of their once numerous army disbanded and dispersed; but were for the greater part pursued, hunted out, and destroyed. Nothing in history is more melancholy than the detail of the events subsequent to the passing to the north of the Loire. The personal story of the Marchioness after this period, is as romantic as it is mournful. She took refuge among the peasants; had a succession of alarms and most narrow escapes; was disguised in various ways; was sometimes driven from all shelter to pass whole nights in the fields and woods; was in one of her miserable hiding places delivered of twins; obtained, or rather fell into, at last, a more comfortable asylum, harrassed however still by repeated and terrifying incidents of danger; and finally received the news of the downfall of Robespierre and the Terrorists, and availed herself of the clemency and amnesty that followed.

Art. III. 1. An Inquiry into the Laws of different Epidemic Diseases, with a View to determine the Means of preserving Individuals and Communities from each, and also to ascertain the Probability of exterminating the Small-pox. By Joseph Adams, M.D. F.L.Š. pp. 159. Johnson. 1809.

2. A Philosophical Treatise on the Hereditary Peculiarities of the Human Race: With Notes, illustrative of the Subject, particularly in Gout, Scrophula, and Madness. Second Edition; with an Appendix on the Goitres and Cretins of the Alps and Pyrennees. By Joseph Adams, M.D. pp. 125. Callow. 1815.

IT

T must have been observed by those who have read the medical articles in the New Series of our Journal, that the subjects selected for our disquisition, have been, with little exception, of a popular character; that they have been at the same time medical and not medical; and that their interest is not of a confined nature, but excursive and general.

The title pages of the two works now before us, will be seen at once to be in unison with these principles of selection. We scarcely indeed know any subject that can be made more interesting to an inquisitive mind, than the subjects of the treatises we are about to notice; and the acknowledged abilities and industry of their Author, form a sufficient guarantee for an equal degree of interest, as it respects the manner of their performance. Dr. Adams has long been known as the Author of a work on Morbid Poisons;' a work so ably executed, that it prepared us to enter on our duties as critical inquisitors, with strong presentiments in his favour, and these presentiments we can justly say have not been disappointed. Indeed, we have reason on the whole to be satisfied with the productions before us; and in points about which we disagree with their Author, we do it with reluctance, and with that

respect which is always due to liberal sentiments, and laborious investigation.*

Our first topic of discussion will be respecting Epidemic and Contagious Diseases. Of these, most persons will find that they have unconsciously given themselves credit for knowing more than upon inquiry it will be found they really do know. Whether a complaint is catching, or not, would seem at first sight a problem of sufficiently easy solution; and we should expect to meet in medical writers with a plain and indisputable division of maladies into contagious, and not contagious. Some of our readers will not be surprised then, to learn, that at this moment the medical world is divided in opinion concerning this particular; and whether even the plague itself is, or is not, a contagious disease, is a contested and still unsettled question.

But it is by no means a question of mere curiosity, even to those who are placed at a distance from the ravages of the plague. Every one knows that the metropolis of Britain has been visited with this scourge; and how far we have a right physically to calculate npon a permanence of exemption, is a question in some degree involved in its communicable or contagious nature. To what extent, and in what manner, many other maladies of a virulent kind are capable of being imparted from individual to individual, and from one quarter of the world to another, are inquiries also of great moment. If nothing further rested upon the determination of this point, than the expediency of quarantine enactments, that itself would give a lively interest to its discussion.

On the subject of quarantines,' Dr. Adams says, it is not my intention to dilate by shewing the injury suffered to commerce in consequence of them. This consideration, when compared with the preservation of a town from such calamities as the plague or the yellow fever, is unworthy of notice. But quarantines are not innocent things in themselves. After the arrival of a ship's crew, under circumstances of despondency from scurvy, or any other disease, the disappointment of all their hopes of relief by consigning them to imprisonment, is to abandon many of them to certain death.'

The distempers which affect a considerable number of individuals at the same time and in the same place, are divided into Epidemic, and Endemic.

By endemics we understand diseases which are known only in certain places, often only in certain latitudes, where they are found in every season. By epidemics, those which occur only at certain

*The first of the treatises has been for some time before the public; but as it has not hitherto fallen under our notice, and as the inquiry it involves, is one of so much importance, we have thought it not improper to connect the consideration of it with the work on hereditary diseases, more recently published.

seasons, or from other changes in the atmosphere, with the nature of which we are unacquainted, or from contagion. The first order, for the most part, are chronic; the second, acute diseases.'

Endemics, even by the very term of designation, are supposed to have a necessary connexion with the internal peculiarities of the respective places in which they are met with, and to be capable of being engendered only in such connexion. Epidemics, too, are in a certain degree local; but they seem to come upon the places where they rage, at particular times, and from more extraneous causes. Thus, we should say of the ague in the fens of Lincolnshire, that it was an endemic disorder, while the influenza, which shall perhaps be in Paris one month, and in London the next, would properly be named an epidemic. Now, it is respecting these last that the question has been more especially agitated as to their communicable nature in the way of contagion, although the question cannot be confined exclusively to them. Indeed, a little reflection will lead the reader to perceive that the real question is, whether any given complaint is an endemic, or an epidemic; for, if its growth and progress are decidedly dependent upon the peculiarities of a particular district, and if it can be proved absolutely incapable of existence or propagation elsewhere, that such complaint is not a contagious disease, properly so called, but has something in it of the nature of an endemic, is almost a necessary inference.

For example: Suppose the garments of an individual who has died of the plague, to be folded up, excluded from the air, brought to Britain, and deposited in Monmouth-street; suppose also that a poor man purchase and wear these clothes;-now, although he may be affected with somewhat of indisposition in consequence, yet, if he do not actually become affected with plague, the evidence is more than presumptive, that the malady in question (plague) is not transferable in the manner in which quarantine laws suppose it to be; and the conclusion of Dr. Adams and of other anticontagionists, would seem to be justified, respecting the necessity of an infectious atmosphere for the propagation or communication of this disease-and it would appear therefore, that it is not contagious.

Now this could never be the case, it is urged, in reference to the communication of such poisons as all medical persons agree in denominating contagious. Thus, let us suppose the clothes which had been worn by an individual ill with the small-pox, to have been conveyed, and deposited, and purchased, and worn, as in the instance just imagined: the person who should thus receive the infection from them, would go through the small-pox as absolutely and exactly as if he had worn the garments in the part of the world where they were first imbued with the contagious poison; and-mark this circumstance as the leading feature of

difference he would be able to communicate precisely the same disease to another, while the subject of the first affection would probably be without such power;-because, say the anticontagionists, he would not be capable of forming the atmosphere indispensable to the maintenance and diffusion of the complaint.

So far, then, all would seem to be in favour of that doctrine which supposes an actual and essential difference in the laws of communication between fevers, (for plague is but a virulent fever,) and those distempers which are universally allowed to be communicable in the way of contagion; and the decided language of Dr. Rush would appear to be well founded, when he remarks, It is from nastiness degenerating into infection, that the bodies, clothes, beds and apartments of the poor in Great Britain, derive their poisonous, their pestilential charge. By a common putrefactive process, this septic venom is formed, and derives none of its qualities from pulsating arteries or glands. Away, then, with this preposterous phrase, from the poison engendered by septic processes, and let "human contagion" for the future 'mean nothing but small-pox, vaccinia, and the kindred forms of morbid secretions. It is high time that the products of 'putrefaction, should be distinguished from those of secretion.' And when we take into consideration the remarkable localities of those more violent fevers by which different regions are visited at different times, and recollect the diminution of them in some parts of America, especially since investigations have been made into their alleged sources, and these sources removed, we are compelled, to a certain extent at least, to subscribe to the opinion of the anticontagionist, and we seem to arrive at a very satisfactory inference respecting the transportation of these dreadful visitations from one to another part of the world.

There are, however, several impediments to this straight forward progress, and strong grounds for qualifying our sentiments on the subject of contagion, which claim now to be mentioned.

It has been very forcibly stated by the contagionists, that were nastiness and filth, according to Dr. Rush's account, the cause of disease, the induced complaint would not then be necessarily of the same nature as that of the subject from which it was received. Thus, if two wards of an hospital be devoted, one to the reception of individuals under typhus fever, the other to those under dysenteries, and if the want of cleanliness in each case stand exactly at the same point, the fever patients would never form the atmosphere which would occasion dysentery, nor would the dysenteric individuals ever impart fever. And moreover, both the one and the other disease, are it must

be allowed, occasionally derived from their peculiar and respective sources, even when every attention shall have been given to ventilation and cleanliness, and when perhaps only one or two sick persons may have furnished the atmosphere of infection.

Some few years since, at Edinburgh, when the disputes and divisions between the contagionists and the anticontagionists ran very high, there were several instances of intentional exposure to the alleged sources of contagion, for the sake of shewing its existence to be merely imaginary. Many of the students in that university, who, with Dr. Rush, derided the doctrine of contagion as a bugbear,' exposed themselves fearlessly and with design, to the effluvia from the bodies and lungs of the fever patients in the infirmary, and several in consequence fell with fever, which, in some instances, proved fatal. Now, when Dr. Adams is called upon to reconcile this acknowledged fact, with his notions of the incommunicable nature of fever in the manner supposed by some, he tells us, that there was no instance of the individuals in question infecting others, inasmuch as they went through the disorder in their own apartments, and did not bring with them the hospital air. But we would suggest whether the immunity might not be attributable to more care having been exercised in these cases, and greater precautions taken by their attendants and friends, as the joke of experimental speculation, to use the language of Dr. Gregory, had already been carried sufficiently far. The mention of Dr. Gregory reminds us of a tale which we have heard him relate in his Lectures, for the purpose of establishing the very opposite assumption to that of Dr. Adams and others, and to prove that fever may be communicated in the same way as the more positive contagions, that is, from something secreted by the communicating individual, or formed by pulsating arteries or glands, and imparted immediately and directly, without the intervention either of filth or infectious atmosphere. The Professor informs us that a young woman, of extraordinary beauty, was admitted into the fever wards of the infirmary with typhus, and that several of the students, captivated by her person and manners, were in the practice of sitting on her bed and approaching nearer to her than was prudent; in consequence, several became affected with typhus, who might have ranged the fever wards during a whole season, or, in other words, exposed themselves to the atmosphere of fever, with perfect impunity.

Another fact favourable to the doctrine of contagion, is, that when any reigning disorder of a given district visits a family, each individual of such family becomes more obnoxious to the infection, than his neighbours and friends, whose houses