English authors to M. Boudin for perusal-especially Sir James Clark's work on Climate. He will there find that his theoretical views are not borne out altogether by facts. We do not say this testily, but with a kindly feeling, and a wish that M. Boudin will continue to work at his problem, for we are sure there is something in it, although not that which he anticipates. We apply this remark as well to the supposed antagonism of marsh and typhoid fevers, as of marsh fevers and phthisis.

ART. XX.

The Vital Statistics of Glasgow for 1843 and 1844. Drawn up, &c. &c., by ALEXANDER WATT, LL.D., City Statist.-Glasgow, 1846. pp. 148. We noticed on a former occasion the valuable series of contributions to Vital Statistics, which emanated from the diligent pen of Dr. Watts, and of which the present is a constituent portion. It is not possible to notice here the sixty tables which Dr. Watt presents to the public in his closely-packed pamphlet; we must, therefore, refer the statist to the publication itself for details. Amongst the most interesting of these tables is a series exhibiting the fact, that there are specific laws which regulate the amount of deaths at different ages by the several diseases. These tables, Dr. Watt thinks, seem clearly to prove that, cæteris paribus, the mortality at different ages is uniformly in certain proportions to the amount of deaths by each disease respectively. To ascertain the precise effects of these laws, and the causes that may be brought into operation to produce a variation in their results, is, as Dr. Watt observes, of much importance, both for forwarding the science of vital statistics, and in the acquirement of a proper knowledge of the best modes of medical treatment, as well as for the advantages they must afford in coming to a correct estimate of the relative social conditions of the people of various localities. Illustrations in a tabular form of the operation of these laws are presented by Dr. Watt, derived from the Annual Reports of the RegistrarGeneral. One of these tables shows, that although there was nearly double the amount of deaths by measles during the year 1840, in twentyfour town districts selected for comparison with the metropolis, than there was in the latter during the year 1842, the proportions at the same age are remarkably approximative. The difference under one year is 3.39 per cent.; this is the greatest, and it gradually becomes less at the higher ages. Under three years the difference is only 0.82 per cent.; under five years it is 0.58 per cent.; and under and above twenty years the difference is only 0.10 per cent. Scarlatina presents a similar proportionate mortality.

The causes of excessive mortality are considered by Dr. Watt, and in doing this he takes an opportunity to remark upon some critical observations we thought it expedient to make on some of his deductions in the report preceding this. It is gratifying to us to find that Dr. Watt appreciates our "spirit of fairness ". -a spirit, we take leave to say, by no means foreign to the pages of this Journal-and that he acknowledges our competency to deal with the subject. On a careful perusal of Dr. Watt's statements, we do not feel it necessary to withdraw or modify the juste milieu opinions we then expressed. We stated it as our opinion

(No. XXXVI, p. 512) that much of the controversy respecting the causal relations of poverty to fever has originated partly in an indeterminate use of words, partly in misconceptions. We do not deny that the want of sufficient nutriment will render a person more liable to be attacked by fever, and will render the attack more severe, and more probably fatal. That is a point in pathology on which we could hardly imagine there were two opinions; and we hold also that the want of proper ventilation of the dwellings of the poor (so lamentably manifest) will increase the liability to, and add to, the mortality from fever. On this point we do not apprehend a dissentient voice. We are, however, most decidedly of opinion that the miasm arising from the extended cesspools of our large towns, termed sewers, and from open drains, when heat favours the decomposition of the animal and vegetable remains which they contain, will have two principal effects. Firstly, it will give increased virulency to any epidemic whatsoever that may be prevalent, whether it be measles, cholera, or typhus fever; and, secondly, it may so modify some of the ordinary epidemics that a new form or species of epidemic may arise. Thus a malignant remittent may be changed into a species of plague, as in some nautical epidemics, whether this modification occurs directly-simply by the reception of the miasm or whether it be a new ferment generated by the miasm in a person whose blood is already contaminated by breathing the miasmatic atmosphere, may admit of question. The result of our investigations is, that it may and does occur in both ways. From some incidental remarks made by Dr. Watt, we should think he is not "well up" in the pathology of epidemical diseases, and that his sources of information are not such as to afford him large and comprehensive views on the subject.

The citizens of Glasgow must, however, feel much indebted to their city statist; and it is to be hoped that they will co-operate with the citizens of other large cities and towns of Scotland in a demand for an extension of the English system of registration to their own country. At present much of the labour expended by Dr. Watt on his tables is rendered effete by the want of the statistics of births, and of more exact and comprehensive nosology in the registration of the causes of death. When we find such entries as "bowel hives," "bloody flux," "shortness of breath," &c., among the causes of death, we cannot but attach much uncertainty to the pathological statistics derived from so questionable a source.

ART. XXI.

Essai sur les Tumeurs Solides Intra-Thoraciques. Par J. M. H. GINTRAC, Thèses de Paris, Janv. 1845.

Essay on Solid Intra-Thoracic Tumours. By J. M. H. GINTRAC, &c. &c. 4to, pp. 67.

In this Essay, such tumours as are formed within the walls of the chest, and yet without the proper structure of the organs that cavity contains, are treated of. The author has succeeded in collecting thirty-two cases of the kind. The nature of the material composing the new growth in these cases varied, being encephaloid, scirrhous, tuberculous, steatomatous, &c. This variety of component material he does not regard as a fair ground

for separating the cases, because various kinds of structure sometimes appear in one and the same tumour, because the distinctions between these various kinds of structure are not always clearly defined, and because their local effects and ultimate influence are frequently similar. Hence the only division adopted by the author is one of situation as follows: 1, tumours developed in the pleurae; 2, outside the pleural sacs, either between the lung and pleura, the ribs and pleura, or in the mediastina; 3, tumours connected with the bones of the thorax.

Passing over the narratives of the cases, transcribed (with one exception) from various published works, we reach the writer's general considerations on these growths.

In respect of causes, we learn that these productions are rare in infancy, youth, and old age; most common in adult age. There were nineteen men for nine women. The disease occurred in persons of all varieties of constitution, profession, and previous health; local injury appeared in a few instances, as did also some general causes, to have determined or accelerated the outbreak of the disease.

The analysis of the symptoms includes dyspnoea (the most constant of all); cough, which was common; expectoration, variable in nature or amount; and pain of the thorax, varying in character and in exact site. Inspection of the thorax sometimes discovered tumour protruding externally. "Percussion was in general dull in the regions where the tumours were seated. Auscultation disclosed absence or diminution of the respiratory murmur on the affected side. Mucous or crepitant râles have been observed, and in a case of sub-sternal tumour, the souffle cataire' was heard." This is absolutely the total amount of what is said on the subject of physical signs! We cannot avoid contrasting this ludicrously meagre notice of this most important branch of the author's subject with the minute and elaborate investigations and descriptions of these same physical signs by Dr. Walshe, in the sections on Cancer of the Lungs and Mediastina, in his recent work. While those sections furnish manifest proofs that the number and variety of physical signs is greater in cases of intra-thoracic tumour than of almost any other affection of the respiratory organs, they supply pleasing evidence of the superior advancement of our countrymen in sound acquaintance with this class of diseases.

Palpitation of the heart existed in some cases, attended in one instance with blowing murmur; the heart was pushed to the right or left, according to the seat of the tumour. The pulse varied in character. The face was sometimes flushed or livid; in other cases pale or infiltrated. The lower, and sometimes the upper, limbs were adematous; the œsophagus, diaphragm, stomach, and liver, underwent pressure in various cases;-hence dysphagia, hiccup, vomiting, swelling of the hypochondria, and jaundice. The appetite held good till an advanced period; the state of the bowels

varied.

The course of the disease, though generally equable, was sometimes intermittent. Its duration was scarcely capable of being calculated; death sometimes occurred suddenly.

There is nothing worthy of particular notice in the writer's observations on the diagnosis.

In the hope of effecting the resolution of intra-thoracic tumours, the

author recommends a local discharge to be kept up by caustic issues. He would wish an abundant suppuration produced by the successive production of eschars in various parts of the chest. We doubt exceedingly the value of such applications as curative agents: it is probable they might relieve the dyspnoea and pain, if made to act very energetically; but it would then become a question (and in our minds the question should at once be answered in the affirmative) whether the remedy were not worse than the disease. The iodide of potassium is recommended, more solito -still we believe that something in the way of suspended progress may fairly be hoped for from the action of iodine well managed, and given internally and applied externally. The extracts of conium, hyoscyamus, belladonna, and aconite are thought worthy of trial by the writer. Bloodletting may be required for the relief of urgent dyspnea and symptoms of congestion of various parts and organs; but the writer correctly insists on the importance of being cautious with the lancet: a symptom may be relieved by its use, but the activity of the main disease certainly does not seem to undergo (and why should it?) the very slightest favorable modification by abstraction of blood, local or general. The author seems an advocate of the cura famis, but he is not one of the ultra starvationists. It must be a strong faith indeed in the powers of starvation as a remedial agent, which would induce the physician to deprive of food the wretched sufferer, whose appetite is unimpaired, and who, having little but his own woes and apprehended death to dwell upon, turns to the comfort of satisfying hunger as his sole earthly indulgence,-as to the "dernier fil auquel tient le bonheur d'exister." Probably M. Gintrac has not yet treated many such cases as these; when the sufferers become his patients, he will, we predict, find some difficulty in enforcing the cura famis.

ART. XXII.

Die Nervenkraft im Sinne der Wissenschaft gegenüber dem Blutleben in der Natur. Rudiment einer naturgemässern Physiologie, Pathologie und Therapie des Nervensystems. Von Dr. CARL JOS. HEIDLER, &c. -Braunschweig, 1845.

The Nervous Power of Science versus the Blood-life of Nature. A Fragment of a natural Physiology, Pathology, &c. of the Nervous System. By Dr. C. J. HEIDLER, Imperial Austrian Councillor, Senior Official Physician to the Baths at Marienbad, &c.-Brunswick, 1845. 8vo, pp. 392.

THE regular current of sciential progress is broken at intervals by some queer-shaped rock or uncouth apparition which rises or "crops up" above the ripples. The disturbance thus created is sometimes considerable; there is much chafing, and roaring, and muddiness, before the obstruction is fairly removed. Usually, however, the disturbance is trifling; just so much as an uncouth fish might make when lifting its head above the waves. Not long ago one book was published to demonstrate that the theory of the circulation of the blood was an ingenious philosophical fiction-no more: and another, to set forth a mystery about the blood and muscle; in which the professional public was requested to take notice

that blood and muscle were the all in all, and nerve comparatively nothing. Well, now here we have, in Dr. Heidler's book, a still more uncouth fish popping its queer-looking head above the rippling current of physiological and pathological research; resolved, apparently, to give a new direction to the stream, or, failing in that, to make at least a stir by its queerness. The blood, according to Dr. Heidler, is the first, the last, the supreme in the organism. The blood receives impressions from the external world, and is the medium of communication between these and the nerves. The blood is the immediate and active stimulant of all organs and tissues. There is no nervous power; there are no nervous diseases. The former is a fiction, the latter are dependent upon morbid states of the circulation; in short, nervous diseases, so called, are caused by congestion of the capillaries.

The object (to be more specific) of Dr. Heidler's dissertation, is to show that the practical study of the physiological, pathological, and therapeutical relations of congestions, either with or without "orgasmus," and of spontaneous or primary, and of secondary or consensual hemorrhages, is the most useful, intelligible, and certain means of advancing physiology, pathology, and therapy. A change in the quantity or (less certainly) in the quality of the blood and in the stimulation by the blood of tissues and organs, is the immediate or proximate general cause of all animal sensations, from the first or lowest degree of common sensation to those of the highest degree, and which involve pleasure or pain. The numerous modifications which sensations exhibit are dependent on modifications of the blood. These differ in degree, kind, and locality, according to the organ in which they take place. The nervous system is a machinery for communication only; an apparatus for "animal perception; in animals an animal addition, -in man a humano-animal addition to the vegetative and inorganic vital processes in both. Its functions are simply to be a medium for communicating vibrations, oscillations, or undulations developed by concussions. It perceives and directs.

Certain "introductory remarks" are made up of a variety of gossip. We have references to previous works; references to private criticisms made by persons to whom Dr. Heidler submitted the manuscript of his book; statements of what he did intend, of what he now intends, of what he thinks on this, that, and the other. This preliminary flourish accomplished, he sets himself seriously to work. He first pulls down the theory antagonistic to his own. His first effort is to prove a negative, that the so-called nervous principle or power does not exist. He examines the evidence in its favour under the five different heads of anatomy, physiology, pathology, therapy, and metaphysics. This he does after a crafty method; he collects the notions of various modern writers as to the nature of the soul, the nervous principle, perception, sensation, volition, and elicits a variety of palpable contradictions. Opposing views on these subjects are also cleverly mixed up with ideas of a more rational character, in such a way that we cannot sufficiently admire the author's ingenuity. At the same time, he has a knack of asking puzzling questions, and one really begins to feel a regard for the shrewd and clever author. He appears to advantage as a good puller-down. When, however, we come to examine into his own theory, and into his powers of building up, we find a woful