state of the skin, previous to the affusion being employed, and hence the necessity of giving the emetic a considerable time previous to the washing, that the condition of the skin, from perspiration, &c. may not render it unfit for the application of the cold water.

6. "History of a remarkable case of diabetes, treated in the Royal Infirmary of Edinburgh, and extracted from the records of that hospital."

This is the detail of a case, mentioned in the last volume of the Annals of Medicine, as having been cured by the use of lime water and powder of galls.

7. "History of a considerable wound of the brain, attended with singular circumstances. By Mr. Edward Barlow, student of medicine at Edinburgh, froin Westmeath, Ireland."

The patient, a boy of about 14 years of age, received a kick from a horse above the orbit, by which a large fracture was produced, and many of the broken pieces of the skull driven into the substance of the brain. Portions of the brain also escaped through the opening. The symptoms were very unfavourable during the first week, but in the second they began to improve. Early on the third, however, the suppuration, gradually increasing, became profuse, and as it was undiminished by the use of bark, an examination became necessary into the circumstances which kept it up. This examination discovered, that the discharge which wetted the bandages, nightcap, and even the pillow, was distinct from the purulent matter which the ulce

rated surface afforded.'

That it came from the internal part of the wound, and was perfectly watery, as it now appeared distilling in quick successive pellucid drops from the eye-brow, unmixed with any purulent matter, which would naturally have impaired its transperency."

Various speculations on the source of this discharge were made; but the only probable one seemed to be, that a piece of the bone had penetrated the left ventricle of the brain, and that the fluid discharged was an increased secretion from its cavity. Calomel with opium, and afterwards peruvian bark were employed to remove it, and with success. The boy recovered his health, but his vision remained in a slight degree affected.

8." Case of a gun-shot wound, with a division of the femoral artery. By Mr. David

“The artery, just about to enter the ham, was completely divided by the ball, its two ends fairly separated from each other, 】 yet accompanied by no immediate hæmorrhagy, nor followed by that which was to be dreaded after the sloughs had been throwa off. There was not even any internal bleeding; there was no aneurism; but the divided artery was shrunk, and closed; the eirelation was destroyed in the limb, and the leg perished before nature had forced open other channels for conveying blood to the parts below the wound."

9. "A Letter from Dr. G. D. Yeats, physi cian at Bedford, to Dr. Duncan, giving an account of the good effects obtained from a combination of calomel and opium in infa matory diseases; with observations on effects arising from the acetite of copper, and ca some other important subjects in the practice of medicine."

of calomel and opium conjoined, in inThe author was led to the employment flammatory complaints, from the recom mendation of Dr. Hamilton, of Lyra Regis, who wrote a paper upon the subject in the ninth volume of the Medical

Commentaries. Acute rheumatism, en teritis, and pleurisies, were the complaints in which this combination was found most useful. A case is given in which bleeding, blistering, nitrous and antime nial medicines had all been employed without advantage, for very viclent pneumonic symptoms, indicated by in cessant cough, acute pain of the side, strong, full, and quick pulse, with vic! lent exacervations of fever. Repeated doses of calomel and opium were then had recourse to, which, in a short time, gave great relief, and as soon as the mouth became sore, produced a cessation of every bad symptom.

Another case is annexed, to shew the inefficacy of nitrous acid in syphilitic complaints, and of mercury without a due regard to diet.

Some very serious symptoms are mentioned, as having occurred in a family who had eaten pickled salmon, supposed to have had an impregnation of verdi gris. They went off by the use of suiphur given in large doses. A case cí diseased liver is also inserted, in which

hydatids were coughed up by an opening through the diaphragm, with some relief to the patient. The case was under the author's care at the time of this communication being made.

10." Remarkable cases of convulsions, with some observations on the hemorrhois petechialis, or petechiae sine febre. Communicated to Dr. Duncan, jun. By Dr. Albers, physician in Bremen."

In the first of those cases, the convulsions seem to be produced by the irritation of an abscess in the ear; in the second by an intussusceptio of the intestine. An intussusceptio was likewise observed in the dissection of a Mexican boy, which died of convulsions. The case of petechia sine febre is no way remarkable. The patient had a discharge of blood from the gums, and the body was covered with petechia. He was cured by decoction of bark acidulated.

11. "History of a singular case of an extra uterine fœtus, 'discharged by the rectum. By Mr. John Goodsir, surgeon at Largo."

About the seventh month of pregnancy the patient felt the child give a violent struggle, and at once its motion ceased. Symptoms of labour now came on, and continued six or seven weeks. The patient gradually recovered for as many months, and was then seized with a fever, during which she had frequent

symptoms of labour. She gradually lost ground, but in a short time observed a thick whitish substance to be discharged from the rectum, and on passing her finger upwards discovered something hard, which was found by the author to be the cranium of the child. With considerable difficulty, and after a good deal of time, the whole was brought away, and the mother did well.

12." Observation sur la Cataracte. Par A. Mounot, professeur d'Anatomie & d'Accouchement à Besançon. Communicated by Dr. Inglis."

After giving a general history of this operation, the author mentions the usual mode of extracting a cataract; but as he has frequently found that the operation is unsuccessful, from inflammation attacking the capsule of the crystalline lens, he proposes, immediately after the extraction, to direct to the posterior part of the capsule the same instrument by which it was divided anteriorly, and to cut it by a crucial incision. Thus the vitreous humour replaces the crystalline, the pupil is dilated, the eye is bright and without clouds, and the patient perceives all the objects which present themselves."

The remainder of this volume is occupied, as usual, with several articles of medical intelligence, and with a list of ew books and inaugural dissertations published during the year 1802.

THE author's long official residence at Sierra Leone, gave him an opportunity of acquiring considerable experience in the diseases of hot climates; and the present work is intended to communicate the results of it, to such as may have occasion to be exposed to the warmth of the torrid zone. His observations are not entirely confined to his own experience; as it is his wish to provide general practical directions, for the management of health, and the treatment of diseases in tropical climates, for the use of such persons in particular, as may not have the advantages of medical advice. The directions given for the diagnosis and cure of diseases, will not, therefore, be expected to contain more than is already familiar to the practitioner who is at all acquainted with the complaints incidental to hot climates.

It may be observed of them, however, that they are concise and perspicuous, and, in proper hands, may be useful. The advice given to settlers, though it is that which will apply in a great degree to any climate, appears to be the result of personal observation, and we have no doubt, if it is attended to, will prove useful.

The principal circumstances to which their attention is required, are, sobriety in eating and drinking, early hours, moderate exercise in the cool of the day,. flannel clothing, and the removal of costiveness. Bleeding immediately after arrival, bark and bitters, emetics, and cold bathing, appear to the author to be injurious. The unpleasant sensations frequently experienced in the mornings are more effectually removed by a light breakfast than any thing medicinal.

which the former disease may always be cured in young people, and that bark, steel, oil of amber, misletoe, and valerian, even when employed at the periods mentioned by him, will often be found inefficacious.

A VERY important part of the knowledge which a liberal practitioner in medicine ought to possess, relates to the conduct to be pursued in his intercourse with the world, and with his brethren in the profession. The medical art in this country has long maintained a very elevated rank, as well on account of its acknowledged utility, as the learning and abilities of its professors. The qualifications necessary to make a physician serviceable in his profession, are not of a nature to be duly estimated by the public. It is naturally however expected as a criterion, and in general not an unfair one, of his medical skill, that he should possess general learning and information, with a refinement of manner, and a liberality of conduct, which be speak the well educated gentleman. A certain degree of acquaintance with the world is necessary to furnish that knowledge of mind and manners which are essential to a respectable advancement, and we doubt not that the work now be fore us, will prove extremely useful to the young and ingenuous practitioner, by furnishing him with the rules of professional conduct which have been laid down by a learned and liberal minded physician, after a long life of reputation and utility.

The present work originated in a code of laws which the author was requested to draw up in the year 1792, for the use of the infirmary of Manchester. He was afterwards induced to extend his plan, but various circumstances, for some years interrupted it, particularly the death of a very promising son for whose particular use his labours were intended.

The 1st chapter contains the code of laws above mentioned, and treats of professional conduct, relative to hospitals and other medical charities. It is not to be expected that much novelty should be here introduced. The author has given a summary of the mode of conducting public business, in a way the most satis.

factory and useful to the practitioner, and the most agreeable and beneficial to the patient. The principal objects which he inculcates are, tender and delicate attentions to the patient, and a liberal and unrestrained intercourse among the medical attendants. The advantage of the sick must necessarily be the first point of attention, but with this he always wishes to connect the improvement of the profession. Most of the injunctions which are laid down for the conduct of the practitioner to the patient, are highly proper, but feelings of delicacy may perhaps be carried too far, when it is said, that they should always be interrogated concerning their complaints in a tone of voice which cannot be overheard. Circumstances may certainly occur, particularly with females, when such an injunction is proper; but as a general rule, it seems to us very unnecessary, and will frequently deprive the attending pupils of very desireable information. Many important remarks occur in this chapter, on the utility and management of dispensaries, lunatic hospitals, and lock hospitals, which are equally creditable to the author's judg ment as a physician, and to his feelings as a man. The two next chapters treat of professional conduct in private and general practice, and of the behaviour of physicians to apothecaries. The leading circumstances inculcated are, liberality of conduct to the patient, and medi cal brethren, and a strict regard to mora. lity in general behaviour. Viewing mc. dicine as a profession by which a mau is to be supported, a certain attention to personal interest is necessarily required. The respectability of the profession should never, however, be sacrificed to motives of private interest, and it always becomes the practitioner to exercise a great liberality of conduct to those pa tients, whose situation in life may not make it convenient to obey their own feelings in the acknowledgment made. It is proper however to do our profes-

sion the justice to say, that, with a very few exceptions, there is every disposition to take into consideration the circumstances in which patients happen to be placed.

The following remarks are well worthy the serious attention of the candid physician.

"At the close of every interesting and important case, especially when it hath terminated fatally, a physician should trace back in calin reflection, all the steps which

he had taken in the treatment of it. This review of the origin, progress, and conclusion of the malady; of the whole curative plan pursued; and of the particular operation of the several remedies employed, as well as of the doses and periods of time in which they were administered, will furnish the most authentic documents, on which individual experience can be formed. But it is in a moral view that the practice is here recommended; and it should be performed with the most scrupulous impartiality. Let no selfdeception be permitted in the retrospect; and if errors, either of omission or commission, are discovered, it behoves that they should be brought fairly and fully to the mental view. Regrets may follow, but criminality will thus be obviated. For good intentions, and the imperfection of human skill which cannot anticipate the knowledge that events alone disclose, will sufficiently justify what is past, provided the failure be made conscientiously subservient to future wisdom and rectitude in professional conduct."

The commencement of that period of senescence when it is incumbent on a physician to decline the offices of his profession, it is not easy to ascertain, and the decision of so nice a point, the author justly observes, must be left to the moral discretion of the individual.

"As age advances, therefore, a physician should, from time to time, scrutinise impartially the state of his faculties; that he may determine, bona fide, the precise degree in which he is qualified to execute the active

and multifarious offices of his profession. And whenever he becomes conscious that his memory presents to him, with faintness, those analogies, on which medical reasoning and the treatment of diseases are founded; that diffidence of the measures to be pursued perplexes his judgment; that, from a deâciency in the acuteness of his senses, he finds himself less able to distinguish signs, resolve, though others perceive not the or to prognosticate crents; he should at once changes which have taken place, to sacritice every consideration of fame or fortune, and to retire from the engagements of business.” With regard to the behaviour of phy sicians to apothecaries, the author recommends every proper attention to that very useful class of men, who are genenerally the precursors of physicians, and with whom an amicable intercourse, and co-operation, if conducted with regard to decorum and etiquette, (which should always be steadily observed) will add to the authority of the one, the respectability of the other, and the usefulness of

both.

The 4th chapter treats of professional duties in cases which require a knowledge of law. In many circumstances in which physicians and surgeons may be placed, it is desirable for them to have not only a certain acquaintance with the principles of jurisprudence, but of the forms and regulations adopted in courts of judicature. The necessity of such a knowledge, will evidently appear from the perusal of this chapter, in which much useful information is given on the subject. An extensive appendix is added to this valuable work, which contains a sermon on hospital duties preached by the author's son, in the year 1791, for the benefit of the infirmary at Liverpool, and a variety of notes and illustrations connected with the subjects of the preceding pages, and equally deserving a mi

nute attention.

THE diseases of women form a large and important branch of medical practice, and have received from the author, more than ordinary attention, during a long period in which he has acted as physician to an extensive lying-in charity. His work may be regarded as a useful compendium of the practice which is now most generally employed in female diseases, but we do not observe

that he has, by the observations which he had an opportunity of making, thrown any new light upon the subject. He studiously avoids entering into any discussion on disputed points in the pathology of female complaints, which we should have considered as natural objects of particular consideration; and contents himself with merely stating the opinions of other writers, where such subjects occur.