show the practical tendencies of our American brethren, and prove that they do not belie their relationship to the mother country.

The President of the Society, Dr. Millard, opens the 'Transactions' with an able hygienic address on air, exercise, and light, delivered before the members of the Society and the members of the Legislature. Three biographical sketches of medical men well known in the State of New York-Drs. Ely, Spencer, and Reynolds, follow. Dr. Van Buren supplies a well-written history of anaesthetics, while the employment of amylene is discussed by Dr. Orton. The two next papers treat of cerebro-spinal meningitis, which appears to have been epidemic of late in some parts of the United States, as it has also in Europe.* These papers are both very loosely drawn up, and the evidence of the spinal meninges having been uniformly affected is not satisfactory; the account of the cases related is extremely scanty, and neither of the observers appears to have instituted any post-mortem examinations, although unfortunately the disease was very fatal. Dr. Thomas, the author of the first paper, states that the disease "prevailed with a fearful ratio of mortality in central and western New York" in the spring of 1857. He describes it thus:

"In some cases its approach is accompanied by some disturbance of the stomach and bowels as slight nausea and vomiting, and moderate diarrhoea. This state is accompanied with slight chills and pain in the head and back, sometimes very severe. After a short time, perhaps a few hours, these slight disturbances of the system will be followed by delirium, an anxious countenance, great restlessness, cool or cold skin, and a frequent irregular pulse. As the disease progresses, their muscles become affected with spasmodic contractions, and especially those of the back and neck, which often assume a permanent rigidity, confining the body or neck to one position for days, and sometimes even weeks. In the strongly-marked congestive form the irregular pulse, the cold surface, and coma more or less profound, usher in the disease. In the course of a few hours, reaction becomes established, the pulse becomes frequent and strong, and not unfrequently retains its irregular action; the skin hot and dry; urgent thirst, severe pain in the head and back, local and general spasms, torpid bowels, irritable stomach, ejecting green morbid secretions, delirium, head drawn to one side, or fixed firmly backward, petechiae, and an irritable and excessively tender surface. The morbid condition of the tongue varies with the progress of the disease; in the early stages being slightly covered with a white or yellow brown fur, and later in the disease, dry and red, or a dark brown coat is found to cover it."

The disease appears to be of a malarious origin, prevailing in parts where all the causes of malaria exist; and hence it occurs during the damp weather of February, March, and April, and again in the months of November and December. In spite of this theory, which appears to be borne out by facts, the influence of the old phlogistic doctrine, and the corresponding belief in the antiphlogistic powers of mercury, induced both Dr. Thomas and Dr. Kendall to trust mainly to large doses of the salts of this metal. The results of their treatment, however, were by no means satisfactory, and we think that if they adhered consistently to the malarious theory, and treated any future cases with quinine and brandy, they would be able to render a more favourable report. The Transactions' contain several other medical, obstetric, and surgical papers, to some of which we may be able to refer in the Quarterly Reports.

We cannot, however, conclude this notice of them without adverting especially to the very elaborate paper of Dr. Brinsmade, the Vice-President of the Society, in which he registers the results of an analysis of all the cases of disease which have occurred in his practice during twenty-one years. Having preserved records of all the cases which he has attended since the commencement of his professional career, he publishes the analysis, in order to serve as an inducement to his medical brethren to follow his example, so as to obtain a fair insight into the endemic and epidemic constitution of the State of New York. Valuable as are mortuary registers, such a registration of diseases would prove of equal, if not of greater value, in determining various sanitary questions. We wish Dr. Brinsmade every success in his undertaking, and would be glad to find that

The reader will find an account of the epidemic of spinal congestion observed at Niort, in France, by Dr. Gauné, in the Medico-Chirurgical Review for April last.

medical men generally, in his own and in other countries, kept as complete registers as he has done, so that it were possible to secure an uniform system of registration of disease.

ART. III.-Health and Disease, their Laws; with Plain Practical Prescriptions for the People. By BENJAMIN RIDGE, M.D., F.R.C.S., &c. &c.; author of 'A System of Glossology, &c. &c.-London, 1858. pp. 624.

EVERYTHING in nature presents itself to the author of 'Health and Disease' in a triple form; gender, for instance, is masculine, feminine, and neuter; in arithmetic we have the rule of three; the chemist has acid, alkaline, and neutral agents; and the threefold arrangement is maintained in the constituents of the human body, which is divided into hard, soft, and fluid substances, each of which again admits of a threefold subdivision. Diseases follow the same law, for their diagnosis is divisible into the exciting, the proximate, and the latent cause,

"All of which may be proved and verified by means of, (a) the tongue, (b) the pulse, (c) the history and general symptoms of the case. The characters of disease, in like manner, have three divisions-(1) acid, (2) alkaline, (3) neutral; their subdivisions, again, being (a) organic, which are incurable; (b) functional, which are curable; (c) nervous, which are remediable."

Again,

"The laws of diet and hygiene may be classed under three distinct divisions-(1) the ingesta, that produce in the system, through their ultimate reduction by digestion, a great amount of acidity, as, for instance, all boiled and salted meats, as well as direct acid diets; (2) those which, in their last actions of digestion, produce less acidity than the former, or are in their action on the system, when first taken, of a decidedly alkaline character, as roasted and broiled meats, &c.; (3) the neutral elements of diet, which seem to have no influence in either way."

Dr. Ridge, in spite of his affection for number three, is not consistent in his attachment, for the number of chapters which he devotes to the consideration of the various topics connected with health and disease, is neither three nor a multiple of three, but twenty-five; in them, as may be supposed from the samples taken from his introduction which we have given above, he favours us with a large amount of hypothesis, for which we must refer our readers to the book itself.

Those who have patience to peruse the 624 pages of the work, will find some prac tical wisdom underlying the writer's hypotheses; but we fear, that from addressing himself at the same time to the medical and general public, he will experience the Sate of those who essay to sit upon two stools at once. If he could be prevailed upon to give in a diminished form some of his chapters-as those on nurses and nursing, and on ventilation, with the essential practical points contained in some of the other chapters, shorn of verbiage and hypothesis, he would insure for himself a wider circle of readers than the bulky volume now before us is likely to obtain. His precepts might then become what they now profess to be, plain and practical, and the people might learn to appreciate them.

ART. IV.-Archives of Medicine. Edited by LIONEL S. BEALE, M.B., F.R.S., Physician to King's College Hospital, &c. No. II.-London, 1858. pp. 53 to 160. THE second number of this interesting periodical is now before us, and we are able to recommend it to our readers as strongly as we did its predecessor. The information it contains is very varied, and although the learned editor favours us with several com

munications himself, several of his own immediate colleagues and other observers have come to his support. The number opens with the conclusion of Dr. Todd's remarks on the treatment of acute inflammations, in which the author brings forward his arguments for the employment of alcoholic stimulants in these affections; Dr. Scott Alison follows with a description of his new instrument, the stethogoniometer, destined for measuring the inclination of the thoracic walls. Dr. Farre supplies an article on the exfoliation of the epithelial coat of the vagina, in which he maintains that the current view regarding the form of that passage is erroneous; Dr. Johnson next gives cases showing that solidification of the lung does not necessarily increase vocal vibration; cases of calcareous deposit in the brain by Dr. Ogle, articles by Dr. Guy, by Mr. Henry Lee, by Dr. Marcet, Mr. Hulke, Dr. Handfield Jones, and Dr. Von Bose, besides several valuable papers by the editor, contribute to make this number very attractive. Most of the papers are well and intelligibly illustrated.

ART. V.-Treatise on the Principles and Practice of Veterinary Medicine and Surgery. By WILLIAM HAYCOCK, Veterinary Surgeon and M.R.C.V.S. Part I. pp. 160.— London, 1858.

2. Edinburgh Veterinary Review and Annals of Comparative Pathology. Published quarterly. No. I., July, 1858.-Edinburgh.

WERE it not that Mr. Haycock coquets with homoeopathy, and occasionally speaks of mercurius instead of mercury, of calendula, rhus toxicodendron, and other remedies specially favoured by homœopathists, evidently with a view to captivating the wealthy supporters of the sect who may also be the proprietors of large studs and stables, his pathology and his mode of treatment would not have led us to suspect the tendency. Dr. Anthony Todd Thompson, Dr. Druitt, Dr. Copland, are among the authors quoted in support of the author's doctrines; while Dr. Dudgeon is the only homœopathist whose opinions are brought forward, and only for the purpose of allowing Mr. Haycock to maintain as a sort of placebo to his conscience, that "cases do occur in which it is necessary to resort to other than homoeopathic means for their cure." His homœopathic colleagues will scarcely admit his orthodoxy as a member of their faith. A dose of two ounces and a half of tincture of opium (p. 86), two-drachm doses of ammoniocitrate of iron (p. 89), six-drachm doses of aloes (p. 143), four to six-drachm doses of aromatic ammonia (ibid.), are as legitimate doses for horses as one can desire, and throughout the book we find none but the most superficial indications of a practical leaning towards homœopathy. The book is in all other respects a good one, and but for the ethical principles involved, we should entirely agree with the author's views, which are lucidly expressed, and in accordance with the teachings of science.

We can more unreservedly speak in praise of the second work at the head of this notice; the initial number of what, we sincerely trust, will prove a valuable series of quarterlies, devoted to the science of veterinary medicine in all its important bearings. We believe that great as England has long been in the practical development of its agricultural resources, and the promotion of horse and cattle breeding, and sheep-farming, and in the cultivation of all the domestic animals that surround us, our countrymen are behind other countries in the appreciation of the intimate relation existing between human and veterinary hygiene and medicine. We owe a great debt of gratitude to the brute creation for the numberless aids they have afforded us in the advancement of human anatomy, physiology, and medicine; we shall continue to derive manifold benefits for ourselves in advancing the knowledge of the relative influences that affect both great classes of the creation, while we may hope, in many ways, to improve the condition of the animals committed to our charge, by a careful study of the sanitary and morbid conditions that affect them. Dr. Lindsay, in an admirable article contained in the first number of the Veterinary Review,' well developes and fortifies the position that "the studies of the diseases of man and the lower animals borrow and reflect light mutually

on each other" and he goes on to show that the transmission of disease from man to animals, and vice versa, are governed by laws which it is manifestly and palpably our common interest to study. It was but in our last number* that we drew attention to the labours of Mr. Gant, who has shown the error our agriculturists run into, when they regard the artificial fattening of animals as the only object to be pursued by cattle clubs; the various inquiries connected with the hygienic influence of Smithfield and the slaughter-houses of London, with the influence of scrofulous cows upon the health of our infant population, with the deterioration of our streams upon the health of their finny inhabitants and the food of the population, need only be adverted to, to crowd upon our minds reasons why, in a hygienic point of view, veterinary medicine and comparative pathology deserve to rank high in the estimation of men of science and of the population at large.

The first number of the 'Veterinary Review' is, as we have said, full of promise; the right spirit appears to animate the writers, and they have a large and important field to cultivate. Besides Dr. Lindsay, whose article we have already quoted, Mr. Gamgee, Sen., Mr. John Gamgee, Mr. Dudfield, Mr. Dickinson, and Mr. Horsburg, contribute original papers; while reviews, editorial articles, extracts from British and Foreign journals, and other matters bearing upon animal hygiene and medicine, occupy the

remainder of the number.

ART. VI.-Silver Sutures in Surgery: The Anniversary Discourse before the New York Academy of Medicine. By J. MARION SIMS, M.D., &c.-New York, 1858. pp. 69.

THE substance of Dr. Sims' views is contained in the two following extracts :

"The next eight years will not find an educated physician anywhere who will dare to use silk sutures, for the silver thread will now become as essential to the dressing-case as the needle itself; and if I may be allowed to venture a prediction, I will say that fifty years hence the statistics of our hospitals will show a vast improvement in their bills of mortality after great operations, and this improvement will be due mainly to the use of silver as a suture." (p. 45.)

"With silver there is no inflammation, no suppuration, no cutting out of sutures, no gaping or retraction of flaps, and therefore no necessity for disturbing the dressing till all is firmly united and permanently well."

The author tells us that these are no vain imaginings; for although enthusiastic (which we can readily believe), he is not wildly so; we must, nevertheless, descend from the exalted ground from which he would have us view this subject, to the consideration of the particular ways in which a silver wire differs from any other. In the first place,

then, it must, we think, be allowed, that a metal ligature is not so irritating as silk, and that it will remain in the living tissues without being the cause of irritation for a very considerable period. Secondly, a metal ligature secures the perfect and undisturbed apposition of the parts, which it directly holds in contact; and thirdly, it maintains that contact without exerting that strain and tension which an elastic thread must necessarily in some measure produce. That these may be important objects in the practice of surgery we would be the first to allow, but that they would prevent a wound from ever taking on an unhealthy action or from suppurating, we cannot stretch our imagination sufficiently to believe.

Dr. Sims informs us that, in 1845, he "conceived the idea of curing vesico-vaginal fistula." (p. 9.).... "After nearly four years of fruitless labour, silver wire was fortunately substituted for silk as a suture, and, lo! a new era dawns upon surgery."!!

We must be excused for reminding Dr. Sims and our readers, that in the 'British and Foreign Medical and Chirurgical Review,' for April, 1846, we drew attention to the employment of platinum wire as a ligature thread; and as early as the year 1832, Dr. Mettauer, of Virginia, employed metallic sutures with perfect success. In the thirteenth volume of

* July, 1858.

the American Journal of Medical Sciences,' for 1833, Dr. Mettauer relates very modestly the particulars of a case of recto-vaginal fissure which he had thus treated.

We cannot, therefore, allow that Dr. Sims first conceived the idea of curing vesicovaginal fistulæ, or of employing metallic ligatures in their treatment. Nor do we regard the tone of self-assertion which pervades the Discourse compatible with the dignity of science, or suitable to the occasion when it was delivered.

ART. VII.-Urethro-Vaginal and Vesico-Vaginal Fistules, &c. By N. BOZEMAN, M.D., of Montgomery, Ala.-Montgomery, 1857.

Dr. BOZEMAN's ingenious and important contrivance of the shield-suture as a means for the cure of vesico-vaginal fistula, has been described on a former occasion in this journal. In the present publication the author gives a valuable account of the nature. and varieties of this distressing accident, of the particular modifications of his method required for the treatment of the different forms, and a history of cases. He classifies the cases under five heads :

1st.-All fistulæ causing a communication between the urethra and vagina. 2nd.-Fistulæ established at the expense of the trigonus vesicalis.

3rd. Those situated in the bas-fond of the bladder.

4th. Those formed at the expense of a part or the whole of the vesical trigoni and the root of the urethra; of the trigoni and bas-fond of the bladder; or, all three of these regions together.

5th. Includes all fistula complicating the cervix uteri, either with or without injury of this organ. Of the author's 37 fistulæ, 11, or about one-third, were of this last description.

Of the first class, Dr. Bozeman considers an injury, not strictly a fistula, consisting in a rent of the urethra extending from the meatus backwards, as the most unfavourable form of all the urethral injuries. The shortening which the urethra undergoes is attended by an irritable condition of the sides of the rent, and an escape of a small portion of the urine into the vulva during micturition, the fluid running down upon the thighs, and adding very much to the annoyance of the sufferer. Dr. Bozeman says the following procedure, simple and easy to perform, is suitable to this case. Pare the edges of the cleft; introduce sutures in the ordinary way. The difficulty of getting rid of the action of the urine passing along the newly-formed channel is a chief obstacle to success. Dr. Bozeman meets it by a modification of his button or shield. The catheter, which is indispensable, has no support at the meatus, and hence its motion irritates and prevents union by first intention. To obviate this, the button is moulded to the curve of the urethra, and a notch is made at the lower end. When this is secured in situ by compressing shot upon the several sutures, the end of the notch projects forwards and in front of the meatus, forming a stationary point upon which the catheter may rest, without in the least interfering with the denuded edges of the cleft. The catheter should be introduced before securing the button, and ought not to be removed until the cure is complete. When the suture-apparatus is removed, the catheter should be cleansed, replaced, and worn for three or four days longer. The pressure may now be taken off from the tender cicatrix by means of a loop attached to a bolt carried round the body of the patient. If this precaution be not observed, and the catheter be allowed to hang down, the rent is almost certain to be reproduced. The English male elastic catheter No. 5, is the best.

With regard to the treatment of fistula involving the cervix uteri, Dr. Bozeman points out the difficulty of execution of Jobert's operation of cystoplasty, the danger of peritonitis attending it, and the risk of failure. He proposes another procedure, which he describes as simple, easy, and almost free from danger. In 1855, he met with his first case of vesicovaginal fistula, complicated with a rent in the cervix uteri; he then first demonstrated the practicability and safety of paring the cervix and lodging sutures in its substance. This