"our unqualified approbation of the liberal and candid manner in "which Dr. H. speaks of those writers upon whose opinions and "observations he animadverts, and holding up his style as a model of IMITATION to all those who may engage in controversial "writing

66

"Doctor James Johnson, in his Medico-Chirurgical Review and Journal, a work now much looked up to, expresses himself as follows :— "We now come to the subject of Bronchitis; and here we take up the "work of Dr. Charles Hastings, a gentleman whose zeal and talents "will, we venture to prognosticate, do honour to the present æra of " pathological investigation, and contribute greatly to the progress of "the healing art." In closing this article he observes, "The numerous specimens of Doctor Hastings's work which we have laid before our "readers, cannot but have impressed them with a high opinion of its own merits, and its author's talents: it therefore needs no further re"commendation from us, as the importance of the subject, and the "ability with which it is treated by Dr. H., will speedily induce the "purchasers of select practical works to place the volume in their "library for reference as well as perusal."

"The Medical Repository, edited by Doctors Uwins and Shirley Palmer, and Mr. Gray, bears the following high testimony to the merits of this work :-" Dr. Hastings has proved himself by this performance an accurate pathologist, a judicious practitioner, and able writer. The young physician will, we can assure him, find more of truth than of 66 system in every page of this valuable work."

"

"The editors of the London Medical and Physical Journal introduce their observations by stating :"We had not perused many sentences "of the preface before we felt disposed to entertain some degree of "prejudice in favour of this work, the author so immediately indicates "the accurate and judicious views from which the greater part of it has originated." After enumerating the several varieties of the disease under consideration, and which are so accurately pointed out in the treatise, they proceed:-" The particular symptoms and most striking characteristics of these varieties are considered by the "author with much acumen. Many practitioners affect to despise “such nice distinctions of the varieties of a disease, but it is the know"ledge and application of these that make the difference between a good " and bad practitioner. As favouring considerably these indications the "work of Dr. Hastings must be considered an addition of considerable "value to medical literature, even did it possess no other merit." The following is their concluding observation: "We have given a sufficient "exposition of the pathological part of this work, to shew that our preju"dice in its favour was well founded; and we have no doubt but that "it will be generally referred to, by medical practitioners, as the source " of much clinical information."

"It is not pretended that there is no shade of difference between some of the opinions advanced by Dr. Hastings and those of his reviewers: there is too much original matter in the work to admit a perfect agreement without the fullest discussion; and every one knows that every thing savouring of novelty ought to be very cautiously admitted in medicine: SELDOM, however, has a work issued from the press so GENERALLY ap

proved or which has offered so little scope for JUST censure. Whether the assiduity with which the uncandid remarks complained of have been circulated here, has arisen PURELY from a regard to science, your READERS will determine for themselves. I am, Sir, your's, &c.

Worcester, Feb. 24, 1821.

J. R."

How partial extracts from other journals can be consistent with the "views of just criticism" we are at a loss to conjecture. "Uninformed," indeed, must that reader be who would suppose that such partial extracts can amount to a refutation of our practical objections to certain theories and practice; and "uninformed" must that individual be of the traffic of book-making and the trade of reviewing, who is led by such quotations to suppose that Dr. Hastings is the medical luminary, his reviewers represent him to be, or that such opinions are worthy of notice, although coming, as the Doctor or his friend states, "from the first medical writers of the present day"!!! Now the proprietors of the medical journals in general are booksellers, who but too frequently engage in their service young men to write for them, who, unacquainted with practice, are, of course, very competent judges of the practical merits of a Dissertation on the Causes, Treatment, &c. of a Disease. Through the interest of this class of experienced scribblers, or as they are termed experienced WRITERS, the most contemptible productions have been highly praised. The Edinburgh Medical and Surgical Journal, the property of Messrs. Constable and Co. booksellers, of Edinburgh, was, and we believe still is, edited by Dr. Duncan, jun. a physician well qualified to decide on the merit of medical works in general, but it must be very evident to every practitioner, that all the criticisms which appear in that Journal were not written by him. Published in the first medical school in the world, and edited as it is by a physician, who in point of science and experience is a prominent character in it, its pages should not be disgraced or its readers insulted with partial or unscientific criticisms. If the criticism from which Dr. H. or his friend has given so flattering a quotation, (to a man of genuine science very gratifying) were written by Dr. Duncan, we beg to ask him, what part of the dissertation on the contractility of the blood vessels gained him such great reputation? We never heard of the light it has thrown on this subject, and as to the assertion, that he has "established incontrovertibly that a considerable share of irritability is possessed by the blood vessels in every part of the system," we never met with such ridiculous nonsense in the works of Doctor Solomon, or even of Mrs. Johnson, who sometimes favours us with a little flight of fancy in great verbose splendour. We beg to ask Dr. Duncan, jun. in what century, either subsequent or anterior to the time of Hippocrates, the blood vessels were supposed not to possess a degree of irritability and contractility, and what additional light Dr. Hastings has thrown on this subject? The Doctor's scientific experiments after such a panegyric are entitled to some notice, and this they shall have in our next number. That the Medico-chirurgical Review and Journal by Doctor James Johnson" is much looked up to," we allow to be true, but by whom? The back numbers of this gentleman's labours have been long on the uppermost shelf, to which books of little demand are exalted by publishers, and this shelf retailers of bacon and butter "look up to" regularly every week

for waste paper. Now, were not Dr. Hastings and Dr. Philip advertised patrons of this said "much looked up to Journal," we should really have thought that Dr. James Johnson, who is often in a funny mood, was quizzing his friend Dr. Hastings. To recommend the Doctor's work to the attention of purchasers of "select PRACTICAL Works," must certainly be most gratifying to his feelings as an author, and beneficial to the interest of the publishers. That Dr. Uwins, one of the editors of the Medical Repository (the property of Mr. Underwood, a bookseller) is a competent judge of the merits of a medical production, no practitioner of observation and experience, acquainted with his writings, will deny; but that he should pronounce Dr. Hastings, from his work, "an accurate pathologist, a judicious practitioner and able writer," we cannot prevail on ourselves to believe. The case is, Dr. James Johnson, the friend of Dr. Philip, is connected with the said Repository. The leading editor of the Medical and Physical Journal (the property of Mr. Souter, a bookseller), Dr. Hutchinson, being a firm friend to science, and a physician of great integrity, we suspect the friendly review of Dr. Hastings's work crept into that Journal without his knowledge. It is very easy for a reviewer to compliment an author for his acumen and for his valuable practical observations, but we defy any of the puffers of Dr. Hastings's work to point out one novel idea of the smallest practical utility. By praising a work which possesses no merit whatever, Dr. Duncan, jun. and other medical reviewers, should be aware that they do the community considerable injury by checking the progress of the science of medicine. Dr. Duncan, jun. and his colleagues should also be aware that friendly reviews, or partiality to the works of their pupils, or of the graduates of Edinburgh, lessen the respectability of a Journal in the opinion of men of science. Reviewers should be independent of booksellers. As long as reviews are the property of booksellers, this is not likely to be the case. A subscriber at Worcester, under the signature of " Vindicator," accuses us of " having permitted the sentiments of a practitioner in that city (an opponent of Dr. Hastings), to have prejudiced our minds against Dr. Hastings's work." We are totally unacquainted with the sentiments of Dr. Hastings's opponent respecting him or his work, and we have had no kind of communication with any person on the subject. Our remarks on the work are purely practical, and in making them, we had no other object in view than the promotion of medical science. If Doctor Hastings supposes that our observations are not correct, we are very willing to refer them to any practitioner of experience and judgment; we suspect he will not dare to risk such a reference. Vindicator also accuses us of great inconsistency in having spoken favourably of Dr. Philip's experiments in one number, and unfavourably in another. The results of the Doctor's experiments appearing to throw some light on the office of particular nerves in the animal economy, we spoke in high terms of approbation of them, supposing that his detail of the results was correct, and had they been so, the profession and the community would have been greatly indebted to him for his "experimental inquiries." The repetition of the experiments by Mr. Brodie, although not conducted exactly in the same manner, being attended with different results, induced many scientific characters to doubt the accuracy of Dr. Philip's reports. The late expe

riments of Mr. Broughton, a surgeon of sound judgment and accurate observation, have most satisfactorily settled the question, probably, for ever, they having been uniformly productive of results different to those which were published by Dr. Philip!! Now, if Dr. Hastings's theories are founded on Dr. Philip's experiments, can they be entitled to any attention?

CUPPING.-By this operation, in consequence of the blood escaping from veins and arteries, a greater quantity may be abstracted without producing fainting, or the debilitating effects, which frequently follow the loss of a few ounces from a vein or an artery. Another advantage attendant on it, is the speedy production of a degree of irritation, which often produces as effectual a derivation as that excited by a blister. In inflaminatory affections of the head, chest, or abdomen, many physicians, therefore, give cupping a decided preference to bleeding, either from a vein or an artery. Simple as this operation appears to be, not one surgeon in a thousand can perform it with the adroitness of those who devote their time to it, termed cuppers. We have seen surgeons of this metropolis, fail in extracting an ounce of blood from a part, from which a cupper, in a few minutes afterwards, took twelve ounces with great facility. Mr. Mapleson, the most expert and scientific cupper of this metropolis, has just published an improved edition of his "Treatise on the Art of Cupping," in which he gives the following instructions for conducting the operation.

"The first step in the operation of cupping is to produce a partial vacuum over one or more portions of the surface of the skin. This purpose, as has been already stated, was formerly effected by sucking the air out of a hollow gourd or cucurbit, by the application of the mouth, or expelling it from a similarly shaped metallic vessel, by the introduction of a portion of flaming flax. The invention of glass has for many years wholly superseded these contrivances; and glass cups are now universally used for the purpose of exhaustion, as being neat, cleanly, and light, permitting also the colour and quantity of blood to be judged of, as it flows from the wounds. For the purpose of exhausting the contained air, these are occasionally made with brass caps and valves, and fitted up with a small syringe of the same metal. To this plan there are two objections: 1st, the exhaustion is apt to be carried too far, which, instead of promoting, tends to obstruct the flow of blood; 2dly, the operation is rendered extremely tedious and fatiguing, both to the patient and the operator; besides, the glasses are very apt to be broken, and the valves to lose their elasticity.

"The air contained in the glass may also be rarefied by steam; but the mode now, I believe, universally adopted by regular cuppers, is the momentary introduction of the flame of a spirit lamp, with a thick wick; the larger the glass, (if properly exhausted,) the less pain does the patient suffer, and the more freely does the blood flow,

"When about to perform the operation, let there be provided a hand basin with warm water, a piece of fine sponge, and a lighted candle. Place as many glasses in the basin as may be judged requisite to obtain the quantity of blood intended to be taken away. If sixteen or twenty ounces are ordered, four glasses, of a size adapted to the surface, will in most cases be required. Each glass is then separately to be held, for an instant, over the flame of the spirit lamp, and immediately placed upon the skin of the patient. Upon the quickness with which this is effected, depends the whole neatness and efficacy. of the operation.-To obviate their want of dexterity, many operators in the

country throw a little bit of tow or paper, dipped in spirits and inflamed, into the cupping glass, the moment before it is applied,-a very clumsy expedient, often adding unnecessarily to the sufferings of the patient by cauterizing the skin; doing harm also by rarefying the air more than necessa within the glass; in consequence of which the edges of the cup compress the cutaneous vessels so much as to obstruct the influx of the blood.

"If the glasses have been duly exhausted, the skin will be seen gradually to swell up within the cup, owing to the pressure of the air upon the parts in the vicinity, as well as the expansion of the fluids contained in the cellular rembrane. The skin becomes also of a dark purple colour, owing to the influx of blood into the smaller vessels. If dry cupping be only intended, the glasses may be allowed to remain on the skin for a few moments, and replaced five or six times, varying their position a little, to prevent bruising the skin.-If the intention be to scarify and take away blood, the glass ought not to remain more than a minute, when it is to be removed by gently introducing the nail of the fore-finger under the edge, and the scarificator instantly applied, and the lancets discharged upon the skin, before the tumour has had time to subside: Upon the rapidity or slowness with which the application of the scarificator succeeds the removal of the glass, depends all the sufferings of the patient. If the skin has completely subsided before the stroke of the lancets, much unnecessary pain is inflicted.

"The glasses are thus to be removed and re-applied successively. They should be a second time removed, if necessary, as soon as the blood is perceived to coagulate within them, or when they are so full as to be in danger of dropping off. For the sake of neatness, care should be taken to insert the nail under the upper part of the glass, and open them downwards, gently wiping the wounds at the same time with a warm moist sponge.

"The glasses, previous to every application, should be rinsed in the warm water, but not dried. To obviate the unpleasant sensation produced by the coldness of the metal, it is advisable to pass the instrument for a moment over the flame of the lamp before using it.

"To ascertain the precise quantity of blood-a circumstance generally interesting to all parties concerned--the contents of the cups should be emptied into a graduated glass measure, with which the operator should always be provided.

"When the operation is finished, it is common to apply a piece of fine linen rag to the wounds; but if the patient does not object to a little smarting, either arquebusade water, or spirits of wine, is a preferable application, as it immediately stops the oozing of the blood, promotes the healing of the wounds, and prevents the subsequent itching, which I have heard some patients complain of, as the most unpleasant part of the operation.

"In some gross and inflammatory habits I have seen slight suppuration of the wounds made by the scarificator, but never any case that might not be healed by the application of a little of the common wax ointment.

"It is a common error to make the incisions too deep, especially if the object be to take away much blood; being convinced nothing is gained by going deeper than the cutis, or true skin, while an unnecessary increase of pain is caused to the patient.

"The quantity of blood obtained (in most cases) depends wholly upon the due exhaustion and proper application of the glasses, to attain expertness in which requires some practice and experience. In cupping upon the back or neck, the glasses should never be placed upon the spine itself, which produces unnecessary pain, but on each side of it. If it can possibly be avoided, the glasses should not be applied to parts where the skin is in immediate contact with the subjacent bones or ligaments; though, if care be taken to apply the