by a yellow and dusky putrid bile. The urine, which was before of a high ictericious colour, is now almost black, and frequently mixed with a confiderable quantity of half diffolved blood. The pulle, already much funk, becomes now exceeding. ly low and depreffed; unequal and intermitting; the breathing difficult and laborious; the anxiety almost inexpreffible; an oppreffion, with a burning heat round the præcordia, enfues, tho' the extremities are cold, and often fevered with clayith clammy fweets; a conftant delirium fucceeds, and then a total loss of reason, and the external fentes. In many parts of the body livid fpots are feen, especially about the præcordia, and frequently gangrenes in other parts of the body, which foon terminate in death. After death the body appears much fuller of large livid blackish and mortified spots, particularly the præcordia, the region of the lower belly, cfpecially the right hypocondrium; which parts, from the first attack, feem to be the principal feat of this dreadful difeafe. Upon diffection, the gall bladder, and biliary ducts, are found turgid, and filled with a putrid dark bile; the liver, ftomach, and parts adjoining, covered with blackish mortified fpots, and fometimes gangrenes in thefe and other parts of the body. The whole corpfe foon putrefies after death, and can be kept but a few hours above ground. thor, a great colliquation and diffolution of the blood, and a gangrenescent state of the fluids. He admits, that this yellow fuffufion of bile over the furface of the body, has fometimes, though feldom, proved critical; but then it did not appear before the eighth or ninth day, when the coma, A and other bad fymptoms began to abate, the yellowness increafing as they decreased. When it appears early, it is not only fymptomatical, as it arifes from the colliquated, putrid, diffolved, and gangrenescent state of the blood, but it too frequently ushers in the laft and fatal fymptoms of the dif- B ease; a deep coma, a low vermicular and intermitting pulle, profufe hæmorrhages from different parts of the body, a delirium, with a laborious and interrupted respiration, great anxiety, deep fighing, pervigilia, a fubfultus tendinum, coldnels first of the extreme parts, next of the whole body, C inarticulate fpeech, tremors, convulfions, and death. Thus, from the first appearance of the fymptomatical yellownels, the patient may be faid to be in the last stage of the difeafe, at whatever time it comes on. It has been obferved of patients of full, fanguine, and robust constitutions, where D bleeding in a fufficient quantity has been omitted in the firit, fecond, or third days of the difeafe, that the pulfe continued full, ftrong and rapid, never hard; the face flushed, eyes inflamed, the tongue dry, with intenfe thirst and heat, till the fecond From attentive confideration to all thefe or laft ftadium fupervenes; when all of a fymptoms, the doctor concludes, that a fudden the pulfe has funk, and death foon bilious putrefying diathesis is introduced enfued. In others apparently plethoric, into the blood, and all the circulating the tongue has kept moift through the fluids. Hence, not only the operations of whole courfe of the difeafe, even when they chylification and fanguification are disturb have been long delirious: the heat of the ed, altered, changed, and inguinated, fkin, and the strength and velocity of the with a putrid bilious acrimony, but errores pulfe, have continued after the first stage, F loci fluidorum are produced; whence the near the standard of health, till within a brain is affected, all the animal functions few hours before death. When a coma disturbed, the texture of the blood fo . comes on, a perfon not perfectly acquaint- broke and diffolved, that the humours are ed with this fever, would eafily, from the changed into a lethiferous ichor, which, pulfe, heat, and breathing, imagine the if not timely prevented, must infallibly patient in a fine refreshing natural fleep. end in death. He believes, contrary to the Others again, when the pulle has funk, G opinion of Dr. Warren, that the bile has and the lait fcene was feemingly approach- a principal share in exciting this fever, and ing, have, to the great furprize of all pre- the putrid gangrenefcent ftate of the blood. fent, perfectly recovered their fenfes, talk- The reafoning upon this fubject is fentible ed chearfully for an hour or two, and then and rational; from which, and the predied fuddenly, ftrongly convulfed. ceding fymptoms, he deduces the following indications and intentions of cure. In the laft ftage, fo attenuated and diffolved is the blood, that it frequently flows not only from the nose and mouth, but from the eyes, and through all the pores of the body; large quantities of black, halt baked, half mortified, coagulated blood, are allo voided äva x narw, accompanied E H 1. To moderate the too great and rapid motion of the fluids, and abate the beat and violence of the fever in the two firf days of the difenfe, with all possible expedition and safety. 2. To evacuate and carry out of the body that putrid bile, and thoje unfound humours ai early BOOKS with REMARKS. in the diflemper as may be. 3. To flop the putrefcent difpofition of the fluids, and prevent gangrenes, by fuitable antifeptics. A To answer the first intention, our author prefcribes bleeding on the first appearance of the fever, in a quantity proportioned to the violence of the fymptoms, and the constitution and circumstances of the patient. He has ordered 12, 14, 16, 18, or 20 ounces to be taken; and if the pulfe rofe, repeated phlebotomy the first or fecond, feldom on the third day, which ought to be attempted with the utmoit caution. However frequently the opera- B tion may be requifite before or on the third day, though it is feldom required above twice, or, at the most thrice, he strictly prohibits it after, but upon very pressing and extraordinary circumstances. The blood is now in a diffolved ftate, and the pulfe fo low, that diminishing the momen- C tum of the blood would affift the gangrenef. cent diathefis, and haften a mortification and death. Indeed, by bleeding in any ftate of the difeafe, he differs from Dr. Warren, and all former writers, although his arguments and fuccefs feem itrongly to prove the rectitude of his practice. obferve, that this depends wholly, n the time and circumftances in which they are administered. If they are given early, and before the putrefcent diathetis and diffolved state of the blood come on, they may not only be innocent but ufefil. The mifura antiemetica, in particular, is prescrib ed by the molt judicious practitioners in different forts of icterical and inflamma. tory diforders. In short, we may affirm, that where acid ju eps are convenient, the faline draught, compofed of falt of wormwood, lemon juice, and fimple cinnamon water, cannot be improper. As to Nitre, 'tis only experience that can dictate how far it is hurtful or ferviceable; reason would feem to prescribe it, but experience, the doctor allures us, confirms it to be prejudicial. If the bowels are conftipated, our author advises a gentle purging clytter to be given immediately before the opiate; and after the effects of the thebaic extract have ceased, he recommends a gentle antiphlogistic and antileptic purge. If, on the contrary, the patient is feized with a purging after vomiting, he orders a mild dofe of toasted Drhubarb, and an antifeptic anodyne after it has operated. This purging he always found attended with happy confequences, if the patient's ftrength was properly fuftained, and the fever allayed by antileptics. However irregular the practice of purging may be in many other fevers, the doctor has always found it beneficial in this. Whenever a painful burning heat in the hypochonders,or about the præcordia comes on, a gentle dofe of manna and tamarinds, feldom fails of carrying off the pain and heat, by a difcharge of the putrid bilious matter that excites them. On or after the F With regard to the fecond intention, Dr. Hillary obferves, that the great irritation of the ftomach, the continual reachings and violent vomitings feem to indicate an emetic; yet has the most gentle and mild dofe been attended with almost fatal confequences: fo violently ftimulated, E irritated, and inflamed are the coats of the ftomach, that no remedies can prevent the operation of the emetic, till a mortification in the ftomach enfues, which foon terminates in death. He therefore strictly forbids them, fubftituting in their room large draughts of warm water, with fometimes a finall addition of fimple oxyinel, or a light infufion of green tea, to carry off the putrid humours, and affift nature. After the patient had puked feven, eight, or nine times, he ufually gave Extract. Thebaic. gr. j. veljfs. forbidding the patient to eat or drink for 2 hours after, to prevent his re- G peating the medicine. By this method all the fymptoms were moderated, the patient refreshed, and a truce obtained from the inceffant vomiting. A foundation was laid for exhibiting other medicines, as cooling acid juleps, or other antiphlogistic and antifeptic medicines. Nitre, he obferves, or H any of its preparations, will rarely stay upon the ftomach; and as to the faline draughts, though esteemed antiemetics, he ranks them among the ladentia, on account of their attenuating quality. But we mult VOL. III. July 1759, third day, when the pulfe finks, a coma appears, and a yellowness is diffused over the skin, the regimen must be altered, and the third intention of cure applied to. Here the vis vite must be fustained, and the momentuin of the circulating fluids increafed, antifeptics must be liberally plied, and every thing administered to put a stop to the growing putrefaction, and the gangrenefcent difpofition. Unhappily the Peruvian bark, a medicine the most likely to effect this purpose, can in no form be kept on the ftomach; and after repeated trials, the doctor found himself under the neceffity of intirely laying it afide for a light infufion of the rad. serpent. Virginiana, The following form he has frequently prefcribed with all the fuccefs he could defire. "Rad. Serpent. Virg. 3ij. Croc. Angi. E Angl. 3s. m. et infund. vafe claufo in Aq. Bul. q. f. per Horam unam ut Col. vi. adde Aq. Mentha Simp. 3ij. Vini Maderienf. iv. Syrup. croci, vel fyrup. e Mecon. i. Elix.Vitr. acid. gutt. q. f. ad gratam Saporem, m. capiat cochl. ij. vel iij. fiugulis boris vel fæpius pro ri nata." pleafant, light, and antifeptic, he recom mends above all others. "By Panis bene fermentati leviter coЯiiv. Coq. in Aq. pur. per horam, tum tere diu, dein preme per linteum denfiffimum ut fit Liquoris fic A parati Hils. cui immifce Limonii maturi talcolatim fciffiij. Nu. Mofc. in Polinem triti 31. Servetur ufui. Sumat ager omni biborio 3. vel iij. tempore ufus admifcendo Vini Malerienfis et Sacchari quantum placet palato agri." B This prescription, though not very claffical in the language, may, notwithstanding, be well enough adapted to the circumftances of the patient. Particular care must be taken, that the medicines and diet be of the fame difpofition, each of them tending to check the bad diathesis of the blood, and the bad habit of the fluids. C Such are the directions laid down by our author in treating this diforder. It is true, that after defcribing fo accurately the fymptoms, and laying down fo philofophically the procataractic caufes of the disease, it was unneceffary to enlarge on the pharmaceutic part, and still lefs to deliver formulas, which muft ever depend upon the judgment of the attending phyfician. However, as we muft afcribe the doctor's prolixity to his defire of being explicit, we willingly pafs over thofe little blemishes, and heartily recommend his book to all those whofe fortune or inclinations may lead them to follow the profeffion of phyfic in our colonies. [Crit. Rev.] Should this fail of raifing the pulfe, and producing the other defired effects, the quantity of the fnake-root and faffron are to be encreased, or the vinum croceum, the confe&io cardiaca, or fome fuch warm medicine be given, till a glowing heat is diffused over the whole body. If the fever grows high, it is to be moderated by cooling acid juleps, antiseptics, and fuch like, never by volatile alkaline falts or fpirits, which diffolve and encrease the putrefcent ftate of the fluids. Dr. Hillary reasons fenfibly against the use of veficatories, which would feem to be indicated by the foregoing fymptoms, and his arguments he confirms by repeated experiments: " Yet, fays he, fuch is the unreafonable fondnefs for blifters in this ifland, (Barbadoes) and fome other countries alfo, almost in every cafe where pain and a fever feize, that they D are too often applied even in dyfenteries, and in the beginning of inflammatory fevers, and much too often in this fever, even in the laft ftate of it, to the great prejudice of their patients. I have feen a veficatory, which I ordered to be taken off, as I ufually do as foon as I come in this fever, that E the part where it laid was turned black, and perfectly fphacelated, and if the fpine and ends of the ribs had not hindered, a large fquare paffage into the cavity of the thorax would have been opened, if the patient had lived a few hours after it, but he died two hours after I came." F G From this time the doctor rigidly forbad the application of blifters, in every cafe where he was called; a circumftance that now, upon reflection, affords him great pleafure. This injunction we cannot, however, but think too indifcriminate, as we are perfuaded, that where the pulfe in the firft ftage, as fometimes it happens, is low and depreffed, thefe veficatories might be ufeful. In this fimple, eafy, and elegant manner, did the doctor invariably treat his patients in the putrid bilious fever, and with a fuccefs that confirmed the truth of his theory. With regard to the dietetic H part of the cure, he advifes, that it may be thin, light, aud in a finall quantity, the stomach being too delicate to retain what is not perfectly palatable, nor even that in any quantity. The following panada, as An Examination of the Scheme of Morality advanced by Dr. Hutchefon, late Profeffor of Morality in the Univerfity of Glasgow. By John Taylor, late of Norwich, D. D. DR. Taylor chiefly confines his remarks on Dr. Hutcheion's Scheme of Morality to this fingle point, viz. What is the faculty or principle in the human conftitution, upon which virtue ftands; and which being taken away, there would be no virtue, or no foundation in our minds, thoughts, or apprehenfions, for any difference between moral good and evil? Now, according to Dr. Hutcheson, we are told, benevolence, and a moral fenfe, are the only principles of virtue in the human conftitution. But, according to Dr. Taylor, all our other natural affections and paffions, felf-love, fhame, modefty, fear, anger, love of offspring, that between the fexes, &c. have as good a claim to be virtues as benevolence; fince they are infufed into our conftitution by the fame wisdom and power, all operate in the fame man ner, BOOKS, with REMARKS. ner, are intended to answer the like good In regard to the moral fenfe, our Author fays, it is a monstrous abfurdity, an inconfiftency, a non-entity, the mere fiction of Dr. Hutchefon's own brain; he compares it to a stupid ideot, prefiding in a Court of Judicature of the highest importance, and determining the whole courfe of human actions. Intelligence, according to Dr. Taylor, is the only moral fenfe in all rational Beings. This he endeavours to prove in the following manner. B actions. Reafon is the only faculty that discover and propofe juft and reasonable ends, and excite to the purfuit of them as they are reasonable. Nothing but the most perfect and fimple reafon in the Deity knows, propofes, and excites to all, the ends which he puriues and executes. Reafon is a percipient, and the only percipient of moral good, which is the highest good. An intelligent nature, as fuch, may have and is the only nature that can have, a knowledge and fenfe of intellectual happiness, the pleasures of a virtuous mind; which are by far the molt excellent: And the more perfectly intelligent, or rational, fuch a nature is, the more perfect fuch knowledge and sense of intellectual happiness mutt be, and the more ftrongly it must be excited to pursue it. But happiness, continues our Author, is but one object of reafon and virtue; C which is to be purfued only under proper reftrictions and conditions. The general and all comprehending object of our minds is Truth, or whatever can be known concerning the different nature of things, perfons, actions, relations, and circumftances. And of the different natures of things, &c. every understanding may and must have fome knowledge; and may confider what conduct is or is not agreeable to them. Confequently, wherever there is intelligence, or reafon, there may be virtue, or reasonable action. But if actions are conftituted morally good or evil, only by the blind, uncertain perceptions of fenfes and affections, previously to the ufe of reason, then it is plain, that in themselves, or in their true nature, no actions are reafonable or unreasonable, good or evil, virtuous or vicious; nor can any reafon be given, why fome are right, and others wrong. Which is, in effect, to annihilate virtue, as it leaveth no certain rational principles upon which it can fubfift. Every object, he fays, muft exift, and be what it is, or what it is apprehended to be, before it can be perceived by any sense whatsoever. No fenfe can perceive nothing. Confequently, moral good and evil, either in the general idea, or in relation to any particular action, whether benevolent or D malevolent, or of what kind foever, mult exift in their true or apprehended nature, principles, and qualities, antecedently to their being perceived by Dr. Hutchefon's fuppofed moral fenfe. But the ideas of moral good and evil, either in general, or in relation to any particular action (whe- E ther the action be already past, or confidered as poffible to be done hereafter) being abstract ideas, can exift no where, but in the mind or thought of an intelligent Being, recollecting and confidering their moral qualities. Therefore, they must exist, and be feen, known, and understood, be- F fore they can poffibly become the objects of his moral fenfe; which, without them, can have no object to perceive, and which can perceive no more of them, than what is already perceived by a much fuperior faculty. Into which faculty his moral fenfe muit therefore be refolved, as being nothing G diftinct from it. Dr. Taylor offers feveral arguments to fhew, that virtues neither in principle nor practice, can be conftituted by instincts, and their irrational motions and exertions. Reafon, he fays, which alone can judge of, and reafon about, the natures and relations H of things, is the only faculty that can diftinguish between actions morally good and evil, that can prefer the one, and reject the other; and therefore is the only faculty that can fupply justifying reasons of our According to Dr. Taylor, inftincts are manifeftly figns of the imperfections of our nature, being infufed into our conftitution as auxiliaries to reafon, to aflift its prefent weaknefs, by fpurring it on to action, where otherwife it would be too flow, and by giving it fpirit in refifting and fleeing. from evil, where it would be too deliberate and languid: and thus they are of use in our conftitution, as crutches are to feeble limbs. fuppreffed, he gives them to the world, without any alteration, as he received them; and that they were originally drawn up for the private use of a near relation, whom the Author tenderly loved. As much as fome Critics, and others, continues he, may bufy themfelves in form- A ing conjectures of his Lordfhip, from the ftile, the matter, or other circumftance of the Letters, the refult will be nothing but conjecture; and they may as well fave themfelves the trouble of thinking at all about it. To as little purpose will it be for the bigots of any church to cenfure or B defame him. He was always above their malice, and is now out of their reach.' Who the Author was we know not; nor is it of much importance to the Reader to know. If the letters were not really written by the late worthy bishop of Clogher, it is certainly intended it fhould be thought C they were. Be this however as it may, they are written with a free, generous, and open fpirit; and the Author appears to have been a fincere friend to truth and the best interests of chriftianity, without any bigotted or narrow attachment to parties or party-principles. He inveighs with fome D feverity against the ignorance and floth which are fo prevalent in the church, and the mean and dirty ways, as he justly calls them, which are found to be moit fuccefsful towards getting preferment in it. But we fhall give a fhort yiew of what is contained in each of the letters. E F The first confifts of fome general reflections on the fate of true zeal for religion in the church, and the many difcouragements which men of study and probity meet with in it. The Author laments that no care has been taken by the men in power, to extirpate thofe abfurdities which have given great offence to ferious people in the public worship; and that every thing is not only permitted to continue as in the days of ignorance and error, but that all attempts towards a further reformation, are treated with averfion and contempt. It feemeth impoflible to me, fays he, if G there was not an indifference about religion and truth, that the free and candid difquifitions relating to the Church of England, publithed in that country within the fe few years, fhould have had no manner of weight; but that the fame ignorance and abfurdity, exploded privately in the breast H of every man of fenfe, fhould fill continue to make a part of the worship of the church of England.' In the fecond Letter he endeavours to explain the fenfe in which fubfcriptions are required in the church, and to fhew, that our affent and confent are declared only to the use of every thing in the Common Prayer. In order to fearch this matter to the bottom, he thinks it neceflary to confider the rife, the defign, and the obliga tion of the articles; and concludes what he advances on the subject in the following manner. The Legislature may be affured that there never was, and I will venture to fay, there never will be, a fubfcription to all the articles, according to the plain fenfe and meaning of the first Compilers: and as it hath never been declared, that fuch alone is the fuofcription which is required, by depriving thofe whofe public writings contradict this original fenfe, it is evident, that a fubfcription is allowed in any fenfe which is agreeable to the word of God. For he who fubfcribes the articles in a fenfe equally confiftent with the public good, and the rights and properties of his fellowfubjects, equally anfwers the intention of the legislature in the law which requires any fubfcriptions; and abftracted from the force of the law, ecclefiaftical impofitions in a proteftant church, are impertinent and vain. Why a fubfcription to thefe articles is ftill required in our church, though the fentiments of her Clergy are so much altered, is another question, I own, which it is natural for you to ask, but which a wifer man than I am cannot answer.' The third and fourth Letters contain a serious and earnest exhortation to care and diligence in the difcharge of the paftoral office, and to act up to the dignity and importance of it. In the fifth Letter the Author laments, with a juft and becoming freedom, the little care taken at our Univerfities, to qualify the youth intended for the Church, in reading and elocution, in the study of the fcriptures, and every branch of true theology, and proceeds, in the fixth, to give fome general directions for speaking, and for action. If I had ability, fays he, to found a Profefforfhip in the University, one of the first things I would do, fhould be to provide for the attainment of these two arts, in the education of thofe intended for the Church. But really, as the cafe is at present, inftead of being taught, or even encouraged, thefe arts are defpifed by all our Clergy as things beneath their notice; and to this it is owing, that not one in a hundred either read, or speak in public, with any propriety. They may think of this as they please; but I can affure them it is of confequence to their fuccefs and reputation, with |