pagated to the whole nervous system. It is, however, asserted that "much of the liquor also enters the circulation, and gives there an additional stimulus;" for that vinous spirit mixes with the blood we know to a certainty, from the hydrogenous gas which escapes from the lungs, to be perceived in the fœtor of the breath." Of the fact which is here so confidently asserted, that the alcohol actually enters the blood, we confess that we are by no means convinced. As to the odour exhaled from the mouth, we do not hesitate to ascribe it to the evaporation of part of the alcohol, still remaining in the stomach, and exposed there to a temperature of 98°. There is a strong resemblance between intoxication and mania; besides the external marks of coincidence, it is found that the drunkard, during his paroxysm, like the maniac, possesses an extraordinary power of resisting cold. These states of the body, however, exhibit one obvious and essential difference. The mania of intoxication continues for a short time only, and the body is left as susceptible of the impression of external agents, as it was before capable of resisting them. Hence arises a frequent cause of danger to the drunkard; during his fit of temporary insanity he exposes himself to extreme degrees of cold, of which he is then insensible, but which afterwards acts upon his debilitated frame with redoubled effect. In the second part of this chapter, concerning the chemical effects of alcohol, we meet with a good deal of what appears to us to be loose and hypothetical reasoning. The author thinks it cannot be doubted, that alcohol possesses a chemical operation upon the body, independent of its intoxicating quality; and, in proof of this opinion, it is alleged, that when "Applied directly to the animal solid, it constringes and hardens it; and suspends its progress towards putrefaction when separated from the body. It coagulates the serum of the blood, and most of the secreted fluids." degree, at least decompounds its floridity. "In support of this position, it is said that the blood of a professed drunkard approaches to the venous colour, and that the progress of sea scurvy, a disease supposed by Dr. Trotter to depend upon a deficiency of oxygen in the blood, is much accelerated by the excessive use of spirituous liquors. This idea respecting the origin of scurvy is itself entirely hypothetical, and as to the purple appearance of the blood, a fact of which we feel by no means absolutely assured, it will not warrant us in assuming the conclusions which are deduced from it by our author. The dif ference between the composition of the arterial and venous blood is a subject still involved in much obscurity; it appears probable, however, that the alteration of colour depends less upon the excess or deficiency of oxygen than upon the different state of combination in which the constituents of the blood are maintained. Conceiving the foundation of this hypothesis, respecting the hydrogenation of the blood, to be so feeble, we can attach but little value to the speculations which are deduced from it. The author introduces into this chapter the subject of the spontaneous inflammation of the human body; a circumstance, the reality of which, like that of the falling of stones from the clouds, has been generally questioned by men of science, although it has been difficult to disregard the strong evidence that has, at different times, been alleged in its favour. A paper on this subject was written by M. Lair, and inserted in the fiftieth volume of the Journal de Physique, of which a translation is given in the work now before us. It contains a great number of facts that are said to have occurred at different times, and in different places, the greatest part of them resting on slender and indirect evidence, but a few supported by the testimony of judicious and enlightened men, who had every opportunity of ascertaining the particulars of the case. M. Lair deduces the following conclusions: 1. The persons who experienced the effects of this combustion, had for a long time made an immoderate use of spirituous liquors. But do we judge of the medical effects of nitric acid or the alkalies from their operation on the substance of the animal body? When these substances are taken into the stomach, do we expect that either adipocire or soap will be produced? It is farther stated, that "alcohol certainly deoxygenates the blood in some life. 2. The combustion took place only in women. "3. These women were far advanced in by habitual intoxication." Under one or the other of these heads are included a great part of the most formidable diseases to which the human body is incident; on each of them a few remarks are made, in general judicious and appro priate. They are, however, occasion. ally mixed with the same kind of loose hypothesis which we mentioned above: for instance, the formation of carbuncles on the face is ascribed to hydrogene contained in the blood of the cutaneous vessels, attracting oxygen from the atmos phere, consequently "the blood in them becomes preternaturally florid; the skin is thus excited, and inflamed, and the spots appear in consequence." The expression of the fourth scarcely conveys the meaning of the author; it should be, that the bodies were accidentally set on fire. The chapter concludes with some moral aphorisms, which will probably prove interesting to our read-meet with many valuable observations, "When you hear a drunken man pitying misfortunes which he did not relieve when sober, it is the strongest proof that he pos sesses no goodness of heart. "Receive no donations from a drunken man, lest he should ask them again when sober. "Avoid the company of a drunkard; for if he insults you, and you should insist on satisfaction, he will plead want of recollection as apology. "Let the sober man beware of the society of drunkards, lest the world should say that he means to take an advantage of their credulity." In the fifth part, "on the method of correcting the habit of intoxication, and of treating the drunken paroxysm," we but, as usual, delivered in a desultory style, and mixed with much extraneous matter. Indeed the proper subject of the chapter is not entered upon, until after an introduction of about thirty-five pages, which are occupied in miscella neous remarks, that would more properly have been placed in the second and third divisions. "From these remarks we shall select some that appear to us to be peculiarly deserving of attention. "In those families where gout and dyspep tic complaints are hereditary, the use of wine, and all other fermented liquors ought to be cautiously guarded against in childhood and youth. The parent who offers them to the infant, whatever may be the motives of ten derness, ought to weigh the consequences, If the babe were left to the instinets of nature these articles would be the very last it would fix upon. Their qualities are so diametrically opposite to the mother's milk. and every time they are resorted to, there is The pleasure which they afford is momentary; danger of the quantity being increased: of the evils which result from this practice there is no end. The child that is born of gouty and dyspeptic parents, ought from its birth to be confined to the mildest food; it ought to sub sist on milk alone as long as possible; it must never taste wine, even diluted to the utmost, and broth made from that, light puddings, or beer of the weakest kind. Animal food, and different articles of cookery where milk forms the chief ingredient, will extend the diet as the child grows up; and thus will be and a temperate life. It is a contrary treat laid the foundation of a healthy constitution, ment that ensures the approach of these ma ladies; and early gout is often fixed before the man arrives at thirty. Such are the baneful effects of early bad customs; for when the taste is once confirmed, whether for hot or cold articles; substances sweet or sour, mild or acrid, they become so interwoven with habit, that we strive in vain to correct them." "But it is not drinking spirituous liquors to the length of intoxication only that constitutes intemperance. A man may drink a great deal, pass a large portion of his time at the bottle, and yet be able to fill most of the avocations of life. There are certainly many men of this description, who have never been so transformed with liquor as to be unknown to their own house-dog, or so foolish in their appearance, as to be hooted by school-boys, that are yet to be considered as intemperate livers." We meet with some judicious observations on the supposed effect of spirituous liquors, in enabling the mind and body to endure extraordinary fatigue. The author's own experience, which on this point has been sufficiently ample, is decidedly in contradiction to this notion, so far as respects mental exertion; and we perfectly acquiesce in his opinion, that the same arguments apply to bodily la bour. "Vinous liquors for a while increase muscular strength; but to a certainty bring on premature weariness and fatigue, with more inclination to sleep. Spirits have the same effects in a greater degree, and cause a greater consumption of pure air. In a warm season or climate, the best articles to use under severe corporeal hardships are the acid fruits, such as the lemon and orange, apple, &c.; or in their want, vinegar and water, as practised by the Roman soldiers. In winter, plain diet, with a due admixture of animal food, and moderate exercise, are the sure security of preserving warmth of body. Spirituous liquors, though generally practised, give but a temporary glow, and in the end render the effects of cold more speedily hurtful." His cautions against the habitual use of tinctures, as articles of medicine, of cordials and liqueurs as articles of diet, cannot be too much circulated. We heartily join in his protest against the familiar use of opium, a prevailing, and we fear an encreasing evil. "It is well known that many of our fair countrywomen carry laudanum about with them, and take it freely when under low spirits. This custom is certainly as little to be justified as the use of brandy." In the medical treatment of a person habituated to drunkenness, the first step to be taken obviously consists in the discontinuance of the accustomed potation. It has been a subject of doubt, whether this should be done gradually, or all at once; our author strenuously advises the latter plan. Upon the whole, we are disposed to agree with him, certainly so far as respects the moral tendency of his directions; yet we think there are instances, in which serious bodily disease would be induced, by suddenly subtracting from the diet a large quantity of spirit, to the stimulus of which the stomach had been for a long time habituated. We rather differ from our author, in conceiving that the disease brought on in the liver, by drinking, is a complaint attended with little pain; and we are disposed to place somewhat more confidence in the use of mercury in these complaints than Dr. Trotter does. We also conceive that more stress might have been laid upon the use of aromatics in the dyspeptic complaints consequent upon habitual drunkenness. The stimulus which they afford we have frequently found to be the best preservative against the intolerable languor consequent upon the disuse of spiritu. ous liquors; while their employment, under restrictions, does not appear proper to produce any bad effects upon the system at large. The method of relieving the drunken paroxysm, consists principally in attempting to evacuate the stomach. Where apoplexy is threatened, evacuations of blood should be employed, and temporary relief may be obtained by the application of cold to the head, and parti cularly to the temples. From the extracts which have been given it will be inferred, that the work of Dr. Trotter contains much information, which is valuable both to the moralist and to the physician; and we think the most determined drunkard could not but feel impressed with the view which is here presented of the effects of his rụi. nous habit. We must, however, on the other hand remark, that the conduct of the work is desultory, the style frequently verbose and hyperbolical, and, we are al most tempted to say, the direct reverse of that unaffected simplicity which ought to characterize a scientific publication. The illustrations and tales which are intro duced, are often too extravagant to be instructive, and the poetical quotations are scattered with a cloying profusion. The physiology of Dr. Trotter, we have already ventured to criticise; it appears to us to be in general founded upon loose analogy, rather than accurate deduction from fact. It is somewhat singular, that while modern chemistry, in point of precision, yields only to the mathematical sciences, those physiologists and patho logists who have applied chemical rea soning to the phenomena of the living body, have been, almost without exception, notoriously vague and hypothe tical. ART. XV. An Essay on a peculiar eruptive Disease, arising from the Exhibition of Mer cury; illustrated with Cases taken at the Westmoreland Lock Hospital, Dublin. By GEORGE ALLEY. 8vo. pp. 80. ART. XVI. A Description of the Mercurial Lepra. By DOCTOR MORIARTY. 12mo. pp. 64. THESE two small works are upon the same subject, althogh the title-pages are different. There seems to have been some crossing and jostling in the course of publication; but no notice at all is taken of such a circumstance. We judge from internal evidence. The publica tion of Mr. Alley's Essay has been de layed nearly four months, by the difficulty of procuring good engravings; at last it is published without any. In the mean time Dr. Moriarty appears to have stepped forward to tell the world all that he has seen, beard, and could collect on this subject at Dublin and Edinburgh. Mr. Alley's Essay is entitled to prece dence on many accounts, though there is not much to claim such decided preference in either of these two treatises. 'This discase, we are informed, first became known to the surgeons of the Lock Hospital, in Dublin, in 1789. They considered it as arising from the use of mercury, and adopted a successful mode of treating it in consequence of such an opinion. Mr. Alley, in describing the symptoms and general appearances of the disease, divides it into two species, the mild and the malignant, each character-. ised by different degrees of febrile derangement of the whole system. The patient is seized with the usual symptoms of pyrexia, accompanied with prickly heat and itching of the skin, which pre cede the eruption. This begins about the scrotum and the inside of the thighs, and soon spreads over the whole body. It is said to be similar to that of measles, excepting that it is different by the spots being larger, and of a less florid colour. The plates referred to are unfortunately not given to assist the description; they were so incorrectly finished that the author thought it best to omit them altogether. In the mild cases the eruption begins to desquamate on the fourth day. This desquamation is frequently attend ed with profuse serous discharge, which stains the linen, and is peculiarly fetid. The cuticle peels off in large flakes, but the febrile symptoms do not subside. In some cases the symptoms are not so regular; the desquamation does not begin so soon in the more unfavourable instances. The fever terminates in general on or before the eleventh day: some times this fever is of the low typhoid kind, and proves fatal. Mr. Alley next proceeds to point out the distinguishing characters of this mercurial disease, as he calls it, from all the exanthemata, and from one species of venereal eruption. The method of treatment now successfully adopted, is, first to desist entirely from the exhibition of mercury, to remove the patient from the mercurial at mosphere, to change the cloaths, and to cleanse the skin by the tepid bath. An timonial medicines, and acids, are given with advantage. At the commencement of the disease, bark and wine aggravate the symptoms; but when the febrile state is diminished, the free exhibition of these remedies is of great importance. Pow ders, and frequent washing, should be applied to the excoriated parts. Several cases are detailed: some of them with a tedious degree of minuteness; the languid and prolix copies of some common prescriptions is quite ridi culous. It is curious to remark that the venereal complaints in all the patients disappeared during the coutinuance of the fever, while the use of mercury was suspended; and the patients were dis missed without having recourse to the exhibition of mercury again. This ap pears to render the histories somewhat equivocal, at least it suggests some sus picion of the diseases not being in the first instance venereal. persons on taking mercury, has hitherto This eruption which attacks some been neglected. It well deserves at tention, inasmuch as the febrile state sometimes proves fatal. Both these pamphlets, after being condensed into one, are insufficient to convey a complete view of the subject. They are both superficial; both imperfect productions. Perhaps it was wrong to expect more than we find, since one of these young authors seems to have copied from the other, and both to have borrowed their ideas from the observations of others. ART. XVII. Medical Reports on the Effects of Water, cold and warm, as a Remedy in Fevers, and other Diseases, whether applied to the Surface of the Body, or used internally. By JAMES CURRIE, M. D. F. R. S. Physician in Liverpool, and Fellow of the Royal College of Physicians, Edinburgh. 2 vols. A NEW edition of Dr. Currie's Medical Reports having been for some time called for by the public, the author has embraced this opportunity of making some alteration in the arrangement of the former part, and adding a very large quantity of new matter. The merits of the original work are sufficiently well known; the practice which it recommends has stood the test of ample experience, and it may now be justly ranked among the decided improvements in medicine, established beyond the reach of our commendation or censure. Our attention at present will be chiefly confined to the new matter which is contained in this edition. The principal alteration which has taken place in the arrangement of the former materials is, that the articles which were before thrown into an appendix, are now introduced into the body of the work. An account of two cases of tetanus, which were successfully treated by the author, since the publication of the second edition, are inserted in the first volume. The first case was produced by a wound in the leg. About 15 days after the accident a stiffness of the jaw first appeared, and continued to increase for six days, notwithstanding the plentiful use of opium and wine. At this time the affusion of water of 75° was employed, and produced an evident allevia tion of the symptoms. The patient "Found considerable and immediate relief from the affusion, which, at his own request, was constantly repeated whenever the symptoms were the most severe, and always with sensible and instant benefit. From this time the symptoms became stationary: in a few days there was an abatement of their violence, and under a continuation of this treatment, he finally recovered. The case was, however, a considerable time doubtful; it was not till after the expiration of twenty days that we could consider the recovery as certain. He took during this time, on a medium, twelve grains of opium, and nearly three pints of wine in the twenty-four hours, and had the cold affusions between three and four times daily." The other case was much more violent. It originated from a splinter running under the finger nail. In about a fortnight the disease had assumed the most formidable aspect. Large quantities of opium in the liquid form, the cold affusion, and the free use of wine were had recourse to, and in spite of the most violent symptoms, were finally successful in combating the disease. Being in the vigour of life, and of great bodily strength and resolution, the exertions he made were very uncommon. He could swallow at intervals only, and for several days never, but when turned on his face; and his upper jaw was rigidly shut; yet as it lapped over the under one, he drew duced, and a much larger quantity of wine up the medicine through the orifice thus proand nutriment than was expected. An ace curate journal was kept by his attendants, from the 13th of April to the 11th of May, of every circumstance respecting his case, which extends to forty-two pages 4to. ; and from this it appears, that in the interval of time just mentioned, he drank, mixed with nourishment, and by itself, the extraordinary quantity of a hundred and forty bottles of wine, being five bottles of Madeira a day, besides some ale, and several gallons of brandy. From the 13th of April to the end of that month, he took, one day with another, a hundred and fifty-five drops of laudanum daily, being in all five ounces and six drachms; and used during the same time, twenty-seven ounces in embrocation, with twice the quantity of æther. He also used three drachms of powder of opium in ointment.” "In the use of the cold bath Mr. P. was in like measure left a good deal to his own discretion. From the 13th of April to the 8th of May, when he left it off entirely, it ap pears that he bathed sixty-five times, twice using the tepid, and sixty-three times the cold affusion. As he sweated profusely, we dis rected the water to be made milk warm; but finding no relief from it in this way, he him self desired to return to the cold affusion." |