practitioners. But it cannot, of course, be considered as more than an auxiliary. It is directed against symptoms threatening particular organs. It mitigates violence, but it does not break the chain of the diseased movement, and thus arrest what is wrong.

The third or last is decisive, but difficult of execution, and requiring judgment and boldness to apply it at an early period of the disease. If applied, our author asserts, within six or eight hours from the commencement of indisposition, "it rarely fails to arrest or suspend the ostensible febrile act." Yet even in this case, perfect restoration of health is not always the immediate consequence of the suspension. It often requires three, five, or seven days to bring things to their natural state.

The Andalusian fever, Dr. Jackson thinks, is not an indomitable, though a dangerous disease. Its treatment requires to be modified, but the basis of it is the same in all cases. The first point is to arrest the diseased act-the second, to reproduce the action of health. As the impulse of the circulating blood sustains all the organic actions of the system, so the subtraction of it necessarily brings those acts to a pause, whether healthy or diseased. And as the atmosphere appears to be the general stimulant of animal life, so pure air, and especially movement through pure air, demonstratively maintains life in the greatest activity. "The impulse of the pure air to the proper vital organs is obviously the cause which reproduces the healthy act thus violently disturbed by the impulse of causes of morbific quality."

"The free admission of pure air into the sick apartment, even the transport of the sick through open air in convenient vehicles, is therefore primary and important among the means of remedy which are to be called into use for the renewal and support of health, as soon as the diseased act is brought to a pause of rest by artificial means. The application of cold water to the surface by aspersion or effusion, as more impressive by its weight and impulse than the ordinary breezes of the atmosphere, is still more powerful in its act: but it is perhaps less safe, and its effect cannot be so long sustained without inconvenience. When the movements of health are reproduced; various means, besides the impulses of the pure air of the atmosphere and occasional ablutions of cold water, conduce to maintain them in the forward course with more or less efficiency, that is, to prevent the recurrence of the disease in its original form."143.

The above constitutes, according to our author, the basis of the medical treatment, in fevers similar to that of Andalusia, and this he would recommend in the said fever. He had an opportunity of observing the progress of the Andalusian fever in the Hospital San Juan de Dios, where little

was done to oppose its natural course. He saw it treated and opposed vigorously at other places in Spain with good effect. In some cases, however, where vigour was used, success did not follow," either owing to the want of necessary auxiliaries, or to hidden treachery in the character of the disease itself, which, as not easily seen, was not easily averted." The Andalusian fever, however, like that of the West Indies, varied into three principal forms, according as it acted on the sanguineous, lympho-phlegmatic, or serous temperament, requiring, of course, a modified treatment. These modifications are drawn by our author with the hand of a master, and are particularly recommended to the perusal of the medical practitioner, as containing excellent principles for guidance in many other fevers than those of Andalusia or the tropics. We shall merely cull out a few particulars from this portion of the volume, hoping that they may excite to a more intimate acquaintance with the original.

Speaking of the second form of the fever, and alluding to the gastric irritability which is so very troublesome a symptom, he acknowledges that the prejudices against emetics is not unreasonable, since they are rarely useful, and often dangerous, especially if exhibited prior to abstraction of blood.

"But after the preparation of a given condition by bleeding or other means, the effect of emetics, particularly of emetics of white or blue vitriol, instead of being injurious, appeared to the writer to be eminently useful in allaying irritation, and in giving such a tone of vigour to the parts excited into action as precluded the chances of inflammation rising to excess. The power of the absorbent system is evidently diminished in the form of yellow fever now under consideration; and, as the action of the emetic has a tendency to increase absorption, and the action of emetics of turbith mineral a stronger tendency than others, a trial was made of it at Xerez in the year 1820,-and with signal good effect:-the person was convalescent in twenty-four hours. From this success, Mr. O'Halloran was induced to try it in others; and, from his experience, he considers it to be a remedy of great value-next in power perhaps to the lancet." 158.

A purgative which our author has found very useful in the West India fever consists of tincture of myrrh and aloes, with one drachm of ether, or an ounce of the rectified oil of turpentine, preceded by five or six grains of calomel, and three or four of genuine James's powder. The tincture produces feculent stools more efficiently than any other form of purgative; but as it is slow in its operation, the ether or turpentine stimulates and gives it activity.

Vol. II. No. 7.

We find our limits so far overstepped that we must conclude this article with the following extract :

"There is another point connected with the treatment of this disease at the period stated, which is of great importance to be studied and rightly understood. The head is often principally, at least prominently affected in this form of the yellow fever; and, as the head is the most important part in the animal body, the part connected with every function of the machine, the neglect of its diseased condition often compromises the life of the patient. Besides fits, convulsions, or deep stupor at the period of invasion, a certain degree of stupor-a peculiar degree of indifference and apathy, heaviness, fixity, or vacancy of the eye and countenance indicate distinctly that the substance of the brain is materially implicated in the morbid act. It is customary in such case, after bathing and bleeding, to cut off the hair, to shave the head, and to apply blisters to the scalp and nape of the neck. It is proper to do so; but it is reasonable to believe that the purpose would be attained with more certainty, if moxa or actual cautery were applied to the nape of the neck, as near as possible to the joining of the cranium with the vertebral pile. If the brain be in a state of torpor from what may be called congestion or pressure, the powerful stimulus from the heat of the cautery or moxa may be supposed to excite it into activity if the structure be violated, no calculation can be 'made of a favourable result; but the physician may have cause to be satisfied that he has gone as far to attain it as human art, or human courage allow him to go." P. 174.

The last chapter in the work is on the law of quarantine; and we are sorry we cannot possibly spare room for any notice of his important remarks. We trust that even this very imperfect sketch of Dr. Jackson's work will lead many to consult it who might not otherwise be aware of the nature of its contents. We think that the venerable and estimable author has clothed the work before us in language which is entirely unobjectionable, and almost wholly divested of certain obscure and peculiar expressions or terms that somewhat disfigured his other productions. In fine, we hesitate not to state it as our belief, that, as the work must stand a lasting and honourable monument of Dr. Jackson's unparalleled zeal in the investigation of fever, so will it afford the most convincing proof of the success with which he has cultivated that great and important branch of medical science.

III.

Observations on Sulphureous Fumigations, as a powerful Remedy in Rheumatism and Diseases of the Skin. By WILLIAM WALLACE, M.R.I.A. Member of the Royal College of Surgeons in Ireland; one of the Surgeons to the Charitable Infirmary, Jervis-Street; Surgeon to the Dublin Infirmary for curing Diseases of the Skin; Lecturer on Anatomy, &c. One vol. 8vo. pp. 92. Dublin,

1820.

66

Mr. WALLACE appears to deplore the retardation of the arts and sciences, even in this enlightened era, by the indifference or unwillingness with which new discoveries are frequently received, more particularly when they are much in opposition to accustomed modes of thinking and acting, and when trouble and exertion are required for their application;" while at the same time, for want of sufficient zeal to examine into the foundation of opinions and practice, when first promulgated, "the errors of enthusiasts or the assertions of dissemblers, are sometimes permitted to be propagated, and to have a long and powerful influence in retarding our inquiries after truth."

Our author has, for some years, directed his attention to diseases of the skin, in the Irish metropolis, where cutaneous defœdations are particularly prevalent. In 1818 he was enabled to found a dispensary for this class of complaints, and finding sulphureous fumigations of such great utility, he has, in this publication, attempted a succinct history of the origin of the invention-of its progress on the Continentand of the investigations to which it had been submitted there, contenting himself for the present with adding, in conclusion, some general observations and reflections derived from his own experience in hospital and private practice. The greater part of the pamphlet before us consists of a history of the introduction and establishment of sulphureous vapour baths in France, under the superintendence of Dr. Galés-and of translations of cases and observations by Dr. De Carro, of Vienna, published in 1819. We cannot go into an analysis of these cases, but we recommend a careful perusal of them to all those who have the means of employing the fumigations in question. We introduce the following description of the effects of this bath on the human frame, as it corresponds exactly with what

we have witnessed ourselves at an establishment in this metropolis.

"The temperature of the apparatus should be such as, without creating uncomfortable feelings, will cause a copious flow of perspiration, about ten or fifteen minutes after the patient has entered the apparatus; and, as very different degrees of heat will be required for this purpose, dependent on the various circumstances of sex, age, temperament, or disease, no very determined rule can be laid down. For the most part, I have found a range from 100° to 120° of Ft. necessary. Sometimes, however, a lower temperature has answered the purpose; and not unfrequently, patients have expressed themselves better pleased with one much higher.

appear

"In general, when the patient has been in the apparatus about ten or fifteen minutes, we remark his face to become red, his eyes brilliant and more prominent, his pupils much dilated, the capillaries of the conjunctiva injected with red blood, and all the ance of a high degree of excitement. This is soon followed by an effusion of perspiration; first in minute points, afterward in larger drops, and, in some cases, it becomes so profuse as to trickle in a large quantity down the cheeks.

If the surface of the patient, which is enclosed in the apparatus, be now examined through one of the openings, it feels remarkably warm, and bathed in perspiration; which communicates to the hand a peculiar sensation, not of an oily nature, but astringent, almost as if we immersed our hands in a solution of sulphate of alumen. No doubt this is owing to the deposition of the sulphureous acid on the skin, and its combination with the secretion from the surface. At the same time, the pulse and respiration are a little accelerated; subject, however, to considerable variety, and the former feels full and strong.

"For the most part, when the patient has remained in the apparatus about thirty minutes, (the medium time for adults,) his situation becomes irksome, and he desires to come out. To these sensations we shall particularly attend, as they will afford the best principle to regulate the period of fumigation.

"In some very rare instances, a feeling of debility, of vertigo, and of sickness comes on, while the patient is in the apparatus. This is, however, as I have mentioned, extremely rare; and seldom advances to such an extent as to cause an interruption to the operation. It should, nevertheless, be attended to. If likely to arrive at a serious height, the fumigation must be terminated; and, when repeated, the patient must be kept a shorter time in the apparatus. "When the operation is terminated, and that we have an opportunity of inspecting the surface of the patient, the vascularity of the skin is found to be extremely increased; for not only are all the cutaneous capillaries, but also the superficial veins, particularly those of the extremities, distended with blood. The degree of this deter mination to the surface is nevertheless so subject to variety, depen