ART. V.-On Scarlatina and its Successful Treatment by the Acidum Aceticum Dilutum of its Pharmacopoeia. By ISAAC B. BROWN.-London, 1846. 8vo, pp. 66.

THIS pretty little book is like the Dead Sea apples-fair without, but naught within. It seems as if it came forth on purpose to illustrate some of the statements in the article "Homœopathy, Allopathy, &c.," in our last number. The good man who writes it, no doubt, conscientiously believes that the cases of scarlatina treated by him, would have all gone wrong but for his "sheet-anchor, acetic acid," and his "other remedies as auxiliaries;" and equally conscientiously, no doubt, did the famous fly in the fable glorify itself for the successful revolution of the wheel whereon it sat. Poor Nature, what wouldst thou have done, without the help of our good doctor? Thy wheel would assuredly have stood still under the pressure of the scarlet plague, but for the oiling of the axle with his acid. And should we marvel thereat, knowing, as we know from the lore of Isaac B. Brown, that, in this wondrous acid, this nepenthe rare, "we have all we want, for destroying the poison of the blood, for allaying the vascular state of the mucous membrane, for preventing hemorrhage from the blood-vessels, astringing the tonsils and fauces, and for checking the febrile action and supplying fresh chyle to the blood." (p. 10.) And yet we marvel at one thing, O Isaac B. Brown, and this is-that with such an all-sufficient, and more than all-sufficient, panacea in thy hand, thou shouldst have needed any auxiliaries, and least of all such auxiliaries as thou soughtest and usedst. Most firmly do we believe that if thou hadst satisfied thyself with the pleasant potions of acidulated syrup and water, thy patients would have all got well quite as fast, and blessed thee for saving them from thy naughty and nasty auxiliaries.

But the leaven of the old man of drugs was too strong in good Isaac Brown, to allow him to be content with the really excellent treatment of the acidulated ptisans,* recommended to him by the "assistant to Mr. George Yates Hunter, of Margate," and thus, therefore, does he torment his poor patients secundum artem :-They are carefully purged by calomel, castor oil, rhubarb, and magnesia, their tonsils sponged with a solution of nitrate of silver, their throats rubbed with soap and camphor liniments and laudanum, or surrounded "from ear to ear," with linseed poultices kept constantly applied, their bodies affused with vinegar, &c., the room sprinkled with a solution of chloride of lime, and last, but not least, the patient's strength supported by bark, ether, mutton-broth, brandy, port wine, &c.

How does the author reconcile the two following statements, in pages viii and ix.? In the first he tells us, his treatise is intended for "parents and heads of families," as well as for the "members of the medical profession;" in the next, that there is the utmost danger in any one not "qualified to practise the medical science," "to carry out this or any other plan, without first obtaining the best advice the locality in which they reside affords." Is this, like the rest of his treatise, a bit of posthoc-ergo-propter-hoc reasoning, which he wishes to diffuse among the philosophic fathers and mothers of his "locality?"

• "Diluted distilled vinegar, two drachms; syrup, four drachms; distilled water, two ounces. Mix and take a fourth part every three hours." We would suggest as a great improvement in this formula to quadruple the proportion of water, and then double or yet further increase the amount of the dose!

ART. VI.-On the present State of Therapeutical Enquiry. By JAMES ARNOTT, M.D.-Brighton, 1845. 12mo. pp. 57; with an Appendix. DR. JAMES ARNOTT first takes occasion to lament the great difficulty the therapeutical discoverer experiences in obtaining a notice. This he attributes principally to the frequent disappointments practitioners experience in the use of new and much praised remedies; the remedies being, in fact, inadequate, because recommended from false analogies or imperfect observation. Dr. Arnott then proceeds to consider, firstly, the principal sources of therapeutical knowledge; secondly, to what degree medical theory has in this respect proved useful; and thirdly, the present defective mode of reporting the results of medical experience, and how it may be amended.

Under the first head, Dr. Arnott indicates the principal sources of therapeutical knowledge to be,-the accidental observation of the effects of remedies; the direct calls of instinct for some remedial means, as in wounds, &c., from mechanical injuries; the artistic or technical perfection of remedies thus discovered; and lastly, the analogy between the observed action of certain medicines by which the one has been substituted for the other. Dr. Arnott gives various interesting examples of remedies from these various sources.

With regard to the influence which medical theories have exercised on the progress of therapeutics, Dr. Arnott expresses an unfavorable opinion. If the explanation of the morbid condition, he observes, rest solely on mechanical or chemical principles, the appropriate remedy may originate from such explanation; but what is called the theory of disease usually implies a consideration of the laws of vitality, and, in this sense of the term, it would be easier to show the mischief which theory has occasioned, than to collect the instances of its direct advantage. It has been the source of many dangerous practices, and by the prejudices it has excited, and the conventionalism and routinism it has developed, the practitioner has been prevented acquiring and adopting better plans of treatment. Dr. Arnott thinks that medical prophylaxis has been more advanced of late years than therapeutics. In this opinion we fully concur, and we think that it may be taken as a strong, and, indeed, irresistible proof, of the great advance made in medical science and art in our own times.

Theory has, however, its value; indeed all our greatest practitioners, whether physicians or surgeons, have been theoretical. The faculty to discover necessarily implies a speculative mind. Now a speculative mind is in fact one which collects and meditates on facts, if so be that it be rightly trained. It is only absurdly speculative when it leaves facts altogether to build theories on hypotheses-a series of unsubstantial erections which vanish into nothingness so soon as the speculator is beckoned from his airy height to the regions of plain common sense and utility. A truly practical man is he who continually endeavours to adapt his speculative ideas to the cases of disease that come daily under his notice.

Now we really must give Dr. Arnott the credit of being a speculative man of this class. In his little book the practitioner will find a closelypacked repository of useful inventions. Many of these are eminently

ingenious, and based on sound principles. It is, however, in medicohydraulical mechanics that Dr. James Arnott most distinguishes himself, and we have various ingenious modes for using fluids in the treatment of disease, whether for the dilatation, compression, or regulation of the temperature of parts.

We cannot undertake even to enumerate the different ingenious uses to which fluids, and especially water, are applied by Dr. James Arnott, but assure the practitioner, that the outlay of the trifle which the little book may cost, will be a most excellent expenditure of capital. In addition to the description of various new therapeutical methods, the appendix is more especially devoted to improvements in the obstetric art, many of which are worthy the accoucheur's consideration. Invention seems characteristic of clan Arnott. The present author treads the same paththough at some distance behind his more famous brother Neill.

We would suggest to Dr. James Arnott the expediency of enlarging and somewhat altering the plan of his work in another edition, by noticing at greater length, and on a wider scale, the strictly medical part of his subject. We hope the free-spoken article in our last number may encourage him to tread less gingerly on the toes of ancient prejudices.

ART. VII.-Elements of Anatomy. By JONES QUAIN, M.D. Fifth Edition. Edited by RICHARD QUAIN and WILLIAM SHARPEY, M.D., Professors of Anatomy and Physiology, University College, London. Illustrated by numerous engravings on wood. Parts I, II.-London, 1843, 1846. Svo, pp. 1063.

It would seem as if the very fact of the division of a work into parts, and the separate publication of these, exerted an injurious influence on the minds of the parties concerned, inducing procrastination and forgetfulness of promises, and consequently disappointing all the hopes which credulous buyers had founded on the promises liberally put forth in the first announcement. It has certainly become the exception, rather than the rule, for a work published in parts to be completed in anything like the time originally intended; and the work before us cannot, we regret to say, claim exemption from the censure we have heretofore administered in similar cases. In fact, we are constrained to remark, that we think there is less excuse when a new edition of a work previously complete is concerned than where the entire work is new. Surely the editors might form some tolerable estimate, in the first instance, of the amount of alteration that would be required, and might withhold the publication of any part until the remainder were in an advanced condition. The first part of this new edition of Dr. Quain's Anatomy was issued in the autumn of 1843, with the promise that the remainder should be published "as soon as possible." The second part has only made its appearance within these few weeks, consequently, nearly two years and a half after the first, and it does not complete the work. By way of apology, we are told that "the changes made are much more extensive than had been originally contemplated. In fact the principal part of this volume has been written anew." Our question is,-why were not these changes originally con

templated, or, in other words, why did not the editors decide upon the amount of change they would introduce before they proceeded with the first part? Anatomy is not a science of such rapid progress as to require the complete remodelling of a previously good treatise every three or four years; and we cannot but think, that such highly-qualified editors might have more clearly divined their path at the outset of their course, and that, even if they found it requisite to deviate from it here and there, the delay need not have been quite so long. The evil is much greater in regard to a work especially destined for the student, than with respect to one which is chiefly intended for the established practitioner. The youth who purchased the first part, as the guide of his anatomical studies,-presuming, as he might fairly do in such a case, that the remainder would appear within the session, or at furthest at the commencement of the next session,after spending three or four years in attendance on lectures, finds himself still the possessor of an incomplete work, and the last part makes its appearance just when it is becoming comparatively useless to him.

It pains us greatly to be continually obliged to recur to this subject, by the misdoings of medical authors; more particularly when we have to direct our censure upon those who in every other respect deserve the highest praise at our hands. We have no hesitation in saying that the work before us, completed (as we feel confident it will be) in the spirit in which it has been thus far carried on, will be alike worthy of the fame of its distinguished editors, and valuable to the anatomical student. The former editions of Dr. Quain's 'Elements' had attained a high reputation, as having successfully avoided the useless minuteness of some treatises, and the superficial curtness of others; laying deserved stress upon those points which enter into the consideration of practical questions, guiding the physician in his diagnosis and treatment, and directing the judgment and hand of the surgeon, and, at the same time, giving all needful information upon other matters of less obvious utility. The chief advances made, since the publication of the fourth edition, have been in the department of general anatomy. The whole of this has been rewritten by Dr. Sharpey, and forms an introduction, separately paged, illustrated by a large number of admirably executed wood engravings. It is now a most admirable and concise exposition of that subject; and we should much like to see it issued separately, for the sake of those of our brethren more advanced in life, who desire to make themselves acquainted with what has been recently effected by the aid of the microscope and of chemical analysis, in regard to the elementary structure of the tissues, and who do not require to possess themselves of a general treatise on anatomy. The purely anatomical portion of the work has been chiefly revised by Mr. Quain; but we think we discern, in the alterations which have been made in the account of the nervous centres, the indications of Dr. Sharpey's physiological mode of treating this difficult subject; at any rate, this portion of the work is remarkably well done.

We shall give a more detailed account of the work when it shall be completed, by which time we hope that Messrs. Todd and Bowman's Physiological Anatomy may be in the same condition, so that we may review them together, and point out their respective excellencies.

THE article in the last Number of this Journal, entitled " Homœopathy, Allopathy, &c.," as was, perhaps, to be expected from its subject and object, has attracted a more than ordinary degree of attention from the profession. The Editor has, in consequence, been favoured with numerous communications relating to it from his friends in all parts of this country, as well as from the continent of Europe, and from America. The views of the writers are, on the whole, in remarkable accordance with those given in the article; and the opinion is generally and strongly expressed, that some such changes in the manner of studying and treating diseases as are there propounded, are absolutely necessary for the successful progress of rational medicine. So convinced is the Editor (the author of the article in question) of the truth and importance of this subject generally, that he now offers to open the pages of his Journal for its special consideration, if it shall be found that the warm interest at present excited by it, proves to be deep and strong enough to supply materials for its continuous elucidation and advancement. is doubted. Still it has been thought advisable to evince practically and without delay, the earnestness with which the subject has been taken up and is sought to be promoted by the Editor. From among the numerous contributions with which he has been already favoured, two have, with the sanction of their authors, been selected for publication in the present Number. Whether these shall be followed by others, in subsequent numbers, will, as just stated, depend on the inclination of the profession. It will afford the Editor much satisfaction to be able to present to his readers any authentic communications of the same high stamp and admirable tendency as those now submitted to their notice.

This

Before concluding this prefatory notice, the author of the article on Homœopathy and Allopathy desires to make a few brief observations in reference to one or two points in it, on which he finds he has been somewhat misunderstood. The misconception is admitted by him to be natural on the part of his readers, in consequence of the necessity under which he found himself, for want both of room and time, of leaving all the latter part of the article a mere sketch or outline. Had he completed the whole subject on the same scale as was allowed to the exposition of the character and fallacies of homœopathy, he believes that he would have left no grounds for the friendly criticisms and gentle remonstrances which some of his very estimable and enlightened correspondents have addressed to him. Most assuredly, in this case, he would have run no risk of being set down-as he finds he has been