Infirmary, (March 16, 1810) perceived an enlargement of the extremity of the penis, especially on one side. The diseased part felt hard, and was prominent. A bloody serum issued frequently from the prepuce, and the discharge of his urine gave him pain. Nothing morbid appeared in the integuments; nor was any ulceration perceptible in the prepuce. In other respects the patient was healthy.

"20th, I amputated the diseased part; and, upon examination, found one half of the prepuce ulcerated internally, and covered with a cancerous excrescence, which extended along the corona glandis, from the frænum to the dorsum penis. The rest of the glans was in a sound state; and the opposite side of the prepuce was but slightly affected."

Mr. Hey has ingeniously contrived to prevent the involuntary discharge of urine after the operation of lithotomy in the female, by filling the vagina with a plug of rolled linen. It answered well in a case which he relates; but we have good hope that the operation may be rendered altogether unnecessary, from the example of perfect success which we have given in our medical and surgical intelligence of the present number. The revival of the practice of dilatation of the meatus urinarius for the removal of foreign bodies or calculi from the bladder, is due to Mr. Thomas; and from this gentleman's paper in the Transactions of the Medical and Chirurgical Society, Mr. Cooper, ever anxious for professional improvement, probably borrowed the idea.

It only remains that we should notice the case contributed by the last mentioned gentleman to the work before us: it is one of infinite value. The circumstances are shortly these: "The patient, a woman three months advanced in pregnancy, was reduced to a state of extreme lowness by a strangulation of four days' continuance; the mortified gut was opened so as to admit of a fæcal evacuation at the groin; on the 8th day she passed flatus, on the 8th fæces by the rectum, and continued to do so occasionally and in part for the space of a month, when the fæcal discharge took its natural course uniformly, and the wound in the inguen closed. This happened in the month of May, 1808. She was delivered in the October following of a full grown dead child, and some time after miscarried; from

that time she has continued well in every respect, and only wears the truss when exposed to unusual fatigue." The following is Mr. Cooper's conclusion.

"From the foregoing history it appears that the proper treatment of a mortified intestine in strangulated hernia, consists in the two following circumstances:

"1st. In dividing the stricture so as entirely to remove the cause of strangulation; and,

"2dly. In making an opening into the intestine so as to give a free outlet for the discharge of the accumulated fæces in the intestine within the abdomen. If the stricture only is divided, the constipation, hiccough, and vomiting, continue; but if the intestine is opened, the patient in a few hours becomes relieved of those symptoms.

"This case will serve as an answer to a query in the London Medical Review for April 1808. It remains for the candid observation of those who have the opportunity to determine, Whether in cases where the patient survives the operation, the removal of gangrenous intestine by the scissars is, or is not, an objectionable practice? and whether it is giving a fairer chance of recovery to second the efforts of the constitution during the process of separation, while we facilitate by a free opening the evacuation of the alimentary matters?""

We shall for the present forbear to comment on this interesting case further than to congratulate ourselves on having suggested the practice to which, as we believe, this woman owes her life.

Nothing indeed can be more opposite to this practice than that which Mr. Cooper has laid down in his work on hernia, viz. the removal of the mortified portion of intestine, and the connexion of the extremities by sutures; and we regard this as ⚫ an honourable proof that his interest in the advancement of the profession overpowers those little feelings and political calculations, which have too often induced in men of eminence a pertinacious adherence to their published opinions.

The case which occurred in June, is an incontrovertible instance of the practical expediency of the proposal which we suggested in May preceding. (L. M. R. vol. I. p. 131, 132.) This fact Mr. Cooper has handsomely acknowledged, by pub

lishing it in the form of a reply. If the obvious conclusion should be borne out by future results, it will be a subject of gratification to us, to reflect that the London Medical Review has not lived in vain.

Non ex quovis ligno Mercurius fit.

We cannot close this volume without declaring that in the course of our critical labours, we have never closed one with a stronger conviction of its value, or a higher respect for its author. We recommend it without hesitation or reserve to three classes of persons; first, to writers on practical subjects as a model of useful composition both in substance and in style; secondly, to established surgeons, as a book of reference for many valuable facts in practice; thirdly, to students, as a book which the smallest professional library should contain, and the largest cannot be complete without.

The Principles of Midwifery; including the Diseases of Women and Children. By John Burns, Lecturer on Midwifery, and Member of the Faculty of Physicians and Surgeons, Glasgow, London, 1809. 8vo. pp. 519.

From the Edinburgh Medical and Surgical Journal for 1810.

WE already possess some excellent treatises on the principles and practice of midwifery; and, as this is a department in which no very important discoveries or improevments have very lately been made, we should have thought it at this time no very easy matter to usher into public, with any fair prospect of success, a new publication on the subject. All, however, that could be expected, in the present state of the science, to give a new interest to the subject, Mr. Burns, equally experienced as a teacher and practitioner, has, by a judicious arrangement, by a faithful exposition of facts and observations, and by a methodical induction of the principles and practice

* An edition of this very valuable work, with notes, has been recently published by Dr. Chapman, Lecturer on Midwifery, Philadelphia.

of the art, from these fundamental truths, contrived to accomplish in the work now before us. It is divided into four books; the first, comprehending nineteen chapters, treats of the structure, functions, and diseases of the pelvis and uterine system, in the unimpregnated state, and during gestation; the second, of parturition; the third, of the puerperal state; and the fourth, of the management and diseases of children. So that every subject, directly or indirectly connected with the practice of the accoucheur, is here brought into one connected view. This, indeed, is the great advantage which Mr. Burns's work must be acknowledged to possess over all others, as a system or class-book. But what we are most disposed to recommend in this volume, is the pathological department, and the descriptions and treatment of the diseases of puerperal women and of children. A more copious, scientific, and judicious account of these diseases, is, perhaps, no where to be met with.

To enumerate some of these, in the order in which they are treated, will convey to our readers some notion of the value of this part of our author's labours.

1st. Diseases of pregnant women:

Febrile state; vomiting; heart-burn; fastidious taste; spasm of stomach and duodenum; costiveness; diarrhea; piles; affections of the bladder; jaundice; coloured spots; palpitation; syncope; dyspnea and cough; hemoptysis and hæmatemesis; headach and convulsions; toothach; salivation; mastodynia; adema; ascites; redundance of liquor amnii; watery discharge; varicose veins; muscular pains; spasm of ureter; cramp; distention of the abdomen; hernia; despondency; retroversion of uterus; antiversion; rupture of uterus; abortion, and treatment of pregnant women; uterine hemorrhage; false pains..

2d. Of the Puerperal State:

Treatment after delivery; uterine hemorrhage; inversion of the uterus; after pains; suppression of the lochia; retention of part of the placenta; strangury; spasmodic and nervous diseases; milk fever; miliary fever; inflammation of the uterus; peritoneal inflammation; puerperal fever; swelled leg; paralysis; mania, &c.

3d. Diseases of Children:

Congenite; surgical diseases; diseases of dentition; cutane

ous diseases, viz. strophulus, lichen, intertrigo, crusta lactea; anomalous eruptions; pompholyx; pemphigus; miliaria; prurigo; itch; herpes; itchthyosis; psoriasis; impetigo; pityriasis; porrigo; scabs; boils and pustules; petechiæ; erysipelas and erythema; excoriation; ulceration of gums; erosion of cheek; aphthæ; syphilis; skin-bound; small-pox; cow-pox; chickenpox; urticaria; measles, and roseola.

Hydrocephalus; convulsions; croup; hooping-cough; catarrh; inflammation of pleura and stomach; vomiting; diarrhea; costiveness; chorea; marasmus; tabes mesenterica; worms; jaundice; diseased liver; fevers.

A systematic work like this, embracing so great a variety of description, does not admit of any more extended analysis, or criticism; we shall, however, to enable our readers to form some judgment of the manner and style of Mr. Burns, add a very few extracts.

"Chlorosis succeeding to abortion, laborious parturition, or fever, is often attended with symptoms resembling phthisis pulmonalis. In many instances the pulse continues long frequent; there is nocturnal perspiration, considerable emaciation, with cough and pains about the chest, and yet the person is not phthisical, she suffers chiefly from debility; but if great attention be not paid to improve the health, the case may end in consumption; and hence many consumptive women date the commencement of their complaints from an abortion, or from the birth of a child, succeeded by an hemorrhage. In chlorosis, the symptoms are induced, not by previous pulmonic affections, but by some other evident cause of weakness; the pulse, although frequent, is not liable to the same regular exacerbation as in hectic; a full inspiration gives no pain, and little excitement to cough; the person can lie with equal ease on either side; the cough is not increased by motion, nor by going to bed, but is often worst in the morning, and is accompanied with a trifling expectoration of phlegm. It is not short like that excited by tubercles, but comes in fits, and is sometimes convulsive; whilst palpitation, and many hysterical affections, with a timid and desponding mind, accompany the symptoms. The bowels are generally costive, and the person does not digest well.