fever, which correfponded, in feveral particulars, with the diftemper which is the fubject of the prefent publication.

The danger of mistaking this difeafe for the ulcerated or putrid fore throat, induces us to abridge the Author's judicious description of its mode of attack, and of its subsequent symptoms, in the order in which they occur.

The more ufual and milder fpecies of this disorder commences with a flight foreness or rather ftiffness in the throat, which is fucceeded by alternate chilly and hot fits. On the next day the foreness in the throat increases, and the patients find a difficulty in fwallowing, which feems chiefly to proceed from a difficulty of putting the neceffary mufcles into action. A ficknefs comes on, attended with fhortness of breath, a dry burning heat, and frequent pricking pains in the fkin. In the morning of the third day, the face, neck, and breaft appear redder than ufual; and in a few hours this redness becomes univerfal, and increases to fuch a degree of intensity, that the face, body, and limbs, refemble a boiled lobfter in colour, and are evidently fwollen.-The fkin is fmooth to the touch, nor is there the least appearance of pimples or puftules. The eyes and noftrils partake more or lefs of the general redness; and in proportion to the intenfity of this colour in the eyes, the tendency to delirium prevails.'-The pulfe is quick, small, and uncommonly feeble. The alvine difcharge is regular; and the urine, though fmall in quantity, scarce appears to differ from that of a perfon in health.

At the end of two or three days more the intense scarlet colour begins to abate, and the fkin peels off in fmall branny fcales. The tumefaction fubfides, and the patient gradually recovers his ftrength and appetite.

During the continuance of the fever the tongue is more or lefs covered with a yellowish brown mucus. The velum pendulum palati, the uvula, the tonfils, and the gullet as far as it is vifible, partake of the general rednefs and tumefaction: but though the Author never faw any real ulceration in these parts, yet collections of a thick mucus are fometimes obferved on the back of the cefophagus, which greatly refemble the fpecks or floughs in the putrid fore throat, but which may be washed off with a gargle. In autumn, however, the tonfils were fometimes covered with whitifh floughs; on the feparation of which they appeared raw, as if divefted of their outer membrane.

In the moft malignant or fatal fpecies of this disease, in children, a delirium commenced within a few hours after the invafion. The fcarlet colour appeared on the firft or fecond day, and they died very early on the third.

In adults, the difeafe became fatal upon the fourth or fifth day, especially if a purging fupervened: but fome fur

vived to the eighth or eleventh day. In all these the throat was but little affected. The pulfe, in thefe cafes, was, from the very beginning, fo quick, feeble, and irregular, that it was fcarce practicable to count it for half a minute at a time. The eyes exhibited an equable, fhining redness, resembling that which is obfervable in the eye of a ferret; and yet the strongest light was not offenfive. This redness might first be perceived in those parts of the eye that were covered by the upper eyelid. Small circular spots of a livid colour frequently appeared about the breast.

Sometimes, even ten or fifteen days after the ceffation of the fever, a new disease appeared. After a few days amendment, some new symptoms retard and finally stop the patient's further approach towards health, and at length terminate in an univerfal fwelling of the anafarcous kind, or fometimes in an afcites. In fome, the dropfy affects the brain, producing the coma vigil, delirium, and blindness: in others, it falls upon the lungs, and produces every fymptom of the true hydrops pectoris.

After having given a distinct history of this disease, followed by an account of the more material obfervations made by preceding authors, on the fpecies of scarlet fever most nearly refembling it, Dr. Withering points out the characteristic fymptoms which diftinguish it from other disorders feemingly allied to it. Thefe are, fevers of the petechial kind, the purple fever, meafles, eryfipelas, and particularly the ulcerated fore throat. On this laft head he makes the following obfervations :

There is yet another disease fo much refembling our epidemic in many of its leading symptoms, that I acknowledge it is not an easy task to diftinguish them; and yet the diftinction is a matter of the greatest importance, as the method of treatment ought to be extremely different. The Reader will readily guefs that I allude to the Angina Gangrænofa, or ulcerated fore throat. They are both epidemic, they are both contagious: the mode of feizure, the firft appearances in the throat, are nearly the fame in both: a red efflorefcence upon the fkin, a great tendency to delirium, and a frequent, small, unsteady pulse, are likewise common to both.'-He adds, that it is not wonderful that, with features so strikingly alike, and fo obvious, many practitioners confidered them as the fame disease; and that others, though fenfible of some little differences, ftill concluded them to be of the fame nature-both putrid, and both accordingly requiring a fimilar mode of treatment. The differences between them are given in a table, containing a comparative or contrafted view of these two difeafes, exhibited in oppofite columns; from which we shall extract fome of the more diftinguishing symptoms of each.

Under

Under the Articles of Seafon, Air, and Situation, it appears that this fearlet fever reigns in fummer and autumn; in a hot and dry air; and in high, dry, and gravelly fituations: whereas the ulcerated fore throat is prevalent in fpring and winter; in a warm and moift air; and in clofe, low, damp, and marshy places. The former attacks the vigorous or robuft, without diftinction of fexes: the latter feizes the delicate, and particularly women and female children.-In the scarlet fever, the eyes exhibit a fhining, equable, intense redness, and are seldom watery in the gangrenous fore throat, the eyes are inflamed and watery, or funk and dead.-In the former, in summer, the tonfils, &c. are little tumefied, and without floughs; in autumn, they are more fwelled, the integuments feparate, and white floughs appear in the latter, the tonfils are confiderably fwelled and ulcerated, and the floughs are of a dark brown colour. The breath, in the former, is not foetid: in the latter, it is offenfive to the patients and their affiftants.-The blood, in the former, is buffy and firm in the latter, florid and tender. The fcarlet fever terminates on the third, fifth, eighth, or eleventh day: the ulcerated fore throat has no ftated period. -In fine-and the diftinction is a very material one-the former is characterised as an inflammatory, and the latter as a putrid disease.

After this enumeration of the principal characteristical fymptoms and circumstances attending the two diseases, it will obviously follow that a method of treatment highly falutary in one of them must be noxious in the other. No medicine, fays the Author, ever had a fairer or fuller trial in any disease, than the bark had in our epidemic. The great proftration of strength, the feeble pulfe, and the sharp heat upon the skin, with here and there a livid fpot, were thought to be fuch undeniable evidences of the putrid tendency of the disease, and of the broken texture of the blood, that the bark was poured down with a most unsparing hand. And again, in the autumn, the increased disease in the throat, and the floughed appearance of the tonfils, confpired to keep up the delufion. It was very generally believed that bark was the only medicine that could be depended upon; and mankind had not yet forgotten how many lives were loft in the first attacks of the ulcerated fore throat, before they became acquainted with the efficacy of the bark.'-The Author nevertheless affirms, that by the liberal exhibition of it, and of cordials, much harm was done; and, in particular, that the inflammation of the tonfils, &c. was thereby greatly increased, and the whole lining of the fauces converted into a stinking nough.

The first and principal remedy recommended by the Author, and employed with the greatest fuccefs, was a powerful vomit, frequently

frequently repeated. On the very first attack, it seldom failed to remove the disease at once. He recommends a vomit likewise as the best of preventatives; in confequence of his opinion that this contagion firft made its lodgment upon the pituitary membrane lining the nofe and fauces; from whence an emetic dif lodges it, and prevents its defcent into the ftomach. Another prophylactic recommended by the Author is the caustic alcali, or foap-leys diluted with water, and used as a gargle, on account of its chemical quality of diffolving mucus, and destroying all the peculiar properties of animal matter. He uses likewife the vegetable fixed alcali pretty liberally, though largely diluted, as a diuretic; confidering the medicines of this clafs as most to be depended upon in this difeafe, next to emetics.-But we fhall not dwell further on the Author's method of cure, as we cannot suppose that, after this notification, by which we principally mean to put practitioners on their guard against this difeafe, any of our medical Readers will neglect to confult the pamphlet itself, for information respecting this and many other particulars, relative to a diftemper probably fo little known to them as the present.

The Public were highly obliged to Dr. Fothergill for the light which he threw on the nature and proper treatment of the ulcerated fore throat and equal obligations appear to be due to Dr. Withering, for his early account of the disease which he has fo well described, and the true character of which he ap pears to have fo well afcertained, in this little treatise.

MONTHLY CATALOGUE, For MARCH, 1779.

POETICAL.

Art. 10. An Elegy on the much lamented Death of a moft ingenious young Gentleman, who lately died in the College of Edinburgh, where he was a Student. 4to. I S. Robinson. 1778.

TH

HE ingenious and accomplished young Gentleman, whofe untimely death gave birth to this Elegy, was a ftudent three years at Edinburgh;-where the caufe of his death was a putrid fever, which he got by diffecting the brain of a child who died of a dropfy in the head. A very fmall time before his death, he, by unanimous confent, and with univerfal applaufe, obtained the prizemedal proposed by the Esculapian Society of Edinburgh, for the best effay on the means of diftinguishing pus from mucus. For an account

of his learned and ingenious differtation, which juftly procured him fo much honour; of his other writings; of his much lamented death, and molt amiable character; fee the 19th Number of the Medical Commentaries, from p. 329 to p. 336."

Confidered as the pious tribute of friendship, this Elegy, which abound with natural expreffions of tenderness and fincere regret, demands the most generous applaufe; but, regarded as an

attempt

attempt at poetical compofition, we have little to fay in its praise. With perfect juftice, therefore, as well as, we believe, unaffected modefty, does this fentimental and feeling Writer declare, in his advertisement, that he lays no claim, nor indeed hath he any pretenfions, to poetic merit.'

Art. 11. Bath,-a Simile. Bath,-a Converfation-Piece. Bath,-a Medley. Preceded by a Prologue to the Critics; fucceeded by a Rhapfody, on the Death of Mr. Garrick. 4to. 2s. 6d. Whieldon and Co. 1779.

There is more wit than poetry in this medley. The fimile, in particular, in which Bath is compared to a fet of tea-equipage, of Wedgwood's cream-coloured ware, and which runs through as many verfes as Swift's poem on Bally-Spelling, is well made out. We should have liked the performance better, if we had met with fewer Sternboldian lines in it. But, poffibly, the quaint fimplicity of his strains is meant as a conftituent part of the Author's waggery. Art. 12. Party Satire Satirized. A Poem.

A Poem. 4to. I s. 6d.

Bladon. 1779.

A lick at the lafhers; who are represented as a pack of feditious libellers:

By mad caprice, or patriotic spite,

Induc'd for Congrefs gloriously to write.
Each rhyming Garreteer, howe'er distress'd,
In Transatlantic fervice would be prefs'd.
Their liberties, like fons of ancient Rome,

They prize too high to keep their wits at home:
For injur'd poor America they bawl,

Rejoic'd to fee her rife by England's fall;

Thus politics makes rebels of us all.'

Art. 13. The Tears of Britannia: a folemn Appeal to all her Sons at this tremendous Juncture † : A Poem addreffed to the First Lord of the Admiralty, the Commanders of the Militia, &c.. 4to. 2 s. 6d. Ch. Rivington. 1779.

It is expected that poetical tears fhould flow according to the laws. of Melody, Harmony, &c, but here we have the most unmufical blubbering that hath been heard fince the days of Withers and Taylor the water poet. In fhort, this weeper in verfe is a downright res bel against all poetic authority. If the Writer of the following couplet were, by chance, to ftray within the confines of Parnaffus, the beadle of the facred mount would certainly take him into cuftody," as a diforderly person, and a pilferer:

The wounded war-fhip, now no longer strong,

Drags like a wounded fnake her maim'd length along. But if the Author is a rebel in poetry, he is a loyal fubject in politics; witness the following addrefs to a noble Lord:

On thee, O Sandwich, equal to the weight,
Now refts thy anxious country's naval fate:

* " I rejoice that America has refifted," faid a late patriotic Earl in the Houfe of Peers."

AUTHOR'S Note.

This feems to bear reference to the problematical fea-fight of July 27, 1778.

Able