In this case, I remarked that the sicknurse seized the idea, and commenced the process with alacrity, owing to her having witnessed its success in two former similar cases of forlorn hope, in which I had prescribed the pepper friction, and in each of which it was applied over the whole body, and often repeated. I accordingly found powdered pepper now sticking all over the boy's skin; and I was told that he complained of nothing from this time but hunger and the heat of the pepper. Such an early, sudden, and decisive resolution is not to be expected from the use of the common remedies, even with the best efforts of nature.

A still more surprizing recovery was ef fected last year (1824,) by the same means, in the boy called Christmas, at Anna Regina. This lad, (about fifteen years of age,) recovered from the most hopeless state of inflammation which I ever knew, or which it is possible to conceive one to escape from. The patient was in the latter stage of measles, and the inflammation of the pulmonary organs was in this case so excessive, that the patient could scarcely breathe, and was nearly suffocated; had constant fever, dry skin, parched tongue, and such a metastasis on the brain as rendered him delirious and perfectly insensible for about two days. Both the pulse and respiration were nearly extinct. His eye was glassy, and covered with a film; his appearance, in short, was most cadaverous; he was totally unable to swallow, and the raucum or rattle in the throat withal announced a speedy dissolution.

Mr. Gordon, the hospital attendant, observing that I had omitted this patient in the prescription-book, inquired if any attempt should be made to give him anything, as cold water, his mouth being dry and parched. I told him, that would only add to his distress by impeding respiration, as we had just witnessed, that nothing could possibly be of any avail; but if he pleased he could try the rubbing with pepper and lime-juice. Having seen its effects at Hampton Court, he commenced instantly (having two assistants employed), and diligently repeated it over the whole body.

The patient was entirely insensible to its stimulus until many applications had been made, but the following day he began to shew signs of pain, and soon afterwards he spoke, and complained of the smarting over all his skin. From this period the fever abated, the tongue became moist, and perspiration ensued. On visiting him the next day he was sensible, and raised himself in bed, and said he must have some soup and wine, which were instantly brought him; he actually appeared like one risen from the grave. The fever and all other signs of inflammation had vanished; he complained of no pain; coughed, with a copious expectoration, which at first was dark and fetid. The rubbing was still repeated two or three times a day, and, although reduced almost to a skeleton, his recovery was rapid and perfect. Mr. Frost, the manager, and Mr. Gordon and others, can attest the truth of this extraordinary recovery. It was, however, only by the most diligent and persevering application of the remedy that the patient was saved.

Soon after this, George, a servant of Mr. Evans, in a desperate peripneumony, recovered under the same treatment. Bleeding and various medicines had been used without effect; both the nurse and patient scouted all other remedies, and boldly asserted that nothing but the rubbing saveď him. I was called away for some days, but learned on my return, that in this case, as in the others I had witnessed, the free ex. pectoration and perspiration came on and fever abated, together with freedom of respiration and cessation of pain, in a short time after the frictions were commenced The patient also soon acquired a remarkable craving for food.

Another most striking case occurred on Sparta estate. The man Benjamin was attacked with pleurisy, or rather peripneumony. He was bled four or five times during the first four days with blisters and the usual remedies. On the fourth evening, finding him much worse, with dry tongue, great pain in the chest, suffocating breathing, and all the symptoms pointing to a speedy termination, the pepper frictions

body, by external application, aided then by the two Finlays, alone and while he had dispatched one of them to Maybole, he and the other were assailed by a torrent of abuse, and threats of personal violence, and even of burning the house in which they were with the sufferer, if they should not instantly remove her from Slateford. It was in vain the surgeon attempted to reason with them on the inhumanity and absurdity of their conduct, in forcing her from a place, in which all the danger that could exist from her continuance there-if danger there was-had been already incurred. He was overpowered by a multitude of voices of men and women, repeating their threats, with the additional one of 'dookin of him in the burn,' if he persisted. He was thus reluctantly forced to yield; and Finlay, having placed her on a wheelbarrow, removed her a short distance up the road leading to Maybole. Mrs. Hutchison, a blacksmith's wife, had offered the accommodation she could afford, but they still remained relentless, and would not permit her. She gave, however, some blankets, and her husband furnished hot plates of iron, which were found to be well-adapted for the purpose-for, with all the disadvantages of having only a wheelbarrow, some boards, and a little straw for her bed, and the canopy of heaven for a roof, the surgeon and his few asisstants had succeeded in restoring, in a great measure, the natural temperature of her body, and in diminishing the spasms and other symptoms. The Board of Health, too, having been then made aware of what had happened, the Rev. Mr. Grey, Minister of Maybole, and others of its members, lost no time in hastening to the spot. It was their opinion, as the women had come from Kilmarnock, and as they, therefore, could not think of adopting the apparently unjust and inhumane step of sending her back to Ayr, that she should be conveyed to the hospital which had been provided, about a quarter of a mile from Maybole, and this could easily have been effected without having the least communication with any part of the town. But for this well-meant proposal, they met with much abuse from a

mob of the inhabitants, and received from them the intimation, that they were determined to resist by violence any attempt to carry her to that place. As the people of Slateford, too, had equally opposed her introduction into any of the houses there, no course remained but to send her to Ayr, or leave her to perish. Accordingly, a horse and cart having been with difficulty procured, they wrapped her up as comfortably as they could, and dispatched two men with her, bearing a letter from Mr. Grey to the Medical Attendant at the Cholera Hospital in Ayr, where she was admitted, but then so much too late, that she died in the course of that morning.

It is, Sir, in sorrow, not in anger, and against the delusion, which is the sole cause of such enormities, and not against those deluded individuals who have been the misled and ignorant perpetrators, that I wish to bring the facts under general consideration. For I could gratefully bear my personal testimony in unison with much that is far higher and more honourable to the merits, and loyalty, and charity of the people, in these very communities where they took place, in many, I might even say in all, the former times of trial I have witnessed."

The scene acted at Dawlish was nearly as bad. A man, by the name of Vicary, was dragged by force into a cart, and sent 10 miles, to Exeter, labouring under a violent attack of cholera. He died soon after his arrival. It is a consolation, that a coroner's jury returned a verdict of manslaughter against three men in authority at Dawlish!

latent pneumonia, are occasionally met with in the fever hospital, and are not a little puzzling.

"Here we have symptoms of pectoral oppression, without cough, (at least with very trifling cough,) and considerable fever, joined to unusual prostration of strength, and rather a small labouring pulse. The stethoscope and percussion afford, in such cases, valuable assistance, pulmonary congestion and obstruction being, with their aid, no longer a matter of doubt. The pulse is accordingly found to rise and fill under the cautious use of the lancet. But here, as in most cases, the physician should, if possible, not order the letting any particular quantity of blood, but be entirely guided by the effects produced, and the relief afforded."

Of late, patients have not been able to bear loss of blood so well as in former years. Dr. H. attributes this to the deteriorated condition of the poor. We are of opinion that it is owing to some unknown state of earth or air, for the same inability has been observed all over Great Britain, and not among the poor only, but among all classes of society.

"The history of these fevers generally commences with despondency, the sad attendant on ruined circumstances, or want of employment; this too often leads on to occasional intemperance, but the destructive habit soon grows, and becomes the fruitful parent of inveterate disease, as well as moral degradation.

This subject leads me to make a few observations on delirium tremens, that form of fever well known under the vulgar, but not inapt appellation of whiskey fever. That we meet with this disease oftener now than formerly is certain, but the cause of its more frequent occurrence is not so evident. It may possibly arise from the increased consumption of spirituous liquors by the lower order of people. But this can explain it in part only, as persons of the middle class, among which the disease is also more prevalent now than formerly, are, on the other hand, less addicted to spirituous potations in the present than former times. It appears

to me that, in endeavouring to account for this fact, we must chiefly look to the altered state of society in our age, the increase of luxury, the sedentary habits of men in business, added to the anxious cares attendant on mercantile speculation; the immoderate use of tea, coffee, and tobacco, and to other causes, all tending to lessen the tone of the system. The irritability, then, and laxity of fibre produced necessarily under such circumstances, seem to be the great predisposing cause, although 19 out of twenty times the exciting cause is some recent excess, or, as it is usually termed, hard living. Some cases, however, of delirium tremens occasionally occur, (and I myself have seen a few,) which could not have been caused by intemperance, the contrary being ascertained clearly, and the habits of the patient being abstemious.

The pathology of this disease is extremely interesting to the medicial inquirer. The highest nervous excitement co-exists generally in the commencement, with the greatest debility of the sanguiferous system. The former produces the most extraordinary spectra to the mind's eye of the patient, and very frequently delirium of a furious and unmanageable kind, requiring the use of the strait-waistcoat. The latter is manifested by a small, feeble, compressible pulse. It differs essentially from typhus, which resembles it more than fevers of another type. If fatal, it generally runs its course in a week -the skin is cool, oftener cold and clammy, the patient incessantly talks to imaginary by-standers, the pulse is small and rapid, subsultus tendinum so constant, as sometimes to render it difficult to feel the radial artery. General sinking, convulsions, and a deceitful calmness of manner usher in death. Should the fatal event not occur in the early stage, the danger blows over, and the case merges into one of ordinary fever. Our chief reliance, from the very onset must be on the free use of stimulants, wine, camphor, and opium. Woe to the unfortunate patient whose delirium is mistaken for that arising from meningitis! Two such fatal mistakes came to my knowledge during the last year. One patient was a man of

brought to the bedside of the patient, it is surprising how far they sometimes mistake his positions. The true character of the pulse, the proper time, manner, and measure of depletion or stimulation, the tracing disease through its various channels to its seat,

or nine days before I saw her; delirium supervened; she could with difficulty be kept in bed; blood was freely taken from the head, and her manner became more calm. But in this, as the former case, the calm was deceitful, as the fatal event soon proved. It would, however, be a great mistake to conclude, that in no case of delirium tremens should blood be taken from the patient. On the contrary, reaction in young robust subjects sometimes takes place after the third or fourth day, to that degree, that moderate local bleeding is not only useful, but necessary. The rapid tremulous pulse, and clammy skin, and subsultus, are found to give way to a hard pulse, and warm dry skin, and flushed countenance. At this period, moderate purging becomes still more necessary. It is really sometimes surprising to see what a quantity of dark offensive matter is discharged for some days, demonstrating the great extent over which morbid action of the liver, and of the membrane of the intestinal canal, takes place. In such cases, then particularly, we must not confine our selves exclusively to stimulants and opiates, nor push the use of these too far. Following the plan of cautiously combining purgatives with these, we may generally expect a favourable result."

Our author has come to the conclusion, that fever does not always depend on top ical inflammation, notwithstanding the doctrines of Clutterbuck and Broussais. We shall conclude with the following quota tion.

"Next in absurdity to this is, in my opinion, the specious doctrine of great simplicity of practice in fever. It is certainly very convenient for medical men of limited experience, or idle habits, or destitute of practical acumen. Such persons will sometimes talk very fluently of disease, but when

practice, blunder grossly, however confidently they may speak, or even lecture on them. Among this class of practitioners we certainly cannot place Dr. Elliotson, a physician of great talents and deserved eminence, to a statement from whom in a clinical lecture on his treatment of fever, published in The Lancet, I beg leave to allude. An erroneous doctrine countenanced by such a man must necessarily produce evil consequences, his opinion being justly entitled to the serious consideration of every medical man, and decidedly influencing many young practitioners who look up to him as a teacher. He states that his practice in simple fever is almost always successful, and that it entirely consists of a purgative at first, then a combination of calomel and opium with occasionally tepid ablutions. No one will, I believe, dispute, that this plan may be successful in slight and favourable cases, but in the management of dangerous fevers few experienced physicians will agree that they find it such plain sailing, as from such a statement might be supposed. Are they not often obliged to vary their course not only in different subjects, but even in the same case, according to the stage of the discase, the organs affected, the patient's constitution, and other considerations? In confirmation of this, I might refer to a lecture of Dr. Elliotson himself, more lately published, in which he declares that he found it necessary to order wine for patients then labouring under the first stage of fever. We may then safely conclude, that no plan of treatment is applicable to every case, notwithstanding the theories with which the history of medicine abounds. In making this assertion, we do not disparage the great merit of some of the authors of these, for instance of John Brown, whose talents must be admired, or