It is unnecessary to observe, that such a mode of proceeding is neither satifactory nor decisive; and that if the phenomena be false or incorrectly observed, it can be no very difficult task to disprove them in the one case, or to point out the source of error in the other. Until this be done we must claim the right to suspend our opinion, and question the authority of those who pass the subject over without examination. It is but justice to M. Georget to say, that the candour of his remarks, the place of his observations, (La Salpêtriére,) and the quotations he has given from his published writings at different times, show his own conviction of the truth of what he relates, and that if he has been led into error, it has been unconsciously, and with the best intentions.

We proceed to the consideration of our author's researches on NERVOUS DISEASES, and we cannot but be pleased with the discernment and correctness with which he considers this part of pathology. The object which M. Georget proposes to himself, is to prove the cerebral origin of hysteria, hypochondriasis, epilepsy, and spasmodic asthma, and to detail and account for the various sympathetic affections occasioned by disease.

His opportunities at La Salpêtrière (the receptacle for the insane, epileptics and infirm in Paris), have enabled him to speak with some confidence on the nature of the diseases of which he treats, and have produced in his mind the firm conviction that they are in their nature uniformly nervous; and that the symptoms of disorder in the functions of other organs, which have so frequently been mistaken for their causes, should rather be considered as their effects, and as the sympathies of the organs so affected with the nervous system. Among the CAUSES of these disorders, he insists particularly upon the nimia Venus; which every body knows to prevail so much among youth-though it is in this country thought to savour of empiricism, even to hint at the indulgence.

As far as regards one of these diseases, at least-we mean EPILEPSY we think it quite unr.ecessary to adduce any arguments to prove this fact. We believe that there are very few in this country who feel inclined to deny the nervous origin of the disease in question. We think that a consideration of its symptoms would authorize us in classing it among diseases purely cerebral, in opposition to the opinion of those who believe that is the result of disorder or disease in the spinal marrow. We can readily conceive that any disorder of this part may be a remote or an exciting cause of that state of the brain, which produces the epileptic attack, or what is perhaps more probable, that they may be simultaneous effects

of some one cause; but we can by no means understand how any affection of the spinal cord should produce the symptoms, of epilepsy. Convulsions, it is true, may be the consequence of such an affection, but not the insensibility to sensorial impressions, which constantly attends the attacks of this disease, and which, if it be granted that the brain is the seat of the sensorial power, can only be dependent on some affection of that organ.

If it be proved, or allowed, that epilepsy is a nervous disease, and that most probably the brain is the organ in the affections of which it originates, it becomes, we think, almost a necessary conclusion, that hysteria is similarly circumstanced. It is a fact which has been noticed by almost every author who has written on the history of these two diseases, that the differences which exist between them are rather in degree than in their nature. It is no doubt easy to discriminate the extreme cases of each, but, on the other hand, they run into each other by such insensible gradations, that it becomes frequently impossible to determine under which of the two an individual case should be arranged. Fortunately it is not of material importance in the treatment. M. Georget adds his testimony on this point to that of those who have preceded him :-"The governesses," he says, " at La Salpêtriére attach much importance to the following symptoms, as characteristic of epilesy, namely, the absence of precursory symptoms, the total loss of sense, the distortion of the mouth and the rotation of the eyes."

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We cannot resist the temptation of transcribing the following anecdote, as a proof of the mistaken views of the origin of HYSTERIA entertained in France, at a very recent period. Dr. Bardin, physician to the hospital of Sens, had inserted in his inaugural dissertation (1821). a proposition, stating his conviction from the observations he had made while an interne,' at Salpêtrière, that the brain was the idiopathic and essential seat of hysteria. Professor Fouquier, the president, having assured this gentleman, that the proposition was untenable, and might even injure him in the eyes of his colleagues, requested him to suppress it, which he at once did, not judging it prudent to engage in a conflict where the contending parties are always unequally matched.

But of all nervous diseases HYPOCHONDRIASIS is doubtless that with regard to the seat and causes of which the greatest misconceptions have prevailed. From the black bile of Hippocrates and Galen, down to the disordered digestive organs of our own days, the writings of medical authors abound with erroneous ideas and misconceptions on the subject. The affections

of the abdominal viscera with which this disease is complicated, in the greater number of cases, have been too often treated of, as standing in the relation of causes, while in reality they should be arranged among its occasional symptoms. That such is really the case, is clearly proved by a consideration of the exciting causes of the disease, which are exclusively moral, or in other words, operate upon the system through the medium of the brain. These are the depressing passions, fear, grief, and despondency; habits of indolence succeeding to a life of industry; long continued and excessive exertions of the intellectual faculties. It is strange, that the supposed influence of the abdominal viscera in the production of hypocondriasis should ever have been entertained, when we consider that it is not unfrequently met with in its severest forms, without any derangement in the functions of those organs, and that its degree bears no direct ratio to the extent of such derangement when present. While we deny the influence of these disorders in the production of the disease, we are not disposed to dispute the influence, which through its effects they in their turn exert over it; but we think that the importance of the indication drawn from hence, in the cure of the disease, has been much overrated, and that the correction of the gastric, and other disorders, becomes of consequence, rather from being within the influence of our curative measures, than from any other circumstance.

There is another fact of some importance in connection with this view of the subject; it is, that the sympathetic derangements consequent on hypochondriasis are not confined to the abdominal organs. Nothing is more common than to meet in such cases, with palpitations of the heart, chronic coughs, and difficulty of respiration, and it would be difficult to shew any good reason, why these are not equally entitled with the first, to be considered in the relation of causes rather than effects.

The last of the nervous diseases to which M. Georget has extended his researches is spasmodic, or as he calls it coNVULSIVE ASTHMA. He is of opinion, that in this, as in other diseases which we have mentioned, the cause is to be met with only in the nervous system. He thinks that its essential character consists in the convulsive, or to use his own language, the almost tetanic action of the muscles of inspiration. We shall take an opportunity to state our objections to this idea, and to mention some facts which appear to us totally irreconcileable with it.

The researches of M. Rostan who has much distinguished himself by his pathological labours, had given considerable strength to the supposition, that it was uniformly connected

with, and indeed the consequence of lesions of the heart and great vessels. M. Georget had taken some pains to refute this doctrine, and we think with perfect success. M. Laennec indeed in his work, "De l'Auscultation mediate," had expressed his conviction that the phenomena of spasmodic asthma could not be explained by any of the known affections of the heart or lungs; for that on the one hand the most intense peripneumonies, the hepatization or almost total destruction of the lungs, the largest aneurisms, never cause a degree of dyspnoea comparable to that of an attack of asthma; and on the other hand, in this latter disease, when uncomplicated, all our investigations discover nothing in the organs.

It must be allowed that a considerable degree of obscurity hangs over the nature and causes of this disease, which can only be removed by attentive observation, and the united endeavours of many. We perfectly coincide with M. Georget in the opinion he has expressed, of the errors likely to arise from the attempt to explain all the disorders observed during life, by the organic changes discovered after death. We are far from intending to depreciate or underrate the advantages arising from the attentive study of pathological anatomy, but we feel assured that the indications to be drawn from it are inferior in value and correctness to those derived from philosophical experience and correct observation.

It seems to us, that M. Georget has been led into error with regard to the cause of asthma, by a mistaken view of what he considers the essential character of the disease; the convulsive action of the inspiratory muscles. From the term tetanic which he employs in speaking of this symptom, it is evident that he considers the impediment to respiration, which certainly exists somewhere, to be confined to them. But in doing so, he assumes as a fact what we conceive to be very questionable. Were we to trust to our senses, we should say, that as far as the mechanical powers are concerned, respiration is never more perfectly performed than during the attacks of this disease; every effort is made, every muscle that operates on the thorax, directly or indirectly, is put into a state of convulsive action, to attain one object, namely, the enlargement of that cavity; nor are these efforts fruitless; for, as it seems to us, this enlargement is actually effected, and that in an eminent degree. It is true, that the

* For a review of Laennec's work see Quarterly Journal of Foreign Medicine, Vol. II. p. 51. A translation of the work, but somewhat curtailed, has just been published by Dr. Forbes of Penzance; but here, its day, we understand, has gone by,

patient experiences no material relief from the exertion he feels compelled to make; and this admission strengthens the argument, by showing that we must look elsewhere for the causes producing the disease. If we be asked where, after rejecting the explanation of our author, the disease really is seated, we should say with Dr. Parry that it is produced by a state of vascular turgescence of the mucous membrane lining the bronchial cells. It is needless to mention how accurately the commencement of an attack, with symptoms of coryza, and its termination, by mucous or even bloody expectoration, coincide as Dr. Parry has shewn with the explanation which he has given of the mode of its production.

In answer to the objections drawn from the absence of organic changes in some asthmatic patients, we may state, that to authorize any positive conclusions on this point, in a periodical disease, such as asthma, we should be presented with the results of examinations made in those cases in which death has taken place while the patient was suffering from the attack. In such instances, which are not very commonly met with (for asthma is rarely immediately fatal), we do not hesitate to assert that the morbid phenomena met with will always be fully adequate to explain the unfortunate termination. We do not know that medical practitioners in general are aware of the extreme rapidity with which death takes place in some cases of asthma. We have seen individuals, apparently in good health previous to the attack, perish in four or six hours, literally from suffocation, in part produced by the gorged state of the bronchial membrane, and partly by the excessive quantities of sero-mucous secretions from it; as proved by examination after death. In these instances the lungs though filled with blood, crepitate, contrary to what takes place after inflammation, or other organic changes. The operation of mental causes in the production of asthma, by no means militates against the explanation we have given of its phenomena; for the same influence is exerted over the affections of other organs, the idiopathic nature of which no one thinks of disputing. Whatever theory we adopt of the origin of asthma, must be equally adverse to the idea of its dependence on lesions of the heart; though that which we have chosen certainly accounts in the most rational manner for their frequent connection, and the manner in which the one attends upon the other.

In the TREATMENT of this disease, the author, in conformity to his pathology, directs his attention to the head, advising leeches and cold lotions to the temples, together with laxatives and bathing the feet. He likewise advises moxa and blisters to