which attend sensitive erethism of that organ will also be present, but in a more severe form.

The foregoing observations all tend, more or less forcibly, to support the opinion that tetanus results expressly and immediately from irritation of the spinal marrow or its membranes. Prof. BAROVERO, of Turin, has published a memoir* on this subject, with the intention of establishing this etiology of the affection. The novelty in his observations consists in his endeavouring to show, from the period at which the disease occurs after external injuries, that, when it depends on this remote cause, it is the especial consequence of inflammation of the injured nerves, which always comes on, sooner or later, after a certain degree of injury of these organs, especially contusions of them not sufficiently severe to destroy entirely their vitality. He attributes much influence to the confined purulent matter, which, he says, will irritate the nerves with which it is in contact, when they have been previously injured; and hence it is, he thinks, that punctured wounds, which cicatrize early, are so often followed by tetanus. Professor Barovero acknowledges the influence of impressions of cold on the surface of the body in exciting the disease, when wounds are present as well as when they are absent. He does not attempt a distinction between tetanus arising from the latter cause expressly, and tetanus dependant on wounds; though it seems probable that the seat of the inflammation, which is the immediate cause of the spasmodic symptoms, will be found to vary in these cases, being in the membranes in the one, and in the spinal marrow itself in the other.

The inference relative to curative measures peculiar to Professor Barovero, is that amputation of the parts, when practicable, should be effected, after severe injuries of considerable nerves from external violence, before the period at which re-action or inflammation would

ensue.

The connexion of chorea with inflammation of the membranes of the spinal marrow, and the apparent origin of the former from the the latter affection, is well shown by Dr. COPLAND, in a very severe

tum is said to be a common affection in Cayenne, Minorca, and hot countries, and in those parts of Europe where the rooms are heated by German stoves, and the children oppressed by swaddling clothes. The strongest and the most healthy infants are, chiefly, the subjects of that affection, which comes on from the second to the seventh day after birth, rarely later than the ninth day, occurring about the time of the separation of the navel-string. (See Edin. Med. and Sur. Journal, vii. 225.) In the island Heimaey, the only one of the Westmann-Eyar cluster on the southern coast of Iceland which is inhabited, almost every child that is born is carried off by tetanic disease, which rarely occurs on the main land. This discase comes on very soon after birth, producing strabismus, rolling of the eyes, subsultus tendinum, with contraction and stiffness of the muscles of the back, and is called by the Icelanders, ginklofe. When it has continued from one to seven days after birth, trismus generally comes on, and sometimes opisthotonos, (which strictly is the ginklofe,) and, in some cases, emprosthotonos, which they term ktums.-(Dr. Holland, in Sir George Mackenzie's Travels in Iceland.)

• Récerche sulla Causa della Convulsioni, del Trismo e del Tetano, che insorgono per Ferite d'Arme da Fuoco, o per altra violente Lesioni, onde stabilire il tempo piu opportuno per esiguire l'Amputazione del Membro offeso, Annali Universali di Medicina; fascicolo xlviii.

case of that disease, which has lately occurred to his observation.* The spinal dura mater was the chief seat of the inflammation, and it is an interesting circumstance that its onset was accompanied with inflammation of the fibrous structure in other parts of the body also. Before death ensued, the whole of the nerves of voluntary motion of the trunk and extremities had lost their power, and the limbs were perfectly lax and incapable of automatic movement.

Very considerable progress has of late been made in the knowledge of the seats of the most important of what are called nervous diseases ; and it is highly encouraging to the inquirer to find that the indications of pathological anatomy, in these instances, are perfectly conformable with our physiology. We can comprehend very well how permanent irritation of the spinal marrow, the centre of the nerves of voluntary motion, may occasion a permanent action of the muscles of voluntary motion, that is to say, tetanus; or, when this irritation varies from time to time, according to diversities in the state of the circulation, intermittent violent actions or convulsions; and how these convulsions are confined to one side of the body, in chorea, when the irritation affects only one of the two lateral cords which constitute the spinal marrow. All these relations are conformable with the plainest and best-established principles in physiology. The writer of this Sketch is about to make public the results of some researches respecting epilepsy, which show that there are distinct species of this disease immediately referrible to the cerebrum, the cerebellum, and the spinal marrow, or the nerves especially connected with them, respectively; and another species where the ganglionic nerves are the seat of the first disorder, (in which the spinal marrow and the brain, sometimes one and sometimes the other, act only as intermediate causes in the development of the phenomena of the disease;) each of which is marked by peculiar symptoms and other effects on the system, physical and moral, which permit of the respective characters of the whole being designated with precision. The histories of those affections, thus distinguished, with the illustrations of them furnished by dissections after death, present some very curious and interesting views in pathology; and, it is believed, will tend in no slight degree to improve our modes of treating those maladies.

Excepting that the treatise of Dr. COOKE, on Palsy,† should be no ticed, as a work tending in an indirect manner to promote the progress of medicine, by presenting students with a methodic abstract of what has been discovered and thought respecting the nature of this disease, and thus favouring original investigations, by showing in what respects they are likely to develop novel and important results,-there is nothing else to engage our attention respecting diseases affecting especially the nervous system.

Published in the London Medical Repository, for January 1821.

History and Method of Cure of the various Species of Palsy; being the first Part of the second Volume of a Treatise on Nervous Diseases. By JOHN COOKE, M.D. F.A.S. Fellow of the Royal College of Physicians, and late Physician to the London Hospital. 8vo. pp. 215. Longman and Co. London, 1821.

Diseases affecting the sanguiferous system especially, and more or less generally, are to be considered next in order.

A work of very considerable value on Hospital Gangrene* has been recently published by Dr. WERNECK, physician in chief to a division of the Austrian army, who has had very extensive opportunities of observing the disease during the late campaigns in Italy, Hungary, Poland, and the greater part of Germany. It is only such points as are either of an original character, or such as serve to support doubtful points of theory, that require notice on this occasion. The opinions of Dr. Werneck are, for the most part, congruous with those advanced in the Proëmium for January 1820. He considers that the disease may appear either as affecting primarily the system, or developing itself originally in an open wound, without any specific affection of the general system. He thinks that it arises from a contagious virus, which is a modification of that producing the common typhous fever: in support of which notion he cites numerous facts, furnishing direct and very forcible arguments in its favour. Hospital gangrene, like typhous fever, he also remarks, may occur several times in the same individual, and affect persons living in an insulated manner, as well as in hospitals, transport-ships, or garrisons, where numerous individuals are collected together; and it may be cured, under either of these circumstances, with the use of no other measures than such as are proper to maintain cleanliness of the wound affected. Dr. Werneck has some hypothetical opinions about the nature of the contagious virus, that it would not, perhaps, be right to neglect to notice; though it should be understood that they are not cited here because their truth is acknowledged. He supposes that the essence of the virus is of an alkaline nature, and is to be corrected by acids,† the most efficacious of which, for the implied purpose, is the acetic acid; next to this, the muriatic and oxy.muriatic acids; and, last in the list, the other strong vegetable acids.

Similar in its general character to the foregoing treatise, that of comprising a good history of its subject, with observations and arguments qualified to support those of former well-informed writers, rather than demonstrative of any thing of remarkable originality, is the work of Dr. RUST on the Egyptian Ophthalmy. His most important and interesting observations relate to the appearance of ophthalmy in the garrison at Mains in 1818. The disease had been present in the army during the campaigns of 1813, 1814, and 1815, but it was not till the time above mentioned that it manifested itself in an alarming manner. Its prevalence occurred under the following

Kurz gefasste Beytrage zur Kentniss, der Natur, der Enstehung, der Verhenthung and Heilung, der Hospital Brandes. Von Dr. WERNECK, chef Arzte des Kon. oesterl. 3 Feldjayer Batailums. 8vo. 115 seit.

See the treatment of the disease in the section on Therapeutics.

Die Egyptische Augenentzundung unter der Konig. Preussichen Besatzung_in Mains. Ein Beitrag zur näfhern kenntniss diesen Augenkrankheitsform. Von Dr. JOH. NEPOMUK RUST; Ritter des Konigl. Preuss. rottren Adlerordems und des eiscren kreuzes, u. w. s. 8vo. Berlin.

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circumstances. It affected only the men of one regiment, and, for the most part, only some Pomeranian, Lower.Rhenish, and Nassau recruits. This regiment made a very harassing march from the Rhine to Silesia, and back again, in the autumn of 1817 and the spring of 1818. On its return, the men were crowded into a transport with several French invalids, amongst whom were many who had lost their sight from ophthalmy. On the arrival of the regiment at Mainz, about a third part of the regiment was found to have the itch. After this was got rid of, several other cutaneous diseases appeared, as scarlet fever, measles, varioloid diseases, and nettle-rash; and, on the decline of these, the affection of the eyes first appeared. It augmented in severity from June to September, 1818, when it continued nearly stationary, in regard to prevalence and severity, till March and April 1819, when its extent became more confined; but its destructive agency was far from being suppressed until after the most strict meaşures for preventing its infection had been resorted to.

Whilst the Prussian regiment at Mainz was suffering from this disease, the Austrian soldiers were entirely exempt from it, though they both lived under the same climate and performed similar duty. But, whilst this argument in favour of the propagation of the disease by contagion is brought forward, we must not neglect to notice those which favour the opinion of its primary origin from casual external circumstances. The whole of the facts related by Dr. Rust support the opinion of Dr. Vetch, that purulent ophthalmia originating from any common causes may become contagious; or, in other words, that a puriform secretion from the mucous membrane of the eye, from whatsoever cause, is capable of infecting, by contact, the mucous membrane of the eye of another person, and of thus producing a disease similar to that from which it originated.

It should be considered that the disease first appeared in the recruits in the Prussian army; that the military discipline of the Prussian army is much more severe and harrassing than that of the Austrian army; and that this severity was further increased as the number of the sick augmented. One part of the military discipline to which those recruits were submitted, was that of having the hair cut very close over the whole of the upper part of the head, on their entry into the ranks, whilst they adopted the practice of constantly wetting the back part of the head with beer and soap, for the purpose of making their hair grow en queue, and a very defective covering for the head was commonly worn. These circumstances may be considered quite sufficient to produce a disposition to ophthalmia, just in the way in which it was manifested. Dr. Rust arrived at the garrison on the 5th of April, 1819. He immediately put in force the most effectual means for preventing, the progress of the disease, supposing it to be communicated from one individual to another by contagion. The number of patients now decreased from month to month, till October, when the garrison was relieved, and the disease supposed to be wholly destroyed. From June, 1818, to the end of April, 1819, the number of patients amounted to 1146; from this time to September, 1819,

only 652 new cases occurred; so that the whole number of patients was 1798, not including one regimental physician, two hospital surgeons, and twelve nurses, who were affected with the disease.

Children are not unfrequently born with diseases, both acute and chronic, but these are, for the most part, such as obviously originate either from congenital predisposition, or from some infection communicated by means of the fluids of the mother. The following case of acute peritonitis and enteritis, affecting a fetus in the uterus, is less easily explicable, at the same that it is of very rare occurrence. It is related by Professor CHAUSSIER.* On the 8th of February, 1821, a woman, twenty-two years of age, pregnant for the first time, who had always enjoyed excellent health, had suffered no accident nor committed any known imprudences during her pregnancy, was delivered at the Hospice la Maternité, in the seventh month of utero-gestation. Pár turition was natural, prompt, and easy. The child, of the male sex, breathed and cried immediately after its birth, and was well formed and somewhat lusty: however, his respiration was oppressed, his cries plaintive and languid; and, as the abdomen appeared more voluminous and distended than ordinary, it was supposed that those symptoms might depend on a want of the evacuation of the meconium: a glyster was therefore administered, which caused the evacuation of a small quantity of feces; but, notwithstanding the particular care that was taken of the child, it died an hour and a half after its birth.

On examining the body, Professor Chaussier found that it presented the firmness and development of a fetus of seven months. Its skin was red, as it always is at this period; the abdomen was soft; and there was some serous effusion beneath the skin, most remarkable about the lower extremities. The viscera of the head and chest presented nothing remarkable; but, on the abdomen being opened, there flowed from it about ten drachms of a viscous yellowish serum, mingled with some flocculent matter. The omentum appeared a little thickened. The convolutions of the intestines were so united to each other by a tenacious layer of coagulated lymph, that they formed but one mass, enveloped by the distribution of the colon. On exa. mining more closely the small intestines, the mucous membrane was found, on removing the peritoneal coat, to be of a pale colour externally, thickened, incoherent, and penetrated by a whitish semi-fluid matter, which separated it from the peritoneal tunic. The cavity of the intestine was filled with a greyish mucus, and the intestinal or fol. liculous membrane appeared thickened, and was interspersed here and there by small congeries of vessels gorged with blood. The large intestine was filled with meconium, and presented, as well as the rest of the abdominal viscera, no morbid appearance whatever.

The theory of fever is still a subject of active discussion, especially in France, but nothing very remarkable or of an important character has been produced in the period comprised in this Essay. A disserta

Bulletin de la Faculté de Médécine de Paris, No. 1. 1821.