THE

MONTHLY REVIEW

For OCTOBER, 1755.

ART. XXVII. Medical and Chirurgical Obfervations. By Frederic Muzell, M. D. profeffor of the medico-chirurgical college, and phyfician to the Charité at Berlin. Translated from the German original. 8vo. 2s. Linde,

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HE utility of fuch medical communications as are the refult of careful obfervation, and real experience, has been occafionally taken notice of in a former Review. This performance of Dr. Muzell contains the histories of twenty-five cafes, fcrupulously, even to a degree of tedioufnefs, circumftantiated in the relation; but which, nevertheless, serve to evince the candor, fagacity, and application of the relator; who hath as ingenuously recorded his doubts and mifcarriages, as his judgment and fuccefs.

It will not, we conceive, be arrogating too much, to infift, that the art of healing has been, at leaft, as far, and as effentially, advanced in Great Britain, as in any other country in Europe; whence it is more than poffible, that feveral of these cafes will feem less important here than in Germany, where medicine has not made an equally fuccefsful progrefs t. However, this work ought not to be rejected as totally incapable of conveying inftruction, feeing it furnishes fome practical hints, neither common, nor unworthy of further confideration; and which may, perhaps, be much improved under the Eye of a difcerning practitioner: of this fort we mention our au

thor's first case, which is entitled, Of a confumption fucceeding profufe fpitting of blood.-That fuch a confequence fhould proceed from fuch a caufe, will appear, to our medical readers, far lefs extraordinary than the fimplicity of the remedy, by which the cure was effected. The patient is defcribed to bea young gentleman, twenty-one years of age, who, with⚫out having used any violent exercife, was feized, in December 1748, with a profuse discharge of blood from the lungs, in ftrong fits of coughing; he was of a plethoric habit, as his pulfe denoted, which was quick, full, and hard; his cheft was flat and narrow, and he was very much emaciated: he had been blooded once, but complained of an uncommon • oppreffion about the præcordia, which rendered respiration very difficult.

Under these circumftances, application was made for our author's affiftance. We pafs by the doctor's general treatment of his patient, which, tho' well enough adapted to the indications of the difeafe, had yet nothing uncommon, nor were his endeavours of any great service, for three months; in which time the young gentleman had been bled thirty-three times, in large quantities; notwithstanding which, his pulfe was very quick the whole day.-In the afternoon, he was invaded with fhiverings, fucceeded by heat, which was moderated in the night by fweat; he coughed violently, and the matter he expectorated was purulent, and of a difagreeable taste. His body wafted vifibly, and his breathing was fo fhort, that he was obliged to fit up in bed; and when he rose up, upon the least motion he loft his breath.' Medicine of every kind was grown irksome to him, and a natural averfion he had to milk, rendered a diet of that kind impracticable. The doctor, who tells us, that his mind was wholly taken up in meditating in what manner he might affift his patient,' happened at length to think of cucumbers, and recommended the eating of them without limitation, and without any other preparation than paring them; at the fame time, he allowed for nourishment, only a few biscuits, and, for common drink, water.

The remainder of this cafe we give in the author's, or rather in his tranflator's words. About a week afterwards I vifited him again, and found him remarkably mended; the heat was greatly abated, and the quantity of matter he expectorated was diminished, and was not fo much discoloured • as before.

• As I found him ftronger, I defired him to take fome gentle exercise in a coach in fine weather, for it was now April; by which means he recovered his natural vivacity

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and continuing the fame regimen fix weeks longer, every cir cumftance was fo changed for the better, that he could ⚫ breathe without any great difficulty whe.. he walked abroad. The matter expectorated was but in a very small quantity, and that chiefly in the morning, and the fever had quite left him.

He was now defirous to return into the country, and which, indeed, I advised him to, but directed him to con⚫tinue the cucumbers, and allowed him to eat other aliment; but warned him againft ftrong food, which might occafion • a relapse, and directed him a bottle of Selter water every day, when he grew tired of the cucumbers, and to bleed regu larly once a month for a year, which directions he strictly ⚫ obferved. His diftemper was hereby perfectly healed, and he is ftill living in perfect health, but repeats venefection ⚫ five or fix times a year.'

The happy effects of the Tartarum Tartarifatum in the cure of melancholic diforders, is exemplified in five inftances, one of which was complicated with uncommon cataleptic fymptoms. A cafe of a mania is also recited, wherein the fame medicine fucceeded. To these our author adds, that he has cured ten ⚫or twelve befides by the fame method;'---nor can he 're• member but three who were not cured, and those he could not get to take any medicines.'--- His ufual method of adminiftring this remedy, was to diffolve half an ounce of it, with an equal quantity of honey, in half a pint of water, which was to be taken by spoonfuls in one day, and to be repeated till it produced a favourable change, which for the moft part happened within eight or ten days. General evacuations were premised, and lenitive purges occafionally interpofed.---As there does not appear the leaft room to doubt Dr. Muzell's veracity, and, it is but too true, that these diforders are not infrequent here, this method may, perhaps, appear worthy of further experience in fome of our hofpitals -appropriated to the reception of fuch patients.

Such as are defirous of knowing more of this performance, in which fome other uncommon cures occur, are referred to it: but we muft not difmifs this article without obferving of our author (who has promifed more communications of this fort, as foon as his leifure will permit) that his humanity to the fick under his care, is equally apparent with his skill in his profethion.

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ART.

ART. XXVIII. Reflections on flow and painful Labours, and other fubjects in midwifery; together with obfervations on Several diforders incident to pregnant women. Interfperfed with remarks on Dr. Burton's letter to Dr. Smellie; in which the merits of the caufe between these two authors are in fome meafure confidered. By Giles Watts, M. D. 8vo. Is. 6d. Keith.

HIS young writer, as he profeffes himself, having, in TH his preface, cenfured those who, on the account of a fingle, or a few difcoveries, of more or lefs importance in any art, attempt to burthen the world with a publication, or rather republication, of the whole fyftem of that art, propofes to confine himself to what he has thought most remarkable in lingering labours; on cutting the navel-ftring; on hæmorrhages from the navel, after its feparation; on dropfies during pregnancy; on convulfions during labour; and on violent floodings. He indulges himself in many theoretical notions, of which fome are more clear and probable than others, affirming, with Hippocrates, that the navel-ftring fhould not be cut immediately upon the birth, before the child has cried, fneezed, or made urine, but immediately after any of them; which our author confiders as a proof that the child has breathed: for he fuppofes the cutting it before refpiration will occafion a fatal accumulation and stagnation of blood in the lungs, by increafing the refiftance to its paffage through the aorta and ductus arteriofus.

Dr. Watts is fond of tranflating apwa by nuper viventes, lately alive; which Galen, Hefychius, and Föefius, tranflate fhort-lived; and, indeed, the natural conftruction of the place feems to be this-That thofe children who stick in the pel vis, and are not brought forth without great difficulty, and the affiftance of a phyfician, are apigwa, short-lived [which we fuppofe is often the cafe] immediately after which Hippacrates adds, that such should not have the navel-string cut before crying, &c. which feems to limit that forbearance of cuting to infants fo circumstanced.

He thinks whenever the pulfation of the umbilical cord is imperceptible, it is in vain to strive to recover the child; which opinion he fortifies by reading negatively with Calvus,

woda, inftead of wala, which Föefius adopts from all the copies of Hippocrates, and tranflates in the affirmative; tho' indeed he rather approves the fenfe of Calvus, in his notes, by faying on this place, non temere legiffe videtur, 8, &c. We have heard, however, of infants just delivered, fecming

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ly void of every appearance of life, who have revived from a forcible infpiration made by the breath of a man-midwife or by-ftander; and our author himself mentions the successful ufe of a blow-pipe, in what he calls the apoplectic state of the newly-delivered infant. He fuppofes with Haller, the fenfation of the external cold to be the efficient cause of the child's crying at the birth, and its refpiration to be the confequence, and providential purpose, of its crying.

Having very frequently invefted the experienced Dr. Smellie with the epithet of great, he gives Dr. Burton to know, page 42, that he is ready to enter the lifts with him in defence of Dr. Smellie; which is the bolder, and kinder too, as he had acknowleged in exprefs terms, p. 41.- That Dr. Smellie has made feveral, and fome of them pretty confiderable, miftakes, especially in the hiftorical part of his treatife; and that it contains fome few inconfiftencies and inaccuracies, which are almost entirely unavoidable in a work of that length, and are more especially to be excufed in a man, who is not poffeffed of the most happy talent of expreffing himself, all ⚫ will allow.' Not to dwell on the indifferent ftructure of of the foregoing fentence, this new method of blending fuch high panegyric with fuch depreffing cenfure, by making fo great a man fo very fallible, reminds us of Horace's humorous abatement from the perfection and felicity of the wife man of the ftoics, whom he grants them to be rich, handfome, greater than any earthly monarch, and fecond to none but Jupiter, &c. &c.-exce,t when a troublesome cough, or defluxion, takes him down a peg or two.

In fact, our author, who may have taken much pains in This profeffion, has feveral inaccuracies and improprieties, as a writer, to exercise his attention at home. To mention a few, he fays, p. 51, the increase of the uterus, instead of the extenfion of it: at p. 59, the conception of the ovum, for its impregnation; not fufficiently reflecting, that an impropriety in terms is generally thought to imply a muddy apprehenfion of things. He conftantly prints quondum for quondam, and uses crepatura, a very barbarous Latin noun, if it be a noun, for diruptio: not to fpecify fome ungrammatical efcapes in his language, which furprize us the more from a gentleman who deals in Greek and Latin. And this we mean abstractedly from a few peculiarities of idiom, which may be right elfewhere, tho' they rarely occur in good English books. Neverthelefs, as Dr. Watts appears to have furnished himself with many of the prerequilites to his profeffion; feems ambi

Epift. lib. i. epift. 1.

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cious,