PATHOLOGY. 53 
fingly chained to the wall by the neck, like an infuriated 
and dangerous beaft ; but a den like this, crowded and 
crammed with human beings, chained down, without a 
rag of covering, ftruggling to raife their heads, and ex¬ 
hibiting their emaciated and galled limbs from the heap 
of ftraw that had been thrown over them, was a fcene I 
never expected to witnefs, and which I hope I may never 
witnefs again. In this cell there were twelve men, three 
of whom only were allowed any thing more than ftraw to 
cover them. Some I was told had been confined there for 
many months. On approaching them, they exhibited their 
chained limbs with the moft earneft entreaties for libe¬ 
ration. One man had two chains on one arm. In this 
cafe the fpace between the iron clafps was red, fwollen, 
and ulcerated ; and the mortification, which in all pro¬ 
bability was to follow, would foon render chains unne- 
ceffary for him. Others had their limbs galled, but not 
in fuch a degree as that defcribed. In one inftance only, 
in the whole hofpital, did I obferve any thing introduced 
between the iron ring and the limb. The reft of the 
men’s wards were fimilar to that I firft noticed. 
“From the men’s we were led into the women’s de¬ 
partment, which was in the higher part of the houfe, 
and which, in every refpeft, we found fimilar to that 
we had juft left, the beds huddled clofely together, chains 
always ready, many applied, and moft of the beds oc¬ 
cupied ; for, whether to fave trouble, or from the poor 
creatures having no clothes but the coverlet that was 
throw n over them, almoft every one w r as in bed. Here, 
as below, was alfo a cell where ftraw afforded the only co¬ 
vering, where the chains were more heavily applied, and 
where the date of furious defperation to which the wret¬ 
ched viftims were driven, was exprelfed in terms equally 
violent, and ltill more affedfing. One of thefe tortured 
women held up her arm which w’as raw, and had been 
bleeding, from the iron clafp having worked its way into 
the fiefh i 
“ Such is the dreadful ftate of this houfe, wdiich con¬ 
tains 180 males and 97 females, of whom one third, the 
keeper told me, were kept conftantly chained. From the 
fame fource I learned, that the annual number of deaths 
(and this, I apprehend, is the principal way in which 
this houfe gets rid of its inhabitants) fometimes amounted 
to eighty (nearly one third of the whole); that it had 
b$en as few as thirty ; and that the average was fifty 
(nearly one fifth); a mortality, I believe, unequalled in 
any inftitution of the kind in any country.” But we now 
turn to a more pleafing topic, the general ftate of patho¬ 
logy in Italy. 
We have mentioned the celebrity the Italians acquired 
in the 17th century as profeffors of anatomy; and W'e 
may obferve of the prefent asra, that the labours of Volta, 
Scarpa, Fontana, Roffini, and Mafcagni, have much con¬ 
tributed to maintain that reputation. As far as the 
practice of medicine is particularly concerned, until of 
late, it appears to have been in a very lamentable condition 
yp to the year 1812.. The Italian phylicians were divided 
into Brownifts, humorifts, thofe who followed French 
trpedunte fyftem, and a few who praclifed more correblly 
according to precepts originally derived from Sydenham. 
To thefe are now added others who adopt what is called 
the conlra-J'timvlant method, (fee p. 41.) and who boaft 
among their diftinguifhed advocates Tommafini andBorda. 
It was Rafori, however, who firft introduced this nuova 
dcctrinu medica Italianu. During the memorable blockade 
of Genoa, that phyfician obtained very great opportu¬ 
nities of ftudying the progrefs and charabfer of petechial 
difeafes ; and the calamitous refults which followed the 
application of the means recommended by Brown in al¬ 
moft all cafes foon led him to attempt a contrary plan of 
treatment, the l'uccefs of which amply proved that thefe 
fevers were of an inflammatory nature. Further invef- 
tigation convinced him that fcarcely any difeafes could 
be traced to diredl debility ; and he accordingly eftablifhed 
that theory of fever of which the leading features corre- 
Vol. XIX. No. 1286. 
fpond very clofely with the obfervations of the Englifh 
pathologifts. The medical fchool of Bologna, which is 
in a very flourifhing condition, may be confidered “at 
the head of the new doctrine;” and the profeffors, among 
whom we find the name of Tommafmi, its moft zealous 
and able advocates. A periodical journal, too, has been 
eftablifhed at this place, to give an account of the rife 
and progrefs of thefe opinions. In the mean time, thefe 
opinions are warmly oppofed by many of the Italian phy- 
ficians. Among the moft diftinguifhed of thefe oppo¬ 
nents areSpallanzani of Venice, (a nephew of the cele¬ 
brated Spallanzani,) and Federigo of Venice; but their ef¬ 
forts are not calculated to have much influence in the 
medical world. 
The dodtrine of this fchool in regard to the operation 
of drugs merits our moft earneft confideration. The 
grand axioms in Rafori’s theory, and that in which it is 
moft ftrenuoufly oppofed to the dodtrines of Browne, is 
that “ there exijis a clajs of fubjlances whoj'e uEtion reduces 
fever ; Jlackens the circulation; and, if pvjhed too fur, induces 
diredl debility, without the intervention of any notuble dif- 
charge .” Inflead of prefuming to argue upon this An¬ 
gular and bold affertion, we fhall avail ourfelves of the 
“ State of Medicine,” appended to Lady Morgan’s Italy, 
by Sir Charles Morgan, M. D. for a full expofition of 
Rafori’s dodtrine, and alfo for fome very juft and per- 
fpicuous remarks on the general ftate of medicine through¬ 
out Italy at this time. 
Alluding to the axiom ftated above, Dr. Morgan pro¬ 
ceeds thus : “The notions formerly entertained of thefe 
drugs were, that they operated by diminifhing or dilut¬ 
ing the mafs of circulating fluids ; in which they were 
fuppofed to coincide with the operation of letting blood. 
The contru-Jlimulunt dodtrine attributes their utility to 
their diredt impreflion on the living folid ; to an adtion 
which, when exceflive, will extinguifh life by an inftan- 
taneous exhauftion. In this clafs of fubftances mull be 
placed aconite, digitalis, antimonials, and in general all 
mineral fubftances, cicuta, the venom of the viper, the 
laurel-water and pruflic acid, camboge, tea, coffee, &c. 
&c. The clafles of ftimulants and contra-ftimulants, 
according to this theory, Hand oppofed to each other in 
their relations to the living fibre, and ferve mutually as 
counter-poifons to each other. •-Hence, fay the advo¬ 
cates for this dodlrine, has arifen the abundant life of 
coffee among the Turks, as an antidote to the opium 
they employ fo largely. Hence alfo the utility of the 
vegetable acids as counter-poifons to the fame drug. 
The contra-ftimulant eft’edl of lemon-juice is much 
greater than is commonly luppofed. The author, when 
at Naples, having experienced a flight coup de foleii, in¬ 
ducing a bilious vomiting and febrile paroxyfm, adopted, 
under the advice of the natives, the free ufe of lemon¬ 
ade. Two or three quarts of this fluid, taken in the 
courfe of the morning, not only removed the difeafe, but 
induced a degree of debility fufficiently irkfome to re¬ 
quire vinous ftimulation. 
One of the moft important fails attached to this doftrine 
is, that the effeit of any given dofe of a contra-ftimulant 
drug upon the conftitution, is inverfely as the degree of 
ftimulation; and conlequently, that, in inflammatory 
difeafes, the patient not only requires quantities totally 
unufual in Englifh practice of thefe remedies, but bears 
them without any notable eft eft upon the excretions. 
In practice, therefore, the meafure of the dofe is found 
in the quantity of excitement; and no dofe is deemed 
exceflive which does not change the diathefis and induce 
dangerous debility. Thus in fthenic maladies, the 
Italians employ aconite, from a grain to a drachm ; the 
kermes mineral, from eight to twenty-eight grains ; eme¬ 
tic tartar, from eight to feventy-eight grains; the laurel- 
water, from ten to lixty drops ;<ligitaiis, from four grains 
to half a drachm ; nitre, to half an ounce or an ounce. 
Thefe are commonly given in divided portions through 
the courfe of the twenty-four hours, largely diluted with 
P anv 
