IN Answer to your Request, I have sent you my Sentiments upon the late Pamphlet, entituled, A Discourse on the Preparation of the Bo­dy for the SMALL-POX, &c. I had resolved at first to confine my­self to what had been said in our News-papers; but upon a Review, I found nothing touched upon would give you the Satisfaction I conceived you might expect; the Foibles and little Vanities of the Author, which I found chiefly insisted on in those Papers, were not of that Consequence, as the Methods propos'd by the Author, for securing Mankind from the dire Effects of that malignant Disease: I resolved therefore to take an im­partial View of the whole, with that Candour and Clearness (the Bounds of a Letter would allow me, in a Matter of such Importance) which in a cursory Manner, you'll find in the following Lines.

DISCOURSE, Page 8. My principal Design is, to offer some Things con­cerning the Preparation of the Body, and the Manner of receiving the In­fection; which, from any Thing I have yet seen, appears to me, never to have been consider'd with that Attention the Importance of the Subject de­serves.

REMARK. This Charge against the Learned of the Faculty, upon due Consideration, will be found a Mistake in our Author himself, for want of Attention to the preparatory Methods, previously to be considered; which cannot be fixed upon, before the State and Condition of the Humours of the Body is known, which upon the first Invasion of the Disease, is to be [Page 4] collected from the Disposition of the Fever arising from thence; and as it is different in different Subjects, ^* no general stated Methods for preparing the Body, previous to the Invasion of the Disease, can promise any real Advantage to the Patient: And if the Gentleman will consider the Writings of learned and experienced Physicians, he will find, they have treated this Subject, as the Nature of the Case necessarily indicates, not only with Attention, but with a superior Judgment, above the Reach of those, whose natural Genius, or perhaps Opportunities of receiving Instruc­tion in the Art of Healing, may not render them capable of understanding, much less able to prescribe Precepts, or Rules of Practice in a Science, which as it is the most useful to Mankind, so is it the most worthy to be esteemed before all others; and therefore not to be prostituted to the vain Chimeras of a doubtful Hypothesis.

DISCOURSE, Page 10. It looks inflamed and sizy, exactly like the Blood of a Person in a Pleurisy, or any other inflammatory Disorder; so nearly allied are the Symptoms of this contagious Fever, to that of a simple in­flammatory One.

REMARK. By our Author's Manner of here expressing himself, one would be led to imagine he took a Pleurisy to be a simple inflammatory Dis­ease; but this, perhaps, may be for want of Attention to the antecedent Word Pleurisy, otherwise it would represent the Author guilty of a capital Mi­stake, in his Theory of Diseases: For a Pleurisy has always been looked upon, and treated by the Learned of the Faculty, as an Inflammation of the worst Kind: But our Author takes the Effect for the Cause, when he tells us (Page 10. Line 14.) When the Disease is violent, the dangerous Ap­pearances are all of the gangrenous Kind, arising from a putrid Dissolution of the Blood. What putrid Dissolution of the Blood there can be in a va­riolous Fever, before the Appearance of the gangrenous State of the Pu­stules, cannot be easily apprehended; for a variolous Fever is not ranged by Physicians among the Number of putrid Fevers, but among those of the inflammatory Kind; and notwithstanding the visible Putrefaction occasion­ed by the critical Discharge of the Pustules, which determines the Inflam­mation to the Skin, and membranous Coverings of the Throat and Visce­ra; yet the Putrefaction attending the Disease, is evidently the Conse­quence of the gangrenous Appearances, and cannot be said to take its Rise from a putrid Dissolution of the Blood, a Priori.

DISCOURSE, Page 11. Putrefaction is always occasion'd by too much Heat.

[Page 5] REMARK. It is an undoubted Mistake, to suppose Putrefaction is al­ways occasioned by too much Heat, since it is known that Mortifications from a Defect of natural Heat, in low dispirited Cases, have produced the highest Degree of Putrefaction. In a History of the Plague, written by a Citizen of London, in the Year 1665, we are told, that it was a com­mon Thing to see Persons drop down dead in the Streets, and in their Fa­milies, without any previous Complaint, or Appearance of a Fever at­tending them, yet upon viewing their Bodies after Death, or even when they were yet expiring, there appeared the highest Degree of Rottenness and Putrefaction visible upon them: And it is sufficiently known, that in a Deficiency of animal Heat, after large Evacuations in the Dropsy, &c. the worst Symptoms of a Gangrene, and a Putrefaction of both Solids and Fluids, have appeared: And it is also the Opinion of eminent Phy­sicians, that those fatal Symptoms of Putrefaction attending the Plague, do arise from a Deficiency of animal Heat, being extinguished by the delete­rious Miasms of the Disease, by which the Motion of the Blood is retard­ed, and the Humours do consequently putrify.

DISCOURSE, Page 11. Line 26. But Milk, and all Vegetables by Heat turn acid, which is directly opposite to Putrefaction.

Page 12. Line 6. Blood, prepared chiefly from a sub-acid vegetable, or Milk Diet, must be in general that State of the Body which is best fitted to receive an inflammatory Distemper.

REMARK. It is a Mistake, to suppose Milk and vegetable Diet is always opposite to Putrefaction, for it is known to Physicians, ^* that Milk, but especially vegetable Diet, will turn to Putrefaction, and by a faulty Digestion of the Stomach, will be converted into an acid Acrimony, the immediate Cause of Head-achs, Deliriums, Pleurisies, Peripneumonies, Ophthalmies, Tormina's of the Stomach and Bowels, and the worst Kinds of inflammatory Disorders; from hence may prove as unfit a Preparative for receiving the Infection of the SMALL-POX, as Food of either Fish or Flesh; it is no easy Task for the most accurate Physician, to say, what Sort of Food or Medicine is the most proper Preparative for receiving the SMALL-POX, without previously knowing the true State of the Humours in the human Body: ^† The Blood in Health, from the many Observa­tions made upon it, has no perceivable Alkaly or Acid to be found in it; so that Food or Medicine, which may dispose the Humours of the Body to an acescent State, which Milk and vegetable Diet may possibly do, must in Pro­portion dispose the Humours of the Body to something contrary to Health, [Page 6] or what may be called morbid, and unfit to undergo the Severity of a malignant Disease, of which Kind the SMALL-POX is known to be; and also to prescribe a low, spare and refrigerating Diet, as herein recommended, below what the Patient had been accustomed to, under a regular Way of living, free from any known Disorder attending the human Frame, must necessarily subject the Body to new and uncertain Changes; the Mo­mentum of the Blood (by substracting the accustomed Aliment) will here­by be reduced below the necessary Standard of Health: From hence the animal Secretions will become irregular and imperfect; and those Secre­tions, which otherwise would have been made at the cuticular Glands and Extremities, will be made nigher the Heart, and Fountain of animal Life: From hence the sensible and insensible Perspiration, the gentle Breathings and benign Sweats, greatly conducive to the carrying off the variolous Ef­fluvia, will be lessened, if not wholly suppress'd: Hence the Miasmata, for want of the necessary Impetus of the circulating Fluids, will be inverted: And from hence it is those dire Symptoms afflicting the Brain and vital Parts do necessarily arise, which when attended with an acid Acrimony, the common Case of Children and young Persons, do frequently terminate in Inflammations, Gangrenes, putrid Fevers, Convulsions, Deliquiums, &c. which often resist the most powerful Remedies: Alexipharmacs, and the warm Expellers used to throw the variolous Disease on the cuticular Glands, finding no Passage through their excretory Ducts, which are now become dry, rigid and shut up, serve only to heighten the Inflammation and threa­tening Symptoms: To attempt to reduce these Disorders by Bleeding or any other Evacuation, in this low State of the circulating Fluids, is adding Strength to the Disease, and exposing the Life of the Patient to the ut­most Danger; which fatal Consequences, from a low milk—and especially vegetable Diet, have been observed to happen in Europe, as well as in the Colonies of North America.

DISCOURSE, Page 14. It would be of the greatest Benefit to Mankind to find out a specifick Medicine which would either expel it entirely, or alter it so, as to render it quite innocent, or mitigate its malignant Quality.

Page 15. But the Trial of an easy operating antimonial and mercurial Medicine as a Preparative, can be of no Danger.

REMARK. That excellent Physician, ^† Dr. Mead, has sufficiently ex­pos'd the Folly of hunting after Specificks, the common Amusements of Ignorance, or Tricks of low Craft, to draw Pence out of the Pockets of the unthinking Populace, who generally admire those most who have the Art of deceiving them best. To receive a Medicine as a specifick Pre­parative, Alterative, or Expeller, &c. in a Case where Life is at Stake, [Page 7] from the bare Conjecture of one Person only, especially one, who we have Reason to think has been deceived, in his high Opinion of a milk and vegetable Diet, which he recommends as the most beneficial Prepa­rative, in receiving the Infection of the SMALL-POX, would be as Idle as to take a Journey to the Moon, because certain Astronomers do conceit it is inhabited, and which upon Trial may prove of as little Advantage to the Healths of Mankind, as the many Nostrums, and Specificks, for the Cure of Cancers, and other extraordinary Diseases, which we daily hear pretended to, by boasting Quacks, and bold undertaking Mountebanks: As to the Discovery of the Specifick here pretended to, especially the Mer­curius Dulcis; it has of a long Date been approved of as a beneficial Me­dicine in the SMALL-POX, by the excellent Ludovicus, Etmuller, and o­thers; which also has been long and repeatedly made use of in this Case, in Philadelphia, with the Addition of an antimonial Preparation; and tho' it may be allowed the Place of a good Preparative (by cleansing the Visce­ra and Organs of Secretion) being given immediately before the variolous Fever appears, or in the Manner Ludovicus advises, i. e. so as to open the Body with a Stool or two, upon the first Invasion of the Disease, yet the benign Effects of this Medicine, will not admit of the high Character of a Specifick, by performing the mighty Feats our Author is led to imagine; or will it deserve the Pains of writing a Discourse on purpose to recom­mend the Use of it, as a specifick Medicine in the SMALL-POX, without some other more interesting Consideration, which, perhaps, might have been in our Author's View.

DISCOURSE, Page 16. I gave them a Fortnight's Preparation in the Manner aforesaid, and then they came freely into the Room where the others were. Two of them took the Disease, yet in the most moderate Manner, so as never to lie by an Hour with it: But the Third could not catch it at all, notwithstanding he slept in the Bed with his Brothers and Sisters, with the SMALL-POX upon them.

REMARK. [...] no uncommon Case, where there are several Persons in a Family to have the SMALL-POX, to see them differently handled by the Disease, so that some will labour under the most severe Symptoms, when others will either have the Disease very favourably, or perhaps no Appearance of the Disease at all, except a small Fever, and this very of­ten scarce perceivable: Nor is it an unusual Thing, where a malignant Disease is epidemical, to see Persons who are first taken ill of the Disease, in a Family, ^* as well as in a populous City, to have the Disease in the most severe Manner, whilst those who were not touched with the Disease [Page 8] at its first Appearance, have had it very lightly, and some not at all, at least not to be perceived: And this, any one who has read the History of the Plague in London, of the Year 1665; or Dr. Sydenham, on the SMALL-POX; or has had the Opportunity of making the least Observation himself, will find a Truth not to be disputed. And therefore the Case of the Family which the Author of the Discourse relates, can be no certain Proof of the beneficial Effects of these preparatory Medicines, or Methods he had made use of, in the Cases he is pleased to lay before us.

DISCOURSE, Page 17. The more hot and putrescent the Blood is, the more tense and active the Vessels are, the apter they will be to imbibe any thing applied to them; an Instance of this we see in acute Fevers, where that is the State of the Blood and Vessels; let a Person in this Condition drink as much as he will, the Moisture applied to the Vessels of the Mouth and Throat is sucked up, and they quickly again feel parched and dry, which evidently shews this Power of Absorption in the Vessels.

REMARK. It is an Absurdity scarce reconcileable with Common Sense, to attribute the Thirst and Dryness of the Mouth and Throat, in ardent Fe­vers, to the Absorption of the Vessels, when it is visibly owing to a very contrary Cause; i. e. the Obstruction of the excretory Ducts of the sali­val and sublingual Glands, and Vessels of the Mouth and Throat, being shut up with a dry and viscid Lymph, the Consequence of an ardent Fe­ver; in which Case, the Liquids taken into the Mouth, instead of our Author's imagined Absorption, being rarified by the Heat and Dryness of the Parts, fly off in a Vapour, without the Possibility of finding Admit­tance into the Pores or inhalent Vessels, which are now entirely shut up; from hence the Mouth and Throat necessarily feel parched and dry, so that we might with as much Propriety of Reason and Philosophy, say, That a dried Chip, whose Pores and Surface were filled and smear'd over with a tough and adhesive Glew, would therefore suck up more Water into its Pores and bibulous Tubes, than a Chip of the same Kind would do, whose Surface was naked, and its Pores open and free from any foreign Incumbrance.

DISCOURSE, Page 22. Should the Crisis be principally determined towards the Arm, where the Inoculation was performed, the vital Parts will be in more Danger of partaking of it, than if it was determined towards the Legs and Feet, &c.

REMARK. This, upon a due Consideration of the Case here proposed, will appear a Mistake; for it is known to Physicians and Men acquainted [Page 9] with the Art of Healing, that Issues, Cupping-Glasses, Scarifications, Bli­sters, &c. applied to the Arm, are frequently made use of to determine Pains, Inflammations and Disorders of the Head, to the Inflammation brought on by their Application to that Part; and it is equally reasonable to suppose, that the Scarifications made on the Arm, in the Case of Ino­culation, will have the same Effect; and that the Derivation of the variolous Symptoms usually affecting the Head, will by this Means be thrown on a less noble Part, and as a depending Part by its near Situation, must be best suited for that Purpose; by which the Inflamma­tion, Delirium, &c. usually attending the Disease, will with more Cer­tainty be relieved, than can be expected at so great a Distance as the Leg is known to be, from the Seat of those often fatal Symptoms: And it may here be observed, that the fatal Symptoms, so justly complained of by our Author, are such as is supposed by himself (Page 20) to attend the Disease received in the natural Way only; but he has not produced us one Instance of these fatal Symptoms attending the Disease under Inoculation in the Arm; nor do we believe it is in his Power to produce one in an Hundred, or perhaps double that Number, who have had the fatal Symptoms which he labours with the utmost Stretch of his Imagination to support; except in those Cases, where large and deep Incisions have been made in the Arm, with the Intent of giving a Drain to the variolous Infection, which has been known to produce the very contrary Effect, by contaminating the Juices of the Body, and producing Symptoms of the worst Kind; but when the Inoculation has been performed by a Puncture in the Manner used in Tur­key, and in some other of the Eastern Countries, or by a small Incision, it has not been known that any ill Accidents have happened to the Patient from an Incision made in the Arm, simply considered, without some in­tervening Accident arising from the Misconduct of the Patient, by ex­posing himself to cold Air, or from the Physician's Prescriptions, in direct­ing a low vegetable Diet, Specificks, preparatory Doses, or such like Fooleries.

BUT it is still a Point of no small Difficulty to reconcile, How Inocula­tion in the Arm should produce worse Consequences, than if the Opera­tion had been performed in the Leg; when, at the same time, our Au­thor informs us (Page 22. Line 14.) That the Operation performed in the Leg, is frequently attended with Sores extremely difficult to heal, giving forth a corroding Matter, which both cats and inflames the adjacent Parts. To remedy which he proposes his Catholicon, the Jesuits—Bark, the common Refuge of Ignorance, which too many make use of in almost every Case, when they arrive to the Ne plus ultra of their Practice: But notwithstand­ing our Author's high Opinion of this Drug, it may deceive us; for it is no [Page 10] uncommon Thing to see putrid Ulcers so insect the Humours of the Body, as to produce Hecticks, Mortifications, Atrophies, and other fatal Diseases, which do frequently resist the Force of the most powerful Remedies: ^* Doctor Monro himself, the mighty Advocate for the Use of the Bark in Mortifications, Ulcers, and also in the SMALL-POX, frankly owns it is not infallible; he ussures us, he has known it fail both in Mortifications and in the SMALL-POX; and in this last Case recommends it only as useful in bringing the variolous Matter to a kindly Digestion, and no farther. It must therefore be the highest Degree of Imprudence and Folly, to ha­zard the Healths, and perhaps the Lives of Mankind, upon the single Re­commendation of a Medicine, which upon Trial of its Effects may deceive our Expectations; especially when we are assured of a Method, if rightly pursued, will not lay us under the Necessity of running the Risque of a probable Evil, for the Sake of an uncertain Good.

IT may not be an unnecessary Digression, to farther take Notice of an Observation in ^† Dr. Friend's Commentaries on Fevers, That a young Person seized with the SMALL-POX, was on the ninth Day suddenly taken with Deliriums, Spasms in all his Limbs, and a violent Fever; on the twelfth Day the Fever abated, upon which the Bark was administred, and repeated in the Intermissions of the Fever, for four Days successively, notwithstanding which, the Spasms, Fever and Delirium, continued, with­out any Hopes of an Amendment.

MUCH the same has been observed in a Fever, which of late Years has appeared in this Province, called by some People the Long Fever, or Dumb Ague, which are chiefly different Appearances of the same Disease; for the Cure of which the Bark has commonly been insisted on; and although it did sometimes give a Check to the Return of the Fe­ver-fits, it scarce ever wholly vanquished the Disease, yet it has been found upon Trial, in many Cases, that the Preparations of Tartar, Nitre, and gentle Cathartics, given in small Doses, and frequently repeated, with Bli­sters to the Wrists, &c. have happily overcome the Disease, which clear­ly shews the mistaken Opinion of those great Admirers of the Bark, with Regard to its Nature and physical Use: And this Method of Practice is agreeable to the Nature of the Disease; which from the Returns of the Fever, (very often) without the usual cold Fits, and the critical Sweats not regularly succeeding, shews that the Humours were highly viscid, thro' which the Glands became crouded with an adhesive Lentor, mixed with a heated Bile; ^‡ which Galen, in his Commentaries on Hippocrates's Apho­risms, [Page 11] says, is the Cause of a Tertian, as well as an Ardent Fever, the last of which does not greatly differ from the Fever we are now treating of, except that the Dumb Ague partakes more of what is called by some Physicians, a Glutinosum Spontaneum, wherein neither the Heat or Mo­tion of the Blood is so predominant: In which Case to administer the Bark, can promise no real Advantage to the Patient, but must render the Disease more fixed, and heighten the Symptoms attending it; and by its Astrin­gency purse up the Mouths of the Glands, and imprison the Disease; by which it will not be so much removed, as for a Time supprest, to farther increase its morbid Viscidity; in which Case nothing can so effectually re­move the Disease, as promoting the Discharge of the intestinal Glands, where (as ^* Dr. Friend says) there is a less Resistance, and a freer Passage at the Mouths of these Glands, than in any of the excretory Ducts of the whole Body: And therefore when the Secretion of the cuticular Glands, or those of the Liver and Viscera, by a Viscidity of the Fluids, are ob­structed, nothing so effectually removes the Disease, and relieves the Patient, as purging Medicines; which by insinuating themselves into the Blood, do cause it to flow with a greater Velocity, and at the same Time do attenu­ate and dissolve the Cohesion of the Humours: Hence the morbid Lentor is dislodged from its Seat, and discharged through Means of the Stimulus given (by the Cathartick) at the Mouths of the intestinal Glands; and by encreasing the Force of the Purge, ^† will increase the Secretion of the Liver, as 1 is to 12; by which also the yellow Bile, supposed by Galen to be the immediate Cause of this Disease, as well as the morbid Viscidity, will be removed: And it is certain that those Fevers which take their Rise from a Glutinosum Spontaneum, arising from a Defect of Heat and Motion in the Blood, or an inflammatory Lentor of the sanguinary Fluid, which last comes nighest, by its dry and feverish Heat, to that Species of the Dis­ease called the Long Fever, after using nitrous Preparations, which cool and liquify the heated Lentor; and the tartarous Ones, which greatly dissolve Gru­mosities, and cleanse the Glands of the Liver, Spleen, Pancreas and Mesentery, from the viscid Humours, especially Salt of Tartar, mixed with some proper Vehicle and diluting Drinks, suited to the different Stage of the Disease; or [...] Cream of Tartar, with sometimes also the Addition of Camomile Flowers, the Testaceae, Cinnabar of Antimony, Snake-Root, AEthiops Mi­neral, Flowers of Sulphur, or even the Bark itself, which may be necessa­ry to digest, attenuate or dissolve, or by their Weight dislodge or prepare the Disease, by which it may be more effectually overcome; these regu­larly given, as the different State or Species of the Fever may best admit: Nothing, we are certain, from repeated Trials, will so safely remove these Dumb Agues or Long Fevers; and also some of those of the putrid, as well as [Page 12] those of the bilious Kind, as proper Catharticks, and Blisters to the Ex­tremities, with the above Alteratives and diluting Drinks, suited to the particular Nature of the Disease; in which Cases to administer the Bark alone, is without doubt a Contra-indication in the Cure of these Diseases, especially before the morbid Viscidity of the Humours are removed: And we have frequently known this Method effectually remove a Tertian Fever, when the Bark alone, has afforded no real Advantage to the Sick; except frequent Returns of the Disease might be thought a Benefit to the Patient.

^* TO this Place might be referred, a Disease called by Dr. Friend, an Erysipelas of the Head, attended with a high Fever, Delirium, and an Erysipelas; which overspreads the Face, Neck, and Ears, with an in­tense Redness, which swells to an exceeding Bulk, in which Case Ca­thartick Medicines were found the most effectual, in removing the Dis­ease: Which Case might very probably have been the same, of which a young Person in the SMALL-POX, was in an extraordinary Manner afflicted in this City.

IT is to be observed, that the above Digression being chiefly intended to oppose the Mistake of some Physicians, in their depending on the Cortex Pe­ru, as an infallible Specifick in the Cure of some particular Diseases; it be­came necessary to shew from Reason and Experience, that Medicines of a contrary Nature were the only effectual Means for the Cure of those Disea­ses, amongst which the Yellow Fever is justly enough mentioned, as one of that Number; but as this Disease is of a more complicated and malignant Nature, it will be necessary to call in further Aids and Assistance, in overcom­ing this truly pestilential Disease, and therefore we thought it proper in this Place, to give a short History of the Methods used by us in the several Kinds and Stages thereof.

THE first Appearance of the Bilious Fever (called also the Yellow Fever) in this Province, was in July, 1741. and in August, 1747. it made a second Visit; at its first Appearance it seem'd, especially after three or four Weeks, to shew a Disposition more inclining to a remarkable Inflamma­tion of the animal Spirits, than at its Return in the Year 1747, in which Year, the animal Spirits seemed not so much exasperated by an inflamma­tory Heat, as extinguished by the deleterious Miasma of the Disease, which introduced Gangrenes and Mortifications on the Stomach and Viscera, suc­ceeded with black Vomits and cadaverous Stools; in both Cases the Ma­lignity seemed to exert its dire Efforts on the Stomach and Liver: Which of the two was the first Receptacle of this cruel Disease, we cannot say; [Page 13] but certain it was, that a much heated acrid Bile, was the proximate and instrumental Cause of the tragical Appearances.

To reduce what we have farther to say on this Disease into as narrow a Compass as possible, we shall give as brief a History of the Disease, in the two Years in which it visited this Province, as the Limits of our Letter will allow, to shew the pathognomick Signs, and Difference of the Dis­ease, as well as the different Methods of Cure used in each.

IN the Year 1741. the Patient generally complained of an excessive Pain and Heat in his Stomach, a great Anxiety, and Disquietude, with a Pain of the Head, a quick tremulous Pulse, and a feverish Heat, which seemed to take its Rise, not so much from an Inflammation of the sanguinary Fluids, as from the animal Spirits, and nervous Bodies being stimulated and disturbed by the acrid and overheated Bile, lodged in the Stomach and Viscera; that this was the Cause of the Disease, appears very probable from the Case of a Person (now living) taken ill of the Disease, who fre­quently would jump out of Bed in a seeming delirious Surprize, attended with great Anxiety and Horror, who, when he came to himself, said it was occasioned by something darting like a Flash of Fire from his Sto­mach, through the Muscles of his Side and Neck, and discharged itself with a shocking Explosion into his Brain; which Description of its Pas­sage from the Stomach to the Brain, shews, I conceive, that the nervous Fluid being heated, rarified, and put into a tumultuous Disorder by the Me­diation of the Parvagum Nerves in the Stomach communicating with the Brain, and being perhaps propelled by Means of an electrical Effort, or by Sir Isaac Newton's elastick Spirit, was the Cause of this surprising Sensation: From hence, and from the universal Tremors, Anxieties, and Disquietudes: the great Disorder of the Spirits and nervous System were clearly manifest; in which Case to administer Vomits, greatly exasperated the Symptoms, and instead of relieving the Patient, brought on an irremediable Vomiting, Hiccough, and Inflammation of the Stomach; yet sometimes a little warm Water, to cleanse the Stomach from the acrid Bile, was of Service; Bleed­ing the Patient, with a View to abate the feverish Heat, was succeeded with a Debility of the Pulse, and Sinking of the Spirits; no warm Cor­dial or Alexipharmacs, did seem to agree with the Disease; in this Case a Dose of Glaubers Salt, dissolved in Sack-whey, or If the Heat at the Stomach was great, in Barley-drink, and repeated daily for three or four Days successively, greatly conduced to the removing of the Pain and Heat at the Stomach, with large Draughts of Chicken-broth, Sack-whey or Barley-drink, used in the Working; which Purge was generally succeeded with a large Discharge of a green acrid Bile, which sensibly relieved the [Page 14] Patient: And in the intermediate Times of taking the Salt, the Patient had frequently given him, a Spoonful of Riverius's Anti-emetick, which was made with Half a Drachm of Salt of Tartar dissolved in two Spoon­fuls of Juice of Lemons, with the Addition of a little Treacle-water, and Spirit of Mint; and sometimes Lapis Contrayerva, judiciously mixed with Nitre, Saffron, Cochineal and Castor, given every four Hours in Sack-whey; and after the Stomach and Bowels had been sufficiently cleansed from the distempered Bile, Blisters to the Neck and Wrists, with Sudori­ficks, Restoratives and Pearl Juleps, rarely failed of bringing the Patient to a happy Recovery.

IN the Year 1747. the Pain and Heat at the Stomach was not so gene­rally complained of by the Patient, especially in the first Days of the Ill­ness, as in the Year 1741. but the Pains of the Head, Back and whole Body, like wandering rheumatick Pains, were more perceivable; nor was the nervous Heat, or deadly Vomitings so frequent, especially in the first two or three Days of the Illness, nor was the Pulse altogether so weak and tremulous; so that in a Plethora it would sometimes bear once Bleeding; gentle Vomits of warm Water, or Carduus-tea, &c. upon a Sickness at the Stomach, might be taken with Advantage to the Patient: But although those Symptoms were not on the first two, or three Days violent, yet very often when the Patient was thought to have past the worst of the Disease, he was seized with all the fatal Appearances of Malignity, viz. Hic­coughs, Anxieties, violent Pains of the Stomach, feverish Heats, and black Vomitings, succeeded with cold Sweats and Faintings, which generally concluded with cadaverous Stools, the fatal Presages of a deadly Mortification of the Stomach and Viscera; in which Case the above Medicines and Methods used in the Year 1741. judiciously made use of at the first Appearance of the Disease, were found to answer the wish'd for End. But when, from the flattering Appearances of the Dis­ease, or mistaken Expectations from the Use of other Medicines, the pro­per Methods had been neglected in the first Days of the Disease, the Ma­lignity so far prevailed, as to resist the most powerful Remedies.

IT may be necessary further to observe, That the Fever of the Year 1747. of which we are now treating, did distinguish itself from the pre­ceding Year 1741. by a large and copious Discharge by Vomit, and some­times by Stool, of a grumous Fluid, not much unlike Coffee-grounds, which sometimes appeared mixed with Blood and rotten Membranes, this was called the Black Vomit, which before the Mixture of Blood and rotten Membranes did appear (which were deadly Symptoms) would often yield to the Use of the above Remedies; but when it proved difficult to be [Page 15] stopped (which would greatly aggravate the fatal Symptoms) the only Re­medy which appeared effectual in the Case, was a Mixture of distilled Vi­negar and Spirit of Mint, which sometimes would put a Stop to the Vo­miting, even when the fatal Symptoms had made their Appearance. And it is farther to be observed, that in the Disease of the preceding Year, acid Medicines, even Juice of Lemons, were for the most Part disagreeable to the sick Patient; yet in this Year 1747. they had a better Effect, and were generally, both more acceptable and useful to the Patient, especially Spiritus Nitri Dulcis, mixed with a mild Cordial Julep, which greatly cooled and refreshed the sick and much disturbed Stomach; to which Purpose, Tartar-whey greatly contributed; and sometimes a gentle com­posing Draught, which much refreshed the Sick, after the violent Heat and Rage of the Disease was over; provided the low and vapid Condition of the Spirits (which in this Case was very perceivable) did not forbid the Use of this otherwise comfortable Medicine.

FROM the above I think it is evident, that Catharthicks, by promoting a Secretion of the distemper'd Bile, and cleansing the Stomach and Viscera, were the most advantageous. Medicines in the Cure of this Bilious Fever, especially since it appears, that the Disease was of a Nature which would not admit of waiting, for either Digestion, or critical Days; so that to have rigorously obey'd the Aphorism of Hippocrates, Concocta non cruda, medi­canda sunt, would have exposed the Patient to the utmost Fury of this most destructive Disease.

As to our Author's supposed Excellence of the Bark, in the Cure of putrid Ulcers, notwithstanding the Recommendations of Dr. Monro, and others, it has not been found, in many Trials which have been made of it in that Case, to do more than might have been expected from Wine medicated with Cinnamon; and yet much short of an Aqua Calcis suited to the Temperament of the Patient, and other Circumstances attending the Case: And it is highly reasonable to believe, that the Cures supposed by Dr. Monro, ^† to have been effected by the Bark, in Mortifications, might with as great Probability of Truth, been attributed to the Scarifications, Fomentations, and the other Remedies; which they at the same Time in­dustriously made use of in that Case; which are known to be often effectual in the Cure of this much dreaded Disease: And indeed it is not improbable, that this may be the real Truth of the Matter, since we daily see Men so fond of an Hypothesis they have once entertained, that they will shut their Eyes against the clearest Evidence of Reason and Sense.

[Page 16] BUT to return to our Author: It will here be worth our Notice to con­sider, how the variolous Infection applied to an Incision, made in the Arm, should affect the Brain, by Means of Arteries terminating in the Part, where the Incision was made: The Arteries (says our Author, Page 22. Line 2.) which supply the Arms, come from the Subclavians, and they derive their Original from the ascending Trunk of the Aorta. But how an Artery at its Extremity, should convey the variolous Infection to Parts far above it, will be as difficult, as to say, by what Means a Stone shall raise itself up into the middle Region of the Air, without the Help of a mechanical Power, to repel the Force of Attraction: The Blood in the Extremities of the Arteries (by their Anastomosis with the Veins) is return­ed back to the Heart, where by Means of the ascending and descending Trunks of the Vena Cava uniting in one, they discharge their Contents into the right Ventricle of the Heart; where the whole Mass of refluent Blood is there mixed, and from thence is conveyed by the Aorta into all Parts of the Body; so that from the stated Laws of Circulation, it does not seem very possible, that the Infection should be conveyed towards the Head, rather than the more inferior Parts of the Body; therefore what the Gentleman supposes, That it would be much to the Benefit and Safety of the Patient, is an Imagination not founded on the Laws or Principles of physical Learning, which he so highly lays Claim to.

THUS Sir, I have finished what I at first propos'd, which was to give you my Sentiments upon that Part of the Discourse, which more par­ticularly relates to the Preservation of Persons labouring under that too often severe Illness, the SMALL-POX; and if what I have done may con­duce to give you a just Caution to avoid the Vanity of Hypothesis and ill grounded Conceits, I shall have my End: For I do assure you, it was neither Vanity, or an Itch of Writing, which led me to undertake a Task of this Nature; but to detect Mistakes in a Matter which so high­ly concerns the Welfare of Mankind.