scarcely say that cases are continually occurring in practice, where it is advisable to have a larger amount of blood drawn than may be just necessary to induce faintishness in the upright position. Was such a rule invariably followed, the remedy would often fail of producing the permanent effects upon the system that are desired.

Dr. Hall seems to be quite aware himself of the inapplicability of his rule for blood-letting in certain cases of disease :-—

"There are two exceptions to the rule which I have proposed, which I would briefly mention. In some cases of fever requiring blood-letting, the patient cannot support the erect position: in such a case, the arm should be first prepared, and then the patient should be gently raised and supported in the upright position, carefully avoiding all muscular effort; the vein should then be promptly opened. On the other hand, in the case of congestion of the brain from exhaustion, there is not such early syncope from blood-letting as might be expected; and yet it is obvious that the system cannot bear the loss of blood. I have known this to obtain in exhaustion from undue lactation." P. 358.

We should like to know what cases of Fever these are to which Dr. H. refers, and in which the patient, although he cannot support the erect position, should be gently raised up into it, and then be bled to approaching deliquium. Is the loss of blood, may we ask, ever advisable under such circumstances? The case clearly supposes the existence of great debility; and surely general blood-letting, and that too carried to faintishness, is not the remedy that a judicious physician would employ to relieve either pain, congestion, or even inflammatory action under such circumstances. The local depletion of blood by the cupping-glasses or by leeches will very generally be preferred. The other case alluded to, viz. that of Congestion of the Brain from undue lactation or other exhausting disorders, serves but to confirm the remarks which we have made above, relative to the influence of torpor or unconsciousness as an important element to be taken into consideration in any attempt to investigate the different degrees of tolerance of blood-letting in different states of the system. But without pursuing this subject, who, may we enquire, would ever dream of general blood-letting in the case supposed? And now we must bid adieu to our author.

No one can reasonably deny that he is a man of uncommon powers of mind, of unwearied industry, and indomitable energy; that he has long and successfully laboured in the vineyard of medical science; that his varied writings proclaim him to be a keen observer and a subtle reasoner; that his discoveries in physiology have justly gained for him a foremost place among the investigators of that science; that to him alone belongs the rare honour of having first clearly propounded and manfully worked out one of the most perplexing problems in the history of animal life, unravelling the meshes of a most intricate perplexity, and pointing out the clue, the Ariadne thread of guidance, to all future explorers through the labyrinth of former darkness and confusion; that he has thus not only stamped the impress of his thoughts on the medical literature of the day (one of the surest proofs of original genius), and achieved for himself a world-reputation, but that he has also added to the intellectual and scientific fame of his country; which may now-thanks to the labours of Harvey, Bell and Hall-justly claim the undisputed glory of being the

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The Author's Merits and Failings.

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birth-place of the two mightiest discoveries in physiological science. But these are not the only merits of our author. His more practical writings, even from the very outset of his professional career, have contributed, in no trifling degree, to render the symptomatology and discrimination of many diseases more accurate and intelligible; and, although he has been apt on some occasions to exaggerate the importance of a few phenomena or signs as guides for diagnosis and treatment, we cordially award him the praise of having done good service to the practice of Medicine.

How comes it then that the works of such a man should often have called forth so much censure and disapprobation? That Dr. Hall has met with most unhandsome and unjust treatment from several of our contemporaries, cannot now be gainsayed by any impartial witness. While one party has vainly attempted to rob him of his fair fame, another has, with equal impotence, thought to quench the torch of discovery by refusing to act as one of its honoured light-bearers. No such reproaches can be made by any one against us. We have uniformly maintained the justice of his claims as a great and original investigator of physiological science against all envy and detraction. Ten years ago, we spoke of his labours in these words :-"He has evolved a simple fact (that of involuntary muscular contractions following the irritation of the corresponding sensory nerves, as long as the part retains its connection with the spinal cord) into an extensive and ingenious theory, applied it to the solution of complex phenomena previously surrounded with obscurity, and has done a great deal towards clearing the way to a precise acquaintance with the Functions of the Nervous System. Such appears to us to be the meed, which even a parsimonious critic must award to Dr. Hall.”* In October 1841, we gave what is perhaps the most complete analysis of his researches and discoveries in neurological science, to be found anywhere out of his own writings; an analysis that has been more than once referred to in works on the diseases of the cerebro-spinal system. The ample and enlarged notices too, which we bestowed on the four memoirs of Dr. Hall, published in the Medico-Chirurgical Transactions, must have rendered our readers thoroughly and minutely acquainted with the many interesting facts which he has adduced, and with those doctrines by which he has so ingeniously sought to weave the whole into a tissue of the most admirable construction.t

It cannot, therefore, be fairly said that we, at least, have shewn any unwillingness to recognise the great merits of our author in various departments of medical literature; and therefore it was that we felt the less hesitation in withholding our approbation from the first volume of these "Practical Observations and Suggestions." Would that we could consci

* Medico-Chirurgical Review, No. 52, p. 306.

+ Vide Medico-Chirurgical Review, Nos. 63, 67, and 71. We gladly avail ourselves of this opportunity to direct the attention of our readers to the eloquent and ably-argued summary of Dr. Hall's neurological discoveries and doctrines that recently appeared in successive numbers of the Lancet, for August 8th, 15th, and 29th. Some will probably say that the papers are a little too eulogistic; but no one can fail to admire the lucid exposition, vigorous reasoning, and graceful diction which they display.

entiously make up for the censure of the last by the praise of the present one! But this cannot be; and the fault lies solely and altogether with Dr. Hall himself. He is one of those characters that will not correct his errors for most assuredly he is not so blind as not to see them, or so indifferent to applause as not to peruse what is written of him. Pertinacity is the very woof of his character. He deems it a point of honour never to change or concede aught, except to himself. Jealous of his own, sometimes to very paltriness, he is continually obtruding it upon the public; if it won't attend to him to-day, he is determined to force it to do so tomorrow. Hence his continued repetition, usque ad nauseam, of the same facts, dogmas, or doctrines, varied somewhat it may be in some accessory points, but not unfrequently dressed out in the very same attire. Thus it is, as we have seen, that he has actually republished in the present volume the very same letter which made its appearance in the former series of these Observations, and which, if we mistake not, had already seen the light elsewhere before. This unworthy blemish of his writings has been pointed out more than once; but, as a matter of course, no respect is ever paid to the remarks of others. Dr. Hall has not only erred, but he has suffered, much from this arrogancy of character. Had he but learned to listen more to the voice of friendly counsel, and often less to the suggestions of his own impetuous mind; had he been more conciliatory in his manners, more charitable and forbearing in his disposition; had he attached less importance to (his panacea) knowledge, and more to wisdom; had he trusted more for the advancement of his opinions to the irresistible (although slow and silent) force of simple truth, and been less disposed to thrust them upon others by the ruder weapons of controversy and dogmatic iteration, he would have avoided many of those strifes, heartburnings, and detractions which have beset his path, and might have more peacefully enjoyed the sweets of that reputation which he has so meritoriously achieved. Whatsoever be the spirit in which these remarks may be received by him, it matters little to us. Our duty is simple, and straight before us;-cordially to award praise where praise is justly due, and frankly to express our censure of error, whether this be in the shape of ignorance, wilful negligence, or vain presumption.

SEVENTH ANNUAL REPORT OF THE REGISTRAR-GENERAL OF BIRTHS, DEATHS, AND MARRIAGES, IN ENGLAND. (Abstracts of the Two Years, 1843, 1844). 8vo. pp. 350. London, 1846.

It is surprising that a so practically sagacious people as the English should so often do things by halves. We have now for some years had an admirable system of Registration in operation, the results of which contained in the Annual Reports are quoted almost daily by British and foreign writers; and yet the advantages derivable from it have not been extended to Ireland and Scotland, containing a population of between ten and eleven

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million. If from the present data valuable conclusions are obtainable, how much more would this be the case when these became nearly doubled? We never could understand why what has been done for England and Wales was not attempted in the first instance for the United Empire. It required no very expensive organization, and shocked no prejudice; and even if greater difficulties were to be apprehended in endeavouring to work the measure in Ireland than have been found to prevail here, they should, on account of the great benefits which must accrue from vanquishing them, have been met, not avoided. We are pleased to find the Registrar-General, in his present Report, drawing the attention of the authorities to this important point: and hope that another session will not be allowed to pass by without the blunder being repaired. The able analysis of the Irish Census Returns, by Mr. Wilde of Dublin, and Dr. Stork's spirited exertions at Edinburgh, in framing the Bills of Mortality of that city, show that zealous and efficient coadjutors will not be wanting in either of those capitals. The Registrar-General thus expresses himself, addressing the Home Secretary.

"I submit to you that the Marriages, Births, and Deaths of the people of Scotland, Ireland, and England should all be registered on a uniform plan; and that the inquiry, which has already been so successful and beneficial in England, into the causes of death, should be extended to Ireland and Scotland. Like the institution of the Coroner's Jury, this inquiry deters from crime, fosters a reverence for human life, and by discerning the causes of premature death in the various circumstances of the population, will contribute to the progress of the science of medicine, diminish suffering, and lead to the prolongation of human life to its natural term. No argument that I am aware of can be used in favour of Registration which does not apply to Scotland and Ireland." P. 23.

The present Report will not require a long notice at our hands, inasmuch as it contains little else than the tabulated details, and a much smaller number of these than usual. One admirable feature in the working of the Registration Act is the fact that its administrators are never content with the statu quo, but are ever desirous of augmenting the amount or increasing the value of the information obtainable through its agency. Thus, we find that it is in future intended to furnish "Abstracts of Deaths at different ages in the different ranks and professions of society, in connection with an Abstract of the Ages of the persons following those professions, as returned at the last Census"— '—a work of great labour, involving the rearrangement of the Census-returns in correspondence with the Registration districts.

That the active exertions of the Registrar-General would receive the hearty co-operation of the class of the community best fitted to appreciate their importance, might be expected; and accordingly we are not so much surprised to find that the great mass of our profession has cheerfully aided in furnishing more accurate accounts of the Causes of Death, as we are disgusted at learning that some fifty persons have chosen to throw all the obstacles in the way their insignificant position furnished them with. We believe the Registrar-General possesses the power of compelling these crotchety personages to fulfil so obvious a duty to the public: but probably he is right in not enforcing obedience, on the ground that," although they may have diplomas, it is probable that the information they would be in

duced to furnish would be of little comparative value, and might mingle errors among the facts spontaneously supplied by enlightened and accurate observers."

During 1843 and 1844 there were registered.

Excess of Births registered 180,879 183,813

In the seven years 1838-44, 861,286 marriages, 3,556,649 births, and 2,437,922 deaths have been registered-the Census of 1841 showing a population of 15,912,773, which augmented by the excess of births over deaths would be increased, by the beginning of 1844, to 16,366,876, and by the beginning of 1845 to 16,550,689. This is, however, below the actual increase of population, which probably takes place at the rate of 1.335 per cent., giving 16,684,600, on January 1, 1845, and 17,000,000 before Midsummer 1846. "About 222,000 souls are added to the population of this part of the United Kingdom annually."

All the Marriages and Deaths since 1838 have been registered: but many Births have not. Why the Registration of Births was not rendered compulsory it would puzzle a conjuror to declare. Its not having been so much lessens the value of the returns for the early years; but the indefatigable exertions of the officers of late years, which the legislature might have well spared them, have now rendered the omissions comparatively insignificant. More Marriages were registered in 1844 than in any previous year. The number was 132,249. In 1843 it was 123,818, and but 118,825 in 1842. But so few had not occurred since 1832 as in 1842. From 1839 to 1842 they declined, increased again in 1843, and attained the maximum in 1844-corresponding strikingly with the degree of prevailing prosperity of the country. No less than 4.17 per cent. of the men and 13.16 per cent. of the women were under 21 years of age. 12.81 per cent. of the men, and 8.46 per cent. of the women married in 1844 had been previously married. The test of education contained in the power of signing the marriage register, has been so frequently alluded to of late, that our readers' may like to have the Registrar's opinion upon it. Only 67 in 100 men, and 51 in 100 women, wrote their names. It is probable that a few women, able to write letters intelligible to their friends, signed with marks; but this simple test leaves little doubt that 33 in 100 of the men and 49 in 100 of the women of England, at the marriageable age, are either quite unable to write, or write very badly. Some objections have been raised against this return as a test of the state of education. And it should be taken for no more than it is worth. I have already stated that a certain number of the women able to write, either from timidity or from other motives, may not have written their names. Upon the other hand, many who write their names are able to write little else; and writing the name is no proof of the possession of that stock of the elements of literary and scientific knowledge which it is desirable that the whole mass of a civilized nation should possess. But the return is of unquestionable value, as an evidence of the relative state of elementary education in different parts of the country, and at different times. It will be seen

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