in hysteria, it remains unclosed, and we have heaving, sighing inspiration, while, in epilepsy, we find violent, ineffectual efforts at expiration. The epileptic seizure is usually more sudden, and the deprivation of consciousness more complete; and it occurs more frequently in men than women. There is seldom biting of the tongue, or frothing of the mouth, in hysteria, nor is it followed by the heavy sleep, and insensible pupil. The physiognomy of one liable to epilepsy soon becomes peculiar.

Treatment.-The author truly observes that few practitioners like to be saddled with the treatment of a case of true hysteria; but he recommends those who do undertake it to thoroughly investigate the condition of the general health and of the various functions, instead of merely attacking the local symptoms which may present themselves, and which may lead him a chace over the entire frame. It too often happens that, however judiciously the treatment may be conducted, it proves of little avail. During the paroxysm, generally, little need be done beyond the application of cold water and a smelling-bottle. "It has already been observed, that consciousness is generally retained, and enough of volition, except in convulsive and epileptic hysteria, to enable the individual to avoid danger; so that as the fit, by equalizing the circulation, and by removing nervous irritation, has upon the whole a beneficial effect, restraint need form but a small part of the treatment. A lady, whom I long attended, always rejoiced when the fit was over, because it relieved her system generally, and especially her brain, from painful irritation, which had often existed for several previous days." Encouragement to use voluntary efforts to repress the paroxysm, cautiously practising on the fears of the patient, or the swallowing of iced water, have each been found useful. When there is no plethora diffusible and fetid stimuli may be given; but, where plethora exists, and important discharges are suppressed, a moderate bleeding, or rather cupping low down between the shoulders, is of service. When there is great rigidity of the muscles of the head and trunk, and impaired deglutition, turpentine, or cold water glysters should be administered. The mustard bath, as high as the knees, is a good derivative, and " on some occasions I have known the attack quickly terminated by ringing a loud and shrill-sounding bell close to the ear for several minutes." An approaching attack may sometimes be warded off by the affusion of cold water, its injection into the rectum, or the swallowing half a drachm of ipecacuanha.

The Treatment in the Interval,-will require modification according to several circumstances. A morbid condition of the uterine system is very frequently found in hysteria, as is seen, in girls who menstruate with difficulty, ill-assorted marriages, young widows, &c.

"I am aware it may be urged, in opposition to these opinions, that structural lesions of the uterus are very common in women who have never had hysteria. Of the truth of this statement, to its full extent, I am more than doubtful: as I have accurately ascertained, both in hospital and private practice, that such individuals are by no means, especially in early life, so exempt from this common malady: nor must it be forgotten, although there are exceptions, that these affections generally do not occur until the reproductive faculty is either about to cease

naturally, or has become seriously impaired by the progress of these organic changes.' 230.

Although plethora is not a common accompaniment, yet it is occasionally found, when there is defective menstruation, slothful habits, suppressed evacuations, &c.; and the usual remedies for this condition may avert the attacks, and if persevered in, in a modified manner, remove the disposition to them. Agreeing with the author in these views, we may observe, that the plethora is often rather apparent than real, and the existence of hysteria affords a prima-facie probability that depletory measures, to any extent, or for long continuance, will not be borne. The case of hysteria with debility is, Dr. Ashwell observes, far more common, and when this is, as is often the case, complicated with some local vascular congestion or excitation, it requires delicate treatment. A case in which local depletion and counter-irritation are to be combined with a good diet and tonics. The gastro-intestinal disorder, often attendant upon hysteria, may produce great tenderness in the hypogastric region, relievable by leeches applied to the abdomen or to the anus, or excessive flatulence, frequently itself inducing a paroxysm. This last is to be thus treated-" a small tumbler of water, as hot as it can be swallowed, during or immediately after the meal, with some powdered ginger, a little brandy, sal volatile, or a few grains of Cayenne pepper entirely dissolved in it, seldom fails to afford relief: friction by the hand or flesh-brush over the abdomen, and in really severe cases, the injection of a pint of hot water into the rectum, with or without assafoetida, may be tried."

The diet must be simple, nutritious and slightly stimulating, and the irritation of worms, or fæcal accumulations guarded against by the use of purgatives.

Treatment of peculiar Symptoms.-Notwithstanding the general treatment employed these may have to be met empirically. Headache, and its treatment, have already been considered in the former part of the work. In this distressing and obstinate malady the author has often found the following draught useful. B. Tr. valer., amm., sp. eth. s. c., Sp. lav. c. aa 3ss., Tr. hyoscy. mxx. M. camph. 3x. 2da vel 3tia horâ. Pain of the left side is perhaps the most difficult of all hysterical symptoms to relieve. The author does not agree with Mr. Tate, in referring this generally to spinal affection, and has seen much harm result, both from the rough manipulations employed to ascertain whether tenderness along the column existed, and from the depletion and counter-irritation employed to relieve it. The whole armoury of the Pharmacopoeia has frequently been exhausted in vain in these cases. Dr. Ashwell has found the following liniment useful. B. Ether. rect., sp. camph., tr. opii., tr. lyttæ ãā ziv. M. In regard to hysterical females acting as nurses the author observes: "It is not unimportant to observe, that although marriage often cures hysteria, women who have long suffered from its effects, rarely make good nurses. Doubtless there are exceptions to this fact; nor is it intended to be urged, that such women cannot suckle at all; nor that they may not occasionally be benefited by lactation. But where, prior to a late marriage, hysteria has existed for years, in association with extreme susceptibility, peevishness of disposition, and thinness of person, it is for the most part undesirable that such mothers should suckle their offspring. The milk is often disordered, the child's digestive system is thereby deranged, and a predisposition to nervous disease may be communicated." 258.

attractions, impart its peculiar state of transformation to compounds with which it may happen to communicate, has gone far to furnish a parallel to the hitherto mysterious process of assimilation, while it has thrown considerable light on the action of certain organic poisons.

"As a general proposition we are justified in regarding vitality as a power engaged in continual conflict with the physical, chemical, and mechanical forms to which every species of inanimate matter is invariably subjected. The animal machine is constantly surrounded and assailed by agents whose elective attractions for the several principles of which it consists are so numerous and energetic, that its decomposition must inevitably and speedily result, were not the cohesion of its molecules, maintained by the conservative influence of a superior power-that power is LIFE; and as its energies decline we discover the ascendancy of chemical forces, until, at its final extinction, the elements of which the animal body consists fly off in the form of binary compounds, or, in other words, they undergo that series of changes which constitutes the phenomena of decay and putrefaction."

It was essentially necessary for the preservation of the body that it should have been endowed with a power of resistance to forces calculated to destroy it; it does not follow, however, that Nature will refuse the aid of such chemical powers as may assist her operations, or counteract their tendencies to error. "It would be truly extraordinary," says Liebig, "if the vital principle, which was everything for its own purpose, had allowed no share to chemical forces which stand so freely at its disposal." In fact, the animal economy, in a state of health, affords several obvious instances of chemical agency. In all the chemical processes which take place in the animal economy, we still perceive the control of a power, distinct from those agencies which connect themselves with the phenomena of inert matter.

Since, then, the vital principle, while it vigilantly guards the animal structure from such forces as may injure it, does not oppose such chemical agencies as may be salutary, we are warranted in arguing how far a medicinal substance may be brought to act chemically upon the living body.

Our author having shewn that chemical agency is not incompatible with the vital power, and how chemical action is controlled by the vital influence; having shown also the fallacies which the mere chemist is liable to fall into when he turns physician, then comes to consider the action of medicines as chemical agents, which subject he discusses under the four following heads :

1. Can we by chemical means supply the living body with such materials as may be deficient?

2. How far are we able to neutralize, annul, or remove offending materials by chemical agency?

3. Can we oppose and counteract, by chemical means, any undue ascendency of chemical forces in the living body?

4. Are there any agents by which we can, chemically, influence animal temperature?

For the discussion of these questions we beg to refer the reader to the work itself, where he will find them very clearly and satisfactorily treated

under the several heads to which they belong. We next come to the subject of

REFRIGERANTS, or Substances, which diminish the force of the circulation, and reduce the morbid heat of the body, without occasioning any diminution of sensibility or nervous energy. These may be external or local, or internal and general. In the first case their claims to chemical agency are clear enough; not equally so, however, in the latter.

Topical Refrigerants.-In cases of external inflammation, refrigeration may be produced by cold applications, cold water, ice, certain saline bodies in solution, or by evaporation, which is readily accomplished by lotions. composed of spirit of ether. A convenient method of keeping up a uniform evaporation, for reducing the temperature of any part of the body, as in the case of fractured limbs, &c., is to allow the gradual distillation of water upon it, through the medium of skeins of cotton, or strips of linen rags, so disposed as to act the part of a syphon, which is readily accomplished by placing one end of the wet cotton in a basin of water, and allowing the other end to hang down over the vessel.

By these means we can directly diminish the activity of the vessels of the part, as, for instance, in burns and scalds, the pain is instantly relieved, and the inflammation reduced in directing such applications we must take care not so far to reduce the vitality as to endanger the life of the part, and to induce gangrene.

Internal Refrigerants.-There are certain saline bodies which, by undergoing a rapid solution, and thus acquiring an increased capacity for caloric, produce a diminution of temperature; and if this take place in the stomach, the sensation of cold which it will produce is equivalent to a partial abstraction of stimulus; which, being extended by sympathy to the heart, occasions a transient reduction in the force of the circulation, and by this, or by a similar sympathetic affection, causes a sensation of cold over the whole body.

The theory advanced to explain the refrigerant operation of vegetable acids, acescent fruits and herbs, and certain other substances, is based on those chemical views respecting animal heat, in which the consumption of oxygen in the act of respiration is considered the principal source. Dr. Murray says,

"It is established by numerous experiments and observations, that the quantity of oxygen consumed in the lungs is materially influenced by the nature of the ingesta received into the stomach. When the food and drink are composed of substances which contain a small proportion of oxygen, it is known that the consumption of oxygen in the lungs is increased, and this even in a short time after the aliment has been received. Thus Mr. Spelding, the celebrated diver, observed, that whenever he used a diet of animal food, or drank spirituous liquors, he consumed in a much shorter time the oxygen of the atmospheric air in his diving-bell; and he had therefore learnt from experience to confine himself to a vegetable diet, and to water for drink, when following his profession. During digestion, too, it was established by the researches of Lavoisier and Seguin, that a larger proportion of oxygen than usual is consumed. Now, if the animal temperature be derived from the condensation of oxygen gas by res

piration, it must follow that an increase in the consumption of that gas will occasion a great evolution of caloric in the system; while a diminution of it will have an opposite effect. If, then, when the temperature of the body is morbidly encreased, we introduce into the stomach substances containing a large proportion of oxygen, especially in a loose state of combination, we may succeed, according to this theory, in reducing the general temperature. This, it is suggested, we may accomplish in part by a vegetable diet, but still more effectually by the free use of the vegetable acids, which are readily acted on by the digestive powers, and assimilated with the food; and, as the large quantity of oxygen which they contain is already in a concrete state, little sensible heat can be evolved during the combination of that element with the other principles of the food. The nutritive matter which is received into the blood, containing thus a greater proportion of oxygen than usual, will be disposed to abstract less of it from the air, during its transmission through the lungs, and consequently less caloric will be evolved; the temperature of the body will be reduced; and this again, operating as a reduction of stimulus, will lessen the number and force of the contractions of the heart."

The experiments of Crawford go to prove the chemical origin of animal heat; it is now however generally admitted that the temperature of animals derives its origin from a living principle, although the absorption, in the act of respiration, may indirectly contribute to its production, as a stimulus to the nervous power which produces it. If the heat of the body depended on respiration alone, any one might, by a voluntary effort of quick, deep, and prolonged respiration, increase it at will.

Dr. Murray's theory of animal heat has acquired a renewed interest from the one lately proposed by Professor Liebig, for the purpose of explaining the conversion of the salts of organic acids into carbonates during their transit through the body, and which theory, like that of Dr. Murray's, seeks to establish certain chemical relations between the functions of the digestive and respiratory organs.

"The conversion of these salts of organic acids into carbonates," says the Professor, "indicates that a considerable quantity of oxygen must have united with their elements. In order to convert one equivalent of acetate of potass into the carbonate of the same base, eight equivalents of oxygen must combine with it, of which either two or four equivalents (according as an acid or neutral salt is produced) remain in combination with the alkali; whilst the remaining six or four equivalents are disengaged as free carbonic acid. There is no evidence presented by the organism itself, to which these salts have been administered, that any of its proper constituents have yieided so great a quantity of oxygen as is necessary for their conversion into carbonates. Their oxidation, therefore, can only be ascribed to the oxygen of the air. During the passage of these salts through the lungs, their acids take part in the peculiar process of eremacausis (slow combustion), which proceeds in that organ; a certain quantity of the oxygen gas inspired unites with their constituents, and converts their hydrogen into water, and their carbon into carbonic acid. Part of this latter product (one or two equivalents) remains in combination with the alkaline base, forming a salt which suffers no farther change by the process of oxidation; and it is this salt which is separated by the kidneys or liver. It is then evident, from this theory, that the presence of organic salts in the blood must produce a change in the process of respiration.

"A part of the oxygen inspired, which is usually combined with the constituents of the blood, must, when they are present, combine with their acids, and thus be prevented from performing its usual office. The immediate consequence of which