dicine affords numerous instances equally striking, and both perhaps pro duced by nearly the same cause. The miracles of the Romish church, and the instances of cure produced by empirics, bear a strong resemblance to each other; and the practitioners of medicine in this branch have not much fallen short of their religious associates in the extraordinary instances of success which they exhibit." Pag. 99.

After stating the usual effects of mercury on the system, the learned author proceeds with his inquiry into the operation of calomel in some of the disorders in which it is prescribed. He thinks it is prejudicial in scrofula, and in glandular swellings, being more likely from its "stimulant and inflammatory qualities" to lay the foundation of obstruction than to remove it.

"A state of indisposition, marked by a pale leaden-coloured countenance, defect of appetite, paucity of urine, and sense of weight rather than of pain in the abdomen, accompanied with low spirits; a pulse sometimes rather slower than ordinary, but generally irregular in this respect; and often a dry but harsh or corrugated skin, and a degree of animal heat, rather below than above the natural standard; frequently occurs among those who resort to the Bath waters for relief.

"This disease is generally ascribed, how truly I cannot say, to mesenteric obstruction; and the hardness of the abdomen, which sometimes accompanies the other symptoms, seems to countenance this opinion. But this hardness is often very variable, particularly in women, and though at times evident, is at others scarcely perceivable. Such cases are sometin es relieved by the use of the Bath waters, especially in female subjects, but I fear the failures are pretty numerous. These instances however, afford an ample field for the trial of mercurial preparations, especially calomel, which in these, as in most other obscure chronic complaints, where no specific indication is suggested, is usually plentifully administered; in a good measure, it must be owned, on an empirical footing. The symptoms above described, afford but too much reason to suspect scirrhus of some of the viscera, and the ill effects of mercurials in all cases that partake of a cancerous nature are but too well known. If scirrhi of this kind are but of small extent, and indolent, they may often by a cool regimen, a milk diet, some assistance afforded to the general health, and a quiet manner of life, by avoiding extremes of temperature and other causes of irritation, be kept from spreading, and contributing much either to embitter or to shorten life. But the administration of mercurials, of all which, calomel may in the present age be regarded as the representative, is too apt to rouse the slumbering malady into an active inflammatory state, from the consequences of which few escape, and those few, only by such efforts of nature as we have no right to expect, and know not how to promote or to imitate."

In cases of decided hepatitis, Dr. Falconer affirms, the bad effects of calomel are still more evident; in confirmation of which, he relates the case of a gentleman affected with that complaint, in which calomel seemed to aggravate the severity, and to accelerate the fatal termination. He sees no

reason

reason to prefer mercurial purgatives in simple obstruction of the gall ducts, which often occur without any diesase whatsoever of the liver itself. "Calomel has no specific power in dislodging a biliary calculus." He deprecates the use of calomel in complaints which are often very improperly termed bilious.

Complaints (he observes) of an obscure nature are denominated bilious, on a strange and even contradictory supposition that they proceed from either a deficiency or redundancy of bile, or from its depraved or corrupted state; though no marks of any of these faults appear, either in the colour of the skin, or the colour, quantity, or rather qualities of the evacuations. It would have been fortunate for mankind, if the practitioners of medicine had done in the present age as Dr. Swift satirically describes them to have done in his time, and, for the cure of these imaginary diseases, to have invented imaginary remedies. But, unfortunately, giants have been brought on the stage to combat pigmies, or rather shadows. Every dabbler in medicine prescribes calomel as freely, and on the most trifling occasions, as he would the most insignificant article in his shop; and this active, and in many instances dangerous, article is smployed oftener, I believe, to the destruction than to the preservation of mankind."

We might quote two pages more on the deleterious effects of this powerful mineral, but we believe they would be familiar to most of our readers. Dr. Falconer has unburdened his conscience in relating them, and we have pleasure in assuring him, that we read of many more shocking cases, than we have ever experienced in a very free and extensive use of the remedy, or have observed in the practice of two of the largest hospitals in Britain: Dr. Falconer has himself witnessed some of the evils which he describes, and we cannot doubt his testimony; but it seems to us almost inconceivable, that any intelligent practitioner in the present day can push a remedy beyond due bounds, or persevere in its use, when the direful consequences are manifest. We commend his concluding caution, though we think the practitioner who stands in need of it must be very young.

"I cannot quit this subject without remonstrating in the strongest manner against the too frequent practice of administering on common occasions calomel to young children. It has been found, when largely given, to weaken, and even to disorder, the mental as well as corporeal faculties of grown persons, and the use of it at an early age, when the faculties of either body or mind have not acquired strength and firmness, may both impair the bodily health and debilitate the mental energy of persons, who might, but for such imprudent interference, have distinguished themselves when further advanced in life."

[To be continued.]

Observations

Observations on the Climate, Manners, and Amusements of Malta; principally intended for the Information of Invalids repairing to that Island for the Recovery of Health. By William Domeier, M.D. of the Royal College of Physicians of London, &c. 8vo. pp. 116. Callow. 1810.

THE author has divided this little work into four, or rather into five chapters, for there are two chapters IV. The first treats" of the climate and voyage. Malta lies in 35°.

of north latitude; the climate is mild and dry, and the atmosphere clear. The thermometer throughout the year is very regular and not subject to sudden changes. In summer it ranges from 70° to 88°; and in winter from 57 to 60°. Dr. Domcier thinks that "this equality must be a great advantage for the recovery and the prevention of those numerous diseases, which are brought on, and maintained by suppression of the cutaneous perspiration, viz. chronic dysentery, diarrhoe, rheumatism, gout, coughs, catarrhs, ophthalmia, cholic, dropsy, cutaneous eruptions, &c." During three or four months in the summer, it does not rain at alf, and rarely even in the winter." "Showers of hail fall once or twice in the winter, but snow never." The dews and fogs are inconsiderable. In September the sirocco (south-east wind) prevails, and renders the air dense and damp. "Persons with flat narrow chests, or those who have diseases in their lungs, such as schirri, vomica, ulcers, water in the breast, &c. feel uneasy on the days when the wind blows." The island is free from endemic diseases, and the only epidemic which Dr. Domeier observed during three years residence, was the small-pox, which, however, was much checked by a general inoculation of the cow-pox.

We are informed that a packet leaves Falmouth every three weeks, and arrives at Malta in about a month. The best time for sailing is the middle of August. Consumptive, dropsical, and rheumatic patients, often experience much benefit from the voyage.-The next chapter contains an ac count" Of Medical Assistance and Diet," from which we learn, that the latter is much superior to the former. Provisions of all kinds are excellent, cheap and plentiful, whereas the physicians, except three, are stated to be without knowledge and judgment," and of the three the best is merely said to understand a little of both the English and French languages, to be "acquainted with literature, and a friend of natural history." The second in rank, "cares little for practice, and speaks no English, and only very broken French." The third is a venerable, good man, and one of

the

1

the physicians to the hospital. Pharmacy is in a low state, and surgery still worse. The author wished once to have a cancerous breast of a female patient taken out, but could find no Maltese surgeon who was able to undertake the operation." "I have been present (says Dr. D. speaking of the hospital at Valetta) at the surgical visit after two o'clock in the afternoon in summer, when the surgeon was obliged to dress the patients by candle light. He saw the only window of the end of the ward open, and ordered it to be immediately shut, adding, that he was not a friend to fresh air for surgical patients."

From the two preceding Chapters we learn, that amusement and social pleasures are enjoyed in as great perfection in Malta as at any of our fashionable watering-places in this country, but great temperance and moderation are preserved by all ranks of people in the island. The botanical garden instituted by the late governor Sir A. Ball, affords the inhabitants of all ages, sexes, and classes," a convenient and pleasant promenade, where "devout monks walk near dashing officers; young, blooming girls wishing to attract notice near decrepid men, who feel no attachment for their neighbour, or for this life altogether; nurses paying more attention to the society than to the infants trusted to their arms; English ladies, tastefully dressed, next Maltese ones, covered with the saldarra*; and to fashionables it is Bondstreet. Of course, among this motley groupe we hear of no students.

In the last Chapter we are informed that there are some tolerably good schools in Malta, and a university at Valetta. Of this we are sorry to remark, the medical faculty is extremely defective; perhaps on this account, the inhabitants are prohibited from resorting to the universities of Italy for obtaining instruction, which they cannot receive at liome. Amongst the defects in the medical department may be enu merated the appointment of only one lecturer, who is expected to teach all the branches of the healing art in two hours each day. Natural history and experimental philo sophy are not taught there; no anatomical theatre, and no clinical lectures are delivered.

The Maltese hospital is attended by four physicians, and four surgeons. These "change every month in performing their duty, so that a patient, who comes in the last day of the month, falls the first of the next immediately under the hands of another practitioner." And "in most cases the whole plan of cure is altered." The medical officers" en

:(No. 143.)

* A black silken cloak,
K

deavour

deavour to acquire practice by contradicting and blaming one another, and acting otherwise then their colleagues, though not better"-" Besides these mentioned four physicians and surgeons, there is an equal number of under-physicians and under-surgeons employed; also four governors, sub-governors, apothecaries, four chaplains, dressers, persons who only bleed and cup, even one person, who car ries smelling bottles at the medical visit, for fear that any body might faint away, (and really the atmosphere is, in some words, in such a state, that the fear is not ill founded) a person who keeps the linen under his eare, even disciples, &c. &c. every one of them is paid, though many are of no use." P. 112. We have now stated the most interesting particulars of this publication; if from the extracts which we have given, our readers should conclude that the author does not consider perspicuity and accuracy essential in composition, we may perhaps avert their censure, by stating that he is a Foreigner.

A familiar Treatise on Asthma, Difficulty of Breathing, Wheezing, and Winter Cough, containing explicit Directions for the Use of the Stramonium Herb. By JAMES T. FISHER, Surgeon. 8vo. Lond. 1810.

#

Ir is certain that facts have arisen fully proving the efficacy of the Datura Stramonium in quieting the paroxysm of asthma. In some cases, however, of this disease, it has been inert; in others, it has been injurious. It remains to be pointed out in which it is serviceable, in which inert, and in which injurious. We mean at some future period to collect the evidence for and against this narcotic; and in expectation of gaining infor mation on the subject, we looked into Mr. Fisher's Pam phlet. Though we do not perceive that, in any degree, it elucidates the properties and effects of this species of Datura, we fully understand its object in directing where to find a nostrum, a very odd thing, a Tobacco made of Stramonium. The only way in which it differs from other empirical ephemera, is in its abuse of two gentlemen of most respectable characters, and whose talents are an honor to the profession of medicine.

On