ceptible to disease because it is strong; this is arguing in a circle, without cause or consequence. When points are thus minutely examined their fallacy is soon discovered and easily exposed; but if a superficial view be taken of many parts in the Physiologie des temperamens they will appear plausible, if not true. Thus after endeavouring to prove in the first part that temperaments depend on organic and functional proportions, he endeavours to establish in the latter part that diseases are the consequences of these deranged proportions. When the habit is thoracic the diseases are acute, because the lungs are spacious and form a great quantity of blood, and because the heart is robust and circulates it actively; whereas when the temperament is cranial the brain becomes deranged from excess of action, but, as it is more obnoxious to inquietudes and causes of disturbance, its diseases may be as active, but they will be less regular. The great majority of affections, according to our author's doctrines, are acute. As they all originate in excess of action, they all depend on visceral congestion. The mode of cure which he recommends is, therefore, to diminish the exciting causes, and to moderate the action of the excited organs. To effect this in persons of the cranial habit the fatigues of study must be given up, passions must be moderated, exercise must be taken, extremes of temperature must be avoided, and a vegetable, or a very light animal diet should be used. When the congestion is great general and local bleeding are necessary, after which antispasmodics may quiet the disturbance of the nervous system. The diseases of the thoracic habit being acute, the mode of treatment best adapted to them does not require specification. The abdominal temperament, he says, may be avoided or diminished by frugality, by indulging the passions, by studying closely, and employing active exercise. This regimen may succeed while the system is young, but if neglected to advanced life circumstances as numerous as they are irresistible will counteract its tendency, leaving nothing to be done but to prevent its increase and guard against its effects. All this appears simple and probable enough à priori, and the facilities which it holds out to the changing and modifying of temperaments are encouraging. To convert the abdominal into the cranial temperament all the functions of the former must be discountenanced, those of the latter must be exercised. The mind must be stimulated by study, the passions must be strengthened by gratification, and such food must be taken as will inflame the blood already formed, rather than add to its quantity. Again, to convert the cranial into the abdominal temperament the reverse system must be pursued. The center of action may be thus variously changed, sensuality may take the place of intellect, and every bloated Bacchus may be made, according to our taste, Mercury, Orpheus, or Apollo. This is at all events a convenient system. The man, who is urged by misfortune into poverty, may take advantage of his circumstances, cultivate his cerebral powers, and convert necessity into a school-mistress. Every pauper, when he can do nothing else, may thus be made a Newton; and every workhouse may be converted into a parish-college! Galen has said that the body of man is like Vulcan's forge, to which the anvil and hammer and bellows and fire were all equally necessary. So in man, if one system be removed or one organ engross the activity of the whole, there can neither be harmony nor health. Such gross disproportion Nature has never been guilty of. She may make one organ somewhat stronger than another, or one tissue less susceptible than another. But that, which was constitutionally the strongest organ, may be rendered soon after birth the weakest, by not being introduced into circumstances favourable to its action; and the natural plus-susceptibility of a tissue may be lowered during life into moderation or deficiency. Original constitution may thus be altered by accidental causes, the center of action may vary its position from the head to the heart, or from the heart to the kidneys, and differences may occur after birth, in the powers and proportions of the system, infinitely greater than any which existed previously. As the diseases, to which the melancholic are prone, are more chronic than acute, and as the individuals, in whom this temperament prevails, are not remarkable for irritability, whatever treatment we pursue should be regulated under the knowledge of these circumstances. In many of them the most effectual means for their removal are moral and metaphysical. In hypochondriacism and mania, two of the most obstinate diseases to which man is subject, but little aid can be expected from medicine alone. Much depletion is not well borne; much excitement is improper. The body must be acted on through the medium of the mind, every amiable affection must be exercised, every social tendency must be stretched, amusement must be presented under every form, and every thing must be guarded against which might tend to encourage the favourite hallucination by which the mind is led astray. When medicine is given, it should be given cautiously; purgatives and local bleeding are the safest evacuants, narcotics are, perhaps, seldom, and ardent stimuli never useful. In the other diseases of this temperament, the indications of cure must be formed and followed according to individual circumstances: but, as a general remark it may be observed, that the obscurity and apparent mildness of the symptoms should seldom be considered indicative of either weakness of action, or deficiency of strength. Such symptoms are the effects of such a temperament, and the knowledge of this fact may prepare us for consequences which we might not otherwise expect. The symptoms are mild because the sensibility is low, their progress is tardy because the action is chronic, and the voice of danger comes too late because the vital functions being gently assailed are only gradually disturbed. This insensibility as to disease is usually attended with considerable passiveness as to treatment. The operation of medicine is often weak, the effect of treatment slow, and the physician is obliged to encounter the same resistance which the disease had at first to contend with, but has ultimately overcome. These remarks reversed will apply with tolerable fidelity to the treatment of disease in the sanguine. Ardent in spirit and irritable in structure, weak impressions produce strong effects, action is easily kindled and rapidly proceeds, organization is soon destroyed and disease requires but little time to reach maturity. Treatment in such cases must be adopted early, and vigilantly pursued. Depletion must be liberally employed when necessary, mental excitement and physical stimuli religiously avoided when injurious. Every function is easily impressed, medicines operate in small doses, and the patient is soon saved from danger, or soon hurried to his grave. As the symptoms in the melancholic were chronic, they are here acute. If pain be inconsiderable, action cannot be high; if symptoms be moderate, the danger cannot be great. In affections of this temperament, therefore, there is more to be feared from a sudden attack than a lengthened action, there is less deceit than danger, less to be dreaded from officiousness than neglect. "It has been (says Trotter) unfortunate for the medical profession, as well as patients themselves, that persons labouring under nervous disorders have too much expected from the prescriptions of the physician and shop of the apothecary, what is only to be obtained from their own caution and circumspection. We thus find most of them ready and greedy to swallow every medicine that is recommended, but stubborn and intractable in all that relates to breaking in upon the established habits and customs, whether of luxurious living, depraved appetites, indolence of body or mind, or vicious indulgence of any kind inconsistent with health. Many of these habits, it is true, are so far interwoven with the constitution, as to make some changes almost impracticable; but as indisposition is so frequently brought on or aggravated by the improper conduct of the patients themselves, the physician cannot be too much on his guard in demonstrating to them all what belongs to their own government and demeanor. The medical adviser, therefore, who observes the most disinterestedness towards his friend, will often be the first man to be dismissed; while the selfish dissembler, however ignorant, will become a favourite, and engross the emolument. On such an occasion the virtuous mind of a liberal physician will know where to look for approbation." To prevent diseases is the best way we know to cure them. When habits of idleness and luxury are firmly formed; when the system has become inured to favourite stimuli; when the drunkard cannot do without his bottle nor the glutton without his joint-the prospect of reformation is forbidding. Associations ardently cherished are to be broken up, and passions, which have ever proved the strongest in our nature, are to be overcome. To drink water instead of wine, to be limited to a simple dish, to labour several hours every day, to abandon every haunt of indulgence, to retire soon and rise early, are changes of the most repulsive character, and are more easily approved of than effected by the irresolute voluptuary. The nervous temperament is not natural to man as is the sanguine; it is the creature of abuse, and, therefore, cannot endure active measures. Depletion is badly borne; abstinence, even moderately practised, is often attended with unfavourable consequences. As evacuants are the best class of medicines for the sanguine, perhaps tonics are the safest for the nervous. Their relaxed fibre, their enervated mind, their turbid passions, their debilitated functions, their whole constitutional status is the result of weakness, and can only be removed by communicating strength. Every plan by which tone can be imparted to the body, and firmness to the mind, should be judiciously employed. Exercise properly conducted, amusements moderately enjoyed, temperance in rest, food, drink, and passions, tonics carefully administered, and, perhaps, sedatives and antispasmodics occasionally given, are the most promising means for accomplishing this object. We have now brought to a close our observations upon Temperaments. We have examined their history-investigated their causes-ascertained the leading principles of their constitution; we have inquired into their connexion with mind-have defined the limits of their intimacy with matter— have shewn how they may depend upon both, and how original confirmation may be modified by accident; we have seen how they influence the system in a state of health, giving to one energy of function and vivacity of thought, to another sensibility of body and volatility of mind, and to a third corporeal apathy, and metaphysical dulness; we have observed to what extent they favour the establishment, the character, and the progress of disease; in this system discountenancing its attack but encouraging its advancement, in that hurrying forward action to a crisis, and in another obscuring every symptom, and resisting every remedy; and lastly, the indications to treatment which they hold out have been examined. Did space permit, a subject so extensive might be more extensively pursued, but we believe the assigned limits have been already overstepped, and it only remains for us in conclusion to observe, that since temperaments stand very much at the mercy of circumstance, whether they be favourable to health or to disease, to happiness or to misery, to mental cultivation or to moral wretchedness, and since the nature and influence of these circumstances are very much under our control, the advice of Pythagoras, with respect to habits, may be applied as forcibly to temperaments; Maximum vitæ genus eligite, nam consuetudo faciet jucundissimum. II. LECTURES ON PRACTICAL AND MEDICAL SURGERY, COMPRISING In a former number of this Journal we had an opportunity of speaking favourably of the talented and observant author of these Lectures, while reviewing his Essay on Medical Education in the Transactions of the Associated Apothecaries. It is true, we differed from Mr. Alcock on some points connected with the apprenticeship system, and if we may judge by the following passage, Mr. Alcock drew a hornet's nest about his ears by the admonitions addressed to the masters or preceptors of apprentices. "I soon found, that the fate of the Miller, his Son, and their Ass, in the fable, awaited my opinions on this subject. "Some of my young friends who were apprentices, and not a few of others in practice, who had tasted of the inconveniencies arising from ill assorted engagements of this kind, wondered that I did not explode apprenticeships altogether. "The greater part of masters (for the term preceptors did not suit them,) accosted me, 'A pretty piece of work you have cut out for us! Who do you think can submit to the drudgery of giving daily instruction to his apprentice? The idea is absurd!' "Another class, and they were for the most, part parents themselves, who had experienced the anxieties, the arduous responsibility of duties for which no one can be too well prepared, greeted my efforts with their cordial approbation, and added, that they felt assured, had such a system of instruction been pursued in their own education, it would have saved them much valuable time, and have obviated many of the anxieties which they had suffered." 14. In another part of the same lecture from which we have taken the above extract, Mr. Alcock acknowledges that a general practitioner, who is in any thing like good practice, has not time to study himself, or keep on a level with the progress of the literature, art, and science of the day. How then is he to pay all the attention which Mr. A. recommends to the studies of his pupils? We do not say that he ought not to give this minute attention to bis apprentices. God forbid! We know that it is his duty, as a Christian, to prefer the good of others to his own, ard therefore even at the sacrifice of emolument as well as time, he should do as Mr. Alcock desires. What is, and what ought to be, are very different things. "Love thy neighbour as thyself," is a precept in the mouth of every one-but practised by nobody! We need not, however, dwell on this subject at present. This volume of lectures, although modestly intended for those who have not yet acquired experience, will be found to contain a series of most useful practical observations and instructions on the minor, but more common operations and duties of the medical practitioner, and more especially the general practitioner. The elementary nature of the work, and the great minuteness with which Mr. Alcock treats the details of medical and surgical practice— the investigation of disease-and the discrimination of its varying characters-render it quite impossible to attempt an analysis. The only portion of the volume which will bear this process is a section entitled : “OBSERVATIONS ON THE INFLAMMATIONS OF THE MUCOUS MEMBRANES OF THE ORGANS OF RESPIRATION, and to this we shall direct our attention. Our author is convinced that the strict relations existing between these inflammations and some other diseases, especially measles, scarlatina, variola, and pertussis, have not been sufficiently considered by practitioners or pathologists. The following is the arrangement which Mr. Alcock proposes, founded on the situation of the parts affected. « A. The nostrils, the fauces, and the mouth. “B. The larynx; the top of the pharynx; as the latter is generally implicated in inflammation of the larynx. "C. The trachea. "D. The bronchia. "To the above division A. appertain some forms of Catarrh, Aphtha. Cynanche tonsillaris. maligna. "To B. Cynanche laryngea, or laryngitis; Cynanche Pharyngea. "To C. Cynanche trachealis, or croup. "To D. Bronchitis. "To the second order B, (sometimes including the third and fourth, C and D,) chiefly appertain those accidental inflammations of these parts which occur in the Exanthemata, or rather, which, as far as relates to practical treatment, seem to constitute the essential part of the disease, the mere exanthema being for the most part of subordinate importance. In the milder cases little is to be apprehended: but when the inflammation of a part of the mucous membrane is severe, it is more apt to run a rapid course when attendant on the exanthemata, |