active virtue in the plasters or ointments with which they are dressed, but is entirely the work of nature, and best performed when the mildest substances, or even dry lint only is applied; and that heating gums, resins, and balsams, rather retard than promote their cure; the internal use of such remedies ought to be rejected now, on the same principles they were adopted formerly.

No kind of reasoning ought to have weight, when opposed by fair experience. But physicians have formed contrary and opposite conclusions, with respect to the effect of the natural and artificial balsams, even when they have laid all theory and reasoning aside, and decided on their powers from practice and experiment only. This is sufficient to prove, at least, that their efficacy is very problematical. For my own part, after the fairest trials, and the most accurate observations I have been able to make, I cannot say that I ever knew them of service in any hectic complaint proceeding from an ulcer in the lungs; and I have generally found those physicians, on whose judgment I have more reliance than on my own, of the same opinion.

It is far from being uncommon to see a cure retarded, not to say any thing stronger, by the means employed to hasten it; and physicians who found their practice on theoretical reasonings, are not the only persons to whom this misfortune may happen, Those who profess to take experience for their sole guide, if it is not directed by candour, and enlightened by natural sagacity, are liable to the same. A man may, for twenty years, order a medicine, which has in every instance done a little harm, though not always so much as to prevent nature from removing the complaint at last; and if the reputation of this medicine should ever be attacked, he may bring his twenty years experience in support of it. It ought to be remembered, that as often as the animal constitution is put out of order, by accident or distemper, nature endeavours to restore health. Happily she has many resources

and various methods of accomplishing her purpose; and very often she succeeds best without medical assistance. But medical assistance being given, she frequently suc ceeds notwithstanding; and it sometimes happens, that both physician and patient are convinced, that the means which did not prevent have actually performed the

cure.

A peasant is seized with a shivering, followed by feverishness, and accompanied with a slight cough-he goes to bed, and excessive heat and thirst prompt him to drink plentifully of plain water; on the second or third day a copious sweat bursts from all his pores, and terminates the disorder. A person of fortune is seized with the same symptoms, arising from the same cause, and which would have been cured by the same means, in the same space of time; but the apothecary is called, who immediately sends pectoral linctuses to remove the cough, and afterwards gives a vomit, to remove the nausea which the linctuses have occasioned: the heat and fever augment: the physician is called; he orders the patient to be blooded, to abate the violence of the fever, and gives a little physic on some other account. All this prevents the natural crisis by sweat; and the patient being farther teased by draughts of powders every two or three hours, nature cannot shake off the fever so soon by six or seven days, as she would have done had she been left to herself. She generally does her business at last, however; and then the physician and apothecary glory in the happy effects of their skill, and receive the grateful thanks of their patient for having cured him of a dangerous fever.

Every body of common penetration, at all conversant in medical matters, must have seen enough to convince them that the above description is not exaggerated; but it is not to be inferred from this, that the art of medicine is of no use to mankind. There are many diseases in which nature sinks, without medical assistance. It is the part of the penetrating and experienced physician to distinguish

these from others, and leave it to the knavish and weak to assume the merit of cures in cases where they know, or ought to know, that medicine can do nothing.

Some physicians, who have abandoned the other resins and gums, as useless or hurtful in hectic complaints, still adhere to myrrh as a beneficial medicine; but from what I can learn, the cases in which this gum has been thought serviceable, are hectic complaints, from debility, in consequence of excessive evacuations of various kinds, and not proceeding from ulcerated lungs. After it is fully established that myrrh is of use in such instances, it will still be worthy of investigation, whether it is of more or less than Jesuits bark. I have repeatedly mentioned bloodletting, and a spare, diluting regimen, as the most powerful means of preventing and curing all affections of the lungs that depend on inflammation. In the case of external wounds, or bruises of the lungs, this method facilitates the immediate cure by the first intention. It is the chief thing to be depended on for the cure of pleurisies; and it is often owing to a neglect, or too sparing an use of this evacuation, that the complaint terminates in an abscess. In people predisposed by the form of their bodies, or the nature of their constitutions, to a spitting of blood, it may prevent the turgid vessels from bursting; and in those who have tubercles in the lungs, it is of the greatest utility, by preventing those tumours from inflaming, and becoming ulcers; but after the ulcers are actually formed, I have great doubts with regard to the propriety of attempting a cure by repeated bleedings, even in small quantities. This method has been often tried; but I fear the success with which it has been attended, gives no encouragement to continue the practice. That symptoms may be such, in every period of this disease, as to require this evacuation, is not to be denied; but there is a great difference in the application of what is considered as an occasional palliative, and that from which we expect a radical cure. In the one case, it will only be used when some particular symptom strongly

urges; in the other, it will be used at stated intervals, whether the symptoms press or not; and may tend to weaken the already debilitated patient, without our having the consolation of knowing, with certainty, that it has had any other effect.

Blisters do not weaken so much; they are of undoubted use in pleurisies; perhaps, by exciting external inflammation, they may contribute to draw off the inflammatory disposition within the breast; perhaps-But in whatever way they act, I imagine I have frequently seen blisters and setons, particularly the latter, of considerable service, even after the symptoms indicated the existence of an ulcer in the lungs.

As for the numerous forms of electuaries, lohochs, and linctuses, composed of oils, gums, and syrups, and by the courtesy of dispensatory writers called pectoral; I am convinced they are of no manner of service in this complaint, and seldom have any other effect than that of loading the stomach, and impairing the digestion of salutary food. So far from being of any permanent service to the disease, they cannot be depended on for giving even a temporary relief to the cough; when that symptom becomes troublesome, gentle opiates will be found the best palliatives. Some practitioners object to these medicines, on a supposition that they check expectoration; but they only seem to have this effect, by lulling the irritation to cough; the same quantity will be expectorated in the morning, after the influence of the opiate is over. It is surely better that the matter should accumulate, and the patient spit it up at once, than allow him to be kept from rest, and teased with coughing and spitting through the whole night. These palliatives, however, are to be managed with great caution; never exhibited while the patient enjoys a tolerable share of natural rest. Small doses should be given at first, and not increased without absolute necessity. Exhibited in this manner, they cannot do harm; and those who reject the assistance of a class of medicines, which afford ease and

tranquillity in the most deplorable state of this disease, ought to give better proofs than have hitherto appeared, that they are able to procure their patients more valuable and lasting comforts than those they deprive them of.

The known efficacy of the Peruvian bark, in many distempers, especially in intermittent fevers; the remission of the symptoms, which happens regularly every day at a particular stage of the pulmonary consumption, and in some degree gives it the appearance of an intermittent, joined to the failure of all other remedies, prompted physicians to make trial of that noble medicine in this disease. In consequence of these trials, the bark is now pretty generally acknowledged to be serviceable in hectical complaints, proceeding from debility, and other causes, exclusive of ulcerated lungs; but when the disease proceeds from this cause, the bark is supposed, by some very respectable physicians, always to do harm. I am most clearly of the first opinion, and perhaps it would not become me to dispute the second. It may be permitted, however, to observe, that the most discerning practitioners may be led into a notion, that a very safe medicine does harm, when it is exhibited at the worst stage of a disease, in which hardly any medicine whatever has been found to do good. In every stage of this disease, elixir of vitriol may be used. It is a pleasant and safe medicine, but particularly efficacious when the patient is troubled with wasting sweats.

Having, in obedience to your request, delivered my sentiments freely, you will perceive, that, besides the objections already mentioned to the person under whose care our friend is at present, I cannot approve of his being directed to take so many drugs, or of his being detained in town, at a season when he may enjoy, in the country, what is preferable to all medicine; I mean air, exercise, and, let me even add, diet.

Had I known of our friend's complaints earlier, I should have advised him to have met the advancing