advanced to that stage which constitutes consumption, the inhalation of air, at the temperature the doctor proposed, (about 65 Fahrenheit) uniformly accelerated the disease of the lungs, and by occasioning a distressing sensation of oppression and fainting, considerably aggravated his sufferings. As a preventive of consumption, it will, no doubt, operate beneficially; but when the substance of the lungs is diseased, the application of warm air to the internal surface is always injurious.

About ten years ago, the Doctor published a treatise on a species of cough, which he termed winter cough, because he had met with it only during the winter season: and, by a series of ingenious arguments, he endeavoured to prove, that, if there were no winter, there would be no winter cough. As a remedy for such cough, a warm atmosphere was, of course, highly extolled.-Unfortunately for the Doctor's hypothesis, those that are subject to this cough in winter, are also subject to it during very warm weather. The next and last communication the Doctor has made through the medium of the press, are, a few cases of diabetes, which we noticed in a late number. The Doctor, as a practitioner and general philosopher, is highly esteemed by his city connection; and from his intimacy with Dr. Babington, and other men of science, we cannot have a doubt of his possessing superior talents, and of his being a judicious practitioner.

PALSY.-Dr. Cooke, Fellow of the Royal College of Physicians, and late Physician to the London Hospital, has published the first part of the second volume of his Treatise on Nervous Diseases, which comprises the "History and Method of Cure of the various Species of Palsy." The species, most prevalent in this country, is palsy of one side of the body (hemiplegia). When this disease is the sequel of apoplexy, which is generally the case, the treatment differs only in degree to that recommended for apoplexy. With the view of preventing an accession of this species of palsy, Doctor Cooke recommends moderate, or, in some cases, low diet and gentle exercise, especially in the open air. "The exercise," he says, "ought to be such as may encourage perspiration, without heating the body, or hurrying the breathing, and this some mode of gestation will afford. For persons not liable to fits of giddiness, and who are accustomed to riding on horseback, this exercise is the best," Walking, with attention to the circumstances above mentioned, may be tried; but in old subjects, and in persons of corpulent habits, he advises bodily exercise to be very moderate.

"Where a predisposition to apoplexy is shewn in early life, it is probable," says Dr. Cooke, "that a low diet, with a good deal of exercise, might prevent the disease; but when persons become advanced in life, before they take precautions, and are, at the same time, of a corpulent habit, and accustomed to full living, it might not be safe to put them on a low diet, it may be sufficient to reduce their mode of living, especially with respect to animal food. All heating liquors should be avoided as much as former habits will allow, and the smallest approach to intoxication to be carefully shunned." He prefers small beer to water, the latter being more

likely to occasion costiveness, which in apoplectic habits should be carefully avoided. In the apprehension of a paralytic attack, the bowels should be kept regularly open, by the use of a gentle laxative medicine, and a discharge from the neighbourhood of the head excited and preserved by means of issues, blisters, or setons." Such discharges, the doctor considers a powerful preventive.

"On the supposition that palsy of one side of the body depends on partial pressure upon or within the brain, the object of practice is to remove or to lessen the compressing cause, which," says the doctor, "cannot be more rationally done than by blood-letting, purgatives, emetics, diaphoretics, and discharges by blisters, issues, and setons. With respect to the propriety of abstraction of blood, in this species of palsy, physicians, both antient and modern, greatly differ. The necessity of such a measure must solely depend on the constitution of the patient. If the disease be the consequence of apoplexy, and the patient be of a plethoric habit, and subject to giddiness, drowsiness, &c. evidently from an over distended state of the vessels of the head, the loss of blood is unquestionably proper. Mr. Hunter was of opinion, that in palsy of one side of the body, we ought to extract blood very copiously, especially from the temporal arteries; and Dr. Cooke's experience is in favour of blood-letting, when accompanied with strongly marked apoplectic predisposition, and, under such circumstances, he has never observed any mischief produced by it. He "once saw this species of palsy terminate in a fatal apoplexy, soon after a free evacuation of blood, in the case of a gentleman, seventy years of age, of a plethoric constitution, and free mode of living; yet," says he, "I am convinced, that bleeding, all circumstances considered, was, in this case, highly proper, and that by a still more copious evacuation of blood, the total abolition of sensation and motion might have been prevented." The Doctor has omitted to state from what vessel the blood was taken. We have lately met with two cases of this disease, which terminated fatally, a few hours after the abstraction of blood from the temporal arteries. On the impropriety of taking arterial blood from an elderly subject, in cases of apoplexy or palsy of one side, a communication appears, in a late number, from a physician of very extensive practice. When the patient is of a great age, of a debilitated leucophlegmatic habit, dropsical tendency, &c. the Doctor states, "I should think it right to abstain altogether from bleeding, and from every other powerful mode of depletion, unless there was an evident great determination of blood to the head, marked by flushing in the countenance, throbbing of the arteries, redness of the eyes, &c. In doubtful cases, which are very common, the Doctor recom mends topical bleeding, by leeches and cupping glasses, and to proceed as circumstances may direct, carefully watching, from time to time, the effects of the practice." Dr. Cooke, and all writers of medical experience, agree on the necessity of keeping the body open, with such aperients as the nature and circumstances of the case may indicate. When there is much determination of blood to the head, and the habit full, the Doctor recommends the neutral salts, as the Epsom, Glauber's, &c., but in debilitated, leucoplegmatic, or

dropsical habits, he advises a stimulating aperient, as aloes, calomel, scammony, &c. With respect to the use of an emetic in this disease, very opposite opinions exist. The French are very partial to the exhibition of this remedy; and in the treatment of this species of palsy, they place great dependence in it. When the disease follows apoplexy, especially in the beginning, in a plethoric habit, Dr. Cooke observes, "I should not venture to recommend an emetic." In regard to diaphoretics and diuretics, so much extolled by some practitioners, no dependance is now placed upon them; and the Doctor's experience will not justify a recommendation of them.

The antients, and many of the early moderns, certainly erred by a speedy and indiscriminate employment of stimulants in this species of palsy, under the supposition that it was a disease of debility. The stimulants which produce a determination of blood to the head are decidedly bad, as passions of the mind, electricity, and spirituous liquors. Those which occasion a determination to the bowels and extremities are, on the contrary, uniformly beneficial, as the internal use of capsicum, horse-radish, &c. Of the stimulants to be used externally, the Doctor recommends friction by the hand and flesh brush, as the most safe and efficacious. The most powerful external stimulant in such cases, is the mustard poultice.

Dr. Cooke has very judiciously collected the opinions of the most able of the antient and modern writers on the causes, prevention, eure, &c. of the palsy, the value of which he has greatly advanced by his own practical remarks. It is a production which we very seldom meet with on medicine-a "mullum in parvo," every page possessing its quantum of solid matter, or intrinsic worth, We can assure those of our readers who may be desirous to obtain further information of palsy of one side of the body, and of the other species, as palsy of the lower extremities, gutta serena, &c., that they will not be disappointed by a reference to this work. They will soon discover, that the object of the Doctor is to communicate valuable information, and not to enrich himself by making a book.

Since writing the above, we have received a letter from a medical Gentleman of great practical experience and ingenuity, in which he proposes the use of the trephine in desperate cases of apoplexy. When the effusion of blood is between the skull and dura mater, which is very seldom the case in apoplexy, immediate relief may be afforded by removing a portion of a parietal bone; and if it has taken place just between the pia mater, or between the two membranes, it may be evacuated by the lancet. If after the operation there should be no appearance of an effusion of blood, the opposite side should be treppined; for when a side of the body is evidently paralyzed, the effusion is sometimes in the opposite side of the head. When the effusion is deep seated, the removal of a greater proportion of the skull, by allowing of an expansion of the brain, would, no doubt, prolong the life of the patient, and give him a chance of recovery. Such a practice is only to be justified by the absolutely hopeless condition of the patient, which, after copious bleeding, blistering, purging, &c., in the course of two days, may be determined by his remaining in a state of insensibility, with

stertorious breathing, dilated pupils, involuntary escape of the fæces, urine, &c. &c. &c.

STONE IN THE BLADDER.-To Mr. Richard Smith, senior surgeon to the Bristol Infirmary, a practitioner of acute observation and extensive experience, the medical world is much indebted for an interesting statistical inquiry into the frequency of stone in the bladder. Of secondary calculus, four instances only have come to the knowledge of Mr. Smith; viz. a male and female at the Chester Infirmary, by the experienced Surgeon Rowland; a man at the Bristol Infirmary, by the late Mr. Lowe; and a lad from Wales. The late Mr. J. P. Noble operated on the son, and Mr. Smith on the daughter, from the same parents, which is the only instance with which Mr. Smith is acquainted, of more than one case in the same family, although his inquiries have been directed to the point, and many of the boys he has cut belonged to numerous families. At the Bristol Infirmary, during the last 82 years, there have been cut about 361 persons. From the divisions made by Mr. Smith, it appears, that the numbers have regularly diminished in a very remarkable degree, so that within the few last years, there are admitted into that Infirmary from three to four in two years, and formerly there have been six in one year. In London, at St. Bartholomew's, Guy's, and St. Thomas's hospitals, about 27 are cut annually. The failures here considerably exceed, in proportion, those at the Bristol Infirmary. It is a very curious fact, that at the Hereford Infirmary, not one case of stone in the bladder has occurred since the Infirmary was instituted, and the disease, we believe, has scarcely been known to happen in that county; the purity of the water, and the general use of cider, may be the cause. The disease, in proportion to the number of inhabitants, is most prevalent in Norfolk. In Scotland and Ireland it seldom occurs.

THE LONDON PHARMACOPOEIA.-A few weeks after the College of Physicians published a corrected edition of their pharmacopoeia, three translations appeared; one by Doctor Powel, with long notes, chiefly chemical, at the price of twelve shillings; one by Dr. Thornton, with a few notes, at four shillings and six pence; and one by ourselves, with a few medical notes, at the same price. Within the last two months, another translation has appeared, by Mr. Collier, an able chemist and surgeon of London, at the price of ten shillings and sixpence, so that the profession have now a greater choice of translations than they have had at any preceding period. The College of Physicians, on publishing a revision of their phamacopoeia, always appoint the gentleman who took the most active part in it, to publish a translation, who, as a means of remunerating him for his trouble, having the superintendance of the printing of the work, has the great advantage of bringing out the translation on the same day as the Latin edition. The pharmacopoeia, both in Latin and English, being considered the property of the College, no person ever ventured to publish a translation of the Latin edition, till the last revision appeared.

Mr. Collier has, for some years, devoted much of his time to the

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instruction of medical Tyros in the Latin language, and the departments of medicine, particularly chemistry and botany, so as to enable them to acquit themselves with credit before the court of examiners at Apothecaries' Hall. To effect this, in as short a period as possible, he undertook a literal translation of the pharmacopoeia, to put into their hands.-In the preface we find the following very just remarks.

"If we only reflect a moment on the routine of a country practitioner's education, we shall not much wonder at the shallowness of his classical attainments. A lad is taken from school at fourteen or sixteen, when he is considered by his sapient parents as a second Erasmus, that is, he shall be able in half an hour to construe a hundred lines of Horace, and ramble through a page of Homer with tolerable facility. He is immediately put in the trammels of a five years noviciate, and in those five years faithfully unlearns what he had learned the five years before. Whether what he learns by dispensing and spreading plaisters be equivalent to the loss of his classical knowledge, is to me a matter of doubt. However, he comes up to town with a full pocket and empty head, and too often returns with a vacuity in both.

"Then for his chemistry, he attends one or two courses of lectures, when his mind must necessarily be occupied with the studies of anatomy, physiology, practice of physic, surgery, &c. &c., and he runs from lecture-room to lecture-room, imbibing principles and hypotheses from one, which, in all probability, will be flatly contradicted in the next."

The late act of parliament for the better regulation of the practice of surgeon-apothecaries through England and Wales, renders a knowledge of Latin indispensable. The Court of Examiners complain of many pupils having appeared before them for examination, who were acquainted only with what is vulgarly termed Medical, or Dog Latin, and, also, ignorant of the rudiments of chemistry. It was in consequence of these complaints, that Mr. Collier undertook the office of giving lectures on chemistry, &c., and of instructing pupils in the Latin language.

On the many errors committed by the College, even in the corrected edition of their new Revision, Mr. Collier states, he did not consider himself authorised to animadvert, and expresses a hope that in. their next work they will be corrected.

The College of Physicians have been some time engaged in preparing a new Pharmacopoeia, which, from the well known abilities of those who are actively engaged in it, we may venture to predict that the work will be creditable to them. We are glad to find that they have determined to make very little alteration in the names of the chemical preparations.

Mr. Collier's translation is correct, and his chemical annotations are very judicious. The only objection we can discover to the work is, the high price he or his publishers have put on it. The retail price of a book, consisting of 230 pages, (octavo demy) with large type, should not exceed six shillings. The author's notes, however, add greatly to the value of the work.