the effects immediately arising from the application of salt water to the body, and those which arise from the increased warmth of temperature in the bathing seasons of the year, from the exercise which patients going to sca-bathing generally take in the open air, from the change of situation and amusements, and, among the poorer classes, from the more nourishing diet and exemption from labour, in which they are usually permitted to indulge during their residence at sea-bathing quarters. It is not improbable, that those living on the sea coast, who become affected with scrophula, would, for similar reasons, derive equal benefit by going from the sea coast to reside for a time in the interior of the country." P. 201.

Upon the subject of adhesion, Dr. Thomson gives a clear and satisfactory account of its application to the cure of wounds, of the means of procuring it in cases of wounds from incision, and of the treatment necessary during their healing; he also adds some admirable practical rules to be observed during the operation of dressing, which we cannot too strongly recommend to every young practitioner, not only for their surgical merit, but for that spirit of humanity and feeling which does credit to the author's heart.

Upon the subject of suppuration, we have a very clear and satisfactory account of the formation of abscess, of different species of pus, and their separate qualities, and of the constitutional symptoms attending suppuration. The reader will be pleased with the account of the rigors or shiverings, which too often attend the unhappy sufferer.

"The process of suppuration, particularly when it occurs in the internal parts of the body, is often accompanied by constitu tional symptoms which indicate its existence in a manner almost unequivocal.

"In the progress of the fever accompanying acute inflammations, rigors or cold shiverings not unfrequently take place, which recur at irregular intervals, and are in general followed by a hot fit and slight increase of the febrile symptoms. These rigors, or cold shiverings, in general indicate, when they occur in the progress of inflammatory diseases, that pus either is formed, or is about to be so. In inflammation succeeding to injuries of the head, these rigors are often the first constitutional symptoms which give alarm to the well-informed practitioner, for they are generally, though perhaps not always, an indication that inflammation has already made a dangerous, if not fatal, progress. These rigors also accompany the formation of pus in the viscera contained within the cavities of the chest and belly, and are often the first symptoms which inform the practitioner that his endeavours to procure resolution have not been successful.

66

Rigors may occur, it is true, in the progress of inflammatory diseases, as from accidental exposure to cold, which do not arise

from the formation of pus, but they are not on that account the less alarming, because we are never able to say, in cases of internal inflammation, to what cause, if not to the formation of pus, the rigors which occur are to be ascribed. We are completely ignorant of the relation or connection which subsists between the formation of pus, and the occurrence of rigors. All we know, and all we shall probably ever know, with regard to this point is, that it is a general fact, or, in other words, a law of our constitution, that rigors of longer or shorter duration, and of greater or less degrees of intensity, usually accompany the production of pus in all the organs and regions in which it is formed.

"Rigors, Mr. Hunter very justly remarks, are more common at the commencement of spontaneous inflammations, than in inflammations which arise from external injury. They seldom occur in the suppurations which succeed to operation. In these, on the contrary, the febrile symptoms suffer an abatement, and in many instances disappear,-undergo, as it were, a natural crisis, upon the commencement of the state of suppuration.

Rigors, however, are not peculiar to the state of suppuration, for we find them occurring in the commencement of febrile, as well as of inflammatory diseases. Thus, most fevers, whether arising from cold or from contagion, whether of a continued, remittent, intermittent, or eruptive kind, are ushered in by a cold fit. Rigors also, it deserves to be remarked, are often produced by local irritation, in cases where inflammation does not exist. This is remarkably the case in whatever affects the urethra. The introduction of a bougee, of a sound, or of caustic, into that canal often excites them, and in this case, instead of being in every instance followed by a hot fit, they frequently terminate by vomiting, or end in a cold clammy sweat. Rigor is now well known to be a symptom arising from the presence of stricture in the urethra. I have repeatedly known the rigors which accompany stricture_in the urethra mistaken for, and treated as intermittent fever. Indeed, the appearances are in many instances so similar, as to render this, in those who are ignorant of this effect of stricture, a very pardonable mistake. This is another proof, if any more were wanting, of the difficulty of distinguishing often in practice between idiopathic and symptomatic fevers. A smart attack of rigor runs in general through all the stages of a true intermittent." P. 321,

The peculiar character of this volume in general is its practical tendency; and we cannot give too much credit to the author, for the frequent and frank confessions of his ignorance upon those dark and mysterious points of our animal economy, which many a medical writer would have endeavoured to conceal both from himself and his reader, by involutions of language and confusion of ideas, and in a vain attempt to frame au uscless and often an extravagant theory, or system of absurdity.

Ulceration

Ulceration next employs our author's attention, under which head he considers the effect of absorption in all its varieties-of caries and necrosis in bone-of the formation and progress of granulation. The section, in which the various kinds of ulcers come under his consideration, is full, clear and satisfactory. Upon the callous or indolent ulcer in the leg, Dr. Thomson has quoted the authority, and recommended the practice of Mr. Baynton, of Bristol. As we consider that this gentleman has introduced a very considerable improvement into the treatment of this sort of ulcer, we shall extract the directions which he has given, as we conceive that they may become of general utility to all those, who especially in the decline of life, are affected by a similar disease.

"The parts should be first cleared of the hair, sometimes found in considerable quantities upon the legs, by means of a razor, that none of the discharges by being retained, may become acrid and inflame the skin, and that the dressings may be removed with ease at each time of their renewal; which, in some cases, where the discharges are very profuse, and the ulcers very irritable, may perhaps be necessary twice in the twenty-four hours; but which I have, in every instance, been only under the necessity of performing once in that space of time.

"The plaster should be prepared by slowly melting, in an iron ladle, a sufficient quantity of litharge-plaster or diachylon, which, it too brittle when cold to adhere, may be rendered adhesive by melting half a drachm of resin with every ounce of the plaster; when melted it should be stirred till it begins to cool, and then spread thinly upon slips of smooth porous calico, of a convenient length and breadth, by sweeping it quickly from the end held by the left hand of the person who spreads it to the other, held firmly by another person, with the common elastic spatula used by apothecaries; the uneven edges must be taken off, and the pieces cut into slips about two inches in breadth, and of a length that will, after being passed round the limb, leave an end of about four or five inches. The middle of the piece so prepared is to be applied to the sound part of the limb oppetite to the inferior part of the ulcer, so that the lower edge of the plaster may be placed about an inch below the lower edge of the sore, and the ends drawn over the ulcer with as much gradual extension as the patient can well bear; other slips are to be secured in the same way, each above and in contact with the other, until the whole surface of the sore, and the limb, are completely covered at least one inch below, and two or three above, the diseased part.

"The whole of the leg should then be equally defended with pieces of soft calico, three or four times doubled, and a bandage of the same about three inches in breadth and four or five yards in length, or rather as much as will be sufficient to support the limb from the toes to the knee should be applied, as smoothly as can be

possibly

possibly performed by the surgeon, and with as much firmness as can be borne by the patient, being passed first round the leg at: the ankle joint, then as many times round the foot as will cover and support every part of it except the toes, and afterwards up the limb till it reaches the knee; observing that each turn of the bandage should have its lower edge so placed as to be about an inch above the lower edge of the fold next below. If the parts be much inflamed, or the discharges very profuse, they should be well moistened and kept cool with cold spring water, poured upon them as often as the heat may indicate to be necessary, or perhaps at least once every hour. The patient may take what exercise he pleases, and it will be always found that an alleviation of his pain, and the promotion of his cure, will follow as its' consequence;` though, under other modes of treating the disease, it aggravates the pain, and prevents the cure." P. 448.

The hospital gangrene is now discussed with much ability by Dr. Thomson, and his mode of treatment appear to us unobjectionable. From this he is led to examine the subject of mortification in general, its symptoms and its treatment. His observations upon the system of amputation, which was by our forefathers considered as the surest method of arresting the progress of the disease, are exceedingly judicious and good.

Amputation was long regarded as one of the most effectual means which could be employed to prevent the extension of gangrene. This practice, however, has not received the sanction of experience; on the contrary, it has been generally found, whereever it has been practised, in either acute or chronic gangrene, to accelerate much the progress of the disease, and in this way to hasten the death of the patient. The parts which were divided in amputation, though at a distance from a spreading gangrene and from sphacelus, were found speedily to assume the appearance of the affection for which the operation had been performed. Till, therefore, the adhesive inflammation comes on, and a distinctly marked separation of the dead from the sound parts takes place, amputation is, in few, if in any cases of mortification, admissible. We never know, previously to this, where a gangrene or sphacelus are to stop, nor whether the powers of the constitution be sufficient to sustain the injury that the mortification has inflicted. Even when the adhesive inflammation comes on, it is, in most cases, best to allow some time to elapse before we operate, partly with a view to give time for the constitutional symptoms to abate, in other instances to allow the patient's strength to be recruited by nourishment and cordials, and partly also with a view to learn, whether the constitution of the patient be indeed capable of so great a fresh shock, as that which amputation must necessarily occasion." P. 582.

The volume concludes with two sections upon the effect of the two extremes of temperature, burns, and frost bite. Upon the

first

first of these, he introduces many practical and useful rules respecting the treatment of slighter burns and scalds, which are well worth the attention not only of the professional man, but of the matron and mother. In severe burns, he appears generally 19 recommend the usage of the emollient poultice; he also states that he has generally found those burns slough and granulate in a more rapid and favourable manner, to which the common emollient poultice applied, than in those cases, where it has been mixed with carron oil, oil of turpentine, or vinegar. When the suppuration is too copious he recommends of course the abandonment of their use.

We have thus given a hasty analysis of the contents of this volume, which we must consider as a most valuable one to the young practitioner; or even to those who are more experienced in their profession. It is copious without being diffuse, and prac tical without anility. We highly approve of the candour which Dr. Thomson shews, in adopting the opinions of others, and in giving free extracts from their works whenever they illustrate his subject. The instruction and advantage of his pupils appear to be his principal aim, which is never to be advanced by captious objections or controversial cavil. We heartily wish that all our medical lecturers would imitate our author in this important point. We are aware that many may differ both in opinion and practice with Dr. Thomson; where however the ground-work is so excellent, it is not our intention to bring forward even the few objections which might be raised against any particular part. "It is a good text book, and we hope that it will be so esteemed by those, who may reap much advantage from its study.

BRITISH CATALOGUE.

DIVINITY..

ART, IX. A Sermon preached before the University of Cambridge, on the 25th of October, 1814. By Herbert Marsh, D.Ď. F.R.S. 1s. Deighton, Cambridge; and Rivington, London. 1814.

Whatever comes from the pen of Dr. Marsh has an irresistible demand upon the public attention. Whilst, therefore, we are preparing an analysis of his celebrated work upon the difference between the Churches of England and Rome, for the ensuing month, we would not omit to notice the sermon before us, as a discourse admirably adapted to the place from whence it was delivered, and to the occasion which gave it birth. Its language is

clear