operates as a powerful and general stimulant on the system; two table-spoonsful of the flour of mustard, or the same quantity of the powder, of the common black mustard seed, (which is to be procured in every bazaar in India, and which I found to be decidedly more active than the Europe flour) given in half a pint of pretty warm water, operates effectually in a few minutes, without inducing any subsequent feelings of exhaustion; on the contrary, the eyes sparkle, and a genial glow of warmth succeeds throughout the system, with proportionate increased vigour of the circulation.

After the operation of this, rather preparative measure-to the stomach's being placed in the best condition, to be acted upon by our remedies more particularly curative, and in furtherance of the same, a warm clyster should be administered, consisting of a dessert spoonful of table-salt dissolved in a pint of warm water, and a spoonful of common, or castor oil; and the same should be repeated every half hour, or oftener-for by thus keeping the bowels excited, tranquillity of the stomach is insured, and the consequent retention of our remedies-the chief of which is calomel; but as this requires some time before it can be received into the system, and effect its operation-as the absorbing power of the stomach, or susceptibility to its influence-in this disease, the distinguishing character of which, being the subduction of all the powers of life-is greatly diminished, it becomes necessary to give it in proportionately large doses, and at the same time, in aid of its operation, and in support of the living powers-to administer occasional cordials. A scruple of calomel in powder should therefore be placed upon the tongue, and the patient gargling his mouth with a little brandy and water, should swallow it; but it must be observed, the quantity of the latter should at no time exceed three table-spoonsful, which may be in the proportion of one of spirit to two of hot water,-as a bulk of any fluid, in a delicate irritable state of the stomach, is invariably productive of its rejection.

If the case is urgent, the same dose of calomel may be repeated every hour; otherwise, in two hours; or if the patient is much improved, in half the quantity; and thus prolonging the interval, or reducing the quantity-it must be continued, according to the state of the patient, till bilious stools and urine are produced;— the spirit and water, or mulled wine, either; or where the system is very low, thirty drops of (sal volatile) aromatic spirits of ammonia, or of hartshorn in half a wine-glassful of water, may be singly, or alternately administered, every quarter or half hour; with the precaution before given, to avoid oppressing the stomach by undue quantity.

In addition to these means, if the skin is cold, warm flannels should be constantly applied; or if the skin is damp and the patient suffers by cramps in his legs and arms, the parts may be well compressed, and rubbed with the flannels besprinkled with hot salt. We have yet omitted to mention a very important remedy, one capable of producing much good, or no less harm-this is bloodletting which, if the patient is an European, or native of pretty robust habit, should be early resorted to-if the pulse admits of it, that is, if compared with another person's-it is of pretty moderate strength: the object to be borne in mind by bleeding in this case, is to excite, by removing oppression from the brain and circulation, and not to subdue the action of the heart, that it should be taken from the patient whilst continuing in the recumbent posture,-and here I must insist once for all, that on no account, and for no purpose, is the patient to be permitted to sit up, or leave the recumbent state, or sickness almost immediately takes place; the evacuations should therefore be received in a bed-pan, or cloth; and the blood be taken from a rather small orifice, that, the stream being in consequence small, the system may have time to accommodate itself to the deprivation,-the effect of which, however, should be carefully watched the operator keeping his finger during the time on the pulse, at the

This is an excellent dog medicine, a spoonful operates upon their bowels effectually in a few minutes.

same time encouraging the patient by suitable conversation ;-when, at the instant it is found to flag, without reference to the quantity withdrawn, whether much or little, the finger should be placed over the orifice; but it must be borne in mind, that fear, nausea, or sickness may occasion this result, that should the quantity taken have been small, after a few minutes-if the pulse recovers its wonted strength, as it is an object to carry it to as great an extent as the circumstances of the patient admit-the finger may be removed from the orifice in the vein, and the blood allowed again to flow, with the precautions before specified; but should, after a further small loss, the same result ensue, it is clear that any additional attempt at this time would be injurious; though it may be afterwards practised, as excitement becomes developed, either in relief of spasms, sense of burning heat in the stomach, or pain in the head, or oppression of breathing; and with the precautions I have given, may be frequently put into practice, and without the possibility of harm-but, on the contrary, with the happiest effect; for in this disease small bleedings in relief of the engorgement of the brain, stomach, and heart, are clearly and most forcibly indicated. (See case A. in the Appendix.) The same intention is partially fulfilled by the clysters, but as warmth and excitement become developed, evinced too by the desire the patient has for cold water-these may be aided, or superseded by a weak and cold solution of Cheltenham or Epsom salts, or of cream of tartar, with which the patient may be now indulged-in the quantity of a wine-glassful at a time, instead of the cordials-which would now prove injurious; these will not, however, supersede the calomel, the necessity for which still continues, not only till bilious stools are procured, but even then, though in smaller doses, till healthy evacuations follow. It may however now, on febrile symptoms taking place, be well to combine it, with an equal weight of James's fever, or antimonial powder, and give it, if it is preferred, in the form of pill; but mind if the calomel is thus combined, acids, such as cream of tartar, are not admissible, as an emetic compound would be the result. The calomel and antimonial powder we would now advise, in the proportion of two grains of each, every two hours, with a teaspoonful of Epsom, or Cheltenham salts, in a claret-glassful of water with every second dose and if there is much thirst, the patient may, at the same time, be allowed a wine-glassful of barley or cold water every half hour; and the same be continued, till the secretions of bile and urine are restored-when, and not before, may the patient be allowed some sustenance, the best of which will be light beef tea, or chicken broth, for it must be remembered, and borne in mind, during the convalescence, that in proportion to the feeble state of the patient, so is the stomach weak and powers of digestion.

:

Many have an objection to salts; where this is the case, two table-spoonsful of castor oil may be substituted, or a dose of rhubarb and magnesia when this is preferred. Should the operation of the purgative be attended with much exhaustion, it may be necessary to support the patient with some spiced broth, wine and water, or mulled wine; or it may even be necessary to moderate it if there is much sinking-by a dose, of from twenty to forty drops of laudanum ; but this is providing against contingencies, which with moderate care and attention will seldom be found necessary.

The secretions from the bowels are now sometimes so exceedingly acrimonious, that in passing along the line of bowels and from the anus, they produce, from extreme irritation-very considerable exhaustion; when this is the case, it will be advisable to inject an occasional emollient clyster, of starch or thick conjee water, with oil; to the first of which may be added a tea-spoonful of laudanum, and this repeated if necessary; at the same time hot flannels may be applied to the belly.

In the treatment recommended, we have had in view an ordinary attack of the disease, and coming on with symptoms of indigestion, or stomach derangement; should however the disease, which it not unfrequently does, have made an insidious approach, under mask of a simple loose state of the bowels, and from the continuance of which the patient is much exhausted; in a case of this

sort it may be necessary to quiet the system, and arrest further action of the bowels, till a certain degree of excitement of the system becomes developed; this may be effected, by adding a grain of opium to the first dose of calomel, or an equal proportion (thirty drops) of laudanum, and which it may be necessary to repeat, but it is only under these and the like circumstances that opium can be recommended. The treatment in other respects becomes the same, save that, in such cases, rhubarb and magnesia, or castor oil is to be preferred to salts, in the stage wherein these are recommended; and that bleeding and clysters can only become necessary, in the relief of the symptoms we have pointed out, when excitement becomes developed; excepting, when there is experienced a sense of oppression and distention about the stomach and bowels, when the clysters may be advisable; otherwise it is to be feared, the stomach will be affected with sickness, which will obviate all our attempts at relief. Should there be burning heat of stomach, while at the same time the body is death-like cold, it will be in vain to attempt resuscitation with stimulants, calomel is the only one admissible,-the stomach being in a state of inflammation, a scruple may be given every hour, and at the same time, as there is a great desire for cold water, and Nature's craving should be respected, a tablespoonful or two may be allowed every five or ten minutes, but not more at a time, as the stomach is in this state very irritable, and were a quart to be given, it would not satisfy the patient, who would desire as much more five minutes afterwards; that this precaution is indispensable. The clysters are also in this case to be continued; and should the sense of heat in the stomach be great, a dozen leeches may be applied over the part, and after their removal a flannel wrung out in warm water may be applied, and with this covering exposed to the air, so as to encourage a little evaporation if grateful to the feelings of the patient; it should however be observed, that the temperature be not too much reduced in this way. If the pulse admits of it, or as general excitement becomes developed, bleeding may be resorted to, particularly if there are spasms, with the precautions I have already enjoined in having recourse to this remedy.

There is another remedy, simple in the extreme, always available, and speaking both from personal experience and observation, I may add, of powerful operation, which is the fan or hand punkah-it not only renews the air, but condenses it, and thus aiding the respiratory function, assists in no inconsiderable degree in supporting the actions of life; that I cannot too earnestly recommend its uninterrupted use from the earliest period of attack; it is, at the same time, exceedingly grateful to the patient." 121.

The foregoing extract, and indeed the whole work will convince Mr. Searle's readers that he is not a very practised writer. The composition, in a literary point of view, is very inferior; but this we should not, in the slightest degree, object to, if the originality of views or importance of practical precept had answered the expectations which are excited by the author, in the title page, preface, and various parts of the work. We cannot say, however, that a perusal of Mr. Searle's book has given us any additional insight into the nature or cause of cholera. His therapeutical indications we have laid before our readers, for, as they are founded on experience or observation, they form by far the most valuable part of the work.+

Since the above was written we have learnt that the author's health was so bad at the time when the work was printing, that he was unable to superintend the correction of the press.

Nearly half the work, or at least 100 pages, are dedicated to an appendix, consisting of cases and observations "extracted from the report of the Madras

Medical Board." We grieve that Mr. Searle had not some friend to advise him in this publication. It is astonishing that his own common sense did not tell him how unlikely it was that such a plan would succeed in these times.

At the end of this Appendix is another, containing an Essay on Vital Temperature and Nervous Energy; which was submitted to the Medical and Physical Society of Madras-a society which appears to have been dissolved soon after its formation, for want of support. We are sorry to find that the "nervous energy"-ur at all events, the professional zeal of our Madras brethren is not equal to that of their more northern countrymen at Calcutta!

Of the original Essay we are unable to take any analytical notice. The following extract will afford a specimen of the author's electrical reasonings.

"The medulla oblongata (from which all the nerves of sense I believe arise) is the organ appropriated to receive the impressions of the senses, and which it communicates to the mind, by the blending of its nervous fibres with those of the cerebral organ, in the medullary portion of the latter. It is very clear that the senses are united in function, as they are only thus conjointly under the power of volition, as a proof, I cannot will to see, without both hearing and smelling, nor have I the power to arrest the function of either singly, but the whole I can simultaneously, by going to sleep; and thus it is that the muscular nerves of the organs of sense arise also from the medulla, as they are united in effect; and hence also it is, that the medulla oblongata is formed, by the union of the crura cerebri et cerebelli, or at least, that they enter very largely into its composition, thus blending the animal functions or voluntary, with the mental in this organ, as they are conjointly in operation.

The state of being awake, or alive to all the impressions of sense, I am of opinion is that, in which the current of electricity passes through or is extended to the medulla oblongata, and thus are the senses and all the functions in a state of excitement; whereas, in sleep, the stream of electricity takes a different channel, or perhaps wholly passes off by the 8th pair, which, it will be remembered, arise from the inferior part of the medulla; hence it is that digestion and the secretive processes are much more active during the state of sleep, and that dreams, we may infer, are occasioned by the excitement of the intellectual organ, by the 8th pair not withdrawing a quantity of electricity equal to the supply; meaning, of course, the quantity over and above what is required for the excitement of the respiratory muscles, which are at all times in operation; and, as their action is voluntary, it is very clear the organ of volition can never be at rest, like that of the mind and senses; and hence it is that we often turn over and move unconsciously during sleep; and this consideration affords some insight into the state of somnambulism. Finally, the spinal marrow appended to and surmounted by the cerebellum, are organs appropriated to volition, and the numerous functions more particularly characterizing animal existence.

In conclusion, it may be observed, that the scale of animal life comprises three conditions of existence. First-the organic, or that going on in the capillary system, or structure analogous; this, bordering on vegetable life; and the latter, on chemical affinity; rendering the last, the bond of union between organic and inanimate nature.

Second-the nervous and sentient, dependent on the first-or the more particularly animal, connected with organs of sense and volition.

The third and last surmounting the whole, the intellectual; on the summit of which, man stands proudly pre-eminent, with a brain or cerebral organ, developed in a ratio with his vast comprehension, and superiority of mind, above the rest of the Almighty's creation; and holding communion with an immortal spirit, in a way inconceivable to the limited number of faculties, with which, it has been the pleasure of the Almighty to endow him."

X.

OBSERVATIONS ON THE STRUCTURE AND DISEASES OF THE TESTIS. By Sir Astley Cooper, Bart. F.R.S. Serjeant-Surgeon to the King, Consulting Surgeon to Guy's Hospital, &c. &c. Quarto, pp. 245; 22 Plates. Longman's, London, 1830.

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THE medical reviewer has oftentimes a pleasing, but oftener an unpalatable task. The number of good books which issue from the press bear a wofully small proportion to the bad and the indifferent; but the honest critic must wade through all, and expend his time and labour upon many. This is mere drudgery, and of drudgery we do not complain, for it is our business to undergo it. But it is a curious and by no means inexplicable fact, that the worse the book the more importunate and exorbitant in his expectations is the author, and many " a puddle in a storm" is it our fate to witness and our task to appease. An able author is altogether a different sonage to deal with. He is strong and he knows it; having nothing to dread from criticism or the critic, he neither annoys the one nor is galled and nettled by the other. In short, as a real gentleman invariably gives less trouble than a would-be one, so the author of a valuable work is infinitely more tractable than the writer of a volume of trash. We believe we have contrived to give as little offence as any of our editorial confréres; but God knows we stand upon ticklish ground, and, like the Roman legions in the Caudine forks, a single faux-pas sends us under the yoke of an irritable author's ire.

These reflections were naturally excited by the contemplation of the mag. nificent volume before us. In a preface, displaying the modesty which real merit always wears, Sir Astley Cooper observes, that they who are aware of the expenses of such works, require not to be told that his object in publishing cannot be pecuniary advantage. Having been placed for forty years in a situation of ample opportunity-having been fostered by the profession and the public infinitely beyond his deserts-he feels that he is only performing his duty in giving to his medical brethren, without any sordid views, the result of his experience. How plain, and manly, and noble a sentiment! How honourable to the veteran who has fought, we may say, the battles of science for nearly half a century, to dedicate his trophies to the Commonwealth, and expend his latter years in bestowing information and conferring benefits on those who shall come after him. None can fail to be struck by the contrast between such a man and the fry of small authors, whose flippant étourderies too frequently disgrace the medical periodical press. A contributor of a false fact to the most obscure journal, would make more pother and raise more dust with his stupid egotism, than all the distinguished authors of ancient or modern times put together.

The present work on the diseases of the testis is divided into two parts. The first is occupied by a copious, and in many respects novel, description of the anatomy of the healthy organ-in the second, its diseases are treated of at large. We intend to give a full, yet, we trust, succinct account of all the contents of this splendid volume, but we cannot pursue the order of the No. XXVI. FASCIC. III.

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