APPENDIX. NOTE A, p. 3. IN the same Preface, Dr Walker states: "During the short while I lived at Glencross, I went one season to the Goat Whey, in Breadalbane, along with Dr Cullen, when our whole time was employed in examining and collecting the fossils in that part of the Highlands." And again, "It is now sufficiently evinced that the numerous fossils on the globe cannot be investigated, discovered, and ascertained by either of these two methods (viz., the internal or the external characters), independently of the other. This leading principle was the maxim of the two best judges I have ever known, Dr Cullen and the Earl of Bute, whose opinions and instructions I always found judicious and useful." And in a subsequent passage, Dr Walker says, "In the following catalogue, fossils are distributed into Classes, Orders, Genera, Species, and Varieties. This fivefold division, though arbitrary, is excellent, and has now, from experience, been found the best in the arrangement of natural bodies. It is even applicable and commodious in other departments of science. Dr Cullen thought that no other should be followed in Mineralogy; and he accurately observed it himself in his Nosology, in the arrangement of Diseases. He certainly did much in ascertaining the Classes, Orders, and Genera of Diseases, but always regretted that neither his opportunities nor his life were sufficient to ascertain the species. The same complaint may be applied to Mineralogy." "DEAR SIR, NOTE B, p. 4. Dr DOBSON to Dr CULLEN. "LIVERPOOL, 28th October 1764. Mr Bostock, the bearer of this, is a young gentleman of Lancashire, who proposes to go through a course of medical studies at Edinburgh. He is well grounded in the languages, mathematics, and natural philosophy, and has made that quick progress in every thing he has yet applied to, which might be expected from uncommon talents and uncommon assiduity. As he is a stranger at Edinburgh, I take the liberty of thus mentioning him to Dr Cullen.* He will be much obliged by your directing him how he may most advantageously go through the several Colleges.† I am much obliged to you for your last favour. Your medical information is always much to my advantage, and makes me very happy. I have run over, in a very cursory manner, Sauvages's lesser work. The drawing out of a Nosologia Methodica is attended with many difficulties. To form the Classes Morborum from their proximate causes, i.e., the morbid alterations in the solids and fluids, would, I imagine, be the most simple, natural, and philosophical; but to execute this method in a satisfactory manner, there are many desiderata to which you are no stranger. To take the Symptomata Morborum Pathognomica for the distinguishing characters likewise promises fair; but to this a much more accurate history of diseases is necessary than we are yet supplied with. Besides, in the zoology, as well as in the botanical classes, the several subjects speak a language very intelligible; their appearances are obvious, and, consequently, the characters readily ascertained. But in the pathology, the symptoms depend upon the internal motions of * Vol. I., ↑ The term College was at that time often used to signify a Course of Lectures. the system, and many of them are sensations in themselves not easily to be expressed, and rendered still more vague by the imperfect and confused description of the patient. The ten classes of Sauvages have their uses; but in this method, I think, many diseases, which are in themselves analogous, fall under different classes, and are thus unnaturally and unusefully separated. With best wishes for your health, and continued usefulness, believe me, dear Doctor, your affectionate and obliged friend and servant, MATT. DOBSON. P.S.-Pray what do you say to Hunter's Transudation ?” NOTE C, p. 71. CRITICISMS ON DR CULLEN'S SYNOPSIS OF NOSOLOGY. This Note relates to certain criticisms pronounced by the late Dr Milligan on various terms, and some alleged grammatical errors in the Synopsis Nosologiae Methodicae. The criticisms relate mostly to modes of orthography; and it is believed unnecessary now to notice them. NOTE D, p. 88. Reasons against Disjoining the Practice of Physic from that of Surgery, Midwifery, &c., by Legislative enactments, as assigned by Dr CULLEN and other Members of the Royal College of Physicians of Edinburgh, in 1769. "The study of the whole of Physic is certainly too much for one man; there are few who attain to it, and we believe the most grave of physicians do not go half the length they ought in this matter. It might therefore be a project to divide the study of the profession still further, and confine practitioners to certain diseases only; but it would be a foolish one, and would produce practitioners not knowing in any disease. The principles are in common with the whole, and the application to different particulars serves to establish and to illustrate each other. It is however true, that from particular dispositions and accidents, physicians will often attach themselves to some parts of their art in preference to others; and if they can persuade the public of their particular talents and acquirements, they will meet with encouragement in their particular branch of skill, and perhaps in that chiefly, by which means they become more knowing in it, and less exposed to avocations in other parts of the profession. This is, indeed, establishing certain persons for particular parts of the art, and perhaps in this way it is always with advantage to the public. But that such accidental determinations should be made a separate profession, which any man practising should be obliged to practise alone, and that no other physician should be allowed to practise the same, appears very improper. It is probable that practitioners will always be best formed by setting out upon a general plan of study, and encouraged by a view of a comprehensive employment, though we may allow particular determinations to take place afterwards. If, then, a physician upon this footing shall be determined to the practice of surgery, or any part of it, no harm can ensue to the public; on the contrary, such a physician is likely to become more excellent in surgery than any man who, from the beginning, was determined to be a surgeon only. There is no advantage, therefore, to be got by forcing the separation in study, nor is there any necessity for any regulations to separate them in employment. The memorial mentions that one part of a profession may attach a man to one patient and place, and prevent him from attending others; yet there is no necessity for obviating such accidents, nor is it possible to do it by any regulations. We may as well enact, that no physician shall go out of town, because he cannot attend his patients in town and country at the same time, or limit every physician to a certain number of patients. We must leave to the public to obviate this inconvenience, which they certainly will, whenever they find |