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advocate for the doctrine of the faid Appendix, has, on account of his publishing his fentiments relative thereto, undergone fome fuch hardships as have not been heard of for many years in this proteftant country.' We have had occafion to take notice of this alarm to the public in our review of that work: and whatever reafon there may be for delaying the publication of the cafe of the worthy perfon referred to, the friends of free enquiry muft be naturally impatient to have it, as promifed, with all its circumftances.

To return to our Critic: whatever be his own fentiments of the doctrine itfelf, he certainly appears to be an able disputant, and has particularly recommended himfelf by that clofenefs of argument and punctual adherence to the question, (as rested on fcripture) in which his antagonist appears very deficient. Mr. Steffe's affectation of wit, too, when argument only should have been used, is properly treated by the Doctor, who takes occafion, from it, to introduce the following pertinent and pleasant remark upon a Right Reverend Author:

After pronouncing Mr. Steffe's witticifm to be perfectly innocent, he adds,But will the R. R. Author of The Divine Legation of Mofes be thought to have exercifed this fame talent of wit, either, in a manner worthy of himfelf, or, indeed, with innocence? It can, furely, be deemed but a vulgar pleasure his Lordship feems to take, in calling the controverters of the doc trine of an intermediate ftate by the name of Dreamers, Sleepers, Middle-men, &c. Such language is more worthy of that inferior and popular clafs of writers, (to which indeed it has hitherto been chiefly confined) than that eminence, which the Bishop of Gloucefter holds in the learned world. Thefe gentlemen too, with whom his Lordfhip makes fo merry and fo free, have been too long dinn'd with fuch fort of names to have their fleep broken by a repetition of the rude noife. Nor can the R. R. Author be thought to have acquitted himself with more decency and propriety of character, in making a very ferious expreffion from a facred writer ferve the purpose of a witty farcafm. "St. Jude's filthy dreamers only defiled the flesh. Thele defile the spirit." But, though we cannot fuppofe that St. Jude and the Bishop are equally ferious, yet it is not fo clear, that his Lordfhip, in bringing this charge of fpiritual defilement against the dreamers, is altogether in jeft. Certain it is, that, however unwilling his Lordfhip might be to fupprefs fo jocular a fentiment, he is willing we fhould confider the doctrine in a ferious light, as of a dangerous and defiling nature. For the learned author of Confiderations on the Theory of Religion, is reprefented as a reviver of the Sadducean opinion, of the extinction of the foul on death, his valuable quo

See Review, Vol, XXXII. p. 345.

tations

tations from fcripture fcornfully térmed, A Number of Wonder ful Things, and this fcrap of fcripture, there be gods many, judged by the R. R. Author to be a ftronger text against the unity of the godhead, than any this learned writer has produced for his opinion. The late worthy Dr. Taylor of Norwich is called • Another of thefe Sleepers,' and a very fenfible quotation from him has the following decent reflection paffed upon it: This is the old exploded trafh of Coward, Toland and Collins.' And yet, I dare fay, his Lordfhip will think this writer as honourably claffed, in point of authorship, with Coward, Toland, and Collins, as the Bishop of Gloucester would be, fhould fome one, illnaturedly pleasant, and availing himself of his Lordship's decent expreffion, clafs his performance on this fubject, with the old, po pular-trash-of Goddard, Steffe and Fleming.'

An Inquiry into the Nature, Caufe, and Cure of the Group. By
Francis Home, M. D. his Majefty's Phyfician, and Fellow
of the Royal College of Phyficians in Edinburgh.
Is. Kincaid, Edinburgh. Sold by Millar in London.

DR

8vo.

R. Home, who has already given the world several proofs of the ufeful application of his genius and abilities, propofes, in this little piece, to afcertain the hiftory, nature, caufe, and cure of the croup; a disease which he looks upon as hitherto undefcribed, and entirely, he fays, unknown as to its nature, cause, effects, and cure.-The croup, from our Author's hiftory of the disease, we apprehend to be a fpecies of catarrh, attended with an inflammatory fever; and, fo far as it is local, chiefly affecting the mucous membrane and the numerous glands of the trachea or windpipe. He obferves that it is peculiar to children ;—that he never faw or heard of one, above twelve years of age, affected by it-that it is local, and rarely found at any great distance from the fea-fhore ;-that it likewife only attends certain feafons of the year, appearing from the month of October to the month of March. Our Author gives twelve cafes or hiftories of the disease, with the diffections of those bodies in which it provedfatal; and from thefe he deduces a number of corollaries. We fhall transcribe one of thefe hiftories; which appears the leaft complicated with any fimilar difeafe.

September 29th, 1760, I was called to a boy of feven years of age, who had been fome days fick. He lived on Leithbridge, had been ill of the chin-cough the preceding winter, and had recovered of the meafles about fix weeks before this. He had been frequently purged, and had been tolerably well,

excepting

excepting a flight cough, till he was feized, four days before I faw him, with fever, heat, thirft, and the fhrill croupy voice. When I faw him his pulfe was quick, with a little degree of hardness, but not ftrong. He fwallowed eafily; but complained of a pain in the trachea, when he spoke, or when I preffed it with my fingers. His face had been fwelled. Great drought. Breathing high, but not very quick. He fometimes expectorated, and had often frothy faliva upon his lips: the urine had a white ouzy fediment: his fenfes and his head were quite clear and diftinct. He was immediately blooded, and at night had leeches applied to his throat, and a blifter round it: the next day his pulfe was weaker, and beat 175 in a minute: breathing quicker, and often altered: diftinct in all his fenfes : died that night.

On laying open the parts, there was no appearance of any inflammation on the fauces: but to my great furprize, the whole fuperior internal surface of the trachea was covered with a white, foft, thick, preternatural coat or membrane, eafily feparable from it, and generally lying loose upon it, and purulent matter lodged below, and around it. The fubjacent parts were red; but no great degree of inflammation. As we fearched downwards, the fame appearances continued through the ramifications of the afpera arteria, though the membrane feemed here fofter, thinner, and to become of a more purulent nature. All the branches of the windpipe and bronchie were filled with purulent matter; and we could eafily fqueeze it out, in great plenty, from all these pipes. The fubftance of the lungs was quite found, and in a natural state.'

From this and the other hiftories and diffections related by the Author, he deduces his corollaries.In the first corollary, are pointed out the pathognomonic fymptoms of the croup: a peculiar, fharp fhrill voice, not calily defcribed, and which can be refembled to nothing more nearly than the crowing of a cock; a remarkable freedom from all complaints when in imminent danger; a quick, laborious breathing; frequent pulfe, ftrong at first, but foft and weak towards the end; little difficulty in deglutition or inflammation in the fauces; often a dull pain, and fometimes an external fwelling in the upper part of the trachea; the fenfes quite diftinct to the laft; and all the symptoms most rapid in their progrefs :-fufficiently characterize this difeafe. From the fhrill voice and difficult breathing, which our Author fays are the leading fymptoms, he calls it the fuffocatio fridula; but whether it can with propriety be called an unde-, fçribed difeafe we pretend not to determine: those who will turn to Boerhaave's account of the angina inflammatoria when it attacks the trachea; or to Sauvage's Cynanche trachealis; will find the vox acuta, clangofa, fibilans, ftridula; refpiratio parva, frequens,

erecta

erecta cum molimine; of which, our Author's leading fymptoms, the sharp, fhrill, ftridulous voice; and the quick, difficult, high breathing, would not be a bad tranflation.

In Corol. 2, Dr. Home obferves, that as the fuffocatio ftridula is peculiar to a certain, age, as it is local with refpect to its fituation, fo it is likewife particularly connected with the cold and moift weather of winter.

In Corol. 3, our Author endeavours to afcertain the feat of the fuffocatio fridula: it is not placed in the muscles of the glottis ;-nor in the lungs ;-nor in the coats of the trachea ;— but in the cavity of the trachea.-We profefs we cannot fee with what propriety this disease can be faid to be feated in the cavity of the trachea independant of its coats. It is true, indeed, the membrane which is found on diffection, and which is described by our Author, is feated in the cavity of the trachea; but then this membrane is only to be confidered as a symptom or effect; and is produced by an encreafed fecretion from the mucous membrane, or the glands of this organ, which are in a preternatural, difeafed ftate: and Dr. Home fo far forgets himself as foon after to obferve, that this diftemper ought to be confidered as originally feated in the mucous glands which are in great abundance in the coats of the trachea. The airy cavity of the windpipe is to be fure a very uncommon place for the feat of a difeafe; but our Author's fprightly imagination may poffibly have catched the thought from a circumftance not unfrequent in his part of the world; the houses there confift of a great number of flories; and a perfon may have property in the upper parts of fuch a building, but none in the foundation:-now property fo fituated may be justly termed a tenement in the air: and why may not Dr. Home be indulged in fixing the feat of the croup in a manner alike fanciful and aerial!

The obfervations and conclufions concerning the cause of the croup, in Corol. 4, are equally wild and unphilofophical, and quite unbecoming that gravity, foundnefs, and referve, which are generally affociated with the word COROLLARY.- Various, fays be, have been the theoretical opinions of people, who never had the opportunity, or gave themfelves the trouble, to fearch into the real cause of this diftemper. But from the inspection of the morbid body, that true fource of knowledge, we learn, that the caufe of this difeafe is a preternatural, white, tough, thick, membraneous cruft, covering, often for many inches, the infide of the trachea.'- -This wonderful membrane feems to be our Author's hobby horfe; mounted on which, he with the greatest ease bounds over every difficulty relative to the nature, feat, and cause of the croup.-But the obfervation of this membrane is not so very nouvelle as Dr. Home may imagine: it has been feen lining the back-parts of the fauces, the stomach and

5

inteftines;

inteftines; in flight inflammations of the glans penis, we have obferved a fimilar, thin, membranous coat, formed between the prepuce and the glans; practical writers mention a number of cafes, in which it has been coughed up in greater or leffer portions from the afpera arteria and bronchie. The epidermis or interior membrane of the trachea is deftroyed and renewed, fays Haller, and is fometimes coughed up in the form of a thick, white membrane; the mucus of thefe parts is in like manner thrown up in fome difeafes, and retains the form of the cavity from which it was rejected*. This membrane, however, has but a flender claim to be confidered as the cause of the croup. The proximate caufe of every disease we apprehend to be fuch an alteration in the folids or fluids of the fyftem, as to interrupt the natural and regular motions of fuch fyftem: hence a variety of unufual fenfations and appearances; thefe constitute the fymptoms; and a particular enumeration of fuch fymptoms forms the hiftory of the difeafe.From the hiftories related by our Author, the membrane feems to be rather an effect, than the cause of the difeafe; this too is confirmed by Dr. Home, who, in one of the fubfequent corollaries, divides the fuffocatio firidula into two ftages, the inflammatory and the purulent. In the latter he fays the membrane is compleatly formed; he sufpects it is not fo during the inflammatory ftate; nay, in another paffage, he even queftions whether the membrane is not a fequel to the purulent ftate. Dr. Home fuppofes, that mucus, by heat and flagnation, may be converted into pus; and perhaps, fays he, this change from mucus to pus happens before the membrane is formed, as pus fhows fuch a tendency to affume a folid form.'-The natural progrefs of things, therefore, according to Dr. Home, is as follows: there is a fever; a quick, difficult refpiration; a degree of inflammation affecting the glands and coats of the afpera arteria; confequently a flow of mucus upon thefe parts. This mucus is changed into pus; and this pus is converted into that membrane, which is the true cause of the croup-or, in plain English, after the disease has run through its firft ftage, and is come to the clofe of the laft, there is then formed the true and genuine caufe of fuch antecedent difeafe.-Good logic! found philofophy! and the moft penetrating acutenefs in phyfiological difquifitions!

But our Author proceeds to inquire, whence there is pus, or true matter, without ulceration?That pus is formed without ulceration we know and believe from experience; but Dr. Home's thoughts on this fubject are certainly a little outré. Pus is not formed, he fays, as is generally fuppofed, by the vellels of the ulcer; it exifts in the blood, and is probably the

Vid. Haller Elem. Phyfiol. lib. 8. p. 148. 150.

true,

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