practitioners of the place, and surely this diffusion would extend its beneficial influence to the lay inhabitants themselves, when on the bed of sickness. The only plausible objection to this rotation duty might lie in the idea that the same patient might, in the course of treatment, come under two or more medical practitioners. This objection is perfectly futile. It is every day refuted by patients in private life, who naturally and properly change their medical attendants when they think they are not deriving so much benefit as they expected from remedial agency. And why should the poor be deprived of an advantage, real or imaginary, which the rich prize so dearly? The fact is, that such changes in public hospitals and infirmaries would very often be productive of the best effects to the suffering inmates. We can only make room here for the following conclusion of an admirable address from the Medical Practitioners of Carlisle to their High Mightinesses, the Governors of the Infirmary. vation. "By accepting, then, the services of all the resident Medical practitioners who may be willing to devote a portion of their time and labour to the duties of the Hospital, the Governors would give to each a permanent and an active interest in its prosperity. By thus creating among them, at the same time, an earnest spirit of emulation, and a desire on the part of every man to discharge his duty in the manner most conducive to his own credit, they would certainly obtain the best pledge for his watchful attention to the interests of the sick. The perfect freedom of intercourse among the Medical officers of the Hospital would necessarily foster a more extended desire for scientific inquiry and obserTheir common stock of practical information would be consequently increased; and under circumstances where no unseemly or disparaging jealousies would be likely to interrupt the general co-operation in a design of so much importance, a higher tone of professional feeling would as certainly be produced. Situated as the Infirmary is, at no inconsiderable distance from the town, the continual necessity for daily attendance during every season of the year, would unquestionably become irksome to the medical men, were the appointments limited to a few; but this inconvenience would be completely obviated by the division of a larger number into successive sections. The recurrence of the periods of active service would be looked forward to by each with an interest perpetually fresh. Every remarkable circumstance would be open to the observation of all; and in cases of peculiar doubt, danger, or emergency, the resource of a general consultation would at all times be promptly available. Even were there no superior advantages presented by the arrangements which we propose, we conceive that a wish on the part of those who in either case would be appointed, to be associated with their professional neighbours, and to share with them in the labours and the advantages of the institution, ought to be regarded by the Governors as a proof of the earnest sincerity with which they would endeavour to carry out its design, and an ample guarantee against those selfish and sordid motives which have been too often known to interfere with the fulfilment of a similar purpose. Believing that we have now fully and fairly stated everything requisite for the explanation of our views upon this subject, we conclude by reiterating our strong sense of the preference due to the system we have suggested; at the same time that we make known our rooted aversion to that which would engender and perpetuate distinctions derogatory to the general character of the resident members of our profession, whilst it would in no manner yield any countervailing advan tage to the institution, by respectfully announcing our unanimous resolution to decline the acceptation of a service upon terms of which we so highly disap prove. (Signed) WILLIAM JACKSON, M.D. RICHARD JAMES, M.D. JAMES MARRS, Surgeon. R. ATKINSON, M.D. EDWARD BOWMAN, Surgeon. JOHN MORTIMER, Surgeon. WM. JACKSON, Chairman. R. JAMES, Secretary." It is hardly necessary to state that the voluntary and gratuitous services of the above highly respectable practitioners were declined, and we believe a stipendiary surgeon has been engaged to perform duties in an institution supported by subscriptions, and which might have enlisted in its favour the whole influence and abilities of the medical corps of the city, without expense! INSTITUTION FOR THE TREATMENT OF CURVATURES OF Few in the Profession, or out of it, are aware of the existence, in this country, of an Institution for the Treatment of Spinal Diseases, so perfect as to rival the best establishments in France. Such an Institution there is in the immediate neighbourhood of London, and it comprises every requisite, mechanical and general, for the efficient management of those complaints. The place to which we allude is Vanburgh Castle, contiguous to Blackheath. This spacious mansion, built by Sir John Vanburgh, has been taken by Dr. Potts, and within its walls, as well as on its lawns and pleasure grounds, contrivances of the most ingenious and appropriate description have been laid out for the use of spinal patients. Planes for reclining, reading, working, playing at the piano-apparatuses for exercising the various muscles in the recumbent or any other posture-swings and all kinds of calisthenic instruments-baths of every sort-may be found there. Besides the corporeal, there is mental discipline, the establishment being educational as well as remedial. Mrs. Potts and her daughters superintend the former, assisted by the best masters in all the branches of knowledge aud accomplishments cultivated by females. A lady from Dresden, who teaches the German language, is resident in the house. It is impossible to do justice to the scientific acuteness and mechanical talent displayed by Dr. Potts in his arrangements. Every apparatus is made on the premises, where there is a turning lathe, a forge, &c., superintended by himself. He is a first-rate mechanic, and not only directs but can execute. We know of no pleasanter excursion for a medical man than that of Vanburgh Castle. The admirable character of the arrangements, the absence of charlatanery, which so often pervades these kinds of establishments, the beauty of the spot, and the frank hospitality of the host, are attractions that it is impossible not to feel. The Institution deserves the warmest encouragement on the part of the profession, and the liberal patronage of the public; never before were there such means in this country for remedying spinal disorders. To be known is all that is necessary for its reputation and success. PHRENOLOGY. (To the Editor of the Medico-Chirurgical Review.) Newtownards, November, 1841. SIR,-If you think the following remarks, confirmatory of some of the doctrines of phrenology, worthy of publication, I will feel honoured hy your giving them a place in your valuable Journal. I am, your obedient servant, D. JAMISON, M.D. DEFICIENCY IN SIZE AND DISEASE OF THE CEREBELLUM, THE CAUSES OF ANAPHRODISIA. Since I became acquainted with the science of phrenology, some years ago, my attention has been directed to the condition of the cerebellum in those individuals who have consulted me for impotence, and in others. I have attentively observed and studied a great number of cases, and am led to regard the following conclusions as correct. I hope their publication may have the effect of directing medical practitioners more closely to observe the undoubted connexion which exists between the state of the genital organs and the cerebellum, and a disease which in its various degrees is much more prevalent than is commonly imagined, and is the cause of a great many evils. 1 The sexual passion has its seat in the cerebellum, and is energetic or the reverse in proportion to the size and tone of this organ. 2. Smallness of the cerebellum, much inequality of its lobes, and deficiency of its tone, are the causes of impotence. 3. When the cerebellum is very small, impotence is permanent. 4. When the cerebellum is small, it soon suffers in tone if made to perform its functions with ordinary frequency. 5. When one lobe of the cerebellum is small and the other large in a man, it is sometimes the case, that he, at intervals distant in proportion to the size of the large lobe, performs the generative act imperfectly, until the large lobe, which had been exhausted, recovers its tone. 6. When the cerebellum is very large, and is much exerted, as it usually is in such cases, it becomes impaired in tone, and impotence is sometimes the result; but the generative act may be well performed by a large cerebellum, even when impaired in tone. 7. Average endowment of the cerebellum is most favourable to permanent potency. 8. When the cerebellum becomes much deficient in tone, if it be not soon cured, the spinal marrow and its nerves, the organic nervous system, the intellect, and moral feelings are successively debilitated. 9. Deficiency of tone of the cerebellum in the male or female is often transmitted to the offspring. 10. Impaired tone of the cerebellum is the cause of spermatorrhea. 11. The size of the genital organs exercises no influence on their activity or vigour; they are often inert when large, and vigorous when small. 12. The father of a monstrocity, an account of the post-mortem examination of which I published sometime ago, had the cerebellum small and debilitated, and had also spermatorrhea; he was permanently weak in the genital organs, and was the means of making me acquainted with many similar cases, and their peculiar symptoms. His wife became jealous and went mad in consequence of believing that he was unfaithful, and that what was the result of debility, was caused by dislike of her. She died in a lunatic asylum. These facts, in connexion with remark No. 8, render it probable, in my opinion, that the subjects of abnormal organization are the products of parents whose generative apparatus was diseased, and general health consequently much impaired. I think the condition of the cerebellum in the parents of monstrosities should be observed. 13. Permanent or frequent impotence, or even continued partial debility of the genital organs, in men who have large self-esteem and destructiveness, and benevolence and conscientiousness not very large, often produces strongly selfishness and malignity; and also cunning and falsity; for though secretiveness should not be large, it is so much exercised in these cases to conceal the symptoms of their disease and preserve the reputation of virility, that it operates as if it predominated in size. This is in accordance with the remark of Dr. Cox, "that it seems to be a law of the human constitution that when any of the faculties is pained or disagreeably active" destructiveness instantly comes into play. Here amativeness is mortified, and self-esteem and love of approbation disagreeably active, and destructiveness becomes consequently excited, secretiveness being active also, malevolence, cunning and falsehood result. 14. Over exertion or exhaustion of the cerebellum robs adhesiveness and combativeness of their power and thus causes cowardice. 15. Whatever exhausts the power of the constitution, seems not only to diminish the power of combativeness, but also to stimulate cautiousness. 16. In some men an activity and power of the cerebellum greater than what we would expect from their temperaments and developments may exist for a long time without producing impotence; here it seems to appropriate more than its own share of the nervous energy of the system; the other organs of the body suffering a diminution of power apparently that the generative apparatus may obtain an increase. 17. The cerebellum is in general too much exercised in the married state. 18. When the cerebellum is too much exercised, no matter what the size of it may be, it becomes impaired in tone. 19. Men and women who have the cerebellum much below the average size should not marry. 20. Impotence is curable in all cases but where the cerebellum is very small or disorganized. 21. Fluor albus is caused by deficient tone of the cerebellum in many cases. 22. Deficient size and tone of the cerebellum in males or females is a cause of want of liveliness, and sometimes of melancholy and madness. 23. Disease of the cerebellum is often the real cause of absurd eccentricities. 24. The treatment of impotence should always be directed with a view to its origin in the cerebellum. NITRATE OF SILVER IN GONORRHOEA. Mr. Carmichael, of Dublin, has strenuously repudiated the practice attributed to him by Mr. Acton, of using injections of nitrate of silver, so strong as ten or twelve grains to the ounce of water. In Mr. C's published work on the venereal disease, he stigmatizes the above mode of treatment, as a practice that cannot be too strongly deprecated." In a more recent publication-a lecture-he states that he has used the injection, but never in a greater degree of strength than one grain to the ounce-more frequently a quarter or half a grain to that quantity. SUICIDE AND CROSS-WAY BURIALS. It appears that a little while ago there was a sort of suicidal epidemic in the city. Night after night persons threw or tried to throw themselves into the Thames. Sir Peter Laurie determined to punish those who failed in their attempts at drowning. They were imprisoned, sent to take their trial and so forth, and the epidemic subsided. On this text our contemporary, the Medical Gazette, enlarges and though we think there is much good sense, we also think there is much that is questionable in his remarks. The gist of them is contained in the following passage. "Need we point out how these cases afford another proof, though of a very different kind from those commonly adduced, of the propriety of treating those who are, or who seem to be, insane, in the same manner as if they were thoroughly rational? It is quite plain that for all these cases, the best method of preventing suicide is, to treat it as a punishable offence, that is, as the evil deed of a responsible man; to make no difference, primà facie, between suicide and homicide. They show, also, the power which is in the hands of coroners' juries to put a check upon this fearful practice by bringing in, in every case where the contrary is not clearly indicated, such a verdict as may lead to the body of the resposible self-destroyer being deprived of that respectful treatment which seems to all men an object of anxious desire. No sympathy can be more unsound than that which dictates men to believe a suicide ipso facto insane; nor can any be attended with worse effects. Make all suicides objects of pity, of sympathy, and of respect, and they will not be rare but put them on the level with homicides, let the bodies of all be disgraced in whose cases there are not plainly circumstances that proved them to be irresponsible to themselves (and, for their last deed to their Maker), and then will the number of these criminals diminish yearly. In a word, let juries act towards the dead in the same spirit as the magistrates have acted to the living, and they will soon very materially diminish their own and the coroners' labours." We think that the danger of acting literally on our contemporary's advice in the treatment of mania must be obvious. A man who is confessedly deprived of reason is to be amenable to punishment; like him whose reason is intact. It would be equally difficult to show the justice and humanity of this proposal. Punishment implies crime-crime the power on the part of the criminal to distinguish between right and wrong-and the loss of reason abrogates that power. A great proportion of our punishable offences are not stamped as such by any natural laws, but defined by highly cultivated reason, or by the revealed will of the Almighty. To punish the irrational for sinning against what it required reason to create, and implies reason to observe, is harsh and unjust indeed. We grant the occasional difficulty that exists, in determining the requisite quantum of insanity, but that is a question of detail, and excluded from the broad principle laid down by our contemporary. No doubt there are certain cases, like the fashion for drowning in the City, where law may thrust its arm between the act and the actor. But these are samples of a pseudo sort of mania, and admit of a special treatment. Nor can we quite agree with our contemporary in his advice to coroners' juries. The stake and the cross-way burial would be revived were his suggestions to be acted on. But we would remind him that this is no new methed-it has been tried and failed. The intelligence of the age put it down. It proved, we apprehend, in practice unavailing in deterring from the guilt, powerful only in injuring the innocent. The feelings of survivors are lacerated sufficiently by the dreadful act itself, without any posthumous addition. Are the unhappy widow and the helpless children of the suicide to be tortured by the reflection that as the husband and the father's death was dreadful, his corpse is spurned as infamous? Experience has proved the inutility, our feelings proclaim the injustice of this. Would all the horrors of the old suicidal code of England have prevented Romilly from committing self-destruction, or would enlightened Europe have tolerated their infliction upon his remains? We fancy not. Then if insanity is to save from the coroner's vengeance the bodies of the rich, are only the poor to be consigned to it? Is Castlereagh to repose beneath his gorgeous pall, and some wretched victim of seduction to be staked? These are some of the difficulties that they would have to grapple with, who should venture to resuscitate the penal treatment of suicide. |