and boiled; and it requires some argument to pursuade them that we are in earnest when we tell them actually to reverse their proceed- . ings, and to betake themselves to those very articles which they reject as "dressed dishes." In estimating the dietetical qualities of different kinds of food, too much consideration is given to the kind of meat which may be used, and too little attention is paid to the mechanical condition in which it is served. This may in great measure be left to choice, provided the form of preparation be appropriate. In order to point out the appropriate form, it is not necessary that the physician should be an adept in cookery. Unless his patient be very unintelligent, it will commonly be enough to lay down the general rule that whatever approaches nearest to the soft solid consistence will answer best. Minced meats of different kinds, which may be varied in many forms, from the homely "minced collops" of Scotland to the more recondite performances which constitute the side dishes at every dinner party, sweetbreads, white fish, &c., make up a diettable in which there is ample room for selection, and by which the interest of the stomach and the pleasing of the palate may easily be reconciled. It has often been urged upon me in reply to such recommendations, that they require for their accomplishment a better cook, and infer a more expensive style of housekeeping, than the patient's establishment affords. This, I am very sure, is a complete mistake, for I know that, when duly insisted on, all that is requisite can be obtained in families of the most moderate means and humble pretensions. Lehmann, in commenting on the much more frequent observation of oxalate of lime in the urine, in England than on the continent, ascribes it to the larger average density of the urine in England than in Germany or France, the oxalate being more rapidly deposited from a concentrated than an aqueous urine, and this higher density he accounts for chiefly by the assumed fact that much more animal food is eaten in England than in the other countries. "From statistical data it appears that any given number of Londoners eat six times as much animal food as an equal number of Parisians." But it appears to me that a better explanation can be found than in the mere proportions of animal and vegetable food consumed. Vegetable substances are not a whit less likely to furnish oxalic acid, where the dyspepsia exists, than animal food. On the contrary, many vegetables, such as sorrel, much used in France, it is well known, absolutely send oxalate of lime into the urine without giving rise to any ailment, because they contain the oxalic acid ready formed. The reason why oxalic urine has been more observed in this country is, that the dyspepsia which causes it to be looked for is more frequent, and I believe that this is rather to be ascribed to the national addiction to solid masses of meat than to any sixfold carnivorous propensity. The nearer we approach to French cookery the less I believe shall we encounter this form of urinary deposit.Monthly Journal of Medical Science, Dec. 1853, p. 473.

71.-ON THE TREATMENT OF OXALURIA.

By DR. JAMES GRAY, Glasgow.

[The terms oxaluria and oxalic acid diathesis are now well understood to mean that morbid state of the digestive and assimilative functions in which oxalic acid is eliminated by the kidney in combination with urine. It is by no means an uncommon complaint. The prevailing forms of the crystals are the octohedral and the dumb-bell. It is at present believed that the former consists of the oxalate, and the latter of the oxalurate, of lime; and this is likely, because therapeutic agents do not act alike in both cases. Dr. Gray, in this paper, endeavours to show the value of the nitrate of silver in cases where the dumb-bell form is present.]

Case 1.-James Fleck, aged 48, of a melancholic temperament, married, by trade a cooper; came under my care on the 3rd of Aug. 1851, complaining of intense pain in the epigastric region, so severe as to render him wholly unfit for his work. He attributes the first of his present illness to a debauch about three years ago, up to which time his general health had been good.

When I saw him he had a very haggard and emaciated appearance ; skin of a greenish-yellow colour, tongue red, pulse regular, but weak. Complains of excruciating pain in the region of the stomach, both before and after taking food. This pain comes on in paroxysms, and is frequently attended with vomiting; the matter vomited has a dark grumous appearance, During the paroxysm the skin is cold and bedewed with moisture. Bowels confined, fæces of a dark colour; has occasional pains over the renal region. To take a mild aperient, and a wine glassful of calumba infusion thrice daily.

5th. No change for the better, pain still as severe. Is greatly depressed, and under the impression that he is consumptive and dying. This morning's urine has a dark amber colour, acid, specific gravity 1030, contains a large excess of urea; under the microscope, numerous octohedral crystals of the oxalate of lime, mixed with epithelial scales in great numbers, are visible. To have a nutritious diet, to abstain from spirituous liquors, to sponge the body every morning with tepid water, and to take a teaspoonful of the following mixture every six hours;-Tincture of calumba, Zij; nitric acid and muriatic acid ăă 3ss.

8th. Greatly improved in appearance. He is now quite free from pain, is in better spirits, and takes his food with greater relish.

He went to the country shortly after this, and returned to his work about the beginning of November perfectly well.

On the 15th of Feb. following, he returned to me with all his former symptoms aggravated; which he attributed to irregularity in diet and exposure to cold. On examining the urine it was found to contain the oxalate of lime in dumb-bell crystals.

He was ordered to take a mild aperient, and the acidulated tincture of calumba as before.

18th Feb. Bowels freely moved, no improvement, passed a very bad night. Ten drops wine of colchicum every six hours, and grain sulphate of zinc, night and morning.

22nd. Much the same, is evidently weaker and more emaciated, can take no food, greatly depressed in spirits. One grain nitrate of silver every six hours.

24th. Felt greatly relieved after taking the first dose of the nitrate of silver, is now improved in appearance. The paroxysms are less frequent and not so severe. This morning's urine contains the oxalate of lime in octohedral and dumb-bell crystals. Continue the nitrate of silver ingrain doses; a teaspoonful of the acidulated tincture of calumba night and morning,

March 3rd. Decidedly improved. The dumb-bell crystals have disappeared from the urine. Omit the nitrate of silver and continue the

mixture.

April 10th. No trace of the oxalate of lime in the urine. He feels quite well, and has again resumed his work.

On the 3rd of Dec. last I was called to see him. I found him in bed, perfectly prostrated, with a small thready pulse, weak tremulous voice, skin cold and clammy, features contracted, countenance expressive of intense pain, low moaning, tossing of the arms, breathing slow, tongue white and coated. I learned that while at work this morning the pain had returned, and that he was induced by a fellow-workman to take two glasses of whisky, which increased the pain and brought on vomiting. Sinapism to the epigastric region, warm drinks, and bottles of hot water round the body.

The urine, on examination, was found to contain myriads of dumbbell shaped crystals of the oxalate of lime, mixed with uric acid. Nitrate of silver in grain doses every four hours.

4th. Pulse fuller, no decided improvement in the other symptoms. 7th. Has improved greatly. The pain has now all but left him. Continue the nitrate of silver in grain doses three times a-day.

On the 14th he went to the country, and returned to his work on the 27th. Up to this time he continues well.

Case 2.-On the 29th of April, 1852, I was consulted by J. R., aged 23, of a nervous temperament. He has been ailing more or less for the last nine months. Complains of pain and difficulty in swallowing, harassing cough, with roughness at the upper part of the larynx. When the cough is severe, the expectoration is tinged with blood: no appetite, bowels constipated, great weakness and emaciation, tonsils enlarged, and fauces considerably inflamed, tongue slightly coated. Percussion elicits a normal sound over the whole chest.

A strong solution of the nitrate of silver was applied to the upper part of the larynx and fauces, and he was ordered a mild laxative. 30th. The urine contains an excess of urea, and oxalate of lime in

octohedral crystals.

A teaspoonful of the acidulated tincture o calumba three times a-day,

He went to the country shortly after this, and returned about th beginning of June, so much improved as to be able to resume hi duties. No trace of the oxalate could be detected after his return and with the exception of a few days' confinement to his room from an attack of "cynanche tonsillaris," he has since then enjoyed goo health.

Case 3.-J. M'Intosh, aged 25, ship cooper, came under my care o the 2nd Jan. 1852. From his history it appears that when at George town, Demerara, he was very irregular and intemperate in his habits that on the voyage home he was attacked with sickness, vomiting headache, and loss of appetite, by which he was greatly reduced in strength, and confined to his berth for the greater part of the voyage and since his return on the 18th of Nov. 1851, he has been confine to bed.

Complains of great feebleness, and of daily becoming weaker. The countenance is wan, and expressive of great anxiety. Tongue coate posteriorly, red at the point and edges; has no desire for food, and what he does take is often rejected, bowels loose, severe spasmodi cough, respiratory murmur healthy; profuse perspiration, particularly at night, and after awakening from sleep; pulse 120, weak and small heart's action normal, urine of a dark amber colour, density 1035 contains oxalate of lime in octohedral crystals, with a large quantity of the urate of ammonia. A mild nutritious diet, tepid sponging night and morning, a tea spoonful of the acidulated tincture of calumba every four hours.

Under this course of treatment he continued to improve daily About the 1st of Feb. he went for a few weeks to the country; on hi return no trace of the oxalate of lime could be detected. Since ther he has enjoyed good health.

Case 4.-John Anderson, aged 34, nervous temperament, by trade a cabinet-maker, consulted me on the 6th of July, 1852, for what he conceived to be an affection of the stomach. He informed me that about the middle of April preceding he began to lose his appetite, hac slight pain in, and distension of the stomach, frequently accompanied by heartburn, palpitation of the heart, and pain in the loins. Wher he called on me in July these symptoms were considerably aggravated his pulse was 84, strong and full, the slightest excitement caused palpitation of the heart, and severe headache. He has no appetite for food, which when taken causes pain in the stomach, flatulence, and sometimes vomiting. Bowels confined, urine of a pale yellow colour, specific gravity 1042, contains oxalate of lime in octohedral and dumbbell shaped crystals; a small quantity of urate of ammonia and epithelial scales. Acidulated tinct. of calumba every four hours, a grain of nitrate of silver night and morning, tepid bath, and to abstain from vegetable food.

He continued this course of treatment for five weeks, when the oxalate of lime entirely disappeared from the urine, the specific gravity fell to 1020, and he felt quite well. Since then I have not seen him.

Case 5.-On the 13th Jan. 1853, I was consulted in the case of J. M., aged 43, melancholic temperament. From his history it appears that in Jan. 1852, he had an attack of jaundice, accompanied by vomiting and pain in the stomach. The jaundiced appearance disappeared about the beginning of April, the vomiting and pain in the stomach, however, continued, but in a modified degree; towards the end of April a small tumour made its appearance in the epigastric region. Up to this date he has been gradually getting weaker and more emaciated, and for several weeks back he has been unable to leave his bed.

When I first saw him his complexion was of a dark yellow hue, and emaciation very great. He complains of intense pain in the stomach, which comes on in paroxysms, and generally causes sickness and vomiting, after which he experiences partial relief; the matter ejected has a dark coffee colour. Tongue coated posteriorly, and red at the point; bowels confined; pulse 106, small and weak, breathing slow but regular; has occasionally a pain in the loins, and along the anterior and inner side of the thighs and legs. On examination I found a tumour extending from the scrobiculus cordis downwards, to the extent of five inches, and on either side of the linea alba three inches. For several nights back he has been very restless, and unable to procure sleep. This morning's urine has a dark brown colour, specific gravity 1038, it contains mucus, epithelial scales, urate of ammonia, and oxalate of lime in dumb-bell crystals. Nitrate of silver ingrain doses every six hours, friction to the skin, and light nutritious food.

19th. Can now retain his food, looks more cheerful, the abdominal tumour is considerably reduced in size, the urine is not so high in colour or density, still contains oxalate of lime.

27th. The abdominal tumour has entirely disappeared, which seems to have depended upon spasmodic contraction of the upper division of the rectus abdominis, feels stronger, and is able to take his food with relish.

Feb. 14th. The oxalate of lime has entirely disappeared, he is now able to take a little exercise. Continue the nitrate of silver, night and morning.

On the 22nd he went to the country, where he still remains. When I last heard from him (on May 4th), his general health had greatly improved, and he felt nearly as strong as before his first illness.

Remarks.-1. From the history of these cases it will be observed that the most prominent symptoms were the epigastric pain, vomiting, and emaciation; indeed the emaciation in the first and last cases was so great as to resemble the emaciation in the last stage of schir