"It has been asserted, that the purification of the blood is the effect of the vital principle; but if so, then the air must possess life; for Priestley ascertained that a similar change is produced when dead blood is exposed to the air, even through the medium of a dead membrane; and how little either the brain or the nerves are essential to this process has been well proved by the more recent experiments of Mr. Brodie, who found that, when respiration was maintained by artificial means, the blood continued to be purified in the lungs, even for hours after the head of the animal had been cut off; and as this fact is unquestionable, we must look, not to the nerves or the living principle for an explanation of this process, but to the agency of some other power." 45. The fine bewilderment displayed in the foregoing passage must be too apparent to need exposure. But we repeat that, turn which way we will, we are met with the same stuff, and we positively would not insult our readers by a serious notice of any more of it. We have another duty to perform, and passing over the four hundred and twenty-nine pages of nothingness that precede the chapter on cholera, we come without further hindrance to that subject. We do this the more willingly as Dr. Stevens' speculations on fever and its treatment are not worth our notice, and his statements respecting the fever at Trinidad are sufficiently exposed in the letter from Dr. Hacket in the present number of this Journal. Dr. Stevens enjoys the proud satisfaction of seeing a reviewer, with some character to lose, deliberately assert that he does not even think his views worth ridicule, whilst an able and estimable physician to a military hospital publicly contradicts his assertions. We do not envy him. Before we pass to the consideration of the chapter on cholera, we will devote a few, and but a few lines, to Dr. Stevens' abuse of Drs. Johnson and Hacket. We shall not rip up the controversy; Dr. Hacket has replied, and Dr. Johnson will not. There are some persons over whom victory in a personal contest is humiliating, and such an one is Dr. Stevens. Let him rail then as he likes at Dr. Johnson and Dr. Hacket, and he may be certain that neither of these gentlemen will in future stoop to notice his abuse. Dr. Stevens is not the man to do them injury, and truth would be a scurvy protectress indeed, if her shield received a dint from the shafts of such an adversary. We therefore declare, once for all, that Dr. Stevens may write as many letters as he pleases, in as many journals as chuse to insert them, against Dr. Johnson and Dr. Hacket, without the most distant expectation of the honour of a reply. It is not with Dr. Stevens we are now contending, for, independent of our dislike of personalities, we should feel ashamed to be engaged in so mean a strife. We are demolishing his absurd and contemptible notions, and we venture to say that, after this exposure of the 'saline treatment,' it will sink into utter obscurity overwhelmed by public derision. Dr. Stevens sets out with condemning the conduct of both the Boards of Health. He then proceeds to say that he has reason to dread that "the metropolis is at this moment slumbering on a volcano of pestilence." This, as the newsmen say, is alarming intelligence, and the metropolis will be greatly obliged to Dr. S. for waking it out of its nap. The volcano, however, is after all a mere popgun, for Dr. S. immediately informs us that "when cholera is taken in time, and properly treated, it is in the majority of cases, almost as easily cured as either the common typhus or ap the marsh fever." After proceeding, in a pitiful tone, to lament that the facts which he had stated, relative to the effects of salts on the blood, peared for a time to have been almost forgotten," a type of the utter oblivion that will speedily overtake them, he proceeds to say that some gentlemen, "who consider their profession as something more than a trade," advocated the saline treatment. The public will mark the modesty of this gentleman. Those who do not laud his trash are denounced, by implication, as men who make their profession a trade; whilst those who may happen to approve of his notions are instantly held up as models of disinterestedness and honour. We stand up, in the name of the many professional men whom this Dr. Stevens libels, and repel his foul and foolish slander with utter scorn. If such men as Sir Astley Cooper and Dr. Prout have inadvertently patronized him, we know that they will repent their having been deluded into countenancing his saline absurdities. Those who have not been led away, will have the satisfaction of feeling that they have never been praised by Dr. Stevens. Proceeding to wade through this article on cholera, we are next presented with two letters which appeared in the Medical Gazette, of which it is difficult to say which is most absurd. The first article, or letter, for we know not which it is, was penned by a Stevenite; the other is a sort of second in the duet, by the Doctor himself. The little endearments that pass between them remind one of the caresses of Mrs. Hardcastle and Tony Lumpkin. As they both consist of a sort of exposition of the Stevenian principles, and may be resolved into the Koran of this medical prophetthat salts make black blood in a porringer red, and acids make red blood black, with a number of wise corollaries thereto tacked, we need not exhaust our own patience nor our readers' by much further notice of them. We shall, therefore, only notice a passage or two illustrative of the accuracy and sagacity of this Siamese couple. For instance, No. 1 affirms-" this method of treatment, which Dr. Stevens has the merit of having first proposed, is gaining ground in the West Indies, &c. &c." The etc. etc. is certainly very significant, and a great deal is judiciously left to the imagination. Perhaps we may be permitted to transfer to vulgar prose the hidden sense imprisoned in these cabalistic symbols. We are enabled to do this by Dr. Hacket's opportune letter, in which we find the following glossary on the passage above quoted. “I shall now finally state, in answer to all Dr. Stevens urges in his communication, and to shew the profession generally of how much value in practice his doctrines were, and are yet considered in the treatment of tropical fever, that, as far as I could learn, throughout all the following islands, which I lately visited on duty, there is not one convert to his opinions, and that the practitioners generally throughout them cry psha! both to his writings and pretensions at Antigua, Dominica, St. Lucia, Barbados, Tobago, Trinidad, Grenada, St. VinFor the last fifteen months that I had been stationed at Antigua, not one particle of his 'sodaic mixture' was administered to a single fever case, and yet our practice had been equally successful there as at Trinidad."* cent. So much for the ground that is gained in the West Indies. * Vide Dr. Hacket's Letter, p. 591, Extra Limites. Let us now look a little at the letter of Dr. Stevens himself. It begins thus. "As I have never seen even one case of the Indian cholera, of course I can only judge of the treatment of that disease by reasoning from analogy, betwixt this and other malignant fevers which I have actually seen; but probably I was not far from the truth when I stated, that the practice which I had found so useful in the malignant fevers of the western world, would be equally successful in the treatment of all other forms of malignant disease; and perhaps, also, after this treatment has been fairly tried, the outline of the practice in all malignant diseases will ultimately be nearly the same." 440. Well done! The salines will cure all forms of malignant disease, and the outline of practice will be nearly the same in all. We shall soon have a malignant millennium, and the Procrustian tumbler of salt and water will put out all fevers of all complexions. We shall next subjoin a specimen of another kind, a sample of the Doctor's peculiar ratiocination. "The sickness of the stomach which is so generally met with in the commencement of all those fevers that are produced by the specific aerial poisons, is probably the effect of the poison itself, which is thrown out of the circulation, and causes irritation in the gastric organs, in the same way that tartarized antimony produces nausea and vomiting when we inject a small portion of that agent into a vein when proper remedies are used, that sickness at the stomach which begins with the disease soon passes away; but the peculiar irritation in the gastric organs which comes on at a later period, and which is often so distressing in the last stage, is evidently in these fevers produced in a great measure by an excess of acidity in the stomach. This may perhaps arise from the decomposition of the saline ingredients of the blood by the nervous or electric fluid which appears to exist in excess in all fevers, but particularly in those of a malignant character." 441 Clever analogical reasoning this, to compare the nauseant effect of a poi. son, "thrown out of the circulation," with that of tartarized antimony thrown into it. Then, the sublime idea that the acid is produced by the decomposition of salts by "the nervous or electric fluid, which appears to exist in excess in all fevers." O rare physiology; O happy pathologist! Again "There is no question of the fact, that there is in all the malignant fevers of the new world, particularly in the last stage of these diseases, an excess of acids in the alimentary canal, which extends from the very tip of the tongue to the verge of the anus." 441. Now does Dr. Stevens know, or does he not, that if a piece of litmus paper be applied to the tongue of any one in health, it is rendered acid-in fact, that the saliva is acid? If he does, then why should he wonder at the circumstance in fever; if he does not-but why should we express what every one must feel. "When we apply at this period of the disease a piece of litmus paper to the foul or red irritable tongue, the test is reddened almost instantly; and when we apply the same paper to the fluids ejected from the stomach, it is reddened almost as suddenly as if it had been dipped in a pure acid." 442. Did ever Dr. Stevens test the matters vomited, under ordinary circumstances, from the stomach? If he did, we need not tell our readers that he found it acid, at least we never saw it otherwise, and God knows we have eonsumed many a sheet of litmus paper in this and similar experiments. In fact, it is lamentable to see the intelligence of the profession insulted by such trumpery arguments and ridiculous assertions. The story in the Arabian Nights' Entertainments, of the enthusiast who purchased some crockery, and arranged the mode of making his fortune and procuring the hand of the Princess of Bagdad, must be familiar enough; Dr. Stevens' saline crockery is to do as much for him. "By this treatment we not only remove that irritation and severe burning in the stomach which is so distressing to the patient, and even so destructive to the gastric organs, but we gain another point, which is, at this period of the disease, of still more importance than the mere removal of a local irritation. The fixed acids are, as I have said, immediately neutralized by the alkali of the carbonate. The mariate of soda, and the other natural saits of the blood, are instantly formed in the stomach itself. Now we know that these salts do enter the circulation; we know also that they mix with, and become a part of the circulating blood; we know that they change its properties and remedy its morbid condition; we know also that they add to the stimulating power of the circulating current, and enable the heart to keep up its action. In consequence of this addition of saline matter, the kidneys, and the other secreting organs, continue to perform their functions. The skin does not become yellow, nor the breath fetid; neither is the mortality one-twentieth part so great as it had been under the old modes of treatment. In fact, the successful results which have already followed the use of the above practice, prove that the saline remedies are the agents of all others the best that we yet know of, for the successful treatment of malignant diseases." 444. Like a lively flea, the Doctor hops with surprising vigour from assertion to assertion, until he satisfactorily ascertains that his treatment is the very best that has ever been devised by the wit of man. Be it so. "The dark colour of the blood, which we observe in the beginning of pestilential fevers, is the effect of the poison on the vital fluid; but the blackness in the last stage of these diseases is produced by the loss of the saline ingredients, which I can prove are beyond all question the true cause of the red colour of healthy blood." 445. In this short passage there are three assertions, not one of which is easily proved. But this is of a piece with all the rest. We solemnly declare that we do not believe there has ever been published a medical work containing a greater mass of reckless, unproved, and improbable assumptions, stuck together with such a putty of ridiculous reasoning. A connected criticism of such twaddle would be next to impossible, for one would have to argue every sentence. The severest censure is to expose passages, in the nakedness of their nonsense, to public laughter. We are told by Stevens, that the salines should be given in the collapse stage of fevers or cholera, because they enter the circulation and are stimulants; but such is their wondrous power, that we are also to give them in the stage of reaction, because they prevent a black and dissolved state of blood. "When this (fever) is effected (by the stimulant salines), should the re-action run high, the excitement may be reduced by the use of the lancet, and the typhoid symptoms, which sometimes afterwards occur, may probably be prevented by the subsequent use of the carbonate of soda and other saline medicines, which we know do possess the power of preventing that black and dissolved state of the blood, which is, in reality, in fever, the true cause of the nervous as well as the other bad symptoms." 449. Thus we are told the usual story; the remedy is good for the cold stage and good for the hot-cures yellow fever and blue cholera-is the best treatment known for all malignant diseases. We suppose that by and bye Dr. S. will denounce all remedies but salines, like the Kaliph Omar, who burnt the Ptolemæan Library because it contained more or less than the Koran.* Let us take another specimen of Dr. Stevens' reasoning. "I know it will be asked, why have the citric and other acids been successful in scurvy, where the blood is darker than it is in health? To this it may be answered, that the scurvy is not, like the cholera, or the yellow fever, a disease that causes death in a few hours, or a few days; and therefore medicines that may be used without causing immediate death in the one, cannot be used in the others with equal impunity. My own conviction is, however, that there is no one disease in the whole catalogue in which the profession has been so much misled as in the very disease now under consideration. During a residence of twenty years in the West Indies, I have only seen one case of scurvy, and that case was decidedly brought on by the excessive use of citric acid, which an American gentleman had been recommended to use as a preventive against the yellow fever. His own conviction, as well as mine, was, that the scorbutic symptoms had been brought on by the acid. This was immediately laid aside, and, under the use of the carbonate of soda, he was completely cured in three weeks.” 451. Thus, Dr. Stevens never saw in the West Indies but one case of scurvy, and on the strength of this he denies the efficacy of the vegetable acids, a fact established by facts of a very different description from those of Dr. Stevens'. It would be very inconvenient, in sooth, to allow that a disease, characterized by black and dissolved blood, can be brought on by a diet containing much of the identical salt which is to remove such a condition. See to what shifts the Doctor is reduced, when, to answer such an objection, he tells us that one gentleman made himself ill by an excessive use of citric acid," and was cured by carbonate of soda-a very likely circumstance. The quibble on scurvy not being, like yellow fever, an acute disease, is laughable enough, and would be apparent to a school-boy. We now arrive at the Cold-Bath-Fields affair. We have hitherto had to do with doctrines too absurd to require argument, assertions manifestly unsupported or insupportable, and facts which, however one might disbelieve, it would be difficult and troublesome to disprove. But here we have the practical application of the saline treatment-we have the doughty Doctor dispensing its benefits with his own discriminating hand. All this happens in our own country, in some degree beneath our own eyes; and, therefore, we have a better opportunity of testing the value of the practice than when the scene of action is in the Danish West India Islands. To this ordeal Dr. Stevens should confidently appeal, if his cause were good. We shall see how he will come out from it. As it is of consequence to lay the whole affair before our readers, we shall do so most impartially. Dr. Stevens may be assured that, from us, he shall have justice, if we do not grant him mercy. "In the beginning of April, I received a note from Mr. Pout, a medical gen * On the gates of this library were inscribed the words ΨΥΧΗΣ ΙΑΤΡΕΙΟΝPhysic of the Soul, whence Pope's lines "From shelves to shelves see greedy Vulcan roll, |