country practice, which certainly points out, that much more may be expected from the refources of nature, than fome imagine; because the efcapes with life and limb are not very rare, but frequently happen. You fee Mr. Gooch, who has wrote. well on this fubject, is not in general for speedy amputation; and I am certain you will have much more fatisfaction, and acquire more reputation by the difcerning part of mankind, in preferving a limb, than in taking it off.'

The following are part of the author's remarks on the use of oil of turpentine in wounds of the tendons and ligaments. Perhaps it may seem strange to you, that I fo frequently ufed greafy applications in wounds of the ligaments; as they have in this cafe been decried by almost every writer, fince Celfus and more especially, as the oil of turpentine is still ufed and recommended by very eminent men, both in this and other nations, as a specific in wounds of the tendons and ligaments, because it is an old practice.

:

"Oil

But I am apprehenfive the use of oil of turpentine in these cafes is very pernicious; for I do believe, it has not infrequently, by irritating and inflaming, brought on abfceffes, and mortifications, which were thought to be in confequence of the accident alone. I know an eminent writer fays, of turpentine has the virtue of allaying pain, arifing from wounds of the tendons and nerves, as is confirmed by the practice of Parey, by the opinion of all authors, and his own continual experience." And yet there is not a lad, that has played tricks with a mountebank's horse, who does not know, that it has directly a contrary effect; and only reflect one moment upon the application of this remedy to an inflamed nerve! but I cannot any way fo effectually explode this practice, as by giving you a fhort view of the principles upon which it was first introduced; and I hope you will give me the hearing a little longer, as the getting clear of this remedy, in this cafe, feems to be a matter of confequence.

Hippocrates, who used the word nerve to fignify a glutinous, (fuch as the tendons, ligaments, and the like) inftead of a medullary fubftance, fays, that cold is injurious to the nerves, and a moderate warmth, which does not exceed the third degree, useful. Wherefore, he orders them to be dressed, when wounded, with myrtle roots powdered, fifted, and kneaded with oil; and with five-leaved grafs, rubbed in oil, which are to be removed the third day; which applications, he says, had better be used in winter, than fummer. And Celfus, who ufed the word nerve in the fame claffical sense, says with Hippocrates, that they are injured by cold, recommends the application of agglutinants to heal recent wounds of them that

would

would admit of cure by the first intention; but where the wound was fevere, emollient cataplafms were outwardly applied; in ulcers where the nerves were laid bare, he first covered them with linen to prevent their being injured by remedies which might be neceffary to cleanfe the fore; and mild. digestives were also used in ulcers amongst the nerves. But this practice Galen overturned.

He had learnt the improvements made in anatomy by He' rophilus and Erafiftratus, and after making a new diftination betwixt nerve and tendon, and then again, confounding these different fubftances under one name, we are informed, that his principal aim in the cure of wounded nerves, was to guard against putrefaction." Seeing, fays he, (De comp. med. fecund. gener. lib. 3. (that putrefaction in all things is produced by heat and moisture, I always think the cure, in wounds liable to putrefaction, fhould be attempted by cold, and drying applications."-Again: "I agree with Hippocrates, that cold is an enemy to the nerves, and imagine, that that medicine is the propereft for wounded nerves, which dries, and is of a middle nature betwixt heat and cold, or rather inclining to heat; for heat without humidity cannot moilten.-In punctures, therefore, of the nerves, after opening the external wound, medicines of thin confiftence, vehemently drying. which will excite a moderate warmth, penetrate to the bottom, and draw from afar, without giving pain, or injuring the interjacent parts, should be applied.—But warm water, though it mitigates other inflammations, yet it is very prejudicial in wounded nerves, &c. For the fame reafons, relaxing cataplafms fhould not be applied: nor are things of thick confiftence of service. It is better to foment with old thin oil made warm, for cold obftructs the fmall opening, &c. and the nerves are the most fenfible parts, being a continuation of the brain, of a cold nature, and eafily affected by cold. Or with oil, in which the feeds of the fir tree and poplar flowers have been boiled; or the oil of favin, which is void of aftringency and of thin part."

Compound medicines for the fame purpofe were made of refin, turpentine, euphorbium, fagapenum, opopanax, and the like. But when the nerves were laid bare, he advifed milder applications, that would dry without irritating; for he fays they will not bear the force of euphorbium, &c. as when the skin interferes; he therefore in this cafe ufed washed lime, or pomphylyx mixed in a large quantity of oil, &c. but when the wound was accompanied with pain, he applied a caraplafm made of bean flour, and the lixivium ftillatitium called ftacte.

• Now

Now, though it is true, that heating and drying fub. ftances prevent putrefaction in dead bodies; yet in living bo dies, and especially in tendinous parts, they produce exaâly a contrary effect, by hardening and inflaming the veffels and fibres. However, this theory and practice, with very little variation, was implicitly copied by the Greeks, Arabians, and Latins, except that, by fome unlucky mistake, instead of the lixivium ftillatitium, which is a liquor that fweats from the myrrh tree, before it is lanced, they ufed common ley, which, I dare fay, you will eafily conceive, could not afford much eafe, when the injured parts were inflamed and painful. And yet, upon no better authority than this blunder, a foap fuds poultice was applied by Parey to the King's arm, Charles IX. of France, when he was pricked in a nerve, inftead of a vein.-Oil of turpentine fo perfectly agreed with the remedy described by Galen for pricked nerves, that it' immediately came into ufe, when the method of making it was known; and, perhaps, more especially, as Galen himfelf had used oil in which the feeds of the fir-tree had been boiled. And to the oil of turpentine, fome aqua vitæ, you fee, was added, to make it ftill more capable of exhausting and drying up the ferous and virulent humour, which sweats from the fubftance of the pricked nerve; of preventing bad fymptoms, and of mitigating pain by its actual heat!

Now the oil of turpentine, &c. was applied before any ferous humor could he difcharged, provided the tendon had been pricked; therefore it must be used by way of prevention. But is not this ferous humor the natural discharge from a wounded tendon? and therefore would not ftopping it by drying remedies increafe inflammation and pain? It is highly probable the ease the king enjoyed was from the oxycrate and nutritum; but thefe gave way to the poultice above mentioned, which was thought to be a better remedy for diffolv ing and drying virulent humors occafioning pain, But I dare fay, from the nature of this application, you will think the king had a narrow efcape from torture, as he was to have been cauterized with fcalding oil, if the pain had not luckily ceased; and the cure took up three months, which is a much longer time than is ufually required for the recovery of accidents of this kind.'

y. The

V. The Marine Practice of Phyfic and Surgery, including that in the bot Countries. Particularly useful to all who visit the Eaft and Weft Indies, or the coaft of Africa. To which is added Pharmacopazia Marina. And fome brief Directions to be ob ferved by the Sea-furgeon in an Engagement, &c. Northcote, Surgeon. Two Vols. 8vo. Pr. 12s. De Hondt.

By William

Becket and

Hough the practice of phyfic and furgery be the fame, in

all effential points, at fea as on land; yet, the particular circumftances of those who live on board a ship, and visit different climates, render it neceffary for an author, who writes chiefly for the naval department, to defcend to more minutenefs in his inftructions, and adapt them to a greater variety of fituations, than other phyfical writers. Mr. Northcote appears to be extremely well qualified for the work he has undertaken; for, he feems to be not only thoroughly acquainted with the economy of a marine life, at far as it regards the convenience and particular fituation both of the furgeon and patient; but he is alfo converfant in the writings of the best practical authors, and is evidently poffeffed of great experience in his profeffion. The firft of these volumes treats of surgery, contrary to what might be expected from the title page. We know not for what reafon fuch an arrangement has been adopted; but it is a matter of no importance. In this part of the work, Mr. Northcote has omitted no article which can lay claim to any confideration; and though he defcends to many minute distinctions, his divifions are feldom unneceffary, or his precepts too prolix. The following are his injunaions and obfervations in regard to bleeding.

• Plebotomy is an artful and careful opening of a confpicuous vein with a lancet, chiefly in the neck, arm, hand, or foot; being the most ancient, effectual, and extenfive remedy upon moft occafions with which we are acquainted, but reqires judgment in the performance, to avoid the adjacent nerves, tendons, or arteries: therefore the young furgeon's reputation may fuffer as much by neglect or accidents in this way, as in many of the other lefs ufual and feemingly more difficult operations.

A good furgeon or plebotomist should have a fharp eye and an undaunted mind, with a steady, nimble, and active hand; without which advantages the operator may either be fiable to mifs the vein, or commit fome accident that may be injurious or fatal to the patient and his own reputation. For thefe reafons it is, that venefection is lefs readily practifed by the furgeon as he advances in years; because old age is gene

rally

rally accompanied with a weak eye and a trembling hand; which is alfo the cafe with those of younger years, that have made too free with their conftitution, &c.

• When you are to bleed in the arm provide a fillet of about an ell long, a comprefs, a bit of lint and diapalma plafter, a receptacle for the blood, and another for water, and have some hartfhorn in readiness in case of faintness: then fingle out the vein which presents beft, and apply the ligature moderately tight above the elbow by two circular rounds about the arm and with a flip-knot. Choose out a lancet either broad or spear-pointed in proportion to the depth or rifing of the vein; place it betwixt your teeth, with the blade removed from the shaft so as to form an obtufe angle, and in the mean time rub the arm from the hand upward, to make the vein appear more confpicuous. Then preffing with your finger to discover the vicinity of the artery, nerve, or tendon, make a small impreffion with your nail upon the skin where the vein appears beft for opening. Next place your left thumb upon the vein a little below the impreffion to keep it fteady, and taking the lancet betwixt your right thumb and fore-finger, refting upon the other fingers almost as you would hold a pen, plunge the point into the vein, so as to make an orifice tolerably large by an oblique incifion carried upward, by raising a little the point, which then instantly withdraw, and prefs your left thumb upon the orifice, till the receptacle is ready to receive the blood; which if obstructed from flowing freely by too great preffure of the ligature upon the artery, you must flacken it a little, and relax the kin and vein by bending the arm in a small degree, which is then to be fupported by a stick, which the patient should keep turning round.

When you have drawn off as much as you think proper, untie the ligature and wash off the blood; clofing the lips of the orifice in their natural posture (as the skin is apt to contract, and occafion the fat to protrude, which leaves a troublefome little ulcer, or at beft fince it thus unites with a large fcar) endeavour as much as poffible to retain the skin together with a bit of diapalma plafter, in the middle of which fix a bit of lint or clean linen fufficient to cover the orifice; over this apply your fquare comprefs of fufficient thickness, and retain it by the fillet, one end of which is applied obliquely across the arm over the comprefs, letting enough of it hang loose above the elbow to tie in a knot: then the other part being carried round below the elbow and up again, croffing the former upon the comprefs, is carried round above the elbow, and fo on like the figure ∞, leaving enough to tie