which was taken into the stomach. The diarrhoea amounted to severe dysentery, and the march of the marasmus was surprising. All this time the circulating system showed no evidence of febrile movement.

Dissection. Body greatly emaciated-vessels of the head engorged, and the cerebral substance red and firmthoracic viscera sound-stomach so contracted as to leave no cavity-intestines greatly contracted also-mucous membrane thickened, dry, and of a deep red colour, resembling linen steeped in port wine-the mesenteric capillary vessels much injected, while their trunks contained hardly any blood. The serous or peritoneal covering of the intestines unaffected. The body, when opened, exhaled a remarkable ammoniacal odour.

We find that our limits will not permit us to introduce more than another case.

Chronic Muco-Enteritis, propagated to the Stomach. A drummer in the 9th regiment of the line, 24 years of age, slender, but active, became affected with an intermittent fever for two months, in Germany, without using any remedy. He was then sent to an hospital, two months after which he came under M. Broussais at Udina. He was now emaciated in the second degree-had from five to six stools per diem, with colic and much uneasiness. The pulse was nowise febrile. He was placed on rice water, mucilaginous acidulated drinks, and farinaceous aliment. In a few days the diarrhoea was reduced to two stools per diem, without pain -the appetite returned-the complexion cleared, and the patient was in full march towards convalescence. M. Broussais now ventured to gradually increase the food until he came to ads allowance or more. All at once the diarrhoea and colic returned, and in three or four days, he lost all the flesh he had gained in thirty. He grew rapidly enfeebled. M. Broussais now learned that the impatient patient, tormented with his appetite, had purchased provisions from his comrades frequently. He was now put back to the original regimen; but too late! In ten days he was reduced to a complete state of marasmus, although the bowel complaint was moderate, not exceeding two or three stools daily. Vomiting now came on, with entire loss of appetite, great anxiety, frequency of pulse, and heat of skin. It was now evident that the phlogosis had reached the stomach. Yet he lived twenty days longer, when he died a perfect skeleton., On dissection, the whole alimentary canal was found so contracted, as to have all its internal surfaces almost in contact.

In the stomach, this membrane was red, thickened, and covered with a yellowish exudation about the pylorus. Throughout the whole of the intestinal canal, the mucous membrane was dry, and of a logwood colour, with scarcely any fecal contents.

Before closing this paper we shall introduce an extract from Dr. Abercrombie, showing that gentleman's sentiments respecting the treatment of affections of the mucous membrane of the alimentary canal.

"The active form of the disease, especially in its early stages, is to be considered as an inflammatory affection of the most dangerous kind, and requiring to be treated with activity by the usual remedies-especially blood-letting. The first urgency of the inflammation being thus subdued, if the pulse continue frequent, digitalis is given with much advantage, or Dover's powder, in repeated doses; and, after the necessary bleeding, moderate opiates may be given, with mucilaginous articles and absorbents, or opiate clysters. The effect of purgatives is extremely ambiguous. In the more severe cases, they evidently aggravate the symptoms. There may be cases in which it is expedient to evacuate the bowels, as when the discharges are scanty and slimy, with retention of natural fæces, but the practice requires caution; and in the more common form of the disease, with copious discharges, they appear to be injurious. Though the evacuations in such cases may be of an unnatural appearance, it is to be remembered, that this is the result of morbid secretions, not to be corrected by purgatives, but by curing the disease on which they depend. When the disease appears to be seated in the lower part of the great intestine, bleeding from the hæmorrhoidal vessels might probably be useful. When the tormina are severe, with tension of the abdomen, the tobacco injection might probably be employed with benefit. Great attention should be paid to the ingesta; to keep them in as small quantity as possible, and of the mildest quality.

"It is in infants that the disease most frequently occurs to us; and there is some difficulty in determining what is the best treatment. This results from the difficulty of distinguishing the disease, so that, when a case terminates favourably, we cannot say, with certainty, that it really was an example of this dangerous affection. In some cases, in which there is no vomiting, a gentle emetic seems to be useful in the early stages; afterward, Dover's powder, combined with chalk, opiate clysters, opiate frictions, opiate plaster, and tepid bath. In some cases, the free use of digitalis seems to be extremely useful, and blistering on the abdomen. It is worthy of consideration, whether topical bleeding would be admissible in the early stages, when the disease exhibits much activity. In the advanced stages, when there is a tendency to sinking, wine is to be given very freely; when there are threatenings of coma, blistering on the neck should be employed; from both these conditions, infants often make most unexpected recoveries. When the case is accompanied, as it often is, by a peculiar and most ungovernable vomit

ing, blistering on the epigastrium seems to be the most effectual remedy; and considerable benefit, on settling the stomach, is often obtained from the vegetable bitters, as the powder of colombo root, in doses of a few grains, repeated at short intervals. In the protracted bowel complaints of infants, in which there was reason to apprehend this affection in a chronic form, I have found nothing so useful as lime-water. The teeth are to be attended to, and the gums cut, when they appear to be giving irritation.

"In the chronic form of the disease, what we have to contend with is either the chronic fungous inflammation, or ulceration. The treatment is extremely precarious, and very few of the cases end favourably. The remedies to be kept in view, and which appear in some cases to be useful, are chiefly the following: Lime-water, the vegetable bitters, and astringents, especially the cortex cuspariæ and logwood; preparations of iron, as the tincture of the muriat, in large doses; small quantities of mercury, with opium; the resins, as turpentine and bals. copaivæ, combined with opium; sulphur, with opium; repeated blistering on the abdomen; bandaging with a broad flannel roller; the tepid salt-water bath." Ed. Journal, p. 347.

In respect to Dr. Grimaud's Dissertation on Inflammation of the Follicles of the Mucous Membrane of the Intestines, as distinguished from common Inflammation of the Membrane itself, we have only to say that we do not believe such a distinction to exist in nature—and, if it did, we are quite sure that it would never be recognised in the living subject, at least, by Dr. Grimaud's diagnostics. We shall not, therefore, waste time in entering into any analysis of the paper. Those who are more curious, may refer to it in the Journal Complimentaire, for December, 1820.

It is somewhat curious that Broussais's work should never have been translated into the Eugish language, while several very indifferent publications have been honoured with that distinction. We confess that a literal translation would subject the English reader to a great loss of time, in consequence of endless repetitions, and redundancy of cases, with which the work is swelled out to two volumes. We are disposed to think, that we have rendered a translation, in a great degree, unnecessary, by analyzing the different parts of it in this article, and in the eclectic review on peritoneal inflammation. To most of our readers, the original work is virtually unknown, and to them we think we have offered something valuable. To those who were previously acquainted with M. Broussais's work, we hope this concentrated analysis of its most interesting features, will not be unacceptable, as a refresher of their memory, when, probably, they would not again go through the original. At all events, we have endeavoured to be useful to our brethren on the present occasion, and can only hope that our labour has not been thrown away.

II.

A Sketch of the Physiology and Pathology of Urine; with an Historical Introduction. By JONATHAN OSBORNE, M.B. T.C.D. Licentiate of the King's and Queen's College of Physicians in Ireland.

THE phenomena which the urine presents, attracted considerable attention even in the earliest ages, as may be seen in the writings of Hippocrates and of other ancient authors. From some cause, probably from the prevalence of uromancy and an enactment of the London College, to suppress it among physicians, the study of the excretions was for a long period made the subject of ridicule. In this age of science, however, it was natural to expect uriology would be revived, particularly as the discoveries in animo-chymical philosophy have rendered the pursuit comparatively easy. The different analyses of the urine lie scattered in various publications, and it has been the aim of the author of the Treatise before us to collect and arrange them, without making any pretensions to originality.

"Thus the following Treatise may be regarded as an index of what has been hitherto discovered, concerning the urinary secretion, and is the result of an attempt to frame for any person interested in the subject, such a sketch as I should have been desirous to possess, when I commenced my inquiries." Pref. p. 6.

The colouring matter of urine is soluble in water, and when an extract of urine has been obtained by evaporation, it gradually concretes into a mass of crystals. All that is soluble in alcohol may be separated from the rest by macerating the mass with four times its weight in that fluid for some time. The decanted liquor, having been slowly evaporated to the consistence of sirup, presents, on cooling, the substance called urea, in tabular, quadrangular crystals. This may also be detected by nitric acid. Urea is stated by Berzelius* to be a compound mass.

Uric acid is precipitated spontaneously and gradually acquires a reddish hue. It may also be diluted by nitric acid.

The lactic, the phosphoric, the muriatic, and sulphuric acids, may also be detected in the urine; and carbonic acid, which was long suspected to exist in it, was discovered by

Berzelius's View of the Progress and Present State of Animal Chymistry being out of print, we think that a more acceptable present could not be made to the Profession, than a second edition. The rapid sale of the work is a proof of the avidity with which the subject is pursued. Rev. G

Vol. II. No. 5.

4

Vogel. The presence of carbonic acid is, however, by no means constant. Fluoric acid has been found by Berzelius.

Potash, soda, lime, magnesia, and ammonia, have been proved to exist in urine, and by various processes sulphur and silex.

The mucus of the bladder is separated by filtration.

The urea, uric acid, mucus, and the earthy phosphates, are constantly changing their proportions.

Healthy urine is always acid, and remains so for a few days, and in winter it has been found to redden litmus-paper nearly three weeks. Berzelius thinks this acidity is derived from the lactic, uric, and carbonic acids.

The specific gravity of urine ranges from 1010 to 1020. The quantity and qualities of the urine are influenced by cutaneous exhalation and other evacuations, by exercise, by diuretics, age, posture, abstinence, various kinds of diet and medicine, particularly by acids and alkalies.

In the analysis of the urine, that passed in the morning is always to be preferred, and it should, previously to an examination, be suffered to cool. It is sometimes turbid, as soon as it is voided. This arises from an excess of alkali, or of the earthy phosphates, or from the admixture of mucus or of blood. Exposed to 160 degrees of heat it coagulates, when much albumen is present; and when this test fails, albumen may be discovered by nitric acid, or, with certain precautions, by the oxymuriate of mercury.

In examining the urine in febrile diseases, we observe the following phenomena: a greater specific gravity and higher colour than in health; the mucous cloud floats towards the surface, or is absent; a precipitate is formed with the oxymuriate of mercury; there is a tendency to become scanty. Fever is sometimes accompanied with ardor urine and dysury, occasioned by the deficient secretion of mucus in the bladder and urethra. These symptoms are particularly evident in hepatic affections, as have been noticed by modern observers.*

In opposition to the opinion of Dr. Scudamore, the author believes that the precipitation caused by the oxymuriate of mercury is a characteristic property of inflammatory urine, and that it appears to have some analogy with the buffy coat of the blood. The diseases furnishing most of his observations were continued fevers, hepatitis, phthisis pulmonalis, nephritis, rheumatism, and pneumonia.

See an Essay on the Influence of Tropical Climates. By Dr. James Johnson, Svo. London, 1818.