are fully sustained by most practitioners who have treated the disease.

Among the remedies which enjoy the most reputation, are active cathartics, frequently repeated. We have used them with decided benefit, but we think reliance should not be placed upon them to the - exclusion of other remedies. Rayer, and many others, employ cal. omel combined with jalap, whilst others give a preference to castor oil in union with the oil of turpentine. This last article has attracted considerable attention, and enjoys some reputation as a purgative in this disease. In the case of a child of seven years of age, the only case ever seen by Eberle, he found benefit from small doses of turpentine together with the nitrate of silver, twenty drops of the former to a quarter of a grain of the latter, every six hours.

The use of the mineral acids will be found of great advantage, particularly the sulphuric, which is among the best hemostatics that we are acquainted with. In one case, a comparatively mild one it is true, we effected a cure with the diluted sulphuric acid, aided by frequent laxatives.

Some of the best remedies have, in our opinion, been too much overlooked: we allude to chalybeates. Tonics we are aware have been fully tested, without any satisfactory result, and their use is generally condemned; but the preparations of iron are not merely tonics; they obviously effect changes in the blood, and to these changes we attribute their efficacy in this, as in some other diseases. We have treated two cases successfully with these remedies. In one very alarming case, the precipitated carbonate of iron was given in as large and often repeated doses as the stomach would bear, followed by frequent cathartics. Under this treatment, marks of amendment were soon visible, and the patient soon recovered. Several slight relapses which afterwards occurred, were promptly arrested by the iron alone. We have great faith in its efficacy. The cases in which we would expect the least from it, are those which occur in subjects in good health, and presenting some vascular fulness.

Astringents, internal as well as external, are in frequent requisition for the hemorrhages which take place. We have employed the acetate of lead and other articles of established reputation as astringents, without their usual marked effects; still, when hemorrhages occur, we are compelled to resort to these remedies.

It may be laid down as a general rule, that the hemorrhages which accompany Purpura, are to be arrested by the same means that we

would employ to arrest such discharges from the same sources under other circumstances-internal astringents, &c., when the hemorrhage is from some inaccessible source, and cold, styptics, compression, &c. when these can be efficiently applied.

We have met with a few cases of the Purpura simplex. It always yielded quite readily to the use of laxatives, together with a free use of the diluted sulphuric acid.

PART II.-REVIEWS AND EXTRACTS.

ARTICLE XXXV.

Proceedings of the National Medical Conventions held in New York May, 1846, and in Philadelphia May, 1847.

There is no profession entitled to a higher place in the estimation of mankind, than that of Medicine. Among the contributors to science, the votaries of learning, and the enlightened philanthropists of every age, physicians have occupied a prominent place. For many ages, with Theology and the Law, Medicine was known as one of the learned professions. But whatever may have been its former rank or its present claims, it must be obvious to the most superficial observation, that it has undergone a gradual decadence, and at this time, in our own country at least, it has fallen from its high estate, and is looked upon by many, even of the intelligent, as a mere art which any dolt may easily acquire. Medical men have long seen and deplored this state of things, and have at length united in an effort to rescue their profession from the reproach which has fallen upon it. In the proceedings of the National Medical Conventions, which embodied a large amount of talent and respectability, we have before us the causes which in their view have brought about the present order of things, and the remedies which they propose for their removal. From these proceedings it is to be inferred that the Convention suppose the evils complained of, to arise principally from three causes: first, from the want of a suitable preliminary education among those who apply themselves to the study of Medicine; second, from the lowness of the standard of strictly medical acquirements, which is generally adopted by the Colleges; and third, from the failure on the part of these institutions, to require from those who seek their honors, a full conformity to that low standard.

That each of the causes enumerated contribute to lower the profession of Medicine cannot for a moment be doubted, although some diversity of opinion may prevail as to the part which each performs. Our own opinion is, that the want of a proper preliminary education is the most efficient of those enumerated in degrading the profession. When we speak of a proper preliminary education, we wish to be understood as going far beyond the recommendations of the Convention. "A good English education, a knowledge of Natural Philosophy and the elementary Mathematical Sciences, including Geometry and Algebra, and such an acquaintance, at least, with the Latin and Greek languages as will enable them to appreciate the technical language of Medicine, and read and write prescriptions," will do much to facilitate the acquisition of Medical Science, but it will not prove of very essential service in elevating one whose knowledge is thus limited, in the estimation of the intelligent and cultivated men of the land. We admit that with this, or with even something less, a man of good mind, and untiring perseverance, may become a useful and safe practitioner, but the people at large have no means of estimating his fitness to exercise the functions of his profession, but by his general intelligence, and acquaintance with those branches of knowledge with which well educated men are familiar. If his knowledge goes not beyond what is strictly professional, they will suppose him ignorant in that, or as is too frequently the case, they will deem Medicine itself as a mere art which requires neither learning nor intelligence for its successful application. This test is the only one which the unprofessional can apply, and we hesitate not to say that a man of general learning will do more to render the profession honorable in the public estimation, than one much superior in medical skill, but deficient in every other species of knowledge. How can a man of cultivated intellect respect either the physician or his occupation who betrays a gross ignorance of the very rudiments of school-boy learning. We may lengthen the collegiate course-add new branches of science to the curriculum, and adopt the most stringent measures to secure a more thorough instruction in the Medical Sciences, but the profession will never be respected as it should be, until the great body of physicians is composed of well educated men. In view, therefore, of these reasons, we would advocate a high standard of preliminary education as a requisite for the degree of Doctor of Medicine. It has been ob. jected that such a course would induce great numbers of young men to engage in the practice without the degree. Be it so. The public

would learn the difference between these, and the thoroughly educated physician. Moreover, many young men of proper ambition, would be induced to acquire the requisite education even by their own unaided efforts, who now are contented to remain ignorant because ignorance upon these subjects is common. We do not agree with the Convention, however, in their recommendation that practitioners should not receive pupils into their offices, and the Colleges should not matriculate such as have not attained the standard of prelimina, ry education they have prescribed. Many young men, we have known several such, could carry on their scientific and literary stu. dies at the same time. It is quite a common occurrence in France, for young men engaged in the study of Medicine to devote a portion of each day to lectures, and other instruction in those departments of knowledge, without which they would not be eligible to the honors of the Medical profession. It will be sufficient, and indeed all that is practicable to require conformity to the prescribed standard, of those who seek the honors of the Colleges. We cannot make every practitioner a man of general learning, but we can require all to be such, who are honored with the Doctorate.

That the standard of medical education is too low, is a fact which no one is disposed to deny. It is certainly lower than in the most enlightened countries in Europe, and as a consequence a large por, tion of our medical practitioners are inferior to their foreign cotemporaries in the extent, and minuteness of their scientific knowledge. It is equally true, and indeed what might have been reasonably expected, that a large portion of those who are thus imperfectly educated, make no sufficient effort to supply the defect, and fail to keep pace with the improvements of the age. We therefore heartily concur in the sentiment that, "it is indispensable that the standard of medical education should be elevated." It may not in so considerable a degree increase the respectability of the profession, as would a high standard of preliminary education, but it would render it more worthy of public confidence. We believe, however, that the defect in the present system of medical education does not consist solely in a lack of instruction, but that the shortness of the period into which the whole amount of instruction is crowded, also exert a prejudicial influence. The report upon this subject justly remarks, "the shortness of the time devoted to the delivery of Lectures, we believe to be an evil of no small magnitude. It is next to an impossibility that the strongest intellect can receive, and well digest some half a dozen or more dis

courses a day, embracing subjects which have oftentimes little or no immediate connection with each other. The mind becomes wearied with the multiplicity of its occupations, and the thoughts of to-day are forgotten in the constantly recurring duties of the morrow. A proper allotment of time cannot be given to that deep reflection which the importance of the subject demands, and without which no solid advancement can be made." For these reasons we approve of the extension of the course of Lectures, not only because new subjects may be taught, but because fewer lectures will occupy the attention of the student daily.

The Convention has not advised the introduction of new branches of science into the curriculum, if we except Medical Jurisprudence, which is now a distinct professorship in some few Colleges, and to some extent incidentally taught in all. There are doubtless some collateral sciences, instruction in which would add much value to the collegiate course, yet, under present circumstances, we think the Convention did well, in not requiring such branches to be taught.

Clinical instruction is also deemed by the Convention to be an indispensable element in a proper medical education. Of course they do not refer to that kind of clinical instruction to be derived from a case placed once or twice a week in a large amphitheatre, and surrounded by several hundred young men, many of whom are unavoidably at such a distance, as to be unable to distinguish the color of the patient's eyes. Such clinical instruction is a mere farce. In view of the fact, that in many of our cities, the hospitals and alms-houses are not under the direction of the Faculties of the Colleges, the Convention has not urged it as a prerequisite to graduation.

On the subject of dissection, the Convention says, "to enter into an argument to prove its absolute necessity, not only to the surgeon, but to the physician, would be a work of supererogation," and it is therefore very properly recommended that it be required of candidates for the degree, that they shall have steadily devoted three months to dissecting. It certainly speaks but little for the state of medical education in this country, that of the twenty colleges who reported their rules to the Convention, THIRTEEN do not require candidates to have dissected at all. We are pleased to say that the Medical College of Georgia is not among this number.

In relation to the influence which a failure on the part of the col. leges to exact a full conformity to their own standards, exerts upon the character of the profession, and the remedy for the removal of