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THE

CRITICAL REVIEW.

For M

M À Ê Ċ H, 1787.

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Observations on the Ule and Abuse of the Cheltenham Waters, in

which included Occasional Remarks on different Saline Compositions. By 9. Smith, M.D. 8vo.

8vo. 15, 6d. Murray." R. Barker complained of the neglect of these waters,

but Dr. Smith gives a more favourable view of the attention paid to them by the public. The great object of these Observations is to explode the opinion of the Cheltenham waters acting as alteratives, and of course to prevent their being made a common drink; fince, in full seasons, there is not a sufficient supply for those who repair to Cheltenham for their assistance. Dr. Smith has performed this part of his talk with success ; indeed he has succeeded so well, that, where the waters are not fufficiently powerful as laxatives, he recommends the Cheltenham falus, procured, we suppose; from the water, in the intervals of the seasons. We entirely acquiefce in his opinion, and think the Cheltenham waters chiefly useful as a mild; regular, and constant laxative: his medical directions; for their use, ate very exa&t.

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 fcrupulously; there are few pages to which we should not object; and; if we were to defend our objections, we should 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 cpinions are not only tinctured with the same errors, but with the usual ones of magnifying the virtues of these springs. We wilh to avoid the apparent per tulance of inceffant carping; and this is certainly not a place either to pull down or establish chemical systems of extensive influence. Dr. Smith too deserves respect; yet a higher claim compels us to mention some 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 observes,

• If the conftitution could suftain, unruffled and unimpaired, a long daily perseverance in any other cathartics, equally with these waters, the fame falutary effects would probably ensue 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, seldom fail of discomposing the habit, in some degree, during their operation; and if repeated daily, but for a single week, they would be found not only to enfeeble the Atoutest constitution, but to bring on a train of complaints often worse than those they were intended to remove.'

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 subsequent paffage, that all the neutral purgatives are found, when the falt is plentifully dibuted, not to ruffle the constitution so much as other physic,' Is not this imputing the ease with which the Cheltenham waters are borne to the dilution of their falts ? and does this preclude every other medicine from acting in the same way, when prepared in the same manner :

We allow that the fixed air and the steel guard' the pur. gative quality of the waters, and that obstructions are most 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 discharge, but easy to stop it; and a diabetes is not owing to an increased fecretion only, but to an imperfect assimilation of the aliment.

It is neither confistent with the philosophy 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 state of a very dilute folution of green vitriol. It foon subsides, not on account of its tenuity, but of the volatile nature of its acid. Dr. Smith attributes also the tenuity to heat : we know that by heat bodies are expanded, that by abforbing even heat which re. mains latent in their composition, their density is lessened ; but we know not that fixed air has a greater effect, in this respect, than any other acid: there is much reason to suspect that it has less. The salts of the Cheltenham waters are supposed to be in an attenuated state, because they contain much water in their cryftals. 1

First, • First, the Cheltenham falt may be placed at the head of all the usual purgatives of that class; its cryftals being found to contain confiderably above fixty parts out of an hun. dred of pure water, and to be foluble in about an equal weight of that Huid. Next to the Cheltenham may ftand the pure glauber salt, as the water in its crystals is found to amount to more than fifty out of the hundred, and to be soluble in a little more than double their weight. Near the glauber, may rank the Epsom salt; its crystals containing somewhat under fifty of water. As to the folubility, it is said, by some authors, that its crystals are more susceptible of solution than the glauber salt, notwithstanding they contain less water in their compofition. When so, the variation may be owing to a small com: mixture of other ingredients besides the magnefa earth and the vitriolic acid of which they are composed, as is not unusual in the native falts, conjoined with the feeble attraction that is known to fubfiit between its original constituent parts. After the Epsom comes the sea-salt, led 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 solution. Lastly, at the bottom of the scale may be placed the vitriolated tartar; its crystals containing but fix out of the hundred, and not being soluble in less than fixteen times theit weight of water. As to the other artificial purgatives, com posed of the different acids united with the different alkalies, such as soluble tartar, diuretic salt, Rochelle salts and the di. gestive falt of Sylvius; their places in the above scale vary according to the various circumstances of their preparation:

It is a little remarkable, that a chemist should estimate the solubility by the mode of crystallization, which exifts only in a dry state : it is more remarkable that the author should not have seen, in these experiments, that the salt actually brought a great proportion of the menstraum entangled in its crystals, which explains these differences in a great degree. Again, he speaks of pure Glauber's salt and Epsom falt, as different fube stances from the Cheltenham falts; and, in this work, refers to Dr. Fothergill's analysis, who supposes that the Cheltenham salts are of this kind only. In our review of his work we suggested some doubts on the subject, and these doubts are not yet cleared. Besides, the terra foliata tartari is more soluble than Epsom salt; nitre, foluble tartar, common salt, and sal gem, are more soluble than Glauber's salt, if abstracted from the water of the crystallization. Our author perceives the great force of our objection on another subject.

wWith respect to the fatal effects of the nitrous solution, it is to be remarked, that nitre is one of those falts that contain very little water in their crystals, and that when compared with the glauber falt particularly, which is che molt aqueous of any excepting the Cheltenham salt, the proportion of real faline matter is as eight to one. When, therefore, equal weights of these two falts are diffolved in the same quantity of water, the water must be charged with eight times more faline matter in the nitrous solution than in the other; and that to bring those two folutions to the fame degree of strength, there ought to be forty-eight ounces, or a pint and an half, of water instead of fix ounces in the former.'

Dr. Smith's observations on mercury and antimony, as we have hinted, are from the corpufcular philosophy. The latter is supposed to act by its fpiculæ, and the former by its weight, in giving force to the spiculæ of the acid. Our author's

geometry here forsakes him. As the velocity is nearly given, the momentum must be as the weight; it rem::ins then to be enquired what the weight is which the blood in any one organ receives, by five grains of corrosive sublimate diffused in the whole mafs; or to fhew why calomel, of a greater specific gravity, is less successful than the lighter sublimate. He ought also to show where the acid arises when mercury is killed with an absorbent earth, or to prove that it is in this state useless.

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

A Philosophical and Medical Sketch of the Natural History of the

Human Body and Mind. To which is subjoined, an Esay on the Difficulties of attaining Medical Knowledge. By James

Makittrick Adair, M. D. 8vo. 45. in Boards. Dilly. WI

E reviewed Dr. Adair's Medical Cautions, in our Sixty

first Volume, p. 149, we think, with candor and im. partiality :' we have some private reasons to suppose that the author's opinion was not very different, though we were accused of somewhat too much feverity ; yet his acknowledgments to the Reviewers, in the Preface to this work, is too pointedly ironical to be passed 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 constantly been observed. But we must apply to our business ; and, though we may mention fome errors, we shall still find much to praise.

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The Medical Cautions respecting regimen are foon to appear again, with additions, and, we suppose, with corrections. To explain the author's regulations this Sketch is first published. The design is to instruct men of judgment, and of a liberal education, how to conduct themselves in the common circumstances where diet only is required, and to point out the great extent of the science of medicine, the necessary' qualifications of its profeffors, and the variety of its objects, to enable them to decide on the merits of the persons to whom they would intrust their health. In fact, Dr. Adair levels a destructive blow at quacks and their noftrums, under whatever plausible pretensions they may appear.

The Natural History of the Human Body contains a mort and perspicuous account of the human frame in general, its functions, and the first rudiments of its pathology. Dr. Adair aims at being clear and instructive, and he has fully attained his purpose; for a common understanding will easily comprehend every sentence of it, and a more enlightened one will be pleased with the manner in which intricate subjects are divested of their obscurity. There are some doubtful and some erro-, neous positions interspersed, but, in general, they are of litile importance ; and many of these are given as the opinions of others rather than his own. A little credulity seems sometimes to have led him to transcribe wonderful stories ; but this belief is no more a fault than our unbelief: both are perhaps involuntary. There is an instance of both these observations in a few lines,

• From the communication of the ear with the mouth, we can account why deaf persons can hear when a slip of board is. placed with one end on a musical instrument, and the other be. tween the teeth ; and we are assured that a deaf person heard, what was written on her back or arm.'

That the former part of this sentence is erroneous, Dr. Adair will easily perceive, by laying a small 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 soon perceive that the means of communication are the bones of the head.

As to the second part: of the sentence, we would as soon believe all the miracles of Schenckius, or that women may be burnt alive by inflammable air generated in their constitutions, as this fact from Haller, for this plain reason, that the skin in the living body is not elastiç: we cannot help it; every one, doctor, has his peculiarities.

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

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