same person, three months afterwards, became ill again, without, however, losing his sight, but he was attacked with epilepsy, which was cured by the usual remedies.

The same author says also, that he knew many persons attacked with pains in the chest, with pleurisy, and many other disorders from a repelled itch, particularly a youth of 14 years, who having used some kind of ointment for the cure of an itch, passed black urine, was deprived of sight, and seized with epileptic fits, which frequently returning, at length put an end to his life.

What must be done then to free us from a disease which,

besides

besides being so troublesome, obliges us to avoid company, and deprive ourselves of the pleasure of society?

I answer, that in order to proceed safely and securely, we must keep in view the four distinct species of itch, which we find in practice, always observing the greatest circumspection, and must never employ external remedies too hastily to drive in the eruption, for the most fatal consequences, as we have seen, are produced by such methods.

We sometimes find in old people such a violent itching takes place, that it cannot be borne, without scratching to that degree as to rub off the skin and fetch blood; it would not be proper to give the name of itch to this complaint, for it is rarely accompanied by pustules; the skin is generally dry, wrinkled, rough, and covered over with small points scarcely perceptible, resembling in some measure shagreen. If in old age they do not experience this inconvenience, they will have some other, equally or even more troublesome; as ardor urinæ, inflamed eyes, or bleared or weeping eyes, or a frequent obstinate cough, sometimes dry, and at other times attended with expectoration of thick, yellowish, or greenish matter. These are the four usual complaints of old age; they are seldom all present at one time, but generally some one or other of them, and they all depend upon the same cause. In short, as we grow old our fibres become hard, dry and stiff, almost cartilaginous, and even nearly ossified; they are deprived by degrees of that soft, bland, lubricating fluid which renders them supple, facilitates their motion, and prevents the stiffness and rigidity of the solids, as well internally as externally.

The humours also, at the same time, become vitiated; they daily lose their bland and softening properties, they dry up, become more saline and thicker, because their motion through the vessels is slower, from the want of power in these to circulate them so freely as before. The fluids then rendered saline, and deprived of their mild qualities, slowly circulated through the solids, in some manner become stagnant, and produce an irritation which causes the itching, the ardor urine, the inflamed eyelids, or the cough and expectoration, according to the state of the part, or the effect the vitiation of the blood or lymph produces upon the fluid contained in it, or separated therefrom by it."

A young physician, when he is called to a patient who iş ill from a repelled itch, must immediately determine if it