something a little more in detail than these cases; something like Louis' invaluable work on Typhoid Fever, in which the signs of a particular disease are brought out to absolute demonstration. Still we have not the slightest hesitation in stating that the most precise and trustworthy evidence we can as yet command, and which, in the case of the African fevers, has been chiefly accumulated by Drs. Bryson and M'William, leads to the conclusion that those fevers, so variable in intensity, and so different in the appearance of the mildest and the severest forms, will yet be found to display unequivocal marks of identity, and to depend on analogous conditions.

The second work on our list need not detain us long. It is chiefly occupied with a careful selection of every particle of evidence which can be of use in proving the contagion of yellow fever; every adverse document is carefully excluded; and it really is impossible to avoid congratulating Sir William Pym on the skill with which he has presented one side of the question. Did we want a special pleader, acute, uncompromising, bigoted, and bitter, to discuss a point of scientific inquiry, we know no man whom we should prefer to the chief of the quarantine department. Unfortunately, the qualities which make a first-rate lawyer, ardent for victory, are not the best for ensuring a dispassionate inquiry after simple truth. The second edition of the work on Bulam Fever is marvellously altered from the first. In some points it is decidedly improved; it is more logical; the argument is better preserved, and doubtful points are more judiciously kept in the background; in other respects the tone of the work remains unaltered; it is just as confident, cynical, and biting, as it was in 1815, when it called forth the indignant rejoinders of Bancroft and his school, and reanimated the controversial flames which, after twenty years of vigour, were beginning to pale and languish for want of fuel.

Sir William Pym does not at all favour the view that the contagious yellow fever can be an offshoot and derivative from the endemic fever; he bestows very hearty abuse, indeed, on those who adopt such an opinion. He has not, however, advanced a single valid argument against it. As a specimen of his mode of arguing, we will very briefly analyse a passage in which he attempts to controvert a position which we formerly advanced. In our previous articles we observed on the cases of the Eclair, the Bann, the Scout, and the Kent, that if it was denied that a marsh yellow fever could acquire contagious properties, then we had no resource but to assume that on board these vessels two diseases must have been present at the same time. But this appeared to us highly improbable, as the Kent, the Scout, and the Bann had been exposed only to the common local causes of disease. Now we can add, also, the Eclair to the list, which at that time our deficient information did not permit us to do.

Sir William Pym proceeds to demolish this argument; he affirms that yellow fever existed at Port Royal, when the Scout sailed from that place. In answer to this we can only say that when he tells us on what grounds he makes the affirmation, we will take them into consideration. We can hardly be called upon to retract our deliberate opinion on a mere assertion unsupported by a single additional fact. In the cases of the Bann and the Eclair, Sir William Pym declares that contagious yellow fever prevailed at Sierra Leone, when these vessels were at anchor in the roads.

We have, in the present article, given tolerably conclusive evidence that, in the case of the Eclair at any rate, this was not the case.

In the instance of the Kent, Sir William Pym has recourse to a very singular argument. The Kent sailed from an unhealthy anchorage at Port Mahon, for Gibraltar; a fever appeared during the voyage, which was decidedly contagious, and was called yellow fever. Now Sir William Pym cannot venture on the statement that epidemic yellow fever existed at Port Mahon when the Kent sailed, because this could be disproved. Yet he cannot question the fact that the Kent carried a contagious fever, which some of her crew communicated at Gibraltar to other vessels. How does he get over the difficulty? Very simply; he denies that the contagious fever was yellow fever.

The facts of the case were these: on the 5th of August, 1809, the Kent arrived in the bay of Gibraltar. Nearly the whole of her crew had been attacked with a fever, which, according to the surgeon's certificate, "was attended with marked symptoms of yellow fever, and appeared off the coast of Barbary, on the 6th of July." In addition to the common febrile symptoms, the surgeon states that there was continual hiccough and vomiting; acute pain in the epigastrium and hypochondria, general diffused yellowness of the eyes, and the skin of a deep orange tint; syncope in the erect position, frequent hemorrhage from the nose; tongue, black and parched; retention of urine occurred, which was relieved by the catheter.*

Now we had and have several reasons for calling this fever contagious yellow fever:-1. There is the statement of the surgeon that it was so. 2. There is the opinion of Sir William Burnett, who also admitted the contagious nature of the disease. 3. The Kent was boarded in the bay by an officer from Gibraltar, who inquired into the nature of the disease, and reported it as contagious yellow fever both to the governor of the garrison, and to the Army Medical Board in England. That officer was Sir William Pym. Now when there was this wonderful unanimity of opinion between the rival parties, we did think ourselves justified in believing that little doubt could exist as to the nature of the disease.

What are the reasons, then, which have led Sir William Pym to change his opinion? He states that he has looked over the official report again, and finds the symptoms not those of the Bulam fever. But we cannot admit he has made out his case. The symptoms he now details, and which we have given above, are all those of yellow fever, and not of any other disease. Moreover, relapses, exacerbations of fever, bilious, green, and yellow vomiting, and even increased action of the kidneys, which he says were symptoms present in the Kent fever, and which distinguish it from Bulam fever, may be, and have undoubtedly been, present in true contagious yellow fever. The sore throat and desquamation of the cuticle which occurred in most cases, according to Sir W. Pym's account, we confess we do not quite understand. We should like to know the exact nature and number of the cases in which they occurred.

As Sir William Pym will not derive this disease from Port Mahon, as he cannot admit its production in the ship, he has been obliged to look out for some other mode of origin. He has discovered that on the 22d of June, fourteen days before the fever appeared, the Kent received on

These are the symptoms detailed by Sir William Pym in the present edition.

board forty-eight French prisoners. But he has not been able to prove that these prisoners had any fever when they came on board; and on the contrary, so little was it suspected at the time that they introduced the disease, that the surgeon omitted all mention of the fact in his report; and although he mentioned it verbally to Sir William Pym, it does not seem to have made any impression, possibly because, as the French prisoners were taken on board at Toulon, which is not in the yellow-fever latitude, such introduction might have raised doubts as to the correctness of Sir William Pym's assertion, that the disease in the Kent was the Bulam fever.

There is not, then, the slightest proof that the French prisoners brought the disease with them; they may or they may not; no human being can tell whether they did or not. But certainly it is utterly illogical and wrong to assert that they did, simply because in that way only can an opposite opinion be overthrown. But this is a good specimen of Sir William Pym's method of judging,-first form your conclusions, then bend your facts to meet them; thirty years hence, if you change your opinion, bend the facts the other way.

For ourselves, we are quite unconvinced by any of Sir William Pym's later reasonings that his early opinion was not the correct one; and we must still continue to hold to the belief that a yellow fever which, as in the case of the Bann and the Eclair, acquired contagious properties, did exist on board the Kent. Not, however, that we attach any special importance to this case, but, on the contrary, would at once surrender it, as too doubtful to be used in the discussion, if the presence of yellow fever did not seem to be really supported by good evidence.

We trust that ere long the unlucky blockade of the African coast may be abandoned, and that no more victims may be the prey of that miserable and unhealthy station; but still we should like to see some scientific results arise out of, and in some small measure make amends for, the terrible mortality which has prevailed there. Let us hope that if opportunities are again thrown in the way of any of our enterprising and able brethren of the navy department, they will not fail to bear in mind the chief points which demand inquiry, and, by careful examination, endeavour to investigate and comprehend them. It is, we are convinced, only by deeper research into the signs of tropical fevers than has yet been made by any one, that these vexed questions of contagion and non-contagion, identity or dissimilarity, can be satisfactorily and finally elucidated.

And, in conclusion, we would observe, that the questions we have been discussing have a much more direct bearing on the practical aspects under which the fevers of our own country should be viewed, than some of our readers might at first suppose. We have argued on a former occasion (Vol. III, p. 74 et seq.), that the question of the connexion between specific causes and specific types of fever is the most important we can now pursue; and it seems almost superfluous to insist upon the aid and guidance we may derive from investigations carried on, frequently under peculiarly favorable circumstances, with regard to the fevers of warm climates, whose causes and whose course present a degree of intensity, of which, in this country, we have scarcely any experience.

ART. XI.

Selecta Praxis Medico-Chirurgica quam Mosquæ exercet ALEXANDER AUVERT, Augustissimi omnium Russiarum Imperatoris Consiliarius Status, Cæsareæ Universitatis Mosquensis Professor P. O., Medicus senior Nosocomii Urbani, &c. &c.—Parisiis et Mosque, 1848.

Selections from the Practice of ALEXANDER AUVERT, at Moscow, Professor in the Cæsarean University, and Senior Medical Officer of the Urban Hospital, &c. &c.-Paris and Moscow, 1848. Folio.

WE have before us six fasciculi of this magnificent work, which, as its title denotes, is destined to comprise a series of selections from the practice of its author. The plan and arrangement of the work are, that, when completed, it should consist of 120 coloured plates, illustrating different forms of disease, medical and surgical, each being accompanied by its particular sheet of text, descriptive of the case which forms the subject of the drawing, and explanatory of the illustration. There will be four divisions of the work, each comprising six parts, and each part containing five plates the whole will take four years in its appearance. The engravings, which are executed in Paris, under the inspection of M. Tardieu, are truly splendid specimens of the art of copper-plate engraving, as applied to the illustration of diseased structures; they are coloured, and retouched by the hand to give them greater accuracy and faithfulness. They are almost unmatched, and certainly not surpassed, either in elegance of execution or fidelity to nature, by anything of the sort we have ever seen. The Latin text which accompanies the illustrations, and the paper on which it is printed, are both in keeping with the plates.

:

In the present series, issued during last year, and constituting the first division of the work, the illustrations include certain affections of bone, some malignant diseases and peculiar forms of nævus, &c. There seems to be no pretension to pathological uniformity of plan, nor attempt to embrace in a systematic way any particular class of diseases; at least as far as we can judge from the engravings under our inspection. Therefore, in this our brief notice, we merely purpose to glance at the drawings and text, to give our readers an idea of the subjects selected and the mode in which they are treated.

In his preface, our author professes to have arranged his "selections" according to the regions affected, under the following six heads. "The head, the neck, the vertebral column, the chest, the abdomen, the extremities." The present division does not extend beyond the first heading. The five plates comprised in Part I. illustrate the following subjects. a. "Hyperostosis and fungoid exostosis of the calvaria," occurring in a young girl of 19, and of a scrofulous habit. We have seen a very

similar case, but in a much older person. b. "Perforating ulcer of the cranium, and an extensive fracture of the calvaria ;" in different individuals. c. "Syphilitic caries of the base of the skull." The part affected is the anterior or frontal division; and the disease appears to have extended to it by contiguity, from the spongy bones of the nose; which, according to the history, were the parts first attacked. Further, the membranes of the brain were affected; nay, the very structure of the cerebrum to its

yet all the

centre (usque ad ipsas hujusce organi partes centrales), and faculties,"sensibility, intelligence, judgment, will, motion," were unimpaired, until just before death; when the patient was sinking from exhaustion. We have seen cases quite as significant, in a phrenological point of view as the above, and quite concur in the remarks with which our author closes his case, to the effect that we have still much to learn before we can venture to dogmatise on the special functions of this or that part of the encephalic centre.

d. We next have a singular specimen of "horny excrescence over the os frontis." It stands out perpendicularly from the centre of the forehead, is conical in form, and has, we should judge, a circumference of three inches at its base. It appears to have attracted but little attention at first, and to have been slow in growth. This curious production (not however unique) was removed by the author, who seems disposed to view it as having its origin in the obstruction of the excretory duct of a sebaceous follicle.

Lastly, the fifth plate of this division exhibits a huge deforming "polypus of the right frontal sinus," pressing out the eye, and involving nearly the whole of the corresponding side of the face.

The first plate of the second fasciculus exhibits the appearances presented by a case of "elephantiasis, combined with nævus of the right ear, and neighbouring part of the scalp." The details of this disease, which occurred in a girl of 22, are interesting, but too long even to admit of an abstract of the whole. The carotid artery was tied, in imitation of analogous cases treated by Dupuytren, Travers, and Dalrymple ; and though all pulsation in the tumour ceased, and the ligature came away on the twenty-second day, yet the diseased parts ulcerated and bled; and the patient ultimately died, soon after a sudden attack of hemiplegia of the left side. Her health seems to have been much deteriorated beforehand, and she was of a scrofulous constitution.

An illustration of a case of "elephantiasis of the scalp in the occipital region" succeeds; and certainly a most hideous, and at the same time ludicrous effect is produced by the back view which is given. This also occurred in a young and scrofulous woman.

The remaining three figures of this fasciculus are occupied with two illustrations of "Fungus hæmatodes of the eye," in a child, and at different stages, and one of "Encephaloid fungus, of the same organ," in an adult. They do not present any peculiarities calling for special comment. The first plate of the next fasciculus represents, and very beautifully, the appearances of the encephaloid and melanoid diseases, when removed.

In the third fasciculus we likewise have two drawings of cancer of the lower eyelid; or, rather, one exhibiting the disease, and the other the plastic operation by which it was cured: also a singular example of large angiectasis of the tip of the nose; and one of a similar production from the right cheek: these two latter both occurred in children. In the nosecase, milder means having been tried ineffectually, the diseased growth was removed with the knife, the copious bleeding being controlled by iced water and compression. The boy made a good recovery in the course of a month.

The projecting and pendent nævus from the cheek was also excised ;