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fevers are attended with violent local affection. Even in cases which we have examined post mortem, we have frequently found no local affection sufficient to occasion death. As to ihe effusion on the brain, we have never had an opportunity of examining a subject after fever without it; but in very few instances with suppuration or adhesions sufficient to produce death; or with more effusion than appears to us sufficient to induce the pain in the beginning of fever, and the dulness of the senses towards and during convalescence, until the effused Auid is absorbed.
Dr. P. afterwards remarks, that, even in tropical fevers, local affections are usually discovered. We believe, with much more certainty than in colder regions, especially in the army, consisting chiefly of the natives of the north, in the flower of youth, and in an unnatural state of animation.
After a few other remarks, very judicious, but we can hardly say new, some cases follow, in which some patients were sparingly bled with leeches, others more copiously by the arm, according to their previous condition and mode of life.
“ Some of the above cases (continues Dr. P.) were so short in their progress towards recovery under the use of the evacuants administered, that the peculiar symptoms of the typhoid state had scarcely time to develop themselves; and a doubt may hence arise in the minds of some readers, whether they were genuine cases of typhus or not. In order to be convinced that they were such, it was sufficient to witness the circumstances of the origination of the disease in every single instance. I believe there was scarcely one patient whose malady could not be distinctly traced to infection. As a proof of the virulence of the contagion, I may mention, that, at the beginning of the period through which it prevailed, a man who assisted in carrying to the grave the body of a patient who died under this fever, was seized with rigors immediately after his return, and expired on the third day.”
By this are we to understand that contagion was sufficient proof of typhoid character without typhoid symptoms, or what are we to understand by the perpetual recurrence of this unexplained word? If we are to understand contagion, the consideration is important, as directing us in the means of prevention. But, though we thus discover the cause, does this lead in the least to the mode of treatment? Small-pox is contagious; but is every fever from such a cause to be treated alike? On the whole, we are much pleased with the author's practice, excepting that we are quite of opinion, with Dr. Kinglake, * that blisters, in these cases, and espe
* See page 102 of this volume,
cially, cially, as Sir Gilbert Blane* has remarked, blisters in the immediate vicinity of the inflamed part are often worse than useless. We could wish, also, that Dr. Prichard would look a little further backward than the medical gentlemen he has quoted : highly respectable as they are, it should be recollected that R. Jackson and Sutton were much before them in this mode of treating fevers, equally infectious and more violent than those described by Dr. Prichard.
(The other Articles in our next.)
Medico-Chirurgical Transactions, published by the Medical
und Chirurgical Society of London. Vol. VII. Part I. Longman and Co. 1817.
These Transactions begin now to assume a kind of official form, the Society having expressed its intention of producing a yearly volume. It is not less certain that it consists of men who have the largest opportunities of practical knowledge, and who are not less respectable for scientific attain
But it unfortunately happens, in every branch of medicine, that such men have but little leisure, and, for the most part, less inclination, to write. The first difficulty might seem a sufficient apology were it universal; the second may often be imputed to the sage answer of Lucullus's wealthy veteran—" Vadat qui zonam perdidit.” It is, however, much to the public advantage that a rival Society to that of Bolt-court has been established. Highly respectable as the last part of the Memoirs of that venerable institution must be universally considered, the papers were principally medical. These - Transactions" are, with very few exceptions, chirurgical, and, though chiefly produced by the junior members, are none of them without their share of merit. The first involves a question concerning early amputation, which has of late come frequently before us. Report of the State of the Wounded, on board His Majesty's Ship Leander, in the Action before Algiers; extracted from a Letter from D.QUARRIER, M.D. Surgeon to the Leander, to the Commissioners for Transports. Communicated by Sir GILBERT BLANE, Bart.
“ Herewith I enclose a Report of the wounded on-board this ship, by which you will perceive that the Leander has suffered most severely in this arduous conflict; many of the wounds were inflicted by large round, and double-headed or bar shot; others by grape, langrage, and musquetry, and some few by splinters; but we were
* Paper on Tracheitis in Medico-Chirurg. Trans. vol. vi. p. 147 3 G2
A System of Anatomy, for the use of Students of Medicine.
By CASPAR WISTAR, M.D. Professor of Anatomy in the University of Pennsylvania. 2 vols. 8vo.
[From the New-England Journal of Medicine, &c.] The honour of giving to the United States the first American system of anatomy, belongs to the distinguished author of the publication before us. Nor is this its strongest claim to our attention, since it is the production of one, who has long been a celebrated and successful teacher in the first medical school of our country, of one, whose name has long been in the mouth of thousands of physicians, grateful for the fruits of bis instructions. With such titles to notice as these, we presume that our tardiness in attending to it, will be attributed to other causes than a want of proper estimation of its importance, or of respect for its scientific and honourable author.
In an attempt to review a work of this nature, it will not be necessary to give an exact account of its contents; and still less so, to enter on a discussion of minute points in anatomy, or doubtful questions in physiology. The proper inquiry is, whether such a publication was called for by the wants of the country; and if so, whether it is well calculated to supply those wants. The first step in such an inquiry seems to be, to take a view, perhaps quite cursory, of the books on anatomy, in common use, especially in the United States.
Our students of medicine have been, we believe, in the habit of employing formerly the system of Cheselden, and of late years, that of the Bells. The precision, simplicity, and comprehensiveness of Cheselden, have continued its popularity longer than is common; and it has passed through iwo or three editions in this country; but it is too concise for present use, and its physiology is in many parts defec. tive, and in some quite erroneous. The writings of Mr. John Bell, the principal author of the system bearing that name, have caused a great diversity of opinion, as to their merits; for, while none have been more sharply criticised, nione bave been more generally read. They are evidently the effusions of a man of strong feelings and great talents; who, resolved not to fetter himself with exact forms of expression, indulges the free current of his pen, and does not allow himself to be checked by precision, when it would interrupt the interest, and cool the ardour of his description.
He always colours strongly, often with coarseness, and sometimes incorrectly. It may very properly be made a question, whether this kind of style is admissible in anatomy, or any other science composed of descriptions of natural objects. Boyer, so remarkable for his exactness, objects decidedly to the use of figurative or ornamental language, where clearness and precision are so important; and he not only recommends, but gives, through his works, an example of the most severe and unmixed style. Voltaire, he says, complains, and produces it as a proof of bad taste, that eloquence had been introduced even into anatomy. While the justness of these remarks would prevent our recommending Mr. Bell as an exclusive elementary author, we ought to be grateful to him for opening an avenue, which conducts us pleasantly through the rough and forbidding parts of the science, and which invites the advances of many, who would be terrified and repelled by the difficult and barren descriptions of Boyer.
There is a work, which passes under the name of the Edinburgh system of anatomy. This is not destitute of merit; but is defective in some parts, and redundant in others, and altogether a heterogeneous mass, thrown together without method. We have, therefore, no great reason to regret that it has never been reprinted in this country.
Dr. Alexander Monro of Edinburgh, the third professor of anatomy and surgery, bearing that name, bas lately made public the course of instruction pursued by his illustrious predecessors and himself. His arrangement is peculiar. He places first the organs of motion, next those of nutrition; namely, the digestive, absorbent, circulatory, and respiratory; then of the voice; afterwards of the urinary and generative funetions; next the nervous system, the brain and organs of the senses ; and lastly, the distribution of the arteries, veins, nerves, and iymphatics. The description of each apparatus is preceded by a general account of that apparatus, and followed by a collection of relative pathological facts. The latter contains many interesting observations ; but cannot be ranked with the collections of Portal; and appears extremely meagre, compared to what we might expect from the storehouse of the Monros. The work, however, appears valuable as well as agreeable, and therefore will be popular; and the author's industry will no doubt be excited to maintain the great name of his family, by improving and enlarging his future editions.
The French anatomists have been distinguished by the production of some excellent treatises. The anatomy of Sabatier differs from the systems of the other French writers, in being a mixture of anatomy and physiology. Notwith. standing this deviation from the custom of the French, it was well received and used as the standard work, until the apa-, tomy of Boyer appeared, which, by its exactness and its re. jection of physiology, immediately superseded the former, Boyer's anatomy is a specimen of the most exact and mipute description of physical objects. His descriptions of the muscles especially, are extended to a minuteness, which seems unnecessary, and perhaps will not be very acceptable in any country but. France. An exact description of the osseous fabric is more useful, because the description of most other parts is continually referring to this; that of Boyer, therefore, if diligently studied, is calculated to form an excellent foundation for the science, and even to create a passion for it. This author is also to be admired for the firmness, with which he maintains his exact method of description against all the obstacles that present themselves. The descriptive anatomy of Bichat, bears strong marks of that powerful genius, that gives an air of novelty to every thing it touches. One would scarcely have thought it possible to add so much interest to so ancient and precise a study, as that of anatomy, by some changes in arrangement, some alterations of nomenclature, and some new ideas, or rather new views of things already known. It is unfortunate that a part only of the descriptive system was the work of Bichat; for he died when about half of it only was accomplished. The remainder was performed by his pupils Buisson and Roux, in a manner, not dishonourable to the reputation of these ingenious men, but which has not the spirit of their master. Bichat did not attempt great innovations in the system of descriptive anatomy, probably because he did not consider them necessary, or did not believe they would be received. He proposed, indeed, a different arrangement, because the old one was extremely defeetive ; but he corrected the nomenclature with a temperate hand, and yet availed himself with so much address of the labours of Chaussier, that, while the nomenclature of the latter is hardly adverted to, but as a curiosity, the changes of Bichat are actually adopted in France, and will be so in England, as soon as his anatomy has received an English dress. *