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THE

CRITICAL REVIEW.

For MARCH, 1787.

Obfervations on the Ufe and Abuse of the Cheltenham Waters, in which are included Occafional Remarks on different Saline Compofitions. By J. Smith, M. D. 8vo. 1s. 6d. Murray. ›

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R. Barker complained of the neglect of thefe waters, but Dr. Smith gives a more favourable view of the attention paid to them by the public. The great object of thefe Obfervations is to explode the opinion of the Cheltenham waters acting as alteratives, and of courfe to prevent their being made a common drink; fince, in full feafons, there is not a fufficient fupply for those who repair to Cheltenham for their affiftance. Dr. Smith has performed this part of his talk with fuccefs; indeed he has fucceeded fo well, that, where the waters are not fufficiently powerful as laxatives, he recommends the Cheltenham falts, procured, we fuppofe; from the water, in the intervals of the feafons. We entirely acquiefce in his opinion, and think the Cheltenham waters chiefly useful as a mild, regular, and conftant laxative: his medical directions, for their use, are very exact.

We have not often felt greater difficulties than occurred in forming our opinion, and determining how to speak, of this performance. If we were to examine it fcrupuloufly, there are few pages to which we should not object; and, if we were to defend our objections, we fhould chiefly draw from our author in other parts of the work. We must explain: the whole fyftem is built on the corpufculár chemistry of the earlier ages; and many of the medical opinions are not only tinctured with the fame errors, but with the ufual ones of magnifying the virtues of these fprings. We wish to avoid the apparent pe tulance of inceffant carping; and this is certainly not a place either to pull down or eftablish chemical fyftems of extenfive influence. Dr. Smith too deferves respect; yet a higher claim compels us to mention fome of his inaccuracies, and, as we fufpect, his errors.

VOL. LXIII. March, 1787.

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When Dr. Smith speaks of the virtues of the Cheltenham waters, he obferves,

• If the conftitution could fuftain, unruffled and unimpaired, a long daily perfeverance in any other cathartics, equally with thefe waters, the fame falutary effects would probably enfue from their operation. But the art of pharmacy has never yet attained to that excellence of compofition. For it is well known that the most mild and gentle purgatives, however judiciously guarded and corrected, feldom fail of difcompofing the habit, in fome degree, during their operation; and if repeated daily, but for a fingle week, they would be found not only to enfeeble the ftouteft conftitution, but to bring on a train of complaints often worse than those they were intended to remove.'

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This differs greatly from our experience; for we have seen the lenitive electary, Rufus's pill, or James's analeptic pills, continued for more than a year, without inconvenience. Our author acknowleges, in a fubfequent paffage, that all the neutral purgatives are found, when the falt is plentifully diluted, not to ruffle the conftitution fo much as other phyfic,' Is not this imputing the eafe with which the Cheltenham waters are borne to the dilution of their falts ? and does this preclude every other medicine from acting in the fame way, when prepared in the fame manner?

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We allow that the fixed air and the fteel guard' the purgative quality of the waters, and that obftructions are moft fuccessfully removed by the continuance of eccoprotics; but the author goes too far when he excludes every other emunctory. We have often used diuretics in dropfies and cutaneous complaints, but never found a diabetes produced: it is very difficult to excite the difcharge, but eafy to ftop it; and a diabetes is not owing to an increafed fecretion only, but to an imperfect affimilation of the aliment.

It is neither confiftent with the philofophy of chemistry or of medicine, to afcribe effects to the attenuation of the remedy. We know not that iron, suspended in water by fixed air, is more attenuated than when in the ftate of a very dilute folution of green vitriol. It foon fubfides, not on account of its tenuity, but of the volatile nature of its acid. Dr. Smith attributes alfo the tenuity to heat: we know that by heat bodies are expanded, that by abforbing even heat which remains latent in their compofition, their density is leffened; but we know not that fixed air has a greater effect, in this refpect, than any other acid: there is much reason to suspect that it has lefs. The falts of the Cheltenham waters are fuppofed to be in an attenuated ftate, becaufe they contain much water in their crystals.

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First, the Cheltenham falt may be placed at the head of all the ufual purgatives of that clafs; its cryftals being found. to contain confiderably above fixty parts out of an hundred of pure water, and to be foluble in about an equal weight of that fluid. Next to the Cheltenham may ftand the pure glauber falt, as the water in its cryftals is found to amount to more than fifty out of the hundred, and to be foluble in a little more than double their weight. Near the glauber, may rank the Epfom falt; its cryftals containing fomewhat under fifty of water. As to the folubility, it is faid, by fome authors, that its cryftals are more fufceptible of folution than the glauber falt, notwithstanding they contain lefs water in their compos fition. When fo, the variation may be owing to a small com mixture of other ingredients befides the magnefia earth and the vitriolic acid of which they are compofed, as is not unusual in the native falts, conjoined with the feeble attraction that is known to fubfift between its original conftituent parts. After the Epfom comes the fea-falt, fed longo intervallo; as it is found to contain of water in its crystals, but fixteen parts out of the hundred; and requires above three times its weight for folution. Laftly, at the bottom of the fcale may be placed the vitriolated tartar; its cryftals containing but fix out of the hundred, and not being foluble in less than fixteen times their weight of water. As to the other artificial purgatives, com pofed of the different acids united with the different alkalies, fuch as foluble tartar, diuretic falt, Rochelle falt, and the di geftive falt of Sylvius; their places in the above scale vary ac cording to the various circumftances of their preparation."

It is a little remarkable, that a chemift fhould eftimate the folubility by the mode of crystallization, which exifts only in at dry ftate it is more remarkable that the author fhould not have feen, in thefe experiments, that the falt actually brought a great proportion of the menftruum entangled in its cryftals, which explains thefe differences in a great degree. Again, he fpeaks of pure Glauber's falt and Epfom falt, as different fub. ftances from the Cheltenham falts; and, in this work, refers to Dr. Fothergill's analyfis, who fuppofes that the Cheltenham falts are of this kind only. In our review of his work we fuggefted fome doubts on the subject, and these doubts are not yet cleared. Befides, the terra foliata tartari is more foluble than Epfom falt; nitre, foluble tartar, common falt, and fal gem, are more foluble than Glauber's falt, if abstracted from the water of the cryftallization. Our author perceives the great force of our objection on another fubject.

With refpect to the fatal effects of the nitrous folution, it is to be remarked, that nitre is one of thofe falts that contain very little water in their crystals, and that when compared with the glauber falt particularly, which is the most aqueous of any

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excepting the Cheltenham falt, the propertion of real faline matter is as eight to one. When, therefore, equal weights of thefe two falts are diffolved in the fame quantity of water, the water must be charged with eight times more faline matter in the nitrous folution than in the other; and that to bring those two folutions to the fame degree of ftrength, there ought to be forty-eight ounees, or a pint and an half, of water instead of fix ounces in the former."

Dr. Smith's obfervations on mercury and antimony, as we have hinted, are from the corpufcular philofophy. The latter is fuppofed to act by its fpicule, and the former by its weight, in giving force to the fpiculæ of the acid. Our author's geometry here forfakes him. As the velocity is nearly given, the momentum must be as the weight; it remains then to be enquired what the weight is which the blood in any one organ receives, by five grains of corrofive fublimate diffufed in the whole mafs; or to fhew why calomel, of a greater fpecific gravity, is lefs fuccefsful than the lighter fublimate. He ought alfo to fhow where the acid arifes when mercury is killed with an abforbent earth, or to prove that it is in this fate useless.

We are forry to be obliged so often to differ from Dr. Smith, for whofe talents we have a great esteem: but it was neceffary to say why we do not follow his guidance implicitly in this path; and it was neceffary to enter our protest against the revival of doctrines, which would fcarcely explain the few facts known in the earlier ages of chemistry. In the hands of Boyle, Boerhaave, and Newton, they were found incomplete.

A Philofophical and Medical Sketch of the Natural Hiftory of the Human Body and Mind. To which is fubjoined, an Essay on the Difficulties of attaining Medical Knowledge. By James Makittrick Adair, M. D. 8vo. 4s. in Boards. Dilly.

WE

E reviewed Dr. Adair's Medical Cautions, in our Sixtyfirft Volume, p. 149, we think, with candor and impartiality we have fome private reafons to fuppofe that the author's opinion was not very different, though we were accufed of fomewhat too much feverity; yet his acknowledgments to the Reviewers, in the Preface to this work, is too pointedly ironical to be paffed without notice. He will allow us to observe, that we can pretend to candor,' when we bring faults and merits equally forward; to impartiality,' when we are neither influenced by names or by connections. If Dr.. Adair examines our conduct, he will find that these rules have conftantly been obferved. But we must apply to our business and, though we may mention fome errors, we shall still find much to praife.

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The Medical Cautions refpecting regimen are foon to ap pear again, with additions, and, we fuppofe, with corrections. To explain the author's regulations this Sketch is first publithed. The design is to inftruct men of judgment, and of a liberal education, how to conduct themselves in the common circumftances where diet only is required, and to point out the great extent of the fcience of medicine, the neceffary qualifications of its profeffors, and the variety of its objects, to enable them to decide on the merits of the perfons to whom they would intruft their health. In fact, Dr. Adair levels a destructive blow at quacks and their noftrums, under whatever' plaufible pretenfions they may appear.

The Natural History of the Human Body contains a short and perfpicuous account of the human frame in general, its functions, and the first rudiments of its pathology. Dr. Adair aims at being clear and inftructive, and he has fully attained his purpose; for a common understanding will easily comprehend every fentence of it, and a more enlightened one will be pleased with the manner in which intricate subjects are divested of their obfcurity. There are fome doubtful and some erro-, neous pofitions interfperfed, but, in general, they are of little importance; and many of these are given as the opinions of others rather than his own. A little credulity feems fometimes to have led him to transcribe wonderful ftories; but this belief is no more a fault than our unbelief: both are perhaps involuntary. There is an inftance of both thefe obfervations in a few lines.

From the communication of the ear with the mouth, we can account why deaf perfons can hear when a flip of board is placed with one end on a mufical inftrument, and the other between the teeth; and we are affured that a deaf person heard what was written on her back or arm.'

That the former part of this fentence is erroneous, Dr. Adair will eafily perceive, by laying a fmall watch on his tongue; and, without any communication with his teeth, he will not then hear the vibrations: if he touches any part of it with his teeth, he will foon perceive that the means of communication are the bones of the head. As to the fecond part: of the fentence, we would as foon believe all the miracles of Schenckius, or that women may be burnt alive by inflammable air generated in their conftitutions, as this fact from Haller, for this plain reason, that the skin in the living body is not elastic we cannot help it; every one, doctor, has his peculiarities.

The refiftance to the power of the heart and arteries, by the weight of the air, is not, in our opinion, a ftimulus to

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