is insusceptible of analysis, and we can only introduce to our readers a few specimens of the style and matter of which it is composed, in order that they may form some judgment of its execution. Speaking of Prejudices, Dr. Dunglis on remarks that :

"A prejudice is still found, however, against the use of iced water in fever where calomel is given. The feeling exists strongly in many parts of the Southern and Middle States, but it is rapidly yielding, and ought to be altogether abolished. Some cases have occurred in which individuals have caught cold, or have had disagreeable symptoms supervening, after cold water has followed calomel; but they have been cases of the post hoc, rather than of the propter hoc. The author has been for years in the habit of allowing the use of iced water after calomel in fevers, and has never had the slightest evidence of any disagreeable results from it." 58.

We have never hesitated to apply ice to the head, when the brain is affected, whatever calomel may be introduced into the stomach; and we have rarely found that cold drink produced griping or other inconvenience, during the use of mercury in fevers.

The doctrine of Homœopathy does not appear to captivate the senses of our author, no more than Mesmerism.

"One of the strangest of the assertions of Hahnemann and his followers isthat homeopathic medicines acquire at each division or dilution a new degree of power, by the rubbing or shaking to which they are subjected, 'a means,' says Hahnemann, of developing the inherent virtues of homeopathic medicines that was unknown till my time; and which is so energetic, that latterly I have been forced, by experience, to reduce the number of shakes to two, of which I formerly prescribed ten to each dilution." 82.

What tremendous powers might thus be called forth by agitation! Daniel O'Connel has evidently caught the idea from Hahnemann, and has determined to shake the Repeal question till it overpowers and lays the Saxon in the dust!

Speaking of the therapeutical agency of Nauseants, Dr. D. remarks:

"In constipation, a union of nauseants with cathartics becomes occasionally advisable, and at times effectual, after cathartics alone have been unsuccessfully employed. If the constipation be dependent upon any irritated condition of the exhalents of the canal, the use of debilitants, such as those now under consideration, reduces the erethism, and facilitates the operation of the purgative. Whenever, too, it is desirous to break in upon a morbid chain, and especially in the neuroses, nauseants may be beneficially administered: but, in these cases, the revulsion, induced by a nauseating emetic, is generally preferred, in consequence of the more powerful impression which it makes on the nervous system." 92.

Small proportions of tartrate of antimony, combined with colocynth and the pil hydrarg., we have been long in the habit of using in the obstinate constipation of bowels that too often accompanies dyspepsia and torpidity of liver.

Enemata.

That Dr. Dunglison and nine-tenths of the profession labour under erroneous notions as to the physiological, medicinal, and mechanical effects of enemata, we have had ample opportunities of knowing.

"When thrown in contact with the lining membrane of the rectum they irritate it; and. by sympathy of continuity, their influence is extended to the upper portion of the tube. Hence, they may be administered with advantage, when cathartics cannot be easily given by the mouth, as where deglutition is impracticable." 139

Now we know, from twenty-five years of personal, as well as general experience in regard to enemata, that it is not merely by sympathy, but by general distention of the colon-sigmoid flexure and transverse arch-that the effects of enemata are produced. Of what use would be a few ounces of fluid, to distend the rectum? None at all. Besides, the rectum is not really distended till nearly the close of the operation. The fluid ascends into the transverse arch of the colon much more easily than it distends the strong muscular tube of the rectum. Any one who is accustomed to use the syringe, will feel the fluid, after two or three strokes of the piston, run along the transverse arch, and when that portion of the bowel is filled or excited into contraction, the rectum is distended, and the enema can no longer be retained. The best mode of using a lavement is to put two or three pints of warm water into a basin-wash the hands with Windsor or other soap and then pump the soap-suds gently and slowly up the gut, till re-action takes place, and the enema and fæces are discharged. It is all very well for the French lady, or the English invalid, to throw up a pint or so of warm water, and then lie down for an hour or two to knead the bowels and push the fluid about in the colon. But the lawyer, the merchant, the doctor, or the man of business, cannot go through this tedious process, and must use the summary one which we have describedand which, after all, is the "cito, tute, ac jucundo" operation.

We can only spare space for one more quotation, and that is from the second volume, under the head of "BLOOD-LETTING," upon which important therapeutical agent Dr. Dunglison has made many judicious and important remarks.

"It may be laid down, perhaps, as a general law, that when blood is lost to a considerable amount, the great nervous centres receiving an inadequate-and the rest of the nervous system an irregular-supply, their excitability becomes largely and irregularly developed, so that, under this impressible condition of the nerves, the blood-vessels, whose functions are carried on under their presidency, assume augmented action; and if, owing to the previous existence of hyperæmia in any organ, the nerves, proceeding to that organ, are in a morbidly excitable condition, a fresh development of excitability may ensue after the bleeding, and the hyperæmic condition, instead of being relieved by the loss of blood, may be augmented by it. In individuals, whose nervous system is very impressible, the same effects may be induced by a full bleeding, as have been described to result from excessive discharges from the uterus, and, accordingly, where hyperæmic conditions occur in such individuals, the practitioner is cautious in the use of the lancet, and if he employs it, he does not carry the depletion so far as to depress too much the powers of the system,-aware, that if he should do so under the nervous irritability or neuropathia, which he develops, re-action might succeed to such an extent as to reproduce the exaltation of organic actions in the part, and perhaps to a greater degree than before the operation. It is in such impressible habits that advantage is found in the adoption of other sedative agents; and that a combination of blood-letting, short of inducing syncope, with a full sedative dose of opium, is often so serviceable;-the bleeding diminishing the exaltation of the vital manifestations, by acting on the nerves through the blood

vessels; and the opium preventing the subsequent development of nervous excitability. In strong individuals, the same plan, pushed to a still greater extent, is equally successful and not the less philosophical, when employed for the removal of internal inflammations. It is the plan which, as before observed, is adopted with so much success, in acute peritonitis;-the bleeding being carried so far as to make a decided impression on the system, and the opium administered in a full dose; a sedative influence is thus exerted on the body generally, and on the inflamed tissue in particular, under which the hyperemia is effectually subdued." 151.

Our junior brethren in America will find in these volumes of Dr. Dunglison, a "THESAURUS MEDICAMINUM," more valuable than a large purse of gold.

LECTURES ON OSTEOLOGY, INCLUDING THE LIGAMENTS WHICH CONNECT THE BONES OF THE HUMAN SKELETON. By B. B. Cooper, F.R.S. Highley, London, 1844. 8vo. pp. 270.

THIS work, a second and improved edition of Mr. Bransby Cooper's first volume of "Lectures on Anatomy," furnishes a very good description of the various bones and joints of the human skeleton; the different accidents to which each part is liable, and the most appropriate means of relief, being concisely stated in smaller type at the foot of each article. Practitioners of medicine forming the great bulk of our readers, the noticing a production intended as a class-book for students may seem somewhat out of place: but we do so for two reasons. In the first place, a young man naturally consults his seniors in the profession as to what books he had better purchase; and, seeing the tempting variety offered to his notice, and the limited means frequently at his disposal, we think he only acts prudently in so doing. But, secondly, and chiefly, because we think this is one of a class of books a practitioner should consider himself responsible for all pupils committed to his care, being familiar with the contents of prior to the expiration of their pupilage, and the formal commencement of their studies at the schools. This is a very important matter, but we believe the discussion of it comes almost too late. The days of the apprenticeship system are numbered. But why? Not so much from any inherent rottenness in the thing itself, as from the neglect of those who have had the working of it out, in not having allowed it to participate in the spirit of modern improvement. Formerly, when the apothecary was the mere humble attendant upon the physician, and when the careful preparation of the complex forms of prescription then in vogue, constituted the great object of his existence, an apprenticeship passed in culling simples, and in pestle and mortar slavery, seemed not very unreasonable, especially as the act of dispensing was necessarily a more tedious and difficult matter than at present. But, after the apothecary had succeeded in elevating his position in the profession to that rank which the general practitioner now occupies, it became a gross and palpable inconsistency on

his part still to limit the instruction of his pupils to mere pharmaceutical matters, and to neglect preparing them for that wider sphere of activity and usefulness which had been opened out to them. It is a subject of daily complaint that the curricula of the examining bodies compress so large a quantity and great a variety of requirements within so short a space of time. They, however, have no option if they wish to maintain the present high standard of professional education, and yet not preclude young men of comparatively limited means from endeavouring to attain it. The only mode of diminishing the inconvenience is for students to commence their attendance upon the various lectures in a better state of preparation than they do at present, and which it is impossible for them to do, as long as the mere compounding of medicines forms the chief employment of their apprenticeship. Under any arrangement much must remain to be done in London, for which the time allotted is barely sufficient; but when this time is trenched upon by commencing learning that which ought already to have been acquired, the case often becomes desperate, the bewildered student, harassed and frightened by the multitude of objects which are demanding his attention, throws himself into the arms of the grinder as his deliverer, and spends hour after hour in repulsive, mechanical, parrot-like labour, disgusting himself with studies, which, judiciously conducted, possess unequalled attractions, and losing the opportunities which his residence in a large capital can alone afford him, of observing examples of disease under every possible variety of circumstance.

During his apprenticeship the pupil should have the facilities offered him of obtaining a general idea of the structure and functions of the frame, and a complete knowledge of the bony portions of it. Of Chemistry, Materia Medica, Natural Philosophy, and Botany, by the aid of some of the excellent works now published, he might also acquire all the outlines. Thus informed, he arrives at the schools fit and ready to make the most of his opportunities; and when there, Practical Anatomy and Chemistry, and the minute and constant Observation of the Sick, become to him improving and interesting occupations, and should indeed chiefly absorb his attention. Many practitioners, we are aware, afford these facilities to their pupils; but that the great bulk do not, the very ignorant condition which many young men arrive in, and the consequent loss of time they incur, is a sufficient proof. Did all do so, there could be no solid objection to apprenticeships; for no one wishes young men to be empowered to enter the profession at an earlier age than they do at present; and where could they so well pass the three or four years intervening between their leaving school and commencing attendance in the large towns, as under the careful inspection of one already versed in the knowledge they seek to attain, and willing to afford them assistance and instruction?

To revert to Mr. Cooper's book: we have only to state that the decriptions of the various bones and joints are very complete; while the surgical observations appended are sufficiently so to point out to the student the practical bearings of the subject-thus at once showing to him the importance of the study he is engaged in, and relieving, in some degrce, the tedium of its pursuit. One or two of these we may extract.

"Treatment of Fractures.-Immediately after fracture of any bone, when there is a tendency to great tumefaction, it is wrong to apply either splints or

bandage, for any restriction of swelling is liable to produce gangrene: under these circumstances, the limb should be placed on a pillow in a semi-flexed position, so that the muscles may be perfectly relaxed, and the bones placed as nearly as possible in their natural position; which circumstances may be ascertained, whatever may be the swelling, by the immediate comparative ease of the patient. An evaporating lotion is then to be used; or should there be any tendency to involuntary contraction of the muscles, strips of soap plaster may be gently applied around the limb, which, by causing a secretion beneath it, diminishes the irritability of the muscles, as well as the urgency of the inflammation. If it can be avoided, purgative medicines should not be given, as they would produce a necessity for frequent change of position: but should their use be considered essential, such medicines are to be given as are least likely to keep up a continual action on the bowels. As soon as the tumefaction and inflammation have subsided, which, under the treatment recommended, generally happens in three or four days, well-padded splints should be applied, and retained in their situation by broad pieces of tape resting firmly on the splints, but which should not be anywhere in contact with the limb.

"It has been stated, that a bandage should never be applied immediately after the occurrence of fracture: however, it may be considered as an exception to this rule, that when a portion of fractured bone has wounded and irritated a muscle, a bandage is the best means of relieving its spasmodic action. When fracture of a bone happens in the neighbourhood of, or passes into a joint, local bleeding, by means of leeches, is always necessary, and may require to be frequently repeated even the necessity for general bleeding may sometimes be indicated, when there is much constitutional irritation in which case, calomel and opium will also be found of the greatest service. In fractures into joints, when inflammation becomes so violent that the surgeon sees that anchylosis must necessarily occur, the joint should be placed in such a position, as to render the limb as useful as possible. Under these circumstances, for instance, if the elbowjoint be the one affected, the fore-arm should be semi-flexed; by which position the patient will afterwards be able to feed himself. In the knee-joint, the leg should be very slightly flexed upon the thigh; by which method he is better able to direct the foot, and the limb is rendered more manageable in the sitting posture. In the ancle-joint, we should endeavour to procure a union with the foot perfectly flat; whereby the patient will afterwards enjoy very considerable use of his limb."

Among the observations upon Diseases of Bones we find the following:

"Bones fall more slowly into disease than the softer parts, and their restoration is proportionally more tardy; they receive their nutriment chiefly from the periosteum; and hence it is, that disease or injury to that membrane immediately affects the bone itself-a circumstance that should ever be borne in mind by the surgeon when operating upon bone; for it is scarcely possible that any very extensive destruction of periosteum can occur without exfoliation of the bone itself.

"The inflammation may be either acute or chronic, common or specific, and the strict antiphlogistic discipline, and counter-irritants, are the remedies to be adopted with a severity to be regulated by the power of the patient's constitution. Calomel and opium will be found particularly useful when the pain is very urgent. It may be remarked, that the increase of pain at night is one of the diagnostic marks of the inflammation of bone, whether it be affected by simple or specific action; although it is too generally considered that the nocturnal pains indicate syphilitic affection, when, on the contrary, it seems to be concomitant with inflammation of bone from any cause. When the inflammatory symptoms have been relieved, or it has terminated by what is called resolution, a thickness of the inflamed bone remains, usually for a considerable time, from