extreme hunger; drinking stagnated water into which withered leaves have fallen; taking a full meal without appetite; neglected constipation.

Dr. Ainslie defends the character of the Hindoo medical men from the illiberal attack of Mons. Sonnerat in his "Voyage to the East Indies." In proof that they are not chargeable with the ignorance which Mons. S. imputes to them, he refers to their various writings, to the Tamool Materia Medica, and also to the testimony of Sir Wm. Jones, who has highly eulogized them, stating that they are generally poets, grammarians, rhetoricians, and moralists, and may be esteemed the most virtuous and amiable of the Hindoos.

We are sorry to observe, that surgery is in a most debased and neglected state amongst the native practitioners, indeed its operations are never performed either by the Tamool or Telingoo doctors, but are left to an inferior class of men. The Mahometan doctors bleed occasionally; they likewise couch for cataract, but in a very clumsy manner.

The articles employed for medical purposes by the Tamools are extremely numerous, perhaps ten times more so than those of any European materia medica; amongst so great a number, of course, there must be many which are trivial or totally inert.

In a paper in the appendix, are contained some details respecting the croton tiglium: these we shall not extract, as we have already given a pretty full account of it in the present volume (pp. 288. &c.).

This work must be highly valuable to those young men who intend practising in India: we regret its scarcity here; but have no doubt but that so useful a book can be easily procured by them on their arrival in Hindoostan.

DR. CHEYNE ON THE DYSENTERY OF IRELAND *.

THIS Tract is by one of our most enlightened physicians, and manifests all that clearness and precision so estimable in scientific authorship. DYSENTERY is a much more frequent disease in the sister island than it usually is in any other part of the kingdom, and it also varies there from the usual descrip

Medical Report of the Whitworth Hospital House of Industry, containing an account of Dysentery as it appeared in the latter end of 1818. By J. Cheyne, M.D. F.R.S. Ed. &c. Dublin Hospital Reports, vol. III. Svo. Dublin, 1822.

tions which have been drawn up from the symptoms attending the disease in other quarters; so much so, that the great Sydenham terms it the endemic dysentery of Ireland. Dr. Cheyne shows from numerous authorities, that this has been the case for several centuries, and justly concludes that there must be some permanent cause for an effect so invariably recurring. It seems also that it becomes unusually prevalent soon after the prevalence of epidemic fever, probably depending on the same or similar causes. Mr. Pack, surgeon to the Fever Hospital in Kilkenny, states, that the number of patients, convalescent from fever, who were attacked with dysentery, was often such as to oblige the medical officers to appropriate an entire ward of the Fever Hospital for the reception of dysenteries. Mr. Dillon, of the Clonmel Dispensary, reports, that in 1818, dysentery frequently appeared as one of the sequelae of fever; and also prevailed in those who had not been affected with fever, the mortality being as one to ten. Since that period both Clonmel and Kilkenny have been, comparatively, free from the disease. In Limerick, Dr. Geary remarked, that among the poor, dysentery was more frequently an attendant on the epidemic fever than among the rich. When it supervened during convalescence from fever, it was most severe, being attended with rigors, and sudden and fixed pain in the bowels, which yielded to bleeding and purgatives. It continued to prevail from September till March, which differs very much from its prevalence in Waterford, which was from July to September; the opinion being, that the cold weather put an end to it. At Cork, we learn from Drs. Pitcairn, Hallaran, and Milner Barry, that it was most prevalent in Autumn and Winter, and that during the last thirty years it has been more frequent in years of scarcity, and when the common articles of food have proved of bad quality. Dysentery frequently occurs as an endemic in Cork, accompanied with a fever peculiar to itself, which has invariably subsided on relief being afforded to the dysenteric symptoms. The writer of this analysis experienced this variety of the complaint in a very severe form when at Cork, about three years ago, and though he gave himself up without the slightest hope of recovery, Dr. M. Barry, brought him round in a few days by simple but active treatment. Dr. M. Barry proved it to be non-contagious, by using, for the dysentric in the hospital, the same glyster pipe which had been employed for the other patients, and none of the latter were ever infected. Dr. Cheyne, however, thinks, and very justly, that dysentery at Cork, as well as in other places, is non-contagious when attended with intermittent; and contagious when attended with continued fever.

It is a fact worthy of notice, that all strangers going to Cork, are at first affected with diarrhoea, which often leads to dysentric symptoms more or less violent, the cause of which may be traced to the low damp situation of the city, or to the water. The river Lee, indeed, whence the inhabitants are chiefly supplied with water, runs over a bed of limestone, but its tributary streams all come from bogs and stagnant lakes, such as that at Blarney Castle. That the water is implicated, is proved by the fact, that dysentery was speedily stopped by the late Mr. Bell, of Cork, who had water for the troops brought from a spring called the Lady's well, while they were prohibited from drinking the water of the river.

Dr. Cheyne himself, studied and analyzed ninety-eight cases of dysentery, which were carefully noted: he found, that thirty-three of them arose during recovery from fever; fifteen, while the fever was in progress; fifteen arose from cold, or cold and wet; four, from indigestion, and the rest were doubtful; but it is observable, that of these many had been exposed to febrile contagion, and that nine of the number had been in close communication with patients labouring under dysentery.

With respect to the discharges from the bowels, the only remark which Dr. Cheyne has to make worthy of attention is, that, notwithstanding very diligent inquiry, it could not be discovered that scybala were passed by any one of the patients, and none were found on dissection. All the other appearances of the stools characteristic of dysentery, were repeatedly witnessed; the stools varied in being of a natural colour, of a drab colour, or of the colour and consistence of flummery; feculent matter mixed with mucus or with clear blood; or blood without any addition; mucus alone, mucus tinged with blood, or mixed with blood, or with purulent matter; purulent matter alone or mixed; a bright green discharge, (produced by calomel and opium,) like the Crow-silk of streams; a loose natural discharge, alternating with bloody, mucous, or purulent stools, when the disease was near a fatal close, and in a few instances shreds of membrane which had sloughed, or portions of coagulable lymph, were observed.

Dysentery was productive of several forms of dropsy,—ascites, and anasarca in particular; and it is worthy of remark, that a swelling occurred in several of the patients, both males and females, resembling the phlegmasia dolens in all respects, but in its connection with parturition. In one or two cases, symptoms of hydrothorax were observed.

On DISSECTION, which occurred only after the disease had run

its course, the mucous membrane of the stomach and small intestines, sometimes presented an inflamed appearance, which in general became more remarkable as we approached to the great intestines; then ulceration began to shew itself, at first superficial, afterwards laying bare the muscular fibres of the intestines; the ulcerations became larger, more numerous and deep as the rectum was approached; but it was remarked, that the last three or four inches of the rectum were sometimes pretty sound. In some instances, the colon was found contracted; in others, it was distended, and always more or less ulcerated. The peritoneum was found less diseased than might have been expected.

In many respects, the dysentery of 1818, was like that of tropical climates, the functions of the liver and skin being disordered from the commencement. In point of severity, there was great difference among the cases; sometimes, the complaint appeared in the form of mucous diarrhoea without much pain or fever; and sometimes, it was attended with all the symptoms of an acute enteric inflammation. The most severe cases in the first, and the most unmanageable throughout, arose in the course of fever: the mildest cases were those which seemed to have the least connection with it. The symptoms, on which chiefly we formed our PROGNOSTIC in the early part of the disease, were the tenderness of the abdomen, the degree of pain, the frequency of the stools, the extent of febrile affection, and particularly the quickness of the pulse. The state of intestinal ulceration, could with difficulty be ascertained in the early stages, though it was more easily known from the stools in the later stages. When emaciation came on, and no relief within twelve or fourteen days, or where a hagard look, with quick pulse and the abdomen impatient of pressure, appeared in the third week, the case was considered hopeless.

Dr. Preston, of Limerick, says, that the diseased appearances which he observed, were very much alike in all. The chief seat of the disease was in the colon, the coats of which were found greatly thickened, with strong marks of inflammationportions of the gut, in some cases, approached a schirrous state; the passage in this part being much narrowed. Part of the ascending colon generally adhered to the peritoneum, and where the disease had made greatest progress-it felt thickened, and was dark coloured. The rectum was also in general thickened, and its inner coat much destroyed by ulceration. The small intestines were more or less occupied with red vessels, and some parts exhibited a dark livid appearance. In one instance, the omentum was firmly attached to the peritoneum, nearly in its whole

extent, and in some parts, pus had formed between the two membranes. The mesenteric glands in some were greatly enlarged, and converted into a firm cheesy-looking substance. The stomach was always found about half full of dark green fluid, and fully distended with flatus, the coats seemed healthy; the liver was invariably much diseased, in general considerably enlarged, and its whole structure apparently destroyed. two cases, the surface was studded with large yellowish white spots, which on cutting into them were found to contain pas, and yellow purulent matter was lodged in distinct cells throughout its whole extent. The concave surface commonly presented a livid aspect, and was indurated. The gall bladder was usually nearly empty.

A harsh, dry, opaque, dirty looking skin; a florid, clean, varnished tongue; vigilance; a hollow eye; and a pallid, wasted, faded cheek; tenesmus after drinking; pains in the knees, and cramps in the legs; fits of dyspnea; a tendency to cedema and ascites belong to an advanced stage, but not the last, which was characterised by extreme emaciation, supine posture, involuntary stools, a thin reddish secretion flowing without check, sordes on the teeth; hiccup, tendency to delirium, difficulty of swallowing, and a pulse like a thread.

In detailing the TREATMENT, Dr. Cheyne makes some judi cious remarks on regimen. Little benefit can be expected from mere prescription, unless an hospital be suited to the diseases which it contains; unless proper regard be paid to comfort in the supply of the patient's food, to the cleanliness of his person, to the spaciousness of his ward, to the purity of the air which he breathes, and above all to his feelings. When these things are neglected, the consequence is not merely that recovery is retarded, but that new complications of diseases arise. these principles the sashes of the windows in the wards of the hospital were closed, while at the same time ventilation was secured by additional apertures, which were made into the chimneys near the ceiling. A cotton bed-gową and a pair of thick worsted stockings were supplied to all the patients, who were also swathed with compresses and flan nel rollers. With respect to diet, farinaceous food seemed entitled to a preference, all kinds of nutriment which had either a tendency to quicken the pulse, or to leave much focal residuum being prohibited.

It is well remarked by our author, that nothing can be more erroneous than to suppose any one disease to admit of only one mode of treatment, and he only claims for his own method a preference to all that he had seen tried in the same circumstances.