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being the [an] immediate cause of death, are distinctly affirmed in the essay, and are enforced by the evidence of various authors.
A brief critique might be made on the division of his subject, by Dr. Cross. He gives, under a sub-head, the “ APPEARANCES ON DJssection; and, subsequently, another sub-head, “ PATHOLOGY." If pathology be that branch of medicine which teaches us a knowledge of the causes, signs, seats, and effects of diseases, one expects that morbid anatomy, by which the seats and some effects of scarlatina are more distinctly revealed, should come within the domain of pathology. An opposite and less venial error is gaining ground among some of our writers nearer home. It is, to speak of the pathology of the disease as synonymous with the lesion of the organs, or, if the case be fatal, of the post mortem appearances. This narrow and imperfect view has, we fear, served to indispose many from studying pathology, and even made them look with complacency on their attention to diagnosis and prognosis, as if these were actually subjects in broad contrast with pathology, in place of their belonging, as they do essentially, to this highly important branch of medicine.
The several modes of practice pursued in scarlatina are pressed in succinct review by the author of the essay, under the head of “ TREATMENT.” Conformably with the importance that he more especially attaches to certain pathological features of the disease, which consist chiefly in irritation and subsequent inflammation, and morbidly increased and accumulating secretion in the bronchial mucous membrane, Dr. Cross lauds the employment of ipecacuanha, used as an emetic in the beginning, middle, and end of scarlatina. The generally alleged effects of vomiting are described ; and the cause of a recourse to it, in the diseases under notice, is to be found exclusively in the condition of the respiratory passages. “If they are but slightly disordered, it need not be frequently induced; but if there is serious obstruction, it will be necessary to use them assiduously and often.” “ Though emetics are decidedly useful in the management of secondary lesions, they are certainly much more efficacious in preventing them. They effectually clear the air passages, secure the complete arterialization of the blood, and thus prevent debility and the formation of local determinations and congestions.” “The stage of the disease should not be considered an argument against the use of emetics. Respiration may be already very much oppressed, local lesions may have already formed, and debility may already prevail to a considerable extent; and yet we should not be deterred from their prompt and decided use.” “There is more danger in too little than in too much vomiting. I have, in a great number of instances, given as many as from four to eight emetics in twenty-four hours, and so far from doing harm, I have invariably had every reason to be satisfied with the result. To my own son, then but eight months of age, I gave no less than nineteen emetics in three days and a-half, with a success which, under the unfavourable circumstances of the case, I confess was not anticipated.”
Most physicians would, probably, join in the confession of the author, expressed in the last sentence which we have quoted ; and many might be found to make the captious remark, that children who could bear this course of iterated vomiting were proof against the most violent attacks of scarlatina. With the common,
but sincere, delusion of discoverers or innovators in any way, Dr. Cross now regards “the disease as in a great measure divested of its former terrors,” since his “main reliance has been in ipecacuanha." He says, “My success, if it has not surpassed, has at least equalled that of any other physician of whom I have read, or with whom I am acquainted.” Specifications of his success, in numbers, are subsequently given. Should the author be called upon to treat patients with scarlatina, in one or two future visitations of the disease, he will, we fear, like so many others, and we include ourselves among the number, have cause to modify not a little this present tone of confidence.
It will have been seen that Dr. Cross gives a decided preference to ipecacuanha, over the other two emetic medicines which he mentions, viz: tartar emetic and sanguinaria canadensis. He objects to tartar emetic, if repeatedly used, to produce the effect which he advocates of frequent vomiting, that it causes such a relaxation and severe discharges, when thus used, as would prostrate without being productive of any commensurate advantage. To some other of its effects, urged by the author, the facts adduced by Bayle are directly opposed; and we are not warranted, in the present state of our knowledge, espe cially after noting the practice of counter stimulus, in which this medicine has been so largely and even prodigally given, to coincide with the language of Dr. Cross, that "tartar emetic is a powerful irritant: and if given in any disease where there is a tendency to gastro-enteric congestion, it will be certain to produce it; and by its injudicious repetition, gastro-enteric inflammation will result."
The following sentence is introductory to an enumeration of the other remedies employed in the disease, and of their relative value and application: “We have spoken of vomiting in terms of such warm approval, that it may be thought we rely upon it exclusively. This would be a great mistake : for, although we have a confidence in ipecacuanha that we have not in the united powers of all other remedies, we have considered it judicious and safe to make such use of certain adjuvants as we have, by experience, found useful.” Cataplasms are alleged to be entitled to a conspicuous place. A common wheat bread poultice, impregnated with mustard or pepper, is the form usually employed by Dr. Cross. But when he adds, “It should be kept constantly applied ; not venturing to omit its use for a single moment; nor should one poultice be suffered to remain on until it has become cool, before another of a suitable temperature is substituted in its place,” we would venture to ask : of what texture must that skin be which can bear, without excessive irritation and disorganization, this uninterrupted application of mustard or pepper? No limits are assigned by the author to the duration of the practice. It may be for one day, two or three days, or during the whole period of the disease, for aught we are told to the contrary.
Of vesication the author is not disposed to think favourably in the disease under notice; nor do we differ from him on that point. On cold affusion there is nothing new stated. Attaching, as we do, so much importance to this remedy in scarlatina, Dr. Cross's remarks seem to us to be less full and explicit than could be desired. The warm bath is next mentioned : and the circumstances which seem to indicate its use are stated. The remarks on blood-letting, in scarlatina, are clear and pertinent; except where the author specifies his favourite conditions—vomiting, the application of cataplasms and refrigerants; after which, if properly complied with, there will, he thinks, be little if any need for the general or local detraction of blood. Whilst he deprecates active purging, “recommended by Hamilton, Armstrong, and others, as useless and in many
instances highly prejudicial,” he admits the advantage of keeping the bowels open, and of the occasional use of a strong cathartic, in cases of congestion. Gargles he regards “ as either useless or prejudicial.”
If, in our brief remarks and comments on this paper by Dr. Cross, we have sometimes pointed out what we believe to be exclusiveness, we have also indicated, with sufficient clearness, its general scope and merits; and these are such as to entitle it to a careful perusal.
Health and Beauty; An Explanation of the Laws of Growth and Ex
ercise: through which a Pleasing Contour, Symmetry of Form, and a Graceful Carriage of the Body are acquired, and the common Deformities of the Spine and Chest prevented. By John Bell, M.D., Lecturer on the Institutes of Medicine, and Medical Jurisprudence,
&c. &c. Pp. 253 : 18mo. The objects of this work are sufficiently indicated in the title-page, as above. Of the manner in which the author has performed his task, it does not become us to speak in terms of laudation; and if, separating, for a while, the editor from the author, we were to indulge in a contrary strain, we might be more successful in obtaining credit from the public than from the publishers, for our candour. The latter have not thought it worth while to set off by the extrinsic aid of good paper and print, this little volume—the very title of which ought to have procured it more attention in these particulars. Though not addressed to the medical profession, all the members of it are intimately concerned in the topics of the present work : familiarity with which, can alone enable them to give, in season, the requisite practical advice, both for the prevention of many ills, and the securing of many comforts and true pleasures. Ready, with the requisite knowledge, and strong in his conviction, the physician ought not, through any timidity, or false notions of policy, to be deterred from early, regularly, and persistently urging on the attention of parents, all those observances by which health, strength, and free and easy movements of the body are procured for their children. There is no mystery or patent process in the matter. All that is necessary is, to protect, it may be to guide, but never to improve nor torture, nature, in her instinctive impulses and clearly defined wants.
The first fifty-six pages, and the two or three concluding ones, of this volume, were delivered in the form of a lecture, and had been written with such a view, before the Athenian Institute of this city, last winter. We mention this fact, as it will serve to explain some differences which may be observed in the style and illustrations, between the first and the remaining portion of the work.
Discourse on the Importance of a General Diffusion of a Knowledge
of Anatomy, Physiology, and Hygiene. Delivered at the Auburn Female Seminary, May 30th, 1838. By F. H. Hamilton, A.M.,
M.D.-Auburn. Pp. 20: 8vo. To the other titles of Dr. Hamilton there ought to be added, Y.L.M. (Young Ladies' Man,)—a mark of distinction, be it noted, not derived from his being the ready servant at parties and balls, or in the morning lounge, of the youthful
fair, but the legitimate reward of essential service done to them, by advice in the important matters of health, and with health, their good looks.
Among the innovations of this bustling and meddling, but yet timid, and for some important purposes of reform, cowardly, age, we cannot but regard that as one of great moment, which consists in teaching, as a part of elementary knowledge, to the young of both sexes, but especially of the other sex, the outlines of anatomy, physiology, and hygiene. By no other means, by no kind of persuasion, or force of argument-pathos or ridicule-can we hope to correct the pernicious and often destructive career of fashion, which makes sickly girls, and feeble if not deformed women, who are incapable of performing the part of mothers.
The design of Dr. Hamilton in his Discourse, is mainly to show the usefulness and dignity of the profession of medicine, and to inculcate distinctly sound max. ims, by showing the fallacies of quackery, under various titles. Were he not for the nonce in the service of the ladies, and of young ladies too, we should be inclined to tilt a lance with him on the subject of phrenology, which, in imitation of some others, whom we are obliged to regard as shallow reasoners and superficial observers, he classes with animal magnetism, homeopathy, and Thompsonianism. Dr. Hamilton's style of address is earnest and fervid. It might, perhaps, be alleged that more knowledge, by his auditors, of the various topics on which he descants, is taken for granted, than they can be supposed to possess. But this objection, if it really exists, is of little moment, when we bear in mind the general merits and the scope of the address. With the sentiments contained in the following extract we entirely coincide :
“I have chosen to preface this course with a brief outline of the value of a general knowledge of the sciences upon the investigation of which we are about to enter; and trust I shall be able fully to show that, whatever charlatanism or imposture has crept into the science cr practice of medicine, it has not been because the science is not in itself important-nor because its pursuits are not exalted—nor because its guardians are not learned and intellectual; but that it is solely because the community themselves are wholly ignorant of anatomy and physiology, and all that pertains thereto; and that a general diffusion of knowledge upon these subjects will lead to the detection and exposure of empiricism, and add greatly to the stock of human happiness, by leading to the prevention of ten thousand maladies and accidents which befal us in consequence of ignorance of the laws of our own nature and organization.”
The address is introductory to “ a short series of lectures on the important sciences of anatomy, physiology and hygiene,” delivered at the Auburn Female Seminary, which is under the charge of Mr. Hosmer; at whose instance Dr. Hamilton was led to undertake the task, which, as he informs us, was an entirely gratuitous one. We think the design of the principal, and the ready performance of the lecturer, creditable equally to them both; and we cannot but hope that the example which they have thus formally and authentically set, will be generally followed in institutions for education.
That there is a spirit of inquiry abroad, on these matters, is evident from many indications recently furnished. Amongst these, we may mention an announcement in one of the newspapers in an eastern town, that a Mrs. Gove will deliver lectures on anatomy--but to ladies only.
Annual Circular of the Washington Medical College of Baltimore.
July, 1838: pp. 16. This pamphlet contains a brief notice of the advantages enjoyed by a student of the Washington Medical College, in the unusual facilities and comforts for anatomical investigations and clinical practice, owing to the construction and arrangement of the building, and the contiguity of a hospital to it; or rather, from the fact of the latter being within the walls of the college buildings. The student has also the option of residing in the college, and enjoying all suitable conveniences. “ The Washington Medical COLLEGE OF BALTIMORE, and HosPITAL edifice, are so constructed as to be under the same roof, and are situated in the highest and most pleasant part of the city. The building is large and commodious. The theatres are designed from the most approved plans, and are conveniently connected with the rooms used for the purpose of practical anatomy. In the dissection room care has been taken to provide space, light, and security, together with every convenience that may afford to the student facility in prosecuting to advantage this requisite part of his college studies. The hospital is in immediate connexion with the lecture rooms and the student's apartments, and has constantly within it a number of patients; and being one of the places selected by government, for the marine of the city, will be doubtless augmented: thus affording to the student superior advantages for clinical observation.”
The Washington Medical College was incorporated, in 1832, by the legislature of Maryland. The Faculty is complete; and if we might venture an opinion, without the pleasure, (except in the case of one of them,) of personal acquaintance, we should suppose it to be an efficient one. Of the means for instruction placed at its disposal, the extract in the preceding paragraph gives a favourable, and, we doubt not, a correct view.
An Address; delivered at the Medical College of Georgia, on opening
the Course of Lectures, 17th October, 1837. By Paul Eve, M.D. Professor of Surgery, and Dean of the Faculty, Medical College of
Georgia. Dr. Eve's address is a comprehensive history of the origin and progress of the College of Georgia, with which are blended some remarks in favour of a southern school for southern students, and important suggestions for improvements in the system of medical instruction.
We learn that the charter for the college was granted in 1830. A Faculty was organized in 1832; and the first course of lectures delivered in the winter of 1832–3, to a class of twenty-seven students : four of whom were graduated at the first commencement. " At the last session, with but six professors, there was a flattering increase to forty-six-being a much larger class than has ever yet been in attendance here" (Augusta). The number who received the degree, last April, was fifteen.
The zeal, perseverance, and ability of the Faculty of the Medical College of Georgia, have already commanded the respect of their southern brethren, and will ultimately, we hope, ensure them high national reputation.