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where he was induced to consider it (as Hales, Haller, and others had done) as the cementing principle, or the bond of union between the insensible particles of bodies; yet, from a plausible analogy, founded on the observations of voyagers, as well as on philosophical experiments, he was led to a falutary application of this substance, in the cure of the sea fcurvy, considered as a putrid disease, originating froin the want of this antiseptic principle in the food of seafaring perfons. He considered that this defect might be most commodiously supplied by the exhibition of malt, or other portable substitutes for frei vegetables'; which are known to abound in this principle, and at the fame time to effect a fpeedy cure in this disease, independent of their peculiar qualities; whenever the scorbutic had the good fortune to reach land, though even in the last stage of the distemper. :
Afterwards, when the method of impregnating water with fixed air was difcovered, the medical application of this substance was still farther extended, and to cases of a very different nature. It was not only considered as a remedy for all diseases of a putrid kind; but likewise, in consequence of its acid quality, as a solvent for calculous concretions, or the stone; particularly by Dr. Percival, and Dr. Saunders. The Author of the present Commentary, actuated by a laudable spirit of improvement, has peculiarly attended to this new subject of the Materia Medica ; and has here given us not only the results of his trials in the diseases abovementioned, but in others likewise, in which he was led, by analogy, to administer it.
The different methods by which fixed air may be admitted into the system are either by exhibiting, 1. The natural mineral waters, such as those of Spa, Pyrmont, Seltzer, &c. that are known to contain it :-2. Water artificially impregnated with it, in the different manners described by Dr. Priestley, Dr. Nooth, the Duke de Chaulnes, and others :-3. Solutions of mild alcaline salts, from which the fixed air that they naturally contain is expelled, by adding a proper quantity of lemon juice, or other acid, at, or immediately after, the time of drinking them; in the manner proposed by Dr. Hulme :-4. Wort, or other vegetable and saccharine infusions, qualified to generate fixed air in the stomach and primæ viæ; as recommended by Dr. Macbride :-- 5. Solutions of alcaline salts, previously neutralifed, or even acidulated, or supersaturated, by fixed air, or the mephitic acid; as proposed by Mr. Bewly.-These laft may either be taken fingly, on an expectation that they may be decompounded in the stomach; or, in some cases, pombly 'to more advantage, a part of the large quantity of fixed air, with which they have been superfaturated, may be expelled from
them, by a subsequent draught of any acid liquor :-6. Clyf'ters of fimple fixed air, as recommended by Dr. Priestley :-of,
in whe different are either of Spa, Pyrmartificially pimientaley, D
-7. The same fuid externally applied, to the Jungs, for instance, in inspiration, or to other parts morbidly affected, by means of a proper apparatus; as hath been practised by Dr. Rotheram, Mr. Hey, Dr. Warren of Taunton, and Dr. Percival.
The Author commences his work with an account of some experiments, made with a view to ascertain the quantity of fixed air contained in fixed and volatile alcalis, and in chalk; by expelling it from them, by means of vitriolic, acid added to them, in a large and tall vial. He found that two drachms of salt of tartar contained 28 grains of fixed air; the same quan tity of volatile sal ammoniac contained 48 grains; and the same quantity of chalk contained 42 grains.
The diseases, in the treatment of which the Author gives us the result of his own experience, respecting the administration of fixed air, as well as that of some of his medical correspondents, are, -Putrid fevers, small-pox and measles attended with symptoms of malignancy, gangrene, ulcerous sore throat, sea scurvy, cachexies and phagedenic ulcers, and the stone and gravel. He relates the various cases fimply, without shewing any attachment to mere hypothesis ; drawing no other inferences from the successful events which occurred, than such as appear to be justly deducible from each case respectively. With regard to the cases, we must refer the reader to the work; confining ourselves, for the most part, to general observations..
Under the head of putrid fevers, in which four cases are related, the Author declares that he has directed fixed air, both in hospital and private practice, for a variety of patients, in fevers attended with symptoms of putrefaction, and with success. In the fourth care, in particular, a train of very alarming symptoms, attending a putrid diarrhoea, appears to have been removed in the space of thirty hours, by means of quickly. repeated doses of salt of tartar and lemon-juice given in the state of effervescence. Some bad cases follow of the confluent small-pox, gangrene, and putrid sore throat; in some of which the same method was successfully pursued : in others, the alcali, first neutralised, or supersaturated with the mephitic acid, was em ployed. In the putrid sore throat, evident benefit was obtained by the topical application, or inspiration of fixed air, expelled from chalk by oil of vitriol. .
In a case of this last kind, related by Dr. Haygarth, a judicious hint occurs, respecting the exhibition of strong wort, as an antiseptic; and which consiits in exciting a commencement of the fermentatory process, by adding a tea-spoonful of yeast · to a pint of it, and placing it near the fire about an hour bea. fore it is administered. Dr. Haygarth apprehends that, with out such'addicion, the spontaneous change of wort is into an acetous state, by which very little fixed air is evolved.'' T 2
In the case of pulmonary consumptions, the Author has not met with one instance, in his own practice, in which the patient recovered by the use of fixed air, when the disease originated from tubercles : but in cases of abscess in the lungs, whether from peripneumony, or accidental injury, he has seen very falutary effects from fixed air ; two instances of which he relates. '
We cannot, a priori, conceive any diseafe more likely to be removed or relieved by the ufe of fixed air, than the true fea fcurvy; had we even no other foundation for such an opinion than the observation that it peculiarly, though not indeed exclusively, affects seafaring persons; who from their situationi, as we have already in part observed, are deprived of such vegetable and fresh animal food as is adapted to generate fixed air ; and that a cure almost invariably ensues, when they have an opportunity of eating food that abounds in that antiseptic principle.
On this head, the Author briefly relates his own success in the exhibition of fixed air in this disease, particularly among the seamen at Liverpool ; as likewise two extraordinary cafes communicated by Mr. Dawson, in which the cure was effected by the mephitic julep, or fixed alcali neutralised by the mephitic acid: but as the Author had been favoured with a letter on the subject, from the late Dr, Macbride, the ingenious proposer of the method of curing this disease by the use of wort, and which contains the present state of the evidence with respect to its efficacy; we fail transcribe from it some of his last words on this important subject.
Dr. Macbride first mentions the favourable accounts of the efficacy of the wort experienced in the trials made of it at sea, in his Majesty's ship Yafon, and in the Nottingham East-Indiaman, in ten cases formerly published. He next takes notice of the success attending the exhibition of the wort on board the Queen East-Indiaman; and of the abstract of the journals delivered in at the Admiralty-office, by the surgeons of the Dolphin, Swallow, and Endeavour ; and of a remarkable hilory, communicated by Dr. Fothergill, in which the efficacy of the wort was very confpicuous. A short account of these trials was published in the Appendix to his Methodical Introduction to the Theory and Practice of Phyfic. He then adds :
« Since the time of the laft-mentioned publication, I have received the journal of Mr. Skiddy, furgeon of the Intrepid man of war, on a voyage to India, in 1772; and that of Mr. Patten, surgeon of the Refolution, during her late voyage to the Southern Hemisphere, of which we have the twofold history, by Capt. Cook and Mr. Forster.
« Mr. Skiddy gives a very distinct account of about twenty scorbutic patients, though he says there was more than double that number on his fick lift. It appears that the ship was but scantily provided with water, and for that reason he could not afford more than two quarts in the day of the infusion, to such of the fick as stood most in need of it, and three pints to those whose distreffes were less urgent. Only two patients of the whole number could be said to recover, while the fhip contia nued ar fea; but all of them were kept alive, and in most, then progress of the disease appears to have been retarded.
. With respect to the success of the wort on board the Re. solucion, the Public is already pretty well informed, from the two histories of the voyages already mentioned, and from Sir John Pringle's discourse annexed to Capt. Cook's account. But the surgeon's journal, in my pofleflion, is still more exo' plicit and satisfactory; for whereas Capt..Cook makes a doubt whether the wort will cure the scurvy in an advanced ftate, at fea; the cases in Mr. Patten's journal demonstrate that it will; and he expresses his opinion, that the wort (if the malt be sound, and the infusion properly prepared) will seldom fail to . accomplish a cure, even though the ship should happen to be kept out at lea; and he thinks that when it has failed, the disappointment has been owing, either to the unsoundness of the malt, inattention with respect to preparing the infusion, or not administering it in sufficient quantity. There will, no doubt, however, sometimes occur such an untoward combination of severe weather, scarcity of water, bad provisions, and a crowded thip, that even the most approved antiscorbutics, if they were to be had, muft fall short of their usual effects : as seems to have been the case on board the Swallow, in her pas. sage across the Pacific Ocean; and in the Talbot East Indiaman, according to Mr. Clark's account, in his book entitled, Observations on the Diseases in long Voyages, to hot Climates."
For reasons which will quickly appear, we shall quote one paslage more from this letter of Dr. Macbride's to the Author. Alluding to the ten cases referred to above, that late ingenious philosopher, and physician thus feelingly expresses himself:
6 I did imagine that these cases (lix of which are sufficiently conclusive in favour of the wort) would have gone near to establish the credit of the male infusion as an antiscorbutic; but my expectations, it seems, were rather tno sanguine; since I find they did not serve to convince the person whom of all others I could have withed to be convinced, namely, Dr. Lind; who still continues to pronounce,that it is not probable a remedy for the scurvy will ever be discovered from a preconceived bypothesis, or by speculative men in the closet.'-And he complains moreover of the mischief done by an attachinent to de la five
theories.' See the preface to the third edition of his Treatise on the Scurvy. : We cannot avoid stopping to express our surprize at such an observation as the foregoing, proceeding from fo intelligent a practitioner. An attachment indeed to delufive theories is certainly not to be defended : But how is the art of physic to be improved, or new methods of curing diseases to be discovered ? Surely not by merely exhibiting untried substances at random; or without soine preconceived hypothesis ; or, in other words, without reasoning on the sensible and more obvious qualities of bodies, or those other properties discoverable by the aid of chemistry, and applying that knowledge to the æconomy of the human system.
With respecć to Dr. Macbride's application of the doctrine of fixed air to the cure of the sea scurvy, Dr. Lind's observaiion is ftill further particularly exceptionable : as the efficacy of the wort in the cure, or in the mitigation of the symptoms, of that disease was not then a subject of mere speculation ; but had becn rendered very probable by the results of the trials that. had even then been made of it.-In fact, the practical tannes might with equal justice authoritatively pronounce on the improbability of improving the tanning art · from a preconceived hypothesis,' or by speculative men in the closet;' and yet, as we lately had an opportunity to thew *, Dr. Macbride has invented not merely a speculative but a practical improvement in a branch of that art, in consequence of speculations of a similar kind to the present...
In a matter of such great importance to the Public, we have thought proper to bear our teftimony against this unedifying ard disheartening observation of Dr. Lind's; which tends, as far as mere authority can go, to discourage all designed improvements in the art of medicine, though founded on the justest seasonings, or deduced from the most plausible analogy: and which would induce us to rest with our arms folded, and our eyes shut, content with our present inadequate resources; till Dame Fortune, in one of her liberal moods, shall condescend, in her own good time, to throw a remedy unexpectedly at our feet.
Soon after we had written the foregoing remarks, a paper contained in the volume of the Philosophical Transactions just publithed, fell under our obfervation : and though the speaking of it in this place may seem premature, the contents of it are so very appofite to the present subject, that we cannot avoid anticipating, in part, our Review of that Article, by giving one quotation from it peculiarly applicable to the present question. Dr. Lind will there see that the “ fpeculative men in the clo
See our Review for June laft, P: 419::