Reply to Mr. Maxwell's Anfwer to Mr. Kirkland's Effay on Fevers; wherein the Utility of the Practice of fuppreffing them is further exemplified, vindicated, and enforced. By Thomas Kirkland, Surgeon. 8vo. 2s. 2 s. Becket. Becket. 1769.

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UR Author reduces the argument between Mr. Maxwell and himself under the following heads:-1. Whether a fever is an oeconomical procefs of nature for relief; 2. Concerning concoction in fevers; 3. Concerning the extinction of fevers; 4. Reftrictions in the use of cold water, &c.—Mr. Kirkland makes fome fenfible and pertinent obfervations on each of thefe fubjects; he then illuftrates his doctrine of fevers, and the propriety and usefulness of his practice, by an appeal to the experience of the moderns, and a further appeal to his own experience; and concludes with the following aphorifms; which are intended to fhew, at one view, the practice recommended in the cure of fevers.

1. The nearer the human body is to its natural degree of heat, the more readily will any matter be expelled from the blood.Wherever, therefore, morbific matter is to be discharged from the habit, the heat of the body fhould be reduced, or raifed, according as it exceeds, or falls fhort of, the ftate prescribed by nature.

2. Preternatural heat should be extinguished by its proper antidote, cold, and vice versa.

3. In order to extinguish a fever with propriety, we should first enquire into the ftate of the patient, previous to his prefent illness; that we may judge with greater certainty, whether the vifcera are found.

4. In the beginning of every fever, fuch evacuations, and fuch deobftruents, muft firft be used, as the ftrength of the patient will admit of, and the nature of the disease requires; with the free use of cool air.

5. If, notwithstanding proper evacuations, and the ufe of cool air, the fever should increase without fhewing any favourable fymptom; a greater degree of cold, in proportion to the degree of heat, and the strength of the pulfe, must be used to fupprefs it.

6. In general, the earlier a fever is fuppreffed, the less will be the degree of cold required for this purpose.

7. In fupprefling fevers, cold air and cold water, under different circumftances, will have preference to each other; but they may more frequently be joined with advantages that cannot arise from either alone;-the vivifying spirit of the air, and the diluting quality of the water, producing each, falutary, tho' different effects.

8. In ardent, or putrid fevers, where the fluids are thin enough to pass the circulation, both cold water and cold air may be used as extinguishers.

9. Fevers accompanied with a fizinefs in the juices, or arising from an inflammatory obftruction in any part of the vifcera, may fafely be fubdued by cold air, and moderate draughts of water, which is not very cold.

10. Cold

10. Cold water, in moderate draughts, may be given to fubdue an inflammatory fever, arifing from a dry and cold conftitution of the air; but this kind of air ought to be frequently renewed and corrected by fire, before it enters the patient's lungs.

11. In flow fevers, or when the patient's ftrength has been reduced previous to his fever, or where the pulfe is weaker and flower than in a ftate of health, cold air ought to have preference to cold water; and when cold water is given, it should be mixt with wine, or other cordials, that the preternatural heat may be abated, and the strength of the patient preferved at the fame time.

12 Cold air alone should be used to suppress a fever accompanied with a diarrhea; as cold water might, perhaps, haitily ftop this dif charge, which is often falutary.

12. If an eryfipelas is the crifis of a fever, the neceflity of extinction is at an end.- he fame may be faid of other external inflammations, which are produced in the fame manner: chirurgical treatment being all the affillance that is neceffary -But where an eryfipelas precedes a fever, it is an original complaint, and after defending the affected part properly from cold air, the patient may be advantageously cooled by breathing cold air, and drinking cold water, if the violence of the fever requires.

14. By experience, in the small-pox and measles, it evidently appears, that cold air, under proper regulations, is not attended with that danger, in fevers accompanied with eruption, as has generally been thought.

15. Fevers, which come upon a perfon who has an oedema, are, for the most part, of the flow or putrid kind; and will be properly extinguished with cold air.

16. If a fever feizes a perfon, who has any chronical complaint in the vifcera, there is the greatest neceffity for its being extinguished; as exceffive heat, and increased motion, must be injurious to the parts affected. And though cold water, in very large quantities, may not always be proper; yet the extinction with cold air always takes place.

17. A fchirrous is not any objection to the use of cold water; for as certainly as heat increafes its growth, fo cold water preferves it longer in a state of indolence.

18. Whenever a fever is fuppreffed by cold air, the patient muft be got out of bed, every day; or, if he cannot rife, he must be covered very lightly with bed-cloaths, a fheet alone being often all the covering that is neceffary.-The doors and windows alfo of his room must be fet open, due regard being paid to the season of the year,' and the circumftances of the cafe.

19. After the fever is fuppreffed; if the temples, or other parts of the body become. moift, it foretells an approaching fweat; which fhould be encouraged by diluting liquors, rather warm than cold, with fuch other fudorifics as the cafe requires.-But if there should be no fymptom of this evacuation, the morbific matter may be car. ried off by the kidnies: for which purpofe, diuretics may take place; and purges may be given, if the patient is able to bear them, to carry off part of the offending matter by itool.

20. If the heat of the body is reduced below the natural degree, more bed-cloaths may be laid upon the patient, and warmer liquids may be drank, to raise a sweat.

21. When a fweat is raifed, and the body continues unnaturally hot, it must be cooled, or the fweat will be of no fervice.

22. When we fupprefs a fever, we only fubdue a most dangerous fymptom; the caufe, therefore, of the fever muft be removed by proper remedies.'

We have already obferved, that preternatural heat comprehends the whole of Mr. Kirkland's idea of fever; and that this is to be extinguished by a proportioned degree of cold. The fever being thus fubdued, or the heat of the body reduced to its natural standard by the intervention of actual cold, fhould there remain a quick pulfe, anxiety, reftlefsnefs, or other fymptoms which have in general been confidered as conflituent parts of fever, (but which according to Mr. Kirkland are no part of it,) that thefe, together with the caufe of the fever, are to be removed by proper remedies.

Prefixed to this piece, is the following advertisement:

This Reply was nearly printed off before Mr. Maxwell's death, and would now have been fuppreffed, had not the fubject, instead of the adverfary, been principally confidered. Mr. Kirkland, therefore, begs the reader would overlook any ftrictures which do not reflect credit on the memory of his antagonist, for whom he fenfibly feels that concern, which naturally arifes, where an untimely disease prevents the regular courfe of nature.'

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A Difcourfe on Public Oeconomy and Commerce. By the Marquis Cæfar Beccaria Bonefaria, Author of the Treatife on Crimes and Punishments *. Tranflated from the Italian. Small 8vo. 1s. 6d. Dodley, 1769.

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HE occafion of pronouncing this difcourfe, is explained by the Tranflator in the following words: The importance of the study of public oeconomy will not admit of a doubt. It is fully demonftrated in the following difcourfe, which was pronounced by the celebrated author of the " Treatife on Crimes and Punishments" at the opening of a new profefiorfhip inftituted at Milan, for teaching this science.'

The nature of this inftitution is thus farther explained by the Marquis in his difcourfe:

The whole extent of the views of government, with respect to fo interesting an object, is not yet made known. In the mean time, from a generous preference, orders are given to teach in the language of the country that science, which formerly, from an ufelefs or rather hurtful degree of caution, was with held from See Review, Vol. xxxvi. p. 298, 382.

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public fcrutiny and examination. All sciences, but more efpe cially the political, are enlarged and brought nearer to evidence, by undergoing numerous and repeated bocks from the various difcuffion of different men. General knowledge gives fuch weight to public opinion as to prevent abufes. And feeing on the other hand a thousand prejudices often oppose the wifeft defigns, and corrupt, in the eyes of the fubject, the pureft and moft beneficial decifions of administration; while ridiculous fears, envy, prepoffeffion, and error, fanctified by ufe, ftand ever in the way of the most useful innovations; it is furely of the highest importance, by diffufing light among the multitude, to difpel thefe dangerous phantoms, and render in this manner obedience to fuperior authority readier and more eafy, because spontaneous and founded in reafon.

It is therefore felf-evident, that nothing can be of greater utility than the fupporting this fcience by public authority, and encouraging the ftudy of it by thofe citizens, who are defirous of rendering themselves worthy to be trusted by their fovereign, with the jealous cuftody of his interefts, and those of the nation.

In guiding us through the unforeseen combinations of politicks, we muft not believe that blind experience and mechanical habit can fupply the place of fure principles, and maxims drawn from reafon. Neither will the knowledge of general truths fuffice, without defcending to thofe particular ones, which oscafion fuch numerous and diverfified modifications in the theories of this fcience. It is not alone neceffary, for example, to know that there are four principal means of promoting trade; to wit, concurrence in the price of trade, oeconomy in the price of labour, cheapnefs of carriage, and low intereft of money. It is not fufficient to know, that induftry is enlivened, by eafing the duties on the importation of the firft materials, and on the exportation of them when manufactured; and by loading those which are impofed, on imported manufactures, and exported materials: that every oeconomical operation may be reduced to the means of procuring the greateft poffible quantity of labour and action among the members of a ftate; and that in this alone confifts true and primary riches, much rather than in the abundance of a precious metal, which, being nothing but a fymbol, is always obedient to the call of induftry and toil, and, in spite of every obftruction, flies from idleness and floth. Along with these maxims we must attend to the particular fituation of a country; the different circumftances of population, climate,

This word is unhappily chofen, either by the Marquis or his Tranilator. Various difcuffions of a fcience, if they bring it nearer to evidence, or proof, cannot be faid to fhock or confound it.

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and fertility of foil, whether natural, or the gift of industry the nature of the frontiers; the wants of adjacent countries, and the various kinds of productions, with the arts which they fupport.'

The following fentiments, confidering where they were delivered, have more than ordinary merit:

All truths are linked together by an immenfe chain, and they are always more variable, more uncertain, and more confufed, in proportion as they are more limited and restrained; more fimple, greater, and more certain when expanded into a wider space, or raised to a more eminent point of view.

In proof of this we need only call to mind the æras and countries, where the fciences, being buried in feudal anarchy, and filenced by the din of arms, private jurifprudence became the public lawgiver. To hinder the free internal circulation of commodities:-to load the expeditious bufinefs of commerce with dull and tardy formalities:-to dream of rendering a state opulent by impofing ftoical fumptuary laws, with a view to check the expence of the rich individual, and thus dry up the fources of induftry, blunt every fpur to labour, and deaden in the ambitious the hope of bettering their condition, which is as it were the central heat of every body politic:-to reduce ar tifts almost to monaftical difcipline, condenfing them into corporations, or rather litigious factions, with the power of levying taxes on themselves, and prefcribing themselves laws (the fureft means of making the arts languish fince their nourishment is liberty to leave a free scope to those people who (perhaps from refpectable motives) formed inftitutions of moft dangerous confequence, fince they tended to establish this general canon, which may be termed anti-political, "Let inactivity be nourished at the public expence, and receive the reward of sweat and labour :"-Thefe and fuch like effects have flowed from confining jurifprudence within the bounds of private juftice, while it ought to embrace all the great principles of mora lity and politics."

Inftitutions, which give rife to the propagation of fentiments like thefe, may produce effects beyond the views of the founders, The difcourfe ends with a loofe hiftorical sketch of the progrefs of commerce, from the earliest ages.

• The author here alludes to the inftitution of religious orders, the most pernicious invention of misguided piety. Happily for mankind the different governments of the catholic countries feem to vye with each other at prefent in the fteps they are taking towards their abolition. Indeed, the French and Italians are in a fair way of accomplishing, with peace and quietnefs, the fame reformation in religion (at leaft in what immediately regards the happiness of civil fociety) which soft us, about two centuries ago, fo much devastation and bloodshed.' REV. Sept. 1769.

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