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condition of animal fluids, are particulars yet involved in great obscurity, and are therefore still subjects of dispute.
There is another particular, in which Boerhaave's doctrine concerning the fluids appears to me imperfect and unsatisfactory; and that is, in his doctrine de Glutinosb spontaneo. The causes which he has assigned for it are by no means probable, and the actual existence of it is seldom to be proved. Some of the proofs adduced for the existence of the phlegma calidum are manifestly founded on a mistake with respect to what has been called the inflammatory crust, (see Van Swieten's Commentary, page 96); and the many examples given by Boerhaave, of a glutinosům appearing in the human body (aph. 75) are all of them nothing more than instances of collections, or concretions found out of the course of the circulation:
If, then, we consider the imperfection of Dr. Boerhaave's doctrine with respect to the state and various condition of the animal fluids; and if, at the same time, we reflect how frequently he and his followers have employed the supposition of an acrimony or lentor of the fluids, as causes of disease, and for directing the practice; we must, asI apprehend, be satisfied, that his system is not inly deficient and incomplete, but fallacious and
apt to mislead. Although it cannot be denied, that the fluids of the human body suffer various morbid changes; and that, upon these, diseases may primarily depend; yet I must beg leave to maintain, that the nature of these changes is seldom understood, and more seldom still is it known, when they have taken place; that our reasonings concerning them have been, for the most part, purely hypothetical; have therefore contributed nothing to improve, and have often misled, the practice of physic. In this, particularly, they have been hurtful, that they have withdrawn our attention from, and prevented our study of, the motions of the animal system, upon the state of which the phenomena of diseases do more certainly and generally depend. Whoever, then, shall consider the almost total neglect of the state of the moving powers of the animal body, and the prevalence of an hypothetical humoral pathology, so conspicuous in every part of the Boerhaavian system, must be convinced of its very great defects, and perceive the necessity of attempting one more correct.
. After giving this general view, it is not requi. site to enter into particulars : but I believe there are very few pages of his aphorisms in which there does not occur some error or defect; although, perhaps, not to be imputed to the fault of Boer. haave so much as to this, that since his time a great collection of new facts has been acquired by
observation and experiment. This, indeed, affords the best and most solid reason for attempting a new system : for, when many new facts have been acquired, it becomes requisite that these should be incorporated into a system, whereby not only particular subjects may be improved, but the whole may be rendered more complete, consistent, and useful. Every system, indeed, must be valuable in proportion to the number of facts that it embraces and comprehends; and Mons. Quesney could not pay a higher compliment to the system of Boerhaave, than by saying that it exhibited La Médecine collective.
But here it will, perhaps, be suggested to me, that the only useful work on the subject of physic, is the making a collection of all the facts that relate to the art, and therefore of all that experience has taught us with respect to the cure of diseases. I agree entirely in the opinion ; but doubt if it can ever be properly accomplished, without aiming at some system of principles, by a proper induction and generalization of facts: at least I am persuaded, that it can be done not only very safely, but most usefully, in this way. This, however, must be determined by a trial. I know that the late Mr. Lieutaud has attempted a work on the plan of collecting facts, without any reasoning concerning their causes: and while I am endeavouring to give some account of the present state of physic, I.
cannot dismiss the subject without offering some remarks upon the promising Synopsis universe medicina, composed by the first physician of a learned and ingenious nation.
In this work there are many facts and much observation from the author's own experience, which may be useful to those who have otherwise acquired some knowledge and discernment; but, throughout the whole work, there is such total want of method, arrangement, system, or decision, that, in my humble opinion, it can be of little use, and may prove very perplexing to those who are yet to learn. The distinction of the genera of diseases, the distinction of the species of each, and often even that of the varieties, I hold to be a ne. cessary foundation of every plan of physic, whether dogmatical or empirical. But very little of this distinction is to be found in the work of Mr. Lieutaud ; and in his preface he tells us, that" he meant to neglect such arguta sedulitas. And indeed his method of managing his subject must certainly interrupt and retard all methodical nosology. His arrangement of diseases is according to no affinity, but that of the slightest and uninstructive kind, the place of the body which they happen to affect. His Generalia et incertie sedis, have hardly any connection at all; the titles, Rheumatismus, Hypochondriasis, Hydrops, follow one another. When he does attempt any generał doc
trine, it is not till long after he has treated of the widely-scattered particulars. Under each particular title which he assumes, he has endeavoured to enumerate the whole of the symptoms that ever appeared in a disease under that title; and this without aiming at any distinction between the es. sential and accidental symptoms, or marking the several combinations under which these symptoms do for the most part steadily appear. From the concurrence of accidental, symptoms, the variety of the same disease is frequently considerable, at circumstance necessarily perplexing and distracting to young practitioners ; but it seems strange to me, that an experience of thirty years, in considerable practice, could do nothing to relieve them.
Mr. Lieutaud has, at the same time, increased the confusion that must arise from this want of distinction, by his considering as primary diseases, what appear to me to be the symptoms, effects, and sequels, of other diseases only. Of this I think the Æstus morbosus, Virium'exolutio, Dolorus, Stagnatio sanguinis, Purulentia, Tremor, Pervigilium, Raucedo, Suffocatio, Vomica, Empyema, Singultus, Vomitus, Dolor stomachi, Fenesnius, all treated of under separate titles, are examples. Argeneral symptomatologia may be a very useful work, with a view to a system of pathology; but, with a view to practice without any system, it must have bad effects, as leading only to a palliative