CONTENTS OF THE MEDICO-CHIRURGICAL REVIEV JULY 1, 1846. Reviews. I. Lectures illustrative of various Subjects in Pathology and Surgery. By Sir BENJAMIN C. BRODIE, Bart, F.R.S. 1. On the effects of Strangulation and Drowning 2. Ununited Fractures 3. Sero-Cystic and other Tumours of the Breast 5. Tic Douloureux 6. Use of Caustics 7. Chronic Abscess of the Tibia II. On the Alternation of Generations; or the Propagation and Development of Ani mals through Alternate Generations, &c. By JOH. JAPETUS SM. STEENSTRUP. Translated by GEORGE BUSK 1. Generation of Bees, Aphides, &c. 2. Reproduction of Medusa, Salpæ, and Entozoa 3. General Results III. On Disorders of the Cerebral Circulation, and on the Connection between Affections of the Brain and Diseases of the Heart. By George Burrows, M.D. 1. On the Circulation of the Brain 2. On Vascular Pressure within the Cranium 3. Connection of Apoplexy, &c., with Diseases of the Heart 4. Treatment of Apoplexy and Hemiplegia 5. Affection of the Brain in Pericarditis IV. I. De la Folie, considérée sous le point de vue Pathologique, Philosophique, & Par L. F. CALMEIL, D.M.P. II. An Act (8 and 9 Vic., c. 100) for the Regulation of the Care and Treatmen of Lunatics. Edited by G. FORBES WINSLOW, M.D. III. Observations and Essays on the Statistics of Insanity. By John Thurnam M.D. IV. The American Journal of Insanity V. A Letter to Lord Ashley, M.P. By W. B. COSTELLO, M.D. VI. Clinical Lectures on the Principal Forms of Insanity. By JOHN CONOLLY, M.D VII. Annual Report of the Managers of the New York State Lunatic Asylum By AMARIAH BRIGHAM, M.D. Druit's Vade Mecum, and quoted and taught in every medical school of the metropolis. We may instance the excellent lectures on Varicose Veins and Ulcers of the Legs, on Corns and Bunions, and on Mortification, which we will venture to say have already been more read in the journals than many works of greater pretension. We do not, however, make this remark as an objection to their publication in a collected form, for on the contrary, their popularity is the best proof that, in a corrected and enlarged form, they cannot fail to be acceptable to the profession. Besides these discourses originally addressed to the Students of St. George's Hospital, Sir Benjamin Brodie has also included two lectures, forming part of a course which he delivered as Professor of Anatomy and Surgery to the Royal College of Surgeons of England more than twenty years ago, and which had not been previously published. The two first lectures are introductory addresses to the students of the Medical School of St. George's Hospital. The first was delivered in 1838, and the second in 1843. These discourses are admirable. They convey in language terse, clear and precise, valuable advice, seasonable hints and useful directions-in fact, just such hints and just such directions as are wanted by the majority of young men on commencing their educational career. They place before the medical student the proper objects and true ends of his professional education, and whilst representing the real difficulties of his course, they offer every encouragement and every incentive which should stimulate a virtuous and honorable ambition. Sir B. Brodie knew well the rock on which the fortunes of many men of ardent minds are shipwrecked, when penning the following passage :— "Let it always be borne in mind that this last (whatever relates to Medical and Surgical treatment) is the real object which you have in view. I address you as future medical practitioners. If, taking another course, you choose to study anatomy and physiology, merely as interesting branches of human knowledge, you are at liberty to do so, and you will be as well rewarded for your labours as if you had applied yourselves to geology, optics, or astronomy. În like manner, if any one apply himself, as a philosopher, altogether to the study of pathology, he will find much in it that may interest himself, and that may be useful afterwards to those who carry their researches further. But as medical practitioners, you must not stop at either one or the other of these points; and, never losing sight of the ultimate object of all your investigations, you must estimate the value of whatever other knowledge you acquire by the degree in which you find it to be directly or indirectly applicable to the healing art." P. 4. There is not a school in London which cannot furnish examples of poor victims of science, who, little heeding this friendly warning, have blasted their prospects and disappointed the hopes of their friends by acquiring habits of study and tastes for pursuits which have thoroughly unfitted them for the business of life as practitioners. The second of these two addresses, on the duties and conduct of medical students and practitioners, is far superior to the first. When every page, indeed every sentence, in this Lecture contains some judicious counsel or valuable suggestion we feel at a loss to select passages to convey to our readers an adequate idea of its merits. We may quote the following observations on the disadvantages resulting from the neglect of education in early life : "One business of education is to impart knowledge; but another, and still 1846.] INTRODUCTORY ADDRESSES. more important one, is to train the intellectual faculties. To acquire the habit of fixing the attention on the object before you; of observing for yourselves; of thinking and reasoning accurately; of distinguishing at once that which is important from that which is trivial; all this must be accomplished in the early part of life, or it will not be accomplished at all. Nor is the same remark less applicable to qualities of another order; integrity and generosity of character; the disposition to sympathize with others; the power of commanding your own temper; of resisting your selfish instincts; and that self-respect, so important in every profession, but especially so in our own profession, which would prevent you from doing in secret what you would not do before all the world; these things are rarely acquired, except by those who have been careful to scrutinize and regulate their own conduct in the very outset of their career. P. 31. How encouraging, yet how just, are the author's reflections on the differences in the intellectual powers of competitors in the race of life. "With respect, however, to the last-mentioned subject, I have no doubt that the difference is not so great as you, or the world generally, may suppose it to be. There are few persons who have not some talent, which, if properly cultivated, may be turned to good account, and he who is deficient in one kind of talent may excel in another. But the greatest talents may be wasted. They may be blighted by indolence; they may be used for base or improper purposes; or they may be directed to too great a variety of objects. It is well indeed for you to have some diversity of study, so as to keep all your mental faculties in wholesome exercise; so that you may not be without some sympathies with those around you, and that you may avoid the evils of narrow-mindedness and prejudice; still, whoever would be really useful in the world, and be distinguished in it, must act to a great extent on the principle of concentration, keeping one object especially in view, and making his other pursuits subservient to it. And let no one sit down in despair and say, 'I have not the abilities of my neighbours, and it is needless for me to exert myself in competition with them.' If you would know what your own powers are you must try to use them. Industry is necessary to their development; and the faculties of the mind, like those of the body, go on improving by cultivation. It is impossible for you to form a right estimate of yourselves in early life, nor can you be rightly estimated by others. The self-sufficient, who do not keep before their eyes an ideal standard of perfection, who compare themselves only with those who are below them, will have an advantage with inexperienced and superficial observers; but I must say that I have never known any one to do any real good in the world, or obtain ultimately a bright reputation for himself, who did not begin life with a certain portion of humility. The greatest men are humble. Humility leads to the highest distinction, for it leads to self-improvement. It is the only foundation of a just self-confidence. Study your own characters; endeavour to learn, and to supply your own deficiencies; never assume to yourselves qualities which you do not possess; combine all this with energy and activity, and you cannot predicate of yourselves, nor can others predicate of you, at what point you may arrive at last." P. 35. Let the slave to the opinions of others, as well as the hunter after posthumous fame, remember "There is no profession in which it is more essential that those engaged in it should cultivate the talent of observing, thinking, and reasoning for themselves, than it is in ours. The best part of every man's knowledge is that which he has acquired for himself, and which he can only to a limited extent communicate to You will spend your lives in endeavouring to add to your stores of information; you will, from day to day, obtain a clearer and deeper insight into others. the phenomena of disease; you will die at last, and three-fourths of your knowledge will die with you; and then others will run the same course." P. 39. The young practitioner is told "He who has not a full sense of the responsibilities which it involves, is unfit for our profession; and the anxieties of a professional life are but a wholesome stimulus to diligence and exertion. I say this, supposing them to be kept within reasonable bounds. You may allow your thoughts to dwell on subjects of anxiety until an entirely opposite effect is produced, and life is rendered miserable, and the mind enervated. Such a morbid sensibility is as mischievous on the one hand, as a want of just sensibility is on the other. You must be careful to train the mind so that it may not fall into either of these extremes. Make every exertion to obtain knowledge, and to use it properly; and then keep it in your recollection that there are bounds to human knowledge, and to human powers; and that, in the exercise of our art, we cannot do all that is required of us; for, if we could, pain and misery would be banished from the world, man would be immortal, and the order of the universe would be disturbed. Do not begin life with expecting too much of it. No one can avoid his share of its anxieties and difficulties." P. 43. We cannot deny ourselves the pleasure of giving one more passage, the spirit and tendency of which exhibit the good sense and good feeling of the writer. "There are some employments which bring those who are engaged in them in contact more especially with the bad qualities of mankind, their pride, their arrogance, their selfishness, their want of principle. It is not so with your profession. All varieties of character will be thrown open to your view; but nevertheless, you will see on the whole the better side of human nature; much indeed of its weakness, much of its failings, much of what is wrong, but more of what is good, in it. Communicating, as you will probably do, with persons of all conditions, you will be led to estimate others according to their intrinsic qualities, and not according to those circumstances which are external to themselves. You will learn, that of the various classes of which society is composed, no one is pre-eminently good or pre-eminently bad; and that the difference is merely this, that the vices and virtues of one class are not exactly the vices and virtues of another. You will have little sympathy with those prejudices which separate different classes from each other; which cause the poor to look with suspicion on the rich, and the rich to look down upon the poor; and while you cannot fail to perceive the great advantages which education gives, you will acknowledge, that, to be well educated, is not the necessary result of having the opportunity of education; that a bad education is worse than none at all; and that what is called the uneducated classes present many examples, not only of the highest religious and moral principles, but of superior intellect, and of minds stored with valuable knowledge." P. 52. We need scarcely add that we strongly recommend the perusal of these addresses, especially of the second, to all medical students and young practitioners. The third Lecture is on the effects of Strangulation. Sir B. Brodie states "The mode of death from strangulation or hanging is sufficiently obvious. 1. The trachea is obstructed, so that air cannot enter the lungs. 2. The blood passing through the lungs does not undergo that change which respiration produces, and which is necessary to life. 3. Dark-coloured blood, which has not been purified by exposure to air, is transmitted to the left side of the heart, and |