The cases which press upon our notice in this division of the work, are so very important and interesting, that we entreat the most serious attention of our readers to them, nor do we deem it necessary to make any apology for extending this article by the introduction of such valuable materialsmaterials which must otherwise be almost entirely lost to the British public.

Case XVII. "Cotier, a soldier in the 32d regiment, had been cured of itch at the St. Louis Hospital, but not yet discharged. On the 8th May, 1814, after a debauch in vinous and spirituous liquors, he fell asleep in an open court, where he lay several hours exposed to the sunbeams. In the evening he was carried into his ward, and his companions reported that he passed a very restless night, often starting out of his bed, and uttering piercing cries. Next morning he presented the following phenomena :-General cephalalgia, intolerance of light and noise, red and dry tongue, nausea, difficult deglutition, tenderness on pressure of the epigastrium, respiration laborious, pulse small and quick, marked stiffness in the neck and trunk. A vein was opened in the arm, and another in the foot; but they furnished very little blood. Towards evening, somnolency when the patient was left quiet, but great agitation when touched. Efforts to get out of bed-piercing criesconvulsions of the facial muscles-confusion of intellect, and extreme difficulty in answering questions. A dozen of leeches to the neck. Third day, face flushed-eyes fixed-pupils dilated and immoveable-conjunctivæ injected-involuntary lachrymationcontraction and rigidity of the extensor muscles of the neck and spine, forming opisthotonos-inability to speak-diarrhoea--involuntary discharge of urine. Twelve leeches to the anus, blisters to the legs. Fourth day, tetanic symptoms augmented-subsultus tendinum-pupils still dilated and insensible to the most vivid light -erysipelatous edema of the left side of the face-breathing short and embarrassed-pulse intermitting. Died at three, P. M.

Dissection. Vessels of the dura mater gorged with black and coagulated blood-arachnoid membrane almost universally inflamed, being red, thickened, injected, and covered with a sero-purulent exudation, in considerable quantity. The medullary substance of the brain was of a reddish hue, and presented innumerable bloody points when sliced. The ventricles contained between six and seven ounces of watery fluid. On laying open the spinal canal, the same marks of this terrible phlegmasia were evident. The spinal arachnoid was inflamed and thickened throughout its whole extent, and a sero-purulent exudation pervaded all parts of the canal." 571.

In the above case, it will be observed that the pain along the vertebral canal was not complained of, as in most of the cases already detailed. This may be accounted for, however, by the intense state of disease in the brain, and the con

sequent derangement of intellect. Indeed, it may be very generally observed, that intense cephalalgia, when it exists, absorbs greatly the attention of the patient, who often neglects to mention other pains, unless closely questioned. This ought to be borne in mind.

We shall introduce but one more case, and that principally with the object of admonishing some of our brethren, who would appear to view the vascular system as the grand agent in all maladies, to the almost exclusion of the nerves. We shall perceive, in the following case, several of the characteristics of spinal arachnitis, terminating in death, and yet without presenting a particle of inflammation in head or spine. We shall make some farther reflections after the case is stated.

1 Case XVIII. "A woman of the name of Roux, 62 years of age, and enjoying habitual good health, experienced a fall, in the middle of April, 1817, which, according to her own account, gave the spinal column and head such a shock as deprived her of sense for a few minutes. From this time till the 29th August following, the occipital region and vertebral column were the seats of constant pain. On the last-mentioned day she experienced contractions in the arms, especially the right arm, with great stiffness and rigidity in the neck and trunk-difficult deglutition-pain in the throat, occipital region, and spinal column-tenderness and tension of the abdomen-contraction of the left pupil. The intellectual functions were free; but the tongue was dry and red, with heat of skin, bitter taste in the mouth, and inclination to vomit. The pulse was quick, but void of force. Venesection, warm bath, purgatives, enema, sulphate of soda in her drink, great restlessness during the night, with pain in the limbs, but no delirium. Fourth day of these symptoms, trismus complete-increased rigidity of the left armother symptoms the same. Trifling remedies. Fifth and sixth days, nearly the same; the tetanic symptoms continued, but the intellects were clear to the last moment. Forty leeches were applied to the spine, but the patient died next day, being the seventh from the commencement of the tetanic symptoms.

Dissection showed the brain and its membranes, the spinal marrow and its coverings, in the most perfect state of integrity, with the exception of a very small quantity of serum in the vertebral canal, and a few varicose vessels near the cauda equina. Every other organ in the body was examined without finding any sign of lesion." 598.

We may observe, on the above case, that the preservation of the intellectual faculties throughout the whole course of the disease was a strong evidence against arachnoid inflammation in the head; but there were most, if not all, the symptoms which accompanied spinal arachnitis in numerous other

cases. What are we to infer from this? Why, that the ridiculed state called irritation of the nervous system will sometimes imitate inflammation, and go on to the destruction o' life, without leaving a single trace of organic lesion after death. This may teach our younger brethren what a part the nervous system is capable of playing occasionally in the animal economy. At the same time we would be very sorry to advise the practitioner to lean much on the chance of having these nervous irritations to deal with, when the symptoms are equivocal, and there are any reasons to suspect inflammation. In the first place, where the proper phenomena or signs of phlogosis are present, there will be actual inflammation in three cases out of four. In the second place, the mischief arising from treating a neurosis as an inflammation is nothing compared with that which must result from treating a phlegmasia as an irritation or nervous affection. Finally, as we are convinced that nervous irritation is the cousin-german, if not the frequent parent of inflammation, we think it by far the safest practice, in all doubtful cases, to combine the depletive mode of treatment with that which may have a soothing or sedative effect on the nervous system.

We have now brought the analysis of this important work to a close, after expending on it no inconsiderable portion of time and labour. We may again repeat it as our conviction, that the authors of the work before us have taken the only proper mode of investigating a most important class of diseases; and that, although they may not empower us to always distinguish the precise seat of disorder within the head or spine, yet that they will often assist the inexperienced practitioner, and enable him to ascertain, with very considerable probability, not to say accuracy, whether or not he has inflammation of the brain or spine to contend witha point of knowledge, in the determining of which the life of his patient, and possibly his own reputation, may be involved.

We shall take an early opportunity of introducing to the English reader an account of those pathological researches on the diseases affecting the medullary substance of the brain, now publishing on the continent, and part of which are already in our possession. In the mean time we entreat the earliest attention of our junior brethren to what we have here presented them.

II.

An Essay on the Effects of the Fucus Helminthocorton upon Cancer, more especially in the Stage den minated Occult &c. &c. &c. By WILLIAM FARR, Member of the Royal College of Surgeons, &c. One vol. 8vo. pp. 112. London, With a Plate.

1822.

Prona via est et eget moderamine certo.

OUR readers need not imagine that we have one particle more faith in the power of" Corsican moss" over cancer, than in that of "Iceland moss" over consumption. We notice the work before us merely for the sake of alluding to some of the pretended specifics for this last formidable disease, which have, in their turn, excited the curiosity of credulous practitioners, abused the ear of the public, and, as may readily be imagined, disappointed the hopes of the suffering patient. Human life, though despised, in theory, by philosophers and enthusiasts, is yet so highly prized, in fact, by all ranks and ages, that when assailed by incurable diseases, the patient will fly from the candid physician to the lying quack, or ignorant pretender; and to insure a trial of any nostrum, however absurd, it is merely necessary to roundly assert, without a particle of evidence except the ipse dixit of the assertor, that it is infallible. If a new and a hard name can be found for the remedy-or a juggling mysterious air given to the measure, the work is half done. Those veracious records of the times, the newspapers, proclaim the important discovery, and the system of delusion is forthwith in full operation.

Now did the nostrum-monger and "peculiar practice" man extend their fallacious promises only to those whose maladies resisted the regular practitioner, it would be exceedingly pardonable, for what can be a more terrible situation than that of corporeal suffering without prospect of relief, except by a lingering death! But the misfortune is, that thousands of people are persuaded through their own fears, and the representations of the unprincipled, that they are labouring under formidable diseases, when their complaints are really harmless, and thus they become the dupes, and too often the victims of mercenary Medicasters or barefaced Charlatans. We have reason to believe that, in this way, a quantum of mischief is committed, and a quantum of

misery inflicted far exceeding belief. We wish we could assert that none of the regular faculty ever compromised the dignity of the profession, or forgot their own rank in society, by setting the example of manoeuvring but a degree removed from the practice of empirics themselves!

Mr. Farr introduces a short, and we imagine, a pretty correct, account of the different means, regular and irregular, now in use for the relief or cure of cancer. He commences with the pressure process of Mr. Young, which he considers to be ingenious, and indicative of mechanical talent in its inventor; but laments that this gentleman should not have confined his plan to those cases where it was likely to prove useful, as he would then have sustained the credit and reputation he gained at its first introduction. We foresaw, indeed, that when Mr. Young had got so enamoured of his favourite measure as to make it paramount, or even exclusive in the treatment of open cancer as well as schirrhus, his plan would soon fall to the ground, as it has now done. We have reason to know, however, that the pressure, applied by himself and a few others who followed carefully his exact mode of application, was, in some instances, successful, and in several productive of relief. But the "cancer institution" is now no more, and its founder, we believe, has left this metropolis.

Mr. Lloyd, of Falcon Square, appears, Mr. Farr observes, to follow, with some variations, the method proposed by Mr. Carmichael, using, in addition, setons near the diseased part, and occasional sedatives.

Mr Wheeler, of this city, is much in the habit of treating cancerous cases, (and he has a good deal of practice in that line) by hemlock internally and externally. Mr. Chevalier, of South Audley Street, it seems, follows the same plan.

There is a Dr. M'Donald, of Orchard Street, who treats cancer constitutionally, and, from Mr. Farr's account, has been successful in four cases. But we have now entered the· domains of the nostrum-monger; for Dr. M'Donald, who is like the famous Captain Wattle-" all for love, and a little for the bottle”—throws a veil of mystery over his method of treatment, and "like the miser with his hoard, bugs himself in the thoughts of his possessions," without communicating, for the good of suffering humanity, this important secret. But we absolve this medical miser of the sin of withholding his treasures from the community, perfectly convinced that he has no such treasures to distribute.

After what appeared in a former number of this Journal, it will not be necessary to say much of the knight of Nelson Square, Mr. Aldis, who is running his career of glory in the