ceeds to consider the treatment of the disease, first, as it appears in its regular form.

Viewing gout as a constitutional affection, the author pro perly observes that the removal of the inflammation is not the principal aim of the practitioner. The objects we have chiefly in view are so to remove the paroxysm that the succeeding interval may be as long as possible, and that any tendency to atonic gout may be obviated, the danger in gout proceeding neither from the local affection nor the general excitement, but from the paroxysm becoming frequent and irregular.' Respecting the use of evacuations during the gouty paroxysm, practitioners are nearly agreed; they may occasionally be employed with advantage, when any particular circumstance calls for their use but they are not remedies that can be regarded as of indiscriminate application, nor as being possessed of any specific virtues. Concerning the effects of opium, much difference of opinion exists; and probably in this, as in similar cases, the truth may be in the medium. We are not disposed to place great reliance on any of the local applications that have from time to time acquired a degree of reputation, many of which are insignificant, and some dangerous; and in this last class, we do not hesitate to rank external cold. Dr. W. informs us that he had not seen Dr. Kinglake's work when he composed his remarks on gout; and consequently little notice is taken of the practice which has lately been recomended by that writer. We have perused Dr. Kinglake's performance with considerable attention; and, as we shall speedily give our sentiments concerning it, we shall not here enter on the discussion.

In the atonic gout, Dr. Wilson points out two indications of cure; to remove the symptoms of debility, and to restore the regular fits. It is to be observed, (he adds) that if we succeed in either of these indications, the other for the most part is answered at the same time.' Unfortunately, the means of fulfilling these indications are not much within our power; and all that we can effect is to be accomplished rather by a strict and uniform attention to regimen than by the use of any medicines. The author reviews the different remedies which have been recommended, and manifests considerable judgment in appreciating the degree of benefit which we may respectively hope to derive from them.On the whole, we consider the chapter on gout as containing a valuable summary of the information which we at present possess on this subject; and if it does not promise any certain or immediate relief, we fear that this is to be ascribed, not to any want of skill or knowlege in the author, but to the deficiencies of his art.

The

The volume concludes with some remarks on hæmorrhages; an ample and judicious account of phthisis pulmonalis and of dysentery; and an appendix containing an experimental essay on the manner in which opium and tobacco act on the living body, which had been previously published in the year 1795.

Our readers will perceive that we have a favourable opinion of Dr. Wilson's labours: which, though they do not exhibit any prominent marks of genius, evince his judgment in the selection and arrangement of his materials. His treatise must be regarded as principally valuable to the student, but it may occasionally be consulted with advantage by the experienced practitioner.

ART. VII. Medical Sketches of the Expedition to Egypt, from India. By James M'Gregor, A. M. Member of the Royal College of Surgeons, of London; Surgeon to the Royal Regiment of Horse Guards; and lately Superintending Surgeon to the Indian Army in Egypt. 8vo. pp. 260. 7s. Boards. Murray.

THESE sketches were originally composed in consequence of

orders from the Court of Directors to the Government of India; and, from the character of the author, and the sources, of information which he possessed, we may confidently affirm that the task could not have fallen into better hands. We are, informed that, during an uncommonly long voyage, in a. march over extensive deserts, and in a country and climate, described as the most inimical to the human race, the Indian. army enjoyed a considerable degree of health, and suffered but a small mortality.' This extraordinary exemption from sick*ness appears to be justly attributable to the exertions both of the military and the medical officers; and particularly to the attention which was paid to the comforts of the soldiers by the commander in chief, General Baird.

Mr. McGregor divides his work into three parts; the first gives the medical history, or rather the journal, of the expedition in the second, after attempting to assign the causes of the diseases which prevailed, some modes of prevention are offered and in the third there is some account of the diseases.'

The army left India in the beginning of the year 1801, and arrived at Kossier, on the Red Sea, in May; and in June they commenced their march across the deserts. During this tedious expedition, they retained an unusually good state of health, although their progress was attended by many unfavourable circumstances. The heat was intense; for we learn that on the 29th June, at Le Gita, in the author's tent, at REV. DEC. 1805. three

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three P. M. the mercury stood at 114°. In the soldiers' tents it could not have been less than 118. A burning wind also prevailed, which perpetually produced clouds of dust that penetrated into the stomach and lungs. During July, the army still remained in a very healthy state, encamped on the banks of the Nile, which now began to exhibit signs of its annual overflow. They afterward moved about 400 miles down the Nile, and were stationed at Rhoda, a small island formed by the river, on which the Nilometer is placed. Soon after their arrival at this spot, a fever broke out among them, and in three weeks the number of the sick was more than a thousand.

In September, the army removed to Rosetta; and on the 14th of the month, a case of plague was discovered. Every precaution for preventing the spread of the disease was imme diately put in practice; yet other cases occurred, the hospital itself appeared to be infected, and it was found that the disease was prevailing among the inhabitants of the town. Ophthalmia now also manifested itself very frequently; and in the beginning of November the total number of sick in the army amounted to 1350, or more than one fourth part of its whole strength.

In December, they removed to Alexandria, a situation much more favourable to health than Rosetta; yet here cases of plague continued to arise, and in January the disease was more frequent and fatal. After having become less severe during the months of February and March, in April the sphere of infection again grew more extensive; some of the medical attendants were themselves seized with the disease, and four of them died but in the following month its violence again declined, the army was more healthy, and crossed the deserts in order to return to India. The embarkation took place in June; and at this time, says the author, never, perhaps, was there an army embarked for any service more healthy than the Indian army was when it re-embarked on its return from Egypt.'

We now enter on the second division of the work, in which Mr. McGregor assigns the cause of the diseases, and details the mode of prevention. The troops who were sent on this expedition were composed of nearly equal numbers of Europeans and Indians: but the Europeans had been for some time either at the Cape of Good Hope or in India, and were therefore well prepared for the effects of heat. The author conceives that we are to attribute the diseases which prevail in Egypt, to some peculiarity in the climate and soil of this country. The exha lations proceeding in Lower Egypt from the lands which are left covered with mud, after the inundations of the Nile, in

fluenced

fluenced by a warm sun, added to the total want of attention to cleanliness, must be considered as fully adequate to produce not only intermittent fevers, but even those which are attended with what are usually called putrid symptoms. The plague, however, the writer regards as an imported disease, and as propagated by contagion alone; yet it is evident that it must be diffused with more facility, when it occurs in a situation favourable for the increase of its violence.

In general, the mortality was observed to be more considerable among the Europeans than among the natives of India; and, although this may in some measure be attributed to an original difference of constitution, yet the author thinks that a part of it must be ascribed to the intemperance of the Europeans in eating and drinking; indeed, he notices one instance in which the effects were immediately perceptible. Mere heat appears to be less unfavourable to the human frame than it might at first view be supposed; for at the period of the greatest heat, and when the men were exposed to the most severe duty, they enjoyed the best health.

The third part of the work commences with some remarks on the plague. Mr. M'Gregor affords an ample testimony to the value of Dr. Russel's publication on this subject: confess ing that, since his time, little addition has been made to our knowlege of the phænomena of the disease, and but little im provement in the method of treating it. He observes, however, that the proper and well timed use of mercury, and, perhaps still more, the application of the newly-discovered remedies analogous in their effects to the calces of that mineral, hold out a prospect of success the most encouraging.' Dreadful as are the effects of this disease, we are induced to hope that much may be done in the way of prevention. The present author appears to entertain no doubt respecting its contagious nature; and he seems to think that, by the strictest attention in avoiding every source of infection, and particularly by adopting the utmost cleanliness and using the nitrous fumigations, its progress may be arrested:-he imagines that there is no danger but from actual contact.

It is observed that the plague assumes very different appearances, according to the countries and the seasons in which it is found; it has sometimes the symptoms of typhus, at others those of an intermittent, and the author was forcibly struck with the resemblance which it bore, in some instances, to the West Indian yellow fever. In order to convey a clear idea of the nature of the disease, he details the cases of seven of the medical gentlemen who were attacked by it, of whom only three recovered. The first case is that of Dr. Whyte; who, conceiv

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ing that the disease was not contagious, inoculated himself with matter taken from a bubo; on the third day he became indisposed, and, on the sixth, fell a victim to his own temerity.' Mr. M'Gregor then enumerates the different symptoms of the plague as they occurred to his observation, and offers some remarks on each of them.-It may appear somewhat difficult to form an exact idea of what he means by the plague; since he informs us that fever is not always present, and that in many instances there are no glandular swellings. In such cases, we must suppose that he determined the nature of the disease rather from concomitant circumstances attending its production, than from its actual symptoms.-The symptoms are enumerated in the order of their frequency, and are as follow fever, tremors of the limbs, affection of the head, glandular swellings, affections of the abdomen, petechia, peculiarity of countenance, state of the pulse, of the tongue, affection of the lungs, and dry skin. The process of the disease was frequently very rapid, and its prognosis always doubtful.

Mr. McGregor lays down three indications of cure; 1st, to clear the prima via, which is best effected by calomel; 2dly, to produce ptyalism and perspiration; and, 3dly, to obviate debility. Mercury is the remedy on which he places his principal reliance: but he is disposed to think favourably of the nitric acid, though, according to his own statement, it must be rather from theory than from actual experience of its effects. The more quickly a salivation could be excited, the more favourable was the termination. Bleeding, and the employment of stimulants, he decidedly condemns. He has great confidence in the preventative effects of the nitrous fumigation.

Though much less dangerous, yet scarcely less troublesome was the ophthalmia. The author is inclined to regard it as contagious, and, we think, with reason; he believes that it may be prevented by frequently washing the eyes with cold water during the period of its prevalence.

After these observations on what may be considered as the two endemic diseases of Egypt, Mr. McGregor attends to the other complaints to which the army was subjected during the expedition. Of these remarks, the most important and original are those which relate to dysentery :-not only the most frequent but the most fatal disease which the army experien ced. After having noticed the character which this complaint assumes in different parts of the world, he concludes that it ought to be divided into two species, one of which he calls the tropical dysentery, the other the dysentery of Europe; the former having its origin in the biliary system, while he supposes that the other is seated in the intestinal canal. It is the

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