mit that they possess a contractile power peculiar to themselves, on which the motion of the blood depends. Dr Carson, as far as we know, is the only modern writer who denies al! power to the veins.

If there were nothing else to oppose the opinions of Dr Carson, the state of the lungs in the foetus would to us be conclusive against them. The objection has not escaped Dr Carson, and we admit the ingenuity of his explanation. He maintains, that, as the diaphragm rises higher in the foetus than after birth, we may suppose that there is a constant tendency in it to bring itself more into one plane; or we may suppose, that, in the fœtus, it acts much in the same way as after birth. In either of these cases, he justly observes, the external surface of the heart would be relieved from part of the pressure of the atmosphere. These, of course, are both mere suppositions: the first highly improbable, because we cannot regard the state of the diaphragm in the foetus as a forced state: the other not capable of answering the author's purpose if he could prove its accuracy, because either the auricles or ventricles of the heart are always contracting, whereas, according to this supposition, the action of the diaphragm would only lessen the pressure of the atmosphere on the external surface of the heart by intervals. What Dr Carson says of the disposition of the valves of the heart being favourable to his opinion is of little weight, because it is equally so to the commonly received opinion.

We have now, we believe, mentioned all the arguments of any importance which he brings forward in support of his opinion, that the motion of the blood in the veins depends on the resilience of the lungs. From all that has been said, we feel no hesitation in regarding the opinion as erroneous. We still, however, think ourselves obliged to Dr Carson for his book. He has pointed out a cause which, in the nature of things, must after birth have some effect, however small, compared with what he believes it to have, towards dilating the heart, and, consequently, promoting the motion of the blood in the venous sysIf ever a correct estimate of the forces which support the circulation be made, the power pointed out by Dr Carson must be taken into the account.

tem.

It only remains to make some general observations on the manner in which the work is executed. We wish our report on this head could be more favourable. We object to at least four-fifths of it, being what every student of medicine already knows; to the unnecessary diffuseness of every part of it; and to the language being what may be called affectedly scientific, because it is more so than the subject requires. Had the au

thor, instead of making a book, given a concise and simple account of his opinions in a small pamphlet, or a paper in some periodical work, we think they would have met with a better reception. We have paid the more attention to them, because they have already been treated with unmerited contempt in a medical jounal of a neighbouring kingdom.

IV.

Medico-Chirurgical Transactions, published by the Medical and Chirurgical Society of London. Volume the Sixth. 8vo, pp. 676, with six Plates. Longman and Co. 1815.

W

E can do little more than announce the large and valuable volume, published by this industrious and well-conducted society, as the produce of the sittings of last season. It contains many original and interesting communications in almost every department of the medical art, which it would occupy too many of our pages to give even a slight and imperfect account of. The importance of the society as a central point of communication throughout the profession, is every year more and more manifest, and is particularly evinced by the following statement in the preface to this volume.

"From the articles of this year it will be perceived, not only that the medical department of the army has continued its communications, but that one of the branches of the legislature, the several public offices of the navy, and the Honourable East India Company, have al lowed the society access to their records, from which much interesting and valuable information has been derived. This liberal co-operation, so honourable to these bodies, and so flattering to the society, is gratefully acknowledged by the president and council."

From these sources, indeed, we may anticipate many important accessions to medical science, respecting the origin, progress, and treatment of endemic and epidemic diseases, which might not be obtainable by other means. The increasing list of highly respectable members, which every successive volume exhibits, the announcement of a valuable and extensive library, and of accumulating communications, and the proposal of pubJishing their Transactions twice a-year, are an earnest of the ad

vancing and permanent utility of the society, and a demonstration of the success of individual zeal and energy, in the steady pursuit of science, unsupported by patronage, and unsanctioned by corporate privileges.

This volume contains twenty-seven papers, some of them possessed of great interest, but the substance of which we cannot undertake to detail. The first, seventeenth, twentieth, and twenty-first, from the pens of Dr Calvert, Dr Denmark, Sir James Macgrigor, and Sir Gilbert Blane, relate to the medical history of particular epidemics or periods of time; and are extremely valuable communications. The introduction and progress of the contagion of the plague, in the island of Malta, in the year 1813, is detailed with great distinctness and much interest, in Dr Calvert's paper, which opens the volume; and the whole of the proceedings of the police, with their proclamations, and public acts, are minutely given. Dr Calvert, however, differs, in the inferences, which he deduces from this interesting history, from the generality of writers on this subject for he not only denies that contact is necessary, or fomites, to propagate the contagion; but he maintains that a single individual may, in certain seasons, infect the atmosphere of a whole city.The short paper of Dr Denmark on the Mediterranean fever is an excellent epitome of what has been said by Dr Irvine, and the best writers on this subject. It contains a clear and judicious estimate of the value and peculiar effect of the leading remedies, especially blood-letting, and purging by calomel and antimony. The fever was clearly contagious in the hospital at Minorca.

The important document of Sir James Macgrigor, describing the medical history of Lord Wellington's campaigns in the Peninsula, will be read with great interest. Sir James first de

scribes the progress of the armies, the situations of the hospi tals, and the state of sickness which occurred in the four succes sive seasons, from December 1811 to June 1814, when the war terminated in France. In the second part, he enlarges upon the nature of the diseases, which prevailed, and of the remedies employed. And in the third portion of the paper, he gives an account of the means of prevention, or of those measures by which sickness was diminished in the army, and mortality in the hospitals. During the period of time just mentioned, 346,108 cases of disease or wounds were treated in the hospitals of the army, of which 232,553 were discharged cured;-4,586 were invalided, or sent to England for recovery, and 18,513 died. This mortality, however, includes every wounded man, who had been seen by a surgeon, and therefore comprehends many hundreds who did not live an hour after they were seen.

Deducting these, the mortality from diseases appears to have been small, considering the causes; and Sir James speaks in high terms of the professional zeal and talent of the physicians and surgeons in the general hospitals in the Peninsula. The analysis of this portion of the paper would afford sufficient interest for an article of our review, the subjects of fever, dysentery, tetanus, and other important maladies, their treatment, and their variations in number and violence in different seasons and places, being given from public and authentic documents. The effect of regularity in the supply of food, proper clothing, cleanliness, warmth, &c. in producing a great degree of health, during the last year and half of the service of the Peninsular army, is very clearly established. This was remarkably demonstrated by the Germans. "The temperance, steadiness, and regular habits of the German legion kept them always in good health." It is added, that "the First German Hussars neither lost a man, nor sent one to the general hospitals, during the retreat from Burgos, nor till after the next campaign was opened, and when we were advancing into France." This important document concludes with a just and well-merited eulogium on the zeal and utility of the medical department of the army, which contributed most largely to a successful issue of the contest; and with several tables, containing a general abstract of the admissions, discharges, and deaths, during the respective periods, and of the particular diseases, and their respective and proportionate mortality.

Another document of the highest interest and importance, is from the pen of Sir Gilbert Blane, to whom, with the late able Dr Lind, this country is indebted for much of the improved health and strength of the other arm of her power, the navy: it is entitled "Statements of the comparative Health of the British Navy from the year 1779 to the year 1814, with proposals for its farther improvement." This paper is drawn up partly from the sources of information open to Sir G. Blane as physician to the fleet in the American war, and as commissioner of sick and wounded seamen from 1795 to 1802, and partly from the liberal access given to Sir Gilbert, on behalf of the society, by the public offices of the navy to their records, from which all requisite extracts were freely supplied. Perhaps medical science has no ground of triumph so solid, as the great security to human health which it has established, upon clear and rational principles, under circumstances which, half a century ago, were productive of so much mortality. The sum of the information collected is condensed in six tables, and the substance of the paper consists of a detail of the principal diseases, by

which the former mortality was occasioned, and of the causes of the gradual diminution of that mortality, which the tables demonstrate. "It has been proved that it has added at least onethird to the national force."-This, however, is not the whole benefit; for the mortality of commercial sailors, in all long voyages, has been in a similar manner diminished.

Though there are no papers of equal moral and political importance with the two just noticed, this volume contains some others of great practical interest and originality, and which directly contribute to the advancement of the medical art. Among the most novel and valuable we may mention the communication of Mr Lawrence, respecting" a new method of tying the arteries in aneurism, amputation, and other surgical operations," which appears likely to constitute a great and important improvement in these formidable operations. In the cure of these great artificial wounds, a great impediment to union by the first intention is the interference of the ligatures, which must be extended through the apertures. Mr Lawrence ingeniously proposes to substitute a ligature, equally effectual in its operation upon the artery, but so minute in substance as to be probably not felt by the constitution as an extraneous body. The following paragraph will explain.

"The method I have adopted consists in tying the vessels with fine silk ligatures, and cutting off the ends as close to the knot, as is consistent with its security. Thus the foreign matter is reduced to the insignificant quantity which forms the noose actually surrounding the vessel, and the knot by which that noose is fastened. Of the silk which I commonly employ, a portion sufficient to tie a large artery, when the ends are thus cut off, weighs between and

of a grain: a similar portion of the thickest kind I have tried weighs of a grain, and of the slenderest 1 These ligatures do not interfere with the process of adhesion, and we shall hardly entertain any serious apprehension that substances so minute will excite subsequent irritation and disturbance."

In noticing objections that may occur to this practice, Mr Lawrence shews, both from reasoning and experiment, that the notion, that a large artery requires a large ligature, is not correct; but, on the contrary, affirms, that, " if any proportion is to be observed between the size of the artery and of the ligature, it should be an inverse one; the large vessel requiring a small ligature, while a small artery may be tied without danger with a large one." He acknowledges, however, that he is not yet in possession of facts enough to answer satisfactorily a question, which will naturally suggest itself. "What becomes of these ligatures? Do they come away with the discharge, or remain