nastic medicine), it must be confessed that Ling's doctrines do not deserve the name. They 33 embrace merely the most general principles, and do not descend to particulars. They concern merely the commonest principles of life and their mutual relations, without attempting more recondite explanations of these, or of the operations of gymnastic medicine. They assert the claims of gymnastic medicine to take its place as a system of education and of therapeutics, but they do not explain physiologically the nature of gymnastics. In my ideas, a true theory of gymnastics would be a complete body of ascertained laws, respecting the operation of movements; we should have rules laid down to explain and exhibit the laws of active muscular movements and their consequences; laws, too, for the action of these movements upon other parts of our system, on the nerves, the blood vessels, and the absorbents; laws concerning the operation of passive movements or manipulations on the various tissues and organs, as, for example, to illustrate and declare the effect of pressure, or of vibration, applied to a nerve or to a blood vessel. Of all this, we find in Ling's works merely practical hints, but there is no approach to a developed and completed theory. Most assuredly is it requisite, that those who devote themselves to the practice of gymnastics should have a more thorough acquaintance with medical science, and particularly with physiology and the diagnosis of disease, than can be obtained from the general doctrines promulgated by the kinesipathists." (p. 18.)

We have already said that Dr. Sonden's pamphlet is by far the most moderate in its pretensions of all the works that we have seen on this subject; he honestly admits the want of a true scientific foundation for the system; and yet the successors of Ling boldly claim for this fantastic theorist the honours that are accorded to a Berzelius or a Linnæus. We had expressed a doubt, in a former page, as to the exact length of the course pursued in the Central Gymnastic Institution in Stockholm, but we have since ascertained, that in a six-months' course the gymnasiast is made perfect, and is ready to be sent forth to the world as a practitioner of this new art of healing. Our readers may, perhaps, scarcely credit this assertion, but besides having obtained positive evidence thereof from those well acquainted with the proceedings of this Institute, we can refer to M. Georgii's own pamphlet for a corroboration of this statement:

"The Central Institute of Gymnastics at Stockholm, founded by the Swedish government, occupies a vast space, divided into large halls, some specially destined for gymnastic exercises and fencing, others devoted to the amphitheatre of anatomy, to the anatomical museum, to the library, and to divers classes. The object of this establishment is to form annually, to the number of fifteen or sixteen, masters of gymnastics for all the colleges, for the primary and secondary schools, and lastly for the army. The subjects of the courses are, descriptive anatomy with dissection, anatomy in its relation to the movements of the human body, physiology, the principles and theory of gymnastics, the theory of self-defence, gymnastics with and without apparatus, medical gymnastics, the bayonet, the sword, and the sabre exercise," &c., &c. (p. 8.)

Two questions occur to us, and will no doubt suggest themselves to our readers on perusing this long list of accomplishments and attainments, to be completely mastered in a six-months' course. as Baron Düben remarks, most universal and extraordinary geniuses, to be able thus to First, we must believe the rising school of kinesipathists to be, become perfect in anatomy and physiology during a winter session, while they are at the same time devoting no small part of each day to manual exercises with the sabre and the bayonet. We hear nothing of chemistry; but perhaps that too, both practical and theoretical, is included within this wondrously active half year. Again: are we to understand that without clinical instruction, without the means of observing disease at the bedside, these men are sent forth into the world to diagnose and to treat disorders of all kinds whatsoever? If such be the case, we cannot wonder that their reported cases of disease are so lamentably deficient in accuracy of detail, that their descriptions of the various maladies they have heroically subdued, are such as to render it a matter of great doubt, in many instances, what were the disorders with which they had to engage. Nay, it would seem that even in reporting cases which admitted of but little doubt, the usual want of honesty that characterizes the quack, exhibits itself in their published works. At page 69 of his "Kinesitherapie," we observe the following statement by M. Georgii :

"Dr. Liljevalck, in his report of the treatment of venereal disorders in the garrison hospital at Stockholm, says, ' In twenty-three cases of urethritis, many of which were complicated with stric

3

ture, percussions applied from above downwards upon the os sacrum were employed with suc("'"&c. cess,'

The pamphlet of Baron Düben supplies us with Dr. Liljevalck's real report, as follows:

"This gymnastic mode of cure was only employed in simple gonorrhoeas, and the milder complications of that malady. If stricture, prostatic inflammation, or epididymitis was present, I had recourse to the ancient and usual method of cure (har jeg ätergätt till gammal slentrian)."

It has been justly complained, by those who have preferred legitimate medicine to kinesipathy, that as yet no attempt has been made to give a scientific exposition of the system. Such has certainly been the case in Sweden, where Professor Branting has evidently shrunk from this test, proposed to him eight years ago by the Royal Medical Society of Stockholm. Drs. Roth and Blundell have, however, been more bold in England; but after perusing their respective volumes, we are satisfied that the Swedish gymnasiarchs have chosen the wiser and the better part, of almost total silence on this matter. We can only judge of kinesipathy at its fountain-head in Sweden, by Branting's annual reports and orations; while in the cases that have been published to illustrate his doctrines there is so little detail, so little by which we can judge of the accuracy of the diagnosis, that they must be received with extreme caution. In a truly scientific work on any subject, it is at all events necessary, that the cases of reputed cures effected by the agency of a specific mode of treatment should be especially complete in the detail of their symptoms, so that no possible question could arise as to the real character of the disorder. We are constrained to say, that this essential rule has been most grievously neglected by almost all the writers whose works are now before us: we must confess that the enumeration of their cures reminds us more of Holloway or of Morison, than of the sober and prudential reserve that should characterize a scientific report. In many instances the mere name of a disorder is given, with hardly any of the symptoms we should look for to authenticate the diagnosis. Here, for instance, is one of M. Georgii's cases, copied from his master's, Professor Branting's, report:

"We would refer here to the case of a patient who, to all appearances, suffered from tubercles in one of the hemispheres of the brain, an affection which, for the space of several years, had given rise to violent and periodic headaches. He was at first treated by derivative movements, and subsequently by circular percussions applied with the hand over the superior part of the cranium. This last-named application arrested the headaches; and the excessive heat, the painful and continual pulsations, the convulsions and vertigo, also disappeared." (p. 90.)

"We hardly know," says Baron Düben, "whether the last sentence belongs really to the report or no, for at first it is said that the headaches were periodic, but, finally, we are told that the pulsations were painful and continuous." Our readers will at once perceive the utter insufficiency, in a scientific point of view, of such a report as the above. How was the diagnosis of tubercles existing in the brain at all, made out on this occasion? Does M. Georgii mean to infer that the tubercles, if they did exist, were dissipated by the circular percussion on the exterior of the patient's cranium? How did he ascertain that the disease existed in the hemispheres, unless by the marvellous powers of animal magnetism? Were the tubercles absorbed ? or did they dry up and shrivel before such powerful manipulations ?-Such is a fair and average sample of the cases reported by the heads of the gymnastic school; and their disciples in this country, Drs. Roth and Blundell, have not been more happy in their descriptions of disease. We turn to page 178 of Dr. Roth's curious volume, where the author begins to explain "the treatment of single diseases." The first class of disorders are enumerated as "congestions of the head, headaches, giddiness, humming in the ears," &c. For these are prescribed-1. Derivative movements of the legs and feet; 2. Passive rotation of the feet, with active passive extension and flexion of the feet and below is one of the beautiful woodcuts that ornament the volume, where a stout gymnasiast is depicted rotating his patient's toes and foot; and we are gravely told, that the operator, after fixing his patient's leg across his knees, then "moves his

left hand, which presses a little on the point of the foot, in a circle from right to left from three to six times, and then the same from left to right, more or less quickly, according to the prescription. This rotatory movement is repeated two or three times." (p. 180.) Such of our readers as remember Hahnemann's famous directions for the divers shakings of the elbow and elevations of the arm in the preparation of his wonderworking infinitesimal doses, will not fail to perceive some analogy here. But, after all, kinesipathic treatment, however ludicrous it may seem to the reader and to the man of science, is, like hydropathy, no joke for the unfortunate patient. Dr. Neumann employed the following measures in a case of opaque cornea-1. Pressure on the supra-orbital region twenty or thirty times daily; 2. Passive rotation of the head eight or ten times daily; 3. Frictions in the direction of the superior longitudinal sinus and transverse (sic) and the beginning of the internal jugular vein; 4. Flexion of the trunk with resistance; 5. Active rotation of the lower extremities; 6. Percussion on the soles of the feet with a cylindrical piece of wood. These were continued for the space of fourteen weeks; but the narrator honestly adds, that he does not know whether the further effects of the treatment entirely restored the eye.

In "chronic inflammations of the larynx and windwipe, and irregular activity of the vocal cords," a tolerably strong vibration, with moderate pressure, is employed on both sides of the larynx and windpipe. In addition to this we find that there is recommended-1. Submaxillary vibration; 2. Double oblique lateral friction of the throat; 3. Point vibration on the windpipe; 4. Double frictions from the throat down the shoulders and arms; 5. Longitudinal friction of the larynx with three separated fingers, and loud speaking, reading, singing, and declamation; though we cannot seriously suppose that these are employed in cases of laryngitis. Passing on to tubercular phthisis, we are gravely told that Ling "advised movements as soon as the lungs show traces of incipient ulceration, and difficulty of breathing, cough, congestion of the chest, inflammation, and formation of pus, become manifest." thought that kinesipathy would have seized on the disorder in its earliest stage, and We should have by some wonderful gymnastic combination of movements, have prevented the formation of tubercles at all. But perhaps we are in error; for on the same page we are told that Ling himself, and Professor Branting, were both cured of this disease by movements; and we conclude that what is here meant is, that Ling and Branting were both in this way freed from the predisposition to phthisis. It could not be possible, in the narrow limits of these observations, to analyze carefully all the singular modes of cure by movements, projected and practised by Ling and his disciples. Of Branting's method of reporting cases we have already given a specimen; and let us now see how Dr. Roth acquits himself in this respect. The following is given as a case of phthisis and its treatment; and if the disease itself was not severe, the same cannot assuredly be said of the mode of cure that was adopted:

"The patient was twenty-six years of age, and was principally employed at needlework; she was extremely nervous, irritable, and very thin; feet and hands generally cold; continual tickling in the throat, cough, sometimes spitting of blood in small quantities; the expectoration moderate, slimy, greenish, and like pus; the upper part of both lungs, during the percussion, yielded a dull sound; short breathing, a little stooping, in consequence of weakness of the muscles of the back, the shoulders projecting forward; the digestion deranged, sometimes no appetite, and at other times vomiting, frequent diarrhoea, menstruations regular as to time, but little, and only during one day; leucorrhoea; the skin dry and flabby; the countenance livid, blue circles around the eyes, which were sunk in, the sclerotic coloured like mother of pearl, the lips blue, the pulse almost insensible, great weakness, and continued fear of death. We have no exact copy of the prescription, but as far as we remember the movements were:

"1st. Transverse frictions of the loins from the spine downwards, while the patient was in the supported sitting position.

2nd. Active-passive extension of the leg, previously placed and kept by the assistant in the same position.

"3rd. Active turning of the trunk in the upright standing position, with the assistance of the operator.

"4th. Active-passive extension of the trunk in the high, long, sitting position, till the trunk

was almost in a horizontal line with the legs, and passive-active flexion from this position in the sitting one.

"5th. Active-passive pressing down of the extended leg in the reclined supported sitting position.

"6th. Lateral vibration of the larynx and windpipe, with the double parallel frictions of the throat, and friction down both the shoulders.

"7th. Vibration on the lowest point of the windpipe, and longitudinal frictions with separated fingers on the larynx, downwards.

8th. Pumpings."

The "pumping" (sic) is an entirely passive movement, the commencing position of which is the following:

"The patient is in a supported sitting position, with his arms hanging down quite passively; the operator stands behind the chair, puts both his hands on the sides of the patient's chest, strokes them gently to the armpits, which he holds, and raises the shoulders of the patient, which he keeps in this position for half a minute or longer; afterwards he lets them gently down, and begins again the same movement, which is repeated from three to six times. This movement produces, in the generality of patients, a very agreeable feeling, caused by the artificial passive imitation of the respiratory movements." (p. 210.)

"9th. Passive flying. (!!) The patient is in a standing position, and leans with the head on the chest of the operator, who stands on an elevated level behind the patient; the operator seizes the entirely passive arms on their lowest parts, or on the hands, and makes quick or slow flying movements-three, six, or nine times-one after the other. After an interval this movement is repeated.

10th. Passive rotation of the feet, and active-passive extension and flexion of the feet. 11th. Passive rotation and active-passive extension and flexion of the hands.

"12th. Active-passive extension of the leg in the half-standing position, with hips held, resting with the thigh on a transversal bar.

"13th. The active-passive raising of the trunk from the stooping-standing position to the upright one.

14th. Circular frictions, alternating with vibrating movements on the relaxed abdomen of the recumbent patient, for five minutes.

"15th. Active-passive flexion and extension of the arms, in the sitting position.

"16th. Longitudinal frictions of both sides of the chest, from below upwards to the elbows, in the supported sitting position.

"17th. Active flexion of one leg, in a half-standing position, while the other rests backwards on the point of the foot, on an elevated level.

"These different movements were not employed at the same time, and not in the above-mentioned order." (p. 213.)

Our readers will share in our wonder at such treatment adopted in a patient, with almost insensible pulse, and extremely debilitated. Marvellous, indeed, must have been the inherent vitality of her sinking frame, to withstand the various active-passive movements enumerated above.* Continuing the case, we are further informed, that

"Two months have passed since this treatment was commenced; the chest of the patient has developed more than half an inch in the periphery of the thorax; the breathing is less short; the countenance is less livid; the blue circles around the eyes have disappeared; the eyes are less deep; the lips red; the cough not much changed; the expectoration not so much; spitting of blood seldom, and less, and of the same nature; no diarrhoea," &c. &c. (p. 214.)

Throughout the whole report there is not the slightest allusion to the actual condition of the lungs, as ascertainable by the stethoscope; no microscopic observations are recorded of the sputa, no observations of the conditions of the gums, and finally, there is not a word about the state of the pulse. In the next page we find the following rich morceau, on "Acute Edema of the Lungs, and Incapacity of Expectorating;" quoted, without any observation, from Richter:

"I do not know a better treatment than to put the patient (who begins to be benumbed, and who is unable to expectorate) in an upright position, to keep him on the arms [sic], to shake his shoulders, to knock on his back, to excite him by repeated screaming [query, of the operator or of the patient?] to expectorate, and to remove with the fingers the slime from the posterior part of his mouth. Many persons on the point of suffocation are saved from this danger; and l'am * Active-passive movements are explained to be those where the patient offers more or less resistance to the manipulations of the operator.

astonished to see many medical men allow patients so circumstanced to lie quietly and continue their rattling till they die." (p. 215)

It is evidently not the policy or the practice of the gymnasiasts to allow their patients an interval of rest, and we should be curious to know what are the symptoms of acute cedema of the lungs, and what the rationale of such treatment.

In the same page we have a paragraph on " Adherences of the Lungs," and they are to be treated-it is not said how they are diagnosed, or if fresh or ancient-" by friction in a straight line on both sides of the chest, alternating with a vibration round the thorax, while the patient keeps his arms raised and fixed on an object during this passive movement." (p. 215.)

Dr. Roth is neither luminous nor long-winded in his observations on diseases of the heart and their treatment by movements, while Dr. Blundell favours us with six cases, where hypertrophy of the heart was relieved; and even where disease of the mitral valves (p. 260) disappeared under the all-powerful influence of kinesipathy. Dr. Roth gives us the rationale of the "chopping-and-knocking treatment" in such cases, copied from the writings of Dr. Neumann, of Graudenz.

"Dr. N.," says he, "finds an analogy between the excrescences of the endocardium (which he considers as the products of a previously inflammatory state), and the fibrous or tendinous texture of cicatrices from ulcers, which had formerly been of very long standing [sic]. As indirect pressure can [cannot ?] be used for increasing the absorption of these excrescences, the movement is substituted by vibrations, point-shakings, choppings, percussion, &c." (p. 218.)

After all, then, the heart, the important organ so wonderfully guarded in our system from external injuries, will not escape the choppings and knockings" of the kinesipathic operation; but we should as soon expect that the excrescences would be knocked off by a few vigorous well-directed blows, as that they would be absorbed, by tapping the outside of the thorax. There may be indeed a hidden virtue in these tappings, which has not been revealed to Avenbrugger and to Piorry.

"Chronic catarrah of the stomach and bowels, flatulence and obstruction, are treated by movements increasing the activity of the abdominal muscles, the contraction of which produces a squeezing of the liver and gall-bladder, by which the excretion of blood and gall is promoted as in a sponge!" (Richter.)

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Our author is eloquent on piles; see the following:

Suppressed piles causing [?] mental diseases. After a sudden spontaneous or artificial stoppage of discharge of blood or slime, persons suffering from piles often become lunatics; these must be treated immediately, without any loss of time, by movements acting very violently on the brain, which must all be done in a horizontal position, and the patient must be overturned [!!], and as quickly as possible kept up and down by the assistants.

"Many fear this overturning, because they wrongly believe that the blood acts only by its weight, and that it comes in too great a quantity to the brain; if the first were the case, the blood would never flow to the head in an upright position; with respect to the too great quantity, the blood is pressed on to the brain only, if the patient being nervous retains his breath, and actively resists while his trunk is moved up and down. overturning is made by the assistants, the head becomes cool," &c. (p. 227.) If the patient is entirely passive while the

Whether a lunatic patient, or even a sane one, would be likely to remain passive under such violent manipulations, we leave to our readers to decide. We observe at page 235, that a similar mode of treatment is spoken of for the cure of epilepsy; and at page 257, when speaking of mental disease, a system resembling the ancient mode of treatment by the turning-chair is seriously advised.

"It is to be observed, that mental disease has been successfully treated by mechanical influences; as, for instance, by the turning-table, on which the patient, with his feet towards the centre of motion, is fastened in a supported sitting or lying position, and then, by a mechanical apparatus, turned round in a slow, quick, equal, or decreasing manner. this manipulation is manifested by the change in the respiration or pulsation, by the production The curative effect of of giddiness, and an uncommon excitement of the conestesis. This has been useful generally in melancholy and obstinate patients; also to those suffering from fits of insanity, and in mania with a suicidal tendency. Quiet and indolent patients have been roused and excited by this