Remittent Fever in their most intense forms; and that if it was possible to give this mineral, so as to produce the characteristic effect on the mouth, the patient was safe.* It was, accordingly, believed to be good practice to administer to patients labouring under Yellow Fever and intense Remittent, very large doses of calomel or blue pill, in some instances to the extent of 500, 1000, and 1600 grains; and the periodical and other medical writings of England and the United States contain records of sundry instances in which mercury was given to a very large amount. It was in no long time found, however, that though certain cases, by some it is said. many, recovered under this mercurial treatment, as it was named, yet patients suffering under Yellow Fever died after the gums had been completely affected; and of those who recovered under the treatment, it was by competent observers doubted, whether they would not have recovered without the use of the mineral.

These experiments, nevertheless, showed, that when the system is under the influence of Yellow Fever or intense Remittent Fever, it becomes greatly less amenable to the action of mercury. The human frame in that state acquires a sort of physio

* Practical Observations on the Treatment of Acute Diseases; particularly those of the West Indies. By William Wright, M.D., &c. Medical Facts and Observations, Volume VII., pp. 1, 5, and 7. London, 1797.

† A Sketch of the History and Cure of Febrile Diseases. By Robert Jackson, M.D., &c. Stockton and London, 1817.

8vo. Pp. 238, 241, 243.

Ibid., p. 243.

logical insensibility to the action of the mineral, and perhaps to other agents. Whether it can be said to tolerate and endure this mercurial action better than in the state of health, is a point which may be left to the judgment of the reader.

f. The Sulphate of Quinine often requires to be given in very large doses; and these doses to be often repeated and long continued, in order to subdue the symptoms of certain obstinate forms of Remittent or Endemic Fever. The effect of this use of Sulphate of Quinine is to induce ringing in the ears, and various symptoms of fulness and congestion in the head; and as this assemblage of symptoms has been regarded by practitioners in the Tropics as indications of the physiological action of the remedy upon the system, it has been designated by the appropriate name of Cinchonism. It seems to be scarcely a matter of doubt, that this condition is one which is more readily endured or tolerated by the system, when under the action of endemic fever than either in the state of health or in other morbid states. At all events, very large quantities of the remedy have been given in such circumstances, until the economy is, as it were, charged with the substance.

Other medicinal substances, as Indigo and Iodine, have been given in such manner, and to such amount, as to try the powers of endurance in the economy. But enough has been said to elucidate the nature of this supposed capacity of the human frame for enduring the action of various powerful agents upon its organs. If we are to admit the existence of this power of endurance, readers will readily think of the

doctrine maintained by John Hunter of the incompatibility of two actions in the system at the same time, and may regard endurance as a modified illustration of this doctrine. Endurance or tolerance of powerful agents takes place chiefly during morbid conditions; but this endurance or tolerance, when it exists and continues, either extinguishes the morbid state, or induces a condition of the system favourable to the abatement, the removal, and the abolition of that morbid state.

The account of the peculiar speculative opinions of Dr John Brown has unavoidably occupied a larger proportion of space and attention than that to which their intrinsic merits entitle them. From their relation to the doctrines of Cullen, and from the ingenious manner in which they were represented by their author to differ from these doctrines, it became indispensable to give some account of them. But a most erroneous estimate of the true nature of these speculations, and of their influence upon the Practice of Medicine among contemporaneous and succeeding physicians would be entertained, if the statements of the followers of Brown were to be received without question and without examination. In forming a just estimate of the nature and effects of the speculative opinions of Dr Brown, it must be observed, that, in Edinburgh, where their author lectured, and in England and Scotland in general, these opinions never made a strong or durable impression. They were listened to for a short time by a number of persons more remarkable for their love of novelty than

for soundness of judgment. They formed the subject of discussion, and not unfrequently of experiment, at the Medical Society of Edinburgh, and some other associations of students and young persons in general; but they never exerted much influence upon the treatment of diseases as conducted in the hands of respectable English and Scottish physicians. Neither did the doctrines of John Brown engross, in the medical schools of England and Scotland, that amount of attention, or excite that degree of interest, which the representations of some foreign authors would lead us to believe they did. In Edinburgh, the interest excited by the doctrines of Dr Brown at no time penetrated into the University, and it was confined to one or two extra-academical teachers, more noted for paradox and singularity than for qualities supposed to distinguish rational instructors. In Glasgow and Aberdeen, these doctrines were scarcely known. In London, the lecturers attached to hospitals appear scarcely to have noticed these doctrines; and they certainly at no time became the subject of discussion or the foundation of practice. One or two surgeons, indeed, sometimes employed the terms Collapse, Excitement, Depression, Stimulation, and the analogous terms, Sedatives and Stimulants; but this they had done previous to the promulgation of the doctrines of Brown; and all the idea that they had of the author was, that he was fond of giving stimulants where other physicians condemned the employment of these articles, and of exhibiting opium in the treatment of symptoms which were in general more safely managed upon the antiphlogistic method. John

Brown himself was indeed almost the only lecturer in London, during the short time that he taught in the metropolis, who attempted to explain the theory and treatment of diseases upon the principles peculiar to himself. It was not, in short, to be expected, that in London, where the courses were at that time of only three months' duration, and where all the instructions were of a kind bearing directly upon practice and treatment, the speculations of Brown should occupy much or any attention; and there, accordingly, they never did excite more than temporary interest.*

Other circumstances further contributed in a very direct manner to render the reception of the principles of John Brown, by the Medical Profession in Great Britain, not only partial and imperfect, but altogether null. At a period so early as 1731-32, the physicians and surgeons of Edinburgh had, under the auspices of the first Monro, Charles Alston, Robert Whytt, and Andrew Plummer, in that city, and Thomas Simson, and George Martin of St Andrews, formed themselves into an association for the purpose of collecting and preserving such isolated but important facts as individually could not be published with advantage, but, conjointly, might form a work of considerable value to the members of the Medical Profes

"It is neither in Scotland nor in England that the doctrine of Brown found most partizans. Italy received this doctrine with enthusiasm, and the progress which it made in that country forms in some sense a sort of prodigy. For if there is one country in Europe where the method of Brown must produce inconveniences, it is unquestionably Italy, where the susceptibility of the gastric system renders the practical application of this system in almost all instances dangerous."-Broussais, Examen des Doctrines Medicales, Chapitre v., p. 150.