SYPHILIS, PSEUDO-SYPRILIS, MERCURY. 1. Dr. SINTELAER'S Scourge of Venus and Mercury 2. Mr. BACOT's Observations on Syphilis 3. Dr. THOMPSON on Mercury 4. Dr. SWEDIAUR on Venereal Diseases 5. Mr. HARRISON'S Engravings, &c. X: A Manual of the Diseases of the Human Eye. By Dr. C. H. TEATH, M. D. XI. 597 626 SUPPLEMENTAL REVIEW; OR QUARTERLY PERISCOPE OF PRACTI CAD MEDICINE, SURGERY, &c. Art. 1. Contusions on the Epigastrium 2. Dr. Hancock on Pestilence 3. Dr. Newman's Case of Internal Hæmorrhage 662 665 668 669 5. Sir Gilbert Blane on Hydrocephalus 6. On Kinine, Cinchonine, and Sulphate of Kinine 670 673 16. Mr. Wheeler's Case of Dislocated Patella 682 683 THE Medico Chirurgical Review, AND JOURNAL OF MEDICAL SCIENCE. (Analytical Series.) "Perhaps that is nearly the perfection of good writing which effects for knowledge what the lens effects for the sunbeam-it condenses its brightness, in order to increase its force."-Lacon. VOL. II.] DECEMBER 1, 1821. [No. 7. I. A Treatise on the Hydrocephalus Acutus, or inflammatory Water in the Head. By LEOPOLD ANTHONY GOLIS, Physician and Dissector to the Institute for the Sick Children of the Poor at Vienna. Translated from the German, by ROBERT GOOCH, M. D. One volume, 8vo. pp. 280. London, 1821. IT is not among the least of the blessings of peace, that the scientific and literary, as well as the commercial, stores of Europe are opened, and their treasures diffused over the world at large. In language, however, which is the great medium of communication, there still exists a powerful check on its own operations-a defect which has not ceased to embarrass social intercourse from the "confusion of tongues,' at the building of Babel, down to the present moment. Translation, the great remedy of this evil, is seldom rewarded in proportion to its merits: yet there is not a more praiseworthy undertaking than that of clothing, in vernacular language, the useful productions of a foreign soil-especially of a German soil, fertile as it is, in intellectual vegetation, but difficult of access over the frowning barriers of its rugged literature. The work before us is characterized by Dr. Gooch, a gentleman whose competency of judgment will not be questioned, as "the best book he ever read on the acute hydrocephalus." The author, Dr. Golis, has been physician to an extensive institute for sick children, since the year 1793, enjoying great opportunities for observation, and possessing practical talents of a very high order." Under these propitious circumstances, the reader will be prepared to expect Vol. II. No. 7. 3 P something beyond the usual run of medical publications: and in this expectation we believe he will not be disappointed. True it is, as Dr. Gooch has justly observed, the work in question "like all books, has its weak parts;" but where are we to look for perfection-except in the sublime dicta of the infallible critic, or his imaginary BOARD of censors? Dr. Golis informs us that he has already opened 180 bodies of those who have died of hydrocephalus, in the presence of several physicians and surgeons, and that these dissections always confirmed the accuracy of his diagnosis. We confess that such an assertion surprised us not a little; for, according to this statement, the Doctor's diagnostic acumen was as great at the beginning as it was at the end of his experience! But let that pass. It is only a way of talking, not very unusual among continental writers of the first respectability, though confined in this country to authors who seek fame or fortune through the medium of popular credulity, rather than the esteem of their brethren. Dr. Golis divides hydrocephalus into the hyper-acute, acute, and chronic forms; denominating the first wasserschlag, or, in our language, "WATER-STROKE." "The hydrocephalus hyper-acutus, apoplexia hydrocephalica, wasserschlag, literally water-stroke, is a sudden effusion of fluid within the brain, either occurring idiopathically, or the consequence of the repelled matter of a previous disease (defect of crisis,) or the consequence of obstructed evacuation from an excreting organ, from which death occurs in a few hours. To this belong all those depositions on the brain which arise from small pox, measles, erysipelas, and other febrile eruptions; also those convulsions which follow the sudden cessation of chronic, or habitual discharges, the repulsion of chronic eruptions, as crusta lactea, tinea, discharges from the ears, and the like, or from diarrhoea, dysentery, general perspiration, when the same has been suddenly stopped without previous perceptible turgescence or inflammation. In all these cases of sudden death, there is found, on examining the bodies, an effusion of fluid in the head, for the most part in the ventricles of the brain itself." P. 6. It appears, then, that in this form of the disease the stages of turgescence and of inflammation are wanting-a circumstance which distinguishes it from acute hydrocephalus. Here, too, the effused fluids are always found turbid, and accompanied with less coagulable lymph than in hyd. acut. It is almost needless to remark that the water-stroke runs such a rapid course as to give no time for remedies to produce any effect-it is therefore invariably fatal. Hydrocephalus Acutus. In this form, the effusion is always a consequence or sequela of previous turgescence and inflammation of the membranes or vessels of the brain, consisting in a collection of serum and coagulable lymph-the former in the ventricles or substance of the brain; the latter, like a membrane, filling the depths of the convolutions, and lining the walls of the ventricles as a preternatural coat; or covering the basis cranii, and hindering the absorption of effused fluid. The inflammatory nature of the complaint is inferred from the symptoms, which are those of encephalitis; from the influence of medicines; and from the appearances on dissection. From an attentive observation of nature, Dr. Golis divides this disease into four stages, which he thinks have distinguishable symptoms--viz. that of turgescence, inflammation, effusion, and paralysis. Turgescence. Of the premonitory symptoms of the_turgescent stage Dr. Golis draws a minute, and we believe, faithful picture. We can only notice the prominent traits. Children grow indifferent to things that formerly amused them become inactive, silent, irritable, disliking light and notice. The eye and countenance lose expression, the body plumpness, the bowels and kidneys activity. On getting out of bed the child complains of giddiness, and moves the hand towards the back of the head, with a whining tone. The pulse, though generally natural, will be found, on attentive observation, "to beat oftentimes a few beats weaker, and sometimes to intermit altogether"-the skin is without perspiration-the colour of the face changeable--the gait is tottering. Such are the premonitions in healthy children; and it must be confessed that very many of them precede other diseases than hydrocephalus acutus. Dr. Golis also acknowledges that, in feeble, irritable, scrofulous, and unhealthy children, this premonitory train of symptoms is generally overlooked, even by the most.acute physicians. "Indifference succeeding to increased sensibility and irritability; a constipated state after habitual looseness or diarrhoea; a scanty, unusually yellow urine, with or without sediment; dryness of the skin, which, previously, on the slightest exercise, even on eating and drinking, and particularly during sleep, perspired profusely; sleep without medicine often suddenly occurring in restless children; remarkable gravity and earnestness, which had never been previously noticed; these taken together, with the symptoms already mentioned, are the signs by which the turgescence of hydrocephalus may with great justice be suspected." 16. In children of one, two, three, or four months, the premonitory symptoms are very equivocal, and require a careful consideration of all the symptoms in connexion. The rarest mode of approach is what our author calls the tumultuous; where, for instance, a lively healthy child, after a sudden accession of languor, confusion, giddiness, headach, gastric irritability, full, hard, slow pulse, ocular sensibility, tinnitus aurium, &c. is suddenly seized with violent fever, and, generally, convulsions. If the practitioner now uses efficient means, effusion is arrested; but, "if he does not apply the necessary remedies with overwhelming power," effusion will take place, in one, two, or three days, "but most commonly in a few hours," and the child will be irrecoverably lost. The duration of the turgescent stage is frequently only a few hours; but often eight, ten, fourteen, or even more days. Inflammatory Period. In this stage the symptoms of turgescence are merged in those of phrenitis. The little patient complains of severe headach, pressing upon the eyestension and shooting sensation in the nape of the neckgreat restlessness-high sensibility of the eye to light, opening perfectly only in the dusk-heat of the head to the touch, particularly the forehead and nape-but the vessels of the surface are rarely turgid or red. In the tumultuous accession of the inflammatory period there are convulsive tremblings of the eyes. The carotid pulsations are now evident, and there is a peculiar alteration of the physiognomy, in acute hydrocephalus, which our author considers to be pathognomonic. The nose is dry-the lips a faint dark red, and chapped-the tongue becomes covered with a white or brownish-yellow fur-thirst and appetite generally cease -vomiting usually occurs four or six times in the twentyfour hours-digestion ceases-food taken many days before is often passed undigested, with much slime, and a peculiar foul smell. The breath, at this period, has generally a bad odour-there is tenderness, on strong pressure, in the region of the stomach and liver-the belly, before tumid, now falls in, which our author considers as another pathognomonic sign of acute hydrocephalus, and the surest distinction between that and typhus. The bowels often remain obstinately constipated, in spite of purgatives-the stools are gluey, most commonly brown, sometimes yellowishgreen-only during the use of calomel green in all shades, and not very fetid." The urine is scanty, and often passed with pain-at the beginning turbid and white; but in the following stages of a bright yellow, with white, heavy, slimy deposit. Our author has not seen the lateritious sedi ment. The sense of hearing now becomes acute-pains are felt |