single row of houses in a locality of this description, which I must not name more specifically. All of these families were ultimately compelled to quit the neighbourhood, from a succession of anomalous ailments and frequent fevers. I believe, indeed, that the fevers so common among farmers and farm-labourers often arise from this cause.

"Now, from all these and similar causes of indisposition, Brighton is entirely exempt. Its supply of vegetables is brought from a distance, and the Downs, with their dry soil and elastic turf, equal to the greensward of a fine lawn-the Downs, which surround the town, furnish the purest and most exhilarating air in the world. Never on the Alps, the Appenines, or the Jura have I felt so intensely, so exultingly, the abstract pleasure of mere animal existence, as on the Downs in the neighbourhood of Brighton. No manure, no decomposition on the surface, because no humidity will remain there,—at such a distance, or such an elevation above the sea, that all which is insalubrious in the air has been deposited before it reaches them. A canter over the Downs in a fine day produces the feelings of the Arab in the desert: the breathing deep and complete, and every air-cell of the lungs fully opened and performing its duty. Eat and drink whatever you please, and as much as you please, if you can take abundant exercise on the Downs. I believe, indeed, that an occasional excess in the pleasures of the table is harmless, and even beneficial, when you have such a rectifier as this. I speak, of course, here chiefly of such as have been suffering from confinement to a town, and insufficient exercise. There are very few of the diseases (not organic) to which such persons are liable that will not yield to this kind of exercise-to fencing and to tennis. An occasional excess, and an occasional fast, call into action some of the most valuable functions of the stomach left in abeyance by those who practise extreme regularity.” 40.

Dr. Wigan observes that, according to his experience, ALL CONGESTIVE DISEASES (with very few exceptions) ARE AGGRAVATED BY A RESIDENCE AT BRIGHTON."

"By congestive,' I mean such diseases as are caused or accompanied by local accumulation of blood, principally venous, circulating languidly in any of the organs of the body, and unattended with inflammation.

"It would not be difficult to give a plausible explanation of the above, but I prefer to state the simple fact, (of which my conviction is absolute,) and leave each practitioner to form his own opinion.

"For a long time I lent a very deaf ear to this very disagreeable conviction, but in the end felt it a matter of conscience to send all such persons, not only away from Brighton, but from all influence of sea-air. A man will be rarely wrong in acting boldly on convictions which are decidedly opposed to his own interest; and I rest absolutely and entirely on this." 41.

Inflammatory dyspepsia is another of the ailments for which Brighton is objectionable and generally in diseases of the kidneys and bladder unattended by albuminous secretion, which, Dr. W. says, is checked by the air of the place. The localities differ remarkably-some being beneficialsome noxious to disorders. Even that delightful promenade the chainpier-he thinks, produces so much mischief in the early part of the year, that the medical men of the town ought to pay for its wear and tear, on account of the practice which it brings them! The sheltered walk, under the cliff which leads to it, affords a safe retreat from the bitter cold northeast winds. The reflected heat from the Cliffs gives quite the feeling of Summer-and this shelter and warmth will even extend to half the length of the pier itself. At a certain point, however, you lose the protection of the Cliff, and pass, at once, from a warm to a cold climate.

No LXXVII.

H

"A very valuable auxiliary in the treatment of disease at Brighton is THE GERMAN SPA; where almost all the celebrated waters of England, of the Continent, and even of America are prepared in absolute perfection by the consummate chemist who superintends the establishment. Although, however, some of the cures performed by these waters seem little less than miraculous, I am inclined to attribute a large portion of them to the early rising, the active exercise, the abstinence, the air of the Downs, the entire change of habits, and, above all, to that thorough cleaning' of the internal coats of the stomach, which accompanies their administration. The combined effect is that of establishing a completely new sanguification. That is, it creates a perfectly new mass of healthy blood." 49.

The natural water of Brighton is excellent, and now abundantly supplied by water-companies, whose works are situated on the Lewes road. The water filters through several hundred feet of chalk. The well-water in the town, though naturally pure, is too often contaminated by the cesspools. Baths are numerous enough here, and although douches are procurable at all of them, they are very seldom demanded-from the great ignorance respecting it which prevails among the profession in this country. In the following passage we quite agree. It is the doctrine we have been preaching for nearly twenty years.

"On the subject of general bathing, information can be obtained from so many sources that it is quite unnecessary to dwell upon it; but bathing in the open sea by invalids, and especially by young females, requires a great deal of caution. The chance of benefit rarely equals the risk, and the mischief done every season by premature, excessive, or improper, bathing is enormous. It is really frightful to see the consequences which sometimes arise in young females from indiscriminate bathing in the sea. Many a case of chlorosis have I seen changed into phthisis by this dangerous practice. No young female ought to bathe in the sea, unless under the clearest medical instructions of a man on the spot. All, and more than all the benefits may be obtained by modifications of house bathing, and by resources, which practice and observation have made familiar to medical men." 53.

One of the chief annoyances at Brighton is the extreme violence of the wind-especially when it is Easterly, for then the pungency is beyond expression. This wind is uniformly dry, and has much fine sand suspended in it. "On such occasions stay at home, unless you are well enough to resort to fencing, tennis, or such like amusements." (55.) Even the respirator is no safeguard against the fine particles of dust which penetrate readily through its bars and apertures. The complicated structures in the nose resemble not a little the respirator in warming the air, and arresting the influx of sand or dust. When people are obliged to go out in such winds as those described, they should endeavour, as much as possible, to breathe through the nose. In strong exercise, however, they cannot do so, and then the respirator is of some use.

We must now conclude. We have afforded sufficient samples of this little work to prove its utility: and we would advise all invalids going to Brighton to take it with them—and all medical men who are in the habit of sending patients to that place, to look into the pamphlet, lest they injure, instead of benefitting their clients.

METHODUS MEDEndi, or the DESCRIPTION AND Treatment OF THE PRINCIPAL DISEASES, INCIDENT ΤΟ THE HUMAN FRAME. By Henry M'Cormac, M.D. Consulting Physician of the Belfast Hospital, and Professor of Medicine in the Royal Belfast Institution. London: Longman and Co. 8vo. pp. 574, 1842.

THAT Dr. M'Cormac is an accomplished medical scholar is abundantly apparent from the character of the present as well as of his former writings. He seems to have made himself acquainted not only with all the current literature of the present age, but also with most of the works of the olden time, from that of the great Father of Medical Science down to the close of last century. How far this elaborate scholarship has subserved his fitness to become an author of a systematic work on practical medicine, we will not venture to determine; but this one thing we may say with confidence that, had he given us less of the opinions of others, and more of the results of his own clinical experience, we fully believe that this present volume would have been much more acceptable to the public, and decidedly more useful to the practising physician. When we first read the title of the work-Methodus Medendi-we had formed to ourselves an idea of a very different work from the present, and had expected to find rather a somewhat original exposition of the general principles of medicine, and more especially of its therapeutic department, than a minute description of its nosological catalogue. It may have been, therefore, partly from this circumstance that the perusal of it has disappointed us a good deal, alike in respect of the subjects that are brought under review, and the manner in which they have been discussed. We had supposed that it might have been similar in its general character to Dr. Alison's Outlines, which we introduced to our readers in our last Number, and to the admirable volume which Dr. Billing published some years ago. But, instead of this, we have a solid closely-printed volume of nearly 600 pages, commencing with the description of Fever, and-after a history of almost all the ills to which flesh is heir, not even excepting toothache and anaphrodisia-closing with a long account of Mania.

The author has grouped all diseases in the following eight classes :-k. Fevers; 2. Diseases of the respiratory organs; 3. Diseases of the circulatory organs; 4. Diseases of the digestive organs; 5. Diseases of the urinary and genital organs; 6. Diseases of the absorbent system; 7. Diseases of the organs of relation; and 8. Diseases of the nervous system. No classification, we are well aware, will meet all difficulties, or can possibly be exempt from many defects; but we much question whether any arrangement could be more objectionable than the one adopted by our author.

Let us take a few examples :-Cholera is made a fever, while dysentery is a disease of the digestive organs; Scurvy is a disease of the circulatory organs; Hydrophobia is a disease of the absorbent system,-why more so than syphilis? and Anasarca is a disease of the organs of relation! Hydrothorax and ascites do not appear in the catalogue at all; the one being incidentally introduced under the head of pleuritis, and the latter under

that of what the author calls sero-enteritis. Then we have Chorea described under the head of epilepsy; and Dyspepsia as if it were a mere form of gastritis.

The 7th class is perhaps the most objectionable of all; as it seems to us to comprehend and groupe together the most dissimilar diseases, while it excludes others which certainly belong to "the organs of relation." Have not erysipelas and urticaria, we may ask, quite as good a title to be ranked among the cutaneous diseases, as eczema or strophulus ? and surely that must be a very arbitrary nosological arrangement that places dropsy of the cellular tissue between vermin in the skin on the one hand, and rheumatism and gout on the other. In some instances the classification appears to be not only unwise, but positively erroneous, and calculated to mislead the inexperienced. Not a few cases-perhaps we should rather say, not a few forms-of puerperal fever ought unquestionably to be placed among the Pyrexiæ; and yet all are alike grouped together under one common appellation of metritis or inflammation of the uterus-a term expressive of a most erroneous and hurtful pathological doctrine, if intended to be of universal application.

It appears to us that Dr. M'Cormac has erred, in more than one part of his work, by attempting to assimilate and simplify too much various diseases and classes of disease; from his dislike, we should imagine, for the over-minute divisions of many of his predecessors. But then, be it remembered, there is as great an evil in a forced condensation, as in a wearisome amplification, of any subject. Nowhere is our author's mistake in this respect more conspicuous than in the very first chapter of his work; that which treats of Continued Fever. Under the term Fever,' he comprehends and describes together the history, symptoms, pathology, and treatment of all the different forms of synochus and typhus-mild, serious, and malignant. The confusion of the narrative, it may be well imagined,. is extreme; indeed it is almost impossible for the reader to form any distinct image or picture, if we may so speak, in his mind of what the manyheaded Protean monster, that the author is attempting to portray, really is; for its features are ever varying, and withal are so numerous as utterly to defy all attempts at prehension. But let us see what Dr. M'Cormac says himself, in order that we may do no manner of injustice to his sentiments. At page 7, it is written :

"Our knowledge of the pathology of fever is unhappily limited. After describing the complaint, its varieties, complications, and making a few inferences beyond, little remains to be said. We know nothing of the indoles of the complaint, or its proximate cause-why it lasts a given period, and then declines. Fever is a disease of the whole system; it affects the solids and the fluids, the organs of digestion, circulation, respiration, and relation; it affects the body, and it affects the mind. It is a disorder with peculiar characters, often propagating itself by a poison, which, not unlike a leaven, sets up a new series of actions in the system. In other respects, individuals are variously affected: in some there is inflammation, in others none; some get better and recover, while others grow worse and die. The intestinal follicles are inflamed in one person, the lungs in another, while the brain is affected in a third. A few perish in whom there is no discoverable lesion, while others gain health and strength in cases where organic derangements have been numerous and severe. As fever pursues its course, there is progressive deterioration of structure and function; yet, for all this, when

the disease is at its height, when destruction seems to impend, it quickly or slowly takes a turn, and all does well." 8.

And again, a little further on, we find our author saying,

"Those writers, who, like Pinel and the Franks, divide fever into numerous varieties, complicate and embarrass the treatment. According to such, we no longer have a given malady, with certain symptoms and complications to deal with, but a number of distinct affections, bearing such epithets as mucous, nervous, putrid, adynamic, ataxic, and typhoid. I would not advocate a simplicity that nature did not sanction; but, assuredly, fever does not present varieties more numerous than most other diseases. From whatever cause the malady may arise, the treatment is mainly alike." 17.

We need scarcely comment upon these passages. With a good deal of shrewd and just remark in them, there are one or two very glaring errors that cannot fail to attract the notice of every reader-witness the concluding paragraph. We had marked several other passages for notice; but perhaps this is unnecessary; as the whole chapter requires a very thorough revision. That Dr. M'Cormac is fully competent to write ably on any medical subject to which he directs his attention, we are quite confident; but, to do it justice, he must consent to no inconsiderable labour in arranging under clear and distinctly marked heads the mass of materials which he has collected together.

He is evidently a man of highly cultivated mind, and of liberal and most enlightened views; and withal, we should presume, a sound practical physician. We observe too, that he is a public teacher of his proprofession. Is it the case that the present volume is made up of the notes or short memoranda used by him as aids to memory in his prelections?— This idea certainly suggested itself to our mind more than once in reading the present volume.

Most systematic works on the practice of medicine open with some prefatory observations on the animal economy; the composition and contexture of its different parts; its active powers in health; the changes to which these are subject from a variety of disturbing influences; its reparative energies, whether spontaneous or promoted by art; and so forth. Dr. M'Cormac would not have done amiss, had he followed the good old path of his predecessors, even at the risk of censure as a mere imitator.

If, instead of plunging all at once in medias res, i. e. the description of particular diseases, he had given a brief but lucid exposition, in an introductory chapter, of the leading and characteristic features of the various classes of his nosological catalogue, and of the particular states of the system with which these are generally associated-and a right knowledge of this, by-the-bye, is essential to any rational system of therapeutic instruction-he would have saved himself much unnecessary repetition of detail, and his readers not a little embarrassment in following him. In the review of Dr. Alison's work, in our last Number, we pointed out the due importance which this excellent author has attached to the morbid changes of the blood as intimately connected with the etiology of many diseases; and we then-as indeed on many former occasions-expressed our own convictions that no truly scientific exposition of the principles and practice of medicine can be given in the present day, without considerable attention being paid to a Humoral system of pathological doctrine. The