Imatges de pàgina
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the forehead, feebleness, absence of thirst and appetite, and slight fever, in which, however, the pulse was at the natural quickness and fulness; yet I already remarked irregularity in the beats, as some were hardly to be felt and others were omitted. He was constipated, had scanty though natural urine, the skin was dry to the feel. My first care was to restore perspiration, from which I expected much good. In the second night after this exposure to cold, the fever became greater, and, at the same time, the above-mentioned symptoms more violent; a remarkable remission of the fever followed toward noon of the third day. Emollientia, with radix sambuci, and ammonia acetata with syrup, were the medicines which he took; and mustard cataplasms to the feet, and clysters, which operated, were the external remedies which I employed. I expressed to the parents of the child, my fear of the acute hydrocephalus, and proposed blood-letting, at which they were more terrified than at the danger to which their child was exposed, because a surgeon, a stiff Brunonian without principles, had related some horrible stories about blood-letting, and prophesied the worst consequences. In a consilium with a learned physician and this surgeon, the disease was stated to be an intermittent fever, because at this time intermittents reigned epidemically in and about Vienna, and in spite of my remonstrances, Peruvian bark was ordered, which the parents with great readiness administered to their child. But the results verified my prognosis; for the inflammatory period with severe pains in the head, and all the symptoms which accompany this stage of acute hydrocephalus, showed themselves. A second consilium with true practical physicians, attached to no system, and intimately acquainted with this form of disease, was now called, but too late. All the means employed, which, earlier would certainly have hindered the effusion, were no longer capable of arresting the progress of the disease. Insensibility came on, followed after six days by palsy with the most violent symptoms, and at the end of eight and forty days from that time, his sufferings ended.

"Dissection. This was attended by the physician who in the first consultation proposed the bark, and was performed by the surgeon. The blood-vessels of the covering of the cranium were turgid; the bared bones of the cranium were blue, the sutures were separated from one another by a line, and the interval was filled by a bloody extravasation. The blood-vessels of the membranes and of the brain itself were uncommonly large, and turgid with blood, as were also the sinuses, in which cruor and much lymph floated in the serum. Between the pia mater and the brain, which was firm and elastic, I met with much coagulable lymph. On the corpus callosum lay the same, about as thick as the back of a knife; and equally thick, at the basis of the cranium, where it enveloped the vessels and nerves. The ventricles, in which more than six ounces of clear waterwere contained, were lined by the same, through all their length and incurvations. The plexus choroides was very pale, and wholly covered with lymph. The pituitary gland was in its natural state, but covered with lymph;

the septum of the ventricles was broken through; the white substance of the brain was of a reddish colour; the viscera of the thorax and abdomen were perfectly healthy. The incredulous physician began, after this, to believe in the acute hydrocephalus. Whether the surgeon, who soon after went to Russia, was converted, I know not.' P. 230.

Fortunately these "stiff Brunonians without principles" are now rather scarce in this country, where physicians attend more to practical indications collected at the bedside of sickness, than to physical and metaphysical speculations engendered in the libraries of the learned.

In closing this analysis, we have no hesitation in stating it as our opinion, that the medical profession of this country is much indebted to Dr. Gooch, for introducing to their acquaintance an illustrious stranger, whose treatise reflects credit on the age and country in which it was produced. That Dr. Gooch's translation is sometimes rather stiff and literal, must be acknowledged-nor can it be said that, "materiam superabat opus." But where the matter is so excellent, the manner is of very subordinate consideration.

The experienced reader will readily perceive that Dr. Golis's description of the disease sufficiently proves that climate, education, and diet, often modify the features and course of maladies, and consequently that his symptomatology, in some particulars, does not exactly apply to hydrocephalus, as usually seen in Great Britain. Still, however, the general traits, and frequently the minutest shades of this insidious disease, are so evidently and so faithfully copied from Nature, that they will be read with interest, and remembered with advantage by practitioners of all ranks, ages, and countries. We shall look forward with much anxiety for the appearance of Dr. Golis's promised Treatise on Chronic Hydrocephalus, and hope Dr. Gooch will lose no time in presenting his countrymen with a version of the forthcoming essay.

11.

Remarks on the Epidemic Yellow Fever which has appeared at intervals, on the South Coast of Spain, since the year 1800. By ROBERT JACKSON, M. D. One vol. 8vo. pp. 207. London, 1821.

PRONE as the world is, in general, to vice, there are numerous and splendid examples of virtue in every age and

country-and beset as the medical profession is by selfishness, knavery and charlatanism, there is, thank Heaven, a great deal of honour, integrity, disinterestedness-we had almost said devotion to the advancement of knowledge and the interests of humanity, scattered through its members. We see indeed, with feelings of humiliation for poor human nature, too many men, whose education ought to have elevated their views, sacrifice all the nobler sentiments of humanity at the shrine of SELF, or cast off all sense of shame, and turn the credulity of mankind into a source of lucre to themselves, totally regardless of the contempt or even abhorrence of their brethren. But, on the other hand, the profession exhibits numerous examples of men devoting their time, their talents, their wealth, and what is more than all, their HEALTH, or even LIFE, to the welfare of society at large, or to a posterity who can only know them by name. We do not wonder so much at these instances of philanthropy in youth, whose warm blood nurtures generous sentiments, feeds enthusiastic feelings, and engenders those aspirations after ideal beatitude, which time and experience too often prove to be unattainable by mortals. But when we see this philanthropy grow with man's growth, and strenghthen with his strength-when we see it as fervid at sixty-five as at twenty-five, unchilled by hoary age, unchanged by length of years, it commands the respect of the most unprincipled, and excites the admiration of the most virtuous portions of society.

The venerable author of the work before us has sustained a character of this description, from the earliest period of his professional career, down to the present moment. Whether serving amid the foggy marshes of Flanders, the burning defiles of St. Domingo, the dreary savannahs of America, or the romantic valleys of Spain, Dr. Jackson was actuated by but one ruling passion, one predominant impulse—the acquisition of useful knowledge for the promotion of MEDICAL SCIENCE, not the advancement of SELF. This thirst after knowledge, this true philosophy, has not deserted him in his old age, for, qualis ab incepto, he lately left the comforts and quietude of a country retirement, so congenial to declining life, to wander among scenes of pestilence and death in a foreign land-aud that without the chance of remuneration, but the certainty of loss as well as danger and fatigue.

The Cadiz fever of 1819 having excited our author's curiosity to ascertain its true nature, he applied to Government for a passage and credentials to the Spanish authorities, without any other condition or exemption from expense.

The passage and introductions were granted, but not till after a lapse of time which rendered it improbable he should that year see the epidemic, excepting in its decline. He embarked, however, in the beginning, and landed at Gibraltar towards the end, of December. There he was detained nearly two months, in consequence of a military insurrection at Cadiz. There being now no hopes of seeing the epidemic of that season, Dr. Jackson determined on a journey to the Levant, at his own expense, partly in the desire of seeing Greece, a country in which he had lived in idea the greater part of his life, and partly in the hope of obtaining information respecting the diseases (particularly plague) of the Mediterranean shores. He therefore visited Malta, Constantinople, Smyrna, the Islands of the Archipelago, Athens, and the Morea, returning to Gibraltar in the end of July, 1820, from whence he proceeded to Cadiz, where he arrived on the very day that the epidemic was officially an

nounced.

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In this expedition (so different in its object from most other expeditions) our able author was accompanied by Mr. O'Halloran, assistant surgeon of the 64th regiment, a gentleman who had courage to look danger in the face in whatever shape it might present zealous in the pursuit of professional knowledge, and of an ardency of temper which committed him wholly to the duty which he undertook.' This gentleman was of infinite service to our author in post mortem researches, as well as therapeutical labours.

The first chapter of the work contains an animated sketch of the medical topography of Cadiz and its environs, of which we can present but a very few features. The province of Andalusia is of irregular surface, the scenery being, in many places, beautifully picturesque. The elevated part of the province is generally dry, of a light unproductive soil, and covered with heath or brushwood. The extensive level plains are nearly in a state of bog in the rainy season; and the soil being loose and light, the water penetrates deep into it, and rises again in copious vapour during the great heats of summer. It is well known that exhalations from the earth cause, or at least carry with them the cause of, intermittent fevers. Accordingly we find that the people of Andalusia who live on the plains, or on eminences near the plains, are "much harassed by agues.

"The type sometimes assumes the quartan form; sometimes it appears as distinct remittent; and sometimes it sinks into obscure remittent or gastric. From gastric there is an easy transition to continued or contagious typhus; and sometimes, under epidemic influences, a form of disease not unlike that which has obtained the name of yellow fever prevails to some extent." P. 2.

Cadiz itself occupies a peninsular point nearly level with the sea, the houses being erected on shelves of rock, at one place, on alluvial sand at another-of course, many of them stand over a bed of water. The confined site of Cadiz has induced the inhabitants to build the houses very high, and make the streets very narrow-the former, however, being good, and the latter kept very clean-"insomuch that this city, crowded as it is with population, rarely, if ever, presents any thing that is offensive to the eye, or that can be supposed to be noxious to health." 4. The Isla, contiguous to Cadiz, is of considerable extent, and mostly a swamp intersected by numerous sluice canals. Yet it is not unhealthy, which may fairly be attributed to the strong salt water forming the moisture of the soil. Topographical sketches follow of Puerto Real-Puerto de Santa Maria-and Xerez, for which we must refer to the volume itself.

The second chapter is on a very important subject-the introduction (if really introduced) of the yellow fever into Spain, and its real or supposed propagation by what is termed contagion. The facts and arguments brought forward by Aregula, or still entertained in that country, are dispassionately examined and candidly weighed by our author, aided by all the information he could gain on the spot; and this discussion we recommend to the serious attention of the profession, hoping as we do, that it may lead to important conclusions, medical and commercial. Mean time we shall endeavour to present our readers with some of the results to which our author has come, from the details alluded to.

1. The importation of the disease from a foreign country is still credited by the authorities and mass of people in Spain, though, Dr. J. thinks, it has never been proved by evidence, or even brought to reasonable probability-the events of the year 1820 stripping the assumption of every claim to credence, as no attempt has been made to trace the disease, in that instance, to foreign origin.

2. The belief universally obtains through Spain that the disease is personally contagious; that is, capable of propagation from individual to individual, by contact or proximity. Yet our author thinks that this opinion, confidently as it is maintained, is invalidated by authentic records and facts.

"In proof of the assertion, an authority is here adduced which may be thought to be valid, because it is admitted by the persons who report it against the dictate of their prepossessions. In the year 1800, when upwards of ten thousand souls died at Xerez de la Frontera, sixty persons were employed to bury the dead. The burriers entered the houses where the dead lay, took the bodies in

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