a circular incision, nearly, however, in the manner above described. The bone was sawn through at the trochanter major, and the arteries tied afterward, a ligature being placed separately on the femoral artery and on the profunda. The patient lost very little blood, and was not more than fifteen minutes under the operation. In this case matter formed in the stump in four different places, requiring four incisions of two or three inches in length, to give free vent to the discharge. At the end of six weeks he was walking about the streets on crutches. But being caught in the rain, in Bond-Street, he was attacked with thoracic inflammation, of which he died.

Our limits are so far exceeded that we cannot notice the many improvements which the formerly published part of this work has experienced. Neither can we do justice to the new edition of Dr. Hennen's volume. These two works will necessarily be in the hands of all naval and military surgeons, as well as those surgeons in civil life who are at all in the way of operations. To these classes in particular we most urgently recommend the volumes before us, as highly illustrative of the exalted eminence to which BRITISH MILITARY SURGERY has attained, and exceedingly honourable to the officers who have effected such improvements in the surgical science of their country.

XIV.

A History of the Epidemic Fever, which prevailed in Bridlington and the Neighbourhood, in the Years 1818 and 1819. By HUMPHRY SANDWITH, Surgeon, Bridlington. Also, Observations in Medicine and Surgery. By THOMAS SANDWITH, Surgeon, Beverly. One volume, 8vo. pp. 327. London,

1821.

"Leges omnium salutem singulorum saluti anteponunt; sic vir bonus et sapiens, et legibus parens, et civilis officii non ignarus, utilitati hominum; plusquam unius alicujus, aut suæ consulit." Cicero de fin. bon. et mal.

SYDENHAM, in his epistle to Dr. Brady, complains that four years after the publication of his Observations on the Use of Bark in Intermittents, his precepts remained unnoticed, or contemned by his cotemporaries. Nay, in return for his exertions to enlighten his professional brethren, the ENGLISH HIPPOCRATES was loaded with vituperations by those persons" de quibus hoc habeo dicendum," says he, "quod si vita innocua hominis, qui neminem neque facto, neque dicto, læserat, me ab illis sartum tectum reddere valuisset, nunquam in me detonuerant." Thanks to the PRESS, no valuable work can now slumber unnoticed for four long

years or even as many months. Neither dare Slander raise its snaky heads against the promulgators of useful facts or ingenious doctrines without danger of a fatal recoil on itself. The muzzled monster can now only gnaw, in dark holes and lurking places, the reputations of those whom it dare not openly assail; because public sentiment will not permit such unprincipled aggressions in matters of science -and particularly medical science. We maintain then, that in these respects, we live in a better age than did Harvey or Sydenham. In ancient times FAME marched on foot, "magnas it fama per urbes," however high she might lift her head among the clouds; but now Fame and Knowledge are wafted with more than was ever fabled of Cyllenian velocity over every portion of the civilized globe. That the press pours forth error with truth, like fabled FAME of old, "tam ficti pravique tenax, quam nuntia veri," is not to be denied, nor even wondered at, considering the imperfections of our nature, the narrow limits of our capacities, and the infancy of our science; yet, were the proportion ten times greater than it is, it would weigh as nothing in the light of an objection to books. The paramount utility of reading does not consist in the quantum of information directly received, though that is considerable; but in the mental exercise and excitement thus produced, by which the intellectual faculties are strengthened and rendered more capable of profiting by direct and personal observation and experience. Books therefore which are well calculated to stir up thought in the reader, are often of more service than those which contain richer materials buried under an awkward exterior, and conveyed in confused or barbarous language. The Pedagogues who clothed the idea of Sydenham in such difficult and elaborate language, (a curse in perpetuity on candidates for academic honours, per omnia secula seculorum,) must have done him a great injury in his own days, and rendered every subsequent translation participant in the deformities of the original. Medical writers are now growing wiser, and many of the wisest attend to language and style. Those who neglect the attractions of composition, and particularly those who, from carelessness or innate defect, convey their thoughts in obscure instead of luminous diction, suffer from a cause which, though not openly assigned by their readers, is not the less operative in its results. It will not do, in these days, to spread our thoughts on paper in characters that require deciphering-or in long sentences that demand reperusal before their drift can be understood. Yet there

are, and have been, many writers whose obliquity of intellect (for we know not how otherwise to account for the

phenomenon) renders turbid every stream of thought that! passes through their brain, and thus they mystify that science which they undertake to elucidate. These observations are general, and not addressed to particulars-still less are they applicable to the work before us, which evinces a vigorous conception, united with perspicuous delivery, in its intelligent authors.

The first division of the work, (on the epidemic fever,) by Mr. Humphry Sandwith, is the only part which we shall attempt analytically to delineate in the present number of the Journal, reserving the miscellaneous observations, by Mr. Thomas Sandwith, for our next. To say the truth, we have been much gratified by the perusal of this volume generally, and even where we cannot entirely coincide in the views of Mr. H. Sandwith, we admire his ingenuity, his candour, and his independence of mind. The strength of his judgment too, and the force of his reasonings, are well calculated to make strong impressions in his favour on the minds of his readers.

Messrs. S. address their work to Dr. John Simpson, of Malton, as illustrative of principles long acted on with success by that Physician, while they thus publicly acknowledge their professional obligations for the benefit of his conversations and correspondence. We are always gratified to observe this unanimity and friendly cooperation among the members of our profession; and deprecate most heartily every act, word, and writing, calculated to produce irritation, excite the turbulent passions, or keep up those repulsive manners which too often, alas! unhinge the frame of medical society, by sowing the seeds of discord where harmony should prevail. Every wise and good man should discountenance, publicly and privately, all tendencies of this kind, as in ical to peace of mind among individuals, and subversive of that public esteem which can only be maintained by the profession, as a body, while philosophic decorum and mutual urbanity prevail.

The first section of the work before us is dedicated to meteorological observations, and a topographical sketch of Bridlington and its vicinity, which we shall pass over; the second section is headed" Internal Evidences" of the epidemic, comprehending, 1st, those cases in which the nervous system suffered merely from the agency of general fever-2dly, those in which the nervous system was thrown into additional disorder by intensely sympathizing with inflammation or congestion of some important organ-3dly, where the nervous system appeared to be implicated in idiopathic or primary inflammation or congestion.

1. First Species, or Simple Typhus. Mr. H. Sandwith justly observes, that when we come to class fevers, we find cases holding a place so exactly intermediate, that it is difficult to assign them their situation. Thus, what he denominates "simple typhus, bordering

on the inflammatory," might, he conceives, be considered with much justice, as mild cases of the inflammatory species; yet, the description of this variety forms a sort of connecting link which unites simple and inflammatory typhus.

During the late epidemic, thirty-four examples of simple typhus presented themselves to our author, of which, eleven assumed its more aggravated character. To the readers of this Journal the symptoms of simple typhus need not be detailed. They are slightly sketched by our author, from a conviction that a minute detail was unnecessary. Although this form of fever had an open expression, yet the utmost sagacity could not, from early symptoms, predict, with certainty, that the disease would pursue a safe and gentle course.

"In fact, many examples of this species of fever, I allude to those of Simple Typhus bordering on the Inflammatory,' were restrained within the limits of the present classification, and prevented from passing into the inflammatory or congestive forms by the timely use of the lancet or leeches, in other words, by anticipating evil." P. 17.

Our author concludes, with Dr. Percival, that the degeneracy of this fever was considerably, if not principally, dependent on delay or neglect of energetic remedial treatment.

Simple Typhus bordering on the Inflammatory. The aspect of this variety impresses the medical attendant with the sense of more existing danger than in the preceding. In our author's experience there was greater prostration of strength-higher degree of temperature-greater local pain, whether in the head, chest, or abdomen. Where pulmonic disturbance prevailed, the distress was more exquisite. The bowels were more intractable-nervous irritation, both mental and corporeal, more distressing.

"The nature of simple typhus will be further illustrated by a view of its duration, allowing for the influence of treatment. Premising that critical days were seldom noticeable, I find there were three recoveries within the first week, seven in a fortnight or less, seven in three weeks or less, eleven in a month or less, four in five weeks or less, and two in about six weeks." 20.

Mr. S. seldom marked the regularly formed crisis so well described by Dr. Cheyne, as consisting of three stages-one of general disturbance, a second of rigour, and a third of perspiration, resolving the complaint. On the contrary, a gradual, though increasing perspiration, or an improving and soluble state of the bowels, or long-continued and refreshing sleep, with the gradual resumption of impaired vital functions, terminated the disease.

II. Second Species, where the nervous system intensely sympathizes with inflamed or congested organs. In the first species no lives were lost-in this, some few failures took place. The author

confesses (perhaps with more candour than justice) his conviction that more energetic measures might possibly have saved even these. But men will die, under the most judicious treatment sometimes. When the French soldiers at Flushing petitioned Napoleon to remove them from a situation where they were dying, his answer was equally laconic and true-" L'homme meurt par tout"-" men die in all kinds of places."

The nervous system is disturbed by simple inflammation of an internal viscus, as well as in simple typhus. This disturbance will, of course, be much increased when both morbid conditions are combined. In this variety, the typhoid countenance was rendered peculiarly impressive by the physiognomy of distress or even agony. Intellect, sensation, the developement of temperature, and the motion of the voluntary as well as involuntary organs, were all seriously affected. Acute bodily pain, no less than occasional injury of the different orgaus of sense, indicated much interference with the function of sensation. The secreting organs were much deranged-the pulse ranged from 100 to 140, and the animal heat was morbidly increased, in half the cases, excessive.

Mr. S. thinks that one great cause of the nervous disturbance may be attributed to the pulmonary affection, which, by obstructing the free return of blood from the head, deranges the sensorial functions. "But it is not improbable, that the delirium may also, in part, depend on those inexplicable sympathies which exist in the nervous system." In some cases Mr. Sandwith found that the brain became inflamed after sympathizing for some time with other inflamed organs. The duration of this species varied exceedingly --recovery taking place at different periods from the 5th till the 43d day. The occurrence of critical days was noticeable only in two instances. Of the two fatal cases, one died on the 17th, and the other on the 18th day.

III. In the THIRD SPECIES Mr. S. conceives the nervous system to be essentially implicated in an idiopathic and primary inflammation or congestion, with occasional subsequent disturbances elsewhere.

66

In the Bridlington epidemic the numbers of this formidable variety nearly equalled those of both the preceding. In order to prove that the disorders observable in the nervous system have their origin in vascular derangement," Mr. Sandwith presents us with the minutes of a dissection--the only dissection, unfortunately, which he was allowed to make. The symptoms of this case nearly corresponded with the account given by Dr. Armstrong of the less severe forms of congestive typhus. The fever lasted three weeks, ending on the 21st day.

I only witnessed its course during the last eleven days; in the first five of which there was generally slight yet distinct mental aberration, with occasional maniacal extravagancies; and in the last six almost constant delirium, with great reduction of the bodily strength.