Page images

practice, and diverting from the proper efforts to. wards obtaining a radical cure." Mr, Lieutaud, indeed, has endeavoured to exhibit the symptoms above mentioned as so many primary diseases : but he has seldom succeeded in this; and, in delivering the practice, he commonly finds it necessary to consider them as symptoms, and that not without some theory, implied or expressed, with respect to their proximate causes. His title of Dolores may be taken as an example of this; and from which it may be readily perceived how far such treatises can be really useful.

In establishing a proper pathology, there is nothing that has been of more service than the dissection of morbid bodies. Mr. Lieutaud has been much and most commendably employed in this way, and in this Synopsis he has endeavoured to communicate his knowledge on the subject ; but, in my humble opinion, he has seldom done it in a manner that can be useful. In the same way that he has delivered the symptoms of diseases, without any instructive arrangement; so, on the subject of the appearances after death, he has mentioned every morbid appearance that had ever been observed after the disease of which he is then treating : but these appearances are strangely huddled together, without any notice taken of those which belong to one set of symptoms or to another; and, with regard to the whole, without any attempt to distin-.


guish between the causes of diseases and the causes of death; although the want of such distinction is the well-known ground of fallacy upon this subject. I take for an example, the appearances mentioned as having been observed after dropsy. Here morbid appearances, found in every part of the body, in every cavity of it, and in every viscus contained in these cavities, are enumerated ; but which of these morbid states are more frequent or more rare, and which had been more particularly connected with the different causes, or with the different state of symptoms previously recited, we are not informed, nor has he enabled us to discover. In short, the dissection of morbid bodies has been, and may be, highly useful ; but, in order to be so, it-must be under a different management from what we find, either in this Synopsis, or even in the Historia Anatomico-medica.

I cannot dismiss this subject without remarking, that the dissection of morbid bodies is chiefly valuable upon account of its leading us to discover the proximate causes of diseases : and the great and valuable work of the illustrious Morgagni is properly entitled De sedibus et CAUSIS. It may well seem surprising, then, that Lieutaud should find the whole of proximate causes atra caligine mersas ; and that he should never have thought of applying his dissections towards the ascertaining at least some of these.

But let me now proceed to consider the import ant part of every practical work, and of this Sy. nopsis universe medicina; that is, the methad of curing diseases,

Here, again, upon the same plan as in giving the histories of disease, the method of cure is de. livered by enumerating the whole of the remedies that have ever been employed in a disease under the title prefixed; without assigning the species, or the circumstances to which the remedies, though of a very different and sometimes opposite nature, are peculiarly adapted. On the subject of asthma, he very justly observes, that physicians have been to blame in confounding, under this title, almost all the species of dyspnea, and he himself very ; properly considers asthma as a disease distinct from all the other cases of dispnea. Still, how. ever, he considers asthma as of many different species, arising from many different causes, which, till we understand better, we cannot attempt to remove. Notwithstanding all this, he proceeds to deliver a very general cure. Parum abest,' says he,

quin specifici titulo gaudeant pectoralia, vulneraria, et incidentia !" But from such language I receive no clear idea; nor can I obtain any clear direction from the enumeration of his medicines, Baccæ juniperi, gummi tragacanthum vel ammoniacum, sapo, aqua picea, terebinthina, &c. qua tamen haud indiscriminatim sunt usurpanda, sed pro

re nata, delectu opus est. Very justly indeed, delectu opus est ; but here, as in many other instances, he gives us no sort of assistance.

From his endeavours, though not always successful, to neglect all system, his practice is generally delivered in a very indecisive manner; or, what has the same effect, in a way so conditional as will render it always difficult, and often impossible, for a young practitioner to follow him. Let us take, for example, his cure of dropsy. . The

cure may be begun by blood-letting in certain conditions ; but, in others, it cannot be employed without danger. It gives relief in difficult

breathing; but, after it is practised, the symp6 toms are aggravated, and rendered more obstie o nate. It is not to be concealed, that some per.

sons have been cured by repeated blood-lettings, * or spontaneous hemorrhagies, but it is at the same time known, that such a remedy inoppor. tunely employed, has in many instances hastened. " on the fatal events'

In the same manner he treats of vomiting, purging, sweating, and the use of mineral waters : but I must confess, that he has nowhere removed any of my doubts or difficulties, and indeed he has sometimes increased them. He says, that hepatics, or aperients, such as the lingua cervina, herbæ capillares, &c. deserve commendation; but that, when the disease has arisen to a certain degree, they have been, for the most part, found to be useless. He observes, that the powder of toads given in wine, to the quantity of a scruple or more, has succeeded with severals.

Such are, commonly, the methods of cure delivered by Mr. Lieutaud, longiori et forte felicissima praxi edoctus.

It would be tedious to enter further into that detail, which a criticism of this immethodical and uninstructive work might lead me into; but, if the bounds proper for this preface did not prevent me, I would particularly shew, that the work is far from being free from those reasonings which the author pretends to avoid, and would affect even to despise. He still holds the doctrines of the CONCOCTION and CRITICAL EVACUATION OF MORBIFIC MATTER ; doctrines depending upon subtile theories, and which, in my opinion, can in nowise be ascertained as matters of fact. Mr. Lieutaud likewise is still very much upon the old plan of following NATURE, and therefore gives often what I consider as a feeble and inert practice. The humectantia, diluentia, demulcentia, et temperantia, are with him very universal remedies, and often those which alone are to be employed.

The mention of these medicines might lead me to take notice of Mr. Lieutaud's second volume, in in which, al insulsa remediorum farragine alienus,

« PreviousContinue »