explain the rapidity of the secretion of urine, by the rapidity of the circulation of the blood, which usually performs its course in three minutes, and by the numerous villi of the intestines, in each of which are placed the mouths of several absorbents, amounting, perhaps, to three or four millions. The experiments of Rasori on a kid, to which he gave rhubarb, which in half an hour was found in the urine, and also in the lacteals, led him to the opinion that it was by these, that fluids reach the bladder. Tiedemann and Gmelin, however, seem to have, in some measure, set the question at rest, by finding the indigo which they had given to a horse, in the urine, the urinary absorbents, and the infundibula of the kidneys; and though the stomach and intestines also contained the indigo, none of it was found in the chyle of the lacteals, and they conclude that it must have passed immediately into the veins of the stomach and spleen.

M. M. PARENT-DUCHATELET AND L. MARTINET ON THE THEORY AND TREATMENT OF ARACHNITIS.*

The authors of this work claim the high merit of having made important distinctions, which have hitherto been either overlooked or disregarded. They claim the merit of distinguishing inflammation of the arachnoid membrane of the brain and spinal marrow, from inflammation of the substance of the brain itself; and that they can, by the train of symptoms, form a diagnosis, when either of these two classes of affections exist, and can accordingly adapt their treatment to each. Now, though we object, in limine, to their evidently too hasty generalization, and to the sometimes imperceptible niceness of their distinctions; yet are we willing to bestow the highest commendation on their cases of morbid affections, and their description of the coincidence observed between certain symptoms and certain appearances, which were observed in post mortem exami

nations.

Of inflammation of the arachnoid membrane we were possessed of but few details previous to the present work. Morgagni says

* Recherches sur l'Inflammation de l'Arachnoide, Cerebrale, et Spinale, ou Histoire Theorique et Pratique de l'Arachnitis, Par P. Duchatelet, M. D. &c. et L. Martinet, M. D. &c. &vo, Paris, 1821.

nothing of it, and Baillie in his Morbid Anatomy says, that almost the only diseased affection of the membrane is, a certain thickening of its substance,-blood-vessels ramifying through it being few and rare. We have, besides, the high authority of J. P. Frank for rejecting the minute distinctions between inflammation of the different membranes, and substances connected with the brain; and for the best possible reason-that the symptoms are common and the treatment the same.* The Italian pathologists expressly deny that the arachnoid membrane can be inflamed at all, and refuse to admit the authority of Pinel (Nosogr. Philosoph. II. 403), who is the first writer, we believe, that mentions the subject, and think that he mistook for inflammation the turgidity of the vessels consequent upon inflammation of the meninges, or of the substance of the brain, a phenomenon well described by Mascagni. (Prodrom. di Anat. fas. III. Oper. postum.) Even Pinel himself allows, that though the brain and its membranes, (among which he expressly includes the arachnoid), may be separately inflamed, yet it is next to impossible to discover by the symptoms when it is the one and when the other. But even granting that the symptoms may sometimes lead to an accurate distinction, we cannot perceive its utility in a practical point of view; as the practice must be the same in both cases. (Barzellotti, Medicina Practica Razionale, I. 117.)

We must do our authors the justice of having been very persevering in their researches. They were aware of the objection arising from Mascagni's descriptions, and expressly assert that inflammation of the arachnoid is easily distinguished from congestion in the vessels of the pia mater, by raising it with the scalpel, as it will, in the latter case, appear transparent, but when inflamed, it will appear opaque, reddish, and often thickened. When there does appear the blush of inflammation, it is generally in patches, being rarely found to extend over the whole brain; and it is from this confined locality of it, that it has so often been overlooked in dissections. When, therefore, the inflammation goes on to produce thickening and opacity in the membrane, this is also in detached portions, or in spots and lines. Sometimes the acute symptoms terminate in suppuration, but oftener in serous effusion or in adhesions. In other cases is found a false, or what Beclard would call an accidental mem

“Inflammatorum interim," says Frank, "vel cerebri, cerebelli, vel integaontoram ilsdem communium symptomata, ob hanc sedis differentiam nullo inter ác, quod constans, firmumque esset, signo distinguenda, in sequentibus fere observantur." J. P. FRANK, De Curandis Hominum Morbis, II. 51,

brane, covering the whole or the greater part of the arachnoid, particularly on the upper part of the cerebrum and cerebellam.

The SYMPTOMS are divided, with all appearance of precision, into three stages. Of these, the first is characterised by increased sensibility, producing intense head-ache and fever, accompanied, but not uniformly, with drowsiness, with nausea and vomiting, and sometimes with coma. The second stage succeeds for the most part very rapidly, though sometimes it may be retarded for several days. It is marked by less sensibility, but by all the symptoms of nervous derangement, such as restless jactitation, delirium, convulsions, and various affections of the eyes; coma and head-ache being less constant, though never wholly absent. The third stage comes on generally in a few days, though in some cases it may be more than a week. It is known by decided coma, loss of sense and of the power of motion. The authors confess, that in this stage they are completely baffled in discriminating arachnitis from other cerebral inflammations; yet they imagine it easy enough to tell by the eyes, and the facial muscles, what part of the arachnoid membrane is inflamed! This, we think, is carrying distinctions as far as the minutest nosologist could desire. We should be glad to find them equally precise in their means of cure, since they are so anxious to establish the various diagnoses of the affection; but this is unfortunately beyond their genius.

Their TREATMENT presents nothing peculiar, if we except its timidity, in a disease which requires such bold and decided measures. We have the usual routine of antiphlogistic remedies and regimen, such as blood-letting by venæsection and leeches; -sinapisms to the soles of the feet, and a hot bath for the feet, composed of water with mustard and salt;-pomatum of ammonia applied to the scalp,-blisters,-cathartics,-ice or cold water, applied to the head, or affused over the head and body, of which remedy they speak highly,-compression of the carotid, as recommended by Blaud, and, in fine, keeping the head elevated. They reprobate the attempt to operate with the trephine, and they are right when the disease is not caused by contusion or fracture, but otherwise, we think their reprobation is contrary to sound practice.

Nothing could be a stronger proof of the spirit of making distinctions being predominant in the minds of our authors, than their attempt to establish a diagnosis in what they call spinal arachnitis, though they ingenuously confess, that they never met with a case uncomplicated with cerebral arachnitis. But that their suppositions have at least been fortunate, they have reason to congratulate themselves, for some of their

friends who have met with genuine cases without complication, assure them of the correctness of their diagnosis. The leading characteristic of it is spasm of the posterior muscles of the body, and intense pain in the course of the spine, or its vicinity, with a spasmodic or a voluntary bending of the spine backwards. The treatment is precisely the same as that already detailed; and it ought to be remarked, that the French physicians are not so forward to follow active practice as they are to recommend it. There is a wide difference between the boldness of their words and the timidity of their deeds, several very striking examples of which are detailed in this singular work.

Upon the whole, we should advise our readers to refer to their details; though these, particularly in the morbid anatomy, are much more meagre and vague than could have been anticipated, when their doctrine is so essentially founded on them. Besides, the vagueness of their descriptions of the inflammatory appearances in the arachnoid membrane, give rise in the reader's mind to a suspicion of the authors' accuracy, which greatly detracts from the confidence he can place in their acuteness and observation. If their claims to originality, indeed, had been more humble, they would, we are confident, have been more successful.

BARON LARREY ON YELLOW FEVER.*

WERE we not aware that the profession have been quite satiated of late with discussions upon epidemics and yellow fever, we should have been tempted to discuss the subject at length with Baron Larrey; for though his brochure is in small compass, some of his opinions are sufficiently singular, and from a man of his celebrity, ought not to be quietly allowed to become a portion of the medical creed of his country without undergoing some scrutiny. We do not intend to enter into the dispute about contagion, which we still think is by no means understood or settled, notwithstanding the number of works and papers to which it has given rise. We venture, without fear,

* Considerations sur la Fièvre Jaune. Par Le Baron Larrey, D. M. C. &c. Seconde edition. Paris, 1822.

to give this as our opinion, at the hazard of being arraigned by the several parties for want of industry in reading their arguments, or for want of acuteness or of candour in deciding upon their force. To defend ourselves from such charges, we beg merely to state the names of those who have espoused the different sides of this question, on each of which, will be found ranked, many of high respectability. We are chiefly indebted for our catalogue to a very learned paper on the subject, by our friend Dr. Copland, in the Repository for January last.

Among those who consider yellow fever to be an imported and contagious disease, are ranked :-Arejula, Batt, Berthe, Dalmas, Sir J. Fellowes, Moreau de Jonnés, B. Progetto, Salgado, &c., who founded their opinions on the yellow fever of Spain ;

Bally, Sir Gilbert Blane, Caizerques, Chisholm, W. Currie, Des Portes, D'Oyarvide, Lind, Ried, &c., who derived their facts from the West Indies and America.

Among those who deny that yellow fever is contagious, and assert its origin to be entirely local, or dependent upon some mysterious and inappreciable change in the atmosphere, are ranked :-Amiel, Burnett, Cassan, Doughty, Keutsch, Lacoste, Langermann, O'Hallaran, &c., who drew their observations chiefly from the fever of Spain ;

Bancroft, Barker, Browne, Comstock, Clarke, Coventry, Davidge, Denmark, Devéze, Dickson, Ferguson, Gilbert, Hillary, J. Hunter, R. Jackson, Jefferson, M'Arthur, M'Lean, E. Millar, Moore, Mosely, Musgrave, Muttlebury, Ramsay, A. Robertson, B. Rush, Savarési, Selden, Sheppard, Trotter, Valentin, Vanel, Veitch, Whitehead, &c., in the West Indies and America ;-and in Africa, Drs. Copland and Winterbottom. Among those who hold a middle course, allowing the local origin of the fever, but asserting that it may become contagious, we find :-Eymann, Hosack, Humbolt, J. Johnson, Le Blond, Nicol, Palloni, Pugnet, Romans, &c.

After this proof of the diversity of opinion on the subject, we think we are strongly justified in suspending our opinion, as to the merits of the several arguments, till something be discovered more decisive than has yet appeared.

The departure of M. Pariset, with the other physicians deputed by the French Government to visit the South of Spain, for the purpose of investigating the nature of the disease which committed such ravages there during the past year, has been the cause of the publication of this memoir. It had already made its appearance in the 38th No. of the Journal Complementaire du Dictionnaire des Sciences Médicales, August,