the size of these plates. Sometimes the development of these villi, as they changed to form the plates, could be distinctly observed. A beautiful coloured plate illustrative of the lesions we have noticed is given.

Much interesting information has likewise been collected by our authors relative to the remedial powers of various measures proposed for the cure of the disease in question. When the disease first invaded Europe many physicians thought that the disease was a form of malignant intermittent fever, and that it might be cured by bark. Unfortunately, experience has not justified this hope, and after the numerous trials that have been made with this remedy without success, our authors think themselves justified in confidently advancing it as an axiom, that

"Bark and its preparations administered with the view of treating algid cholera as a maligant intermittent have not produced the beneficial effects which were expected."

Other practitioners, with the view of arresting the evacuations, resorted to opium and its preparations as the basis of their treatment; but these were found according to our authors to increase cerebral venous congestion, and they were finally proscribed in Russia, Prussia, and Austria.

The physicians of the north of Europe believed that they could arrest the afflux to the digestive organs, by exciting an active derivation to the external surface. With this view they resorted to vapour baths and frictions. The patients surrounded with vessels filled with hot water, parched oats, hot sand, &c.; and hot drinks were administered. The result of these measures, for the most part, was to precipitate the progress of the disease. Hot drinks increased the changes, rendered the thirst inextinguishable, and produced renewed evacuations; the different articles and numerous coverings with which the patients were overburdened, were so insupportable, from the uneasiness, anguish, and inexpressible anxiety which they determined, that the dying summoned all their strength to relieve themselves from them. These measures in all instances exhausted the strength of the patients, and destroyed the little vital energy which lead to or induce, the period of reaction. Vapour baths were particularly employed in Russia, but their utility was considered so doubtful that their use was abandoned in Prussia and Austria. In France, and in this country, where these measures have been employed, their inefficacy and even injurious tendency have been fully recognised. Had the practitioners in these latter countries taken proper measures to ascertain the results of experience elsewhere, much suffering might have been spared to cholera patients. As to the various stimulants, our authors state, that

"All practitioners agreed in regarding them as often inefficacious, and

still more frequently as aggravating the symptoms they were given to relive."

The mode of treatment which seems to have united in its favour the most eminent practitioners of the north of Europe is that by emetics and cold. The following was the method of treatment pursued at the temporary hospital of Aboukoff at St. Petersburg, and by means of which cures were effected which often struck our authors with astonishment.

"As soon as the patient entered the hospital he was placed in a bath of from 28° to 30° R. (95° to 190° Fah.) and retained in it for half an hour or an hour; he was then placed in a warm bed and rubbed all over with ammonia, whatever might be the intensity of the disease. A draught, containing four or five grains of emetic, was immediately administered in divided doses, and at shorter or longer intervals. As soon as the action of the medicine became manifest, the nature of the matters vomited changed; they became better, and presented a bilious and poraceous aspect. From this moment the cholora vomiting ceased and rarely returned; the diarrhoea was arrested, or much diminished; finally, after some hours the symptoms of reaction were progressively manifested; in a word, the algid cholera was changed to febrile or inflammatory cholera."

Our authors have presented in much too favourable a light the results of the above treatment. Thus they state that of 313 patients treated by the above method, 231 were cured, or 74 per cent. which is extraordinary success in cholera. But it appears from a table joined to the work that the whole number of patients received into the hospital of Aboukoff was 626, of which number 122 were received dead, leaving 504 actually received alive into the hospital, of which number 106 died in twelve hours, 85 in twentyfour hours, 55 in three days, 14 in six days, 13 in ten days and after; making the whole number of deaths 273, and cures 231, which shows the mortality to have been upwards of one-half. To make out the favourable result of treatment as given by our authors, all those who died within twenty-four hours after admission are considered as received in the state of agony, and are excluded, and those only who lived beyond the period just mentioned are considered as having been treated. Now if those patients alone who are received before collapse, or who live upwards of twenty-four hours after being taken under treatment, are to be considered, there are few hospitals or modes of treatment which cannot boast of great success. We do not think then that any evidence has been furnished of great success having attended the method adopted in the hospital of Aboukoff, and certainly subsequent experience has not induced practitioners to repose any confidence in this method of treatment; indeed, both the warm bath and tartar emetic appear to have been pretty generally abandoned.

At Vienna, our authors state, that the ipecacuanha was adminis

tered with positive success in the different forms of the disease, and at different periods of the epidemic. The employment of this substance was not limited to a particular establishment; its use was general in the civil and military hospitals of Austria, and everywhere it is said to have justified the confidence of practitioners.

"The ipecacuanha was commonly administered in the dose of from 10 to 15 or 20 grains, at once or in divided doses, according to the age and constitution of the individuals. If in an half hour or hour, this remedy did not operate, it was repeated a second or third time; its action being favoured by warming the patient and exciting perspiration, (unless it rendered him uncomfortable,) by means of dry heat. The limbs were surrounded with flannel or warm cloths, and repose and even immobility of the body was recommended. The horizontal position was preferable to every other. Attentive nurses watched the motions and administered to the wants of the patients, who were strictly forbid not to rise or leave their beds, for when they did so, as soon as they returned to them they fainted and speedily died. Cold drinks, often slightly acidulated, replaced with great advantage the hot and aromatic infusions, to which the patients exhibited a great aversion; finally, cauterizing sinapisms over the abdomen, over the chest and even upon the neck; frictions with camphorated, volatile linament, combated with much success the spasms and cramps in different parts of the body. By the combined employment of these means, algid cholera speedily terminated in a return to health, or assumed a second from, or that of reaction."

The evident success obtained by the use of cold drinks, soon gave rise to the treatment of algid cholera by cold. The following is the account of this method as employed by Dr. Günthner, at the great general hospital of Vienna.

"Cold was employed internally and externally, in the form of water and ice.

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Internally, according as a greater or less degree of cold was desired, recourse was had to spring water, ice water, and even small pieces of ice. Spring water was given by mouthfuls, every two or three minutes. Ice was administered in pieces of the size of a hazel-nut, every five or ten minutes. In mild cases the degree of cold was gradually augmented, but when the disease was violent and urgent, the highest degree of cold was immediately used; it was continued even during the increase of diarrhoea and vomiting, and when these symptoms had ceased or subsided in an evident manner, the intensity of the cold was by degrees lessened, until it was at the temperature of water which had remained some minutes in a room at the temperature of 12 or 15o Reamur.

"When the diarrhoea did not yield to the use of ice internally, it was stopped by one or two injections of cold ice or water. Externally, cold was employed in the form of lotions of cold or ice water, and frictions on the surface of the body with pieces of ice. The lotions were applied with sponges or towels. The limbs and sometimes the whole body were rubbed with ice until they began to grow warm, which most usually occurred in five or six minutes. Then the patient was rapidly dried with towels moderately warm in which he was enveloped. Soon and gradually

the surface of the body increased in temperature; vital turgescence insensibly developed itself, the choleric appearance of the face and the spasmodic pains of the inferior limbs was dissipated, perspiration more or less free announced that imminent danger no longer existed.

"In the most violent cases, the more the features of the face were dis torted, the smaller and more insensible the pulse, the colder and more livid the surface of the body, the more violent the cramps of the limbsthe more necessary was it to persevere in the internal and external use of cold. In these cases frictions with ice were preferable to lotions with cold water.

"An important remark, which we must not pass over in silence, is, that the external employment of ice was always preceded by its internal administration; the former was never used alone; moreover, when the lotions or frictions were discontinued before the body had become warm, precious time had been lost, and it was necessary to recommence their employment.

"A phenomenon of much interest is the agreeable sensations experienced by the patients after this treatment; they ask for and insist on the repetition of the lotions and frictions, they drink the cold water, and suck the pieces of ice with inexpressible delight; they reject with a kind of horror all medicaments. Certainly, if nature has given to suffering man an instinctive faculty to discover remedies appropriate to the nature of his disease, it can be affirmed that the action of cold is the only one that will always be agreeable to cholera patients, and which will invariably be sought by these unfortunate beings even in their last moments. Even when the termination of the disease was unfortunate, it was still easy to recognise the energetic influence of this method, by the various modifications it exercised on the circulation, the colour and heat of the skin, the quantity and nature of the excretions, &c.

"From the middle of September to the end of October a hundred patients were treated by this methed, of which number sixty-five recovered, and thirty-five died. From the last of October to the 12th of December forty-two patients received this treatment, of this number thirty-four were cured, and eight died.

"It appears from these authentic documents, that of all the curative methods that by cold has proved most efficacious, since nearly two-thirds of the patients were cured by it, a proportion of cures not yet obtained in any other country.

The employment of cold has also other advantages. Whilst hot drinks excite only disgust, increase the thirst, and in place of relieving it produce anguish and agitation; cold drinks, on the contrary, gratify the wishes of the patients, render them calmer and more docile. These drinks also supply rapidly to the system the losses caused by the excessive evacuations."

Under this treatment a prompt cure is often obtained; but in violent cases, an inflammatory state supervenes, most frequently congestion of the brain and chest. These congestions and local inflammations cannot be ascribed, however, to the action of cold, as they supervene after every method of treatment. They demand for their cure antiphlogistic remedies.

The details of six cases treated according to the above method have been given by our authors.

In desperate cases an attempt was made in Vienna to cure the disease by the conjoined employment of cold and stimulants; but of fifty-eight cases, nineteen only were cured.

From the space we have devoted to this work, it will be readily concluded that we estimate highly its merits. Indeed, notwithstanding the many works which have since appeared on the subject, and the enlarged experience the profession has had in the disease of which it treats, this volume may be consulted with much advantage; and may be ranked among the most valuable contributions to our knowledge of the terrible scourge which has swept over the greater portion of our globe, and which has recently and is at the present moment committing its ravages in various parts of Europe.

ART. VI.-A Home Tour through various Parts of the United Kingdom; being a Continuation of the " Home Tour through the Manufacturing Districts." Also Memoirs of an Assistant Commissary-General. By Sir GEORGE HEAD, Author of " Forest Scenes and Incidents in the Wilds of North America." London: Murray. 1837.

SIR GEORGE HEAD is a capital sketcher. But this is not all. He delights to sketch what most tourists overlook, or think too commonplace to deserve notice. And yet he never throws off a picture that is not striking, or from which a pointed moral may not be derived. His sentiments have a freshness about them, a raciness that speaks the man, at the same time that it invests the object described with individuality and arresting effect. He is the farthest possible from pretending to be an antiquarian, or caring about what has acquired fame on account of its age. He seems recklessly to bid defiance to everything in the shape of romance. But give him the inside of a steam-boat, or the outside of a coach; plant him in a hedge-inn, or place him on the bleak and lonely shore, and if he does not give you things that you are forced to call new and good, that come upon you unawares and render it painful not to desire more, he will be another sort of person than he is in his Home Tours. Not that there is any connection between the parts, or any preconcerted plan entertained by Sir George. Quite the reverse; and, in fact, were he obliged to keep by any defined arrangement, the beauty and excellence of the whole would be spoilt and lost. It is when he talks of having had nothing to do, or when, by mere chance, something has attracted his notice, which, by people who are familiar with it, is thought most unimportant, that we find him most entertaining. On account of the miscellaneous nature of the work however, and its singularly plain characteristics, to be perceived in every