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ART. X-1. On the Nature of Limbs. A Discourse, Delivered at an Evening

Meeting of the Royal Institution of Great Britain. By Richard Ow EN,

Fr.S. - - - - - - - - -

2. The Homologies of the Human Skeleton. By Holytes Coote, F.R.C.s, De-
imonstrator of Anatomy at St. Bartholomew's Hospital - -

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4. The Undercliff of the Isle of Wight; its Climate, History, and Natural Pro-
ductions. By GEORGE A. MARTIN, M.D. . - - - -

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£ibliographical Notites.

BERT MAYo, M.D. - - -

ART. IV.-1. The Hunterian Oration delivered before the Royal College of Sur-

geons of England, on the 14th of February, 1849. By CEs.AR H. HAw-

kins, Surgeon to St. George's Hospital - - - - . 241

2. The Retrospective Address on Diseases of the Chest, delivered at the Fif.
teenth Anniversary Meeting of the Provincial Medical and Surgical Associa-

ART. VII.-Questions and Observations in Hygiene: recommended to the consi-

deration of Naval Medical Men; suggested to the mind of the Author by

the approach of the Asiatic Cholera. By FRED. JAMES BRow N, N.L., Lond,

&c., Assistant-Surgeon, R. N. . - - - - - ... 244

ART. VIII.-Portraits of Diseases of the Scalp, with the Safest and most Efficient
Modes of Treatment. By WALTER Coopert DENDY, Senior Surgeon to
the Royal Infirmary for Children, &c. &c. Fasciculus I . - ... ib.

ART. IX.-1. Memoirs on the Ganglia and Nerves of the Uterus. By Robert

Lee, M.D., F.R.s., Lecturer on Midwifery at St. George's Hospital, &c. &c. . 245

2. Practical Observations on the Diseases of the Uterus. By Ron ERT LEE,
M.D. F.R.S., &c. Coloured Illustrations from Original Drawings by Mr. PERRY ib.

ARt. XIII.-The Training Institutions for Nurses, and the Workhouses : an at-
tempt to solve one of the Social Problems of the present day. By Edw ARD
Sievek ING, M.D., Physician to the Northern Dispensary, &c. &c. . . ib.

jJeriscope.

On the Composition of the Salts of the Blood, and of their Relations to the Forma-

THE

BRITISH AND FOREIGN
MEDICO-CHIRURGICAL REVIEW.

JULY, 1849.

PART FIRST.

2 malntital and (Iritical lirpictus.

ART. I.

1. Parturition, and the Principles and Practice of Obstetrics. By W. Tyler SMITH, M. D. Lond., Lecturer on Obstetrics in the Hunterian School of Medicine.—London, 1849. Feap. 8vo, pp. 396.

2. Obstetrics : the Science and the Art. By CHARLEs D. Meigs, M. D., Professor of Midwifery in the Jefferson Medical College at Philadelphia, &c. &c. With 121 Illustrations on Wood.—Philadelphia, 1849. 8vo, pp. 686. It seems to us not a little strange that writers who show a considerable amount of acuteness on other topics, should continue to entertain such vague and confused ideas with respect to the relation between Science and Art, as are presented by the authors of the two works before us, in the opening sentences of their respective treatises. According to Dr. Tyler Smith, “Labour : the study of the act of parturition itself, and of all that relates to the prevention or alleviation of the pangs and dangers in which women bring forth children, and to the preservation of their offspring, are the principal aims of the Obstetric Art.” (p. 1.) We do not precisely understand the relation of the first word in the above quotation to the rest of the sentence from which it is separated by a colon; according to all ordinary rules of punctuation, it is entirely isolated; and although certain clever writers of fictitious or imaginative works have lately broken through all these for the sake of effect, we shall set our face against the introduction of any such method, or rather want of method, into treatises in which the clear and sober exposition of truth is the only object. Leaving the word Labour, then, to stand alone like, the monosyllabic noun-verb which in the Chinese language forms a sentence by itself, we shall inquire into the meaning of the remainder of the passage. Inverting the sentence, we find Dr. Tyler Smith asserting that 7–1 v.

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“ the principal aims of the Obstetric Art” are “the study of the act of parturition itself, and of all that relates to the prevention or alleviation of the pangs and dangers in which women bring forth children, and to the preservation of their offspring.” In our apprehension, this is rather a definition of the science, than of the art, of obstetrics. The object of the art is to alleviate the sufferings, and preserve from the dangers, incident to the performance of the function in question; that of the science is to know how to alleviate. The art consists of a set of rules for practice, deduced from the scientific study of the function in its normal and abnormal conditions; and these may be successfully applied by a practitioner, who knows nothing of their rationale. On the other hand, the science is evolved from the philosophic contemplation of the phenomena presented by clinical observation, guided by an acquaintance with the general principles of physiology; and this may be successfully pursued by a man who has never conducted a case of labour for himself. Although we are far from thinking that a mere observer is the man best qualified for such a pursuit, yet on the other hand, we are confident that he would be much more likely to contribute towards the advancement of the science, and the consequent improvement of the art in precision and certainty, than the mere practitioner who isolates this department of biology from every other, and looks at the parturient woman as a being with whom no one but himself has anything to do. Let us see whether Dr. Meigs is more successful in his definitions. The following are his opening sentences: “Midwifery is the art of assisting women in labour. “Obstetricy comprises the sciences of anatomy, physiology, and pathology, as relates to the reproductive organs, and the arts of therapeutics and surgery, as applied to sexual affections in women. “Midwifery is an Art. “Obstetricy is a Science. “A Midwife or Accoucheur is one who assumes the conduct of cases of labour. “An Obstetrician is a physician, who, in addition to a general knowledge of physic and surgery, adds the special information that it is necessary for one having the peculiar charge of all sexual affections, whether in the department of midwifery proper, or in other complaints of the sex. “ Notwithstanding obstetricy is composed of several different branches or sorts of knowledge, it claims to be considered as a distinct science.” (p. 17.)

In these oracular dicta, we have an attempt at greater precision of statement; and we believe that, by a little amendment, they may be made to express the true view of the subject. We will take Dr. Meigs's definitions of Obstetricy as the Science, and Midwifery as the Art ; and inquire what are their respective provinces. Obstetricy, strictly speaking, consists of those departments of the sciences of anatomy, physiology, and pathology, which relate to the reproductive function; but as the obstetric practitioner is the one generally consulted upon the diseases and injuries to which the female sexual organs are liable (unless these diseases, like syphilis, be purely constitutional in their nature), the whole pathology of these organs (with the exception we have named) must be considered as included under the designation of obstetrics. Now so far as obstetrics is a science,—in other words, to use the definition of Mr. John Mill, as it consists of a collection of truths, whose language is “this is, or this is not ; this does,

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