the union of carbon and hydrogen with oxygen, to form carbonic acid and water, must be regulated by the vital powers in such a manner as "to yield very different quantities of heat at different times." (p. 78.) This conclusion we fear, if it follows necessarily from the premises, only proves the insufficiency of that theory of animal heat which requires to be so propped up.

Our author's theory of animal heat leads him into some curious speculations on the sources of nutrition. Conceiving that in herbivorous animals in hot climates, and in the rice-eating Hindoo, the non-nitrogenous principles of their food would be insufficient for the renewal of their animal fabrics; and that at the same time, to obtain the little azotized matter which it can afford, they would be compelled to consume an unmerciful quantity (considering the heat of the climate) of fuel in the "heat-producing carbon and hydrogen" of their vegetable food; he comes to the conclusion that the nitrogen of the atmosphere is laid hold of by the vital power, and by its means the non-nitrogenous principles of vegetable food are assimilated. This hypothesis, ingeniously as it is advocated, calls for more evidence than has been advanced in support of it in the work before us. But we think, on the other hand, that the doctrine of Liebig cannot be regarded as by any means satisfactorily demonstrated; and that many of the objections urged by Mr. Jeffreys should be weighed better than they have yet been, ere we assent to the principle, that no conversion of a non-azotized to an azotized compound ever takes place in the animal body. That this conversion, however, if it should be demonstrated to take place, is effected by any other than chemical agency, we cannot by any means admit. Much as we respect the "vital power," we have our doubts of its ability to do several things attributed to it in the work before us. While we protest, as we have always done, against the too-prevalent error at the present day of regarding the human body as a mere laboratory or machine, we would guard equally against resuscitating, for the sake of an hypothesis, the vis medicatrix nature of former times, and ascribing to it the discretionary power of regulating entirely the operations of the living body, of uniting or separating elements "at will," depositing or removing substances, forming them out of their elements, and tearing them asunder when formed. (p. 122.) The vital power has no will or discretion in the case; the will and discretion are in the arrangement of the vital laws, which are doubtless as definite and determinate in their operation as those of chemical action.

In a chapter devoted to the examination of the function of the capillaries, Mr. Jeffreys endeavours to explain the changes produced in inflammation, by vermicular contractions of those tubes. Just as a leech fills itself by vermicular contractions, so, he conceives, the capillaries of an inflamed part fill themselves with blood; and warm fomentations resolve the inflammation by diminishing the tone and action of the capillaries, so that they no longer force blood in undue quantity into themselves. The theory and illustration appear to us to be alike unsatisfactory. If a leech were a tube, patent during the time of its contractions at either end, we question whether it would become distended; nor can we conceive how the capillaries would become distended by similar movements, unless there was added to the hypothesis a "tonic spasm," or sphincter, on some point of the vessels.

In Part III, "On the dissipation of animal heat, and its influence in producing local determinations of blood, especially to the head," Mr. Jeffreys, in pointing out the secondary effects of cold and warmth, boldly controverts the common axiom "keep the head cool and the feet warm.' He points out that the Hindoos, who habitually reverse this rule, are remarkably exempt from cerebral affections, in a climate where Europeans are peculiarly liable to them; and that persons who habitually act on the vulgar axiom produce, by preventing the proper functions of the parts, and the usual extrication of heat from them, a cold and bloodless state of the extremities; while the head, on the other hand, kept bald and cool, displays by its flushings and perspiration an increased tendency to vascular action. The observations are to a great extent true, and deserving of consideration; the axiom we have been accustomed to hear, and to act upon, however, will bear, we think, the test of our author's experience and observation; and is, we believe, the full and proper exposition of the axiom in question, namely, "keep the feet warm with exercise, and the head cool with temperance."

The work before us, although we have expressed ourselves thus freely on several of the most prominent theories which it propounds, contains much interesting matter for inquiry and reflection. It is the production of one who has enjoyed very favorable opportunities of observing nature in widely different circumstances, and who has brought to bear upon those opportunities the powers of an intelligent and reflective mind, sharpened and chastened by an acquaintance with the gradual progress of physiological research throughout the world. The critique on Liebig's views, contained in the various articles which form the Appendix, is especially deserving consideration; although we think that more extended chemical and physiological information on Mr. Jeffreys's part would have prevented him from making some unfounded attacks upon the doctrines alluded to.

ART. IX.

Traité Pratique de l'Amaurose ou Goutte-Sereine, avec des Recherches Nouvelles sur les Méthodes spéciales de Traitement qui conviennent à ses differentes Espèces. Par J. E. PÉTREQUIN, D. M.P.-Paris, 1841. 8vo, pp. 120.

A Practical Treatise on Amaurosis, containing new Researches on the particular kinds of Treatment adapted to its various Species. By J. E. PÉTREQUIN, M.D.-Paris, 1841.

ALONG with much that is valuable, there is a good deal of flourish and pretence in the work now before us. The author talks perpetually of his new researches, new studies, new ideas, new therapeutical views. We have been able to detect almost nothing that is new. We defy M. Pétrequin to put his finger on any one fact, or any one opinion in his book, which is not to be found fully discussed in the writings of his predecessors. Our only reason for directing our readers' attention to M. Pétrequin's work is, that, if his cases are not exaggerated, he has been very successful in the treatment of amaurosis, and we consider it important to inquire to what this success has been owing. He tells us, that a radical cause of failure, in the practice of many, is the notion, that amaurosis is simply

a palsy, and ought to be treated as such. His own success he attributes to an accurate diagnosis of the different species, and to a treatment appropriated to each, but varied according to their periods and complications. He ascribes much also to his establishment of the species, not according to the seat of the disease, which he thinks must always be problematical, but according to the essence or nature of the cause. This is a very reasonable view of the matter. To distinguish, for example, between an amaurosis affecting the retina and one seated in the optic nerve, must be frequently impossible, and even were the diagnosis made, it would generally be of no manner of use; but to confound a congestive amaurosis with one of an opposite kind might lead to the most serious evil.

The work is divided into two parts: the first consisting of particular observations, and the second of general reasonings.

The following is an analysis of the facts presented to our consideration in the first part.

Asthenic nervous amaurosis. M. Pétrequin tells us, that this species of amaurosis is the most simple, the least complex. When primary, it arises chiefly from an inordinate exercise of sight, or from some debilitating influence; such as want, age, narcotics, venery, hemorrhage, typhus, &c. It is often consecutive, originating in some other variety of the disease, as the verminous, the traumatic, or the congestive. Sometimes the cause is local, sometimes general.

The course of asthenic amaurosis is slow and free from pain. The pupils are dilated, and their motions impeded; the patient complains of visus reticulatus, and has a dull expression of countenance. This species often assumes the form of night-blindness. The patient searches for more light, and often changes his glasses in the hope of seeing better. The prognosis has generally been unfavorable, but to this M. Pétrequin cannot agree.

A tonic plan of treatment should be followed, both internally and externally, strengthening diet, the preparations of iron and of cinchona, frictions with the tincture of nux vomica, aromatic vapours, stimulating collyria, blisters to the forehead dressed with strychnia, and electricity. Setons in the neck, so much used, are hurtful in asthenic amaurosis, as well as exclusion of light from the eyes by shades.

CASE I. The left eye of a woman, aged twenty-five, employed in embroidering, is affected. No photopsia, no muscæ, no pain of head or eyes. Pupil a little dilated. Everything seems as if in a whitish cloud. A cure is effected by blisters and the application of strychnia and nux vomica; ammoniacal vesication; and frictions with tincture of nux vomica.

CASE II. The right eye of a tailor, aged twenty-four, becomes incompletely amaurotic, after bathing in the river. Headach, mistiness of vision, myopia, muscæ, with a little dilatation of the pupil. Cured by frictions with tincture of nux vomica.

CASE III. To intermittent fever there supervene anæmia, anasarca, and debility, with incomplete amaurosis, and dilated, but moveable, pupils. No pain nor photopsia. Cured by good food, strychnia and powdered nux vomica repeatedly to the blistered forehead, and frictions with tincture of nux vomica.

Amaurosis from lightning. In its symptoms and nature, M. Pétrequin regards this amaurosis as approaching the asthenic or torpid, and, therefore, as requiring the same treatment. He considers it as a result of a perturbation of the nerves and of a subtraction of the nervous fluid, phrases to which no accurate signification can be attached.

CASE IV. The conductor of a diligence is deprived of sight by a stroke of lightning. He has been bled, leeched, had emetics and purgatives, and been blistered, without benefit. Cured after fifteen months, by the internal use of alum. Probably a natural cure.

CASE V. A sailor is struck blind by lightning. His eyes appeared so natural, that he was suspected to be simulating. Various remedies were tried, but with no effect. Gradually he begins to see in the dark, then during day, and ultimately recovers perfectly, probably in consequence of careful regimen.

Amaurosis from worms. The disease of the eyes which arises from worms in the intestines is at first only a mydriasis, and may readily be cured by anthelmintics. If the case is neglected, the retina becomes implicated, and then the removal of the worms may prove of no avail. The amaurosis approaches the asthenic. The countenance is tumid, and of a pale yellowish hue; the belly distended; the head heavy; there is nausea, with itching of the nostrils and throat, disturbed sleep, and twitchings of the face. The anthelmintics chiefly recommended by M. Pétrequin are worm-seed (artemisia Judaica,) and Corsican wormweed (fucus helminthocorton.)

CASE VI. A child is cured of complete amaurosis, after passing a

knot of lumbrici.

CASE VII. A girl of fourteen passes sixty lumbrici, and is cured of amaurosis. M. Pétrequin merely saw the worms at Padua.

CASE VIII. A girl, twelve years old, after having been troubled with worms, and suffering from tinea favosa, becomes incompletely amaurotic. No pain; pupils dilated, but contractile; complains of the sensation of a black mist; sees distant objects; diplopia. Passes no worms, but is cured by vermifuges, especially wormseed and Corsican wormweed. Appetite and general health improve under this plan, and patient gains flesh. It is not clear that the amaurosis arose from worms.

Traumatic amaurosis. M. Pétrequin refers traumatic amaurosis to three principal causes, viz. contusion of the eye, concussion of its nervous system, and injuries of its accessory nerves. It generally occurs instantaneously. Sometimes it yields as the symptoms by which it is accompanied subside under treatment, but often it persists, under an asthenic character. M. Pétrequin supposes an analogy to exist between the injuries of the eye which determine amaurosis, and concussion of the brain producing palsy. The pupils are dilated and irregular.

The first indication is to combat the general effects of the injury; the second, to attack the congestive or other complications; and the third, should the disease continue under an atonic form, to employ either the means already recommended for asthenic amaurosis, or those hereafter to be pointed out for the cure of the torpid variety.

CASE IX. A fall on the head, from a considerable height, produces concussion of the brain, which is successfully treated by bloodletting and other remedies, but vision is double, and that of the right eye is short

and indistinct. The right pupil was at first dilated; now the pupils are natural, and there are no signs of inflammation, congestion, nor irritation. The visual asthenia is treated by frictions with tincture of nux vomica. Next morning, no diplopia. The frictions are omitted, and double vision returns. They are resumed, vision again becomes single, and a complete cure is effected under a continuance of the remedy.

CASE X. By an explosion in a mine, a strong man is thrown to a distance of fifteen paces. Amongst other consequences of the injuries received, the eyelids are oedematous, the conjunctivæ ecchymosed, and the patient deprived of sight. The cerebral symptoms are combated by bloodletting and other remedies. Fifteen days after the accident, the patient sees a little with the left eye, but the right continues completely amaurotic. Sixteen leeches behind the right ear restores the left eye nearly to a natural state, but the vision of the right eye is still defective. Pupils unequal in size. A gradual recovery takes place, without any particular treatment being mentioned.

CASE XI. By an explosion in a mine, a man, among other injuries, receives two deep wounds on the forehead, and has his left eye destroyed entirely, while the right presents a superficial scratch of the cornea, with a dilated and irregular pupil, which is displaced upwards and motionless, and a loss of vision. The cerebral concussion and other symptoms are treated by bloodletting and abstinence. On the tenth day, vision of right eye begins to return, the pupil remaining dilated and irregular, but moveable. The patient complaining of weight in the head, fifteen leeches are applied behind the right ear. Vision improves, but it is still dim and easily fatigued. Six weeks after the injury, the visual asthenia continuing, frictions with tincture of nux vomica are had recourse to, and in three days a great improvement takes place. In six days, the sight of the right eye is perfectly restored.

CASE XII. A fall on the right cheek is followed by epistaxis and insensibility, and by ptosis and complete amaurosis on the right side. Pupil dilated and motionless; malar bone depressed; palsy of the zygomatici, dilatator nasi, buccinator, and masseter; deafness of right ear; loss of speech; lower jaw motionless. Fifteen leeches are repeatedly applied behind the right ear. Sensibility returns, but the patient can neither speak nor chew. The blindness and deafness continue. Skin round orbit becomes ecchymosed. Leeches are again employed, and on the sixth day, the muscles of the lower jaw resume their office, and the ptosis disappears. On the seventh day, the patient begins to see a little, and the other symptoms gradually abate, till the twenty-third day; when, being exposed to the air and to the sun, the patient is seized with headach and other alarming symptoms; sixteen leeches relieve him, the pupil becomes normal, and vision is restored.

Congestive amaurosis. This depends on vascular derangement of the organ of vision. M. Pétrequin distinguishes three principal varieties of it, which he designates by the names of simple congestive, irritative sanguineous, and irritative nervous or erethistic.*

He has seen simple congestive amaurosis arise, especially in some debilitated individuals, without any premonitory symptoms, without any

From pi0w, I irritate, provoke, disturb.