sufficed for the percolation of the remedy into the subjacent living parts. Each day the incisions were a little deepened, and fresh strips of anointed calico, or rolls of cotton-wool covered with the paste, were inserted into them, until in the course of from two to seven weeks (the average time being about three weeks), the whole depth of the tumour was penetrated; and then the use of the paste was discontinued, and the eschar left to separate."

We refer our readers for the very lucid and practical description of the action of the caustic paste, of which it is almost superfluous to repeat that chloride of zinc forms the active ingredient, and of the systematic manner in which it is applied, to the Report itself. It forms an era in the history of the surgical treatment of cancer, and ought, therefore, to be in the hands of every one whose studies or occupation force him to reflect on this important subject. The cases, which are given in sufficient detail, fully bear out the general conclusions at which the authors of the Report have arrived, while they enable the reader to follow every link in the arguments which they employ. These are given under four heads:

"1. The constitutional effects of the treatment. "2. The local effects of the treatment.

"3. A comparison of this treatment with that by means of the knife.

"4. A comparison of this mode of inserting caustics by incision with other modes of applying caustics."

The main point in the disquisition is the opinion expressed by the surgeons of Middlesex Hospital upou the feature which may be regarded as the characteristic novelty of Dr. Fell's method. We use the term advisedly, for though here and there a surgeon may have scored over, as it were by chance, a cancerous tumour, to which caustic had been applied, no one has until now adopted the system of making regular incisions with the professed object of allowing the caustic to enter more completely into the morbid growth. The pith of the whole Report is the opinion expressed by Messrs. Shaw, De Morgan, Moore, and Mitchell Henry upon these incisions. We cannot do better than conclude this brief notice with their concluding paragraph:

"Incisions. The last peculiarity of this treatment is the practice of incisions; and we are of opinion that this is its only, but its very great merit. The sanguinaria is inert; the chloride of zinc paste was known before; but the incisions constitute a new feature in the treatment of cancerous tumours for which we find no parallel in the writings of the past or in the practice of present surgeons. Cancer, in its constitutional nature, remains as ruthless and as unassailable as ever. Chloride of zinc may or may not continue to be used for the destruction of the local disease; but the advantage placed in the hands of surgeons by the insertion of gradual incisions, claims henceforth their very frequent adoption in the treatment of cancerous tumours, as well as a grateful acknowledgment of the ingenuity of their inventor."

The names of the authors of the report are sufficient guarantees for the truthfulness of all the statements contained in it; but we may add that they use all due caution in the manner in which they approach the subject, while the details of the fifty-two cases which are appended fully bear out all the conclusions given in the body of the Report. If, then, Dr. Fell, as these gentlemen tell us, deserves our thanks for the

ingenuity of his suggestions, they themselves merit our gratitude for the manner in which they have undertaken and carried out a task, which can scarcely have been one of unalloyed pleasure.

ART. IX.-Archives of Medicine: a Record of Practical Observations and Anatomical and Chemical Researches connected with the Investigation and Treatment of Disease. Edited by LIONEL S. BEALE, M.B., F.R.S.; Physician to King's College Hospital, and Professor of Physiology and General and Morbid Anatomy in King's College, London; Honorary Fellow of King's College. Illustrated with Woodcuts and Lithographs carefully copied from Nature.-London, 1857. No. I.

THE contents of this first number of a new medical periodical, the object and purpose of which are sufficiently indicated by the title, are mainly contributed by the editor. In drawing so largely upon his own resources, his intention is to enable those whose support is desired, to form "some idea of the general nature of the periodical."

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The Archives' open with a portion of a clinical lecture recently delivered by Dr. Todd upon the treatment of acute internal inflammations, upon which we refrain from making any remarks, because, though we might have no objection to adopting Dr. Todd's creed so far as it is here given, we might inadvertently pledge ourselves to conclusions which are not in consonance with our views and our experience. Dr. Beale follows with a very practical paper, and one that will be acceptable to all micrologists, On the Manner in which the Drawings Illustrating the Papers have been made, and of Obtaining Lithographs from Microscopical Drawings.' In the paper, Dr. Beale dwells forcibly on the importance of every microscopist ascertaining the magnifying power of his object-glasses, and supplies us with directions for preparing "a scale of measurement by which the dimensions of every object can be at once ascertained.' The next paper describes the method by which the editor separates the cholesterine which he has detected in the epithelial scales found in the urine of patients labouring under fatty degeneration of the kidneys. The reason why so few observers have found cholesterine in these cases is that "it is always dissolved in other fatty matters, so that its presence cannot be detected except by extraction with alcohol and subsequent crystallization." To the weight of the cholesterine the author attributes the subsidence of epithelium charged with oil molecules.

"That the cell-walls and casts are not the sole cause of this subsidence is proved by the fact that individual oil-globules, quite free from these structures, are frequently found at the bottom of the vessel with the deposit. Crystals of cholesterine sink in fluids of a specific gravity even some degrees

above 1000."

A report upon some examinations of chylous urine follows, which in the cases observed by the author was mainly due to the presence of fat in a granular condition; the urine commonly contained albumen at the

same time. Astringents, and especially gallic acid, were the most successful remedies in the cases referred to.

The two ensuing papers, "On the Best Methods of Injecting Healthy and Morbid Structures," will doubtless command the attention of all practical physiologists and pathologists; the large experience of Dr. Beale entitles his remarks on such matters to particular respect. The next two brief papers are mainly descriptions of the illustrations, representing injected and other preparations of the liver. Two of these were taken from livers containing cysts—a morbid condition which is but rarely met with. Dr. Beale concludes that these hepatic cysts may be formed in at least three ways,—

"1. By the obstruction of a branch of a duct, and by accumulation of secretion behind the obstructed part.

"2. By the gradual dilatations, caused by the obstruction of a large duct extending backwards to the smallest ducts-even to the point where they become continuous with the cell-containing network of the lobule. The thin walls at length giving way, extravasation would take place amongst the vascular and cell-containing networks; under these circumstances the duct would gradually become obliterated, while these little cavities might remain in the form of closed cysts.

"3. By a gradual alteration occurring in a portion of the secreting structure within the lobule, leading to the deterioration of some of the meshes of the vascular and cell-containing networks, and the gradual pouring out of a serous fluid to occupy the place of the wasted structures."

Dr. Beale's assistant, Dr. Moritz von Bose, is the author of the next paper, which contains the clearest account of the volumetric method employed for the determination of the chief constituents of the urine, that we have met with. The practical utility of this method will doubtless secure its general adoption as soon as it is better known; it is simple, requires but a small expenditure of time, and with ordinary precautions yields results that are reliable and satisfactory. Those anxious to carry it out cannot obtain the necessary information more easily than by referring to Dr. Bose's account.

The remaining papers are entitled "Chemical and Microscopical Examinations of Morbid Specimens," "Analysis of Softened Cerebral Matter surrounding an Apoplectic Clot in the Left Hemisphere of a Woman, of the Clot itself, and Healthy Portion of the Brain," "Case of Rape in which Spermatozoa were Detected in the Mucus removed from the Vagina," "Examination of Ragged, Fibrin-like Masses found in the Sputum of an Obscure Case of Solidification of the Right Lung," "Examination of a Large Tumour connected with the Thyroid of a Woman aged Fifty-one," and "Tumour connected with the Left Corpus Striatum in a Man aged Twenty."

Explanations of the ten plates, which are lithographed from preparations made by the author, and which illustrate the papers, conclude the letter-press.

Of the whole, we would say that a large amount of valuable and available information is compressed into a small space; and while we anticipate that the Archives of Medicine' will take a high rank among the scientific medical periodicals of Europe, we found that hope

more particularly upon the personal zeal and the distinguished abilities which have already secured for Dr. Beale a large and lasting repu

tation.

ART. X.-The Successful Treatment of Scarlet Fever: also, Observations on the Pathology and Treatment of Crowing Inspiration in Infants. By P. HOOD, Surgeon.-London, 1857. pp. 200. THE opinion of gentlemen engaged in extensive private practice is always worth listening to, although we may miss in their arguments that stringency, and fail to discover in their statements that careful record of pathological details, which are to be expected of those who may have more leisure to devote to the exigencies of modern science. We might object to various points contained in Mr. Hood's book if we were to subject it to a rigid criticism; but we accept it, as we believe it to be intended, as a faithful representation of his experience. We cannot but desire that he should have informed us of the number of cases of scarlet fever which he has attended, in order that we might be able to appreciate the exact value of his statement, that in five-andtwenty years he has lost but two patients from scarlet fever. Our estimate would also be more precise if we knew something of the class of persons among whom Mr. Hood has chiefly had opportunities of watching the effect of his remedies.

Regarding scarlet fever as essentially "a disease of debility," Mr. Hood places his chief reliance upon the employment of quinine; but although he lays great stress upon this agent, he does not neglect the employment of evacuants, and other remedies demanded by the features presented at different stages of the malady.

"The success of the treatment," he says, "is dependent upon the adaptation, in regular order, of all that is valuable out of the many agents hitherto employed for the cure of scarlet fever by others, and I take no credit to myself beyond the discovery of the most suitable arrangement of these remedies to combat scarlet fever.

"The order of treatment which I adopt is as follows:-1st. Emetics. 2nd. Purgatives. 3rd. Quinine. 4th. Opium. 5th. Wine and diet.

"I have not, for some years, found it necessary to alter this arrangement in treating scarlet fever; nor have I made any difference in the treatment of the disease according to the variety it presented, whether it showed itself as simple scarlet fever, scarlatina anginosa, or scarlatina maligna, beyond the more liberal use of wine, and larger doses of quinine in the last-named form. I have found that one and all are to be safely treated on the same plan, subject, of course, to those modifications as to the strength of medicine and the amount of support which particular constitutions demanded." (p. 74.)

Those who desire to know more of Mr. Hood's views and mode of practice will do well to refer to the book itself, which bears the stamp of having issued from the pen of a shrewd observer. This remark applies particularly to the second part of the book, in which the author discusses the pathology and treatment of crowing inspirationa disease that is invariably connected with great mal-nutrition. Having, at a post-mortem of a child whom he attended for this affection, dis

covered "the liver much enlarged, dense in its structure, and double the thickness of a healthy liver;" Mr. Hood subsequently invariably examined the state of the organ in infants labouring under laryngismus, and

"The result" (he says) "of what I have observed in all cases that have come under my notice, is the conviction that this disease has its origin either from enlargement of the liver taking place, or from derangement of the function of that organ; and that upon the restoration of the liver to a natural size, and the correct performance of its functions, depends the successful treatment of this discase.'

The author in thus stating the result of his experience, avoids the question as to whether this "enlargement of the liver is the sole and primary cause of the disease." He expresses the opinion, however—

"That the former arises from a mal-assimilation of the food; and that the blood thus formed, being of an unhealthy character, facilitates a preternatural growth in this organ [the liver], in the same manner that it occasions enlargement in the glands of the throat."

We have no doubt that Mr. Hood's statement will attract attention, and that the hepatic region of young children will be more frequently subjected to examination than it usually is, in order to verify or refute it. The cases which he details certainly justify the conclusion at which he arrives; but here again, as we remarked in reference to his observations on scarlet fever, it would be more satisfactory were we informed of the number of cases which have fallen under his notice.

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ART. XI.-Summary of New Publications.

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As usual at this season of the year, the number of works accumulating on our library table is very considerable. Many of them are manifestly of high merit, and will receive ampler notice than we are yet able to bestow upon them. Medicine is most largely represented. Dr. Barclay treats of the whole science of pathology in a work entitled, A Manual of Medical Diagnosis,' which, with Dr. Aitken's 'Handbook of the Science and Practice of Medicine,' will be specially introduced to our readers in the ensuing number of this Review. shall then also refer to Dr. Robinson's valuable collection of essays, entitled, Contributions to the Physiology and Pathology of the Circulation of the Blood.' The subject of Spinal Irritation has a rational exponent in Dr. Inman, to whose views on the cause of certain painful affections commonly regarded as neuralgic, we drew attention in the April number of last year. Two prize essays on Consumption, by Mr. Edwin Lee, of balneological repute, and Dr. Warren, have reached us from Philadelphia; while Dr. Cotton's well-known volume on the same subject comes before us in a second edition. A specific treatment of pulmonary phthisis is vaunted in a good-sized octavo volume, upon grounds which the author, Dr. J. Francis Churchill, regards as conclusive, but which appear to us far from possessing the necessary stringency. His remedial agents are the hypophosphites of lime, of soda, potassa, or ammonia. We are the more anxious to consider the ques