Book Reviews

There is demand for a more widespread understanding of population genetics. Many a ‘health scare of the week’ highlights the lack of public understanding of population processes. Areas ranging from law enforcement through agricultural and medical practice to biological conservation now require some expertise in population genetics. Does this book promise to satisfy the demand? Star qualities are immediately apparent: enthusiasm for the subject, a clear overview, and a universal style. Such qualities did not arise overnight. The two previous editions were considered to be the leading modern text for advanced undergraduates and beginning postgraduates. However, I feel that the presentation is too ambitious for most undergraduates, especially for those with no background. For such, Professor Hartl’s Primer in Population Genetics (2nd edn) from the same publisher will provide a more accessible introduction. To make life simpler, education tends towards telling a linear story. Population genetics on the other hand resembles a multidimensional jigsaw puzzle: its language is a colourful amalgam of physical mechanisms, mathematical models, and statistical descriptions. This text deals with the conflict by dividing the subject into its major processes and applications. Nonetheless, the authors try to emphasize connectedness: for example, between inbreeding and genetic drift. Another recurring theme is the current deficit in our understanding of the relationship between genetic and phenotypic variation. The third edition introduces many changes in structure and content. The effect is to give a better flow from background concepts through processes to applications. The genetic system at the centre of attention is the classical gene in an outbreeding diploid. Nonetheless, glimpses are provided of other systems, such as selfing plants, transposable elements and bacterial chromosomes. The first two chapters provide the genetic and statistical background. The resolution of the conflict between the biometrical and Mendelian views of inheritance by Sir Ronald Fisher is inserted to give the subject a historical perspective. Chapters three to seven form the core of the book, and describe the main influences on genetic variation, including the relationship between gene and genotype, population subdivision, inbreeding, mutation, recombination and migration. Chapter six provides a panorama of Darwinian selection, from single gene models, through the mutation-selection balance and interactions with genetic drift, to all the complexities of agestructured populations and epistasis. The long-standing debate about the relative roles of selection and drift in adaptive evolution is referred to without the reader becoming enmeshed, and Kimura’s neutral theory is accorded the role of universal null hypothesis in this context. The reader is given a taste of the diffusion theory which identified the equilibrium states of the classical literature, and which led to the latest coalescence models. Chapters eight and nine deal with two major applications of population genetic theory: molecular evolution and quantitative genetics. The use of insights from the neutral theory to interpret protein and DNA sequence data is described, as are the methods for gene tree construction. Important applications of gene trees are described: for hypothesis tests of the direction of organismal trait evolution, for estimation of long-term migration rates, and for demonstrating selection at the gene level over evolutionary time scales. Quantitative genetics is given the standard presentation: the definition of heritability, and the estimation of components of genetic variance. The use of dense linkage maps for locating quantitative trait loci is presented as one way to elucidate the relationship between genetic and phenotypic variation. The book ends on this characteristically optimistic note. This book is essential reading for anyone requiring a firm foundation in modern population genetics. JOHN DALLAS NERC Molecular Genetics in Ecology Initiative Department of Zoology University of Aberdeen Tillydrone Avenue Aberdeen AB24 2TZ U.K.

without any official instruction respecting the most eligible mode of applying the fruits of his labours to the public benefit, felt himself under the necessity of putting his manuscript into the liands of a printer -; for, with the conviction that two thirds, even with the conviction that one third of the means prepared for the use of the medical department of the British army, might actually be saved to the state, he would have deemed himself culpable to the nation had he withheld his communication." The work itself is divided into five chapters. The first on the Constitution of a Medical Staff. The second on Military Hospital?* The third on Medical Management in Hospitals. The fourth on Economical Administration. The last contains a general Recapitulation of the Whole. At the end of each chapter are subjoined copious notes, illustrating the various reasonings and arguments, by facts universally admitted, well authenticated, or which passed under the author's own eye.
To render the first inquiry more, perspicuous, and in some measure to introduce the main scope of the work, the first chapter contains a statement of the constitution, qualities, number, rank, and pay of a medical staff for a given military force. After a few words on the importance of the subject, Dr. Jackson, with his usual acuteness and accuracy, offers a short historical detail of the mode in which the health; of soldiers was'attended to in ancient and modern times.
Of this we have only a slight sketch in the text, the more minute detail being referred to notes at the end of the chapter. Though this method is well calculated to preserve the uniformity of the work, we shall be obliged, in order to render our extracts intelligible, to incorporate some of the notes with the text.
The following is the detail of the British medical arrangement in war. " The British nation, which is often engaged in war, and which has often fought with a brilliant success in the field, does not claim claim an equal share of praise fer the correctness of its military arrangements. The medical system adopted for the purposes of the army has fluctuated extremely ; and it still fluctuates. In the earlier part of the last century, the medical provisions, constituted for the use of British troops acting in foreign countries, like the medical provisions of other warlike powers of the time, appear to have been very inadequate to the needs: the estimate of the soldier's value had not then been duly made. Whether the Duke of Marlborough was not sufficiently interested about the fate of his sick and wounded from conviction of the importance of the concern; or, whether he was not enabled, in defect of means, to afford the necessary assistance to those who suffered in misfortune, it has been often said, and it is believed to be true, that while the actual slaughter of Marlborough's battles was great, many, who might have been saved, perished in the field, in want of timely assistance from the surgeon. The voice of humanity was heard, or the interests of the state were better understood in the succeeding period. Earl Stair commanded on the Continent under Ilis Majesty George II. and, during his command, such arrangements were effected with respect to the care of sick and wounded, as give more real value to his character than the fame of many victories.
The value of health and the importance of the life of the soldier still rose in estimation. In the following continental wars, the hospital department was extended, with a view of better preserving the lives of men. The intention was good; the effect did not correspond with the intention. The hospital staff consisted of men of ability, and there is reason to believe that they did their best; yet the general hospital was esteemed to be the destroyer of the army; it was even noted by military officers of unprejudiced observation, who served under the Duke of Cumberland and Prince Ferdinand, that, where troops, trusting wholly to their regimental resources, were so circumstanced as not to have connexion with general hospitals, the loss by death was proportionally less than in the opposite ease. Such was said to be the fact on the continent, under the rule of distinguished commanders and celebrated physicians ; the practice was tried, and the effects were proved not to be different in America, in the American war. The British army was {here well appointed in all respects; the hospital staff was numerous, and, upon the whole, well selected; the general hospitals were rarely crowded jvith sick beyond a just number, so that there was rarefy any mortality from the operation of adventitious causes of contagion; y/t, even where circumstances were so lavonrable, it may be said, without risk of incurring error, that, as the cure was more tedious, so the mortality was greater in proportion to numbers, in general hospitals than in the hospitals of regiments, though the latter were not always well equipped with necessaries, and sometimes could not boast ot able medical officeit; ?this was verified wherever there existed means of making compa-Dr. Jackson, on the Medical Department of Armies. " The British general hospitals, which were dormant after the peace of the year 1763, expanded considerably in the progress of the American war; they swelled rapidly, and burst forth into an enormous production at an,early period of the late war. It may be thought necessary to notice in this place, for the sake of connexion and illustration of effect, that a Board was appointed in the latter end of the year 17<)3 for the management of the medical concerns of the British army.
It is observed in ordinary life, that new men often solicit notice in their sphpre by the adoption of new measures.
The Board newly constituted, acting with the impulses of other men, attempted to distinguish itself by organizing a medical code on new foundations; this, it is natural to suppose, was to catch the impression of its masterg. These, as practitioners in civil life, acquainted with nothing in the circle of medicine beyond the limits of the city of London, conceiving a general hospital to constitute the palladium of an army's health, formed the design of extending the sphere of military hospitals, more strictly speaking, of constituting general hospitals as the main instrument of medical effect for the purposes of the military force. The general hospital was thus considered as the great theatre, designed for the reception of military sick and wounded. The members of the medical board, as not being bred in the army, had no knowledge of regimental surgeons; regimental surgeons were consequently undervalued and overlooked, physicians and surgeons of the regular schools being held, in the opinion of the new chiefs, to-be the only persons competent to act in military hospitals. The admission of the principle called for the adoption of a new measure, viz. the creation of new officers of the privileged classes. The regimental surgeon, not known to the members of the medical board, and scarcely permitted to make himself known by his knowledge and exertions, perhaps not enrolled at Surgeons' Hall, or not a pupil of a London hospital, not a member or licentiate of the College of Physicians, and not eligible to become so, as not admissible to examination while holding his Majesty's commission of surgeon, &c. was now barred the expectation of attaining the higher hospital rank; a privilege which had formerly been open to him, and a distinction which wa6 held out to him as a reward of his services and his merits. The regimental surgeon, so circumstanced, could scarcely fail of feeling himself degraded; most people will be disposed to admit that he was injured ; he may thus be supposed to have lost a portion of his zeal. If barred the expectation of promotion and the hope of advantages bv the rule now enacted by the board, he was even in a manner stripped of confidence in his professional ability; for, as general hospitals were destined to be the great theatre of military sick, the slighter maladies, itch, sore legs, &c. were only supposed to be suffered to remain in t)ie regimental infirmary. It might be deemed invidious to go deeply into the causes of this arrangement; it is important to notice its effects pn the health of the British army." In Dr. Jacksotij on the Medical Department of Armies. 551 In the rest of the note our author enters at large into the ^disadvantages of general, in comparison with regimental, hospitals.
He reminds us, that in acute diseases, on the first measures and the early application of them, depends the future issue of the case. That, in more chronic cases, the sick soldier, removed from his early acquaintance or commilitones, pines under the uninteresting scene before him, or takes every opportunity of indulging that ?sensuality which is now the only source of amusement for him. If by degrees he becomes habituated to his new quarters and mode of life, from that moment he is lost to the service ; his moral character is depraved, his exertions are stifled, and his only anxiety is to perpetuate that indolence which is the natural consequence of the apathy induced by his situation. But this is not all; the means themselves are destructive of the end. " The sick and lame, (says Dr. J.) flocked to these depots by hundreds; they returned not till after a long absence ; and when they did return, it can scarce be said that they returned by fifties." The sickness in the British Army is known to have been great in the end of the year 17.94, and the beginning of 179-V; the mortality was excessive in proportion to the number of sick. The establishment of general hospitals, the means adopted by mistaken kindness for the relief of the army, may be considered as the main source of this dreadful mortality. Bold as this assertion may seem, out1 author proves it to our satisfaction in a variety of ways. He shows that the cavalry, who could with more facility remove their sick, so as to connect them with their respective regiments, were much more healthy. When the retreat became more rapid, it was found necessary to hire, ?r press waggons from the peasantry, in order to transport the sick and wounded infantry along with their respective regiments. During this period, and uriddr these apparent difficulties, the number of recoveries was much greater, and the relapses comparatively few. Our readers will not want to be t?ld, that so important a fact is not suffered to rest only on the: evidence we have produced. The subject is continued through several pages, and in a manner which, we trust, will induce'those, whose business it is, to enquire minutely into v this important-question. Thus much we have thought it necessary to premise, before we offer to' our readers what may be called the inference which is contained in the text. " The mode of applying medical means regimentally is assumed in this place to be the best: it has the obvious approbation of common sense, and the testimony of every military officer's experience that it is so. If the principle assumed be admitted to be the best, the next point of consideration relates to the rule of forming an estimate of the kind and quantity of aid necessary for the medical and surgical care of'an army of a given force, 'i his may be supposed to vary in a small degree, according to the ?manner in which the troops are arranged by'regiments oi* corps, ?>r according as they arc destined for service in native <)r foreign climates. It is considered as preliminary in all cases, that each separate or independent corps, whatever be the force of which it consists, be provided with two medical officers, in order that it may be enabled to act with its own means in the event of indisposition happening to one or other of its medical members* One surgeon and one assistant surgeon will be allowed, by every reasonable person of experience, to be adequate to the ordinary medical care of a battalion of one thousand rank and file, stationed in Europe during the times of peace, whether constantly in garrison, or occasionally in camp. The number stated is supposed to be the common complement of rrjcdical officers for a battalion of the force specified, stationed as alledged ; but, as great benefit will evidently accrue to the military discipline of armies, if battalions, consisting of one thousand rank and file, be formed into regiments of three battalions, or, which amounts nearly to the same thing, if three regiments, each consisting of one thousand rank and file, be formed in brigade, placed under the command of a general of eminent character constantly ?present at his post; so, on similar grounds of reasoning, if a chief medical officer be allotted to a regiment or brigade so conr Stituted, a similar benefit might be expected to be obtained for itiedical discipline, with a more equal diffusion of the blessings of the medical art than now obtains in the army. The appointment of such officer, who is necessarily supposed to be an officer ?of experience and professional skill, capable of connecting and binding all the parts of duty together, would be sufficient to render the proposed medical establishment of the army adequate to its needs in all common circumstances of service.
It is presumed to be adequate in number ; for, estimating the proportion of sick at one in ten, which is a high proportion among 4 Well-organized troops in .Europeau climates, there are provided seven medical officers for a regiment or brigade of three thousand rank and file.
The care of three hundred sick soldiers divided among seven persons, at the allotment of forty-three patients to each person, cannot be supposed to be an oppressive duty to active and capable men ; and, of such only, the army surgeons must be supposed to consist. Such a portion of duty, it is presumed, would not be thought to be hard by any one : it may even be added, that did the number of the sick, on certain occasions, actually amount to one in five, the requisite attendance, in its fullest extent, upon feighty-six sick soldiers in a well-regulated military hospital, where the diseases, have probably a great similarity of feature, and where \ several of them are probably only of the slightest kind, or such as do not require a daily new prescription, cannot with propriety be reckoned a task of hard labour to an active man, particularly as it is a task which is not likely to be of long continuance. If the arrangements be methodical and correct, the duty will he light, as the numbers now stand: if the arrangement be faulty and and deficient, no increase of number will give just effect to execution. " Tin* estimate, which is given in this place, may be considered as the estimate of a just medical establishment for a regiment of three thousand rank and file.
If the number stated, viz. 6even medical officers, be sufficient for the medieal purposes of a regiment of three thousand men, two hundred and thirtyone, the calculation being made upon the same principle, will be equal to the purposes of thirty-three regiments or brigades, consisting of one hundred thousand, or rather of ninety-nine thousand soldiers.
If the sick be calculated upon a scale as amounting to one in ten, an army of one hundred thousand men produces tqn thousand sick. The allowed medical staff, consisting of two hundred and thirty-one surgeons and assistant surgeons, is confidently maintained to be equal to the medical care of the number of troops stated, where hospitals are well arranged, stations permanent, and quarters fixed in a peaceable country. There are for instance only forty-three patients for each surgeon, which is an allotment of duty, sufficient to occupy the time and view to emolument, such will be her only object; and instead of < superintending the economy of the house, she will suffer others to purloin, that she may not be detected herself. All the necessary provisions of the house, even to the captiousncss of sickncss, Dr. Jackson not only admits, but dwells with a most laudable anxiety on the means of inducing the invalid or convalescent to derive every benefit that arises from delicacy and variety of viands. A method is proposed of simplifying accounts, which is illustrated by a table, enabling the most ordinary capacity to fulfil with facility all the complicated offices of clerk and purveyor. All the checks and controuls hitherto imposed on hospital accounts ar# shown to be futile ; and it will be scarcely believed, that the plan proposed is no less than that the soldier should, be provided out of the stopping from his own pay with all tbese articles, yet receive, on returning health, a considerable surplus. It will be of course presumed, that particular cases may occur, requiring extraordinary aids.
Though we have read this part of the work with peculiar ?satisfaction, we must acknowledge that much of this has arisen; from the contemplation of our author in his office as a good Samaritan.
Dr. Jackson is not, perhaps, aware-of all his own good qualities, and may expect to meet with the same dispositions, and the same capacity of action, in other army physician's and, surgeons as he feels in himself. We would not, for a momeut, suspect any want of tenderness in a medical man, however situated : but to accomplish what our author has done, requires not only benevolence and skill, but strength of body and mind ; a courage which can only arise from, and be supported by, a conscious superiority, and a firmness which must sometimes submit to indignities, the more painful as they arc undeserved.
The last chapter contains a general recapitulation of the whole. The language of this part is particularly pointed, and the subject as much compressed as possible; as a specimen of which, we extract the following concluding paragraphs. tiumbers of sick, compared with the expenditure of means, shews the precise quantity. The arrangement, exhibition, and control of accounts is another of the objects which is considered to be of much importance ; but it does not yet seem to be so digested as to touch the useful point. The control alluded to is a control of figures,?the transcript of distant transactions, not of things verified by direct inspection on the spot. This is plain; the evidences incontrovertible.
The medical inspection of hospitals has also undergone a great alteration of late years, or rather it has arisen as an entire new creation. If the subject be well considered, it will probably be discovered that it is not constructed ?upon a principle to produce an uniform and systematic effect; ? the instruments are numerous, and, as they have not been formed on one model, their views may reasonably be supposed to be various or discordant. So constituted, they cannot be expected to produce uniformity in action ; and it is difficult to say in what degree they arc to be regarded as useful. It is undeniable that the cheapest and most effectual way of executing the medical business of armies, is by the selection of able regimental surgeons, ?men who know their duties in all their extent.
The process then moves on correctly without the inspector : it is a vain expectation to hope, if the surgeon be radically defective, that he will be instructed or enlightened by the unimportant or cursory visit of the inspector's deputy. " If the subject of hospital management be viewed in all its details, it will be readily admitted that it is capable of improvement ; and, if the importance of the subject be duly considered, the improvement proposed will strongly command the attention of statesmen.
If there appear evidence, and it is believed the evidence is demonstrative, and may be verified in a reference to the authentic documents which are lodged in public offices, that two thirds of the means provided for the use of the sick in mostof the expeditions which were undertaken since the year 1793 were Superfluous?as exceeding the just needs;?-viz. the medical officers so numerous, as not to have an opportunity of acting fully and effectively in their stations; the stores of medicine, &c. so excessive in quantity as to decay and perish in the magazines before there occurred an opportunity of applying them to their purposes, there exist strong reasons for a reform ; and the plan now recommended, though not the most perfect that might be devised, will stand excused in its motive,?and perhaps escape with inferior censure for the conduct of its detail.
It will not be deemed impertinent by those who regard the interests of the public with a just eye: the subject is a national concern, and the investigation is open to every honest subject of the nation. If error exists, its operation is injurious; if a remedy be attainable, it is a duty to make it known. The reform of error is not an innovation in the real meaning of things, though it has been styled so in the language of those who are prejudiced ; nor is the man iiiimical Dr. Ilarty, on Simple Dysentery.

557
Inimical to his country and the interests of humanity, who suggests such arrangements, as are calculated by the correspondence of things with each other in their natural and just relations, to move with harmony and produce a correct effect. Such arrangement, while economical of means, produces a just and permanent action in all its stages. It is such as the author has attempted to attain.?The idea of the system, which is now explained and made public, arose at an early periodiof life ; it was traced through many varying scencs of service, pursued in spite of difficulties and opposition, till such evidence was obtained of its truth as may be considered to be demonstrative in all its steps. It is finished, and it may be necessary to add, that as the subject was prosecuted as an object of study, the results are now given to the public as a command of duty. The author has no private view nor prospect of advantage from the fruits of the publication : he gives it freely without expectation of reward; and, acting honestly and independently, though placed in an humble sphere of life, he is neither solicitous of praise nor fearful of blame in.
the course which he pursues." Such is the nature of this most important work, the value of which it is impossible to estimate. In distant expeditions, their whole success often depends on the health of the soldiers. That this may be preserved, at least under many unfavourable circumstances, we have many proofs ; but we do not recollect a writer, who has so faithfully explained the causes of that dreadful mortality, which so often prevails in climates, to which European constitutions are habituated, or that has shown such persevering industry in finding a remedy, the success of whfch? he has proved in his own practice. We hope all the valuable instructions contained in these sheets will be duly appreciated, and that our Author will have the happiness which attends virtuous and intelligent minds, when they see their labours justly considered, and mankind benefited thereby.
Observations on the Simple Dysentery and its Combinations, containing a Review of the most celebrated Authors who have written on this Subject; and also an Investigation into the Source of Contagion in that and some other Diseases. By William IIarty, M. B. 1805.
Ix some preliminary observations, the author informs us, that from all he has observed and read relative to dysentery, it appears to him, as to Dr. Cullen, a single disease. But he differs from the Professor in considering dysentery in its simple form, without pyrexia or contagion, as the true disease; whereas Cullen has made pyrexia a part'of its character. Dr. Marty's object is to show, that whenever fever, whether of typhus, or intermittent or remittent kind, attends dysentery, it is an accidental circumstance; that, consequently, the contagious nature of the disease depends on its its combination, and that no form of dysentery is contagious^ ex* Cepting that which is combined with typhus.
In the progress of the work, the author informs us of his intention io show that this contagious character of dysentery is equally applicable to other diseases under similar circumstances. His object in this he professes to be principally to direct the attention of others. In. this we heartily wish him success. Enquiries more minute, descriptions more accurate, and distinctions more precise, have always been wanted in medicine; and, until they are accomplished, it will be vain to look for solid improvements in so complicated an art.
How far our author has improved the accuracy of medical reasoning in this disease, will appear as we proceed.
The first chapter being superscribed simple dysentery, we should have expected a regular history of the disease, had it not been that M'e are before told, this is no part of the author's intention. The chapter consists of a diligent digest of the opinions of the most celebrated authors; from all which a conclusion is drawn, that fever is not a necessary part of the dysenteric character. All the remarks contained in this chapter are judicious and pointed, but every reader will regret that the author is so costive in forming conclusions, which might connect the various threads of which his reasoning is composed.
It may be urged, that all this is referred to the conclusion of the work. This may be enough for all ihe purposes of the logician; but the common reader expects to meet with well established inferences, ready drawn for him, from all the parts as they occur in order; by help of these, he is relieved from the retention of a vast burthen of facts, feels a conscious satisfaction in so far understanding the object of his author, and looks forward with patience to the accomplishment of the whole. However, from the following cxtracr, which contains a very just reproof against the attempt at reducing to nomenclature a class of phenomena in which so few men agree, our readers will form some judgment of our author's views. " When we have it asserted that dysentery is a " Pyrexia contagiosa," I presume it is meant that the disease is attended by* fe-Tcr, not merely symptomatic, but peculiar to that affection, and that its contagion is also of as distinct and independent a character. Now, that it is not necessarily attended by idiopathic fever, the very nature of that fever, when present, and its total absence on other occasions, plainly shew; and that it is not of itself contagious will hereafter appear; as also, that when, in consequencc of a certain combination it becomes so, that contagion is not peculiar to this disease.?I trust then I may be allowed to conclude; with " * When we hear authors, at one dine, calling this fever inflammatory, and at another time, intermittent, remittent, or putrid, surely we must suspect, that the disease can scarcely be possessed of an idiopathic fever, peculiar to itself, inasmuch as such fevers seldom admit of this variety." with an assertion, wliicli as we advance, will be receiving additional proofs, namely, that the genuine dysentery is unattended by any but symptomatic fever, proportioned to the violence and severity of the disease itself; while, at the same time, as shall hereafter appear, it is capable of combining, under appropriate circumstances, with intermittent, remittent, and typhus fevers. " If then it be admitted, that the symptoms already enumerated ean, independent of " Pyrexia contagiosa," constitute a distinct and well-defined disease; and for admitting this, we have sufficient grounds in the experience of every year, and in the testimonies of creditabl? Writers, shall we refuse it the name of dysentery, to which it appears entitled, merely because it does not chance to agree with a scholastic disposition ? Surely we should not: yet that some' hav? been, and still are governed by it, in judging of the disease, an incident which occurred, while I was a student at an academy of deservedly high repute, will too plainly shew: A patient came into the clinical wards of the Infirmary, with every mark of simple dysentery. I examined her : she had no symptom of fever, and it was not possible to trace the disease to contagion. The clinical between increased secretions in these two diseases, beyond what happens in inflammations of any other secreting surfaces.
In the second chapter, on the combinations of simple dysentery with intermittent and remittent fever, Dr. Harty first enters into a distinction of the manner in which two diseases may exist at the same time, in the same constitution. " There are, (says he) two species of combination of disease ; the one is such a combination of the character and features of each, whereby they seem to incorporate together, to possess one nature, and exercise one dominion ; the other is an accidental union of two or more diseases in the same individual, which are naturally, and continue to be mutually independent of each other; the latter are in general local diseases, as itch, syphilis, herpes, &c. or one, or more of them may be local, while a third is a general affection of the system. But then the local complaints arise from specific contagion, as in the combination of typhus with itch, &c." page 3.9.
All this is a little confused ; but our author's meaning is, that two local complaints may exist in different parts of the body at the same time, and also that a local complaint may exist with a constitutional complaint; but that two constitutional complaints cannot exist at the same time, without so altering the form of each that they shall become one disease. Hence, in seasons or situations where intermittent or remittent diseases prevail, dysentery may likewise be epidemic, and the two diseases be so far combined as that one may appear a symptom only of the other.?? This, it is shewn, is the origin of the febris introversa of Sydenham, and also the remittent taken notice of by Clarke, in which a rapid dysentery is one of the most dangerous symptoms.
Morton also refers more obscurely to the same subject. But our author has no difficulty in showing that Cleghorn, and most of the modern writers on diseases of camps and of warm climates, were sensible of the fact, insomuch that some of them, treated dysentery with bark in the manner of a common intermittent.
It should, however, be remarked, that Dr. Cleghorn considered the intermittents of Minorca as contagious; and in this opinion he seems supported by Dr. Rush. We mention this not with a view of giving any opinion on the subject, but to show how unsatisfactory the distinction between a contagious and merely epidemic disease remains even among the most accurate observers of those diseases, to which, at present, the attention of the whole world is directed. The next chapter is dedicated to the subject of combination of simple dysentery with typhus or malignant contagious fever. This the author very properly introduces, in a manner to arrest tlx* attention of the reader, and to force en his recollection all the various distinctions to which he has previously alluded. This, it is remarked, " is the combination which is never free from symptoms of fever, and to which alone the property of contagion belongs; this is the true " Pyrexia contagiosa:" it is after this -t)r. Hariy, on Simple Dysentery. 561 tius form that Cullen has framed his definition of the disease; it is ?iiis form which has always inspired such horror at the name of dysentery. The strong features of such a combination are very ^bcidedly marked in the histories of the most celebrated epidem-1Cs of this disease; and between this and all other forms, the reader may trace the most essential differences in their access, progress, and termination ; in the danger attending them, and in the mode of treatment, which success warrants in each/' After this follow two sections; the first, containing proofs froifi the symptoms that such is the true cohtagious dysentery; the second, proofs from the general history of the disease. In both these our author shows much industry in research and acutencss in judgment. .

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The fourth chapter contains a general inference ifrom these Premises; and as we conceive most of our medical readers will "8 sufficiently satisfied by their own recollection, how much the different writers on dysentery have differed on the subject of its Contagious property, we shall not be thought abrupt in transcribing our author's conclusion. each other in their description of the disease, and in their opinions respecting it, because while one found the disease in its simple, state, others saw it only in its state of combination. That such must have been the case, ought to have been supposed, from the very circumstance of men, well known for their veracity and talent for observation, appearing to contradict each other in so di-.. rect a manner, and to form the most opposite opinions on the same subject; and that such was the case, the facts already adduced have,. . I trust, been sufficient to satisfy any unprejudiced mind. If such then be the case, how grateful must it be to the mind of every man to think, that he may on this, as on other occasions, give some credit to the assertions of his fellow-men, without incurring much danger of running counter to the truth, or of falling into any material error.
" The extremes of opinion entertained on the subject before lis, are, on the one hand, that the disease is never contagious, and on the other, that it is always so, and that this property is owing to a specific virus. On this, as on all such occasions, we shall find, the truth of the adage, medio tutissimus," for between the extremes of opinion now mentioned, a proposition may be stated \vhich( shall embrace a part of each, which shall be agreeable to fact, and swhich shall meet with a general concurrence. The proposition, " The truth of these propositions I shall endeavour to establish in the following manner : We have already seen who the authors _ are that describe the disease in its different forms : of these and of a few others, not as yet referred to, I shall take a general survey, and after stating the sentiments of each on the subject of contagion, and contrasting them with each other, we shall, I believe, find reason to conclude, that such authors as describe the disease either in ITS SIMPLE FORM, Oil IN COMBINATION WITH INTERMIT-TENT and Remittent fevers, uniformly pronounce it, not contagious; while those who met it in combination with.
Typhus FEVER, as regularly and decisively declare it to be so. The inference unavoidably consequent on such a conclusion, must be, that the truth of the propositions, above stated, rests on the fairest and strongest grounds.
Dr. IIarty, on Simple Dysentery* 563 others. This is my only motive for taking any notice here of the opinion of Dr. Cullcn relative to the Contagion of Dysentery, inasmuch as it has been, and is still my intention (with the exception of this deviation) to confine the present survey to original observers of the disease, to men who described it as they saw it, and not as they found it described; among these Dr. Cullen does not, nor pretends not, to rank, for he spoke of the disease not from his own, but from the experience of others. On this account his authority is 011 a level with those, whose writings on the subject he has consulted, and whose opinions respecting it he has adopted ; and as it was his uniform practice, after giving the definition of any disease, to enumerate those authors he had consulted, so he has himself furnished us with the means of judging of the weight that should be attached to his opinions relative to this disease. What these opinions are has been already, in great measure, pointed out: they are pretty plainly specified in the first sentence of his definition, which states the Dysentery to be a " Pyrexia contagiosa:" he even goes so far as to say, that he thinks it doubtful if the application of cold does ever produce the disease, unless the specific contagion has been previously received into the body, t". vol. III. p. lip. Now the reason why Dr. Cullen has adopted these opinions, will be pretty obvious, after enumerating the names of those authors to whom he has referred on the subject of Dysentery : 1 need but mention Pringle, Degner, Roederer, Zimmerman, Grimm, Helwitch, Bontus, Cleghorn, &c. &c.; most of these, have already been quoted, and all of these excepting Cleghorn, who described the intermitting variety of Dysentery, will be found on an examination of their writings, to have seen the disease in its combination with Typhus, which they all with one voice (making the same exception) pronounce to be contagious. Had these been the onlyauthors, whose opinions or observations^elative to this disease could be relied on, Dr. Cullen would have been perfectly justified in the definition he has given of it, but such is far from being the case ; and had Cieghorn stood single, it ought to have been shewn, why he has said nothing of the contagious property of the intermitting species of the disease. As it stands, we may perceive that Dr. Cullen has given us a definition of the combination with Typhus, in place of the definition of the disease itself." , This chapter contains two other sections, in which the subject is further enforced.
The fifth chapter is on the treatment of Dysentery. From the. practice recommended by different authors, the proofs of these various states of Dysentery are further enforced ; the various remedies are stated seriatim, and their application in the different forms and combinations of the disease judiciously marked. Throughout the whole we conceive our author much more fearlul of the lancet thqn is necessary; that its decisive good effects in some instances have at times too indiscriminately recommended its use we pretend not to doubt, but are not less convinced that the occasional n 2. occurrence 564-Dr. Ilartj/, on Simple Dysentery. occurrence of highly putrid symptoms at a later period' Che disease, have rendered many practitioners, constantly apprehensive of debility as the most formidable symptom to contend with. On this subject we have already given our opinion more at large, when we reviewed l)r. Wilson's last vol nine,* The last chapter is on diseases analogous to Dysentery in the source of their contagion. "These arer 1. Catarrh, 2. Angina Maligna,3. Ophthalmia,4. Erysiepelas,5. Malignant Ulter,or Hospital Gangrene, 6\ Puerperal Fever. After which the author concludes with some general remarks, which, if it were necessary,, would further convince us of his industry, modesty, and genius.
Having thus, as far as our limits will permit, gone through this work, we shall find no difficulty in recommending it to our readers. It contains, unquestionably, a larger mass of evidence than is any where else to be found of the various species of a disease, which? though but little known in the common walks of civil life, is among the most formidable in camps, in armies, and sometimes in the abodes of poverty, ami its attendant wretchedness. We sincerely hope our author, before another edition is called for, wifl be able to add his practical remarks to what he has selected from others.
He will then find, experimentally, how difficult it is to make these remarks in a satisfactory manner, and how frequently he is obliged to doubt the faithfulness of such authors as are the most disemharassed in their histories and inductions.
As to the theory contained in the work, it is evident that Dr.
Harty docs not consider it new. The number of authorities quoted in every page, must have convinced him that if the writers he refers to, did not make exactly the same distinctions as he has done, many of them were aware of them, and conceived them well understood. This, however, does not lessen tho value of our author's investigation. Some of the best received writers who, are most commonly referred to, certainly overlooked the distinction. The whole herd of nosologists, with Culleu in their van, and bringing forward all their forces, arevery much confused for want of a: practical knowledge of those forms of the disease which probably never occurred in their own practice. The last mentioned author was totally unacquainted with them, as Dr. Harty has shewn in several passages. Dr. Juekson, however, whom we should gladly have seen quoted more frequently, is very careful in marking all those various effects produced from similar causes. There is, indeed, a difference in the opinions of these gentlemen. Dr. Harty seems to consider typhus as necessary to render these topical diseases contagious: Dr. Jackson considers the tainted atmosphere of crouded hospitals, which at one time produces typhus, may, under other circumstances, produce those local effects which may after- This Title Page shows so exactly the intention of the author,, that a commentary upon it may serve as a review of the work. First, it -is a means of introducing our author's titles : Member of the University of Oxford !?It is usual for graduates, at any University, to specify their precise degree. Dr. Rowley, on account of "his long life, incessantly dedicated to the study and practice of physic,*" must, certainly, stand as Doctor of physic in that Univer-N n 3 sity. * These words are taken from the Introduction, and the following Note is tacked to them, " As Schola et Historia Medico ia Universalis Nova, the rational practice of physic, and other works testify; but with what success, must be submitted to the candid consideration of the learned faculty all through Europe. In the public medical lectures he has had the honour to deliver to numerous students and others of the faculy, it is well known that the Boerhaavian, Cullenian hypothetic systems, as likewise naicotic Brunonian visions, have been proved partly erroneous, and therefore inadmissible in the true practice of medicine. It has been attempted to raise the whole ai t on a more solid basis, bv only admitting selt-evident s.nd undeniable facts from the science of anatomy, physiology, pathology, and successful long experience in practical medicine." When a man writes in jhif manner of himself and his writings, it is impossible not to suspect him; but when he appeals to the learned faculty of all Europe, relative to the success of works scarcely known, but by the frequency with which they are advertised, we then understand that cowpox, or any other popular subject, are convenient things to bring forward ? name, which might be lost but for such opportunities. Thus we find Dr. Rozcley, on Cow-pox Inoculation. sity. But, his modesty lias induced him to take a title, which any term-trotter may assume, almost as soon as matriculated.
As to the works, the authorship of which he claims, we trust, no one will dispute his title to them. His public lectures too, have been too often advertised, for any one to doubt their publicity or the liberality of the author to his audience. If they will but have the goodness to hear him, it is well known, how indifferent he is to all pecuniary considerations We come now to the latter part of the title, viz. The mode of treating the beastly new diseases produced from Cow-pox, explained by two coloured engravings, as Cow-pox Mange, Cow-pox Evil or Abscess, Cow-pox Ulcers, Cow-pox Mortifications, &c. The history of the first of these engravings is a little curious. We have more than a million of people who have been vaccinated, the ingenuity of some, the humour and the malice of others, and most of all, the desire of consequence, which, more or less, attaches itself to all, should not be able to produce as many cases as Dr.
Rowley has here brought forward. It would be still stranger if some real failures and 'well authenticated inconveniences had not occurred in a practice so widely extended ; for what have we of certainty either in disease or health ? Vaccination is not proposed but as the means of avoiding a greater evil, and who will pretend to compare the few untoward cases which have occurred v/ith the numbers that have been always admitted by the warmest advocates for inoculation ? But we have not yet got through our remarks on Dr. Rowley's title page?There yet remains to be considered? " The Auth-oit's certain, experienced, and successful mode of inoculating for the small-pox/' ? Aye, there is the business.
If you wish for a certain, and (which we suppose means something more than certain) successful mode of inoculating, you must apply to Dr. Rowley,. Member, &c. &c. &c.
All this may be collected from the title page, which some may think is as much as the author wishes the public to read, or rather is what he has taken care shall be read in every newspaper, ami in all the diuretic corners of the streets. But we, who in our office of Reviewers', thought it our duty to peruse the whole, can assure our readers, that the Doctor will be greatly disappointed if they stop at the title page. The notes are for the most part not less important. They evince such intense reading, andi so capacious a memory, not only in medicine, but in all the arts and sciences, as must astonish every common capacity. They show also what a great author Dr. Rowley is, and also what a great and experienced practitioner. One instance we have given of this already. The following shows how fortunate it is when the sick consult such a man as the " Lecturer on the art of phyr fcic excluding false systems." " In my lectures," (says Dr. R.) " on the art of physic, both theoretical and practical, I have fully proved, that there is no necessity for that bane of the profession, conjecture or hypothesis ; and if I were asked whether, if I myself were dangerously ill, I would suffer any hypothetical, however plausible physician, to prescribe for my malady, my answer would be, No, assuredly Not unless I wished to risk the loss of life. I could give a remarkable instance of this. Speculation and hypothesis are always at variance with sound experience and successful practice." These quotations are from notes in the Introduction only. of Invalids at Chelsea. In page .9, note, the author has the boldness to assert, that there is no danger in natural small-pox if skilfully treated from the beginning, referring us once more to his "Treatises on putrid fevers, Sec. Page 11, (note) "There is scarce a week passes that I do not prescribe for some miserable* case or other." In p. 15, we are referred to the author's " Trca-.
tise on malignant and putrid Diseases; and in thp text to which this note refers, he expresses his surprise that what he read before the Committee of the Houseof Commons on that subject, is not printed in their minutes. We shall next be taught to wonder that Dr. Squirrpll and Mr. Velno's specifics are not ordered to be administered to all who have been vaccinated, or that Dr. Rowley is not consulted by parliament relative to the " modes of treating the beastly new diseases produced from Cow-pox/' If our readers are not tired of this article, we must leave them to labour through the work as we have been obliged to do. It is scarcely necessary to conclude with any remark ; but to preserve our customary form, we shall just observe, that throughout the whole the author talks piore of himself than of his subject; that those cases which have been proved to be false,"* are assumed with as little reserve as if they had been admitted as true; and that all the others, of which we have had leisure to enquire, stand, on no better ground. Some instances of failure arp doubtless well-founded, and these have been already admitted by the warmest friends of vaccination. Indeed, a true pathologist would be. very apt to doubt the truth of any report which boasted infallii ble success to any practice or discovery. We are pleased, however to find, that, under all these paltry and unworthy attempts to stifle vaccination, it is growing daily more popular : and that alj the arguments against it only excite the \vishcd-for enquiry.
The Modem Practice of Physic, by Edward Goodman Clarice* M. D. Author of Medicince Praxcos Compendium, of the Royal College of Physicians, London. Wc have perused the above work with much gratification, and we earnestly recommend it as deserving of the attention, particularly of the junior branches of the profession, as it is written in an able and scientific manner; and we are well assured that it will not derogate any thing from the reputation the author has already obtained by his Medicince Praxeos Compendium, the fourth edition* of which is shortly going into tlic press. * See particularly our Review of Mr. Merriman's Defence, and other articles, as well as original communications ia our Journal.