COMMENTS ON THE FIRST EDITION. "Dr. Tilt's views on the pathology of the ovaries are likely to modify and improve the present treatment of uterine disease. He could not have selected a subject more difficult as to its practical details; and we regard it as a seasonable and valuable publication, well deserving the attentive perusal of those who are interested in obstetric medicine.”—British and Foreign Medical Review. "We rejoice to see that physicians of weight and authority are beginning to look beyond the os and cervix uteri for the causes of disease in these parts. Already a reformation somewhat analogous to what Abernethy effected for surgical diseases has commenced, and we feel assured that Dr. Tilt's work will powerfully co-operate in helping it forward, and in placing the pathology and therapeutics of diseases of the female generative organs upon a sound and permanent basis.”—Dublin Quarterly Review. "From a careful perusal of Dr. Tilt's work, we feel fully justified in affirming that in none other will be found so complete an account of the various ways in which sterility is produced by the action of inflammation on the ovarian tissues; of the importance of ovarian peritonitis as a cause of disordered menstruation; or of the influence of ovarian inflammation in the production of uterine disease; facts forcibly exemplified, and shown to be not mere conventional probabilities, but events of common occurrence. Investigating a subject beset with extreme difficulties, Dr. Tilt has given the profession a work of real practical value, which we consider to be indispensable to all those who attend to the diseases of women."-Quarterly Medical Recorder. "In our opinion the work of Dr. Tilt is one calculated to do much good. By collecting and arranging in a systematic form the facts and observations in relation to the affections of which he treats, he deserves our thanks; and by the additional observations he has furnished, and the views he has advanced, he has unquestionably prepared the way for a more accurate acquaintance with ovarian pathology, and a more rational management of some of the most distressing and heretofore unmanageable of the diseases of the reproductive organs in the female."-—American Journal of Medical Sciences. "We recommend the work of Dr. Tilt, both on account of the practical importance of the subject of which it treats, and the lucid and logical manner in which the novel doctrines advanced in it are deduced from premises that are certainly undeniable."-Lancet. “Dr. Tilt has, we think, brought forward sufficient evidence of the important part which inflammation of the ovaries exerts in occasioning derangement or disorder of menstruation; and his work is calculated to prove of much service, by calling the attention of practitioners to these organs. We recommend it to our readers, convinced that the principles laid down in it will lead to a more correct, and therefore a safer line of practice in a large number of cases.”— Dublin Medical Press. COMMENTS ON THE SECOND EDITION. "Had the production of Dr. Tilt been merely a second edition, we should observe that the author has thoroughly reconsidered the subjects of his previous investigation, enriched a former work with many new facts, and added chapters on the diagnosis of acute and subacute ovaritis. A chapter on the phenomena of sanguineous pelvic tumours is also worthy of attention. Dr. Tilt has given this edition a wider scope, devoting the first 150 pages to the execution of a plan already suggested in the preface to the first edition. Considering the perfect comprehension of the process of menstruation as the keystone of the pathology of female diseases, the author has subjected each symptom of menstruation to a searching inquiry, carefully following the changes by which from healthy it becomes morbid. He then shows to what extent each symptom is met with in the various acts of reproductive life. For instance, in studying one of the well-known cerebral symptoms of menstruation-hysteria-after establishing the passage from the morbid irritability of the nervous system habitually attendant on each catamenial period, with the various perversions of nervous action which characterize hysteria, Dr. Tilt indicates to what an extent hysterical phenomena may be expected when menstruation first occurs, when the function is regularly established, and then inquires into the frequency of hysteria as the result of connexion, pregnancy, parturition, lactation, and as a subjective symptom of ovarian and of uterine disease. The therapeutical indications of the hysterical diathesis, of hysterical fits, and hysterical apoplexy, are then clearly stated. By doing this in succession for each symptom of menstruation, Dr. Tilt has more accurately established the physiological and morbid effects of the reproductive organs on the system, and has laid the basis of more rational modes of treatment. "Each chapter contains facts interesting both to the physiologist and the practitioner. Space, however, will only permit us to indicate the contents of the first chapters; our readers may from this form an idea of the nature of the work. "The first chapter gives a succinct account of the theories of menstruation, and leads to the conclusion that menstruation is certainly ovarian, but not necessarily ovular. "The second chapter treats of the natural history of menstruation; embodies the statistical researches on which the author has been long engaged; corroborates those of Brierre de Boismont, and unpublished statistics from Sweden. Type in menstruation is the title of the third chapter; and if the author's observations are correct, menstruation should always be considered morbid when it occurs more than once a month. "In the fourth chapter the nature of the ovarian nisus, or of the menstrual force, is considered, and admitted to be a manifestation of a power inherent in the ganglionic nervous system. "The fifth chapter, on the ganglionic nervous symptom of menstruation, contains much that is new in the treatment of unclassified symptoms of ill-health, such as the heats and flushes by which women are often much annoyed; various singular epigastric morbid phenomena, chlorosis, &c. "The sixth is a long chapter, and contains a very important account of the cerebral symptoms of menstruation; and the author's reflections on the production of insanity deserve to be weighed by mental pathologists. The spinal symptoms are considered in the following chapter; and in the eighth the critical discharges of menstruation come under discussion. The ninth chapter is occupied by all that relates to the sanguineous discharge of menstruation. The mucous discharges form the subject of the tenth chapter, and it will be read with interest now that uterine pathology excites so much attention. "The eleventh chapter contains much interesting matter respecting the intestinal discharges of menstruation; and the twelfth, an account of the influence of the menstrual nisus on the skin and the kidneys. The work concludes with a copious general index and a bibliographical index of all recent contributors to ovarian pathology. This last addition has been too much neglected by medical authors, who might imitate Dr. Tilt's manner of compiling so useful a guide to future research. "We have now rapidly accompanied the author through the first part of this work, and we think that its perusal will convince our readers that it exceeds in value his former contributions to medical science. The second part received our meed of approbation when it appeared before the public as a first edition, and the whole now together embodies a vast collection of facts, re-cast, condensed, and judiciously used, while much is suggested on unsettled points which will doubtless stimulate the thoughts and inquiries of those engaged in similar pursuits. "In conclusion, we believe that Dr. Tilt's Diseases of Women will be considered an addition valuable to medical libraries. If we are not deceived, it will soon find favour with the junior members of the profession, inasmuch as it contains what we should call the first principles of female pathology.”—Lancet. "The laws and rules of each of the phenomena of menstruation are pointed out-the consideration of the exceptions being reserved until afterwards-the various symptoms being discussed both in their physiological and pathological bearings. The causes which modify the period of first menstruation are admirably laid down and fully considered under the different heads of family, race, national customs, temperature, habitation, and civilization. In this part of the inquiry, the researches of Dr. Tilt have done much to remove many of the difficulties by which the subject was surrounded, while his industry in searching for the facts of others, and so basing his conclusions upon results drawn from large statistics, are beyond all praise. The same remarks apply to the third and fourth chapters on type in menstruation, and on the ovarian nisus, which well deserve perusal unabridged. Having, then, attempted to give our readers some idea of the most important points in the new matter brought forward by Dr. Tilt, it only remains for us to recommend the entire treatise to their careful perusal."-Medical Times and Gazette. "The application of the recently discovered truths relating to the functions of the ovaries, and to the pathology of these bodies, could not have been long deferred; and Dr. Tilt has interposed at the right time to attach the connecting links, and to complete our knowledge of these important organs. This work has reached a second edition, a proof of the estimation in which the author's views have been held by the profession. It is written with taste and elegance, and is a masterly exposé of the subject. The phenomena of menstruation are investigated with great care, and are lucidly discriminated and explained. The additions to the second edition much enhance the value of the work."-Medical Circular. THE CHANGE OF LIFE IN HEALTH AND DISEASE.* SECOND EDITION. “Le livre du Dr. Tilt a son originalité, et devoit être signalé à ceux qui ne considerent pas la pathologie des ages comme un hors d'œuvre à l'usage des médecins littérateurs. Le traité de l'age critique est rempli de données intéressantes; l'auteur qui s'est spécialement occupé des maladies des femmes, et qui a publié sur ce sujet des travaux estimés, y apportait une solide experience; il avait le mérite de parler d'après sa pratique et de ne pas seulement rajeunir par une phraseologie nouvelle des citations d'un autre temps. En somme, on aurait peine à trouver sur le même sujet une monographie qui valut celle sur laquelle nous venons d'appeler l'attention. Une preuve entre autres que le livre est d'un vrai mérite, c'est qu'il éveille dans le lecteur le désir de le reprendre en souseuvre; de vérifier ce qui parait juste, de controler par une nouvelle étude ce qui semble moins admissible, et surtout de tenir meilleur compte des phénomènes de l'age critique dans l'observation de tous les jours."-Archives Générales de Médecine, October, 1858. "On y trouvera une étude très bien faite et toute nouvelle des réactions nerveuses et reflexes que les désordres ovariques et utérins exercent sur toute la machine sensible de la femme. On comprendra avec lui une foule de manifestations pathologiques qui sont le désespoir du médecin clinique. Cette partie de l'œuvre du médecin anglais suffirait à elle seule pour grandir encore, si cela était possible, la réputation que le docteur Tilt s'est acquise comme praticien des plus distingués, comme savant physiologiste, et pour le placer parmi les écrivains dont les travaux ont fait faire un pas réel aux maladies de la compagne de l'homme. Ajoutons que le livre que nous voudrions faire connaître plus au long, se distingue encore par une profonde érudition, de la richesse dans le style, et une saveur scientifique qu'on ne trouve pas toujours dans les œuvres de ce genre." -Union Médicale, August, 1857. *London: Churchill, New Burlington-street. ELEMENTS OF HEALTH, AND PRINCIPLES OF FEMALE HYGIENE.* "There are two kinds of popular medical writers. Those who introduce the public into the sanctuary of medical science, and tempt them to poison themselves by injudiciously taking medicines; and those who seek to improve the sanitary state of mankind by diffusing a knowledge of the general laws which govern nature, in relation to living creatures, and by imparting those precepts of physiology which, if duly observed, would prevent disease. The first class of writers we heartily condemn. To illustrate the second we point to the names of Drs. James Johnson, Mayo, and, particularly, Dr. A. Combe, deeming them benefactors of the human race. Following in the footsteps of those just mentioned, is Dr. Tilt. In his Elements of Health he has successfully done for women what the others have done for men, and his work is a model for those who propose writing on similar subjects, for in a vast plan every subject receives comment in proportion to its importance, and is lucidly explained so as to bring conviction to every woman of ordinary capacity. The work is characterized by extreme delicacy of expression, a healthy tone of feeling, free from all mawkish leaning to the prejudices of the sex, and it is written in a style which rivets the attention and carries on the reader from page to page. Our space is claimed by professional subjects, so that we cannot review this book so completely as we could wish. We can merely trace its general plan and prevailing idea. Each successive period of seven years forms a chapter, in which the mental and moral progress of decay are sketched, while the physical is treated at full length. Food, sleep, exercise, clothing, occupations, are separately considered; and the chapter concludes with a brief account of the diseases which are common to each epoch, and of the indications heralding their approach, which render medical advice imperative. Dr Tilt's prevailing idea seems to be, that further improvement in the sanitary condition of society is to be principally effected by giving women an insight into the laws to which they are subjected, as living beings and as women; their own health, the improvement of the human race, and the welfare of society being attainable by that means. The work seems also to commend itself to the profession by the careful manner in which is therein laid down the means of preventing that exaggeration of the nervous temperament, which is so fruitful a source of the diseases of women. In conclusion we shall only add, that as Dr. Tilt's is the only work of the kind—at least, in English literature, we trust it will be considered an indispensable guide by persons to London: Bohn, York-street, Covent-garden. |