with our insane establishments, regarding the best mode of treating this class of diseases.

"Each year that I have passed in this extensive field," says Dr. Bell, "has served to diminish my confidence in an active medical treatment of almost every form of disease of the mind, and to increase my reliance on moral means. No individual at the head of an insane institution would now think of combating any form of insanity with the depletory and reducing means once regarded as indispensable. The practice of bleedings, violent purgatives, emetics, vesications, and derivatives, has passed away before the light of experience. A different and opposite mode of treatment by energetic sedatives, I am satisfied, is obnoxious to many objections, although far to be preferred to the first. The recoveries under their administration, occasionally most magical and most gratifying in appearance, and for the present, as far as my observation and experience have extended, are neither so perfect nor so permanent as under a less decided course of measures. A wise expectation, and a cautious use of medical agents to meet symptoms, comprise most of the aids that the pharmacopeia is capable of affording. But in relation to moral means especially, carried through as they can only be, by the instrumentality of an appropriate institution, my annual experience has only exalted my confidence." (p. 501.)

ART. XVIII. The Virginia Springs, with their analysis; and some remarks on their character, together with a directory for the use of the White Sulphur Water, and an account of the diseases to which it is applicable, etc. By J. J. MOORMAN, M.D., Resident Physician at the White Sulphur Springs. Philadelphia, Lindsay & Blackiston. As a general rule, treatises on mineral waters, written by the proprietors thereof, or by the physician who lives upon the reputation which said water may have in the cure of disease, must be received with some grains of allowance. His opinions are not necessarily to be distrusted this will depend upon his general character for integrity and veracity; but they are to be scrutinized with due care, and only admitted when sustained by proper evidence. When we find Dr. Burke of the "Red Sulphur," disparaging the virtues of the " White Sulphur," and Dr. Moorman, of the "White," returning the compli ment by a similar estimate of the "Red," the disinterested invalid may perhaps begin to doubt whether any real efficacy attaches to either, or if any, what may be its nature and extent. We should, however, do injustice to Dr. Moorman, if we conveyed the idea that he denies medicinal virtues to the Red Sulphur; he admits that it is the least stimulating of the Virginia Sulphur Waters, but not sedative as maintained by Dr. Burke, and that it may be successfully used in some cases, especially those of irritation of the pulmonary organs, in which other waters would be contra-indicated and prove injurious. "In sympa. thetic or translated affections of the lungs," says Dr. M., "whether that state be occasioned from disease of the digestive or chylopoietic viscera, or be dependent upon the retrocession of some habitual discharge, this water (Red Sulphur) deserves to be regarded as a valuable remedy." (P. 190.)

The White Sulphur Springs are situated in the county of Greenbrier,

Virginia, on Howard's Creek, six miles west of the Alleghany chain of mountains, Lat. 371⁄2° N. and 32° west Long. from Washington. Temperature of the water, 62° Fahr., clear and transparent, depositing a white precipitate, (sulphur), and tasting and smelling strongly of sulphuretted hydrogen gas. 100 cubic inches contain 65.54 grs. solid matter, of which the principal ingredients are, sulphate of lime 31.680 grs., sulphate magnesia 8.241 grs., sulphate soda 4.050 grs., carbonate lime 1.590, with traces of carb. magnesia, chloride magn., chloride calcium, chlor. sodium, sulph. iron, sulph. alumine, and earthy phosphates; also a trace of azotized organic matter and iodine. It also contains about of its volume of nitrogen gas, oxygen and carbonic acid gases, with a trace of hydro-sulphuric acid-or 1 gallon contains of these gases about 16 cubic inches.

With respect to the diseases to which the White Sulphur Water is applicable, Dr. Moorman remarks:

eases.

"All mineral waters are stimulants to a greater or less degree, and consequently are inapplicable to the treatment of acute, or highly inflammatory disThis remark is especially true as relates to the white sulphur, particularly when drank fresh at the spring and abounding in its stimulating gas. It is true, as before shown, that when its exciting gas has flown off, it becomes far less stimulating, and may be used with safety and success in cases, to which in its perfectly fresh state, it would be totally unadapted. But even in its least stimulating form, it is inadmissible for excited or febrile conditions of the system; and especially to cases of inflammatory action;—at least, until the violence of such action has been subdued by other and appropriate agents.

"It is to chronic affections of the organic system that the white sulphur water is peculiarly applicable.

"Various diseases of the stomach, liver, spleen, kidneys and bladder, as well as some derangements of the brain and nervous system generally, are treated successfully by this agent. To the various affections of the skin, unattended with active inflammation,—te chronic affections of the bowels,—and to gout and rheumatism, it is well adapted. In hæmorrhoids;-in some of the chronic affections of the womb;-in chlorosis and other kindred female disorders, in mercurial sequela, and especially in the secondary forms of lues, and illconditioned ulcers in depraved constitutions, it constitutes the most valuable agent to which the invalid can resort.

"If the individual about to submit himself to the use of this water, is suffering from fulness and tension about the head, or pain with a sense of tightness in the chest or side; he should obtain relief from these symptoms before entering upon its use. If his tongue be white, or heavily coated; or if he be continuously or periodically feverish, or have that peculiar lassitude, with gastric distress, manifesting recent or acute biliary accumulations, he should avoid its use until, by proper medical treatment, his biliary organs are emulged, and his system prepared for its reception. Much suffering, on the one hand, would be avoided, and a far larger amount of good, on the other, would be achieved, if visiters were perfectly aware of, and carefully mindful of these facts.

"It is an every day occurrence during the watering season at the "White," for persons to seek medical advice, for the first time, after they have been using the water for days, perhaps, for weeks, and it is then sought because of vagrant operations, or injurious effects of the water. In most such cases, there will be found, upon examination, either the existence of some of the symptoms just mentioned, or evidences of local inflammation in some part of the body, sufficient to prevent the constitutional efficacy of the remedy. We are often struck with the control which an apparently inconsiderable local inflammation will exert in preventing the constitutional effects both of the mercurial and mineral waters. To remove such local determinations where

they exist, or greatly to lessen their activity, is all important to secure the constitutional effects of sulphur water."

In relation to the effects of the White Sulphur Water in the treatment of dyspepsia, Dr. M. observes :

"In this common and annoying disease, consisting in derangement of function in the organs of digestion, the white sulphur water has long maintained a high character. In this affection, especially in its confirmed stage, we almost invariably find the biliary secretions either vitiated in quality or deficient in quantity; constituting an important, and not unfrequently, an embarrassing feature in its treatment: nor can we ordinarily succeed in effecting a cure, until the secretory functions of the liver are restored to a natural and healthy condition.

"The beneficial effects of this water in dyspepsia, seem to result mainly from its sanative action upon the liver. To alterate the secretory functions of that organ, and establish a flow of healthy bile, is one of the great forts of the water, and almost an invariable result of its persevering use.

"That the water benefits the stomach in many cases by a primary action,— first, as an alkali and stimulant, neutralizing its acidity, and imparting directly a tone and energy to the viscus-and, secondly, by a positive influence on its glandular structure, occasioning a healthy flow of gastric juice, we do not doubt. Still the most decided and permanent benefits derived by dyspeptics, have always seemed to us to be the result of full alterative impressions upon the liver. Certain it is that without such an influence upon that organ, the dyspeptic can never be confident of the permanency of his relief. It would Le well for sufferers under this distressing malady to bear this in mind, and not abandon the use of the water, as many do, until it has fully impressed the liver;-nor be discouraged at its apparent want of efficacy until it has been used sufficiently long to effect this object."

In diseases of the liver and spleen there is satisfactory evidence also that the White Sulphur Water is highly beneficial. Says Dr. M.: "The white sulphur water acts specifically upon the secretory organs, and especially upon the liver.

"We have already, in another part of this volume, shown the striking similarity of action between mercury and sulphur waters upon the animal economy. In nothing is this more manifest than in their operations on the liver.

"The modus operandi of sulphur water upon this viscus, is dissimilar we conceive from that of mercury, and yet the effects of the two agents are strikingly analogous. The potent and controlling influences of the water over the secretory functions of the liver, must be regarded as a specific quality of the agent, and as constituting an important therapeutical feature in the value of the article for diseases of this organ. Its influence upon this gland is gradually, but surely to unload it when engorged, and to stimulate it to a healthy exercise of its functions when torpid. The control which it may be made to exercise over the liver, in correcting and restoring its energies, is often as astonishing as it is gratifying,-establishing a copious flow of healthy bile and a consequent activity of the bowels,-imparting vigor to the whole digestive and assimilative functions, and consequently energy and strength to the body, and life and elasticity to the spirits.

"Attention was directed at an early period in the history of mineral waters, to their controlling influence over diseases of the liver, and by the best informed practitioners both of Europe and this country, sulphur waters have always been favorite remedies in the treatment of that class of affections.

"The celebrated Dr. Armstrong, although of cool discriminating and well balanced mind, was so much devoted to their use in chronic inflammations and congestions of the liver, that some of his cotemporaries, less practised in their use, thought him infatuated upon the subject. He preferred them, most decidedly, as an independent remedy, to mercury in all its forms; but

very properly observes, that in some cases, it will be found best to combine the operation of the two agents at the same time.

"For many years we have kept a case book at the White Sulphur, and have carefully noted the influence of the water upon such diseases as have been submitted to our management. Among the number arise several hundred cases of chronic affections of the liver, embracing disease of simple excitement, chronic inflammation, congestion, engorgement and obstruction to the biliary ducts, &c., &c. These cases were all treated either with the white sulphur water alone, or aided by some other appropriate alterative remedy, and in. looking at the results, we must be permitted to express a doubt whether a larger relative amount of amendments and cures have been effected by the usual resources of the medical shop. This we know is high eulogy of sulphur water in such diseases. It is considerately made, and is not higher than their merits deserve.

"It is proper that those affected with liver disease, (and they constitute no small portion of the population in certain districts of our south-western territory), should know something of the confidence they may place in these waters for relief.

"Volumes might be filled with details of gratifying results that have taken place in the cases of invalids, from almost every section of the country, who visited these waters as a sort of "last resort" for liver disease. And hundreds of delighted witnesses may be found, especially in the warmer regions of the south, who bear a willing and grateful testimony to their utility in such cases.

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Let us not be understood, however, as advancing the opinion, that sulphur water will cure every case of chronic liver disease. Far from it. We have already stated elsewhere, that mineral waters will sometimes fail in chronic diseases of disordered action only. This, it is most probable, happens in cases where the blood-vessels have been so long distended, as to have lost their power of returning to their natural state. Besides, it will happen that among the number of invalids that crowd our watering places, seeking relief from this common affection, many will be found, in whose livers organic lesions have already taken place. In such, perfect cures need not be expected either by sulphur waters or any other agents.

"Jaundice is a form of liver disease in which the white sulphur water is used with very happy effects..

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Although it is often met with at the springs, we remember but few cases that were not either radically cured or greatly benefited, from a proper perseverance in the use of the water. In this, as in most other forms of liver disease, the salutary operations of the water will be hastened by the administration of some mild alterative medicine in connexion with it for the first few days."

For the effects of the water in other diseases we must refer to the work itself, which we doubt not, is entirely trustworthy, as it is written in a spirit of candor and good taste, which cannot fail to make a very favorable impression upon the reader.

ART. XIX.-Summary of the Transactions of the College of Physicians of Philadelphia-From December 1846 to April 1847, inclusive.

8vo.

WE here have a continuation of the very able communications made to the College of Physicians, of our sister city, and they suffer none in comparison with those of former years.

The most interesting portions are the "Annual Report on Meteorology and Epidemics," for 1846, by Dr. Moore, and the "Annual Report on Diseases of Children," by Dr. Condie. We have also a series of

valuable cases by Dr. Hallowell, illustrating the "Natural History of Tuberculous Disease," and a paper by Dr. Parrish, on the "Letheon.". On this subject we quote the following remarks, in the justice of which we cordially coincide, with the exception of the imputation cast upon the Boston Medical and Surgical Journal, which appears to us wholly unfounded. We know no more consistent and hearty opponent of quackery in this country, than Dr. Smith, the able and industrious editor of that periodical.

"That an agent, which is said to possess such useful qualities, should be patented, and that the patent should bear the name of an intelligent physician, and a man of science, must be a source of extreme regret to every liberal member of our profession. We understand that both the patentee and the proprietor, hold a diploma from a medical college; and we observe further, that the course of these gentlemen in making merchandize of this discovery, if not openly justified, is excused by the Boston Medical Journal. We trust that these facts are not to be taken as an expression of the sentiments of the medical community of Boston.

"If the agent referred to, really possess the power claimed for it; if its character as a certain and safe means of assuaging human suffering should become established, how different will be the position of its discoverer from that held by the true promoters of science. Whatever plea may be set up at this late period, for the restrictive policy of securing patent rights for discoveries which tend to relieve the sufferings of mankind, or to extend the boundaries of science; the sordid motive of self-aggrandizement and individual interest in these as in inventions relating to manufactures and the mere mechanic arts will undoubtedly be attributed to those who avail themselves of this policy. It is to secure individual rights against the public appropriation of an improvement that the law grants the patent vesting exclusive ownership in the inventor, with the right to dispose of his invention for his own profit. To us it would appear much more candid and manly for those who avail themselves of this privilege and use it to this end, openly to avow it and not attempt to excuse their course by pretending great solicitude for the public welfare; the fear, if their secret is made known, that unworthy and ignorant people may use it to the detriment of others, when it is well known that many of the most useful and indispensable substances in daily use, are, if improperly employed, exceedingly dangerous and destructive.

"How far the eminent physicians who have given this article their sanction without knowing its contents, are justified in this departure from the rule, which has generally regulated the conduct of the most honorable and conscientious members of our profession in such cases, it is not for us to determine. In the present instance they may have deemed the circumstances of such a character as to warrant them in adopting this course; but we sincerely hope that no precedent will be thereby established which shall tend to lower the standard of physicians on this point. There is a principle involved in this question of patents which is vital to the existence of the medical profession as a liberal, humane, and scientific art. If that be given up, and the doctrine be substituted that the physician has a right to appropriate to his own pecuniary benefit any useful medical discovery which he may make, the barrier that now separates us from the charlatan is broken down, and the high position which our profession has long held as a humane and dignified calling is lost.

"We hope, therefore, that whatever may be the results attained by this new process, that medical men will be especially careful to avoid any compromise of principle in regard to the position in which it stands before the public, and that the whole medical community will, with one voice, enter their protest against keeping secret any process or preparation, a knowledge of which would extend our means for the relief of human suffering."