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exposure to contagion, and not from the appearance of the disease, we shall not be successful in one case in five hundred. Still, he says, the destruction of a chancre is to be attempted, unless there are some special contra-indications, as soon as presented to our notice. The directions for the use of caustic, and for the subsequent local treatment, are explicit and judicious. The importance of bearing in mind the “ golden rule, that the varied appearances of primary venereal sores, and the characters they afterwards assume, depend very much, if not altogether, upon the natural constitution of the patient and upon the particular condition of his health at the time he imbibes the venereal poison,” is very properly insisted on. He has abandoned the use of nitrate of silver as an escharotic for primary sores, and now employs either highly concentrated nitric acid, the acid nitrate of mercury, the acid nitrate of silver, or the potassa cum calce of the London Pharmacopæia, minute directions for the management of all of which are given. After the eschar has separated, (which is to be promoted by means of a poultice), he uses weak solutions of nitrate of silver, acetate or sulphate of copper, alum, or zinc, or tannin in port wine, in the proportion of about two drachms of the former to six ounces of the latter. The local applications must of course be varied to suit the actual condition and aspect of the sore, and definite directions are given as to the time and manner of exhibiting mercury when required for the healing of the primary sore, and also the particular form of mercury to be used. The chapter devoted to the subject of bubo is full of valuable practical directions for the management of them. Our author believes in the occurrence of primitive bubo, or “ bubo d'emblee." as authentic cases are recorded, although he has never met with one. When a bubo is ready to be opened, he does not advise a free incision, but makes several very small punctures on its thinnest part, with a grooved needle, perhaps six, eight, or ten, through which the matter will ooze out until the cavity of the abscess is empty. Through one of the punctures he injects a weak solution of sulphate of zinc, and when the abscess is quite empty, places over it a large compress of lint, and uses moderately tight pressure by means of a roller.
The second half of the book is devoted to the subject of constitutional or secondary syphilis, and contains a plain and satisfactory account of its causes, diagnosis, and prognosis, and of the particular symptoms of it, which are described with minuteness and truthfulness. Our author is a full believer in the doctrine of the communication of secondary syphilis from a diseased to a healthy person. The remarks on the chief causes of constitutional syphilis are full and judicious. He says that “perhaps one of the most frequent causes of secondary diseases succeeding primary, and tertiary succeeding secondary, is the recommendation by the surgeon, and the adoption by the patient, of an incomplete treatment," which may result either from the adoption of inefficient remedial agents, or from discontinuing the remedies too soon. The remedies should be continued for at least fourteen days after the primary sore has healed and the hardness of the cicatrix has disappeared ; and in the secondary form of disease of the skin and mucous membranes, the treatment should be persevered in for a month after the subsidence of the symptoms; and in the tertiary forms, for two or three months after their disappearance. Mr. P. considers the neglect of warm, or simple, or medicated vapor baths, during treatment, more particularly of the constitutional forms of disease, as one of the most frequent causes of syphilis becoming protracted, and its so frequent return after apparent cure. He is particularly partial to the mercurial vapor bath. These baths must, of course, be associated with an appropriate internal treatment. It is now well established that mercury does not either prevent or cause secondary symptoms.
In speaking of the prognosis of constitutional syphilis, and of the denial by some modern writers of its curability altogether, Mr. P. says that if it attacks persons of good constitution under thirty-five years of age, and be properly and perseveringly treated, he believes the disease is eradicated in a great majority of instances; but if the constitutional
makes its first appearance after forty, especially in the forms of pustular or tubercular diseases of the skin, although treatment may do much in relieving the symptoms of such diseases, it would be going too far to say that they are ever perfectly cured; and he is sure, they farely are, unless vapor bathing is associated with the treatment adopted.
In his description of the squamous form of syphilitic eruption, our author differs from Cazenave, and omits any allusion to the peculiar epi. dermic fringe surrounding a patch of a dull red color, slightly elevated in the center, and which Biett regarded as pathognomonic of this form of eruption, and which we have been in the habit of recognising and laying stress upon in our diagnosis of it, nor do we remember to have seen the dermis remain depressed in the parts corresponding to the center of the squamous patches after their cure, as he says is the case.
The constitutional forms of the disease, as it affects the skin, and its appendages and the mucous membranes, nostrils and nasal fossæ, tongue, larynx, testicle, muscles, periosteum and bones, lungs and blood, are minutely described, and their characteristic peculiarities fully pointed out.
The treatment of syphilis in pregnant women, males, and infants, is next considered. He speaks unequivocally as to the propriety of treating the pregnant female constitutionally diseased, which may be done with safety, and with a strong probability of cure to herself, and the eradication and prevention of disease of the foetus in utero. In the treatment of the disease in infants, he prefers the plan of frictions with mercurial ointment, as recommended by Sir B. Brodie, consisting of the use of a flannel roller, on one end of which mercurial ointment, a drachm or more is spread, which, thus prepared, is applied, not very tight, round the knee, and repeated daily. We have treated these cases with the hydr. cum creta for years with satisfactory results, and with little or no inconvenience from its use.
Mr. P. then proceeds to a consideration of the particular remedies used in the treatment of constitutional syphilis, at the head of which he places, as first in importance, the mercurial vapor bath, which he regards as the sheet anchor in the treatment of all its forms. This is administered by means of a proper apparatus, in which are placed a copper bath containing water, and a metal plate on which is put from one to three drachms of the bi-sulphuret of mercury, or the same quantity of the gray oxide or the binoxide; a spirit lamp is put under the bath and plate, and the patient is thus exposed to the influence of heated air, common steam, and the vapor of mercury. The perspiration generally becomes excessive by the end of twenty or thirty minutes, beyond which period he does not prolong its use. The body is afterwards rubbed dry. The form of mercurial used is adapted to the variety of disease to be treated. He sometimes uses the iodide in addition to the three mentioned. A short preparatory treatment is necessary before using the baths; but for their modus operandi and the details connected with their use, as well as the kind of cases to which each form of mercury is adapted, we must refer to the work itself. He considers the mercurial vapor bath as “ not only the most certain, but the safest way of curing all forms of constitutional syphilis," and as capable, in a great majority of cases, of curing the disease without the aid of internal medicine. At the same time, the cure is generally expedited and rendered more certain by its internal use in small quantities. He has never known the most delicate patient injured by this mode of treatment, and has rarely known it fail to cure; and the cure is effected in one fourth or even one-sixth of the time required for the ordinary plan of treatment, and relapses are by far less frequent and important, and when they do occur, yield with great certainty to a second application of the vapor. Internally, Mr. P. uses the chloride, bi-chloride, iodide, bi-iodide, and bi-cyanide of mercury, the iodide of potassium and of iron, the vegetable decoctions and infusions, and opium; but we have already extended our notice so long as to forbid anything more than the bare mention of them. Numerous cases, judiciously selected, illustrative of different points either in the pathology or treatment of the disease are introduced, thus adding still more to the value of a work which is eminently practical in its character, and which presents a subject of great interest and importance in a plain and systematic manner, which renders it a desirable book both for study and for consultation. Principles of Comparative Physiology. By WILLIAM B. CARPENTER,
M. D., F.R.S., F. G. S., Examiner in Physiology and Comparative Anatomy, in the University of London; Professor of Medical Jurisprudence, in University College, President of the Microscopical Society of London, &c., &c., With three hundred and nine wood engravings. A new American, from the fourth and revised London edition. Philadelphia: Blanchard and Lea. 1854. pp. 752.
The world-wide reputation of Dr. Carpenter, and his labors as a physiologist, with which all are so familiar, will always secure for his works a welcome reception by men of science. In the one before us, we have renewed proof of his devotion and industry. Instead of presenting a new edition of his “ Principles of General and Comparative Physiology," and dividing it into volumes, he has divided its subjects, and confined himself in the present to volume that of Comparative Physiology. That part of the former edition which treated of this subject, has received large and important additions, and been carefully revised throughout, and we doubt not that the present work will fully realise the modest opinion of the author, “ that this treatise more completely represents the state of the science at the period of its publication than it has done on any preceding occasion.” The most cursory examination will show that it has been accomplished at a vast expense of time and labor. The illustrations amount to more than three hundred, and are remarkably well executed, and the whole work is gotten up in a most creditable manner. It has been under the supervision of Dr F. Gurney Smith, during its passage through the press, who has secured an accurate reprint of the corrected sheets as they were furnished by the author, and has also introduced a few additional cuts. We need not add, that a work on this subject from such authority will be a valuable addition to any library. We are happy to see an announcement of the learned and accomplished author, of his intention to reproduce the “ General Physiology," of his former edition, as soon as his numerous avocations will enable him to devote the necessary time and attention to it. Besides a copious index of subjects, there is a full one of authors referred to in the course of the work, which will afford valuable aid to those wishing to consult the original source of any
observations. Human Physiology: designed for colleges and the higher classes in
schools, and for general reading. By WORTHINGTON Hooker, M. D., Professor of the Theory and Practice of Medicine in Yale College ; author of “ Physician and Patient.” Illustrated by nearly two hundred engravings. New York: published by Farmer, Brace, & Co., No. 4 Cortlandt Street. 1854. pp. 389.
Professor Hooker is well known as a successful teacher on the subject of medical education, and holds the pen of a ready writer. We are glad to see such talents and efforts directed to the promotion of popular instruction. His aim in the present undertaking has been to produce a book designed for the family as well as the school, and most happily has he accomplished his object. He has produced a work which is attractive as well as instructive. We need not dwell upon the interest or the importance of the study of human physiology, nor stop to dilate upon its claims for far more attention than it receives, especially in primary education. As Dr. H. remarks “ there is nowhere to be found so curious a collection of mechanisms, or so interesting and wonderful a series of processes, as in the human body.” Without a knowledge of physiology, too, we are unable to pursue a judicious system of hygiene, and we feel that it is the duty of our profession to exercise its influence in extending the study of this branch of knowledge, and especially in having it made a regular branch of instruction in schools and colleges. Such a want is also experienced by the family as well as the school ; and as Dr. H. justly remarks, “ there should be a greater community of interest between the school and the family than as yet exists."
From the examination we have been able to make of the work, we should judge that Dr. H. is very clear in his manner of presenting and illustrating his subject. The style of the lecture-room which he has adopted, affords him decided advantages in imparting instruction, and in keeping up the interest of the scholar as well as of the general reader. His arrangement is also judicious, calculated to lead the mind gradually on, from the simple to the more abstruse parts of the subject, and thus favor the better comprehension of it as a whole. The analogies between life in the human system and in the living world about us, are also introduced with good effect, and we congratulate Dr. H. upon having presented a work which promises both to promote the cause of education, and add to his own reputation. The publishers have done their part well, and the numerous well executed engravings add to the interest and to the value of the work, which we trust will be extensively adopted as a text book, and we doubt not will increase the taste for the study of this important as well as interesting branch of education. We are glad to learn that Dr. H. intends to prepare a book on this subject adapted to younger minds. The principal forms of the Skeleton and of the Teeth. By Prof. R. Owen, F. R. S., &c., author of “ Odontography;"
“ Lectures on Comparative Anatomy;" &c., &c. Philadelphia : Blanchard & Lea. 1854. pp. 329.
The Principles of Animal and Vegetable Physiology; a popular treatise
on the functions and phenomena of organic life. To which is prefixed a general view of the great departments of human knowledge. By J. STEVENSON BUSHNAN, M. D., Physician to the Metropolitan Free Hospital, &c., &c. With one hundred and two illustrations on wood. Philadelphia : Blanchard & Lea. 1854. pp. 234.
These works belong to a series of treatises now in the course of publication in London, under the general title of “ Orr's Circle of the Sciences,” the object of which is to furnish works on different scientific subjects, which shall be at the same time, simple in form and popular in style, and yet be in strict accordance with the latest scientific investigations, and which shall be calculated to suit both the general reader and the student.
The first of the works mentioned, is by the most distinguished osteol. ogist of the age, and was written by him as an introduction to his favorite science, and cannot fail to prove acceptable to all interested in this branch of knowledge. It is an original work, and contains the most important results of the investigations of its latest and most successful cultivator ; and though not an extended work, is without any important omission. Seventy-six well executed illustrations enable the author to make his subject plain and intelligible.
The work on Physiology is by Dr. Bushnan, the editor of the series, and presents the same advantages as to comprehensiveness and accord