puncturing the bladder, but cut beyond the stricture, and thus give vent to the urine.

"As soon, therefore, as I should perceive the urethra to be considerably swollen and enlarged, I should direct the patient to make a violent effort to void his urine; at this very juncture, place, your finger upon the perineum, and the tumour and fluctuation will be very evident, and here the incision is to commence : another similar exertion, as just stated, is to be then made, and the tumour being again distinctly felt, there will be no difficulty in proceeding with the further necessary incision, going on, as it were, mechanically. Another method, and one very easy, is to pass a staff into the urethra, as far as the stricture, (for it will go no farther) then cut down and lay it bare, then divide the stricture in the direction of the groove of the staff, carrying the knife towards the arch of the pubis." 217.

The chapters on hernia and dislocation are valuable, as may easily be imagined; but Sir Astley's regular publications on these subjects are, of course, the proper sources for

information.

Speaking of gonorrhoea in the 29th lecture, the lecturer directs that, in the inflammatory stage, a purgative, composed of six grains of extract of colocynth, should be given every night, and two drachms of the sulphate of magnesia with a scruple of nitre every morning. The patient should drink plentifully of barley water, mucilage of gum arabic, linseed tea with nitre, &c. Low living, soda water for common beverage, open bowels, venesection if the symptoms run high, are proper. When these and various other antiphlogistic and sedative means have subdued the inflammation, the discharge may be restrained by bals. capivi, cubebs, or injections.

In the 30th lecture, Sir Astley observes that balsam copaiva is to be ranked as one of the most effectual remedies in enlarged prostate, taken in doses of twenty drops thrice daily; but the only remedy known to give permanent relief is the hydrarg. muriat. in solution, accompanied by the sweet spirit of nitre."

66

On the subject of syphilis, Sir A. proves himself a decided but judicious mercurialist. He has known several instances of the foetus in utero becoming tainted with syphilis. There is an opinion stated at page 385, that a pregnant woman cannot be cured of syphilis during utero-gestation ; but whether this comes from Sir Astley Cooper or others, we are not informed. The work concludes with several lectures on fractures, scrofula, and tumours.

Sir Astley Cooper has great reason to complain of the gentleman's conduct who first published these mutilations of his lectures. We say mutilations, for they are so full of

obvious errors, that we cannot conclude otherwise than that they exhibit an exceedingly imperfect, not to say erroneous, view of Sir Astley Cooper's prælections. Another insuperable objection is this, that the annotator speaks so frequently in the nominative case, and jumbles in the same page such a variety of lecturers' names, that it is, in general, quite impossible to ascertain whose sentiments we are perusing. With the exception of these defects, the work contains a great mass of very important practical matter. It is greatly to be wished that the able surgeon, whose lectures are here garbled and defaced, would employ an amanuensis to revise and print them in a form and state worthy of the man who has so long delivered them orally to crowded audiences in the great school of which he is so distinguished an ornament.

IV.

PRESENT STATE OF MEDICINE IN ITALY.

1. Della Nuova Dottrina Medica Italiana, &c. Del Professore G. TOMMASINI, Firenze, 1817, pp. 98.

2. Dell' Infiammizione e della Febbre Continua-considerazioni Patologico-Pratiche. Di G. TOMMASINI. Pisa 1820, pp. 272.

3. Prospetto De' Resultamenti ottenuti nella Clinica Medica della Pontificia Universita' di Bologna nel Corso di un Triennio Scholastico. Discorso premesso alle Lezioni Medicopratiche dell' anno Scholastico 1819, 1820. Dal Professore GIACOMO TOMMASINI. Pisa 1820, pp. 48.

ALTHOUGH the avowed and actual object of this Journal is, to present to its readers an analytical record of practical medicine, as exhibited in the never-failing produce of the press; neither we, nor our patrons, are so strait-laced as to sacrifice all other considerations of curiosity or interest to that of mere practical utility. When wearied, therefore, with the everlasting labours of our diurnal calling,-in copying in miniature on our pages, the full-length pictures that meet our eyes, on all sides, from the pulse-feeling fingers of practical men, we take no shame to ourselves, nor think it requisite to crave the pardon of our readers, if we occasionally indulge ourselves, and them, with sketches of a less sombre and a lighter character. Of this class is the notice which we take, from time to time, of those theories and speculations, which, God knows, will never be of any other practical benefit, but that of keeping the blue devils from their authors,

during the period of their concoction; and "which play round the head, but come not to the heart" of such musty subjects as ourselves, whose taste and talent for theory have long been spoilt by the ill-mannered and uncourtly obstinacy of vulgar disease. Of a kindred, but less futile, class of subjects are those, which relate to the state of medical opinion and practice in different countries: the progress of medical literature, and the biography of illustrious men. To the former of these subjects, the present sketch will be devoted; and we leave the interest, if not the utility, of the details to plead for themselves.

Italy-the very name of Italy-must possess an interest and a charm to all that look upon that lovely and famous land, whatever be the object of their contemplation or inquiry. Our early intimacy with the nations of classical antiquity, through the proxy of their immortal authors, gives them peculiar claims to our attention; and, from the identification of feeling with the objects of regard, which can only arise in the generous breast of youth, we can never look upon them afterward, even in their evil days and most degraded fortunes, but with a tenderness partaking of the love for a native land. It cannot, therefore, be supposed, that our fraternity, whose official language is still that of ancient Rome, can look with indifference on the existing condition of their profession in Italy. And it must be delightful to them, and to every friend to humanity, to know, that the present state of medical science in that country is, comparatively with former periods, most flourishing. In fact, it is such, as to bear comparison with that of any country in Europe; and is certainly very superior, both in principle and practice, to that of the great majority of continental states. This comparative excellence, however, is, as we shall shortly see, of no very ancient date; and the whole science may be truly said to possess, at this very moment, the boisterous vigour and noisy zeal of youth.

Italy has always been the prey of conquerors; yet none of her masters ever established a more complete authority over her political fortunes, than one of our own countrymen extended, some time ago, over her medical independence. JOHN BROWN, (like his gifted countryman ROBERT BURNS, at once the glory and disgrace of Scotland,) was destined to receive from foreign nations the unbounded honours, to which both himself and his friends considered his genius as entitled; but which were most pertinaciously withheld from him in his native country. While he was struggling for existence in Edinburgh, against the cabals and persecutions of his opponents, and the more fatal array of his own violent and ill

regulated passions;-or was subsisting in London on the charity of his few remaining friends,-with no patients, and scarcely a disciple ;-his New Medical Doctrine was spreading like wildfire over the Continen; and in Italy, more especially, was subduing to its influence, alike the truths and errors of former systems, and fixing itself, like a delightful and unresisted spell, on the minds of the younger members of the profession. In a very few years after the death of its author, while the slight impression which the New Doctrine bad made in England was (with the exception of some of its principles, which can never die,) almost entirely effaced, in Italy the whole of it was established as the catholic rule both of reasoning and practice.

It is needless to observe that the author of such a revolution must have been a great man; and it is equally needless to deny that, as a system, that of Dr. Brown equals, if not exceeds, in originality and ingenuity, any that have been promulgated in medicine. No one will, assuredly, accuse us of being Brunonians; nor will those acquainted with our critical labours, believe us capable of undertaking the merits of Dr. Cullen; yet we conceive it will be now universally admitted, that the merits of the latter, as a theorist, are insignificant when compared with those of his great but unfortunate rival. But for the extreme value of his admirable practical writings, the name of Dr. Cullen would only new be ranked in the class of minor speculators in medicine. Brown, on the contrary-LIO SCOZZESE-THE GREAT SCOTSMAN, as he is called in Italy,-like the sculptor of antiquity, who engraved his own emblem on a part of one of his immortal works,— has so deeply impressed the stamp of his genius on medicine, that it can never be effaced, but by the destruction of the science itself. And yet, however humiliating the confession, we must admit, that his doctrine has been the source and sanction of a practice most injurious to mankind The offspring of a mind more versed in abstract science than in practical medicine, its beautiful simplicity was, in few cases, adapted to the explanation of the complicated phenomena of disease; and, even when just, its principles, when rigidly followed in practice, often led to the most fatal consequences. As necessary inferences from the doctrine of excitability, it followed that almost all diseases either were originally, or speedily became asthenic, or of debility, requiring stimulants for their cure; a class, which was still farther enlarged by that part of the doctrine, which considered general diseases as of the same nature as their causes, and local affections as necessarily of the same nature as the existing diathesis,―sthenic, or asthenic. Accordingly, in Italy, during the dominion of Brown

ism, all fevers, all acute inflammatory affections in their latter stages, and all chronic inflammations, were considered as diseases of debility, and treated with stimulants. The consequences were such as we can now very easily conceive. And it is, perhaps, on the whole, fortunate, that the doctrine and practice of stimulation were carried to the extreme they were; as the glaring and disastrous results eventually sufficed to open the eyes of the profession to the true state of things before them, and induced those to listen to the pleadings of nature, whose ears had been too long closed by the enchantments of a false philosophy.

Signal and complete as was the triumph of the Brunonian system in Italy, still, it is not to be supposed that it was ef fected without opposition; nor that there were wanting here, as in other conquests, some stubborn spirits, who still clung to ancient opinions, and yielded a willing homage to the names and objects of former veneration. It was not, however, before the year 1800, that any thing like a systematic opposition was made to the established doctrines. And this appears to have been first done by Rassori, in his work on the epidemic petechial fever of Genoa. This was followed up by many publications of various physicians, in different parts of Italy; all of which are chronologically arranged in Tomassini's pamphlet. This author, himself, has been for many years, one of the most successful and distinguished opponents of the Brunonian system, and has, by his various writings, contributed largely to the establishment of the doctrine and practice which have now, for several years, very generally superseded it.

This New Doctrine, as it is called,-for the Brunonian, which in the foregoing observations we have been denominating new, is now named the Old,-is held up by the Italian writers as something original; and its discovery claimed for Italy, as if conferring on it the greatest honour. We shall presently see, however, that its principles are a mere modification of the systems of Brown and other theorists, and its practice in a great measure such as has been established for many years in this country. This, indeed, is distinctly avowed as the child of Brownism, but of a regenerate branch, and purged from all the frailties and vices of its sire.

The following is the pompous style in which it is announced in our author's pamphlet.

"The New Italian Medical Doctrine has created an epoch, and will undoubtedly hold a distinguished station in the history of medicine. The offspring of Solidism and Brownism, it is more simple than the doctrines of Hoffman, Baglivi, or Cullen, inasmuch as it abjures the many fruitless suppositions and questions which so long