very fine, so that in adding a trifle to the dilatation, the change should be very gradual, which makes it much less painful. There should be a spring between the handles, to keep them closed when entering. Every possible motion being possessed by the arm, the mirror can catch the sun, and cast a spectrum in any direction. When this is about one fourth of an inch in diameter, which is the proper size, there is no disagreeable heat produced by the hottest summer's sun. All the instruments for operation in these cavities can be made with long handles, so that the hand can be behind the mirror.

No. 2. The valves of their full size.

BIBLIOGRAPHY.

The Philosophy of Marriage in its Social, Moral, and Physical Relations, &c., &c. By MICHAEL RYAN, M. D. Member of the Royal College of Physicians and Surgeons of London, &c. pp. 364, 12mo.

This work is misnamed. It falls far short of the philosophy of the subject which it proposes to treat. Materials we find in abundance-some worthy of being retained, others useless, misshapen, and in part rubbish. The author seems to have chosen his title, as a persevering anecdote monger brings in his apropes des bottes, or talking of a gun, in order to string together a variety of details, many of them entirely foreign from the expectations raised by the catchword.

The subject of marriage is worthy the pen of a philosopher, whose mind has been enlightened by physiology and hygiene, and stored with much and various knowledge of human nature. But the philosophy of the subject does not require, nor even allow of the introduction of the many extrinsic matters which we find in Dr. Ryan's book.

Every now and then the author seems to be on the point of approaching the real truth of the subject; and we are in expectation of at last finding its philosophical bearings and applications; but disappointment follows, and we discover merely a brief annunciation of some common place truisms. To the professional reader its details must be often wearisome, either by the triteness or inappositeness. To the general reader they are perplexing by their number, if not incongruity. Physiology and ethics, which might be made to illustrate one another, and which ought to be exhibited in close and harmonious connexion together, are set forth by Dr. Ryan in shreds and patches of party colours and party tissues.

Justice to his theme did not demand more than an allusion to "generation in the vegetable kingdom," whereas the author has given us a chapter on this point. The professional reader might well ask to be spared also the infliction of an account of the "ancient and modern theories of generation." To the general reader such an account conveys as much instruction as a disquisition on castles in the moon. There is some good, though familiar advice, to pregnant fe

*The remainder of the title is :-"With an Account of the Diseases of the Genito-Urinary Organs, which impair or destroy the Reproductive Function, and induce a variety of Complaints. With the Physiology of Generation in the Vegetable and Animal Kingdoms. Being part of a course of Lectures delivered," &c.

males, which may be said to come, properly enough, within the scope of the philosophy of marriage. By a large construction, what the author calls the hygeology of parturition might be included under the same head; but the whole chapter on " parturition-assistance to be afforded by male and female obstetricians duties of accoucheurs and midwives," may be considered as an attempt to make up a book by superfluous if not extraneous matter. If all the sequences to marriage constitute a part of its philosophy, why not give us an account of the appropriate ceremonies of christening, as there is, in fact, of the "physical management of infants," which ought, according to Dr. Ryan's method, id est the want of it, be followed by a history of the symptoms and treatment of the diseases of children.

A chapter of some length is devoted to the "pathology of the generative organs, malformations and diseases of both sexes, which disqualify for marriage, cause impotence and sterility, or which injure or destroy the offspring.”—Written in a less gossiping mood, the points treated of in this place would not be without their value: but in this case, the whole would have to be recast in order to give it any thing like homogeneousness and unity. We find in this chapter more aliment to prurient curiosity than aids to philosophy.

The last chapter is on "syphilography-history of the symptoms of the venereal disease, comments on sexual diseases." We may well question the necessity of including under the head of the philosophy of marriage, a description of the varieties of a disease which is in no ways connected with or grows out of the marriage institution, or sexual intercourse under marriage sanction; but which, on the contrary, is the result of a neglect of the laws and philosophy of marriage. The author, probably, goes on the poetical plan of illustrating by contrasts and contraries,-lucus a non lucendo.

In fine, the really philosophical inquirer on "Marriage" may continue his studies and observations, without any fear that he has been anticipated by Dr. Ryan in the work before us. The subject is unquestionably an important and engaging one; and, if examined in the right sense, might be placed in such a light as to benefit not a little both those who, after pleading guilty to the soft impeachment, propose to take on themselves the silken bonds of Hymen, and that other numerous class who are already initiated into its mysteries.

An Essay on the Relation between the Respiratory and Circulating Functions. By CHARLES HOOKER, M.D. Read at the New Haven County Meeting of the Connecticut Medical Society, April 12th, 1838.* pp. 47. 8vo.

Boston.

THIS essay is creditable to the industry and observation of its author. The subject is confessedly important; and one cannot but be surprised that it has not engaged more attention. From the good old rule, which generally obtains currency, "to begin at the beginning," we shall deviate this time by beginning at the end, and giving the "Concluding Summary" of Dr. Hooker's essay in his own words:

"The preceding essay, it is believed, establishes several important pathological principles, affording valuable diagnostic and therapeutic indications, which

• Republished from the Boston Medical and Surgical Journal."

hitherto have been but slightly noticed, or wholly unknown. The indications of the pulse have received much attention; but the variations of the respiration have been little attended to, and the relations between the respiratory and circu lating functions have been almost wholly neglected.

"The comparative frequency of the respiration and the pulse in health, which from constant observation, during a period of several years, I have ascertained to be 1 to 4 (p. 3), has not been commonly observed; and most of the indications afforded by variations of this ratio (p. 5) have been altogether overlooked.

"A disproportionate increased frequency of the respiration has been shown to afford the general indication (p. 11) that there is some impediment to the respiration; which may be owing to A. Disorder of the lungs or air passages (p. 5), as pneumonitis, phthisis (p. 7), cedema of the lungs (p. 8), or (p. 9) any affection of the lungs which prevents a portion of them from being freely permeated with air, or any disorder of the bronchia or bronchial membrane which impedes the communication between the air and the blood within the langs: or, B. Some mechanical impediment to the motions of respiration (p. 10): or, C. Imperfect function of the organic nerves of the lungs (p. 10).

"A disproportionate diminished frequency of the respiration, which indicates a want of energy in the nerves which control the respiratory motions (p. 11), has been shown to be common in typhous fever, and in many other diseases.

"The pathological effects of imperfect aëration of the blood, which had been treated of by Bichat and some subsequent writers (p. 12), but which they scarcely noticed except as immediate precursors and causes of death, I have observed to be manifest through the progress of typhous fever (p. 14), and many other diseases. What is commonly termed congestion in the brain, I have endeavoured to show (p. 17), is simply a deterioration of the blood caused by this imperfect aeration, a prominent example of which occurs in the disease termed congestive typhus (p. 17). The effects of this imperfect aëration, depending upon disordered function of the different nerves concerned in respiration, have been traced in various diseases (p. 14 to p. 25).

"The common occurrence, and the injurious effects, of this imperfect aëration of the blood suggest the important general therapeutic indication (p. 26) to remedy deficient respiration. The medicinal agents are detailed (p. 26 to p. 28) which aggravate deficient respiration, by increasing the circulation, or by diminishing the respiratory function.

"The use of remedies, with a view to promote the arterialization of the blood (p. 28), it is believed, has never been distinctly treated of by any author, as a prominent object of medication. Though my 1st class of these remedies—those which diminish the action of the heart and arteries (p. 29)—have been commonly known to possess this power over the circulation, still they have not been commonly employed with the view-a view which I consider as highly important in many cases to obviate a disparity between the respiratory and circulating functions. The 2d and 3d classes of remedies (p. 34 and p. 36)—those which excite and invigorate the motor respiratory nerves, and the arterializing nerves of the lungs-have rarely, if ever, been recommended for those particular purposes; though I think it will be obvious to my readers, that many of the known valuable effects of these remedies are owing to such operations. The other three classes-4th. Ventilation (p. 42); 5th. Remedies which obviate mechanical impediments to the respiration (p. 43); and 6th. Remedies which excite secretions vicarious of respiration (p. 44)-though their general effects on the respiratory function have been known, have not been commonly employed for the distinct purpose of obviating deficient aëration of the blood.

"In short, the general subject of the pathological relations between the respiratory and circulating functions has received little, very little attention. The writer hopes that he has at least shown the subject to be deserving of investigation.'

Objections may properly be taken against some of the divisions of the subject made by Dr. Hooker, as based upon hypothetical or doubtful views. Among the different heads of "Frequent Respiration" he instances that "from imperfect

function of the organic nerves of the lungs :" so, also, a little farther on, he speaks of imperfect aëration of the blood from disordered function of the motor respiratory nerves." Our pathology is not so far advanced as to justify this minuteness of reference to the states of the nerves connected with the respiratory

movements.

"The general therapeutic indication," according to Dr. Hooker, "connected with the relation between the respiratory and circulating [circulatory?] functions, is to promote the arterialization of the blood, or, in other words, to remedy deficient respiration." The remedies enumerated as promotive of the arterialization of the blood are divided into six classes. Under the head of the first, or those which diminish the action of the heart and arteries, Dr. H. specifies venesection, antimony, ipecacuanha, the refrigerant salts, digitalis, sanguinaria canadensis, colchicum, veratrum, nicotiana tabacum, lobelia in flata, and polygala senega. How justly all these, or any one in all circumstances, can be said to be entitled to the place thus assigned them, is a question which to discuss would lead us into details for which we have not room at this time. The position assumed by Dr. H., impliedly, if not positively, is that a diminution of the heart's action will relieve the respiration by increasing its frequency, and that the remedies just mentioned will act as sedatives to the heart without affecting in a similar manner the lungs. This proposition is equivalent to saying that the nerves of the heart, through which it is operated on by the remedies, are in an inverse state from those of the lungs, and that the means chosen to abate the excitement of the former, will, at least, not diminish the activity, if they do not actually increase it in the latter. Is there not more refinement than accuracy in this mode of viewing the subject?

Among the diseases mentioned by Dr. Hooker, in which there is a manifest and morbid inequality between the respiration and the circulation, we see Delirium Tremens. In the treatment of this disease, Dr. H. places great reliance on digitalis, which, he tells us, "relieves morbid wakefulness, subsultus tendinum, muttering delirium, and coma, and sleep induced by it is commonly more refreshing than when induced by opium and most other narcotics, because the respiration is less oppressed." The author had before pointed out "the remarkable deficiency of respiration which occurs in delirium tremens," and he now briefly describes his plan of treatment, in which, be it said briefly, that digitalis and nitrate of silver figure as the most conspicuous and the chief remedies. “I commence," says Dr. H., "the treatment of a case with a full cathartic dose of calomel, which is followed, with the exhibition of nitrate of silver, in doses of gr. th every hour, or gr. 4th every two hours. If called in the early part of the day, I adopt no direct means for inducing sleep until night-the natural time for sleep." In what follows, the reader of this notice of ours will be startled, and but for the expression of our own surprise at the enormity of the doses, he could tax us, or our printers, with a sad and gross mistake in transcribing or copying this part of Dr. Hooker's essay. It runs thus:-"In the evening I direct one ounce of tincture of digitalis, of which a third part is to be given every two hours until sleep is induced. If this fails, the nitrate of silver is resumed, and continued through the following day; and, on the following night, an ounce and a half of the digitalis is directed, one third to be given every two hours." HALF AN OUNCE OF THE TINCTURE OF DIGITALIS At a dose, and said dose to be repeated every two hours. This is more than heroic treatment. After

what pharmacopoeia or dispensatory is the tincture of digitalis prepared in New England. Did the author mean to recommend the infusion?

If we except the mistake just pointed out, the contents of Dr. Hooker's essay will prove a useful addition to our materials for physiological and pathological study, and it may be an improvement in therapeutics.

Transylvania Catalogue of Medical Graduates with an Appendix, containing a concise History of the School from its Rise to its Present Time. Pp. 35.

In the first session of this school which began in November 1819-20, there were 37 pupils, of whom, in 1820, at the first commencement, 7 graduated. In 1837-8 there were 227 pupils, and in the spring of 1838, 64 graduates. The largest class was during the session of 1825-6, being 281. The whole number of graduates, from 1820 to 1838, being nineteen collegiate years, is 1057, and of students during that period 3800.

"The qualifications for becoming candidates for the degree of Doctor of Medicine, are as follows:

"The persons offering must be 21 years of age, and must have been engaged in the study of medicine during three years. Two full courses of lectures in a chartered medical school (the last of which in this institution) are also requisite. But persons who exhibit satisfactory proof of having been engaged in respectable practice for the space of four years may be candidates, by attending one course of lectures, which must be in this school. Each candidate is required to exhibit all his tickets to the Dean, before his name can be enrolled. The fee for graduation is $20.

Annual Announcement of Jefferson Medical College. For the Sessions of 1838-9. Catalogue of Students and Graduates of 1837-8, Pp. 15.

The modification of the charter of this college has been already mentioned, by which its connexion with the Institution at Cannonsburg is severed, and the number of its trustees is increased from ten to fifteen. The latter body consists of the following gentlemen :-The Rev. Ashbel Green, D. D. LL. D., President. Samuel Badger, Esq.; James M. Broom, Esq.; Rev. C. C. Cuyler, D. D.; General Wm. Duncan; Jacob Frick, Esq.; David S. Hassinger, Esq.; Hon. Judge King; Hon. Joel B. Sutherland; Rev. Ezra Stiles Ely, D. D.; Hon. Jno. R. Jones; Hon. Jesse R. Burden; Colonel Samuel Miller; Jno. R. Vogdes, Esq.; J. B. Smith, Esq.-Hon Judge King, Secretary of the Board.

The number of students on the catalogue for the last session 1837-8, is 248; and of graduates at the commencement in the spring is 103.

Proceedings of the President and Fellows of the Connecticut Medical Society, in Convention, May 1838. With a List of the Members of the Society. Pp. 12.

"DR. HOOKER having declined a re-election as Secretary, the following officers were elected for the year ensuing :-Silas Fuller, M.D., President; Elijah Middlebrook, M.D., Vice President; Luther Ticknor, M.D., Treasurer; Archibald Welch, M.D., Secretary."