the French school have already decided against the practice, and few of our most eminent English surgeons adopt this empirical plan of mutilating the body." (pp. 61, 62.)

It is well known that Mr. Bishop has devoted much time and attention to these subjects; and as he takes upon himself to censure a practice which everybody knows to have been attended with speedy and most beneficial results in a vast number of cases, it is not too much to expect that he should support his opinions by some practical results, which might demonstrate their correctness. We search the volume, however, in vain, for anything so reasonable; and are constrained to remark, that while everybody else is condemned, and the author and his principles alone held up for commendation, there is not a shadow of evidence presented to us, whereby we may form an independent opinion.

The next chapter is on the Mechanical Causes of Distortion, and is illustrated by many woodcuts, explanatory of the subject. Apropos of the "effects of wooden legs," the author justly praises the admirable contrivances which of late years have given to the victims of amputation so many advantages not hitherto obtainable, and remarks"When we reflect that every person who is obliged to wear the common wooden leg, not only loses the power of quick walking, but becomes deformed, it is a matter of great importance that surgeons should be familiar with these consequences, more especially as it is too much the custom at our hospitals, as well as in private practice, for them to consider their duty at an end when they have amputated the limb, healed the stump, and directed the patient to an instrument-maker. On the contrary, a very important duty still remains to be performed-namely, that of promoting the future welfare of the patient by prescribing a proper substitute for the natural limb; and the immense funds subscribed for the support of most of our hospitals might surely afford some small allowance to be appropriated for the purpose of supplying poor patients with such improved wooden legs as would enable them to perform all the ordinary occupations of life without difficulty or distortion. This is a subject that army and navy surgeons, more particularly, would do well to take into consideration; since, with the assistance of such a wooden leg, soldiers and sailors might be enabled to discharge most of the common duties of the service instead of being dependent, as they now are, from the moment they are deprived of a natural leg." (p. 79.)

Passing over a good many pages, we find that the author holds the opinion, contrary to that generally entertained, that the white fibrous tissues are elastic. He states that he has verified the conclusions to which reasoning had brought him, by experiments on the lower animals; and that he has found the ligaments of the joints to possess a very high degree of elasticity, but a very limited amount of extensibility (p. 122, note). We are not informed, however, how these experiments were made. In the succeeding pages we find the same condemnation of tenotomy, and the same absence of any proof that it can be dispensed with; unless, indeed, such a statement as this can be allowed weight.

"The author has been called in to complete the cure of cases of tenotomy, which, although the subjects were young persons, required the use of instruments many months after the division of the tendon. This circumstance furnishes an additional argument against tenotomy in general, since in many cases the cure is not hastened by that mode of treatment." (p. 143.)

Let us now pass to the "Pathology and Morbid Anatomy of Deformities." On the subject of caries, cancer, and enchondroma of the bones, we find the author affirming very positively, on the authority of Lebert,-what is, in our opinion, exceedingly doubtful,-the occasional co-existence of tubercle and cancer. We are still disposed to believe in the incompatibility of the two diseases; and shall continue to hold our ancient faith, until more satisfactory evidence shall have been adduced of its incorrect

ness.

We find nothing of particular moment in the chapter on Rickets, save the general doctrines with which it opens, whose special application to the case of rickets we altogether fail to discern.

"In tracing the cause of rickets, the first step will be a physico-pathological inquiry into the development of animal organs. According to Schelling, The peculiar character of organization is, that the matter is only an accident of the thing itself, and that the organization consists of

form alone. But this form, by its very opposition to matter, ceases to be independent of it, and is only in idea separable. In organization, therefore, substance and accident, matter and form, are completely identical.' Dr. Whewell has defined organic life to be a constant form of circulating matter, in which the matter and the form determine each other by peculiar laws, that is, by vital forces.' It is further supposed by him, that the vital forces by which these changes are effected may be distinguished from chemical and mechanical forces, inasmuch as the latter tend continually to produce a final condition, after which there is no further cause for change. Mechanical forces tend to produce equilibrium; chemical forces tend to produce composition, or decomposition; and this point once reached, the matter in which these forces reside is altogether quiescent. But an organic body tends to constant motion, and the highest activity of organic forces shows itself in continuous change. Again, in mechanical and chemical forces, the force of any aggregate is the sum of the forces of all the parts; the sum of the forces corresponds to the sum of the matter. But in organic bodies the amount of effect does not depend on the matter, but on the form the particles lose their separate energy, in order to share in that of the system; they are not added, they are assimilated. These views, if admitted to be correct, will form a basis upon which to found an examination of the origin of the disproportionate growth in rickets, and may at some future period lead to the solution of the question, whether the vital forces themselves, or the materials on which they act, are in fault." (pp. 205, 206.)

As the three concluding chapters of the volume are devoted to an examination of the mechanical means employed for the cure of deformities, we shall dwell somewhat upon them.

The various kinds of machinery are classed under the three heads: 1st. Machines designed to stretch the body either in a horizontal or vertical position; 2nd. Those which tend to prop the body and limbs; 3rd. Those which have for their object the reclining the body either obliquely or horizontally in prone and supine positions.

The stretching plan is very common all over Europe; and was resorted to by Ambrose Paré, on the supposition that distortions of the spine are dependent on the dislocation of one or more of the vertebræ. It is still actively employed in Paris, and apparently on the same erroneous principles; but whether used to reduce supposed dislocation of the vertebræ, or with whatever object, it is condemned in toto by Mr. Bishop. As was before shown, the spine has three curves, the largest of which is designed to give space for the great organs of respiration, circulation, and digestion; and as stretching must, if it does anything, diminish this curve, of course it seriously interferes with the due accommodation and action of these important viscera. A general notion also prevails, that many spinal curvatures are produced either by the weight of the superincumbent parts, or by the abnormal contractions of the muscles of the back; but as this view is erroneous, except in those cases in which there is disease of the bodies of the vertebræ, the extension cannot effect a cure, and must still more evidently fail in cases where the bones of the spine have permanently assumed a wedgelike form.

Propping and Supporting Systems.-Stays, says Mr. Bishop, must be employed from an idea that the human body is not a self-supporting machine; and he proceeds to enforce their injurious consequences by the usual arguments. We shall quote all that he here remarks upon the employment of such supports when the spine is actually curved.

"If corsets are so detrimental to the figure and health of young persons as all experience proves them to be, and if they lead to debility and deformity of the trunk, how is it that they are introduced to correct the evils they produce? Is there really existing in this case an illustration of Hahnemann's dogma- Similia similibus curantur'? A strict examination into this matter will dispel the illusion, and show the practice, although somewhat plausible, to be really unsound. Stays of different kinds have long been introduced with a view of supporting the spinal column, and correcting its distortions, under an impression that curvatures of the vertebral column arise either from its being unable to support the superincumbent weight, and its yielding in the same way as any other elastic column of metal or wood bends when overloaded; or from the muscles on one side of the spine acting with greater force than those on the other, and so pulling the spine into abnormal curves. It is supposed that if the trunk be encompassed with a corset which props up the columns, and at the same time presses against or pushes in the prominent parts, both the tendency to distortion, and the distortion itself, will be removed. Accord. ingly, we have Hossard's lever belt, Tavernier's lever belt, with inclination busk, Amesbury's,

Biggs', and a large variety of stays, all of them designed for the object just mentioned." (pp. 230, 231.)

The supine and prone position of the body next come to be considered; and in these the author seems to admit that there is some value. The triple inclined plane of Mr. Earle is the best of these inventions, because it has the advantage of changing the position of the body as often as may be required, without calling for great exertion. The pith of Mr. Bishop's experience is contained in the following quotation:

"The result of a number of observations, without entering into details, is this-namely, that in cases of curvatures of the spine arising from disease and absorption of the bone, the distortions do not increase while the body is kept in horizontal, supine, and lateral positions; but they do increase when the body is allowed to move and be erect; and that, moreover, when patients are confined to the prone position, so far as the author's experience goes, the curve of the spine is progressive, for which there are obvious mechanical reasons. For instance, in all cases, both of diseased bone and curvature, the superincumbent pressure cannot be wholly withdrawn in any oblique position; and where the curvature is in a plane or planes intermediate between the mesial and transverse, as generally happens, the deformity may often be increased by the tendency of the unsupported curved position towards the transverse plane." (p. 236.)

The author fortifies his conclusions by relating the case of a girl who was confined night and day to a prone couch for nearly two years, but in whom the vertebral disease rapidly advanced, and the general health materially suffered. A most telling wood-cut illustrates the patient's condition; and in the following remark few will hesitate to coincide:

"Since no part of the body can be subjected to continual pressure without ulceration being produced, it is clear that whatever state of recumbency may be adopted, it ought not to be persevered in for any length of time; but relief should be afforded by changing the position, which, as we have seen, may be done without detriment." (p. 240.

The concluding chapter is on the Physical and Psycho-Physical Treatment of Children; but contains nothing that has not many times been said before, with at least equal force and propriety.

In order to justify our complaint of the vagueness of Mr. Bishop's directions for the practical treatment of deformities, and of the occupation of so large a part of his book with the discussion and refutation of the methods of others, we have been much inclined to cite the whole passage commencing at p. 244 and ending at p. 249, which contains all that we can find of his own; but we are so fully satisfied that after the perusal of this, our readers will be very little wiser than they were before, that we refrain from making the extract, in the belief that our space may be better occupied.

The two remaining books on our list may be dismissed with but few comments. They proceed from the pens of two gentlemen who are practising in this metropolis, in the special department of surgery upon which they write. One of them at any rate (Mr. Tamplin) belongs to an institution that ranks amongst the most useful with which we are acquainted, and which can appeal to hundreds of cases which disprove the wholesale condemnation passed upon orthopedic surgery by Mr. Bishop. We are far from agreeing with all that is advanced by many persons in favour of the purely mechanical treatment of deformities, and still less can we join those who constitute themselves the champions of indiscriminate tenotomy; but we ourselves have had too great opportunities of witnessing the results of the treatment inculcated by Mr. Tamplin, to doubt the correctness of the principles upon which it is founded. His present publication is a reprint of the substance of his Lectures on Lateral Curvature, in his work on the Nature and Treatment of Deformities;' and has for its special object to recommend an instrument which he has constructed to assist in the cure of these curvatures. The most questionable passage in the book, is the recommendation that the instrument be worn night and day; and although we have Mr. Tamplin's assurance that the general health frequently improves under this severe management, we must be permitted to agree with what is said by Mr. Verral on this head.

66

'Upon no occasion have I found that I gained any advantage from the application of mechan

ical contrivances, when used for more than five or six hours daily; indeed, about six hours should be fixed as the maximum period for which they can be advantageously worn, any time beyond this serving only to debilitate the patient, and give rise to a dangerous amount of bodily prostration; moreover, I think that such a time will be quite sufficient to enable the patient to engage in an ample amount of exercise and recreation for keeping her in strong and vigourous bodily health; and at all other times she will be deriving infinitely more benefit, from the employment of gymnastic exercises, or lying in the prone or supine position." (p. 90.)

It would be impossible to describe in words the spinal instrument recommended by Mr. Tamplin; and those who have not seen it, can refer to the diagrams placed at the end of his volume.

Mr. Verral's book is somewhat ambitious, but, on the whole, very well executed; and even if it were not so, the humility of his Preface would almost disarm criticism. His great panacea is the prone couch; a useful invention, which we have often employed, but the value of which he certainly overrates.

He has also constructed an instrument, partly on the plan of the one employed by Mr. Tamplin, which, with somewhat of unnecessary parade, he formally makes over to the profession. We dare say it is very useful, and it certainly is very ingenious. There is, however, a something in Mr. Verral's book, which we would gladly see removeda sort of writing for the public; indeed, in one place he fairly enters into some elementary explanations for the benefit of the non-professional reader who may chance to refer to his pages. Perhaps this defect is almost inseparable from a work on so popular a subject as deformities; but certain it is, that we rarely do meet with any author of this class, who is entirely free from this imputation. Mr. Bishop constitutes an honourable exception; and the fault we find with him is, that his work presupposes too much learning on the part of his readers, and requires, for its beneficial use, a capacity for applying principles to practice, which is, we fear, considerably beyond the average of our profession.

Chapters on Mental Physiology.

ART. XVII.

By HENRY HOLLAND, M.D., F.R.S., F.R.C.P., &c. &c.-London, 1852. 8vo, pp. 301.

THE title of this volume is one with which captious critics might find fault, and not without a show of reason. We have no wish, however, to rank under such a category; and readily adopt our author's explanation of it, more especially as we own ourselves incapable of showing how it could be changed for the better. By the term Mental Physiology, Dr. Holland wishes to express "that particular part of human physiology which comprises the reciprocal actions and relations of mental and bodily phenomena, as they make up the totality of life." And he has adopted the title, Chapters on Physiology, "partly to avoid the profession of a complete treatise, which this is not; partly to indicate that most of these topics, and even their titles, are taken from another work, the first edition of which was published thirteen years ago." Those of our readers who have enjoyed the profitable pleasure of perusing Dr. Holland's 'Medical Notes and Reflections,' will doubtless remember certain very interesting chapters on the "Effects of Mental Attention on Bodily Organs,' ," "On Time as an Element in Mental Functions," ," "On the Relations of Dreaming, Insanity," &c., "On the Brain as a Double Organ," "On Phrenology," and "On the Present State of Inquiry into the Nervous System," which are dispersed through different parts of the volume, in the midst of subjects of a more strictly medical character. Thus separated from each other, they were deficient in the sequence and connexion naturally belonging to the topics of which they treat, and indispensable to a proper consideration of the entire subject; and feeling that there are circumstances, at the present time, which render it peculiarly desirable that the subject should be placed prominently before the view both of the profession and of the public, Dr. Holland has brought these chapters together, enlarging them where addition could be profitably made, and re-writing them where alteration had

become requisite, in consequence of the progress of knowledge; whilst he has added three entirely new chapters, "On Mental Consciousness, in its Relation to Time and Succession," "On the Memory, as affected by Age and Disease," and "On Instincts and Habits," which were originally intended for a second series of his former essays. He has thus embodied within the compass of a very moderate-sized volume, a philosophical digest of the products of observation and reflection that have been habitually carried on throughout his professional life, on topics of the highest interest alike to the medical practitioner and to the scientific physiologist and psychologist. The following extract from the preface will convey an idea of the author's general plan and purposes, to those who are not familiar with his former work:

"Much of course will be found in this volume which is familiar to those who have studied the subject, especially of late years. But, if I do not deceive myself, there are still certain facts not heretofore duly recognised or defined, and certain relations of phenomena requiring fuller illus tration than they have yet received. These I have sought to embody in the ensuing chapters, in the order which seems best calculated to give connexion and unity to the whole. To arrange under new combinations what is already known to us, is often in itself a source of fresh knowledge, or a valuable means of correcting previous error. Various instances to this effect will, I trust, occur to the reader in his progress through the volume. I may add, that in the discussion of the subjects, though obliged to adopt certain divisions for the sake of clearness, I have kept in constant view that great law of continuity, which equally governs all mental and material phe noniena. No conclusions are more secure or more profitable, than those drawn from a careful notice of continuous relations; and of those gradations of change, which bring_extreme cases within common laws, and reconcile anomalies with facts familiar to experience. To this I would advert, as a principle I have largely applied in every part of the volume.

"The topics treated of are such in their nature as perpetually to bring us to the very confines of metaphysical speculation. Except in the case of one great question, which could not be put aside, I have carefully avoided passing over this boundary. Convinced of the general truth of the maxim, that it is safer and easier to proceed from ignorance to knowledge than from error,' I have endeavoured throughout to separate what is known from that which is unknown-what is capable of being reached by the human undetstanding from that which is presumably unattain able by it. The close adherence to this principle will probably expose me to the charge of having surrounded the subject with unresolved doubts and difficulties. But I think it far better to incur this imputation, than to assume a knowledge not yet possessed, or to cover the deficiencies of reason by any mere artifices of language." (pp. viii., ix.)

One of Dr. Holland's main objects has been to point out the mode in which the mesmeric phenomena and doctrines, and the topics collateral to them, which have drawn so largely upon public attention of late years, should be scientifically examined. We are glad to find his views in such complete accordance with our own on this point. We are convinced that the profession has done discredit to its own character, and has lost no inconsiderable amount of public confidence, by the tone of ridicule which it has generally assumed with regard to the class of phenomena in question; and that it will not recover its lost ground, until it shall have carefully and candidly examined them, with due attention to their relations to known physiological and pathological actions, in the mode and spirit of which Dr. Holland gives in this volume so excellent an example. The only fault we have to find with his treatment of it is, that it is too general and deficient in explicitness, so that it is likely to be accounted vague and unsatisfactory by those who have not been prepared by their previous studies and inquiries for apprehending the whole meaning which is conveyed in some of Dr. Holland's philosophic abstractions. And this, we fear, will operate against the extended appreciation of the present volume, as it has done against the full recognition of the merits of the former collection. Men are usually more struck by new facts, than by new aspects of facts previously familiar to them; and finding but few of the former in Dr. Holland's essays, they are apt to ask themselves what they have gained by their perusal. In many instances, Dr. Holland has drawn just that inference from the collocation and comparison of facts, which they would have themselves done if those facts had been brought before them under a like arrangement; and they have hence regarded the merit of that inference as being their own, rather than Dr. Holland's, altogether overlooking the fact that it was to him they owed the means of making it. And even where he has