Of M. Alilert's post mortem and chymical investigations, it is not our intention to take any notice, as they do not appear to lead to practical or satisfactory results.

4. Therapeutics. M. Alibert justly observes, that the greater the number of remedies we have for a disease, the less power we have over it. Ambrose Paré recommended surgeons not to attempt the removal of tinea-probably from being convinced that it was one of those diseases which it is" dangerous to cure." M. Alibert, without subscribing entirely to Paré's advice, is nevertheless satisfied that a too sudden removal of tinea is not without serious inconvenience, not to say danger, to many of the individuals affected with it. Thus, he has lately attended a young girl, 14 years of age, who was seized with a most severe stomach complaint, and uterine discharge, on having this eruption too precipitately removed. A woman was lately sent to the Saint Louis, who lost her sight almost immediately after a strong repellent application to tinea favosa. He has seen white swellings, tabes mesenterica, phthisis, fatal diarrhea, and various other dangerous diseases quickly developed, after an injudicious and premature cure of tinea.

At the same time, our author properly observes that the irritation which tinea produces, together with the injury which it may occasion to the skin and subjacent parts, if long continued, renders it improper for us to leave the removal of the disease entirely to the efforts of Nature, though she is generally victorious in the end.

The intimate sympathy which exists between the skin and the interior organs, and the glandular or lymphatic disorders which so frequently show themselves during tinea, demonstrate, our author observes, that the treatment of this disease should not be confined to mere local means. We see, in this complaint, an afflux, or, as it has been termed, a "determination," to the head and its integuments :should we then dream of checking the cutaneous manifestation, without previously, or contemporaneously changing the balance, or rather derangement of balance in the circulation, which occasioned it? Is it not proper to encourage other evacuations which may counterbalance the effects of checking the discharge from tinea? Facts seen every day at SAINT LOUIS illustrate these questions. It is there constantly remarked that those children who are subject to nasal hæmorrhages, or to a large discharge of fetid urine, are very little subject to tinea; or, if affected thereby, that they are very easily cured. Hippocrates, indeed, and his

disciples, inculcated constitutional treatment in tinea, and endeavoured to operate a derivation by purgatives and diuretics. He also advised a strict regimen. These are all found serviceable by practitioners of the present day, and greatly assist the local means of cure.

As to topical applications, these have been multiplied almost ad infinitum. Every one knows the celebrated plaster in use ever since the days of Ambrose Paré, and into the composition of which hellebore, orpiment, litharge, vitriol, alum, quick-lime, mercury, and a great number of vegetable acrids or narcotics entered! The modern pitchcap for deracinating the hair, still employed in most of the hospitals and by regular practitioners, is little less barbarous, M. Alibert thinks, than the monstrous composition above mentioned. Yet this plan has been pursued in Saint Louis (where the greatest number of tinea that can be seen in any part of Europe are collected) for very many years, the results of which are impartially stated by M. Alibert in the following words.

"Imo. The space of six months was the shortest period of cure, on this plan; and the number cured thus was the smallest of any. 2ndo. A considerable number required eleven or twelve months of this process. 3tio. In the course of two years a great number were cured. 4to. Three years were generally required for curing those in whom the disease was obstinate. 5to. A few resisted the process even after the last-mentioned period. 60. The cure was not always permanent, there being several relapses requiring new process. 70. Some children experienced severe diseases after the cure by the cap, and remained languishing and cachectic." 437.

M. Alibert condemns also the process of extirpating the hairs, one by one, with pincers, as "less effectual, and still more barbarous than the preceding." "Cette méthode n'est-elle pas plus defectueuse, pour ne pas dire plus barbare, que la precedente, par les violences repetées qu'elle fait exercer sur le cuir chevalu."

M. Alibert here enumerates and descants on the various topical remedies which have been recommended in tinea, all of which were tried in the most careful manner at the SAINT LOUIS, but with little or no success-many of them producing manifest injury. From this denunciation, however, he excepts a remedy lately much praised in Germany, and used by himself and colleagues at SAINT LOUIS, with considerable and unexpected benefit. This is a combination of equal parts of sulphur and charcoal incorporated with common cerate, and well rubbed on the scalp, after the bair

has been shaven, and the scabs softened and removed by cataplasms and fomentations.

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"Those who have visited ST. LOUIS," says our author, witness, that very frequently this application has been crowned with unequivocal success. "Les temoins assez nombreux savent que fort souvent nous avons vu cette nouvelle application coronnée d'un succés incontestible."

In short, he has seen more certain and speedy cures from this than from any of the applications before enumerated. Out of thirty individuals, thirteen were cured in about four months by the daily use of this application-the rest required seven or eight months. M. Alibert thinks that this application is perfectly safe, as no inconvenience in any case has resulted from its employment. He has lately succeeded in curing a most obstinate case of tinea favosa by this process, which had resisted every other means from infancy to the age of eleven years. He thinks the proportion of sulphur ought, in general, to be greater than that of the

charcoal.

In order, however, to guard the constitution against the consequences of suppressing the discharge from tinea, and removing an irritation of long standing from a cutaneous surface, M. Alibert thinks that the prudent and enlightened physician will establish some other drain, as by an issue or seton or at least take blood occasionally from the system as an equivalent.

In aid of the local means of cure, also, internal and general means should be employed. The alimentary canal should be particularly attended to; and the warm bath, especially in those cases where other parts of the surface besides the scalp, are affected, becomes a powerful auxiliary.

Our author observes that there are many cases of tinea, especially where the disease has not committed great ravages on the integuments, which give way to cleanliness alone; but that there are many others, where there is vice of constitution, and where the disease will not be subdued till this is corrected. The following observation of this expe rienced physician may be worthy the attention of some of our precipitate practitioners, who ridicule the connexion of local, and particularly cutaneous affections, with constitutional disorder.

May I be permitted one final reflection which may account for the diversity of results which men experience in the treatment of the complaint in question. Cutaneous diseases, and of course tinea, have, like other diseases, their periods of access, increase, and de

cline. Practitioners are astonished that they do not succeed—while it is no uncommon thing to see them administering, from the beginning, those remedies which can only be useful when the disease is on the decline. They are too impatient to follow the footsteps or indications of Nature, when she appears slow in her march, and life is short in its duration."

M. Alibert has made numerous comparative trials with all the different means, active and simple; and he found none so good and so safe as the sulphureous application above mentioned, combined with warm bathing, cleanliness, and attention to the general health. This treatment, he affirms, is applicable to all the different species of tinea. Where the disease is very inveterate or of long standing, and where the vital properties of the integuments must be changed, he recommends, as a depilatory, an ointment, the basis of which is potassa and carbonate of lime. In the course of a few days, this application causes those hairs which grow on the diseased part to fall off, after which the scalp whitens, the itching subsides, and the cure proceeds, when aided by proper internal means.

Upon the whole, while we consider M. Alibert, and our continental brethren, as too much afraid of curing or repelling cutaneous eruptions, we are convinced that the practitioners of this country are rather too prone to run into a contrary extreme, and attack affections of the surface with as little ceremony as if the skin was a kind of covering quite unconnected with the rest of the constitution. We have seen so many injurious consequences result from the sudden suppression of long established discharges, and the precipitate removal of local irritations, that we cannot too earnestly exhort our junior brethren to keep their attention turned to this subject. We would recommend to their consideration the many important remarks which Dr. Parry has made on this subject in his elements of pathology, a work too little studied in the present day. It is our intention, ere long, to present to our readers a very comprehensive view of that experienced physician's work, which may perchance convince them that they are allowing a mine of great value to remain unworked, though close to the surface.

VI.

A Manual for the Student of Anatomy: containing Rules for displaying the Structure of the Body, so as to exhibit the Elementary Views of Anatomy, and their Application to Pathology and Surgery. By JOHN SHAW; being an Outline of the Demonstrations delivered by him to the Students in the School of Great Windmill Street. One closely printed volume, 8vo. pp. 342, 2 plates. London, 1321.

WORKS of this description do not usually afford materials for analysis, or even criticism. The origin of a muscle, the distribution of an artery, or the processes of a bone, are interesting subjects to the student, who has yet to pass those awful barriers and unknown trials, in Lincoln's-Inn-Fields or Creed Lane; but they have lost their attractions for the veteran Esculapius, whose objects of pursuit are of a different character. The author of the work before us has deviated from the common road, and endeavoured to render his manual more interesting than manuals generally are, by the frequent introduction of physiological, pathological, and therapeutical observations. The utility of this plan, we know, has been called in question-and here, as elsewhere, "much may be said on both sides." For our own parts, we have always been in favour of this mixture of the "utile et dulce," in spite of all the denunciations against it by those stiff-rumped and sour-crout philosophers, whose discourses are as dry as their skeletons-the one being as barren as the other is bare.

We will not assert that the present form and arrangement of Mr. Shaw's book are the very best that could possibly be devised for the London dissector-especially for the student who has but one short year to swallow (for digestion is out of the question) the whole circle of medical and chirurgical science. But we think it a very useful and agreeable pocket companion for the youth who goes leisurely and fundamentally to work, in acquiring a thorough knowledge of anatomy and surgery. We conceive also that it will prove a very acceptable treat to the provincial practitioner, as a guide in his post mortem researches, considerably more adapted to his taste and habits than any thing of the kind that we have yet seen.

One of Mr. Shaw's main objects, in this publication, appears to be the direction of the student's attention particularly to those points of anatomy which are most useful,