"In a case which came under my own observation, where a complete retention had taken place from an enlarged prostate gland, and which admitted a catheter to be passed as far as that body, it was thought right to puncture the bladder from the perineum: the patient was placed in the attitude in which the lateral operation of lithotomy is performed, but complained much of the position and restraint. A catheter was passed to the beginning of the prostate gland, and an incision made on the left side of the raphe of the perineum, of about an inch and a half in length, and sufficiently deep to allow the enlarged prostate to be felt. The finger of the operator was then introduced into the rectum, and the situation of the gland and bladder towards the gut ascertained. Poteau's curved trochar was then introduced into the wound, and conveyed on the left side, but towards the fore part of the enlarged prostate, as near as possible to the bladder ; it was then pushed on, and the stilette withdrawn: about a pint and a half of urine followed, and the patient almost immediately fell asleep. The canula was left in the wound for four days, when, from the irritation it produced, it was withdrawn. Some urine having passed by the penis, a flexible gum catheter was introduced into the urethra, and, with a little difficulty, passed on to the bladder: it was allowed to remain there so long as the patient lived, which was above five days after its introduction, and nine from the first operation. The wound in the perineum showed no disposition to heal, but otherwise the operation at first promised a favourable result: the patient was, however, too debilitated for any permanent good to be derived from it. Ou dissection, it was found that the trochar had entered the cavity of the bladder, a little to the fore part and left side of the meatus urinarius : it had passed through a small lateral projection of the left lobe of the gland; but that circumstance did not seem to have had any share in the person's death, as no mark of increased inflammation had taken place round the opening. The great corpulence of the patient, and the projection of the gland backwards towards the gut, were what determined the place of the puncture, added to the greater safety that it was supposed the patient would derive from the urine passing by the perineum, should the wound not heal, or should it have been necessary to keep it open."

Diseases of the Testicles; Impotency. Conclusion. (Lecture xv.)-The first affection mentioned in this lecture, if it can be called such, is the retarded descent of the testicle or testicles. The cause of this failure in the descent of the testes is not casy to be ascertained: one of them will often remain for months, for years, within the cavity of the abdomen, or playing nay, about the ring. In the latter position, it exposes the person to some risk of inflammation. Where both have remained in the cavity of the abdomen, it has been supposed by John Hunter that they are exceedingly imperfect, and incapable of perform-, ing their natural functions. Mr. Wilson relates two cases, one of which "seems to confirm this remark, while the other makes rather against it."

"The first is in a young man of very large fortune, now twentyfive years of age, whose testicles have never descended: he has some beard, and not an unmanly appearance; but, although an imprudent, and in some things a dissipated person, he has never shown the least desire for women, or disposition for sexual intercourse. The second is a person between thirty and forty years of age, who has one testicle forming a tumor within the ring, and the other, which descended at puberty, lying immediately on the outside of it. He is a married man, and has children. Before his marriage, he describes himself as having great desire, and not being deficient in the power of performance. He formerly had a venereal gonorrhoea, which was treated by astringent injections: both testicles swelled, and were exceedingly painful; they were mistaken by his medical attendant for bubocs, and I was consulted respecting the propriety of opening them as such. When the parts were shown to me, and the nature of the pain on pressure mentioned, I examined the scrotum, and then discovered in what glands the swellings had taken place. In this person, one testicle is of the full natural size; and the other also appears to be só, as far as can be judged of by feeling it through the tendon of the external oblique muscle."

On hydrocele, swelled testicle, scrofulous, or scirrhous testicle, and fungus hæmatodes affecting the same organs, Mr. Wilson has some concise and appropriate remarks, with a few rules for their diagnosis and treatment.

The book concludes with a few observations on impotency, arising from disease of any important part of the organs of reproduction, or from malformation and the want of perfect accordance between any two parts of that apparatus; or, what is still more frequent, from over-anxiety on the part of the individual, or an apprehension of ultimate failure. The bad effects of these intellectual aberrations on the sound exercise of the generative functions, are to be prevented by friendly and confidential communications, rather than by any medical treatment. The work is illustrated with three plates,-the first representing a side view of the pelvis; the second, showing the course of the urethra; and the third, exhibiting the muscular fibres adhering to the outer circumference of the inner membrane of the urethra formed in packets; and also a partial contraction of the said membrane, constituting what has been called a spasmodic stricture.

The work throughout is written in a perspicuous style, and is free from every sort of affectation. The modesty of its author is only equalled by the extent of his knowledge; and the solidity of his reasoning in support of practical tenets will constitute him a favourite with those students and surgeons who, smiling at the every-day rhapsodies of self-created teachers, look out for orthodox doctrines and orthodox professors. To all such, Mr. Wilson will prove an unerring guide.

Medico Chirurgical Transactions, published by the Medical and Chirurgical Society of London. Vol. XI. Part II. 8vo. pp. 211. Longman and Co. London, 1821.

IT is now exactly fifteen years since the Society, of whose Transactions we announce the eleventh volume, first entered upon the discharge of those important duties which the distinguished founders originally imposed upon themselves, with the Jaudable intention of promoting the advancement of medical science; and we question whether any other Institution of the same kind has, in so short a period, done more towards attaining that desirable object. Undoubtedly, papers of a very inferior description, or of little intrinsic value, have now and then been admitted among those of a different class in the Transactions, (and of this we have one or two examples again in the present volume;) but, on the whole, we are satisfied that the general voice among the practitioners in the healing art, whether at home or abroad, is wholly favourable to the Society, and expressive of commendation for their exertions.

The present volume contains nineteen memoirs and two appendices, of various degrees of merit and importance. Some are important for the novelty of the subjects of which they treat; others, for the interesting manner in which subjects already familiar to the profession are again brought forward; and some, again, there are which lack both these qualifications. In this last class we hesitate not to place Dr. George Gregory's papers: the first, on Scrofulous Inflammation of the Peritoneum, or Marasmus (as he says it is denominated), in children; the second, on a Malformation of the Heart; and a third, on Chorea treated by Arsenic. Indeed, so different are these three memoirs from the rest of those contained in the volume, and from the generality of those usually admitted in the Transactions,and so well do we know the judicious scrupulosity used by the council in the selection of papers for the press,-that we strongly suspect Dr. George Gregory's papers to have found their way into the present volume through some blunder or inadvertency. The sound judgment of those who compose the administration of the Society,-the sense of discrimination which is well known to belong to those who take the lead in it,--and the general satisfaction they have given while in office, authorize us to entertain the above doubt, and to believe that most of them must have been equally surprised with ourselves at the appearance of these said three papers in the present volume. After all, we may be mistaken in our surmise; but, until some one shall have undertaken to prove that the conception which we have formed of the merits of Dr. G. Gregory's papers, and which we are about to submit to our readers, is erroneous, we shall

continue, in charity to the council, to think that the papers in question can scarcely have got into the volume by genuine importation.

Dr. George Gregory's first paper is thus entitled,

1. Observations on the Scrofulous Inflammation of the Peritoneum occurring in Children, and frequently denominated Marasmus. By GEORGE GREGORY, M.D. senior Physician of the St. George's and St. James's Dispensary.

Dr. G. G. begins by asserting, that "the terms marasmus, infantile fever, and diseased mesenteric glands, have long been employed to designate a disease of the abdominal cavity, to which children are subject." This is to us, and we dare say to our readers too, perfectly new: who is there that has ever heard the true infantile remittent fever of children called maras-· mus, or has ever read of a case in which the mesenteric glands were known to be diseased, being styled a case of infantile fever? Dr. G. G. may have made such a mistake, though we are very far from accusing him of it; but to tax the profession, indiscriminately, of committing such a blunder, is rather too much. The fact is, that, before the name of infantile fever had ever been adopted, every book of elementary medicine had treated of the peculiar affection of the mesenteric glands, to which children are liable, in a very distinct manner, supported by pathological investigations; and, when of late years the attention of the profession was called to the "infantile fever," this complaint was distinctly stated to be an affection of the intestines, independent of any morbid condition of the mesenteric glands. Indeed, so far have writers on this subject been from using these appellations indiscriminately, as Dr. Gregory pretends, that Mr. COLEY, who published a treatise er professo on the Remittent Fever of Children, not many years since, has taken great pains to distinguish it from enlargement of the mesenteric glands! As for the word marasmus, we challenge Dr. G. Gregory to name any decent and modern author who has used that word when he meant to say "infantile fever." Has Dr. Pemberton done so? Dr. Butter? Dr. Hamilton? Mr. Coley? But a mere child knows that marasmus is a word adopted (as its etimology indeed implies,) to denote that state of emaciation which, in children, may arise from infantile fever, a protracted chronic cephalitis, a scrofulous affection of the mesenteric glands, or peritoneal inflammation, or enteritis, &c. &c. So much for Dr. G. Gregory's charge against the profession. We now come to the more immediate object of his paper,namely, the right discrimination of abdominal diseases in children; for, as to their treatment, he regrets to say that he has little to offer worthy of the notice of the Society."

Dr. Gregory says that he has been able to distinguish three different states of abdominal disease in children, which have, as a common character, fever of a slow remitting kind, and a general wasting of the body. The first of these consists in simple disturbance of the functions of the intestinal canal without organic derangement." This discovery was made by several authors before Dr. G. Gregory hit upon it. Indeed, he himself quotes Dr. Pemberton as one of those who have been equally lucky with himself in making the discovery.

"The second form of marasmus is that in which the mucous membrane of the bowels is extensively implicated." Dr. George Gregory means enteritis, of course. We need not ask our readers whether the author is entitled to the merit of having first ascertained this second form of abdominal affection in children.

The third form, Dr. G. Gregory goes on to state, is primarily" a disease of the peritoneum :" and

"In my views of the pathology of marasmus, I have omitted any particular notice of the mesenteric glands. I have done so, not because I distrust the observations of those authors who have spoken of such a disease, but, first, because, in the various dissections which I have made with the hope of clucidating this subject, I have never once met with any disease of the mesenteric glands which was not complicated with, and probably referable to, a diseased state of the mucous or serous membrane of the abdomen; and, secondly, because in many of those cases which were seen by other practitioners, and denominated disease of the mesenteric glands, I had an opportunity of proving, by dissection, that those glands were only slightly affected, so as to be scarcely noticed in comparison with the extent of disease present in one or other or both of those membranes."

If this means any thing, it means that children are liable to peritonitis. We have no other book by us just now to refer to but BURNS's; and we find that this author has had the good fortune to anticipate Dr. G. Gregory, for, at page 593 of the fourth edition, we find a whole chapter on peritonitis, "as a complaint not uncommon with children."

Thus, of the "three different states of abdominal disease in children" which Dr. G. G. has been "enabled to ascertain," there is not one which had not been fully ascertained before.

It is worthy of remark, that Dr. G. Gregory, after having condemned authors in general for using three different denomi nations to designate a disease of the abdominal cavity in children," uses but one word himself, "marasmus," to designate the "three different states of abdominal diseases he has been able to ascertain!" For, in speaking of the first state, (page 261,) he says, the "marasmus was here owing," &c.; the next he calls the second form of marasmus;" and the