try for the benefit of the public, by ordinary reports, to be transmitted at fixed periods, from all the hospitals and medical charities in the kingdom to a central board.

Preventive medical institutions, as he calls them, are recommended, as being likely to improve the state of medicine essentially, and he expects soon to submit to the public some observations to which this species of dispensary gave occasion in its establishment at Bristol. He suggests a general experimental hospital, not merely for the trial of secret or popular remedies, but for the exercise of humane ingenuity upon cases deemed incurable in other hospitals, or in private hands; and a place of refuge for the diseased as well as for the destitute, is very much wanted in every large town, where patients are frequently discharged with incurable disorders from the hospitals or infirmaries. Quack medicines, he thinks, ought to be abolished, and all the tricks of the irregulars, even amongst the regulars, ought to be exposed; for any scheme for the reform of medicine cannot be effectual unless some of the enormities daily committed by quacks are suppressed by authority, there will be enough of quackery left in the profession to feed the credulity of the sick and their friends. A striking picture is drawn of the hot-well doctors, and of the corresponding branch of medical practice, and there is too much reason to apprehend the colouring is not too strong. The great remedy for the removal of all these abuses is, according to Dr Beddoes' opinion, medical information. "It is ignorance (he says) that commits, encourages, and suffers from abuses. There is wanting a sceptical or cautionary system of popular instruction in medicine, which shall teach meddlers to distrust themselves, and every body else to distrust meddlers," P. 119.

The progress and reputation of quackery is certainly deplorable; reason and honesty sicken at its presence, and many a modest genius has left the profession because there was such a formidable competitor. But we do not agree with the author in the sort of remedy which he suggests for this very great evil. A smattering of medical knowledge, enough to discover danger as it approaches, does not beget distrust in ordinary minds, but, on the contrary, begets a desire of showing their acquirements; and the precious hours at the beginning of a scarlet fever have often been wasted by some meddler pretending to understand what they were unable to prevent or foresce. Incessant declamations are uttered against medicine, all the worst miseries of life are imputed to it, and it is forgotten that the profession is a source of many comforts, and can alone afford relief sometimes when every thing else fails. Too much good and too much evil cannot be said of those who practise it; but what is provoking, people now a-days never

look

look upon it or speak of it except on the bad side. Medicine holds the first place among the arts. But if we are to form an idea of a half-educated man, running about from one patient to another, giving them all the same remedies, not thinking of what they ail, but of what money he will get, we cannot have a just idea of it any more than we can have a correct notion of agriculture from seeing a miserable peasant limping behind a plough with half-starved oxen, and drawing furrows in a field that is not his own. Complaints against the pretenders to medical skill are to be found in the writings of Hippocrates, and many abuses existed two thousand years ago which are now held up for public animadversion. In the time of Pliny, " Cuilibet medicum se dicenti statim creditur," so that the two sorts of errors seem always to have been attached to the healing art, the first relating to the practitioners themselves, the second to those who pretend to judge of physic and physicians. It appears, therefore, that the cause of the evils complained of, is deeper seated than the reformers imagine. It is not the length of time passed at an university, it is not solely the want of proper education, it is not the irregularities committed by unprincipled individuals, but it is human nature that is in fault, and the abuses of medical practice and medical science are founded upon the principles of the human mind. Vanity and the love of power have a great share in the progress of quackery as well as of methodism. To rail against it is very right, and to strive, by enlightened measures, to crush its growth, is very praise-worthy; but there is no great prospect of ever abolishing it, for if the Legislature suppressed it in one way, like vice or moral evil, it will make its appearance in another direction. The imputation laid to the charge of the Edinburgh College is not fair; for abuses ought not to be scored to the account of education, which are the effects of downright human folly. Men of accomplished medical education cannot at present afford to settle in the country towns: they cannot repay themselves the capital vested in their qualifications. Of course the health of the people is left to a class of men (routiniers) whose knowledge is not extensive, and not capable of being improved by study or comparative observations. These rural practitioners, however, are a very useful set of men, many of them very intelligent, and well suited to the manners of the soil where they live. After all the schemes which have been offered for the reform of medicine in this country, we are disposed to think things had better be left to themselves. Good and bad practitioners will ultimately find their proper level. The cry that "physic is in danger," is like that so often sounded of the Church, and arises, in general, from the weakness of its supporters; for the practice of medicine is, upon the

whole,

whole, more enlightened and more rational than it ever was before in these kingdoms, and is now better here than it is in any quarter of the world.

other

XI.

Riddellian System; or New Medical Improvements; containing a Concise Account of the Advantages to be expected therefrom. With some Illustrative examples. By Colonel RIDDELL. London, 1808.

MEDICINE, like music, is an art, of which every body thinks he has

a right to be a judge, consequently the number of bad judges is very great. Here is another instance of a breach of the word of advice given to the cobbler of old, and the offender is bold enough to glory in his presumption, and to apply to Parliament for a reward. Such a degree of courage was to be expected only from a colonel who has fought against the tawneys. This riddle of a system, as far as it can be understood, is one of those books that any body who can read could write, for it is made up of extracts from some medical dictionary, and letters expressive of thanks to the author for his medicines. His practice is founded on the principle, that "all diseases either originate in the stomach, intestines, and visceral obstructions, or are intimately connected with them;" and he prescribes two or three medicines of known efficacy, in different forms and combinations, the principal ingredient of which is antimony, or Dr James's powder. This is the substance of the system; and as no merit is claimed by the author, either for an invention or a discovery, it is to be hoped that the Lords and Commons, to whom the book is inscribed, will follow the example of the Scots College, which so considerately refused to grant the gallant officer a diploma, lest it should disturb the delightful reflections of an untitled second " man of Ross." What would the sons of Mars say, if an obscure apothecary were to take down Polybius, and, in a fit of disinterested enthusiasm, publish a specific for storming the fortresses in the East, and for conquering all the rebellious nabobs by means of gunpowder and the sword? They would probably think no inquiry necessary to establish the efficacy of those remedia bellicosa, nor would the waroffice be disposed to grant a remuneration of a pension or a place.

VOL. IV. NO. 15.

Bb

PART

PART III.

MEDICAL INTELLIGENCE.

Report of Diseases treated at the PUBLIC DISPENSARY, (near Carey Street, London, from February 29th to May 31st 1808.

With the exception of a day or two of mild weather at the commencement of March, the spring has been cold, and the wind blew from the east during that month, and the greater part of April; so that there was scarcely any appearance of advancing vegetation, until the first of May. The early and middle parts of May were extremely hot, and the month has been on the whole warm, with several moderate rains, insomuch that vegetation has advanced rapidly and luxuriantly. The maximum of the thermometer, in the shade, was 80° on the 4th, and on the 15th it was 83°: the minimum on the former day was 44°, making a difference of 360° in the course of the same day.

The long continuance of cold weather multiplied, as usual, the cases of catarrh and rheumatism, in all their forms; and, in the latter disease more especially, greatly counteracted the operation of medicines, which, under a more favourable state of the atmosphere, seldom fail to give more speedy relief. Several of the rheumatic cases were unusually obstinate. The occasional rains, however, and considerable vicissitudes of temperature, even during the present month, have produced a good deal of illness, not only rheumatic and pulmonary, but also disorders in the bowels; so that two hundred of the patients on the list were admitted during May.

In four of the cases of dysentery, a considerable discharge of blood by stool took place, so as to occasion a speedy depression of the patient's strength. The experience of all our best writers on this subject coincides, in establishing the necessity of a free evacuation of the intestinal canal by purgative medicines, in all degrees of this disorder, in the early stages. But the irritation, which the stimulus of a cathartic medicine excites, in that tender condition of the canal, must be obviated: and this object is best attained by combining an opiate with the cathartic. These cases illustrate that principle in a satisfactory manner; for the patients were all restored to health in a few days, by taking a pill of opium and calomel on two or three alternate nights,

and