and fatal. In the latter disease the vomiting appears to be the only effort which Nature is able to make in struggling with the morbid cause. The great and leading indications then in fever, have long appeared to us much more simple than they are represented in books or in conversations. In these stages of depression, the first effects of the febrific cause, is it not consonant with the best practice to take those measures which promote reaction or excitement-especially the warm bath, and even diffusible stimuli, carefully aud cautiously applied? In these stages, however, there are certain counter-indications. While the heart is incapable of distributing the blood to the surface, from real weakness or oppression, we have the lungs, the brain, and other important organs drowned, if we may be allowed such an expresssion, with congested blood. Here then, while with one hand we stimulate the heart and cutaneous vessels by cordials and the warm bath, we are justified in detracting blood, with the other hand, in order to relieve those organs which are oppressed with an undue proportion of the vital fluid. In respect to the stage of reaction, the clear indication is to control it when it runs high, to prevent local mischief in some important organ; and when topical inflammation is manifested, to combine local with general bleeding till the organ is relieved, whatever the quantity may be that is required for that purpose. It is in vain to talk of husbanding the resources of the constitution, when an organ is a prey to congestion or inflammation. Certainly the greatest assistance we can give the constitution is relief to any of its important viscera when suffering from disease.

When the nervous or scrous temperament was the subject of fever, our author was far from successful, especially at first. But it was still worse with the Spanish physicians, our author asserting that out of more than 100 patients who were severely afflicted in the hospitals of Cadiz and Xeres, and which our author had an opportunity of seeing, not one recovered. Finding the usual remedies of bleeding, purgatives, frictions, fomentations, antimonials, and blisters, unavailing, Mr. O'Halloran had recourse to emetics, and to these he was principally indebted for the recovery of the few who did not fall victims to the epidemic. We must con clude this article, already too far extended, with the follow ing extract:

With regard to the general mode of treatment, I would recommend that the patient, on the first day of the attack, should be immediately placed in a hot bath, and left there until the body is thoroughly heated, or in other words, until a degree of artificial fever is produced. He should then be rubbed dry, and covered,

in bed, with more than the usual quantity of clothes. If, after he has been in bed for half an hour, reaction takes place, I would then advise the abstraction of a small quantity of blood: but if he continues cold, I would only repeat the bath. Recourse should next be had to emetics; and as the subsulphas hydrargyri, or turbith mineral, and ipecacuanha (in the proportion of six grains of the former to five of the latter.) will be found effectually to unload the stomach without much straining, I would recommend it in preference to any other. After the operation of the emetic, calomel and James's powder should be exhibited in the proportions of five, grains of the former to three of the latter, in the form of pills, every two hours; with a view of preserving an open state of the skin and bowels, and of affecting the system. The head should be shaved, and blisters applied to the temples and nape of the neck, while the head is kept cool by means of cold applications. The skin should be rubbed over with heated oils when there is much dryness and constriction. The pediluvium and fomentations may always be used with advantage. Opium, camphor, and ammonia should be had recourse to, where the prostration of strength is great. The liquor ammoniæ acetatis, effervescing draughts, wine, and the mineral acids, may also be tried, according to circumstances; but emetics are the remedies upon which our greatest reliance is to be placed. In two forlorn cases I tried a weak solution of the argentum nitratum with a view of checking severe hickup, and it certainly answered the purpose for which it was intended: the patients did not recover; but as it stopped the hickup and procured rest, I think it right to mention it as a remedy which may be tried without detriment in such cases." 134.

The work concludes with two appendices on the supposed introduction of yellow fever in the town of Xeres, in the year 1820, which we recommend to the perusal of the importers.

Mr. O'Halloran, with that zeal and courage characteristic of youthful and ardent minds, but which we have seen also in our venerable countryman, Dr. Jackson, has again repaired to the scene of this dreadful scourge, with the hope of elucidating its nature and causes, and ascertaining the best principles of combating its ravages. The labours of our countrymen, who have thus risked their lives and endangered their health, in the service of humanity, should meet with liberal encouragement from a British public, and we trust and hope that every medical society, at least, and many opulent individuals, will consider it a duty owing to science and philanthropy, to place the little works of Drs. Jackson and O'Halloran in their libraries. We think we need hardly add, by way of inducement, that these publications were at the private expense of the authors themselves; and it would be most unjustly cruel in the profession at large, to allow these individuals to suffer in their purses as well as

in their persons, while supplying us with information which we otherwise could not possibly obtain.

The perusal of Mr. O'Halloran's work has convinced us that the character drawn of this gentleman by his colleague. in the "holy office" of visiting the sick at Cadiz and Xeres, (Dr. Jackson,) was not overcharged. May he long live to enjoy that pleasure which "nothing earthly gives or can destroy," the approbation of his own conscience; and may he persevere in the cause of medical science till he is crowned with success, by seeing it far advanced beyond the point at which it now stands.

X.

Observations on some of the general Principles and on the particular Nature aud Treatment of the different Species of Inflammation; being, with Additions, the substance of an Essay to which the Jacksonian Prize for 1818 was adjudged, by the Royal College of Surgeons. By J. H. JAMES, Surgeon to the Devon and Exeter Hospital, and Consulting Surgeon to the Exeter Dispensary. London, 1821. Octavo, pp. 305.

"The knoweldge of inflammation, in all its variety of causes, effects, terminations, and method of treatment, may be truly said to constitute the basis of scientific surgery, entering, more or less, into the prevention or cure of every disease which comes under the surgeon's care." MR. WILSON'S LECTURES, p. 243.

THE respect which we entertain for the opinions of the distinguished individuals who preside over the London College of Surgeons, naturally induces us to approach a work which has been honoured by their favourable suffrage, with more confident hopes of finding important information, than if it did not possess such an honourable passport. Let it not be imagined, however, that any favourable prepossessions of the merits of the work before us, even founded upon such a basis as the approbation of the College of Surgeons, will induce us to forego our duty as impartial reviewers. We shall comment upon its contents with our usual sincerity, from a perfect accordance with a quotation supplied by our author himself, that," nothing has been so great an obstacle to the improvement of science, as the partiality or obsequious

regard which men have been too apt to pay to great authorities."

The vast importance of the subject of inflammation must be so evident to every physician and surgeon, and it has been so frequently insisted upon, that it would be a waste of time to obtrude any arguments for the purpose of demonstrating that the practitioner, who is not intimately acquainted with every part of it, can neither execute his professional duties with satisfaction to himself, nor advantage to his pa tient.

Mr. James justly observes, that although Mr. Hunter's work on inflammation has laid an ample and durable foundation for such an edifice of knowledge as may fulfil all the purposes of science in this department; yet, to the superstructure much remains to be added, before it can be considered perfect and complete. The present Essay, however, is not submitted to the profession as a systematic work ; it is avowedly much too concise upon many points, to warrant the assumption of such a title.

The inquiry into the subject of inflammation divides itself, according to our author, into various branches. 1st. The state of the vessels and nerves, in the part inflamed, constituting the immediate cause of the phenomena we observe, 2dly. The general laws of the economy, and chiefly the phenomena of sympathy, as they relate to disease in general, and to inflammation in particular; as also the circumstances belonging to, or affecting the individual, which are capable of influencing its progress and results. 3dly. The objects of inflammation in the animal economy, the phenomena which it exhibits, the effects which it produces, and the products which it affords. 4thly. The general principles of treatment, which have been so ably considered by various modern authors, that in the present work this part of the subject is wholly avoided. 5thly. In the words of our author, "a particular arrangement of the different kinds of inflammation,. I am justified in saying, is very much wanted, and it has been a principal object of my endeavours in this essay to effect this." It is not contended that there are not arrangements of inflammation in existence, proposed even by authors of celebrity; that those, however, which preceded Mr. Hunter were to him unsatisfactory, may be concluded from his having omitted all mention of them. From the opinion of an author of late date and acknowledged authority also, (Dr. Thompson,) it appears that none have subsequently been offered, which is entitled to command our attention. 6th and lastly. To consider the peculiarities of each inflammation, and to indicate the principles of treatment particu

larly adapted to it. "In all modern works," says Mr. James, "and for the most part in those of more ancient writers, the views of inflammation which have been given, are, as it appears to me, too general; and this observation also extends to treatment, which has commonly been laid down under certain heads; such as the antiphlogistic plan-bleeding, cold, &c. It seems, however, important to specify exactly the case in which one mode or one remedy is more likely to succeed than another."

From these observations it would appear to us, that our author had consulted only those general views, which, in systematic works, properly precede the consideration of the nature of, and the peculiar treatment demanded in, the different species of inflammation. We really are not aware that this important part of the subject has escaped the attention of previous writers.

Mr. James has divided his work into two parts; the first containing "Observations on some of the General Principles of Inflammation ;" the second being occupied by a description "Of the different species of laflammation."

Having thus given an outline of the purposes which it is the author's intention to fulfil, we shall proceed to submit to our readers an abstract of the most prominent parts of his work.

CHAP. 1st. "On the Principles on which an Arrangement of Inflammations may be founded." A cursory statement of the modes of dividing or arranging the subject now in use, precedes the exposition of the principles upon which Mr. James has founded his arrangement.

1st. Inflammations are commonly treated of as acute, subacute, or chronic, but these it is observed are merely different stages of the same state in many instances. 2dly. As the adhesive, suppurative, ulcerative, or gangrenous" processes, which cannot be too attentively considered; but they are merely modes of termination, often of different kinds, but sometimes of the same; to a certain extent they will afford a basis of distinction, but to me it seems that this is only in as far as they constitute a groundwork for subdivisions, as will be hereafter explained." 3dly. As phlegionous, erysipelatous, or gangrenous. The following objections to this division of inflammation are submitted :

"Under these titles, diseases of the most opposite nature, and requiring the most opposite treatment, have been indiscriminately brought together. And supposing no objections occurred to the titles, (a point which will be hereafter considered,) would a division into three kinds be sufficient? Is it not looking at this numerous class of diseases in too narrow a point of view? Are we to