will be in proportion to the degree of debility present. This would obviously suggest the propriety of abstracting blood in those cases where, from the violence of the arterial action, the antiphlogistic power of opium may possibly be resisted, or where on exhibiting it no relief has been attained. For my own part, in the treatment of most intestinal inflammations, whether of serous or mucous surfaces, I would confide more in the influence of blood-letting, large opiates, and warm poultices to the abdomen, than in all the remedies included in our materia medica." (p. 195-6)

In a deplorable case of dysentery, Dr. Griffin, following a suggestion of Dr. Gregory's, gave three grains of opium with five of ipecacuanha at a dose, and directed it to be repeated every hour until some relief was experienced, and then continued every second hour until all pain and discharge ceased. "The effect was magical! Before he had the third dose taken my patient was asleep, and enjoyed more perfect and enduring relief than he had experienced for weeks."

"Of all the wonderful influences however exerted by opium, that by which it sustains the powers of life when sinking from hemorrhage, and arrests the flow of blood, is the most extraordinary. When after severe uterine hemorrhage the countenance is sunk, the eye hollow and glassy, the lips blanched, the skin cold, and the whole person corpse-like, when the pulse is almost gone at the wrist, when the beat even of the heart is scarcely perceptible, and stimulants, even brandy or rectified spirits, are either vomited or uninfluential, there remains yet one remedy capable of restoring the patient to life, and that is opium. I believe its power of saving life in these circumstances depends principally on its specific property of producing congestion in the brain. That amount of congestion by which it occasions apoplexy when given in large doses to persons in health, seems only sufficient to sustain the natural and necessary tension of the cerebral vessels in those who are dying of hemorrhage. Persons die in cases of hemorrhage, not so much from mere debility of the beart's action, as from the loss of nervous power in the brain consequent to it, and hence a fainting from which they are never awakened. The opium in such cases not only stimulates the heart's action, but restores a sufficient degree of tension in the vessels of the brain to prevent faintness, and by the judicious repetition of the remedy, life is preserved on the very borders of death. There are no instances in which opium can be given so freely or so fearlessly as in these. When the danger is imminent, five grains may be given at the first dose, and two or three every hour or half hour afterwards, until the pulse becomes distinct, the breathing easier, and the tossing or flinging about in the bed is allayed. It is hardly necessary to observe, that in such cases, in conjunction with the use of opium, the administration of warm wine and brandy, (however inefficient alone,) and the application of heat to the extremities, are highly useful, if not absolutely essential." (pp. 201-2.)

This is a very valuable paper, and fraught with truths of the greatest practical importance.

PROBLEM XI. "What principles should regulate the treatment of hemoptysis?" This is a very useful paper, inasmuch as it is opposed to that system of routinism which subjects all cases of hemoptysis to an antiphlogistic treatment, with strict abstinence. Dr. W. Griffin relates some instances in which a contrary method was eminently successful. We could add corroborate facts from our own experience; and we are strongly convinced that a thorough revisal of the pathology of this affection is absolutely necessary to a discriminating and safe treatment. Dr. Griffin thinks that the starving method increases the tendency to hemorrhage, by rendering the vascular system more lax and irritable. The hypothesis is

plausible; the fact that starvation increases the hemorrhagic tendency is certain. Another bad result of protracted low regimen and frequent depletion is referred to by Dr. Griffin,-the danger of inducing phthisis; and he thinks the need of such treatment is the less when an emetic of ipecacuanha, and the continued administration of it every hour, will subdue a frightful hemoptysis.

PROBLEM XII. "How should acute rheumatism be treated, so as to effect a cure in the shortest space of time, with the least pain or other symptoms likely to protract or interrupt the cure, with the least probability of inflammation of a vital organ, and with the least after ill effects, whether debility, salivation, or chronic disease, and with the least liability to relapse?" Large and repeated bleedings, and the sweating and stimulant plans are going fast out of repute; colchicum is less certain, more painful, and sometimes attended with more serious consequences than other remedial agents.

"Emetic tartar sometimes acts like a charm," Dr. Griffin observes, "but when the practitioner tests the remedy more extensively, he finds, not only it is often attended with inconvenience, and if injudiciously pushed, with hazard, but that its failures are considerable in point of number. With Lepelletier they amounted to half those in which he employed it, and the success was little better even when accompanied by bleedings. In the Limerick Infirmary I believe the failures were more than two-thirds."

Finally, Dr. Corrigan's and Dr. Hope's plans are pronounced the best. The former administers one or two grains of opium every second or third hour. The medicine should be always increased in dose, both as to frequency and quantity, until the patient feels decided relief; and should be then kept up at that dose until the complaint is steadily declining. The first indication that tells the practitioner he has reached the proper dose is the statement of the patient, who in reply to an inquiry, as to how he has past the night, probably says that he has not slept, but that he is free from pain and feels comfortable. This effect having been attained, the opium may then be continued in repetitions of the same dose as to frequency and quantity. Dr. Hope gave from five to ten grains of calomel every night with from a half to two grains of opium, and in the morning a smart pugative. Three times a day a saline draught is also given, with ten to twenty minims of colchicum wine and five grains of Dover's powder. The last essay in the volume before us is entitled, "Observations on the application of mathematics to the science of medicine," and is written by the brothers conjointly. The object of the paper is to recommend the numerical method. Our views on this question have been already very fully stated.

We have now to sum up, and give our critical opinion on the essays before us. We judge then, firstly, that the writers are well-informed and sensible men, and careful, industrious, and observant practitioners; secondly, that they are better practitioners than physiologists; and thirdly, that their pathological theories are (consequently) marked more by ingenuity than by depth or comprehensiveness. To the practising physician and surgeon, however, the book will be found very useful, and will amply repay a careful perusal: we therefore strongly recommend it to all our readers.

The volume is full of typographical defects-partly, no doubt, the consequence of its provincial origin; and it contains some odd expressions, as for instance, "and directions were given if he got any weakness during the night to give him wine and water." We are sure that not long ago the very respectable authors must have regretted, as much as we did, to read a long and prominent notice of their book in a London morning paper. This must have been the work of some over-zealous and ill-judging friend, who did not consider that the legitimate road to professional reputation is through the professional public alone. A writer must be judged by his peers, if he would have a true judgment, and not appeal to an inadequate tribunal. The merits of this publication indeed rendered such an appeal quite unnecessary; its useful and practical tendency will secure it a favorable notice by the profession.

ART. VII.

Chemistry, Meteorology, and the Function of Digestion, considered with Reference to Natural Theology. By WILLIAM PROUT, M.D. F.R.S., Fellow of the Royal College of Physicians. London, 1845. Third Edition, 8vo, pp. 515.

THE high merit of this work, and the respect we entertain for its learned author, induce us to make a departure in its favour from our usual practice; and to avail ourselves of the opportunity afforded by the appearance of this new edition, to bring it under the special notice of our readers, although in its original form it made its appearance eleven years ago,-one year before the commencement of our critical labours. Coming out as one of the series of Bridgewater Treatises, the origin and plan of which are doubtless familiar to all our readers, Dr. Prout's work enjoyed at the time an extensive popularity, and came to a second edition in the course of a few months. We remember hearing the opinion expressed at the time by a competent judge, that this popularity would be more durable than that of most of the other works of the series,-Dr. Prout being in many respects in advance of the general state of knowledge on his science, whilst some of the other authors were scarcely on a level with it. We rejoice to see this opinion borne out by the appearance of a third edition at this distant date, indicating as it does the continued, though perhaps not very rapid, sale of the work. A considerable amount of new matter has been introduced, by an enlargement of the page, without any augmentation in the bulk of the volume; and this is for the most part of much value. We think that Dr. Prout has done wisely in restricting his additions within moderate limits, and in not entering upon the field of controversy; and the modest apology which he makes in his Preface must disarm criticism in regard to what may be deemed errors of omission. "The author is still conscious of many imperfections, arising in no small degree from his professional avocations. The varied and difficult nature of the points to be investigated required more undivided attention than he has been able to bestow."

The work commences with a chapter entitled, "Of the leading Argument of Natural Theology; that Design, or the Adaptation of Means to

an End, exists in Nature." From this we shall extract a passage, which presents an admirable summary of the fundamental points of the argu

ment:

"Our belief, then, in the agency of an intelligent Creator, is founded—

"On our recognition of the identity of the effects produced in external nature, with effects produced by ourselves; from which identity of effect we immediately infer identity of purpose,-the existence of design without reference to a designer.

On our consciousness that the purpose effected by us proceeded from ourselves, the designers; whence we conclude that the design manifested in external nature must have had a like origin,-that the manifestation of design is demonstrative of the existence of a designer.

"On the pervading character of the design shown among the objects of nature, in which design man recognizes the creation of the objects designed, and is thus led to infer the existence of a Creator. Now the faculty of reason, which enables man to recognize the Creator of the objects around him, enables him to recognize in that Creator the Creator of himself and of his faculties. In reasoning, therefore, from his own acts, to those of the Creator of the universe, though conscious that he is reasoning from the finite to the Infinite, from weakness to Almighty Power; yet, when he reflects from whom he has derived his faculty of reason, man feels assured that his own reasoning, when it coincides with the reasoning evinced by his Creator, can be no other than the same. Nor, founded as that assurance is on the constitution of the human mind, can that assurance be impugned, without impugning Him by whom the human mind has been so constituted.

"Thus the argument of design, though not based on necessity, in the strict sense of the term, is of a validity equal to that of our knowledge of the existence of, and of our connexion with, an external world." (p. 7.)

In the second chapter are considered "The rank of Chemistry as a Science; and the Argument of Design with reference to Chemistry." The argument, as treated by Paley, is thus summed up by Dr. Prout:

"Chemistry is a department of knowledge founded solely on experience, for the phenomena of which we can assign no reason. But though the intimate nature of chemical changes be unknown to us, we see them manifestly directed to certain ends; hence, as things directed to certain ends, where the whole of the intermediate phenomena can be traced and understood, always imply design; we naturally infer design in chemical changes obviously so directed, even although we may not be able to understand their intimate nature." (p. 17.)

We are much disposed to agree with Dr. Prout, however, in thinking that the very circumstance of the mysterious nature of the operations of chemistry, gives them an impressive interest, which is wanting in those classes of phenomena which are better understood. We witness the utmost order and regularity, as is evidenced in the "Law of definite proportions;" but we cannot account either for this general uniformity, or for the limitations in the combining powers of different substances, for want of some more intimate knowledge of the forces that are concerned, and of their mode of operation. As to the bearing of this deficiency on the argument from design, Dr. Prout remarks as follows:

"Obvious mechanism, though well suited to display the intelligence and design of the Contriver, is not always so well adapted for arresting the attention of the observer, its very obviousness in some measure depriving it of its interest. But when we see the same Contriver, besides the most beautiful and complicated

mechanism, employ other means utterly above our comprehension, though evidently most familiar to Him, the employment of these means is not only calculated to arrest our attention more forcibly, but at the same time to impress us with more exalted notions of His wisdom and power." (p. 18.)

It is far from our intention to go through the work chapter by chapter, but we wish to offer a few remarks on the general nature of the argument from design, for which this will be the most fitting place, as they naturally connect themselves with the closing passages of this section. The first of these has reference to the possible denial of the reality of the changes termed chemical:

"Perhaps one of the most striking arguments in favour of the reality of chemical changes may be deduced from the subserviency to them of those mechanical contrivances and operations everywhere existing in organized beings. At least half the mechanism in a living animal is subservient to the chemical changes constantly going on in it, and necessary to its existence. Take, for instance, the circulation of the blood: what a complicated apparatus is here employed for the simple purpose of exposing the blood to the action of the air in the lungs, in order that it may there undergo some chemical change. Now, surely no one can reasonably doubt that this chemical change is as much a reality as the mechanism by which the chemical change has been accomplished; and if one chemical change be admitted to be a reality, must not all the others be equally real?" (p. 19.)

There is a class of objectors to the argument from design, who affect to believe that all the beautiful arrangements and adaptations which we witness in creation arise from what they term "the necessary and eternal laws of nature." Such persons are either pantheists, making gods of these "laws of nature;" or, if they recognize a Creator at all, it is by some other mental process. They are thus addressed by Dr. Prout:

"If there be any one who denies the existence of design, and sees nothing in all the more obvious arrangements and order around him but the necessary result of what be chooses to denominate the laws of nature,' let him calmly and deliberately consider the facts brought forward in the following pages; and if he can witness unconvinced all the numerous instances of prospective arrangement clearly made with reference to things not yet in existence; all the beautiful adjustments and adaptations of noxious and conflicting elements, most wonderfully conspiring together for good; and lastly, the subversion of even his favourite laws of nature' themselves, when a particular purpose requires it: if, we say, he can witness all these things, and still remain incredulous of the evidences of design, his mind must be most singularly constituted, and apparently beyond the reach of conviction." (p. 20.)

The fundamental error of such objectors is their assumption that those human expressions of a certain order and regularity in the phenomena of the universe, to which the term "law of nature" is commonly given, are the necessary and inherent properties of matter. This error we have exposed on a recent occasion, (vol. XIX. pp. 160-61.) We shall add to our quotations on this subject one taken from the recapitulation of the argument, as applied to the phenomena of organic chemistry, with which the work concludes:

"The adaptations of mechanical arrangements in the structure of organized beings to the pre-existing chemical properties of matter, afford also an evidence of design, not less impressive than unequivocal. The most determined sceptic