Order Second. In external parts, or those of secondary consequence. Genus I.-Char. Disposition to produce a temporary increase, and morbid state of the secretions of the part, and to resolve. Sub genus, a. Superficial inflammations of the skin. (Cutaneous inflammation.) Sub-genus, b. Catarrhal inflammations of mucous membranes. Genus II.-Char. Disposition to unhealthy suppuration. 1st. Cysts of chronic abscesses Spec. Inflammations of 2d. Sd. bursæ Genus III.-Char. Disposition to resolve, or to suppurate and slough. Sub-genus I.-Erysipelas. a. Verum. b. Biliosum. 3d. Edematodes. when open. Complicated with inflamed absorbents. a. Biliosum in old and debilitated persons. (E. Gangrenosum of many authors.) b. Dependent upon other diseases. a. attending sphacelus from ossified vessels. matter. 7. conjoined with, or produced by, anasarca. } 8. from varicose veins. ■. consequent on bruises, 4th. Infantilis. Sub-genus II.-Paronychia gravis. Species 1st. In thecâ tendinum. 2d. Sub-periosteo. Genus IV.-Char. Acute. Disposition to phagedenic ulceration and sphacelus, produced by morbid poisons. Species 1st. From venereal poison. 2d. mercurial. 3d. Gangrena nosocomialis. 4th. In the labia of female infants. 5th. Malignant pustule. Genus V.-Char. Chronic. Disposition to mortification. Species 1st. From pressure in unsound constitutions ;-in old people; during fever;-during other diseases. 2d. From the effects of poverty, scurvy, &c. The author now enters upon the consideration of inflamma❤ tions resulting from external causes, and treats first of those which arise from "mechanical injury." His observations on this occasion appear to be judicious, and are arranged in a systematic and lucid manner. The treatment recommended is well conceived and discriminative. The chapter on inflammations from chemical causes he subdivides into-1st, those from the effects of temperature; and, 2d, from poisons. The remarks on inflammations arising from the excess of temperature are not sufficiently copious, but those which are offered are correct. The recommendation" of opium and cordials in the first stage" of injuries of this nature is, however, given in too ge neral terms, and in a manner insufficiently laudatory, when the admirable effects of these remedies, especially the former, are taken into consideration: nor, in our opinion, ought their em ployment to be restricted to the first stage; there are instances of such injuries which, owing to the peculiar circumstances of the case, require this treatment in their more advanced stages. The author, after noticing the delusive data afforded by the thermometer of the production of animal heat in a scalded surface, adds, that this instrument will not at all ascertain the quantity of heat a part is giving off, or capable of giving off; for the thermometrical temperature of two parts shall be the same, the one being inflamed, and the other near the centre of the circulation; but the quantity of fluid which the first will evaporate shall be two, three, or four, times greater than the other." He proceeds also to observe, that inflammation arising from scalds is not the only species of this disorder which is benefitted by applications of an opposite nature,-by heat and stimuli, and by cold and sedatives. After offering farther observations upon this kind of inflammation, Mr. James discusses that which results from cold in a few words: we shall select the passages worth the trouble of transcription. "Perhaps the principle on which inflammation is produced by the application of cold, is not so entirely different from that occasioned by the direct influence of heat as might be at first supposed. "Cold does not seem to produce inflammation per se: a person of a part may be kept in a great degree of cold, and no inflammation will occur; but inflammation takes place when heat is applied to a cold part; and that is heat, to all intents and purposes, to a part which has been exposed to a temperature many degrees below the freezing point, which to others is, temperate, or even cool; and while, on the one hand, such a part is liable to be very injuriously affected by a slight degree of warmth, so, its powers being much diminished, it is less capable of resisting an injurious impression of any kind, from the same reason that a slight degree of heat will produce vesications in a limb whose powers have been reduced by paralysis. "Observing, then, that parts exposed to a violent heat inflame, if afterwards subjected to a mean temperature, but do not if gradually cooled ;-observing, also, that parts which have suffered extreme cold also run into inflammation if subsequently exposed to a mean temperature, but do not if gradually warmed; we may infer that the inflammation in either case is less the consequence of the immediate appli cation of heat or cold, than of the sudden change which takes place: nevertheless, I do not mean to deny the direct influence of excessive heat or cold; for, when they are sufficiently intense to disorganize the parts by their action on the vessels, they induce mischief which cannot be remedied by any thing but inflammation." The opinions just stated have been promulgated, as the au thor has shown, by LARREY and PEARSON, and are so far correct; but there still remains much to be done in farther elucidation of the pathology of this species of vascular lesion. Respecting inflammations resulting from the application of mineral and vegetable substances, considered in a strictly surgical point of view, the observations of the author are necessarily brief. On the animal poisons he makes the following observations, "They are of two kinds: the one acts violently and immediately on the part to which they are applied, exciting severe inflammation, but having nothing in common with the living properties of the animal, which therefore throw them off, if they are able to survive the first injurious impression; such are the poisons of reptiles, insects, &c. Their modus operandi would appear to be by the direct destruction of the vital principle of the part, or animal, on which they operate. "The other excite less intense inflammation, have a certain relation with the vital properties of the animal, in whose constitution they produce a peculiar alteration; but are sooner or later eliminated from it, if they do not previously destroy life. Such are the poisons of other mammalia, particularly of man himself." The treatment recommended locally, in the first class of animal poisons, is the same with that given by BOYER in his "Traité des Maladies Chirurgicales." Cordials, as ammonia, &c. and also arsenic, are to be exhibited internally. We now arrive at that part of the work which treats of inflammations from internal causes. These the author believes to proceed" from some defect inherent in the part, or some error in the constitution," either hereditary or acquired. The constitutional indisposition may be permanent and peculiar, constituting a diathesis: under such circumstances, "any inflammation arising spontaneously will be impressed with peculiar eharacters," and will form peculiar kinds; as the gouty, the rheumatic, and the scrofulous. There may also exist other states of constitution, which, arising from peculiar causes, operate specific kinds of inflammation, and whose duration is various; as from measles, the venereal poison, &c. These result from evident and specific causes; but there are other states of the system, recognized with greater difficulty, unless in their effects, and which can seldom be clearly traced to an obvious cause; as phlegmon, or carbuncle, or erysipelas, &c.; "but, though peculiar, they are not permanently so, and the person who now has erysipelas may, in a short time, have phlegmon." After making some farther general observations connected with this subject, and upon the disposition which inflammation may assume to limit or to spread itself, the author proceeds to the consideration of such disorder in vital organs. These he ranks in two orders, according as "their functions may be more or less immediately connected with the support of life." In the first is arranged the stomach, small intestines, brain, and the heart. In the second rank is placed the lungs, liver, and kid, neys; because," although the interruption of these will sooner or later be followed by death, this consequence is not so immediate, nor are the attendant symptoms so urgent. This is still more the case with the pancreas, spleen, bladder, and uterus." To us this arrangement appears arbitrary enough; and we are at a loss to think why the brain ought to be considered an organ more essentially vital than the lungs. Instances of the phenomena of life being continued for some time in several of the more perfect animals, although not a vestige of brain could be seen, are on record: others may be furnished wherein this organ was found ossified throughout, and yet the animal remained in apparent health; and, in the lower part of the scale of animated nature, there are whole orders that may be adduced in proof that the existence of a brain is not even necessary to the continuance of life. The same cannot be said of the lungs : all animals have either such an organ or an apparatus which performs the same office in their economy. We consider, therefore, the lungs as a vital organ of the very first importance in all animals. Inflammation affecting serous membranes is next noticed, and the disposition to diffuse itself in this texture is especially considered. The proneness of these membranes to the spreading inflammation, the author accounts for "from the circumstance of their being ordinarily exempt from all injurious impressions, and therefore may be less capable of resisting them when they do occur; and because all the results of inflammation, except resolution, must be productive of consequences injurious to the functions of the organs they envelop." "We must confess ourselves but little wiser for this explanation, and as little from the following attempt to show why adhesion takes place, as a consequence of inflammatory action, more frequently than any other mode of termination. "The disposition to adhesion certainly predominates, and that for reasons which Mr. Hunter has assigned; namely, because effusion of any kind of fluid into a shut cavity is injurious, and therefore, under inflammation, the natural disposition is to exclude this; and it rarely occurs, excepting under an uncontrollable degree or of a peculiar kind, as in some cases of dropsy." To say that such an effect is not produced because it is injurious, is only one way of expressing our ignorance upon the subject, and conveys us not one step towards a solution of the difficulty. Had the author, instead of having his attention ab sorbed by the distinctions which he has moulded into a system, applied his observation more closely to those which are the result of the texture in which the inflammatory disorders may be situated, he might have more readily discovered a reason why inflammations seated in serous membranes more readily throw out coagulable lymph and form adhesions, than when they occur in any other tissue. He next proceeds to offer some observations on mucous mem branes: these are not viewed "as vital organs" by the author. We are disposed to differ from him in this. According to the common acceptation of the word organ, they may not certainly be considered as such; but, if the separate textures of the body be individually considered in their dependencies, and in the phenomena which they are engaged in producing, no tissue can have greater claims to be considered vital. In enumerating the kinds of inflammation which are observed in this texture, he says, "it may also be their original disposition to ulcerate and slough." We showed the fallacy of this in the former part of this review, and that such affections were the result of the inflammatory action having extended to the adjacent cellular tissue. The causes which produce inflammation in vital organs appear to be correctly enumerated, and therefore afford no grounds for remark. The indications of cure are very briefly, but judiciously, suggested. Of the treatment of wounds in vital organs, he speaks as follows: "Where nature is herself capable of curing disease, we should do well to observe her processes, and to imitate them; for she is not to be thwarted, but obeyed. If a man receive a wound in a vital part, we observe that he drops in general, and there he would lay, perhaps, in a state of inaction, and under the influence of privation, if he were not removed. The wounded soldier does often remain in such a predicament, without help; but without the stimulus of warmth or food, and the processes which are immediately consequent on the wound are not defeated by these causes, and by being moved prematurely; while his comrades, carried to a crowded house or hospital, very frequently die. As syncope from hemorrhage, though alarming as a symptom, is beneficial as a process, so the sudden and entire loss of power which often follows a wound in a vital part, may contribute greatly to prevent mischief, by the contraction of vessels it occasions, and its incapacitating the individual from moving or procuring food." The author proceeds next to the consideration of "limited inflammation of parts of great, but not of vital, importance," as of the joints, the eye, and of the testes; when he arrives at the third order of this class, namely, "inflammation affecting common or external parts." Having disposed of these in a very satisfactory manner, and in the order given in the appended table, the second class, or those which possess "the disposition |