such whimsical and irrational intentions, such as to increase or to diminish excitement, to affect the irritability, as it chanced to be redundant or defective, just as, before, they were addressed to the archæi and animi, and with equal disregard to the effects which they produced on individual organs. It was Sydenham who first proposed the classifying of dis eases; Sauvages seized the happy idea, and, comparing diseases (which are only modified conditions of a living body) to plants (which are living bodies themselves,) gave birth to nosology! Nothing was talked of but classes, orders, genera, and species, as in botany; his adage was, "symptomata se habent ad morbos, ut folia, et fulcra ad plantas," an adage whose absurdity must now be apparent to every one, but whose influence, strange to say, has not yet entirely passed away. It is surprising that no one could see the folly of comparing pain and heat to a leaf and a branch, and a spasm to a flower!! It is useless to advert any longer to these idle abstractions and vagaries of the brain, or to expose more of the ridiculous conceptions which other authors have, at different times, propounded; for surely medical "ontology" is for ever abolished. It was formerly the great problem among physicians "a disease being given, to find its remedy;" but latterly the problem had been somewhat changed, or rather a new problem was in vogue—“ a disease being given to find its place in a nosological catalogue." How humiliating to think that the minds of men were so diverted from the true path of enquiry, and that they allowed their judgments to be blinded and misled by the ridiculous nothingness of empty, sounding words; but let us not boast, but rather ponder on these errors, for the improvement of ourselves.

Our next theme is, to strive to find out some more rational system of medical philosophy. The eclectic school have put forth their claims; they tell us "there is something good and true in all the preceding doctrines-let us only reject the

bad and retain the good." Such is the method of those who profess not to be "exclusives." But we need not waste time in refuting the reasonings of the eclectics, a name which ought to be reserved for close observers and able experimenters, whose time and talents are engaged in verifying facts which have been long admitted, and in seeking after others which are novel and interesting. How is it possible for an eclectic to arrive at any logical correctness, if, surrounded with so many statements and data, brought forward by one party and refuted by another, and encountering so many opinions and hypotheses utterly conflictant with each other? What could a "neophyte” do amid such a labyrinth of perplexities? Eclectics are not known in the true sciences, where the simplicity and the small number of facts appertaining to any theorem, render its demonstration easy and intelligible. The great error of most preceding writers has been, in seeking after the primary and proximate causes of disease; and, even in the present day, we hear men often regret the misfortune of not being able to attain to the knowledge of the essential nature of diseases; they are unwilling to admit any evidences or elements of certainty and truth in science, but such as are proved by the testimony of the senses, forgetting that there is another kind of evidences obtained, by inductive reasonings, from facts which have been well established; and such evidences are not less real than a shadow, a noise, a reflection, or evidences of a material object existing somewhere; they are admitted into mathematics, chemistry, mechanics, agriculture, and exercise a mighty influence in all discourses upon these sciences.

None can be ignorant of the stupendous results derived, through this means, by Cuvier in fossil geology. It is, indeed, difficult to obtain this sort of evidence in medical researches, but the cause of this is, that the facts, or rather data, are so very numerous and complex; but we must not be discouraged, for it is only by the

medium of such evidence, that we can hope to arrive at a knowledg of the causes of disease-to a correct nosology, and a rational and beneficial system of therapeutics. This class of evidences is weak and deficient at present, but we must labour zealously in enriching its domain, for it constitutes the most important aim of medicine; yet such is the medical philosophy of our days, that rigid induction has been less esteemed than mere description; the former is falsely designated as an hypothesis, theory, a system à priòri, and an empty conjecture. If a treatise is written on any disease, the only aim and end of the author are, after describing its course and progress, and detailing the pathological changes in fatal cases, to establish that the disease could not be at all different from what it really was, or that the symptoms were merely the effects of the morbid states and actions which were going on in different viscera, and no attention is paid to appreciate the operation of the exciting cause, and of the agencies which modify the actual state of disease, and scarce any thing is thought of but the hunting after nostrums and specifics. The habit of expecting a necessary succession of symptoms during a definite period, in most maladies, and especially in those which have been denominated putrid and malignant fevers, typhus gravior, &c. is most pernicious and baneful. We have laboured to expose the dangers of such a method, and we deem it one of the noblest endeavours of a physician to shew, that the greater part of these affections may be arrested at the different epochs of their development, by means of a scientific application of those agents which modify and control the functions of our organs. In conclusion, the philosophy of medicine which we have proposed, consists in a more rigorous observation of the effects of all the external agents on the human frame, and of the influence of the different organs of the body on each other. Archiv. Gen. Oct. 1832.

ing is an analytical review of the essay which Broussais read before the Institute of France. It is customary, that the candidates for the honor of being enrolled members of that most distinguished association should present memoirs, in which they give an abstract of their scientific and professional labours and researches, specify the titles and honours which they have hitherto received, and assert their claims to the object of their ambition. The four candidates were MM. Broussais, Esquirol, Breschet, and Double. The latter read an essay on the " Influence of the Nervous System in the production and Development of Diseases." The commission appointed to enquire into their respective merits, selected MM. Double, Broussais, and Breschet to be presented to the Academy of Sciences; and the votes of 50 academicians were afterwards ascertained to have been awarded as follows; on the first scrutiny, 23 for M. Double-16 for Breschet-10 for Broussais, and one for Esquirol; on the second, 24 for Double23 for Breschet, and 4 for Broussais; and, on the third, 36 for Double, and 24 for Breschet. M. Double was, therefore declared the successful candidate.—ED.

XXII.

DEATH OF M. PORTAL.

THIS distinguished veteran died on the 23d of July last, at the good old age of 91, as rich in honours as in years. He was the Nestor of the French physicians; first physician to Louis XVIII. and Charles X., perpetual president of the Academy of Medicine, member of the Academy of Sciences, and of many other celebrated socie ties. His "History of anatomy and Surgery" has long been esteemed and admired; but his greatest work was the "System of Medical Anatomy." which laid the foundation of, and rendered popular, the pursuit of sound pathology in France.

ded analysis of a very valuable paper on the above subject; we now continue the subject, and shall direct our readers to the fittest method of employing the remedy. In most cases, especially those in which the nervous system is much affected, as in the 3d, 4th, and 5th series, it is of importance that the bath should be in the bed-room, or in an immediately adjoining apartment, as the patient ought to go to bed immediately afterwards; in other cases, as in those of the 1st, 2d, and 6th series, it is better that it be at some distance, as the exercise of going to and coming from the bath is beneficial. The heat of the bath ought to be about 86° or thereabouts; the affusions ought to be made with the water of the bath at first, and As a then gradually with cooler water. general rule, it may be said that the temperature of the bath should be about 86° and the water for effusion from 6° to 10° lower. With regard to the duration of the bathing, this must vary according to the nature of the malady. In the cases of the 3d and 5th series, those, namely, characterized by lethargy and nervous stupor, from five to eight minutes is long enough; but in cases of the 1st, 2d, 4th, and 6th series, viz. those of cerebral fatigue and exhaustion, fatigue of the brain and of the organs of sense, nervous fevers, and neuroses of the sympathetic nerve, 25 to 30 minutes may be mentioned as a proper time, the effusions being employed during the six or eight last minutes. Now the number and frequency of the baths is also a point of importance to determine: when the patient is afflicted with stupor, nervous fever, or lethargy (as in the 3d, 4th, and 5th series,) it is seldom that a single bath in the 24 hours is sufficient; generally two baths at least are necessary; sometimes 3, 4, or even 6 and 8, according to M. Recamier, must be taken in one day, before the patient experiences decided benefit, whereas, in instances of the 2d, and 6th series, one bath daily is amply sufficient. A third interesting question of enquiry is, the proper hour of the day for

the use of the bath. In cases of the 1st and 6th series, the most fit time is shortly before the evening repast, or not long before going to bed; the appetite, in the one case, is often much invigorated, and in the other, sleep may probably be soon induced; it may be proper that the patient should take a light supper after he is in bed.-Révue Médicale, Sept. 1832.

Remark. We have repeatedly witnes sed the most agreeable effects from the employment of bathing, in a somewhat similar form to that recommended by the French physicians, in many cases of cerebral exhaustion, of melancholy, of general debility uncomplicated with organic disease, &c.; we suggest the cotemporaneous effects of effervescing draughts, such as the sedlitz powders, to the more robust, and the citrate of ammonia to the more feeble and nervous. The wonderfully soothing effects of a saline purgative are not very generally known, and may probably be rather despised, by those who have never experienced their effects on themselves, or witnessed them in others. Suffice it to say, that Lord Byron mentions it of himself, that when a fit of the "blue devils" was impending over him, a spoonful or two of Epsom salts always restored his spirits more quickly than the finest wines, and we know a writer, of distin guished talent, who confirms the truth of the remark by his own practice.-ED.

XXIV.

CASE OF ANEURISM OF THE LEFT GLUTEAL ARTERY.

MAD. S. aged 66, fell on her left buttock in the month of December, 1821. She was considerably hurt, and a small, hard, and painful tumour very suddenly shewed itself, about the centre of the injured part. In February, 1825, she again fell on the same buttock, and was much bruised; at that time, the swelling was of the size of a hen's egg; when examined, it was found to beat synchronously with the heart. Her medical attendant was not aware of the nature of her malady. The

pains which shot from the hip to the foot were now so severe, as to rob her of sleep, and so much had the swelling increased in a few months, that in the following November it measured 21 inches in circumference; the pulsations could be felt over all its surface. The state of the patient forbad any operation. She died in the February of the following year.

Autopsy. The left common iliac artery presented here and there spots of ossification; the enormous aneurismal sac when opened measured upwards of 20 inches round, and contained a large quantity of broken down blood; the substance of the gluteal muscles had been almost quite absorbed; the gluteal artery was large enough to admit the forefinger; and its parietes appeared healthy to within an inch of the sac.-Ibid.

XXV.

ULCERATION OF THE STOMACH. DR. GRAVES visited an unmarried lady, aged 25 years, who had suffered much from pain in the stomach, nausea, vomiting, acidity, and indigestion. These symptoms first appeared after a severe shock and fright. She had sometimes intervals of five or six weeks at a time, free from complaint, but these intervals had lately become much shorter. She was pale and emaciated. She was free from pain for some months after Dr. Graves commenced attendance, then pain came on, attended often with a discharge of coloured fluid from the stomach, sometimes resembling coffee-grounds. This state continued for some months, when the pain and tenderness disappeared, though vomiting remained, after every kind of food. She was at length worn out. On dissection, an ulcer was found in the neighbourhood of the pylorus, but completely cicatrized. It had penetrated the mucous and muscular coats, but had been arrested by the peritoneal covering, there was no maturation or scirrhus in the neighbourhood. The site of the cicatrix was distended into a kind of pouch, which received a portion of the

contents of the stomach, and thus formed a kind of valve which prevented the egress of chyme through the pyloric orifice, nutriment was thus cut off from the system, and death was the result. Dublin Journal, No. V.

P. S. Our esteemed Contemporary of the Sister Isle, has honoured us by the extraction of several articles, for which we feel obliged. But we trust that it is no unreasonable request that the source may be correctly given. "Johnston's Journal" is not a very clear designation for the "Medico-Chirurgical Review, edited by Dr. Johnson." The term is merely from carelessness, we know, and we are sure the hint will not give offence. We borrow freely from the excellent Dublin Journal, and shall always feel gratified when any of our articles are deemed worthy of transplantation into such a fertile soil.-Ed.

XXVI.

ON THE SECRET CAUSES OF EPIDEMIC DISEASES. By Professor BARON ALI

BERT.

In a preceding article, the learned author had laboured to show that the causes of Epidemics were altogether unconnected with mere localities; they are in no manner dependent upon the nature of the climate and may be developed in temperate, as well as in extremely cold and hot regions. It is a mistake to regard the Torrid Zone as the only cradle of pestilential diseases; we do not indeed deny that the germs of some diseases may exist in the country where these prevail, and that such diseases are very properly designated "endemic;" thus for example of cold and damp districts, intersected with woods and marshes, scurvy and all its offspring of evils, appear to be the natural denizens; while those which are dry, exposed and well watered, are usually much invaded with inflammatory disorders. We may go still farther, and assert that some diseases appear to be so affixed to certain countries, that they are seldom or ever found in others, unless transported by patients

themselves; and then, they usually degenerate and are considerably modified from their original type. But the essential characters of an epidemic miasm, viz. the suddenness, and extent, and sweeping fatality of its ravages, are sufficient to distinguish a pestilence from a disease of mere climate, or in other words from an endemic. Hippocrates, in his Treatise on Air, Waters, and Localities, acknowledges that such can never generate a pestilential disease; they may however modify its character, and impart a colouring to its features. What strongly argues the distinctive nature of an epidemic, is that it is not limited to any one, or two countries or districts, but sweeps over a great extent of the earth. We witness them to prevail alike in Russia and in Poland, among the Turks and the West Indians. It is a very prevailing notion that all the great epidemics have sprung up in warm climates, and have been diffused from south to north; but this is not quite correct; for example, the yellow fever is known to arise in the cold latitudes of Massachusetts and New Hampshire, and in the temperate regions of Georgia and the Carolinas, as well as in the burning Antilles; and it not unfrequently ravages the most northern towns of the United States, while the inhabitants of the more Southern, and of the American Archipelago are quite free from it; so often is this the case, that the merchants between the tropics accuse the people of New York and Boston of having imported the disease. The great pestilence of 1798, which ravaged the United States, commenced at Boston, situated in 45° N. and that which swept over so large a portion of Europe towards the close of the sixteenth century, shewed itself first in the Gulf of Finland, then passed over Livonia and other northern countries, to England, afterwards to Italy and the South of France, even to the Island of Crete. The dreadful plague of 1719 began at Aleppo, and is supposed to have furnished the germ of that one which depopulated Marseilles on the following

year; and again, a previous plague of the early year of the 17th century, appears to have broken out at nearly the same time in the northern and southern nations, as Russia, Livonia, England, France and Turkey. It appears therefore from the preceding date, that epidemic disorders are confined to no particular climates or latitudes; this is one feature of their character; another is, that the human system appears to become somewhat accustomed to their pernicious influences by a long residence in the countries visited chiefly by them, so that it is less susceptible of suffering from their attack; as a proof of this, we may state that the Creoles do not fall victims to the yellow fever in the same proportion as the other inhabitants of the West Indies, thus two-thirds of the fine French army sent in 1803 to St. Domingo, were sacrificed by this plague, at a time when the Creoles, Planters and Negroes, were enjoying complete exemption. The variety of a second attack of pestilential disorders is a subject worthy of attention. Dr. Russel states that out of 4,400 patients who had the plague, only twenty-eight were attacked by it a second time, a statement which shews that the animal system can in course of time adapt itself to the most deleterious atmosphere.-Révue Med. Sept. 1832.

(To be continued.)

XXVII.