deconomy. The Author's clafs of univerfal diseases therefore comprehends all thofe in which there is fuch an assemblage of the general symptoms, that they predominate above any partial or local complaints, and form the principal part of the diftrefs. Thus a fever, and an epilepfy, are univerfal diseases, as they confift of fome of the general fymptoms; the number and nature of which we fhall foon explain: whereas local difeafes, which constitute the fecond clafs, are those in which, though certain degrees or proportions of fome of the general symptoms are included, yet the predominant or moft diftinguishing part of the difeafe confifts in the diforder of a particular organ or function of the body. Such, for instance, are blindness, deafnefs, or, to use one of the Author's examples, a cough; in which the action of the lungs is difturbed, in confequence of an irritation of the larynx or trachea; but which is unattended with pain, loss of appetite, or any of the general symptoms that conftitute an univerfal difeafe.

As these general fymptoms form the morbid ftate, and compofe the bafis of the important clafs of universal diseases, the defcription and treatment of which conftitute the whole of the practical part of this firft divifion of the prefent work, we fhall enumerate them, and fummarily explain their nature and derivation.

Thefe general fymptoms being fo many deviations from a ftate of health, the Author firft properly confiders the several conditions refulting from the general regularity of the animal œconomy in a found ftate; and from them deduces their oppofites, which form the fymptoms, or, in other words, the elements of difeafe. Now the body is in a healthy state, when the ten following conditions exift in it: 1. When the degree of animal heat is fuch as gives a pleafant and agreeable fenfation. 2. When the appetites relish their natural objects, and return, in moderation, at the proper feasons, or after due intervals. 3. When no pain is felt; 4. Or itching. 5. When the fleep is natural and refreshing. 6. When there is no ftraitnefs or oppreffion about the præcordia. 7. When the breathing is free. 8. When the voluntary motions are performed agreeably to the will, with eafe, readinefs, and due degrees of ftrength. 9. When the organs of external fenfe receive and tranfmit their respective impreffions in a proper and moderate degree; and 10. When thofe of internal fenfe enable the mind to perceive clearly, and judge truly, of the impres fions that are made, and of the ideas which arife from memory and imagination.

• The discusion of the three remaining claffes of Local, Sexual, and Infantile difeafes is referved for a future publication.

The

The deviations from, or the oppofites to, these ten conditions of health conftitute, according to the Author's plan, fifteen general fymptoms, or morbid affections, which are the component parts of all the numerous diseases to which the human body is liable. To the first condition are oppofed (1) Exceffive heat, or (2) the fenfation of exceffive cold. The oppofites to the second condition are (3) Sicknefs, and (4) Violent thirft: to which may be added, though they occur more rarely, and are rather local or fexual than general fymptoms, the fames canina, the fatyriafis in men, and the furor uterinus in women. (5) Pain, and (6) Itching, are oppofites to the third and fourth conditions; as (7) Watchfulness, and (8) Somnolency, are to the fifth. (9) An oppreffion and sense of ftraitnefs about the præcordia, ufually termed Anxiety by medical writers, and (10) Difficulty of breathing, are the contraries to the fixth and seventh conditions of health. (11) Weakness and relaxation of the mufcular fibres, and its oppofite (12) Spafm or convulfion, where the mufcles act contrary to the will, and fometimes exert unufual and unnatural degrees of ftrength, are deviations from and oppofite to the eighth condition; as (13) Want of Senfibility, and (14) Super-fenfation, or too high a degree of fenfibility, or an unnatural proneness to irritation, are the contraries of the ninth. The laft general fymptom, and which is oppofed to the tenth condition, is (15) Delirium, or that general difturbance and diforder of the internal fenfes, when the faculties of the mind cannot be properly exercifed; and accordingly the feveral powers of memory, imagi nation, and judgment, are weakened, confused, and perverted.

On one or more of these fifteen general fymptoms, or more bid affections, confidered as difordering the intire habit, Dr. Macbride founds his claffification of general or universal difeafes, which he comprehends within nine orders. These we fhall particularly fpecify, together with fome of their leading fymptoms; adding, merely by way of specimen or example, the titles of fome of the genera, or the popular names of a few of the difeafes, which he arranges under each refpective order.

The Author's nine orders of univerfal difeafes are the following: I. Fevers; the diftinguishing symptoms of which are exceffive heat, thirft, lofs of appetite, weakness, and inability to fleep. II. Inflammations, external and internal; fuch as phlegmon, eryfipelas, inflammatory quinfey, pleurify, &c. III. Fluxes; or all thofe diforders in which there is a præternatural difcharge either of the fecal matter, or of blood, or fome fecreted fluid: fuch as diarrhoea, hemorrhages of various kinds, diabetes, &c. IV. Painful Disorders; in which there is acute pain, without the diftinguishing circumftances and figns of a true inflammation, and without a fettled fever, or præter

natura.

natural discharge., This order comprehends the gout, colic, rheumatifin, &c. V. Spafmodic Difeafes; of which the diftinguishing fymptom is fpafm, accompanied fometimes with pain, and fometimes with infenfibility. The difeafes of this order are the tetanus, locked jaw, hydrophia, epilepfy, &c. VI. Inabilities and Privations; the diftinguishing fymptoms of which are fomnolency, lofs of ftrength, and infenfibility, and the genera comprehended under it are apoplexy, palfy, lethargy, &c. VII. Afthmatic Difeafes; which are diftinguished by difficulty of breathing, and comprehend the dyfpnæa, orthopnoea, asthma, &c. VIII. Mental Difeafes; in which the memory, imagination and judgment, are all confused and perverted, without the diftinguishing figns of fever or inflammation. This order contains only madnefs and melancholy. IX. Cachexies, or Humoral Difeafes; in which there is a wafting or tumefaction of the whole or different parts of the body, cutaneous eruption, difcolouring, or ulceration; attended with weaknefs, lofs of appetite, pain, or fome other general fymptoms. Under this order come the dropfy, jaundice, mortification, fcurvy, lues venerea, and various other complaints.

The preceding analyfis may fuffice as a fpecimen of the Author's manner of arranging his first and principal clafs of univerfal difeafes into order and genera; which laft are afterwards fubdivided into fpecies and varieties. On this head we fhall only further obferve, that the three other claffes are divided in a fimilar manner, and that upon the whole the Author has pro perly avoided the minute and frequently perplexing accuracy of M. Sauvages; who (to give only an inftance or two) has divided his order of Comata, or fleepy difeafes, into feven genera, which he has fubdivided into no lefs than fixty-five fpecies; and has made no lefs than twenty-one diftinctions of fyncope or fainting. To give an idea of our Author's moderation in this refpect, we fhall add that the fum of his genera of univerfal, local, fexual, and infantile diseases is only 179, which in Sauvages's catalogue amounts to 315. This laft number however is exceeded in the catalogue given by Linnæus, who divides difeafes into 325 genera, and still more by that of Vogel, who mounts them up to 560.

In what goes before we have confidered only the Author's fcheme of arranging or claffing difeafes; which is to be regarded not only in the light of an affiftant to the memory of the learner, but as tending, fo far as the arrangement approaches to a juft and natural order, to the improvement of the art itfelf;" by tracing the connections or affinities that different difeafes bear to each other, and furnishing proper indications of cure for each. We shall now proceed to fhew in what manner he has arranged the materials of the work itfelf, which contains,

as

as he informs us, the substance of a course of lectures that were read for fome feafons in Dublin, and is divided into two parts; one containing a view of the theory, and the other, of the practice of phyfic.

The first or inftitutionary part, which is divided into feven books, explains the principles on which the art is founded and may be read with pleasure even by those who would with only to be acquainted with the theory of medicine, confidered as a curious and interefting branch of natural philofophy. Af ter a fummary view of the animal economy, and of the functions of the body in a state of health, which form the subjects of the first book, the Author gives, in the fecond, an analyfis of difeafes; first enumerating thofe conditions of the corporeal frame, and of the animal functions, on which perfect health depends, and then particularly defcribing, in feveral distinct chapters, their contraries, which we have already briefly specified. After this particular view of all the immediate caufes of the different species of general morbid affection, prefented under fifteen general heads, or symptoms, he explains the remote or poffible causes which may co-operate with them in producing difeafes.

Thefe morbific difpofitions muft evidently arife either from the parts containing, or the folids of the human body, confidered either as exceeding, or deficient, in ftrength and fenfibility; from the various combinations of which qualities in the folids, the peculiarities of different conftitutions, diftinguished by the appellation of temperaments, principally arife: or they may proceed from the state of the parts contained, or of the animal fluids; the different modifications or qualities of which have been pretty generally, and by the ancients were univerfally, held as the fources of all difeafes. The theories of the four humours adopted by the Galenifts; the fulphur, and acid, and alcali, of the chemifts; and the cubes, and fpheres, and darts which the mechanical phyfiologifts fancied they faw in the animal fluids, and confidered as the caufes of all diseases, have, at different times, too much influenced the practice of phyfic, by inducing its profeffors to acquiefce fupinely in the truth of the favourite theory which they adopted, and to regulate their practice by the indications derived from it; while they fhut their eyes upon, or at least neglected to obferve, the facts which might prefent themselves in oppofition to it.

To this blind and obftinate attachment to particular theories, either wholly groundless, or adopted without proper modifica tions and a due regard to experience, it is in a great measure owing that, though the art of phyfic has been cultivated during fo many centuries, we are yet in poffeffion of fo finall a number of certain and appropriate remedies for particular ditem Rev. Nov. 1772.

DJ

pers

pers or morbid affections: fuch, for inftance, as the bark, for agues and intermittent fevers; mercury, that peculiar antidote to the venereal poifon; opium, that fovereign remedy against pain; to which we may, perhaps with fome degree of confidence, add fixed air, as a substance capable of rendering the fcorbutic virus inert: and which may probably be adapted to correct or destroy other kinds of morbid, and particularly putrid, acrimony. What has been already effected in this way, the Author juftly obferves, may encourage us to hope that in time fomewhat may be ftruck out, that fhall cure even the gout and cancer.-Terrible as the virus of a cancer may be, he adds, it is not more fo than the venereal was, until practitioners happily difcovered the specific powers of guaia cum and mercury. Guicciardini, the celebrated Italian hiftorian, who was an eye-witnefs, relates that the lues venerea, for feveral years after it first broke out in Europe, proved fatal to a multitude of both fexes and all ages: many became fo horridly disfigured, that they remained ufelefs, and fubject to almoft perpetual pains; and the beft part of those who seemed to be cured, foon relapfed into the fame mifery. If it had fo happened then that a specific remedy had not been found out until this day, how many thoufands of people muft have perifhed in a more fhocking condition than by the most inveterate cancer?'

After giving a sketch of Gaubius's five divifions of acrimony, viz. the acid, the alcaline, the putrefactive, the muriatic, and the ammoniacal, and the feveral fpecies of diftrefs fuppofed by him to be produced by them, the Author properly adds, all this is perfectly fyftematical, and does very well to read; but when we come to look for thefe different fpecies of acrimony in our patients, we shall not often be able either to find out or diftinguish them.'-The obfervation is undoubtedly just in this inftance, and may with equal propriety be applied to many other medical theories, which have no other foundation than partial obfervations, diftant or mifapplied analogies, or are derived merely from the licentious imaginations of their refpective inventors. But the Author feems, fomewhat too decifively, or without proper modifications at least, to cifcourage, probably without intending it, a fpirit of theoretical inquiry on medical fubjects, in the following paragraph; where he obferves that it will turn to most advantage, never to attempt investigating the peculiar nature of the different kinds of acrimony; for that would be pure lofs of time.'-We are confident however that, by this feemingly unlimited diffuafive againft inquiring into the chemical qualities of the animal Buids in a difeafed fiate, the Author does not mean totally to condemn a rational inquiry into the more intimate nature of the causes of certain

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difcafes,