back, another above, and another below it. If these be properly place d and the wire which passes down the back be allowed sufficient room tha it may not drag, the plate will not be moved from its position by any ordinary motion of the body. The zinc plate was fastened in the same manner; but, in place of the second layer of sponge, a bit of muscle, answering in size to the zinc plate, was interposed: that is, a small bit of moistened sponge being first fitted to the aperture below the knee, the piece of muscle, also wetted, then followed; and on this the plate of zinc. The apparatus thus arranged will continue in gentle and uninterrupted action from twelve to twenty-four hours, according to circumstances. This last is the longest period that it can be allowed to go unremoved. The sores require cleaning and dressing, and the surface of the zinc becomes covered with a thick oxyde, which must be removed, to restore its freedom of action: this may be done by scraping or polishing. But it will be better if removed twice a day, both for the greater security of a permanent action, and for the additional comfort of the patient."

For more particular directions on this subject, we refer the reader to the work.

The same motives that made us pass such unqualified censure on the contents of the first part of this book, lead us now to express our sentiments of approbation of that we have just alluded to. There is much ingenuity in the application of the author's remedy; and, if it proves as efficacious in the cure of epilepsy as he anticipates, he need desire no other claim to the esteem of the public, as well as of his professional brethren. The errors we pointed out at the commencement of his work, are such as mark all those not directed by the spirit that dictated the axiom with which one of our truly philosophic treatises on Pathology commences, "All human science is a knowledge of the qualities and order of phenomena." With this we must be content in physiology; and, since the best-informed men in other branches of science contemn "the explicit assertion both of Moses and Solomon," and profess the Pythagorean, or the Copernican, as it is called, doctrine of the relation of the motion of our sun and the earth, we may be allowed in physiology to think, contrary to the opinion of Mr. Mansford, that their assertion on this subject does not demand our assent; and that some respect is due to those inen who think proper to reason on the sensible phenomena of the human body, as they do on those of nature in general.

more adhesive. This plaster is clean in its appearance, and seldom irritates the skin by long use.

CRITICAL ANALYSIS

OF

RECENT PUBLICATIONS, IN THE DIFFERENT BRANCHES OF MEDICINE AND SURGERY;

SELECT MEMOIRS, AND HISTORIES OF CASES;

In the Literature of Foreign Nations.

Discourses on the Elements of Therapeutics and Materia Medica. By NICHOLAS CHAPMAN, M.D. Professor of the Institutes and Practice of Physic and Clinical Practice in the University of Pennsylvania, &c. 2 vols. 8vo. 1817 and 1819.

[Concluded from p. 430.]

N fever, when the intestinal canal is not primarily affected, and when the functions of the liver are deranged, Dr. Chapman judici, ously advocates the use of purgative remedies; but he slightingly notices the practice of treating typhous fever by purgatives solely, which has of late been "much the vogue." In most of the cuta. neous diseases of an inflammatory character, he advocates the use of laxatives: he has pursued the purgative plan invariably in scarla, tina, as it ordinarily oceurs in the United States, with the occasional use of the lancet; and he has "always had abundant reason to be satisfied with its efficacy. It has appeared to be calculated, not only to cure the disease in a more summary manner than any other mode of treatment, but likewise to afford the best means of preventing drop. sical swellings and other derangements of health, or of removing them, when, by negligence or unskilfulness, they have been permitted to take place."

In some forms of acute rheumatism of long duration, when vene section fails to afford relief, even "augmenting the excitability of the vessels, and thereby aggravating the mischief," Dr. Chapman has found that active purging will occasionally prove of great advantage.

It seems, more than any other remedy, to quiet the mobility of the arteries, and to diffuse the excitement over the system, which, in this case, is chiefly concentrated in the blood-vessels."

After noticing the connexion often observed between rheumatism and cholera, dysentery, and other affections of the bowels, the author continues to remark, "Nothing, indeed, is more common in the practice of physic, than to see rheumatism suspended, or even cured, by diarrhoea, spontaneously induced. Taught by this fact, the course which nature points out, I have often imitated it, in the treatment of the more obstinate and protracted cases of the disease before us, and have had much reason to be satisfied with the results."

Modern practitioners, in general, are too little disposed to attend to

indications of this kind; or, if they do attend to them, it is without considering the periods of diseases at which these spontaneous salutary revulsions take place;-a point of the utmost importance, and so carefully studied by the ancients.

The results of accurate observance and judicious reflection may be usefully adduced, although they may not be novel, especially when they tend to complete the destruction of deeply-rooted prejudices : we therefore transcribe Dr. Chapman's remarks on the use of this re medy in gout. "I have now," he says, "for several years, habitually employed purgatives in the paroxysms of gout, and with equivocal advantage. Not content with simply opening the bowels, I completely evacuate, by active purgings, the entire alimentary canal. This being accomplished, all the distressing sensations of the stomach which I have mentioned, are removed, the pain and inflammation of the limb gradually subside, and the paroxysm, thus broken, speedily passes away. To effect these purposes, however, it is often necessary to recur to the remedy repeatedly."

We have ourselves sometimes observed, that the pain has been alle viated by this mode of treatment, though the swelling and inflamma tion has continued apparently stationary for some time afterwards, results exactly similar to what ensue from the appropriate use of cold topical applications. On this subject we witness, in a particular manner, the neglect, and even reprobation, of a useful remedy, because the views of the proposer of it have not been correctly discerned.

On the subjects of apoplexy, palsy, hydrocephalus, and mania, the author evinces an intimate acquaintance with the latest observations published on this side of the Atlantic; and adds his testimony to that of our best authors in favour of the use of purgatives in those diseases. In palsy, especially, he has carried it to a considerable extent, and with the most happy results: but here, as well as in mania, it is often not only necessary, Dr. Chapman says, to excite catharsis, but to give large doses of drastic cathartics, so as violently to gripe, and other. wise harass and torment, the bowels." It is by this intense counterirritation that, in the more severe cases of mania, the morbid action { must be diverted from the head; and it is probably thus that the spirit of turpentine acts so beneficially in many cases of epileptic insanity. The same views regulate the treatment of chorea. Dr. Chapman thinks there is scarcely any chronic affection of long standing that yields more readily to any plan of treatment, than chorea does to purgatives; but, in order to effect this, "the impression once made on the bowels is never to be permitted wholly to subside. Without this is done, relapses are apt to take place, and we lose all which we had” previously gained."

Epilepsy, the author considers to arise very frequently from disorder of the alimentary canal; and here, too, "cathartics must be re

See the very ingenious dissertations on Sensation, by Mr. SMITH of Bristol, in the xxvth and xxvith volumes of this Journal, for some highly interesting il Justrations of this subject.

peated day after day, without interruption, unless imperiously forbid by peculiar circumstances. By continuing this course for several months successively, I have cured several cases of the disease com pletely, and afforded considerable relief in some others." The author, of course, employs auxiliary measures, according to the indications of the symptoms.

So many instances of the good effects of purgatives in the treatment of tetanus have been lately published, that we need not dwell on this subject any longer than to say, that Dr. Chapman's observations, as well as his reasoning, have pointed out their utility in that affection. He makes some remarks on the too indiscriminate use of drastic cathar tics in dropsy: "Every practitioner," he says, "has seen it associated with fever, and no inconsiderable degree of even inflammatory action, [an origin of the disease by no means of recent discovery, since it was distinctly noticed by Stahl.] Exactly as the case assumes this aspect, does it indicate the use of the lancet, the saline purgatives, and especially the soluble, or cremor, tartar. But, in the selection of cathartics, it is much more common to prefer the drastic species, or what were formerly called hydragogues. Medicines of this character are indisputably mischievous under the circumstances mentioned, and are only advisable where the alimentary canal is torpid, the habit generally phlegmatic, without fever or local visceral disease."

In their application to hysteria and chlorosis, Dr. Chapman, as on many points already noticed, coincides in opinion with the author of the work on Purgatives; but, though there is this similarity of senti. ments, it is not from Dr. Chapman having borrowed from Dr. Hamil. ton, as might be supposed; since, nearly twenty years ago, he read a paper before the Medical Society of Philadelphia, in which his doctrine of the gastric origin of those and other diseases to which we have alluded, and the propriety of the use of purgatives in their treatment, was distinctly advanced.

Many of Dr. Chapman's most valuable observations and reflections are dispersed in his discourses on the application of the particular species of each class of remedies: this obliges us to adduce some detached passages from these, although we cannot give a regular analysis of the whole. The following remarks, although made with so much earnestness by HIPPOCRATES, and appreciated by all good observers, are not generally acknowledged:

"It is a very curious fact, but one fully confirmed by experience, that, urged to any extent, evacuations from the bowels are found, in the complaints of the lungs, always mischievous; and, in some cases, so injurious as to be wholly inadmissible. Even in pleurisy, we can. not purge with the same freedom as in other cases of acute inflamma. tion. But, in the chronic pneumonic affections, and especially in pulmonary consumption, the system immediately sinks under the ope ration of purgatives; and hence we are so careful to restrain diarrhoea in this disease."

Dr. Chapman speaks in very favourable terms of the use of olive-oil as a laxative. It is commonly employed in France, especially during pregnancy; and is certainly a mild, agreeable, and efficacious medicine

on those occasions. Many old nurses in this country recommend it for the same purpose; but it is, we believe, bu rarely prescribed by medical practitioners.

Charcoal is another medicine, respecting which the author thinks more favourably than most other physicians; as a laxative, as well as to correct the disordered state of the contents of the intestinal canal, "in acidity of the stomach, in pyrosis, and in some of the stages of dysentery, when the stools are acrid and highly offensive.”

Dr. Chapman speaks of the black hellebore as the species employed by the Greeks in mania; but here he is not correct: various passages, in PLINY, and in AULUS GELLIUS, show that it was the white species they employed in the treatment of that disease,

We shall wholly pass over the discourses on diuretics and diaphoretics, although they contain many dispersed observations possessing some originality; but we have not much more space to allot to this review, and this must be principally given to the dissertations on the diffusible stimulants. We premise a few extracts from those on expectorants and on emmenagogues. The following aphorism respecting the use of the former, is consonant with some remarks already ad. duced: we need not apologize for transcribing it.

"Carefully avoid purging, as remarked on a former occasion, none of the complaints of the lungs will bear this evacuation to any extent. Besides which, the action of the secretory vessels of the lungs, and intestines, would seem to be alternate and opposed. Expectora tion, at least, is uniformly suppressed or diminished by diarrhea or by purging."

The decoction of the inner bark of the red elm, (ulmus of Linnæus, Tournefort, and Jussieu; ulmus rubra, of Mecklenburgh;) has been recommended in this country in dysenteric affections; but, we believe, its efficacy has never had a fair trial. Dr. Chapman says, 66 "It is known to many, that the late Dr. Grant, of Virginia, had for nearly half a century an unrivalled reputation in the part of the country where he resided, in the management of dysentery. As he once informed me, his practice consisted in little more than purging moderately in the commencement of the case, and subsequently pouring in very freely the elm mucilage. By this alone, he declared, that the bloody stools, tormina, tenesmus, &c. were more speedily removed than by the ordinary remedies. Even admitting that one-half of this statement is correct, the article will still appear to be strongly deserv ing of attention."

Dr. Chapman, as we stated on a former occasion, considers the menstrual fluid to be a secretion; but, although his physiological reflections on the nature and apparent causes of the functions producing it are in general judicious, his arguments in favour of a secretory action of the vessels of the uterus, seem to us to indicate no more than what occurs in all the exhalations ;- —a distinction made by BICHAT, that is not, it seems, generally understood.

The polygala senega was discovered by Dr. HARTSHORNE of Philadelphia, the author says, to possess admirable properties as an emine. nagogue: Dr. Chapman has given it a trial "to a considerable extent,