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dose. It behoves every practitioner who prescribes so virulenta poison, to acquire an accurate knowledge of the phenomenato be expected under its use, not only as regards the suspen- Ision of diseased action, but more especially with reference toits influence on the general economy. This knowledge, it istrue, has but recently dawned upon us, and the field is stillopen for further inquiry; but enough is known and publishedto secure the safe administration of the medicine, while itenables us to treat successfully the most inveterate cases oflepra, psoriasis, lupus, &c., as well as other diseases hithertoreckoned incurable, concerning which I hope to communicatesome invaluable information on a future occasion.

I have already demonstrated, that arsenic, in five-minimdoses, generally produces a slight degree of inflammation ofthe conjunctiva, tumefaction of the lower eyelid, and an in-creased secretion of tears; that these symptoms, while theyaccompany the salutary influence of the remedy, actually pre-cede every other deleterious influence, and that these condi-tions depend upon the arsenic being taken on a full stomach,not, as Dr. Cormack and others recommend, on an empty one.I have further shown, that when the conjunctivitis becomesevident, the arsenic is in full operation over the disease; thatthis amount of therapeutical power cannot be increased byaugmenting the dose, but is more fully secured by diminishingit; and I may now add, that I have often found that if thedose be not diminished, and more especially if it be increased,the disease, instead of getting well, often becomes unmanage-able. And recent observation has revealed to me anotherimportant principle-viz., that whereas conjunctivitis is a pri-mary effect of small doses of arsenic, it has also, after a time,a secondary effect. The trunk of the patient first, and, sub-sequently, all those parts of the body which are by the dressprotected from the atmosphere, become covered with a dirt-brown, dingy, unwashed appearance, which under a lens re-veals a delicate desquamation of the dermis, and is, in fact,a faint form of pityriasis. Now this appears to me to be anindication of a secondary form of arsenicalization; for I haveobserved, that when the dose is diminished under conjunc-tivitis, the eyelids may be allowed to get well, yet if thepatient’s skin be kept brown, the disease will vanish just asrapidly as though the conjunctiva were kept sore, which Ionce thought necessary. The first and larger dose of thearsenic appears to knock the disease down, (so to speak,) andto exhaust its energy. Its less malign, or secondary form, willbe subjugated by the secondary or pityriatic action of arsenic.I have repeatedly watched these interesting processes withthe most jealous attention, and commend them to the observa-tion of your readers.Herne Bay, Jan. 1847.

Reviews.

Practical Observations and Suggestions in Medicine. ByMARSHALL HALL, M.D. First and Second Series. Churchill,1846.

THESE two volumes consist of papers already printed in dif-ferent publications, or prepared for the press formerly, and,also, of numerous short articles strictly coming under theheads of the title, as Observations and Suggestions in Medicine.The author, having laboured zealously, through a tolerably longprofessional life, at subjects of comprehensive and lasting im-portance, has chosen to gather up the minor productions ofhis mind, which before lay scattered, and with these he hasinterwoven enough of new and practical matter to make theminteresting to the mere lovers of professional novelty. The chieftopics introduced are diagnosis, the earliest subject treated ofby our author, and one to which he proposes to devote agreat part of his remaining professional life: there is scarcelya page, indeed, in which something relating to this subject isnot apparent. His discoveries in the nervous system are fre-

quently referred to, and he has successfully attempted to placethe subject intelligibly before his readers in short succinctarticles. The essays on puerperal diseases, on which theauthor’s earliest reputation as a practical physician wasfounded, are given, and they are almost as valuable now, aftera lapse of many years, as when they first appeared in print.The subjects of bloodletting, intestinal irritation, paralysis, thephysiology of disease or living pathology, in which Dr. M.Hall stands almost alone, are tersely and ably handled. Dr.

M. Hall’s earlier papers contributed to the Royal Society arealso reprinted. These, and a great number of minor points oftheory and practice, make up the present volumes; and theauthor announces his intention of passing on to a third of thesame kind. Enough has been said to show that the Observa-tions and Suggestions are valuable; still they must be takenfor what they are, not as their author’s most important works;they must be judged of as the labours of his leisure hours,rather than of his studious toil. There is always a tendencyto criticise severely any minor publication from a man

who has previously produced greater works; but muchof the material now collected was produced in detachedforms many years ago, so that the author is scarcely open tothis kind of judgment. Nevertheless, we have seen critics sounfair as to positively estimate Dr. Hall’s worth as a practicalphysician from these little volumes. We have seen them placedside by side with the ripe and mature works of such men asAbercrombie and Dr. Holland, and, of course, the balance givenagainst Dr. Hall. Nothing can be more preposterous or unjust;if a trial is to be made, place the great works of our author bythe side of the greatest works of any other modern physician,living or dead, and we are sure neither Dr. M. Hall nor hisfriends need fear for the issue.

’, But further, the criticisms upon these volumes have beenmade, by the ancient enemies of Dr. Hall, the vehicles of newslanders, and new attempts to rob him of his claim to origi-nality in his discoveries in the nervous system. One of these

attempts - that contained in the current number of theBritish and Foreign Medical Review-we feel it incumbent onus to notice. Many years ago, Dr. Hall was interrupted inhis labours by an impudent pretence, on the part of thisReview, of finding a " complete anticipation" of his doctrinesin the works of Prochaska. Other congenial spirits supportedthe weak invention, by proving, from the records of the RoyalMedical and Chirurgical Society, that Dr. Hall had actuallyborrowed Prochaska’s works from the library, and they gavethis as a clinching proof of Dr. Hall’s dishonesty; thought hesame jealous eyes that took note of the fact, saw, but said not,that Dr. Hall did not borrow the Society’s copy of Prochaska,till long after the publication of the discovery of the reflexfunction. Dr. Hall instantly refuted the insinuation.We quote the words in which, on the present occasion, the

British and Foreign Review repeats its assertion of " completeanticipation" on the part of Prochaska :-"On former occasions, we took some pains to notice the

physiological views of GEORGE PROCIIASKA. In our fifthvolume, we reprinted the whole of his chapter on the func-tions of the Common Sensory; and in our ninth volume, wediscussed, more at length, the claims to priority of neuro-logical discoveries, in an historical retrospect of the wholesubject. We then pointed out the real meaning of the termsused by Whytt and by Prochaska, and maintained, that on adue consideration of the true value of those used by Prochaska,his doctrines did, in fact, constitute, as we stated, ’a completeanticipation’ of Dr. Hall’s doctrine of a reflex function. ’Itim,perfectly evident,’ we said, ’that Prochaska had a very dis-tinct idea of the function of the spinal cord and medulla ob-longata as a centre of reflected action; and that he specified

the principal classes of these, referring them all to the excite-ment of impressions. We do not see,’ we added, what essen-tial difference there is between this doctrine and that of thereflex function of the spinal cord, as first propounded byDr. M. Hall.’" "

In behoof of these opinions, and to show the " complete an-ticipation," the writer proceeds to give, seriatim, the pointsclaimed by Dr. Hall, quoting his own words; and he thenproduces a translation from the " Adnotationes Academicae"of Prochaska, as a triumphant support of his position.

: We shall follow the reviewer by reproducing these claims,’ and by showing, from the very passages adduced in support of. the contrary opinion, that, in the judgment of all having eyes’ to see, the decision must be irrefragably in favour of Dr. M.

Hall upon the very points raised in question. The reviewer. quotes a passage from Dr. Hall, in which he says:-

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" My real objects have been,-" 1st. To separate the reflex actions from any movements

resulting from sensation and volition." 2ndly. To trace these actions to an acknowledged source

or principle of action in the animal œconomy,—the vis nervosaof Haller acting according to newly -discovered laws.

" 3rdly. To limit these actions to the true spinal marrow,with its appropriate incident and reflex nervcs, exclusively ofthe cerebral and ganglionic systems.

"4thly. To apply the principle of action involved in thesefacts to physiology—viz., to the physiology of all the acts ofexclusion, of ingestion, of retention, and of expulsion, in theanimal frame.

"Finally, it is to these objects, taken as a whole, or as asystem, that I prefer my claims; and I do not pretend that anoccasional remark may not have been incidentally made bysome previous writer bearing upon some one or more of them."In subsequent pages, the reviewer passes before him at

length the writings of Prochaska, and after much distortedreasoning, comes to the following conclusion:-"We merely say that he (Dr. Hall) was culpably ignorant

of what he ought to have known, and that he had the misfor-tune, not the fault, to be entirely anticipated, in all the essen-tial parts of his doctrine, by others, and especially by Pro-chaska. So stood the case, we may admit, in 1832, or evenin 1833, the date of Dr. Hall’s first memoir. But how standsit now? How has it stood since 1835, the period at whichDr. Hall acknowledges he became acquainted with the

writings of Prochaska? How, more especially, has it stoodsince April, 1838, when we, in this journal, and about thesame time Mr. Durancd George, in the Medical Gazette, firstdisclosed to physiologists the claims of the Professor ofPrague, and forced them more particularly on the attentionof Dr. Hall? Very different indeed: to Dr. Hall, disgrace-fully different; inasmuch as, instead of acknowledging themerits of his predecessor, when made known to him, or ad-mitting, in any degree, the similarity of his doctrines to hisown-a similarity, to use no stronger term, which it is impos-sible for any unprejudiced person to deny-he has eitherstudiously passed over in silence, or openly ridiculed andmaligned, Prochaska’s doctrines, and poured on the heads ofthose who did no more than assert their resemblance to hisown, all the venom which his bitter nature could engender.And up to the very hour at which we write, he continues, aswe have seen, to boast, as loudly as ever, of his originality;although for more than ten years he has, by his own showing,been familiar with the very writings which we have provedto contain, not merely the elements, but the developed germs,of his early doctrines, and from which he has demonstrablydrawn not a few of the materials wherewith h3 has since sogreatly modified them. We can add no comment, in words,that can in any way emulate, in damning potency, the elo-quence of this simple statement. It is grievous to be forcedto write it down-it is melancholy to contemplate its full

import; we shall therefore turn from the painful theme, andhasten to conclude our task."

Amiable critic! lugubrious dulness! Let us also turn fromthe painful part of the theme, and show thee how thou mayest Itake comfort. Thy intended victim is not to be killed off byany critique. Thou art as much out of place in thy melancholy,as a veritable mute would be, standing with stave and band atthe door of a house where all within was health and vigour.We will take Dr. Hall’s first claim, and contrasting it with

what the Reviewer translates ,from the Latin of Prochaska,show the validity of claim the first:-

" To separate the reflex action.s from any movements resultingfrom sensation and volition."

Prochaska is made to say, by the Reviewer-" That the common sensory extends to the medulla spinalis,

is manifest from the motions exhibited by decapitated ani-mals, which cannot take place without the consensus andintervention of the nerves arising from the medulla spinalis;for the decapitated frog, if pricked, not only withdraws thepunctured part, but also creeps and leaps, which cannot bedone without the consensus of the sensorial and motor nerves,the seat of which consensus must necessarily be in the me-dulla spinalis."

Here the words 11 withdraws," " creeps," and 11 leaps," evi-dently mean something different from what we now under-stand by mere physical reflex action. The " consensus," the"law written on the medullary pulp," is not the purelyphysical incident and reflex action of Dr. M. Hall. In ano-ther sentence, Prochaska shows this by saying, " Decapitatedanimals are observed to continue for a few moments to

perform movements with design." Dr. M. Hall’s doctrinesare entirely opposed to the presence of design, on the part ofthe animal, in such movements.

2. Prochaska is further quoted by the Reviewer-" Irritation being made on the internal membrane of the

nostrils, excites sneezing, because the impression made onthe olfactory nerves by the irritation, is conducted alongthem to the common sensory, there by a definite law is reflectedupon motor nerves going to muscles employed in respiration."Now the olfactory nerve is a nerve of special sense. If any

movements occur from irritation of the olfactory nerve, theydepend upon sensation, and not upon reflex action. The fifthis the excitor spinal nerve of the nostrils, not the first.

3. Again,-" If a friend brings his finger near to our eye, (actual contact

is not here expressed;) although we may be persuaded thatno injury is about to be done to us, nevertheless the impres-sion carried along the optic nerve to the common sensory, is soreflected upon the nerves devoted to the motion of the eye-lids, that the eyelids are involuntary closed, and prevent theoffensive contact of the finger with the eye:’Here, again, sensation is mistaken for an incident impres-

sion. The closure of the eye, which takes place when a blowis aimed at it by way of feiiit, is entirely different from theclosure which takes place when the eyelid or the conjunctivaare touched. The one is spinal, the other dependent on sensa-tion and emotion. Pointing the finger to the eye of one blind,however near the finger approached without touching, wouldnot produce closure of the lid, unless the patient was consciousof the proceeding.

In another quotation, we find the following :-" If the vis nervosa be increased in the common sensory,

there results, firstly, that the external impressions made onthe sensory nerves, and carried to the common sensory, aretoo suddenly and violently reflected, and pass on to the motornerves, and thus excite move1nent and convulsions, contrary tothe will of the soul, as happens in the frights of infants, andalso of some adults, who are terrifed by some trifling crash ornoise."

Here the movements or convulsions, arising from emotions,as of fright or terror, are confounded with reflex spinal actions.Yet with these facts before him, the Reviewer asserts that" Prochaska did separate the reflex actions from any move-ments resulting from sensation and volition." We needmake no assertion after giving the proofs, which might havebeen multiplied, that he did not do so.We proceed to the second point of Dr. M. Hall’s claim to

originality, to which our Reviewer so bitterly demurs." To trace these actions to an acknowledged source or principle

of action in the animal economy-the vis nervosa of Haller act-ing according to newly discovered laws."

’

The Reviewer, in attempting to refute this point, entirely mis-apprehends the whole sentence. Dr. M. Hall defines the termvis nervosa, the motor power of Haller, the simple excito-motor power, as being quite distinct from the power of volun-tary motion and sensation. Prochaska meant by the visnervosa, a power inherent in the whole nervous system, con-cerned in sensation, in volition, and in the automatic move-ments irrespectively. One or two quotations will be sufficientto prove this." This fitness of the nerves to receive impressions, and quickly

transmit them, either way, along their whole length, ought tobe called the vis nervosa of the nerves; it is also properly calledthe sensibility or mobility of nerves; or, as Unzer also rightlytermed it, the corporeal sense, without concomitant percep-tion."

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Again, Prochaska speaks of the vi-3 nervosa as common to Isentient and motor nerves. He describes-’" The equal function of the nerve in exciting sensation and

-motion-namely, to receive the impression of a stimulus, andto pass it quickly along its whole length, which impression,when it comes to the brain, causes a perception of a sensation,but if to the muscle excites its contraction."

. Thus, then, Prochaska’s idea is not Dr. Hall’s idea of a puremotor power,inherent in the excito-motorsystemolily,and quitedistinct from the sensational, and voluntary motor, powers.But Dr. M. Hall lays the greatest stress upon the " nezvly-

discovered laws" according to which the vis nervosa acts. Heteaches the doctrine of a retrograde and a direct action of thevis nervosa in the spinal marrow itself, and of an incidentand reflex action along spinal excitor nerves ; from excitornerves to and through the spinal marrow, and along spinal orpure motor nerves from the spinal marrow to the muscles.We now quote a passage respecting the vis nervosa, whichought, according to the Reviewer, to be parallel with, oranticipatory of, this view. Our readers will be puzzled tofind any similarity whatever.

" If an impression be made on the extremity of a nerve,termed an external impression, it is most quickly propagatedalong the whole length of the nerve as far as its origin, and,viceVersâ, if an impression be made on the origin of the nerve,termed an internal impression, this also most quickly descendsalong the nerve to its termination; but if the impression bemade on the trunk of a nerve, it is at the same momentquickly propagated both to the origin and termination."We ask, is there here anything similar to, or anticipatory of,

the excito-motor arcs of Dr. M. Hall ?This brings us to the third object set forth by Dr. M. Hall

- namely," To limit these actions to the tritespinal marrow with its ap-

propriate incident and reflex nerves, exdusively of the cerebraland ganglionic systems."Prochaska treats of the common sensory, as the place in

which sensorial impressions are reflected into automaticmotor actions. Of this he says,-"It certainly does not appear that the whole of the cere-

brum and cerebellum enters into the constitution of thecommon sensory, which portions of the nervous system appearrather to be the instruments that the soul directly -uses forperforming its own actions, termed animal; but the commonsensory, properly so called, seems not improbably to extendthrough the medulla oblongata, the crura of the cerebrum andcerebellum, also part of the thalami optici, and the whole of themedulla spinalis; in a word, it is coextensive with the originof the nerves."

Any one may perceive that these are the ingenious proba-bilities of an acute and speculative mind, instead of thecertainties of an experimental science like physiology. The

spinal marrow of Prochaska is a centre from which sensorialimpressions are supposed to be reflected upwards to the brain,and downwards to the muscles. Dr. M. Hall’s " true spinalmarrow" is a very difrerent matter. He separates experi-mentally the spinal marrow, which was considered one organby Prochaska, into two the true spinal marrow, the organ ofphysical motion, completely different and distinct from theintra-vertebral cord of nerves, which belongs to the cerebrum,and which is the instrument of the psychical motions. Pro-chaska held nothing approaching to a definite idea of thedivision of the medulla spinalis into two organs-the onecerebral, the channel of the vis mentalis the other, truespinal, the seat of the vis nervosa, the purely physical motorpower of the animal economy.

Neither is there to be found in Prochaska or in any other

writer, the slightest approach to a conception of an exciterspinal nerve distinct from the nerves of sensation, though re-siding in the same sheath. Neither was there any idea of the

compound nature of the nerves of motion. Few persons, even

.at the present time, apprehend Dr. Hall so far as to see, thataccording to him the motor nerve, which produces a reflex

motor act in any muscle, is different and distinct from themotor nerve producing voluntary movements of the samemuscle: the one, in fact, influenced by the vis nervosa, theother by the vis rnentalis, as in the spinal and cerebral divi-sions of the spinal marrow itself.These actions of the spinal marrow exist too " exclusively

of the cerebral and ganglionic systems." This is proved byan experiment performed on the frog:-

"1. Remove the brain. 2. Remove all the viscera. Thefirst operation removes the centre of the cerebral system; thesecond, almost every branch of the ganglionic. What thenremains ? The spinal marrow - the true spinal marrow,hitherto undistinguished from the spinal cord of cerebralnerves, and the spinal connexions of the ganglionic system :’The next object set forth by Dr. M. Hall is," To apply the principle of action involved in these facts to phy-

siology-viz., to the physiology ofall the acts of exclusion, of inges-tion, of retention, ancl of expulsion, in the animal frame."Prochaska gives a number of morbid reflex acts, such as

coughing, vomiting, sneezing, and closure of the eyelid, fromirritation, which he explains by means of his common sensoryand the conversion of sensorial impressions into motor actions.He then sums up all into what he terms a general law."The general law, however, by which the common sensory

reflects sensorial into motor impressions, is the preservation oftheindividual; so that certain motor impressions follow certainexternal impressions, calculated to injure our body, and giverise to movements having this object—namely, that the annoy-ing cause be averted and removed from the body, and, vice versed,internal or motor impressions follow external or sensorialimpressions beneficial to us, giving rise to motions tending tothis end—namely, that the agreeable condition shall be furtherconserved."

The British and Foreign Reviewcrfollows him as interpreterby saying,"Prochaska also applied the principle of action of his

common sensory to physiology, beautifully and clearly point-ing out the general law by which it regulated its operations-namely, the law of preservation of the individual; not simplyby the avoidance of the painful, but by attaining the pleasur-able."

Again, the Reviewer, in reply to the assertion made by Dr.M. Hall, that "we have not in any author" the idea of "areflex physiological act," exclaims:

" Is it not staringly apparent that there is an idea of areflex physiological act in Prochaska’s illustrations, derivedfrom the acts of sneezing or coughing? Does not Dr. Hallhimself reckon them among the acts of expulsion’ ? "

Finally, in reply to another assertion of Dr. M. Hall’s, thatneither Whytt, nor Prochaska, nor any other author, hadever associated one physiological act with any reflexfunctionof the spinal marrow," the reviewer triumphantly says,-

" If Prochaska has not associated the physiological acts ofvomiting, sneezing, coughing, (from an impression on thesensory nerves,) with a reflex function, appropriated to acertain portion of the central axis, then words have no meaning,and language convey no ideas."

Certainly, there are persons to wlzom words have no mean-ing, and to whom language conveys no ideas; and the Reviewerstands at the head of the class. He confounds action with

function, and physiology with pathology, throughout. Wesup-pose any one may, if they please, comprehend that sneezingfrom the introduction of irritating particles into the nares isa reflex act,-a reflex action of the muscles of respi-ration ; but that the play of the respiratory muscles,from the first’ respiration till death, excited, in the first

place, by the contact of cold air with the surface of the

body, and maintained, ever afterwards, by the formation ofcarbonic acid in the lungs, acting as an excitor of reflex actionthrough the pneumo-gastric nerve, the medulla oblongata,and the respiratory znotor nerves, is a function, the functionof respiration ; of the true nature of which there was nothingapproaching to a clear and definite idea, before the researchesof Dr. M. Hall. Yet upon no other evidence than that morbid

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respiratory acts were called reflex in the speculative and in-genious writings of Prochaska, this critic claims for him a

knowledge of the function of respiration. I-Ie jnxnps to aconclusion in these words:-

" Thus respiration is shown to be an excited act, and, there-fore, ordinarily and habitually reflex in its nature."

The whole weight of the argument is made to rest on an illo-gical " thus" and a " therefore."We have said the Reviewer confounds physiology and patho-

logy. He positively does not know that " vomiting, sneezing,coughing," are all pathological reflex actions; to him they are Iall " physiological acts." Neither vomiting, sneezing, nor

coughing, can ever take place, but from some morbid irritation. IDr. M. Hall, we are sure, never treated of them as physiological"acts of expulsion." If they were physiological, then onemight die of the physiology of pertussis, or the rejection of foodfrom the stomach. Does not such blundering admirably illus-trate the fitness of the Reviewer for his office, and fix the valueof his criticisms ?Much stress is laid by the Reviewer on the final end proposed

for the reflex acts by Prochaska, " the preservation of the in-dividual, nosti-i consavatio" and an identity of meaning be-tween Dr. M. Hall and Prochaska is contended for, becauseDr. Hall also sums up the function of the true spinal marrowunder " all the acts of ingestion and egestion, in their relationto the preservation of the individual, and the propagation of thespecies." But the nostri conservatio of Prochaska applied tosuch acts as sneezing, coughing, the closure of the eye on theapproach of a foreign body, conservative acts not natural tothe system, but excited by the presence of substances irritatingto the body, and being of a pathological kind. Dr. Hall, onthe other hand, distinctly sums up all the acts of ingestion andegestion, the physiological acts by which air, food, and semen,are ingested, and the contents of the bladder, rectum, vesiculæseminales and uterus, are egested from the system, for thepreservation of the individual, and the perpetuation of the race.Though the words are alike, there is no similarity whateverin the meaning intended to be conveyed.

In all that we have said we desire to be distinctly under-stood as intending to throw no discredit on the name and fameof Prochaska. We grant him a most subtle reasoner, con-sidering the data on which his reasoning rested, far in advanceof his contemporaries. But his physiology was not founded ’,

upon experiment, the only sure basis, and without which nogreat physiological discovery was ever yet made. His in-

genious speculations are not the discovery of the spinal marrow;and though we would not in aught dishonour the memory ofa great man dead, we would not meanly, and with a vain affec-tation of honesty and generosity, fawn upon and flatter himat the expense of a great man living.On a review of the whole subject, we believe Dr. Hall fully

and perfectly entitled to say, as he does,-" Let any one compare the distinct detail of my views with the

observations of Prochaska, and he will at once discover that thereis nothing in that author possessing the most remote similarity tothose views."

Dr. Marshall Hall is a man of exact, mathematical mode ofthought; if he had not been so, it is impossible that he couldhave ever seized and made plain the mystery of " the silvershining cord." The nearer those who read and study himapproach to his exactitude, the greater the dissimilarity be-tween his views and those of Prochaska, or any previousauthor. It is only loose, inaccurate, uninformed thinkers whowould dream, in the present day, of attempting to show anysimilarity.We may also ask-Was there ever such a tissue of ignorance

or malignity as that we have attempted to follow and expose?Any one, understanding even the alphabet of the subject, maysee that the Reviewer either stupidly mistakes Dr. Hall’smeaning, or wilfully perverts it. If it be sheer ignorance andinability to comprehend the doctrine of the reflex function of

the spinal marrow, then we may smile at the physiologicalDogberry; but if it be malignity, the envy, hatred, and alluncharitableness, of a mean mind, lie well deserves the in-vective launched against Zoilus—

11 Non est vitiosus sed vitium,"

and his impoteut " damning" to be reflected back upon him-self.But we turn from this specimen of the serpent biting the

file, not merely with its teeth, but after its teetli are entirelygone, to an eulogy on Dr. M. Hall, which appeared in anotherquarterly, the Medico-Chirugical Review, on the same day withthe abominable and false slanders we have endeavoured to

expose. Any one who turns to the Medico-Chirugical Reviewwill perceive that this is written by no friendly hand; but thepraise is therefore the more valuable.

" No one can reasonably deny that he is a man of uncommonpowers of mind, of unwearied industry, and indomitable

energy; that he has long and successfully laboured in thevineyard of medical science; that varied writings proclaimhim to be a keen observer and a subtle reasoner; that his dis-coveries in physiology have justly gained for him a foremostplace among the investigators of that science; that to himalone belongs the rare honour of having first clearly pro-pounded, and manfully worked out, one of the most perplexingproblems in the history of animal life, unravelling the meshesof a most intricate perplexity, and pointing out the clue-theAriadne thread of guidance-to all future explorers throughthe labyrinth of former darkness and confusion: that he hasthus not only stamped the impress of his thoughts on the medi-cal literature of the day, (one of the surest proofs of originalgenius,) and achieved for himself a world-reputation, but thathe has also added to the intellectual and scientific fame of hiscountry, which may now-thanks to the labours of Harvey,Bell,and Hall justly claim the undisputed glory of being the birth-place of the two mightiest discoveries in physiological science.But these are not the only merits of our author. His morepractical writings, even from the very outset of his career,have contributed, in no trifling degree, to render the symptom-atology and discrimination of many diseases more accurateand intelligible; and although he has been apt on some occa,sions to exaggerate the importance of a few phenomena orsigns for diagnosis and treatment, we cordially award him thepraise of having done good service to the practice of medicine:’- p. 164.The same writer alludes to the conduct of the British and

Foreign Medical Review, and the Edinburgh Medical Journal,in relation to Dr. Hall and his discoveries.

"That Dr. Hall has met with most unhandsome and unjusttreatment from several of our contemporaries cannot now begainsaid by any impartial witness. While one party has vainlyattempted to rob him of his fair fame, another has, with equalimpotence, thought to quench the torch of discovery by refus-ing to act as one of its honoured light-bearers. No such re-proaches can be made by any one against us. We have

uniformly maintained the justice of his claims as a great andoriginal investigator of physiological science, against all envyand detraction."-p. 165.These were literal truths when they were written; but the

wickedness and folly of former attacks are outdone by thelast, and we are promised more of the same deformed brood.

Dr. Hall may, however, well afford censure or condemnationfrom such a source,—as well expect " the worms of Nile" tobe free from venom, as a foiled and disappointed bookwormto be delivered from the malice of his bitter rancour. TheReview in question has been established many years. Duringthat space it lias not, as the medical world well knows,been stinting of self-praise. In its early youth it hadthe good or bad fortune to be proclaimed unparalleled bysome friendly critic. Ever since, this single criticism hasformed the staple of its advertisements. It has been like theone kiss of the ancient Lady Bellenden in her far-off youth,esteemed and boasted, with occasion and without occasion, toall comers. And what has this publication really done to feedits self-gratulations ?—what bad men and works has it done todeath,-what good ones raised and succoured ? Let us eiidea-vour to strike the balance. If it has driven Müller, the prince

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of experimental physiologists, from this country, has it notraised up an image of brass and clay in his place ? If it has

perverted the deductions and precious facts of Louis, so as toturn this great and good man falsely against legitimate medi.cine, has it not praised Priessnitz, and gloried in the cold watercure. If it has sneered down the science of another of ourown great men, the venerable Dr. Prout, have not its writersvouchsafed a smiling aspect towards Mesmer and Mesmerism,and promised to treat it like any other branch of " science"?If it has striven to drive Dr. M. Hall from out the esteem ofhis day and generation, has it not eulogized Hahnemann as anillustrious renovator of the medical art; and if it has every-where vilified Old Experience and Modern Science, has it notpromised us a professional regeneration from its own hopefuloffspring, "Young Physic—the impersonation of scepticism inall science and art, gloating over the darkness visible of amedical chaos which it hopes to create, and where it woulddesire to reign !

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Rapport a l’ Académie Royale de Médecine sur la Peste et lesQuarantaines, fait, au nom d’une Commission, par M. LeDr. Prus. Accompagnc de pieces et documents, et suivide la discussion dans le sein de 1’Academic, pp. 1056.A Paris : chez J. B. Bailliere, &c. 1846.

Report to the Royal Academy of Medicine on the Plague andQuarantines, edited, on belaalf of the Commission, by Dr.PRUS. Accompanied by documents and papers on the.subject, and followed by the discussion in the Academy, &c.

THis report of the French Commission is to us peculiarlyinteresting in many respects. It affords evidence, that in oneEuropean country, at least, medical men are properly en-trusted with a grave and responsible duty-the solution of aquestion, involving not only the interests of commerce, butthe lives of millions of people. This is most satisfactory.Our government, although our most valuable colony,-India,is continually scourged by cholera, and although that dreaddisease has even desolated this island, has never cordiallyendeavoured to elicit the collective opinion of medical menon the subject. A thousand disconnected monographs, andvarious discrepant reports, have appeared from time to time.But no encouragement has been given to a general " concours "

on this subject. Our Colleges of Physicians and Surgeonshave their little, but to them all-important, intrigues to

manage; for an affair of this kind they can afford no time.And this, whilst our brave army is decimated by this diseaseon the plains of India !Our neighbours manage such things very differently. The

mere probability of an attack of plague at Marseilles orAlgiers, and an enlightened wish to revise the laws of quaran-tine, so far as may be consistent with public health, have beensufficient reasons to induce the Royal Academy of Medicine,at Paris, to appoint a commission to investigate the matter inall its important bearings.The two thick volumes before us, presented to the public

under such auspices, are composed of three distinct parts :-1st. The report itself. 2ndly. The evidence, written and verbal,on which it is founded; and 3rdly, the subsequent discussionin the Academy. A public document of this importancedeserves more than a passing notice. To the members ofthe Commission, and on the medical institutions of the

kingdom that appointed them, it reflects the highest honour.Nor must we withhold our humble tribute of praise fromM. Le Dr. Prus, the indefatigable secretary of the Commission,under whose care the work has been edited.To the Report itself, as the most important section, we

shall direct our chief attention, and endeavour to present ourreaders with a brief analysis of its contents. The first ques-tiou discussed is the important one of the endemicity of theplague,-the fact that certain localities are permanent foci ofthis disease. Connected with this point, it becomes of im-portance to ascertain the antiquity of the disease, and for

once medical antiquarians may serve the profession usefully.The Commission do not consider the symptoms described byThucydides, in the memorable plague of Athens, sufficientlydistinctive to mark it as the true disease of that name. Thefirst undoubted mention occurs in the writings of Rufus, ofEphesus, a physician who lived in the time of Trajan. The

passage in which he refers to this disease was first discoveredat Rome by Cardinal Mai. After noticing bubo as a specialdisease, Rufus adds :-"The buboes denominated pestilential are all fatal, and

have a very rapid progress, especially those observed inLibya, Egypt, and Syria, and of which mention is made byDionysius the stoic. Dioscorides and Posidonius have spoken of it at large in their treatise on the plague which ravagedLybia in their time." " This passage proves, that threecenturies before our era, the plague, marked by buboes, oc-curred as a sporadic disease in Libya, Egypt, and Syria. Itproves, also, that in a period still more remote, an epidemicplague has devastated Libya."-(p. 12.)The first question relative to the endemicity of the plague,

which the Commission has endeavoured to solve, is, " In whatcountry or countries has the plague commenced spon-taneously I" To this the following general answer is given:-" The plague has commenced spontaneously, not only inEgypt, Syria, and Turkey, but in a great number of othercountries of Africa, Asia, and Europe." This opinion, how-ever, is qualified by the observation, "that at present theimportation of the plague is chiefly to be feared from Egyptalone."The second question proposed is—" Can we attribute the

spontaneous development of the plague to certain conditionsmilitating against the health of the community ?" Are thesethe result of climate, or is their principal source to be soughtelsewhere! Z The question is ably discussed by the com-mission. The natural salubrity of the Egyptian climate isinsisted on.

" Every European who enters Egypt during the fine seasonwill be struck by the constant serenity of the sky. The air,possesses that purity, which the proximity of running watersis said to impart. Passing up the Nile, the traveller will becharmed, not indeed with the dull colour of its waters, butwith their fresh and sweet flavour. If he should chance totravel right or left of the river, he will be captivated by theaspect of a country smiling with verdure, covered by citron,date, orange, tamarind, acacia and sycamore trees; wateredby a thousand canals and trenches, bounded by the sands ofthe desert, and guarded on the east and west by a doublechain of mountains. The salubrity of Egypt is still furtherincreased by the winds that blow almost daily, especiallythose denominated the Etesian."—(Pariset, Mémoires sur laCause de la Peste.)Such is the enthusiastic description which Pariset has given

of the natural fertility, beauty, and salubrity of Egypt. "Howis it, then," continues the Commission, "that in a country soabounding with natural blessings, so little exposed to injuriousinfluences, man, through ignorance and carelessness, is ill-

lodged, ill-clothed, and badly nourished, drinking putridwater, and breathing an atmosphere of pestilence 1"M. Hamont partially answers the question; and for his

eloquent narration of the miseries of the inhabitant of theDelta, we must refer to the work itself. Unhappily, our pro-fession is often the witness of misgovernment producingdisease. The "fellah" of Egypt feeds on the kernels of dates,pounded and made into cakes, on putrid fish, rotten cheese,animals who have died from disease, cucumbers, and flavour-less melons : he lives in mud cottages, thickly groupedtogether, lying on a mat saturated with moisture and filth : -.

his residence surrounded by excrement, which, when dried,serves as fuel. Such is the melancholy picture of the ruralinhabitants of Egypt. We do not hesitate to say, thatthe words "ignorance and carelessness," applied by the Com-mission to the miserable sufferers, is but a slight part ofthe causes inducing this wretchedness. Should we not add,what the courtesy or policy of the French Commission to the

97

man "who rules the destinies of Egypt" has prevented themfrom stating ?-should we not say, that in our eyes the care-lessness and ignorance" of the fellah are trivial faults cozn-pared with the vile extortion and tyranny of the governmentwhich (we use the words of the Commission) "forbids thelabourer from tasting the corn his toils have produced." Thiswas not forgotten in the discussion of the Academy. M. Du-

bois, of Amiens, only spoke the language of good sense andhumanity, when he said, " That in other respects it soundedlike bitter derision for the Commission to express their satis-faction at the parental character of the Egyptian governmentfrom the fact, that Mehemet Ali had conversed with M. Pariset,Gaetani Bey, and Clot Bey, on the best means of ensuringfood and healthy habitations to all." The evil remains unre-

dressed ; the misery is still without amelioration; still thesame grinding tyranny exists. " And although," continuesM. Dubois, " it would perhaps have been more prudent if theCommission had said nothing about a matter compromising thecharacter of a firm ally of the French government, yet, formy part, I do not hesitate to declare the opinion, that when acountry is the prey of such horrible miseries, it is the govern-ment that must be held responsible." We have made this digres-sion, because, on this, as on many other topics, it is dailybecoming more obvious, that those who have studied the lawsregulating the health or disease of the community, should holdno insignificant position in the eyes of the legislator. Not forthe sake of professional laudation or advantage, but for thecause of suffering humanity, do we earnestly hope, that onsome subjects governments will listen more to the teachingof the humane physician, and less to those versed only in merepetty conventionalities. By the observance of the wise lawsof hygiene, Egypt was, according to the testimony of Hero-dotus, one of the healthiest countries of antiquity. By theneglect of these, it has become in some places a desert, inothers, a pest house. Not only does this intense misery andfearful neglect of all sanatory considerations prevail in thevillages of Egypt, but these remarks apply with tenfold moreforce to the cities. Cairo is peculiarly marked as a focus ofthe plague. Besides the narrowness of the streets, and thewretchedness of the inhabitants, there is one abundant sourceof disease; this is the calidj, or great canal, which runs throughthe city.

" This is filled, once in the year, with the water of theriver. This water, thick and muddy in itself, is mixed in thiscanal with the drainage, and all imaginable filth. It is in thisstate distributed to the poor, and drank throughout the city.The sun dries up the bed of the canal, the evaporating waterbecomes black, and exhales such a stench that the neighbour-ing houses are filled with a’ mephitism’ oppressing the headand nauseating the stomach."

Erzeroum, Constantinople, and certain portions of the banksof the Danube, are also mentioned by the Commission ashaving witnessed the spontaneous development of the plague.There are local causes of disease to be found in all, moreespecially in the habits and condition of the inhabitants.

These, indeed, would not produce plague without peculiaratmospheric conditions, but the latter would be comparativelyinnocuous without the aid of the former. From these and

other facts, the Commission come to the following conclusion:-" In all countries where the plague appears spontaneously,

its development may reasonably be attributed to certainassignable causes acting on the majority of the population.These conditions are, principally, residence on alluvial ormarshy soils, near the Mediterranean sea, or certain rivers-the Nile, Euphrates, or Danube; small, crowded, badly venti-lated houses; a warm and humid atmosphere; the putrefactivedecay of animal and vegetable matters; unwholesome and in-sufficient food; and great physical and moral misery."

All these causes are united in Lower Egypt, and the resultis, that the plague is there endemic, cases occurring at a cer-tain season, annually, and a terrible epidemic reigning aboutevery tenth year.History teaches us that Egypt was one of the healthiest

i amongst ancient countries. During the reigns at least of the- latter Pharaohs, during the 194 years of the Persian dynasty,- the three centuries during which it was governed by thet Ptolemies, and the 630 years in which it was ruled by the

Romans, it was considered eminently salubrious. Although,3 no doubt, sporadic cases of plague occurred there, it appears- to have been free from pestilential epidemics. But we mustI remember the wise care which watched over public health,I and although embracing only the earlier portion of that. period, yet its results extended over many subsequent centu.t ries. " Sesostris had canals excavated for running waters;, caused all cities to be built above the level of the surrounding plains, on factitious hills, and allotted to every Egyptian a- portion of land for his culture, and (what is more to our

present purpose) for his maintenance also." The practice ofembalmment, including both men and animals, was probably

} an aid furnished by the ministers of religion to a far-seeing,3 active, and enlightened hygiene. Those who, in the nine-r teenth century, crowd the putrefying remains of the deadL amongst the living thousands of our cities, might learn much- from the customs of ancient Egypt.- The Commission conclude, therefore, that the absence ofr pestilence during the long period in which Egypt was blessed

by general plenty, and guarded by the sanatory regulations ofher ancient rulers, justifies the hope that the plague may be

r extinguished, and that the same results may follow the samemeans.

We need not make any remark on the succeeding resumesof the commission, as they bear on points principally of local

; interest. They are, first, " That the sanatory conditions ofSyria, Turkey in Europe, and Asia, the regency of Tripoli,

. that of Tunis, and the empire of Morocco, are in all respectssimilar to what they were in periods when plague has spon-

l taneously arisen in them, and therefore it may again appearin the same localities. Secondly. That plague is not to be

anticipated in Algiers as a spontaneous disease." The Com-

, mission insist on the fact that plague may be expelled fromf Egypt, and conclude by expressing an opinion, that" if the, plague has entered Egypt with barbarism as its attendant, wemay reasonably hope that returning civilization may banish

; it."We shall take an early opportunity of briefly considering

. the views of the Commission on the epidemic and contagiouscharacter of plague, subjects which more especially bear onthe existing laws of quarantine.

Medícal Socíetíes.

ROYAL MEDICAL AND CHIRURGICAL SOCIETY.JANUARY 12.—MR. CÆSAR HAWKINS IN THE CHAIR.

ON THE DETECTION OF POISON IN THE URINE. By H. LETHEBY,M.B., Lecturer on Chemistry at the London Hospital.

(Communicated by Mr. T. B. CURLING.)

THE author briefly referred to the experiments of Wohlerand Steyberger, Tiedemann and Gmelin, Orfila and others, inshowing that many mineral, animal, and vegetable poisons areadmitted into the circulation, and eliminated by the actionof the kidneys.These facts led him to inquire whether the various poisons

might not be disposed of in a similar manner; and if so,whether their existence in the renal secretion might notfurnish a hint for the treatment of cases of poisoning; andthirdly, whether their detection in the urine would not supplyevidence of a very valuable character for the guide of themedical jurist.With these objects in view, he analyzed the urine of persons

under the influence of the various poisons, and tested his re-sults by experiment upon the lower animals.He succeeded in detecting the following poisons - sul-

phuric, muriatic, nitric, phosphoric, and oxalic acids; of thealkalies, he had discovered the presence of potash, soda,and ammonia; of the neutral salts, he enumerated nitrate ofpotash, iodide of potassium, sulphate of magnesia, the red and