whether it be some specific astringent action belonging to the oil, or whether it acts in the same manner as its kindred, the terebinthinate oils, is not definitely known, but it certainly exercises a very powerful influence over the hemorrhages.

A domestic remedy very efficacious in the treatment of epistaxis, is the continued application of cold to the scrotum of the male, or the mammæ of the female. I have been much pleased with the action of this remedy in some very severe cases resisting the usual methods of treatment.

In making these suggestions, I would not seem to wish to detract from the value of Dr. Jackson's ably written paper, which is, indeed, the most exhaustive I have seen upon the subject. My desire is, simply, to bring before the profession a remedy which, I trust, will do as good service for others as it has for me.

BIBLIOGRAPHY.

A TREATISE ON THE FUNCTION OF DIGESTION; ITS DISORDERS AND THEIR TREATMENT.

BY F. W. PAVY, M. D., F. R. S.

Fellow of the Royal College of Physicians, &c., &c. Philadelphia: Henry C. Lea, 1869. Pp. 246, 8-vo.

The subject of digestion is one of unusual interest, but being so fully discussed in all the works on physiology it seems to us that it might have been omitted in this, the design of which is mainly practical. Every physician may be presumed to have read as much as he has any curiosity to read about prehension, mastication, insalivation, &c., and will consequently be apt to pass by the chapters treating of these processes without notice. Writing as we do for the busy practitioner, we shall pursue the same course.

Dysphagia is one of the troubles pertaining to the function of digestion, and it is one which has its origin so generally in mechanical causes, or in malignant disease, that practitioners are too prone to look upon it as irremediable. Dr. Pavy mentions instances in which the difficulty in swallowing depended upon causes that were easily removed. A case is cited in which Sir B. Brodie relieved a dysphagia

of several years' standing by the removal of some internal hemorrhoidal tumors. In the paralytic variety electricity has been employed with success. Where it is the result of constriction induced by swallowing corrosive agents, it may be a question to be submitted to the patient, after all other efforts at removing it have failed, whether an artificial opening into the stomach shall be made with a view to introducing food and sustaining life.

It was by such an artificial opening into the stomach, acidentally made, as all medical readers know, that the great impulse was given to modern physiological research in regard to digestion. To Alexis St. Martin all writers on this subject refer for facts which could never have been revealed except by such an exposure of the interior of the stomach as he afforded in his case. A woman in Germany has since presented to Bidder and Schmidt an opportunity of making similar observations, and by gastric fistulæ in the dog, physiologists have varied and confirmed the experiments upon the human subject. As the result of all these, our knowledge concerning digestion has been greatly enlarged. The learned Dr. William Hunter, in his lectures on anatomy, used to say: "Some will tell you, gentlemen, that the stomach is a stew-pan, some that it is a mill, and others that it is a fermenting vat; but I say that it is neither a mill, a stew-pan, nor a fermenting vat, but a stomach, gentlemen, a stomach." His more distinguished brother, John Hunter, insisted greatly upon the vital principle as the efficient agent in digestion, as in all animal functions. Great would be the surprise of these eminent physiologists if they could return to earth and see how nearly to a chemical process digestion has been reduced. Vitality is not essential to it, although one of the elements concerned in it is a product of life. There is no digestion without pepsin, but pepsin, the secretion of the stomach, is insufficient without an acid. John Hunter directed attention to the fact that the stomach is sometimes found digested after death. The gastric juice never produces any such effect during life. The explanation of Hunter was that the "living principle" protected the organ against the solvent fluid.

The explanation given to the world by our author of this curious fact is a much more satisfactory one. It is this: that the alkaline blood neutralizes the acid gastric juice. When the circulation ceases and there is no longer a stream of alkaline fluid sent through the stomach, then the gastric juice, always present in the mucous follicles of that organ, reacts upon and dissolves it as would any other digestible matter. A rabbit's ear or a frog's leg inserted into the stomach of a living dog,

is corroded by the gastric fluid, because the quantity of blood in them is not sufficient to neutralize the acid afforded by the stomach. That the stomach is not oftener found to have undergone digestion after death, is due to the fact, Dr. Pavy contends, that the temperature of the body so soon falls below the point compatible with that process. He has repeatedly caused the solution of the stomachs of rabbits by keeping their bodies at a temperature of one hundred degrees Fahr., during a single night. Parasites seem to escape gastric digestion by burying themselves in the mucous coat of the stomach. The older physiologists proved by experiments that leeches and earth-worms, when brought under the influence of the gastric juice, are digested like morsels of ordinary food.

Of vomiting our author treats at considerable length, and on account of the greatly varied circumstances under which it takes place, the subject is one of much interest to the practitioner. To allay it we must find out its cause. Ice, hydrocyanic acid, creasote, pepsin, opium or morphine, chloroform, a mustard poultice-some one of these will allay almost any vomiting which is not the result of renal or cerebral irritation. The state of the bowels also claims attention, and their regulation is necessary, not only in cases of gastric irritability, but in all the forms that indigestion assumes.

On the subjects of eructation, rumination, pain and other morbid sensations of the stomach, flatulence and acidity, the remarks are brief and generally practical. Some curious instances of rumination in man are cited from old writers, who believed that there was a double stomach in those who practiced it, and that some of the individuals at least had horns, indicating a further affinity to the bovine family. Sennert has left behind him the history of a case the origin of which he traced to the use of milk "warm from a cow." The child, according to this medical philosopher, sucked in the habit with its nurse's milk! A case is reported from Dr. Copland of a man who ruminated. his food habitually. From a boy he had been troubled with acid eructations. After having reached his thirtieth year he found it impossible to resist admitting into his mouth the food that constantly gurgitated from his stomach. Being asked whether the second mastication of his food afforded him any pleasure, he replied: "Indeed, it is sweeter than honey, and accompanied with a more delightful relish!"

Intestinal digestion forms the subject of an extended chapter. In the stomach, the nitrogenous elements of food are acted upon by the gastric juice. It remains for fluids found in the small intestines to

complete the digestive process by emulsifying the fatty matters, and converting the starch into sugar. This is done chiefly by the pancreatic juice, which, however, according to the latest views, seems to be endowed with very diversified powers, taking part in the digestion of nitrogenous matters, as well as of oleaginous and farinaceous substances. What part the liver performs in the process of digestion is still undetermined. From recent experiments performed by Dr. J. H. Bennett, it appears that the bile may be dispensed with altogether in the dog for a long time without much inconvenience. In one instance the animal actually gained flesh while the hepatic secretion was for months diverted from the duodenum by a fistula.

Colic, flatulence, diarrhoea and constipation are the troubles incident to intestinal indigestion, to which the concluding chapters of this work are devoted. Of these the least is the most frequent and the most refractory. Constipation is the curse of dyspeptics. It is both the consequence and the cause of their disorder. Indigestion is induced by it, and when established, every symptom of the disease is aggravated by its continuance. To its correction the remedial efforts of the physician are to be mainly directed. And our author justly remarks, that it is the laxative group, or milder form of purgatives that is usually required in such cases, and moderate doses, repeated at short intervals, rather than larger doses at longer intervals. The kind must be determined in each individual case; but in far the larger number of instances it will be found that saline laxatives, taken before breakfast and largely diluted, move the bowels most certainly and with the least discomfort to the patient. Common salt may be taken in this way with the greatest advantage.

Dr. Pavy devotes a few pages at the close of his volume to the subject of "artificial digestion as a means of dissolving meat for producing an article of nourishment for the invalid." He is not satisfied with what Liebig has offered to the profession in the shape of beef tea, and is seeking for a process by which all the constituents of meat may be dissolved and appropriated to the support of the sick. He has hopes of being able to prepare a fluid which shall be at once palatable and eminently nutritious. He uses the same menstruum that is employed by nature for dissolving meat, and when the solution is obtained he neutralizes the hydrochloric acid by carbonate of soda, which leaves chloride of sodium or common salt as the product. This substance, on theory, leaves the stomach nothing to do. Its taste seems to be the chief obstacle to its use, but this may be overcome by

improved methods or by condiments. The agent when received gratefully by the patient, is said to afford "a sense of satisfaction to the stomach, like that which is derived from the consumption of solid animal food."

The impression left upon us, after going through this work, is the same made by the perusal of its first pages, and that is, that the anatomical and physiological details would be well replaced by matter of a more practical character. But it is a volume of decided interest, and we recommend it to our readers.

ST. AUGUSTINE, FLORIDA: SKETCHES OF ITS HISTORY, AND ITS ADVANTAGES AS A RESORT FOR HEALTH, &c.

BY AN ENGLISH VISITOR.

G. P. Putnam & Son: New York. 1869.

FLORIDA AND THE SOUTH: A GUIDE-BOOK FOR TOURISTS, INVALIDS AND EMIGRANTS.

BY DANIEL G. BRINTON, A. M., M. D.

George Maclean: Philadelphia. 1869.

These little works will attract attention at this season, when the thoughts of invalids are turned towards resorts for the approaching winter. If all be true that the English author writes of St. Augustine, it does not fall very far short of that earthly paradise of which Ponce de Leon was in search when he discovered Florida. What with its balmy atmosphere, its soft moonlight nights, its forests, flowers and fruits, it presents to the traveler who is in search of pleasure or health, a combination of attractions hardly to be found any where else on our continent. After reading the glowing descriptions of the country by this visitor, we confess we felt the keenest desire to start at once for this land of flowers. Nothing, it seems to us, could be more delightful than a winter where green peas may be had in January, and tomatoes in March-where orange blossoms, scarlet pomegranate, yellow capporelle and crape myrtle perfume the air all the year round. Of the influence of the climate upon patients with pulmonary affections, this author says;