Part 2.-Reviews and Notices of New Works. ARTICLE I. A Practical Treatise on the Diseases of Children. By J. FORSYTH MEIGS, M.D., &c. Philadelphia: Lindsay & Blakiston. 1848. pp. 575 8vo. Sage enfant qui connoit son père, says the old French proverb, and in these book-making days it may be not inaptly said that it is a wise volume that can trace its own pedigree. Originality is a commodity that is well nigh obsolete, and in lieu of it we have compilation better or worse. Especially is this the case in Medical Science; and the fact has become so notorious, that physicians perhaps read less than any other class of professional men, confining their efforts in the way of reading, principally to the short essays and reports furnished in the medical periodicals of the day. We are fully aware that in the above remark upon originality, we have advanced nothing new; even so far back as the days of Chaucer, to say nothing of Solomon, the same idea was entertained. "Out of the olde fieldes, as men saithe, Cometh all this new science that men lere." Its rare to find, even in Medical Journals, an analysis of the various works from time to time issued by our enterprising publishers: we have merely a short notice-nine times out of ten entirely approbatory-containing the title, name of the author, a hasty and imperfect sketch of the table of contents, and perhaps a page or two by way of extract. Medical editors evidently esteem it too great a bore to examine attentively all the works which are furnished them by the courtesy of authors and publishers; and as good manners forbid an entire disregard of such favors, a random compliment is inserted; but as to anything like a searching analysis, or examination of the doctrines advanced, the thing is not to be thought of. The fact is, our medical journals are somewhat faulty in this particular: physicians look to them for all news interesting to the profession, and the meager notices of books which are furnished are not sufficient to inform a physician distant from the great cities and thoroughfares, whether or not a given volume is worthy a place in his library. In consideration of this defect in the literature of our profession, we promised in our last number, to give a somewhat extended notice to the work whose title stands at the head of the present article. It is a generally received opinion amongst mankind, that experience is necessary to excellence in any art or profession, though this opinion is often carried to a ridiculous extent, by persons who forget that talent and close observation are essential to render experience of any value. Our author has cut loose from this long established dogma, and although a junior member of the profession, has written a treatise for the instruction of both students and practitioners; and we cannot say that the task is illy executed, or that the work is a useless addition to our already extensive literature. The author has availed himself of the opportunity of consulting various English and French authorities, the latter of which, are not generally accessible, owing to the fact of their being written in a foreign language; and has collected from various medical journals many items of interest and value, which would otherwise be lost to the majority of the members of the profession. The details of his personal experience are not extensive, but we suppose they are in the main accurate. We desire, also, to bear testimony to the excellent mechanical character of the work the paper is good, the type clear, and there is a singular freedom from typographical blunders; moreover, the price is so low as to place the work within the reach of all. All diseases of children are classified under five general Vol. 1. No. 4.-4. heads, viz: Diseases of the Respiratory Apparatus, Diseases of the Digestive Apparatus, Diseases of the Nervous System, Eruptive Fevers, and Worms in the Alimentary Canal. Class I. is divided into two chapters, the first containing a description of diseases of the upper air passages, and the second, diseases of the lungs and pleura. Chapter 1 treats of coryza, pseudomembranous laryngitis, spasmodic laryngitis, and simple laryngitis. Coryza being a simple disease, and very rarely dangerous, need not detain us. Concerning the section on croup, we have somewhat to say. In the first place, we object to the nomenclature employed by Dr. M., as radically faulty, and tending to convey a false notion of the pathology of the disease under consideration. Pseudo-membranous laryngitis, would seem to designate a complaint affecting exclusively or principally the larynx, and attended with, or marked by, the exudation of false membrane. Now that croup has its principal seat in the larynx, we are by no means disposed to admit, and in support of our assertion we have the weight of modern authority. Stewart, Dewees, Evanson and Maunsel, Elliotson, Watson and Williams, regard the trachea as being the organ most frequently implicated; Condie regards croup as a laryngeo-tracheitis; Bell seems to regard it as primarily affecting the larynx, and the same view is taken by Bichat, and John Mason Goode, the latter of whom, seems to have very indefinite notions of the disease. Dr. M. himself, admits that, in, perhaps, two thirds of the cases, the larynx and trachea are both involved. Now, in nosology, as in any other branch of science, a name should designate something of the nature of what it stands for; and although tracheitis may be an objectionable term for croup, we conceive that pseudomembranous laryngitis is much more so. Were croup principally a disease of the larynx, we might hope great things from tracheotomy, against which, the weight of British and American authority is decided, and in our opinion conclusive. Should Dr. M. still see fit to object to the old name of tracheitis, we would commend to his notice the term used by Dr. Condie, as being nearer the mark than the tremendous cognomen he has seen fit to employ. We object to regarding pseudo-membranous croup, and spasmodic croup, as two separate and distinct affections: we deny that the fact of the exudation of false membrane is sufficient to distinguish one inflammation from another, or that the spasmodic action of the musclesunless such spasm is totally independent of other pathological conditions-is sufficient to authorize a writer to introduce a new species into nosology. In opthalmia it is a common thing to see effusion of lymph into the anterior chamber of the eye (now the false membrane of croup is nothing more than organized lymph); but we apprehend that an author would be considered as given to unnecessary refinement, who would designate those cases accompanied with effusion as constituting a disease distinct from ordinary opthalmia. It seems to us, that what our author designates as pseudo-membranous laryngitis is a severe form of croup, and the spasmodic variety, the same disease in a milder form. As an author, writing in an age when most subjects of interest have been fully discussed by the able st members of the profession, Dr. M. may be anxious to present something that shall bear the impress of novelty and originality; but he should not forget, that in our profession he renders a service who simplifies what has heretofore been complicated, and that the improvements in medicine and surgery have generally tended in this direction. Now the praise of simplicity and conciseness is something we cannot award to the technology of the article on croup. That part which refers to the treatment of this severe and dangerous complaint, we believe to be judicious. One article is recommended as an emetic, which, so far as we know, is not in general use amongst us: we refer to the alum; the advantages of this remedy are thus set forth by the author: The alum is given in powder, in the dose of a teaspoonful, mixed in honey or syrup, to be repeated every ten or fifteen minutes until it operates. It is very seldom necessary to give a second dose, as one operates in the majority of cases very soon after being taken. I have known it to fail to produce vomiting only in two instances, both of which were fatal cases. In one the disease had gone so far before I was called, that no remedy had any effect upon the stomach. In the other, it was administered several times with full success, but lost its effect at last, as had happened also in regard to antimony and ipecacuanha. The reasons for which I prefer alum to antimony, or ipecacuanha, are the following; antimony, when resorted to as frequently in the disease as I am of opinion that emetics ought to be, is too violent in its action; it prostrates many children to a dangerous degree, and is, I fear, in some cases, itself one cause of death. It acts injuriously upon the gastro-intestinal mucous membrane, when used in large quantities, and for any length of time. Again, it is very apt to lose its effects and produce sickness. Ipecacuanha is a much safer remedy than tartar emetic, but its operation is often too mild, and it also ceases to produce any effect after it has been used several times. The advantages of the alum are, that it is certain and rapid in its action, and that it operates without producing exhaustion or prostration beyond that which always follows the mere act of vomiting. It does not tend like antimony, and in a less degree ipecacuanha, to produce adynamia of the nervous system; an effect which, in some constitutions or states of the constitution, or when it has been exhibited frequently, is often attended with injurious or even dangerous consequences. I have given alum in the dose above mentioned, twice and three times a day, for two and three days, without observing any bad effects to result from it. The alum was given in all the cases that I have seen, in which emetics were used, and was the only one employed when it was found to produce full vomiting, with a single exception, one of the cases accompanied by violent angina, in which ipecacuanha was substituted because of its smaller bulk. I have already said that it failed to produced vomiting only in two instances. It was the emetic employed in the three cases in which fragments of false membrane were rejected, and in that in which the yellow viscid fibrin was expelled. Although it did not occasion the rejection of membrane in the other cases, it operated most speedily and efficiently. While on this part of the subject we will take occasion to make a remark or two on the literary character of the work. It is a notorious fact that the technology of the medical profession is peculiarly barbarous: this is, perhaps, owing in a |