properly appreciate the various objects, both animated and inanimated, by which we are surrounded; and to regulate our duties and our pleasures by that knowledge," is a direction and occupation of the mind devoutly to be wished. Among much valuable observation contained in this Essay, we notice a constant effort to direct the naturalist's views beyond the surface of nature; to show him that external lineaments are the least important of the objects subjected to his inquiries; and that his mind should be directed to explain the connections, dependencies, capacities, and final destinations, of the myriads of forms with which the CREATOR has peopled this earth. "It should be the business of the true naturalist," he says, "to study the works of GoD with a view, and an earnest desire to understand His designs respecting them;that he should endeavor to learn their utility, both general and particular, rather than to make himself acquainted with their mere external character, their names, or the classes into which they appear naturally separated, though linked ;that he should regard all created beings as one vast family united together for some great end; over whom, as lord of the whole, he should extend the offices of benevolence, rather than the spirit of persecution;-that in using, applying, or changing natural bodies for his own purposes, he should be careful to fulfil, rather than to counteract, the will of the GREAT FATHER and ARCHITECT of the UNIVERSE; as far, at least, as can be felt and discovered: and, above all, that he should seek to know his own duties in the midst of that beautiful creation, which, like a celestial garden, has been spread out for his footsteps, and given to him as an inhe ritance." The practical part of medicine and surgery have each, within the past six months, received some interesting if not important additions. The destructive effects of that form of fever believed to arise from some certain, or rather uncertain, state of the atmosphere over marshy lands, as its cause, is of so much importance, especially in military expeditions, that every inquiry which tends to clear away the obscurity yet hanging upon apon the subject, claims particular attention. In the expedition to the island of Walcheren in 1809, the effects of this destructive material, whatever it may be, were felt to a most alarming extent. Many of the physicians and surgeons attached to that army have given full details of the morbid effects produced by this material, but none have yet been able to detect any properties peculiar to it beyond its power of occasioning remittent and intermittent fever. Of its constituent principles we yet remain ignorant; but it seems unquestionable that something is emitted by or exhaled from certain marshy ground capable of producing, most extensively, fevers of a violent and fatal nature. Though Sir Gilbert Blane has not removed this difficulty, we are indebted to him for concentrating many facts relative to the operation of this poison, and on the methods employed to obviate its deleterious effects. Our limits will only permit us to attend to the natural history of marsh miasmata. On the facts stated by Sir Gilbert Blane, (Medico-Chir. Trans. vol. iii.) it appears that the whole island of Walcheren, with the exception of some mounds of sand on the western shore, is a dead flat, below the level of the sea at high water, and preserved from inundation by artificial embankments. The soil consists of a fine white sand, known in the eastern counties of England by the name of silt,* and about a third part of clay. It is divided into small square inclosures by ditches, which * Silt is not a fine white sand, but a deposition from sea-water of a brownish yellow in the English counties Lincoln, Cambridge, and Norfolk, where it is found in extensive fenny tracts lying toward the sea. In the fens of these counties the alluvia are of two very distinct kinds. The alluvial deposition in that part which lies nearest to the highlands, and which extends several miles into the great level, is entirely, or very generally, a black substance, provincially termed MOOR: it lies from one to four feet thick upon a sub-stratum of clay commonly, but sometimes of gravel, and is cut into fuel under the denomination of TURF. The alluvial deposition in that part lying toward the sea, is a soft yellow-brown sand denominated SILT: it is extremely fertile, and constitutes the most valuable pasturage of the whole district. Remittent and intermittent fevers are extremely frequent which serve as drains; and these were, in the endemic season, about two thirds full of turbid water. They emitted no smell, but a disagreeable effluvia arose from stagnating pools. The soil seems a mass of alluvial matter like the deltas of great rivers; and the whole islands of Zealand were, probably, formed by the detritus carried down by the Rhine and the Scheldt. The poisonous exhalations from soils thus formed, is not animal putrefaction, for it is ascertained that those who are exposed to putrid vapors, such as anatomists and tanners, are not affected with complaints like those arising from marsh miasmata. Water in a state of stagnation, without any ascertainable principle of contamination, seems to generate these poisonous exhalations. The delta of the Nile does not generate intermittent fever, because the inundations of that river obviate the effects of stagnation; while, in the island of Minorca, in places consisting of a very thin soil on a rocky bottom, this fever ap pears in its severest form, in consequence of stagnant water in channels and pools. The miasmata in Zealand are more noxious than the like exhalations in England. The exha lations of the soil in tropical climates are still more ma lignant than those of Zealand. In the West Indies, and at Calcutta, ships at the distance of three thousand feet from swampy shores were affected by the noxious exhalations. Many facts are stated by Sir Gilbert Blane to show the extent to which the deleterious miasmata may produce its effect, and the direction which it is most disposed to take; and others, still more valuable, go to prove that certain artificial changes may deprive particular localities of the property by which they generate this poison. The principle of this melioration is doubtless an improved drainage. There are still some facts opposed to this principle, which must be cleared away before it is incontrovertibly established. frequent on both these surfaces; but they occur most in the driest state of the fens. In hot and dry autumns the endemic most prevails, and when the surface of the great level, from the texture of its soil, through which water percolates with rapidity, is extremely arid. Some particular facts of considerable importance in the treatment of individual diseases have fallen under our notice. Perhaps the most valuable of these are related by Dr. Sutton, who has established assertions by the evidence of numerous cases. The use of opium in Delirium tremens he appears to have ascertained in a very decisive manner, and to have suggested an improved treatment of peritoneal inflammation, deserving serious consideration. The disease denominated Delirium tremens by Dr. Sutton, is described as often coming on slowly. For some days previous to the distinct commencement of the malady, the patient complains of being unwell, with loathing of food, listlessness, debility, and want of comfortable rest. He has pain in the head, and sometimes vomits, and is dejected. The pulse, in the commencement of the disease, commonly is not quick; but may be frequently observed to have an unsteady fluttering. There is not much heat on the skin, and the tongue is generally furred and moist. In this stage of the disease, the patient has very little disposition to lie down for any length of time, but is ever uneasy, and desirous of a change of position; and there is a general agitation of the frame, with tremors of the hands. Associated with these is a wavering of the mind; and, if the disease proceeds, this becomes every day more manifest. As the disease advances, the faculties do not, generally, show themselves in disorder by any extravagance of thought, but by fatiguing conversations on common affairs frequently repeated; and by broken discourses, caused evidently by confusion of intellect. In the further progress of the disease, the patient discovers great anxiety of mind about his affairs, appears ever desirous to be where business is, and makes great, repeated, and violent efforts to liberate himself from those about him, if under restraint, in order to accomplish the objects that press most forcibly on his mind. These exertions are, however, not made in opposition to others, though violent, with either malignity or ill-nature; nor does the patient mark his restraints with the appearance of much anger or displeasure. He seems to be forgetful of what has immediately passed, and only to be propelled to action NO. 173. D action by those strong impressions on his mind respecting the objects just stated. In other respects he is tractable, and there is seldom any difficulty in administering medicine to him. In this situation he loses the sensation of pain; and when in a considerable degree of this delirium, knows momentarily those about him of his family and friends. The tremors of the hands, which constantly accompany this complaint, are now great, with unceasing workings and elevations of the tendons at the wrists; to which are frequently associated subsultus tendinum, and often singultus. By the action of the tendons at the wrist, the hands are drawn inwards, sometimes to such extent, joined to the constant tremors, as to allow a very imperfect knowledge of the pulse. When the patient is at all still, he is constantly picking the bed clothes, and in various motions with his hands. The evacuations are unconsciously rejected, in the height of the paroxysm. The pulse at this time becomes very rapid, and may appear to be more debilitated than it really is, from the difficulty of ascertaining its actual state. Accompanying the exertions at this time made, there is generally a most profuse sweat, which is commonly clammy and cold; with sometimes an offensive odor. The heat of the skin varies much, but is seldom intense; and the tongue is not often dry, or the patient thirsty. The general appearance of the countenance is dull, and the eye frequently suffused. The state of the bowels vary; but, during the violence of the disease, frequent stools are not common. In the height of the paroxysm, the patient is in an unremitting state of watchfulness, which continues until the disease is alleviated, or is succeeded by insensibility, which may partake of coma or apoplexy, ending in death. This disease will continue, with great violence, from three days to a week, and with moderate symptoms for a longer time, and is sometimes seen in the form of a chronic affection. The curative intention is to procure quiet and sleep; these being effected, the disease subsides. Opium, in large doses, two grains of the extract every two hours, and in 3 some |