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AKT. XVL-Prectical Observations concerning Sea-Bathing. To which are added, Remarks on the Use of the Warm Bath. By A. P. BUCHAN, M. D. of the Royal College of Physicians, London. 8vo. pp. 220.

WHEN persons advance to a certain stage of refinement, one of their most serious occupations becomes that of taking care of their health: their delicacy of constitution renders them obnoxious to a number of real evils; and what is worse than these, they are harassed by a train of fancied ills, the never-failing attendants upon indolence and luxury. A change of residence is one of the most usual methods resorted to, for the purpose of counteracting those sensations of ennui which so frequently assail this description of invalids; and of late years the custom has been adopted of directing their periodical excursions to the sca-side. Though these migrations must, for the most part, be attributed to the influence of fashion, and are frequently carried to a ridiculous excess, yet, upon the whole, it must be acknowledged that the custom is salutary, at least it ought to be regarded as one of the most innocent species of dissipation. At all events, considering how extensively it is practised, we think the author of this volume merits the thanks of the public for having undertaken to lay down in a popular manner some directions for seabathing, and the precautions necessary to be observed respecting its use. It is at present had recourse to so indiscriminately, that it must, in many cases, prove prejudicial; no one can doubt of its frequently proving of the highest utility; but whatever is capable of doing much good, may, if improperly applied, do much harm.

The work is divided into two parts: in the first the effects of sea-bathing upon the general health are considered, and in the second its effects in the cure of specific diseases. The author begins by describing the changes produced in the system by suddenly plunging into cold water, and afterwards those which ensue by remaining immersed in it for a greater length of time. The respiration is found to be more laborious, a circumstance which is attributed to the weight of the water pressing upon the thorax, while the convulsive panting is thought to depend upon the cold being applied to the region of the diaphragm while the body is in the state of half-immersion. We cannot, however, altogether coincide in this last opinion; we believe the same kind of panting occurs, when the legs and thighs

only are suddenly immersed in cold water, or if it be thrown over the body from a bucket or the shower-bath. The effect produced upon the pulse seems not to be accurately ascertained; Dr. Currie has found it to be accelerated, but the contrary effect has been noticed by our author, as well as by some other experimentalists. The fact may probably differ in different constitutions. It is well known that after leaving the water, an agreeable glow is generally diffused over the surface; this is attended with a sensation of heat, but according to the observation of Dr. Buchan,. the absolute heat of the body is not raised. The sensation is attributed to the body becoming more sensible to the accustomed warmth of the atmosphere, after having been kept for some time at a lower tem-, perature, in the same manner as the hands, after being plunged in snow, will be warmed by washing them in water only a few degrees above the freezing point, The energy which is thus produced by a temporary abstraction of the accustomed stimuli, if not pushed to too great an extent, is found to increase the permanent vigour of the constitution; and upon this principle may the beneficial effects of the cold bath be, in part at least, explained.

The great evil of the British climate is the variableness of its temperature, and it becomes of course desirable to employ every means to inure the body to these changes. The excessive care which is. taken by persons in the higher ranks, to exclude the access of cold, only tends to make them more apt to suffer from its effects upon those accidental exposures to it, from which no caution can effectually

ensure them.

The modern refinement of constructing houses so as, by means of double doors and windows, almost wholly to exclude the external air; the thick covering which we spread upon the floors of our chambers; and the heating of them by close stoves, with narrow chimneys; are in direct opposition to the doctrine I am now endeavouring to inculcate. But is disease less frequent? Is catarrh more rare, or consumption less fatal? In vain do the delicate accumulate defences against the vicissitudes of external temperature. Those who never tread but on carpets, and take

of heaven from blowing on them, are more every precaution to prevent the breath liable to be disordered by the impression of cold, than the laborious peasant, or the sea

man daily exposed to the rage of storms and tempests. The occasional use of the cold bath, by inuring the body to a wider range of temperature, teuds to diminish the danger of those sudden transitions from heat to cold, and the contrary; which, in the common tenor of life, it is impossible wholly to avoid. After having bathed in the sea during a few weeks in autumn, I have observed, with respect to myself, as well as in many other instances, that persons prone to catarrhal affections are much less susceptible of them during the ensuing winter. One general effect of the cold bath being unquestionably to induce nominated hardiness, and which may be defined, that state of the living system which is least liable to be affected by disagreeable impressions."

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Our author afterwards notices the beneficial effects which the use of cold bathing appears to have over the state of the perspiration. If the body be uniformly kept in a high temperature, the slightest diminution of the heat will cause the perspiration to be impeded, and will bring on that train of complaints that are usually conceived to arise from this cause; whereas, by inuring the skin to a lower temperature, welcome, in the manner explained above, less apt to suffer from those necessary exposures to cold which must occur in our climate. Upon this principle the indiscriminate use of flannel, as worn next the body, is condemned, perhaps with some justice, though it is a practice to which, in many instances, we feel much attached.

We have next some directions respecting the time and manner of bathing; the author properly cautions those who have been debilitated by the immediate effects of intoxication or bodily fatigue, from going into the water until they have recovered from this state; and he especially advises the ladies "who indulge in the evening ball, to abstain from the morning bath." We have some remarks upon the specific effects of sea-water as applied to the skin; it certainly differs from fresh water of the same temperature; it is more invigorating, and less apt to produce catarrhal affections.

After these general observations, the author proceeds to offer some remarks upon the different diseases for which seabathing has been recommended. Of these, scrofula appears by general experience to be the chief; it seems to originate in cold and want of proper nutrition. The effects of cold, as we have seen above, are best obviated by bathing; the defect of nutrition is obviously to be removed by a suitable attention to diet. Chincough in its latter stages, chorea, hysteria, indigestion, and hypochondriasis, are among those diseases in which the advantage of sea-bathing is the most firmly established. There are some complaints in which this practice is absolutely injurious; of these the principal are all fevers with topical inflammation; erysipelas also appears to be much aggravated by it, and many cutaneous disorders. Upon the whole, it is a practice more suited to youth than to old age, and should not be had recourse to in the latter part of life without due precaution. The internal use of sea-water has been found beneficial in ascarides and other species of worms, and may be advantageously employed in some cutaneous complaints, although applied externally it has appeared hurtful. The work concludes with some remarks upon the warm bath; when employed at a temperature a few degrees below that of the human body, our author conceives it to be not merely an innocent, but a salutary gratification, The idea of its relaxing effects he combats as a vulgar prejudice, and endeavours to shew that it originated from the excessive height to which this huxury was carried in the latter stages of the Roman empire. The moderate use of the warm bath would probably prove highly useful in the debility arising from old age, in atrophy, in feverish complaints attended with an irritability of the nervous system, in gost, rheumatism, and palsy, and in hectie. Upon the whole this performance, although not in the highest rank of literar productions, contains much useful information, conveyed in simple and easy language.

ART. XVII-A Treatise on the Lues Borilla, or Cow-Por. By BENJAMIN MOSFLET, M. D. Author of a Treatise on Tropical Diseases; of a Treatise on Coffee; and of Ales dical Tracts, Containing Dissertations on Sugar; on the Yaws; on Obi, or Arican Witchcraft; on the Plague, and Yellow Fever of America; on Hospitals; on Broncke cele; on Prisons, &c. Physician to the Royal Military Hospital at Chelsea, Member of the College of Physicians of London, of the University of Leyden, of the American Pholosophical Society át Philadelphia, &c.

IN our last volume we noticed, with a degree of concern, the opposition that hai

been made to the vaccine inoculation. The objections, however, appeared to us to be so completely answered, that we hoped the public opinion would have been finally settled, and that no farther interruption would have occurred to the progress of a practice which promised to be so decidedly beneficial. It is therefore with great regret that we have to encounter in the course of our present labours a far weightier load of hostility, advanced not in the form of candid investigation (for this we can never condemn), but in the shape of coarse invective and vulgar humour; invective against those who stepped forward in support of a practice which they esteemed important to the welfare of mankind, and humour bestowed upon a subject in which mirth is misplaced and totally irrelevant.

The author of the treatise before us is not unknown in the literary world, and he has justly acquired a degree of reputa tion by his former productions. But of the present performance we feel ourselves obliged to speak in terms of the severest reprehension, not merely in consequence of our entertaining a different opinion from the author concerning the point in dispute, but from the highly indecorous manner in which the subject is treated. Dr. Moseley begins by informing us, that when the question respecting the cow-pox was first brought before the public, he formed an opinion that,

Experience is not necessary to know the cow-pox cannot be a preventive of the small-pox. For, on the principles of pathology, and analogy; from the laws of the animal economy, and the want of reciprocity between the two diseases, it is impossible to believe, without an entire subversion of our reason, that either should render the human frame unsusceptible of the other."

There is at least a degree of candour in thus coming forward, and declaring that he was determined not to be convinced; but to an opinion formed under such a determination we can attach but little value. We may venture to assert, without being liable to the imputation of that want of candour which we ascribe to our author, that we ought to receive with great distrust all facts brought forward by so prejudiced an advocate.

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tion mania seized the people of England en

masse.

"It broke out in the month of April,-like a symptomatic eruption of nature; the planet Mercury-the delusive author of vain and fond imaginations,' being then in the zodia cal sign of the Bull.

"It increased as the days lengthened; and at midsuminer large societies, of the medical profession which was first attacked, were distempered to an intolerable degree.

"While some members of these distin

guished bodies were absorbed in deep study, tients, the mania stole upon them, taking ad and intense thought, for the good of their pavantage of the absence of their intellects.

"These medical orbs, fixed fast in their firmament, were not known to have had any motion, for the last twenty years. Now they suddenly advanced; left their proper centre of gravity; and surprised the gazing world.

"Nothing but what I have mentioned had happened, either in the moral or physical order of things, as præcursor to so extraordiin former years. The sea continued to be nary an event. Effects succeeded causes, as green, and salt; and the Thames flowed down to it as usual.

"The higher ranks of every description were soon infected by the doctors, who set the example with a spirit worthy of the agricultural society, by experimenting their own flock.

"The philanthropist, the calculator, and statesman, were all captivated with the notion, that millions of lives would be saved annually: slaughter, need to stand still for want of by which means, neither manufacture, nor

hands.

"The tender parent was pleasantly irritated with the amiable insanity. It promised to remove all cares from the nursery; to mend the race of beauty; and to chase a loathsome disease, and with it ugliness and deformity, from the face of the earth.

"The doctors renounced all discussion, concerning the right of parents, to take what liberties they pleased with their infants; whose sympathies and antipathies, as they cannot be known, they determined to be proper objects for experiment."

The author immediately began his attack, "being satisfied," before any trials had been made," that the cow-pox had no affinity to the small-pox." În conformity with this spirit he published a philippic against vaccination in the year is inserted at full length in the present 1799, amongst his medical tracts, which volume; and when examined before the house of commons with respect to Dr. Jenner's claim to a parliamentary reward, he was almost the only person who did not give the measure his concurrence. "In the year 1798 the cow-pox inocula- About thirty pages of the work are occu

The style of the work is so singular, that we shall present our readers with a specimen, and for this purpose shall select

the commencement.

pied with the evidence which was given by himself and the other medical gentlemen upon the occasion; we are somewhat at a loss to know for what purpose he inserted in this place what the public were so perfectly familiar with before. We have afterwards an account of the establishment of the different cow-pox institutions in London, lists of their officers, and transcripts of some of their advertisements and reports.

We shall not pretend to follow Dr. Moseley through his whole train of declamation, but we shall select for our consideration all that can in any way be deemed argumentative. Three different allegations are brought forward against the cow-pox; first, that it is not a perfect security against the small-pox; secondly, that the cow-pox is a dangerous and loathsome disease; and thirdly, that the cow-pox can never succeed in exterminating the small-pox. On the first two points he brings forward a number of cases, detailed with more or less accuracy, in which either small-pox has succeeded to vaccination, or in which the vaccine disease has appeared to be followed by loathsome cutaneous complaints, or by an injury to the general health. In many of the cases there is a palpable want of evidence, in others we confess we do not discover any deficiency; but we make no scruple of declaring, that we look with a degree of mistrust upon all facts adduced by Dr. Moseley on the subject of cowpox. He appears to entertain the idea that the vaccination only suspends for a limited period the action of the variolous contagion; and intimates, in support of his opinion, that it is in like manner suspended by other diseases. Whatever may be the ultimate decision of "this question, our readers would scarcely expect to meet with the following unqualified assertion:

"The cow-pox possesses no more specific power to resist the small-pox, than the scald-head; or a violent state of the itch; or the yaws; or the leprosy; or the pustule maligne; or the temporary influence of any morbid inoculation from diseased animals; or the bites of venomous creatures; or wounds, that dissecters of dead bodies sometimes accidentally give themselves. With these may be included other febrile, eruptive, and cutaneous disorders."

We must also remark that the auther positively denies that the same person has ever had the small-pox twice, or after the variolous inoculation, though it is well known that of late several instances of this kind have been published, apparently upon as good evidence as those brought forward by Dr. Moseley to prove the recurrence of small-pox after cow-pox; we do not see how we are to believe the one without crediting the other. So eager is our author to receive every tale which may make against cow-pox, that he appears willing to impute to it an agency more powerful than any thing that can enter into our comprehension or imagination; he gravely tells us that he knows a philosopher,

"Who says that the cow-pox virus deadens, or dephlogisticates the system; and he thinks he has observed, in some children, a

diminution of mental acumen after the copóx."

As to the effect of vaccination in exterminating small-pox, he thinks the thing impossible, because small-pox is an "atmospheric disease, i. e. as it appears, a disease induced by a peculiar state of the atmosphere." Every one knows that at particular periods the disease rages with peculiar violence; and as we can discover no other cause, we have recourse to this spposition to account for its frequency. But we know that no condition of the air

can give it to those whose constitutions are secured from it by having already gone through the complaint; whether or no vaccination produces this effect is the point at issue; a question totally inde pendant of its being an atmospheric disease. Does Dr. Moseley suppose that any state of the atmosphere can produce the disease, if the specific contagion be not present?

Upon the whole we acknowledge that this treatise contains many cases which appear unfavourable to vaccination, and which certainly deserve to be investigat ed; but when we observe them joined to so much buffoonery and scurrility, and hear the author confess himself guilty of the grossest prejudice, their effect upon our minds is much diminished, we had almost said annihilated.

ART. XVIII.—-Observations on the pernicious Consequences of Cow-Pox Inoculation; containing many well authenticated Instances, proving its Insecurity-against the Small-Por: also, Remarks on the Advantages of Small-Pox Inoculation. By. R. SQUIRREL, M. D. Formerly Resident Apothecary at the Small-Pox and Inoculation Hospital.

FROM the title of this work our readers will perceive, that like the last, it is writ

SQUIRREL ON THE COW-FOX.

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Recollecting the numerous bodies of medical men, both in the metropolis and elsewhere, who have come forwards in support of this practice, bodies no less respectable than numerous, we were at a loss how to solve this paradox, until we found that inoculation is practised by apothecaries, while the encouragers of cowpox have been physicians. To this it is sufficient to reply that the department of the profession who principally practise inoculation are the surgeons, and surgeons have been some of the most active promoters of vaccination. We do not think it necessary to repel the attack that is made upon the character of the physicians, we conceive that they will be able to bear

the assault.

Although Dr. Squirrel did not make up his mind upon the subject in the first instance, like Dr. Moseley, yet it appears that he very soon became panic-struck. Upon the first perusal of Dr. Jenner's publication, he was filled with such "horror and aversion," that he could not a man of honour or of feeling, submit to

as

or coincide with vaccination." When the

small-pox inoculation was first introduced, people must have felt much horror and aversion at voluntarily subjecting their children to so dreadful a disease, and there were no doubt multitudes whose honour and feelings would not let them submit to or coincide with the practice. Our author's feelings have, we apprehend, led him much astray; for he conceives that the grease in horses is a modification of scrofula, and that by inoculating with vaccine matter, we transplant the seeds of this disease into the human body. There are, however, several points that remain to be proved before we can admit this hypothesis; neither the cause, seat, nor symptoms of the two diseases warrant the opinion of their identity; and even were this identity proved, we deny the possibifity of the disease being conveyed by

inoculation.

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After having proved, as he imagines, that scrofula is thus capable of being conveyed into the system by the vaccine matter, the author proceeds to describe the numerous train of ills which flow from its introduction. We shall present our readers with the affecting picture as drawn by the hand of Dr. Squirrel.

"1. Great numbers of children have caught the small-pox, after vaccination, which will be proved by well-attested facts presently, though it had been pronounced to have taken proper effect, and the parents had rested satisfied in believing their children to be safe and secure. Many have afterwards had the variolous disease in a very violent manner; and some have died.

"2. Numerous instances have occurred, where the children have been affected with a very troublesome itching eruption, harassing them, from the time of vaccination, for months, and even years afterwards ; and undermining the constitution from the almost constant irritation, and the continual interruption of sleep. This eruption, very frequently, terminates in corroding ulcers. A child of Dr. Smyth Stuart, who resided in Bloomsbury-square, died from the irritation arising from the inflammation, eruption, and ulceration on the arm; which case will be mentioned. No eruption of any kind had ever appeared on the skin of these children previously to vaccination:--I appeal to the parents for the truth of this assertion, who, I have no doubt, will readily come forward to testify the fact; which fully proves to the unbiassed and impartial part of the public, that these eruptions and ulcers have arisen from the acrimonious and contaminating quality of the cow-pox virus.

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Every day's experience furnishes me with fresh instances of eruptions, inflammations, and ulcerations, on different parts, subsequent to vaccination. These eruptions, which are attended with erysipelatous inflammation, appear generally some months after inoculation, and, in the course of a few days, after they appearance, they terminate have made their in pustules, which bear every similitude to the cow-pox produced on the arm by inoculation: the colour of the matter they contain, and the inflammation surrounding them, are exactly similar. These pustules terminate in scabs, which, in a little time, fall off, and expose to view a deep-seated inflamed ulcer, and produce such an intolerable itching that the child in the morning is nearly covered with blood, arising from the scratching through the course of the night; and the parents in such a state of anxiety and distress, that it would rack any one's heart to see them. The irritation is much increased by a small prickly rash which fills nearly the whole of the interstices between the ulcers, so that the whole body is almost covered with the eruption and ulcers, and the child rendered so sore

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