under Lyne, which terminated fatally. As there was no reason to suspect the existence of canine madness in the town or neighbourhood, excepting in the animal which bit these persons, Dr Ferriar thinks the statement affords full proof of the sporadic origin of the disease in dogs, contrary to the opinion proposed by Mr Meynell, and inconsiderately adopted by one or two medical men. That opinion might indeed be refuted by the now established effect of fever-wards, which are capable of arresting the progress of an epidemic, by separating the sick, but which do not prevent the sporadic generation of infectious fever in individual cases," p. 60. But to this remark it may be objected, in the first place, that the laws which the contagion follows in animals are hitherto very imperfectly ascertained; and, secondly, the effect of fever-wards is a comparison, but not an argument. To prove his point, Dr Ferriar should show, that small-pox and syphilis have a sporadic origin.

The following extract from the account of fever-wards will be read with lively interest by those who watch the improvement which has taken place within these few years in the management of infectious diseases.

"The success attending the establishment of our House of Recovery, has exceeded the warmest expectations of its supporters. But during several years, we were limited in space, and unable to receive the whole number of patients, whom it was expedient to admit. Some adjoining and neighbouring houses were therefore occasionally engaged in the same street, for the admission of patients; and thus, without any previous intention on our part, a set of experiments was made respecting the distance to which contagion will extend. In the first instance, no person suffered in the neighbouring buildings, where the street was only four yards wide, the windows of the occasional fever-ward being generally open, and the house full of patients. In another instance, a house, capable of containing twenty-five patients, not at all separated from the adjoining houses in the same row, was used for twelve months as a fever-ward, without the occurrence of any fever in the immediate neighbourhood. Thus the experimentum crucis has been tried, and the innocence of contagion, when properly diluted with atmospheric air, is fully established.

"So completely were the public now convinced of the utility of the plan, that a subscription, suitable to the opulence and spirit of the town, was raised; a large area was purchased, and a Fever-Hospital erected, capable of easily containing an hundred patients. The expense of the building was upwards of 5000%.-Since it has been in the power of the Physicians to admit every case of infectious fever, as it occurs, we have felt ourselves completely masters of the disease. Epidemic typhus is now unknown to us, while it has been raging in some of the neighbouring towns. A part of the space is appropriated for the reception of patients in scarlatina anginosa; and although

this disease has been repeatedly introduced into the town, generally from Liverpool, and lately from Yorkshire, its progress among the poor has always been checked, by the removal of the patients. The mortality of fever-patients has varied considerably in different years, as the following table will show.

Some additional cases of an affection of the lymphatic vessels are published, which prove the existence of this complaint, independent of pregnancy. The following paragraph is appended to the short chapter on Hooping-Cough.

"The beneficial effect of the limestone soil in Derbyshire has long been known to the old practitioners of this town, in the cure of hooping-cough; and I have had an opportunity of verifying it in some very striking instances. If the climate of the Peak were milder, I am persuaded that many cases of spasmodic asthma might be relieved by residence at Buxton. It is a well-known fact, that broken-winded horses are free from their complaint, while they remain there. This may be attributed in some degree to the quantity of lime which the brooks hold in solution; and in some measure to the impregnation of the atmosphere, from the numerous lime-kilns in the neighbourhood."

Some other additions which we have discovered on a comparison of the former volumes with the present, consist of a few remarks on the subordinate power of nitrous acid in syphilitic cases; some observations on the venereal disease, not very clear or convincing; and a note respecting the treatment of the Walcheren fever, in which the liquor arsenicalis is recommended.

IX.

An Essay on the Effects of the Carbonate of Iron, and other Preparations of Iron, upon Cancer: with an Inquiry into the Nature of that and of other Diseases to which it bears a relation. By RICHARD CARMICHAEL, Surgeon. Dublin, 1809. Gilbert and Hodges. Second edition, considerably enlarged and improved.

G REAT as the degree of scepticism may be, with which we open a book professing to hold out a remedy for cancer, yet the smallest prospect of being able to mitigate so terrible a disease, ought to lead medical men to inquire, with careful attention, into the merits of any class of medicines which may be said to effect its cure.

In our third volume, we took notice of a former edition of this work; and without entering into a minute discussion of the subject, we then gave it as our opinion, that the cases of what Mr C. called cancer, cured by the preparations of iron, were really not cancerous, but of a different nature. On perusing this edition of Mr Carmichael's work, the subject has created a new and lively interest; and we think it our duty again to make some strictures on his writings, and to expose, at more length, the errors into which we conceive he has himself fallen, and into which he also attempts to bring others.

There is much confusion in regard to cancer; not that cancerous sores are mistaken for those of a more mild nature, but sores which are not cancerous, having a malignant character, are often considered to be genuine cancer. This has been the foundation of the repute of a variety of remedies which are daily employed for the cure of cancer; and to the same cause must be assigned any favourable opinion which individuals might have been led to form of the medicine proposed by Mr Carmichael.Such is indisputably the rock upon which Mr Carmichael has split. He has either, from a want of due discrimination, or from some reasons which we will hardly venture to suspect, had the boldness to present to the public, cases which, he says, were cancerous, cured by the different preparations of iron; and of these we hesitate not to assert, that there does not appear one of a true cancerous nature.

In taking a general view of this work, there is another circumstance which is to us equally striking. The author gives scveral

letters from his medical correspondents, in which they express their opinions of the effects of iron in the cure of cancer; and it is singular, that some of them state, in the most clear and decided manner, that they believe these preparations are useful in the treatment of some sores resembling cancer, but that they have found them perfectly inefficacious in curing ulcers of a truly cancerous nature.

But to proceed more minutely into the examination of the work. There are three sets of cases contained in it. The first consists of cases of cancer cured by the preparations of iron. The second, cases of cancer relieved by the same medicines. And the third, cases which were neither cured nor relieved.

The first of these (cases of cancer cured by the preparations of iron) more particularly deserve notice; and it is easy to show, that there is some leading circumstance in all of them, which unquestionably demonstrates their non-cancerous nature. Even the first case gives a strong proof of our assertion. The disease appeared in the upper lip, a part of the body which true cancer is well known rarely to attack, but where peculiar phagedenic sores are not unfrequently observed. And in giving the history of the case, he says, "She was ordered to take pills of the extract of cicuta and calomel; the sores were frequently sprinkled with the hydrargyrus nit. rub., and under this treatment were healed in ten days!" Is not this circumstance a sufficient proof that the sore was not cancerous? Is there in the annals of medicine any cases of cancer healed by such treatment?--In the second case given by Mr Carmichael, the disease is by no means described with the accuracy necessary to enable any person to say that it was cancer. That it was not cancer, is probable, both from its progress and situation.-It appeared in the form of a small tumor on the inner canthus of the upper eye-lid, which ulcerated in a month afterwards, and which ulceration rapidly extended along the inferior margin of the eye-lid to the external canthus. It is well known, that cancer, particularly when it appears in the skin, makes a slow progress, and that such ulcers acquire only a small extent after the lapse of many months, or even years. -In the third case, the age of the patient is a strong proof of the dissimilarity of the disease to cancer, it having appeared on the side of the nose of "a very young lady;" also a part of the body liable to phagedenic ulcers, and seldom known to be affected with cancer. In all the remaining cases, some circumstance may be pointed out, sufficient to show the want of our author's discrimination. The period of life in which the disease occurs, the part of the body affected, and even the appearance of the sore itself, scem never to be taken into consideration, most of the

cases having occurred in parts where cancer has been seldom remarked by others; and he contents himself with the belief, that all sores are cancerous which have any thing malignant in their aspect; and particularly, that no ulcer but a cancerous one ever Occurs in the face.

With regard to those cases said to be relieved by the preparations of iron, we have little to observe: but in justice to our author, we ought to mention, that in some few cases, the preparations of iron seemed to alleviate some of the more distressing symptoms of the disease; and by their well known tonic power, they appeared to strengthen and improve the general health of the patient. The cases of cancer not relieved by iron require no

comment.

That the opinion which we have now given of Mr Carmichael's work may appear to rest on the more firm ground, we shall bring forward the opinions which he himself has given, of other surgeons with whom he had corresponded on this subject; and it is difficult for us, in any satisfactory manner, to account for our author passing over in silence what had been so clearly and decidedly stated to him. In a letter from Dr Alley, we find the following paragraph:

"It is doubted by fome, if the cafes in which the preparations of iron have been successful, were truly cancerous; and, perhaps, the one which I have endeavoured to relate may appear equally dubious. Of this I am fatisfied, had any of the oppofers of the efficacy of the preparations of iron in the treatment of cancer, been confulted upon the cafe, an opinion fimilar to mine would have been delivered; and I am happy that my preju dices are never fo ftrong as to induce me to condemn, without trial, a remedy which has at leaft nothing to forbid its application." p. 95.

Mr Mahary says, "Not having taken notes of these cases, I can only say, generally, that I at present feel a strong conviction of the efficacy of iron in bad ulcers, which, I believe, would scarcely, if at all, yield to the hitherto usual treatment. p. 97. In a letter from Mr Du Gard, he says, "In that peculiar morbid affection of the face, however, which is commonly termed cancer, but which, in my opinion, is a distinct disease from cancer, I have had many cases, and, by the iron treatment, have happily succeeded in curing all of them. " p. 85. I have tried," says Mr Allard, "the oxyphosphate of iron in several cancerous sores, both in private practice, and in the Bristol Infirmary; but the result has not been successful." p. 100. In a letter from Mr George Bell, he states, 66 I shall venture only to observe, as the general results of my experience of the use of iron in cancers, that the preparations of this metal seem to me to be better calculated for

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