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at proper intervals; if to these remedies we join cleanliness, external washing with decoctions of aromatic herbs, and frequent exercise, it is hardly possible but that these sweats, from whatever parts they proceed, or to what degree soever of clamminess they may have arrived, should not be changed in their nature, and their bad qualities be either totally destroyed or greatly corrected.

If however all these means are ineffectual, and the sweats proceed from the head or the arm-pits, we should open an issue in the nape of the neck or in the arm; but if the seat of the complaint should be the groin, the thighs, or the feet, it will be better to open it in the leg, This is our last resource for overcoming this disease, when it is insuportable to the patient and his friends, when it has resisted all other means which have been thought of. Zacutus Lusitanus* has found it effectual in similar cases. But if the issue is of no service, we must always avoid every thing repellent, as the cold bath and all astringent lotions, ointments, &c. lest we hurry our patient into the grave.

It may be said that the issue is as troublesome and disgusting as the sweats, and that it often diffuses a smell as disagreeable as that which it is designed to remove; it is true the issue must be kept open a long time, and must be often dressed; but the advantage derived from it more than counter-balances the care and attention it requires, and if it occasionally offends by its smell, this may be obviated by dressing it twice in the day, by covering it with a plaster, or linen, or perfumed silk, and to keep it open, we should not use peas, but little balls made of wax, of orris root, or yellow sanders.

Article 2.--ITCHINGS.

This disease may be reduced into four classes, according to its causes and origin.

The first is critical; it arises from an internal cause, and is the consequence or termination of some acute or chronic disease, as when it terminates a continued or intermittent fever, of which it indicates the finish and cure,

The second arises spontaneously, appearing of itself, without any preceding indisposition; this species also is owing to some internal cause, and is generally the effect of an accumulation of gross humours, formed by degrees

K 3

in

* Observat. 71. libr. 3, praxis admirand.

in the system, which, quitting the internal parts, are carried by transpiration under the cuticle, producing there a kind of itch, which chiefly attacks those who feed upon gross aliments, such as salted meats, of beef or pork, le guminous vegetables, green sour fruits, &c.; those who have drunk much wine loaded with tartar, those who have respired the sea air, and who have not been careful to wash their bodies, and keep their skin clean. This species commonly affects those who have taken long voyages.

The third is symptomatic, and owes its origin also to an internal cause; it is the effect of and usually accompanies some other disease, as the jaundice, the venereal disease, &c. Nothing is more common than to see persons affected with jaundice, having their skin not only yellow, but rough and studded with risings or small pimples, accompanied with a great itching; they also sometimes have their transpiration and sweat yellow as well as their urine. It must then be the bile retaining its colour, united to the matter of transpiration, which it renders more gross, causing it to be stopped in the pores of the skin; these become filled with it, and are soon enlarged and opened, the same as the scarf skin where the pimples show themselves, as also the pustules and the itching, all symptoms essential to the itch.

It will be the same with the lues, if the venereal virus is floating in the blood, or, to speak more correctly, is mixed with the lymph, it is carried by transpiration to the cutaneous pores; they are overloaded with it, and there will follow pimples, pustules and itching, consequently a venereal itch, referable to the cause which produced it,

The fourth and last species of itch is that which is produced from without, and is entirely owing to an external cause, such as contagion, frequent contact or cohabitation with a person affected with the disease. In this case, the moisture, the scurf, the scales, and every thing that falls from the skin of a person affected, may easily adhere to the skin of a sound person, and there produce erosions, pustules, and itchings, similar to those of the person first affected; moreover, as it is only in the skin it makes its appearance, and if what comes from the skin of the affected person has shut up the pores of the sound skin, and has impeded the transpiration through it, and if by a necessary consequence those pores are filled and obstructed by the infection, we may readily conceive, that in this way the itch may easily be transferred and communicated

from

from a person infected with it to another whose skin is healthy*

I shall not deal in mere possibilities, or vain speculations, but shall give practical facts, as they have been observed by myself and some other of our authors.

(To be continued.)

Perhaps one of the best means of judging of the state of medical science and medical practice in a country, is a perusal of the works most in repute, and generally esteemed in that country; with this view we shall occasionally give an extract from some new French book, that our readers may see how far our neighbours on the continent precede or are behind us in this respect. EDIT.

To the Editors of the Medical and Phyfical Journal.

GENTLEMEN,

I Am a friend to true and candid criticism, and therefore am obliged to your correspondent A. B. for having offered some remarks upon my letter on Superfotation; not that I think he has exactly, in all respects, treated it in the manner I could have wished, because the legitimate and sole end of criticism is truth; therefore, whenever I find a person turning aside from the points on which the argument depends, to ridicule unimportant deviations from logical precision, I begin to fear, that, in his heart, there is some hankering after victory, to sully the purity of his endeavours in the cause of scientific truth. I need scarcely add my thoughts on the observations of A. B. on the lapsus

which

*The itch, properly so called, is to be regarded as a cutaneous eruptio n sui generis, and is characterized by the following symptoms. An eruption of pimples, on the top of each of which there appears some lymph, at first transparent, at length becoming dry; it is accompanied by violent itching, increased in the evening and at night; these pimples are more numerous in the fingers, wrists, loins, hams, and groins, than in other parts of the body, The itch is contagious. If it is very violent, continued watching, agitation of the whole body, extreme itching, want of appetite, hemicrania, and slow fever are the consequence; the system in general becomes infected, a dry cough and wasting of flesh succeed. It is sometimes combined with syphilitic, or herpetic virus, &c.; it may be repelled inwardly, and falling upon some important organ, may there produce chronic diseases of the worst description, as asthma, phthisis pulmonalis, abscess of the liver, hysteria, mania, &c,

which had glided into the first part of my last letter; especially too, in a case like the present, which, when examined with the context, may be defended as being no lapsus at all, because it merely resolves itself into this question, have "the majority of practitioners attentively considered the anatomy of the gravid uterus?" It may be my opinion that they have not.

I consider it extremely unfortunate that I was ignorant of the papers upon the same subject, which appeared in Nos. 125 and 128, of your Journal. From my seeing the Medical Journal only through the uncertain medium of a Book Society, those papers had and still have escaped my notice, so that I am still as ignorant of their contents as I was before the publication of my last letter.*

I now proceed to examine A. B's objections to what he has made me, somewhat ostentatiously, give the title of a new doctrine of superfotation. A B. does not in any place deny my conclusions, except, indeed, indirectly in one instance, where he shows a considerable want of knowledge in the practice of midwifry, but levels his shafts at the arguments which are brought forward to prove them; and at these merely upon the principle, that I consider them the only cause which prevents superfotation from taking place. That this is my opinion cannot be deduced from my premises; because, although the road to the ovarium being stopped, may be considered as a cause adequate. to the effect, yet, that is no reason why there should not be other causes acting, and acting more forcibly, for the same end. The truth is, that in proving an opinion, you can only make use of tangible arguments. I could say, as well as A. B. or Dr. Haighton, that after impregnation has taken place, the organs of generation become changed in their powers and functions, which disqualifies them from further impregnation as long as gestation is going on; but this is mere opinion; we are unable to demonstrate these changes, and therefore it becomes an inadmissible argument on such an occasion as the present. A. B. indeed remarks, that they are made clear by the experiments of Dr. Haighton.

In this place A. B. has given an unqualified assertion, as a quotation from my letter, which upon re-perusal he will find is qualified with the word perhaps

He here states, that the plug which stops up the os uteri during gestation might become the cause of rupture of the uterus, when he ought to have known that the first act of labour is the expulsion of this plug.

Haighton. What these experiments are he does not mention; and as I have been unfortunately debarred the opportunity of gaining information from the learning of that gentleman, I should feel much gratified if A. B. would faYour me with the proofs upon which he grounds that opinion; for, as circumstances at present strike my mind, there seem to be several facts which are in opposition to it. Perhaps, however, this seeming contradiction may only depend upon the different times at which we fix the termi nation of impregnation. If Dr. Haighton considers the process of impregnation not to have terminated till the foetus has descended into the uterus, such an opinion can never be correct, because abundance of cases have happened in which the ovum never has reached the uterus at all, yet still is nourished; but if, on the contrary, he thinks it takes place immediately upon the liberation of the impregnated ovum from the ovarium (and I conceive that no intermediate time can be allowed); then the fact related in my letter from Dr. Hamilton, of bitches bearing puppies of different breed and others of the same kind, seem to stand in direct opposition to the opinion above mentioned. Of this kind, of course, is the fact of the American black woman, mentioned in my letter, which A. B. rather ungraciously doubts being a fact, upon the mere inaccuracy of Mr. Fawell or some other person, who happened to say, that the children were one black and the other white, which the commonest understanding must know could not possibly have been the case, as one child must have been a black and the other a mulatto. I cannot help finding fault also with A. B. for making me say, that, in my opinion, the fright received by the woman was the cause of the death of the child; this he will find was no opinion of mine in the slightest degree.

I should like A. B. to be a little more exact in his examination of my expressions, especially after having begun his remarks by finding fault with their accuracy.

I shall with great pleasure see a more satisfactory answer from A. B. for at present I must own, that I do not think he has established any thing of consequence against my positions.

July 8, 1810.

I am, &c.

H.

To

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