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utterly inconsistent with the character of the Deity, either as revealed in the holy writings or in the great book of nature.
From these sobjects, however, the fuller discussion of which does not form a part of our duty in this work, we turn to Dr. Brigham's publication on the Influence of Mental Cultivation and Mental Excitement upon Health, written a few years earlier, and the appearance of which seems to have been occasioned by his observing the injudicious attempts of parents in general, throughout the United States, io cultivate the minds of their children, at an early age, to an extent quite unsuited to their years and strength, and productive of the worst effects. We are glad to see, by the preface to the second edition, that a conviction of these errors begins to gain ground; although Dr. Brigham is still of opinion that there is much injury caused by too much mental labour being required of children, and by the repression of their natural gaiety and love of amusements. In the preface to the first edition, Dr. Brigham remarked that the females of the United States, especially those in cities, were in general more delicate and feeble than those of Europe ; and, at the same time, that there was no country where females received such early and great intellectual culture, and had so little attention paid to their physical education. It appears, too, that in consequence of the openness of the road to the highest honours for those who evince a capability of serving the republic, efforts, much more strenuous than judicious, are systematically made to exercise and store the minds of children. Infants' manuals of all kinds are sold at the bookstores, on various subjects of science, and new and short methods of universal instruction are sure to find many patrons.
Addressing a population prone to such fatal mistakes in the management of children and young persons, Dr. Brigham devotes several chapters to explanations not required by medical readers, but which are extremely well placed in a work intended to inform the public. He points out the reasons which have induced physiologists to consider the brain as the material organ by which the mental faculties are manifested, describes the condition of the brain in early life, and the known effects of its excitement. He urges that mental precocity is usually a symptom of disease, and not a promise of future distinction, and adduces examples to prove that the best and most powerful minds have not been formed by early culture carried to excess; and in support of these opinions he quotes many authorities.
The section of this little work which is calculated to make the strongest impression on his readers, is that in which he shows the influence of mental cultivation and mental excitement in producing insanity, nervous affections, and diseases of the heart. He states that the number of individuals deranged in mind in the United States is as 1 to 262 of the inhabitants, whereas in England it is but 1 in 820, and in Scotland 1 in 574. The moral causes of this great excess in America deserve investigation; and there can be little doubt that the greater number of them would be resolved into some excitement of the brain. It is an undoubted fact that insanity prevails most in countries where the mind is allowed the freest exercise, and where the people enjoy the greatest extent of political liberty. It is common in America, in England, and in France ; rare in Russia, in Spain, in Turkey, and in China. Among the educated it is most prevalent in those whose imagination is most indulged, and whose reasoning powers are least exercised. In all times of national commotion it is more than usually common. It is rare in children and young persons, but is sometimes observed in them as the result of violent emotions, or of excessive application to study. Dr. Brigham ascribes its extraordinary frequency in America to four principal causes ; 1, too constant and too powerful excitement of the mind, which the strife for wealth, office, political distinction, and party success, produces in that free country ; 2, the predominance given to the nervous system, by too early cultivating the mind and exciting the feelings of children; 3, neglect of physical education, or the equal and proper development of all the organs of the body; 4, the general and powerful excitement of the female mind.
We are certainly not among those who consider the population of Great Brie tain as being yet over-educated; but it cannot be denied that even education may be pushed, or perverted, to the extent of pernicious excitement. There are also evils incidental to education, which are erroneously supposed to belong of necessity to education, but which are only the product of prejudices not yet worn out. Among these may be mentioned the long-continued confinement of children in charity and Sunday schools; in consequence of which, many poor children, without acquiring the blessings of real knowledge, incor the evils of a wearied or over-excited brain. Some of these evils are strikingly set forth in Dr. Brigham's statements respecting the city of Hartford, in the United States, of which the population is not more than seven thousand. Nearly all the children commence attendance at school as early as the age of three or four, and attend six hours a day. Many of them attend Sabbath schools, and go twice to church on Sundays, being thus occupied altogether about six hours. There are nine large churches in that little city, well filled twice or thrice every Sunday ; and meetings, twenty or thirty times a week, in some or other of these, on other days. There are two literary associations, where meetings are held once a week, open to all; at one of which lectures are given, whilst debates are held on political or historical subjects at the other. Seven large weekly newspapers are published, and five large religious papers. Several other periodical works are published at Hartford ; and the papers and reviews of the other cities are eagerly read, and most of the English reviews and magazines are taken. These circumstances assuredly bespeak an astonishing degree of mental activity in so small a population; and it is a most serious question for the legislator to consider, whether it is in a direction to promote health and happiness, or whether as Dr. Brigham apprehends, these multiplied means of stimulating the mind are slowly producing effects to be transmitted to another generation ; not an increase of intellectual power, but increased susceptibility of the brain and nervous system ; individual disease, and national degeneracy.
These observations imply no distrust of the benefit, not even a shadow of doubt concerning the positive duty, of educating every rational being; but the idea of education must not be limited to the mere exercising and storing of the mind. A complete education includes attention to the emotions and the moral feelings, and its objects are individual happiness and the general good ; objects which unfortunately continue to be too much overlooked. Education is desired as the means of making a fortune, and of attaining a certain station ; not as a means of securing simple independence, contentment, a tranquil mind, a habit of benevolence, well-governed affections, and the power of being useful to others. If, then, health is sacrificed, if ambitious views are disappointed, and morality not increased, it is unjust to cry out against education. A partial and unwise system of education produces but partial benefit; a more complete and wiser system would extend it; and such a system would discountenance and exterminate the evils of the false and worldly system to which the name of education is most improperly given. Then it would be found that the proper education of the body was favourable to the healthy condition of the mind; and a rational and cheerful exercise of the mind promotive of health of body; and that both were favourable to the happier emotions of wbich the frame is susceptible, and which are often annihilated by the destructive struggles made for worldly and selfish advantages.
Dr. Brigham's concluding chapter is chiefly devoted to the illustration of an opinion which deserves to be attentively weighed not in America only, but in Europe ; namely, that dyspepsia, far from being invariably a disease of the stomach, is often the result of a disturbed and irritated brain. We are ourselves convinced from observation that what are called sick headachs, occurring in irritable individuals, are often the mere product of disturbance of the nervous system. Nor do we in the least degree doubt that in this busy age, a very great proportion of the cases of indigestion, debility, and nervous pains of which individuals complain, are but the effects of too much labour of the brain ; and we entirely go along with the author in believing that the most careful diet will fail to relieve many forms of indigestion unless the existing pressure and irritation can be removed from the mind. This view is entirely borne out, too, by the
fact, that comfortable living and freedom from care are of all circumstances the most favourable to longevity. Of these truths we trust the readers of Dr. Brigham's very useful works will become convinced to their advantage. We are truly glad to see the medical men of the United States stepping boldly forward, in the face of many prejudices, to instruct the public concerning their real good. It has ever been the just praise of the profession that its members have done so ; and those who cultivate medicine in the United States seem actuated by the same desire to do their duty, and at the same time fully capable of performing that duty efficiently.-Brit. and For. Med. Rev.
PATHOLOGY AND THERAPEUTICS.
NITRATE OF SILVER IN IMMENSE DOSES.
There resides in the vicinity of London, a gentleman whose face must be familiar to many thousands of its inhabitants. His skin is intensely blue from the internal use (or abuse) of nitrate of silver. He is now about 73 years of age, and at the age of 45 became affected with epileptic fits of the most violent and distressing kind. In these attacks he struggled so strongly that it required two or three people to hold him. The fits also were very frequent, and in one of them he totally and for ever lost the sense of hearing. A most distressing noise in the head, however, has ever since harassed the patient. After trying various remedies for the epilepsy, without the least benefit, he was advised by the late Dr. Curry, of Guy's Hospital, to enter on a course of the nitrate of silver, beginning with small doses, a quarter of a grain three times a day, gradually increased. In the course of a few weeks the attacks began to diminish in intensity, and in a few months, the intervals became much lengthened. The medicine was continued in augmenting doses till the epileptic paroxysms entirely ceased, which they did within six months from the commencement of the course of medicine already mentioned. Dr. Curry never warned the patient as to the effect of nitrate of silver on the skin, if long continued, and the physician himself dying about this time, the patient persevered with the medicine for the space of three whole years, the dose being eighteen grains a day for nearly all the third year! The patient, who is a highly intelligent man, avers that he never experienced any unpleasent effect from the medicine--indeed he felt no effect at all, except its remedial power in arresting the epilepsy. Not having any idea of its physiological agency on the skin, he continued the nitrate with the view of effectually guarding against the return of the malady which he so much dreaded. It does not appear that the blue colour made any serious advance till towards the close of the third year, otherwise it is probable that he would have taken alarm, or that he would have been apprized of the circumstance by his friends. At this remote period, however, he cannot distinctly recollect the exact time when the blue tinge of the rete mucosum commenced or acquired its complete acmé of intensity. This fact is of considerable interest, as there is probably no case on record where such a quantity of the nitrate of silver has been taken, or continued so long. It accords with our own experience as to the absence of any sensible physiological effect on the stomach and bowels which usually attends the administration of this medicine-unless we except a certain soothing agency-probably the consequence of obtunded sensibility in the gastrointestinal nerves and tissues. In all cases excepting epilepsy, however, it is never necessary to give more than a grain or two of the nitrate daily (pills made ap with extract of liquorice) and not continued beyond a few weeks at one time. Combined with the compound extract of colocynth, also, it forms an excellent remedy for irritability of the primæ viæ
attended, as is often the case, with torpor of the bowels and vitiated secretions.--Ibid.
BIR F. SMITH ON CREOSOTE AS AN EXTERNAL APPLICATION.
The observations of Sir Francis Smith were originally read to the College of Physicians in Ireland, and have been published in our esteemed contemporary of Dublin.
Sir Francis observes that practitioners in this country evince an indisposition for the use of new remedies-an indisposition, which, he thinks, amounts to a vice, although in its origin a virtue. We feel some doubts of the correctness of Sir Francis's opinion on this point. We see, in practice, in London, little evidence of the bashfulness which he deplores, nor of that coy reluctance to prescribe new drugs, which in Ireland would seem to amount to a vice; nay, could we trust the evidence of our senses, we should rather deplore the whole sale manner in which the new medicines are abused, and the want of discrimination, we might sometimes say of common sense, which is evinced in their selection or their distribution.
Sir Francis has not made many experiments on creosote, and those experiments have been confined to its external application. He observes that one source of discrepancy in results will exist in the difference of specimens made use of; the strength or concentration differing much both from the variety in the mode of preparation and purification, and also from the mode of preservation. That which he has always used was from the Apothecaries' Hall, of sp. gr. of 1,064, and nearly colourless. He has tried the creosote in three cases, or rather, he relates three cases in which he has tried it.
Case 1. A gentleman had phymosis, with the outside of the prepuce covered with ulcers of a ragged phagedæmic appearance, with a good deal of constitutional disturbance. Some alterative doses of blue pill, in combination with morphia and tartar emetic, were prescribed, with soothing applications to the parts. This treatment had the effect, in conjunction with the recumbent posture, of quieting the constitution, and diminishing the tension of the parts. But every mean was tried in vain to cause the ulcers to heal; they still preserved their phagedænic character, and at length united into a zone, nearly surrounding the prepuce, and threatening its destruction. Sir F. Smith now applied the creosote pure with a pencil. Next day the sores were improved, and had contraeted one-third in diameter. Being lightly touched every day for six days, they were entirely healed.
Case 2. A young gentleman, much broken down in constitution, became affected with an abscess by the side of the anus, which opened near the latter. On passing a probe into the orifice, says our author, " I found an orifice through which the matter, which amounted to an egg-cup full, had been evacuated ; and om passing in a probe, I found it to enter about one inch, passing upwards, and resting upon the side of the gut; on further investigation, I found that the sinus branched about midway its course into another cul de sac, which passed rather away from the gut, and presented to the probe a rough, yielding, spongy sensation; at the opposite verge of the anus an inflamed pile existed."
The soothing plan was continued, but it did not answer. Under these circumstances, the Creosote was resorted to. Sir F. introduced to the bottom of each cul de sac a very
small dossil of lint smeared with it. In two days more the creosote was repeated, and four more applications spread over a fortnight, nearly perfected the filling up the sinus. The red precipitate afterwards completed the core.
Case 3. A lady, of a scrofulous habit, had had for some months ulcers of the septum narium, which had resisted much and varied treatment. Sir F. resolved to do nothing but employ the creosote locally.
“ The ulcers amounted to four, varying in size from the head of a pain to the section of a very large pea; three on one side of the septum, and one (the largest, and the first which had made its appearance,) on the other side.
I at first made use of a wash, consisting of one part creosote, with sixty of water; in which proportions they unite at common temperatures; the wash to be snuffed up the nose frequently in the day. The odour was complained of as
• May, 1837.
very disagreeable, and at the end of two days, I was disappointed by finding that I had made no progress in improving the appearance of the ulcers. I now determined to apply the creosote in its pure form, and began by pencilling the edges of the ulcers with a brush smeared with creosote, and directing the patient to inhale the fumes of acetic acid for a few seconds subsequently. The applica. tion of the pencil was rendered easy by firmly grasping the ala nasi, and drawing it outwards; and I advised the inhalation of the fumes of acetic acid for two reasons; first, because acetic acid is the proper solvent of creosote, and would, by being inhaled immediately after its application, have the effect of rendering its action more equable and uniform; and secondly, because the odour would tend to counteract the disagreeable fuliginous flavour of the creosote. The next day I had the gratification to find the character of the ulcers improved ; the edges were much less abrupt, and I now determined to apply the creosote lightly over the whole of the ulcer on the left side of the septum, and to brush those on the right side with a solution of creosote in twenty parts of acetic acid ; and I conrinued to do so on alternate days for a week, at the end of which time, the ulcer on the left side of the septum was reduced to à mere point, having every appearance of immediately healing ; whilst those on the right side, though improved in appearance, having smooth edges gently declining towards the centre, still preserved their original dimensions. I now applied to them also the pure creosote, repeating the application on alternate days, accompanied with the inhalation of the fumes of acetic acid. The rapidity with which the ulcers now healed was truly wonderful. That on the left side, to which I first applied the creosote in a pure state, was completely healed in ten days; and those on the right side, in six days after the first application of pure creosote, and sixteen from commencement of treatment."
Sir Francis observes, that for small ulceration in the mucous membrane the pure creosote is most effective—that the solution of one part in twenty of acetic acid is not destitute of power-but that the solution of one part in sixty of water is only adapted for ulcers where the surface is large.
There can, we think, he little question that the creosote is an useful application where a powerful stimulant is wanted. It must be classed as a local agent with the balsams, the compound tincture of benzoin, &c. Probably those surgeons who possess the greatest amount of experience will be least disposed to attach to it any very marvellous properties.-Med. Chir. Rev.
ON THE INDICATIONS FOR THE USE OF MOXA, WITH CASES. By Dr. Sadler. (From the Archives of the Corresponding Medical Society
of St. Petersburg.) The moxas employed by Dr. Sadler are about half an inch in diameter, and three quarters of an inch in height. They are composed of a nucleus formed of the pith of the sun-flower (Helianthus annuus); wrapped in layers of cotton of various thickness, and surrounded with an external envelope of thin muslin; both the latter are previously steeped in a solution of nitre. They are held, while burning, by means of two long hair pins, the legs of which are slightly bent, in order to accommodate them to the shape of the moxa; and when the latter is burned down to the place where it is held by the first hair pin, it can be seized with the other, and retained in its proper situation. The moxa must be allowed to act for a considerable time: by observing this rule, the pain after the operation is always considerably less than where the application has been continued only for a brief period. The burnt part requires no treatment for the first few days; it is insensible and dry. Larrey states that moistening the past with spirit of ammonia prevents suppuration : this however is not the fact; suppuration always takes place, and is often very copious. Dr. Sadler never uses more than one moxa at a time, except in cases of violent sciatica, in which he sometimes applies one over the glutei, and another over the most painful spot of the thigh or calf. Except in one instance, which appears somewhat