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both sorts of diseases, follows. If the remedies be neglected, the solution of continuity degenerates into a worse and worse nature, and then into gangrene, or the death of the part. It is the excitability, or that property of life by which the functions are produced, that, wherever life, whether in a part, or over the whole body, is hurt, procures the return of the healthy state, by means of the external powers acting upon it. It is, then, the excitability, affected by the action of those powers, that is to say, the excitement, which governs the state of the solids, both in parts, and over the whole body." (Elem. § 701.)

Dr Brown's denial of the existence of the healing powers of nature,-understanding by that term the spontaneous occurrence in the animal economy, when threatened or affected with disease, of vital changes calculated to counteract the injurious operation of external agents, and to restore the functions to a healthy state when any morbid deviation has occurred in them, -seems to have had the same origin to which several other of his opinions have been traced, an exaggerated perversion of generalizations, some of a speculative, and others of a more practical nature, which had been previously formed and expressed by Dr Cullen in his lectures and writings. The Stahlian doctrine of the existence, in the economy, of an intelligent agent, which, perceiving the tendency of noxious powers threatening, or of disorders anywise arising in the system, immediately excites such motions in the body, as are suited to obviate the hurtful or pernicious consequences that might otherwise take place,-appeared to Dr Cullen to be calculated to lead physicians into, or to continue them in a weak and feeble practice, and, at the same time, to supersede or discourage all the attempts of art. Al

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though, therefore, he contends that the operation, in diseases, of the Vis Medicatrix Naturæ, or, in other words, of the vital mechanism of the animal economy, must unavoidably be admitted as a fact, yet he somewhat incautiously, and perhaps even inconsistently with his general views, alleges that" wherever this principle is admitted, it throws an obscurity upon our system; and that it is only where the impotence of our art is very manifest and considerable, that we ought to admit of it in practice." (See Works, vol. i. p. 406-7.) And accordingly, in Dr Cullen's writings, allusion is more frequently made to the influence of the healing powers of Nature, as producing some of the phenomena of diseases, than as superseding the necessity of medical treatment.

It would be unjust to imagine that physicians, in ascribing conservative and healing powers to the animal economy, or in asserting that such is its constitution, had meant to allege that in all the circumstances in which noxious agents operate upon this economy, motions are excited in it sufficient for producing their expulsion, or for obviating their effects. Those who have most strenuously inculcated the propriety of the practitioner availing himself of, and trusting to the powers or efforts of nature, as they have been termed, which tend to the restoration of health, have at the same time acknowledged that, in some instances, Nature seems to make no efforts whatsoever to resist the action of morbific causes; that in others the efforts which she makes, are insufficient to produce this effect, and require the assistance of art; and that in other instances, again, her efforts are injurious, and require to be counteract

ed. Dr Brown, in his recommendation of a constant and universal activity in the practice of the medical art, seems entirely to have overlooked the distinction that exists between those diseases which are known to disappear without the employment of remedies, or the cure of which has generally been attributed to Nature; -those which can only be removed by the employment of remedies, or in which nature has been said to require the assistance of art;-and those which prove fatal, however skilfully remedies may have been employed. In few things, however, do the superior knowledge and skill of the experienced practitioner shew themselves more evidently than in the accuracy with which he distinguishes between these three classes of morbid affections; the caution and prudence which he observes in interfering with the natural course of diseases, and the decision, promptitude, and efficacy of his measures, in the circumstances in which they may be useful. What a contrast to this does the ignorant and presumptuous practitioner exhibit, who, in the treatment of his patients, is perpetually meddling with and thwarting the salutary operations of Nature; employing himself busily, when he ought to be a simple spectator, and remaining confused or idle during the occurrence of morbid phenomena that call for the most prompt and vigorous interference of art.

In conformity with the general principles, physiological, pathological, and therapeutical, set forth in the foregoing propositions, Dr Brown undertook to expound the nature, history, and treatment of particular diseases; and he has, both in his avowed and unavowed writings, lost no opportunity of asserting the

immense superiority of his own modes of practice, as compared with those which had been followed by preceding physicians. Notwithstanding the length to which our examination of Dr Brown's claims to original improvement in the theory of medicine has extended, it seems proper, before concluding the review of his system, to institute a slight comparison of the plans of treatment recommended by him to be pursued in some of the principal diseases to which the economy is subject, with those which Dr Cullen had advised for the same diseases. This comparison, while it will shew that not a few of Dr Brown's practical statements and doctrines had their origin in a desire to contradict precepts inculcated by Dr Cullen in hist lectures and writings, will, at the same time, evince how wide a difference there is between universal and unqualified canons, founded entirely upon speculative views of a practical art, and restricted, qualified, and prudent rules, framed in conformity with the general experience of medical practitioners, and corrected or improved by that of their judicious and reflecting suggester. As might be anticipated from his general view of the comparatively greater frequency of asthenic than of sthenic diseases, the methods of cure enjoined in particular diseases by Dr Brown will be found to differ from those recommended by Dr Cullen and other experienced physicians, chiefly in the more extended application of the stimulant plan of treatment as respects both regimen and medicines.

There is, perhaps, no part of the writings of Dr Cullen calculated to convey a higher impression of his sagacity as a practical observer, or of his perspicuity as

a teacher, than the account which he has given of the circumstances under which debilitating and stimulating remedies, and, in particular, bloodletting and the use of wine and opium, should be had recourse to, in the treatment of fevers. With respect to the treatment of Continued Fevers, his general principle was, that the choice of remedies must be guided by the character of the symp‐ toms which may appear to prevail in the particular case, whether these shall be of an inflammatory, of a nervous, or of a putrescent or bilious character. From the frequent combination of the inflammatory diathesis with the febrile state, the antiphlogistic plan of treatment appeared to Dr Cullen to be of very frequent applicability in the treatment of Continued Fevers (First Lines, § 127.); but, at the same time, he was at great pains to point out the circumstances which indicate the employment of stimulant remedies (ibid. § 201), and particularly of wine (ibid. § 219), which he considered as the safest form of stimulant in this class of diseases. See Works, vol. i. p.644.) Dr Brown, on the other hand, maintained that antiphlogistic remedies are seldom if ever required in any form of fever, whether in that which had been termed Synocha (or inflammatory fever) or in Typhus (or low fever); and that, in the latter form of fever in particular, the hopes of the practitioner must be placed entirely in the free use of stimulant remedies.

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Synocha," he informs us, is one of those mild sthenic diseases in which bleeding is not necessary, and bleeding with any degree of freedom is hurtful." (Elements, § 482.) Of those more gentle sthenic diseases, amongst which he includes. Synocha, he says that," while it is very easy to distinguish them from the asthenic diseases resembling them, if, how

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