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toms being, sickness; purging of rice-water stools; crampsmost violent; coldness, with the blue skin; and no urinepassed. The whole of these eleven patients recovered underthe same plan of treatment. When I am convinced the caseis one of cholera, I bleed; if in the early stage, I take as muchas the patient can bear; if in the stage of collapse, there is nofear of getting too much, as I have only been able, in somecases, to obtain from half an ounce to one ounce; but eventhis small quantity has been of use. I have opened a vein,and taken what blood I could get, even when no pulse couldbe felt, and in a very short time the circulation has got up.The blood taken in this stage does not coagulate. After thebleeding, I give a bolus, with fifteen grains of calomel andfive grains of opium, and have the abdomen covered witha coarse cloth, three or four double, well wetted with equalparts of spirits of turpentine, and the strong solution of am-monia, (liq. ammon. fort.) Half an hour after the bolus, Ibegin with a small teaspoonful of sedative solution of opium,(Battley’s,) in one ounce of which one drachm of musk hasbeen well rubbed, and given all together, without straining.I repeat this dose every half-hour, not having it mixed withany liquid, but give it out of the teaspoon. I do not allowany drink to be given to the patient, except pure brandy, byteaspoonfuls, and as often as it can be got down. This I findto be very distressing to the poor creatures, as they complainso dreadfully of thirst, and would drink quarts, if allowed todo so; but I find the sickness increased thereby. If relief isnot obtained in two hours, I repeat the bleeding, but I haveonly had occasion to do so in three cases out of the eleven.This has been my treatment, and, as I before stated, has suc-ceeded in every instance. In the after management I am ofcourse guided by circumstances. My chief dependence is inthe bleeding, which, even in the state of collapse, when only asmall quantity will flow, and that by drops, the relief obtainedhas been very evident. I feel much diffidence in bringing mypractice before the profession; but, as a reader of THE LANCETand a practitioner for twenty years and upwards, I trust thatI may publish this very brief report without rencering myselfobnoxious to a charge of presumption.

Reviews.

The Three Kinds of Cod-liver Oil, with Reference to their Che-mical and Therapeutical Properties. By L. J. DE JONGH, M.D.,of the Hague. Translated, with an Appendix and Cases,by EDWARD CAREY, M.D. 1849. London: Taylor, Walton,& Maberly. 8vo, pp. 176.

COD-LIVER oil and its properties even now attract much atten-tion, notwithstanding the all-engrossing subject which is

presented everywhere to the consideration of the profession,to the anxiety and alarm of the public. We cannot, there-fore, omit saying a few words about a matter of so much in-terest. Dr. De Jongh, a Dutch physician, feeling desirous ofascertaining the ’modes in which the different kinds of oilwere prepared, and whether the differences in their physicalcharacters extended also to their chemical and therapeuticalqualities, availed himself of some favourable opportunitieswithin his reach of pursuing these inquiries, and the result isnow before us. Dr. De Jongh’s original publication, which isin Latin, has been translated into German, and to this trans-lation several very useful additions appear to have been made.Dr. Carey’s version, with not less useful further additions, isfrom the German, so, in fact, we have here the result of thecombined observations of three physicians. Dr. De Jonghstates, that in commerce there are found three kinds of cod-liver oil. A pale oil, a light-brown oil, and a dark-brown oil.All these should be transparent, and have a peculiar fishyodour. In addition, the smell of the dark-brown oil is

empyreumatic and disagreeable, the taste bitter, and irri-

tating to the fauces; the light-brown oil is less bitterand less irritating; the pale oil does not possess these proper-ties at all. The author’s inquiries show that these oils areprepared indiscriminately from several species of the cod-fishtribe, chiefly from the Dorse, in the region from whence hisspecimens were procured. There is reason to believe thatin many cases, not merely the livers of other fish, but eventhe fish themselves, and not unfrequently some mammalia, in-

eluding seals and porpoises, contribute to the supply. It ap-pears, further, that the livers are thrown into casks, in whichthey are allowed to remain some time. The separation of thepale oil commences spontaneously; it is removed, and then the.livers are subjected to heat in iron pans. The dark-brownoil is the result. The light-brown is either produced in thefirst stages of the heating process, or by a combination of the-other two. Into the chemical composition of these varietiesof oil, the author has pursued a most elaborate inquiry bothqualitatively and quantitatively. He finds cod-liver oil, per se,to be composed of oleic acid, with a peculiar substance which.he calls gaduine, margaric acid, glycerine, butyric and aceticacids, biliary acids, bilifulrein, some peculiar substances, alsoiodine, chlorine, bromine, phosphorus, and some earthy salts-All three varieties of oil contain these elements, but in differentproportions. Strange to say, " the lighter kinds are richer ininorganic substance (as well as in iodine) than the brown-kind ; whilst, on the contrary, the latter is richer in the-component parts of the bile; in butyric and acetic acids."The results of the chemical investigations are succeededby an historical statement of the various therapeutical pro-perties which have been assigned to this remedy, and a.

statement of the author’s experience of the relativemerits of the three kinds is given. We learn from all this.that cod-liver oil has long been known, both here and on the-Continent, as a very useful remedy in chronic rheumatism andgout, rickets, scrofula, &c.; and that it has been applied with,varying success in a great many other diseases in which theprocess of nutrition appeared to be impeded or deranged inany of its stages. For information on these points, we mustrefer the reader to the work itself, or some similar source-Dr. De Jongh then gives the histories of half a dozen cases.treated by each of the three kinds of oil respectively, and con-cludes, that though cures were effected by all, still that theoperation of the brown oil was considerably the quickest.Thus far we have endeavoured to give an outline of the

contents of this work, which, so far as the opportunitiesof the author extended, exhibit as complete and as ablyconducted an inquiry as could be desired - an inquiry-which will be examined by all who are interested in thissubject. There still, however, remains much to be done-The cod-liver oil now used in this country differs in a.

great measure from either of the kinds here described.It is prepared from fresh livers by heat. Thus whilst itretains the less unpleasant properties of the pale oil describedby the author; it also, perhaps, acquires, by the application ofheat, those more powerful therapeutical qualities which thebrown oil is stated to possess. We require, therefore, achemical examination of the English pale cod-liver oil. We-

require more-we need a careful investigation of its capa-bilities in the cure of different diseases, and of the mode ofits action. Our own experience, and it has been extended,.leaves on the mind the impression that no other medicinal ordietetic agent possesses, to the same degree, the powers ofcorrecting the effects of depraved nutrition, whether they aremanifested in the glands, the lungs, the bones, the mucous.membrane, or the skin. As a most useful addition to our

knowledge on this interesting subject, we recommend thestudy of Dr. De Jongh’s treatise, extended as it is, in its pre-sent form, by its able commentators.

The Modern Housewife, or Ménagère; comprising nearly OneThousand Receiptsfor the Economic and Judicious Prepara-tion of every -4-1-eal of the Day, with those of the Nursery andSick Room, &c. Illustrated with Engravings. By ALEXISSOYER, (Reform Club.) London: Simpkin, Marshall, & Co.1849. 8vo, pp. 430.

THE well-known M. Soyer has added another leaf to his laurels-He has produced a book characterized by as much piquancyas his artistic productions of another kind, yet one which isequally well calculated for use by families of moderate

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income, as by establishments of greater pretension. The"Housewife" is sent forth as a companion to the loving,longing, and tasting " Gastronomic Regenerator," and a

delightful companion she will prove." Sure such a pair were never seen,So justly formed to meet by Nature."

M. Soyer may well be proud of his offspring, and he

certainly stands before the public as the first man of his class.The substance of the 11 Mdnag&re" is introduced under the

guise of a correspondence, in such a manner as to render itquite readable and entertaining, as well as instructive anduseful.We give no extracts, as the book ought to be read, and in

the hands of every keeper of a kitchen and larder in thekingdom.We believe that our national cookery is very likely to

derive wholesome regeneration from the efforts of the author.M. Soyer appropriately dates his work from the " Reform"Club. With a knowledge of cookery-in other words, with aknowledge of the mode of making the best and most agreeableuse of everything that is to be consumed, an income of X300or X400 a year may be made available to realize more enjoy-ments than double that sum in a family where no such in-formation exists. If it be true that knowledge is power, it isequally true that knowledge is economy.

If we are to judge of the versatility of the genius of M.Soyer in matters of taste by the exquisite variety of the sub-stantial subjects which he produces for the entertainment ofhis company, he is not less remarkable in the sphere of hisoperations than is Lord Brougham in the most exaltedassembly in the nation. In fact, M. Soyer is the Broughamof literary, practical, and eloquent cuisi?zier8.

A LATE ACTION BY THE SOCIETY OFAPOTHECARIES.

To the Editor of THE LANCET.

SIR,-My attention has been directed to a report of a case,in THE LANCET for August 25, tried at the County Court,Petworth-" The Apothecaries’ Company v. Morris." It seemsto me most impolitic and ungenerous, on the part of thehonourable company, (0 to select men of education, dulyauthorized and legally qualified surgeons, for prosecution, orrather persecution. The feeling of the profession has beenproclaimed against such a proceeding, after the late agitationsand united intentions for reform, in which it was universallyagreed that justice and equal rights should be conferred onthose gentlemen belonging to the time-honoured and mostancient and renowned institutions of the empire !

In " The Principles" issued by the now moribund NationalInstitute, under the especial charge of the Apothecaries’Society, it was clearly understood and defined that the mem-bers of the profession above alluded to should have unlimitedprivileges. They have now broken faith, and must lose allconfidence from the profession. I am led to ask how a sur-geon can practise in surgical cases without practising medi-cine ? 1 Scarcely an accident occurs but the surgeon mustbring into action a knowledge of medicine and an intimateacquaintance with numerous diseases, the sequelse of injuriesto the most important organs of the human frame, and re-quiring the most judicious and skilful treatment.When such important and highly responsible duties fall to

the province of the surgeon, he must be ably qualified to dealwith the whole range of diseases which flesh is heir to."Why should a man be interfered with for doing what belongsto the dispensing chemist, or dispensing and selling medicine? 1It would be desirable, if you were to define what are reallythe duties and the privileges of surgeons. I assume they havefull power to attend every description of cases, and supplymedicines, provided no charge is made for such. A fair andreasonable charge may be made for time, attendance, or visits-the same to be recovered. This mode of practice has nowbecome pretty general, and far more respectable than thevicious and odious system of seeking remuneration by delugingthe patient with physic, which is as repulsive to the patientas it is derogatory to the practitioner.

I have the honour to be, Sir, your most obedient servant,September, t849.

-

CHIRURGICitS.

A DAYLIGHT DRUGGIST.To the Editor of THE LANCET.

SIR,-I was called a few evenings since, at a late hour, tovisit a patient suffering from a severe attack of dysentery, atany time calculated to excite alarm, but especially so just now,from its resemblance to cholera, for which, indeed, in the pre-sent instance, it was mistaken by the other members of thehousehold. I was therefore anxious, both on account of theurgency of the case, and their anxiety, to administer an im-mediate remedy, and went for this purpose, being a consider-able distance from home, to the nearest druggist, who happenedto be Mr. Barton, of St. Join’s Wood Terrace. It was abouta quarter to twelve, and after my ringing several times, hemade his appearance at an upper window, and demanded whoI was, and what I wanted ? I replied that I was a medicalman, and wanted some medicine for a patient dangerously ill.You will hardly believe, Sir, that he had the inhumanity todeny me; but I assure you his reply was, that " he was goneto bed, and could not come down to me"!

I could not of course suffer such conduct to pass unnoticed,and therefore called the following morning, and remonstratedwith him, hoping to convince him, not only of its impropriety,but of the positive danger to himself as well as the patient, ofrefusing medicine under such circumstances. You will judgeof my success by his replies, which I give you as nearly ver-batim as possible, omitting my own remarks for the sake ofbrevity. " He was certainly at liberty to do as he pleased, andwas not under any obligation to go down to any medical manwho chose to go there after he had gone to bed." Again:" Medical men, when called out late, ought to provide them-selves with something or other with which to make shift untilmorning." And again: "He did not see why he should becalled upon to peril his health by going down into his shop atnight, and he should not do it." That he has a legal right todo as he pleases in such a case is, I fear, true, but his moral’right no one but himself, I should hope, would have the hardi-hood to assert. Had I gone there simply for an ordinary doseof medicine after he was in bed, he would have been perfectlyjustified in refusing; but under the circumstances related, hisrefusal was as decidedly unjustifiable. I must, however, statethat he said he understood me, not that I was myself a medicalman, but that I wanted it for a medical man; this, however,as I told him, made not the slightest difference, and was nopalliation at all. He must have understood that it was anurgent case; indeed he did not deny it; and yet, rather thango down into his shop for a few minutes, he would risk the lifeof a fellow-creature.

It is true, as he said, that there were other druggists in theneighbourhood, but that would not absolve him from the re-sponsibility of his refusal; they had, moreover, an equal right,with himself, to deny me, and so, indeed, the next to whom Iapplied did, but it was on the plea of illness, which I after-wards found to be correct.Howe7er, Sir, by way of drawing to a conclusion, the con-

sequence of all this was, that an hour and a half elapsed beforeI returned with what I wanted-a delay which, in many cases,might have proved fatal. I think, therefore, I am only dis-charging a public duty in exposing a man who refuses to do sotrifling a service, when, probably, the life of a fellow-creatureis at stake.-I am, Sir, your obedient servant,

JOHN S. MANSFORD.

THE CHOLERA IN DAMASCUS.To the Editor of THE LANCET.

SIR,-The epidemic infliction under which we now suffer isno doubt severe, and most culpable is the conduct of thosewho should have done so much, and who have so little done,to stay its progress; but still we must bear in mind that ourcountry has been pre-eminently blest when we compare theravages of cholera at home and abroad. In a letter I havelately received from my friend, Dr. Thompson, who for manyyears has been in extensive practice in the East, he says-" Iwas quarantine doctor in Damascus during the raging of cho-lera there in August, 1848, and the only European who redmained in that city. The mortality was 10,000 in the town,(population 200,000,) and in the pashalick, 11,000, making21,000 souls sacrificed to this awful scourge, and cairied off infrom four to six and eight hours. Those who survived thistime were, in most instances, carried off by a low consecutivefever, and never rallied. No remedy was of avail." Should thiemite of cholera information appear to you worth publishing,vou are libertv to do so.-I remain, vours obedientlv.

E. T. TILT.