a host of effects leading to one certain goal, a premature decay both of the mental and physical being. Is the real period of man's probable existence, and the distinction between age and decrepitude ever considered? Instances of extreme longevity occur in all countries. In England, during the last century, several persons died more than 130 years old, and there are authentic records of many hundreds of individuals who have lived more than a century. The votaries of good living may think that an existence thus protracted is undesirable. Let them read Southwood Smith's Philosophy of Health: they will there find, admirably described, the distinction between advancing life, a period to which an indefinite number of years may be added, and decrepitude, which no human power can protract and they will also find, eloquently displayed, the undoubted truth, that enjoyment is the only condition of life which is compatible with a protracted term of existence.

We have entered more fully than usual into the details of this subject, that we might carry conviction to the minds of our readers, of the importance which must attach to the possession of some definite principles, by which, as practitioners, we may be guided in laying down rules of diet. We cannot say that we regard Dr. Pereira's treatise either as complete or faultless. It is a compilation with an original arrangement of the matter. Many of Liebig's beautiful theories are introduced as extracts, without much and sometimes without any commentary; and notwithstanding objections raised against some of these, it is, as before intimated, essentially the application of the organic chemistry of Liebig and of the continental school, to the subject of diet. Many of our readers will regard the principles it comprises as too chemical, and we do not ourselves vouch for the stability of all the doctrines advanced, however cautiously, by the author. The numerous repetitions met with is a great fault, and the tables of analysis might have been concentrated with advantage, and placed together at the end of the work, or at the end of each section or chapter. Thus, the long table from Dr. Beaumont is first introduced piecemeal, and then again entire, under the head of "the digestibility of food." All this serves to increase the number of pages, or to exclude important matter, which otherwise, as we think, might have been introduced. The chemical annotation is also faulty. The chapter on alimentary principles might be curtailed with propriety, and a part of the matter transferred to that on compound aliments. Notwithstanding all this, the work is not only an excellent text-book to be placed in the hands of students, but one absolutely necessary for the use of every practitioner at the present moment, whether he has kept pace or not with organic chemistry in its recent rapid progression; it is calculated, by enabling the regular practitioner to found his directions for diet in some measure on a scientific basis, to prevent the abuse of the public mind by the empirical and frequently pernicious or ridiculous precepts of homeopathists, hydropathists, and charlatans. Dr. Pereira's original plan was to treat the subject in a more full and systematic manner; and we still think that a work embracing the principles of dietetics more extensively applied, the natural historical details more judiciously selected than we find them in Dr. Davidson's duodecimo, and the interesting facts so far as they are authentic, which Dr. Truman delights in, with their philosophical interpretation, and all that is important relating to the subject of food and diet, is still a desideratum in medical literature.

ART. II.

A Practical Treatise on the Diseases of the Testis, and of the Spermatic Cord and Scrotum. By T. B. Curling.—London, 1843. 8vo, pp. 542. With Illustrations.

THIS is not a book written to order, to satisfy the necessity for printing periodically experienced by the brethren of the Row; but is, we find from the author's preface, the legitimate and spontaneous issue of sonal observation and research, aided by ample opportunities and abundant experience.

per

"My attention having been directed in the year 1835 to the subject of the morbid anatomy of the testis, I have since lost no opportunity of studying the pathological changes to which this organ is liable. My inquiries have been much facilitated by a connexion formed very early in professional life with a large hospital and with a dispensary, which have supplied me with abundant means of acquiring a practical knowledge of the diseases of this important organ. The result of these investigations having furnished facts which appear of some interest and value in relation to certain affections of the testis, but imperfectly understood, and to the treatment generally of the disorders of this part, I have ventured to submit them to the consideration of my professional brethren." (Pref. p. i.)

In addition to the practical improvements thus announced, the author's "Researches on the structure of the testis," have led him "to describe certain parts rather differently from other anatomists," and have enabled him "to throw some light on the interesting subject of the descent of the testis." (Pref. p. ii.) In fact, the present work does not appear as a mere digest of the labours and experience of others, but avowedly professes to augment our anatomical, physiological, pathological, and practical knowledge respecting the organs and the diseases it treats of, and it is our duty to present such an analysis of it to our readers as may enable them to judge of its general character and particular merits.

The FIRST PART of Mr. Curling's work is devoted to the anatomy of the scrotum and testis, and to some considerations on the functions of the latter organ. It would be tedious as well as unnecessary to examine this portion of the book in detail, and we shall merely advert to a few points that seem to require notice.

The scrotum. There is considerable difference of opinion respecting the anatomy of the parts intervening between the skin and the tunica vaginalis. Winslow and his successors described them as consisting of— a very delicate layer of cellular membrane; the dartos; a tolerably thick layer of cellular membrane; and the cremaster muscle Many, perhaps most modern anatomists, for example, Blandin and Cruveilhier, consider that the dartos alone intervenes between the skin and the cremaster, but recognize between the cremaster and the tunica vaginalis, the common fibrous sheath or tunic of the cord and testicle, derived from or continuous with the transversalis fascia. Sir A. Cooper, though he does not mention the last structure, and denies the existence of the dartos, nevertheless agrees with those authors as to the number of parts that may be discriminated by dissection between the skin and the tunica vaginalis; and he states these to be the cellular tissue of the scrotum, the superficial fascia of the cord, and the cremaster muscle. Velpeau adopts a kind of middle term between these last two views, and enumerates the dartos,

the superficial fascia of the cord, the cremaster, and the common tunic of the cord and testicle. We might readily extend the list of conflicting authorities, but we believe we have noticed those that are most important,-enough at least for our purpose. As to the structure and connexions of the various tissues of the scrotum, we need only notice the various opinions that have been advanced respecting the dartos. Winslow considered it a true muscle, Cruveilhier thinks it a peculiar contractile tissue intermediate between cellular membrane and muscular fibre. Boyer seems to regard it as a fibrous membrane; Meckel and Sir A. Cooper say it is mere cellular tissue, or in other words deny its existence as a distinct and independent structure; and Velpeau ingeniously reconciles these discrepancies by saying, that it is indeed cellular membrane, which is however occasionally transformed into true muscle. Some, with Cruveilhier, consider the dartos as single; others describe it as being double, but, so far as we know, all who admit its existence have hitherto agreed that it forms the septum scroti. As to its extent and attachments, some say it is continuous with the superficial fascia, others that it is connected with the aponeurotic structures of the penis and of the perineum; and others again describe it as attached to the rami of the os pubis and ischium.

Mr. Curling's account of the anatomy of the scrotum is somewhat different from any of those which we have thus briefly passed in review. He describes the subcutaneous layers of the scrotum as consisting of the dartos, a large quantity of cellular tissue, the superficial spermatic fascia, and the cremaster muscle. We do not think that this description is accurate. In the first place, as our author admits the existence of the dartos as a separate structure, we do not know where he finds "the large quantity of cellular tissue" between it and the superficial fascia of the cord, for the only reticular tissue that exists in the scrotum in large quantity, is that which is known as the dartos. A second error, as we think, and a more important one, consists in the omission of any mention of the deep fascia of the cord or common envelope of the cord and testicle, an omission into which Mr. Curling has probably been led by the authority of Sir A. Cooper. We notice this not merely because it is an anatomical oversight, but because the structure in question is of some pathological importance, inasmuch as it is frequently the seat of encysted hydrocele of the spermatic cord, in the adult at least. We may just observe, that Mr. Curling says nothing respecting the extent or the attachments of the dartos. He mentions Mr. Bowman's opinion, that it is muscular and composed of "unstriped elementary fibres," and says, we think erroneously, that the septum scroti is formed, not by the dartos, but by the cellular membrane beneath it.

We are not exactly certain whether Mr. Curling claims originality in his views respecting the cremaster muscle, though his language leads us to suspect that he does. He says, (p. 5,) "this muscle is usually considered and described as a part or process of the oblique internus abdominis. It has, however, separate attachments; and its office and connexions are so entirely distinct, that it ought to be regarded as an independent muscle." And at p. 31, after again alluding to M. J. Cloquet's view that the cremaster muscle is formed by the testicle drawing down, during its descent, the inferior fibres of the lesser oblique

muscle, he says, "this view is, as I have shown elsewhere, clearly erroneous and inaccurate." Now, the refutation of Cloquet's view has not, as this language implies, been reserved for our author; its inaccuracy has been shown long since. Cruveilhier, for example, has expressly contradicted it. (Anatomie Descriptive, t. ii, pp. 58 and 727.) Mr. Curling's description of this muscle is precisely similar to that of Sir A. Cooper, save that Sir A. Cooper describes its internal origin as attached, on the inner side of the abdominal ring, to the lower part of the sheath of the rectus muscle, while our author describes it as attached to the os pubis, as well as to the sheath of the rectus; but the internal attachment of the cremaster to the os pubis is distinctly mentioned by Scarpa and others.

The testis. The description of the testicle is clear, copious, and accurate; and embodies the researches of Krause, Lauth, Müller, and Gulliver, respecting the minute anatomy of the secreting structure of this organ. In a note (p. 8) it is said, from a misprint no doubt, that Cruveilhier estimates the thickness of the testicle at three lines, it should be eight lines. Meckel states the average weight of the testicle to be four drachms, and Sir A. Cooper about an ounce. Mr. Curling says, "I have found the mean of these two estimates, viz. six drachms to be the ordinary weight of the sound testis of a healthy adult." (p. 9.)

Descent of the testicle. Mr. Curling has advanced some new views respecting this very interesting and obscure subject, which we shall allow him to explain in his own words. After describing the situation of the testicle in the foetus and the general configuration of the gubernaculum testis, he proceeds thus:

"The lower part of this process (the gubernaculum) passes out of the abdomen at the abdominal ring, and diminishing in substance and spreading, terminates in three processes, each of which has a distinct attachment. The central part and bulk of the gubernaculum is composed of a soft, transparent, gelatinous substance, which, on examination in the microscope, is found to consist of nucleated cells, the primitive cellular tissue: this central mass is surrounded by a layer of well-developed muscular fibres, which may be distinguished by the naked eye, and which can be very distinctly recognized in the microscope to be composed of 'striped elementary fibres.' These muscular fibres, which may be traced the whole way from the ring to the testis, are surrounded by a layer of the soft elements of the cellular tissue, similar to that composing the central mass; and in the same way as the testis the whole process, except at its posterior part, is invested with peritoneum. On carefully laying open the inguinal canal, and gently drawing up the gubernaculum, the muscular fibres may be traced to the three processes, which are attached as follows: the external and broadest is connected to Poupart's ligament in the inguinal canal; the middle forms a lengthened band, which escapes at the external abdominal ring, and descends to the bottom of the scrotum, where it joins the dartos; the internal passes in the direction inwards, and has a firm attachment to the os pubis and sheath of the rectus muscle. Besides these, a number of muscular fibres are reflected from the internal oblique on the front of the gubernaculum. It thus appears that the attachments of the muscle of the gubernaculum, and those of the cremaster in the adult are exactly similar. I have succeeded in tracing out the former before the testis has descended, at different stages of the process, and immediately after its completion; and of the identity of the two no doubt can be entertained. (pp. 30-1.) In the passage of the

testis from the abdomen to the bottom of the scrotum, the gubernaculum, including its peritoneal investment and muscular fibres, undergoes the same change as that which takes place in certain of the rodentia at the access of the season of

sexual excitement; the muscle of the testis is gradually everted, until, when the transition is completed, it forms a muscular envelope, external to the process of peritoneum, which surrounds the gland and front of the cord. As the testis approaches the bottom of the scrotum, the gubernaculum diminishes in size, owing to a change in the disposition of its cellular elements; the muscular fibres, however, undergo little or no diminution, and are very distinct around the tunica vaginalis in the recently descended testis. (p. 33.)......the middle attachment of gubernaculum, which may be traced to the dartos at the bottom of the scrotum, gradually wastes away, and soon becomes indistinct, though slight traces of this process often remain to the latest period of life. Thus, after death, in dragging the testis of an adult out of the scrotum by pulling the cord, the lower part of the gland, which is uncovered by serous membrane, is often found connected to the bottom of the scrotum by a band of firm and dense cellular tissue......This band is the remains of the middle attachment of the gubernaculum. In cases in which the testis has been retained in the groin, I have traced a cord of dense tissue from the gland to the lower part of the scrotum." (pp. 33-4.)

Mr. Curling then proceeds to deduce an explanation of the descent of the testicle.

Hunter, Meckel, and others," he observes, "came to the conclusion that the muscular fibres of the cremaster are insufficient to bring the testis lower down than the abdominal ring, and complete the descent. They were not, however, acquainted with the attachment of this muscle to the pubis external to the ring, or it would be difficult to understand why Mr. Hunter, after arriving at the conviction that the cremaster passes up to the testis whilst in the abdomen, chiefly from analogy, was not induced by the same process of reasoning to conclude, that a muscle capable of drawing down the testicle in animals would be adequate to accomplish the same purpose in the foetus. The necessity for some active agent to effect this change in the latter would appear to be greater even than in animals, since, in the usual position of the fœtus in utero, the passage of the testis is contrary to gravitation, and unaided by the movements of respiration. Now, when we consider the attachments and connexions of this muscle in the foetus, the perfect condition of its fibres as ascertained by microscopical examination, and the circumstance that there are no other means, no other motive powers by which this change can be effected, or in any way promoted, I think there is no reason to doubt that the cremaster executes the same office in the human embryo, as that which it undoubtedly performs in certain animals at a particular season. fibres proceeding from Poupart's ligament and the obliquus internus tend to guide the gland into the inguinal canal, those attached to the os pubis to draw it below the abdominal ring, and the process descending to the scrotum to direct it to its final destination. As the descent approaches completion, the muscular fibres which perform so important a part in it gradually become everted; and, instead of drawing down the testicle, acquire the new functions of elevating, supporting, and compressing it." (pp. 35-6.)

The

This account of the structure and attachments of the gubernaculum testis explains the descent of the testis in a very ingenious and satisfactory manner. The great difficulty has always been to understand how the testicle was conveyed from the external abdominal ring into the scrotum; for though its descent to the ring might be referred, either to the slow contraction of the gubernaculum itself, or to the action of the muscular fibres that exist on the anterior surface of that organ, the latter of these influences could clearly carry it no further than the ring, and neither the prolongation of the gubernaculum to the bottom of the scrotum, nor its muscular structure internally were suspected, until discovered by Mr. Curling, to whom the greater credit is due as the structure of these parts and the descent of the testicle have been anxiously investigated by the most eminent anatomists.