Then, after a table of the principal symptoms and causes of the cases recorded in the paper, Dr. Gull proceeds :

"The general symptoms attendant upon the formation and presence of abscess in the brain occur equally in hydrocephalus. In both diseases, acute changes may be going on within the cranium, though the head and extremities remain cool. The altered respiratory rhythm; the slow, occasionally intermittent, pulse; sluggish pupils; vomiting and constipation, are evidence only of an oppressed medulla oblongata, which may arise from many causes. "Rigors are not amongst the constant symptoms. They appear to be more frequent in inflammation of the lateral sinus, or when pus collects between the dura mater and bone. The nervous tissue yields readily, and hence, probably, the tension which excites rigor is not commonly produced by the formation of pus in its substance."

And, again :

"There are no sure criteria of the seat of the suppuration even whilst there is the strongest probability of its existence. The following cases, and the recorded experience of others, show that there may be pain in the forehead, with abscess in the cerebellum, pain in one side of the head, whilst the abscess is in the other hemisphere, and even no symptom but drowsiness, though suppuration is extensive. The not unfrequent occurrence of more than one abscess is also a further complication of the diagnosis. Even where abscess follows injury to the scalp, it is not so entirely under the external wound as to make us sure of evacuating the pus by an incision. Clinical experience shows, however, that the brain-tissue will bear more mechanical interference than might have been supposed, and encourages the hope that as knowledge increases even bere, our power may increase with it. Detmold's case, notorious from the doubts as to its veracity and the subsequent testimony to its truth is a striking illustration. Though life was not ultimately saved, it was prolonged by the surgical interference, and for a time consciousness and reason were quite restored. It might be of the highest importance in a similar case if this only could be effected.

"According to Lebert, there is no recorded case of cerebral abscess undergoing the process of cure. It is not improbable that, apart from the fatal tendencies of the malady, the prevalent use of mercurials as remarked upon at the beginning of this paper, may have had its share in this unfavorable history."

On some of the more Obscure Forms of Nervous Affections: their Pathology and Treatment. With an Introduction on the Physiology of Digestion and Assimilation, and the Generation and Distribution of Nerve Force. By HARRY WILLIAM LOBB, L.S.A. and M.R.C.S.E. (London: Churchill, 1858.)

Mr. Lobb, in the first part of his work, advances opinions, both in physics and physiology, which are diametrically opposed to those ordinarily received. One or two examples will convey a notion of Mr. Lobb's matter and manner. Adopting a system of molecular physics (which would seem to have scarcely any other foundation than ingenuity) he makes this the master-key with which to unlock several of the mysteries of physiology. He assumes that "the ultimate atoms of all matter are spheroids in a state of vibration" (p. 6); vibration gives rise to certain definite currents; "currents in the spheroid produce rotation; rotation will continue the currents; they, therefore, contain within themselves the elements of their own existence" (p. 8); the currents are electrical currents, and as a consequence we have the conclusion that, as no change of any description can take place in matter without causing currents of electrical fluid, and as the combinations and disruptions which take place during an act of growth, and which occur through the agency of what is termed vital force, or as Mr. Lobb prefers to term it, cell force or cell electricity, are always accompanied by molecular changes, therefore, "Vital force is merely a modification of that remarkable fluid pervading all matter and space, always aiming at equilibrium and yet so easily disarranged" (p. 11).

Mr. Lobb's views will scarcely supersede the views of Mr. Groves and Dr.

PART XXVII.

15

Carpenter, the former of whom has dealt most ably with the physical relations of electricity, and the latter with the physiological. (On the mutual Relations of the Vital and Physical forces," Phil. Trans." 1850, Part II.)

Mr. Lobb advances a theory of the formation of chyle-cells. He states that the initial step in the formation of the cell is the vibratory movements of certain minute crystals of phosphate of lime. These crystals during vibration become coated with the proteine and oily compounds of the chyle forming molecules. "When many of these molecules are formed, they, upon approaching one another, become attached in a line like a small string of beads, vibration still continuing; when a certain number are thus joined, they double one upon another, forming a nucleus, to which minute atoms are continually added until a tolerable aggregation is the result; this is a mass of molecules. The external atoms now proceed to form a cell wall, which, in this period of its existence is completely invisible: but it consists of minute atoms, between which are still smaller interspaces, which admit of the passage of fluids," &c. (p. 31). A sad shortcoming of this theory is the absence of all proof of the process of formation here said to take place.

As another example of Mr. Lobb's mode of reasoning, the following may be quoted: "Carbonic acid gas is constantly, day and night, winter and summer, although in varying proportions according to circumstances, being excreted by the blood in the lungs; the repair of tissue surely does not require this immense waste of material. The most idle man-the fat unwieldy inhabitant of the Eastern harem, who is afraid to move lest she should lessen her value in the eyes of her lord by losing a portion of her obesity, eats largely. Merely to throw off this waste from the lungs? Surely not; there must be a cause, and it is this.

"The nutriment absorbed by the lacteals, converted into albumen, fibrine, and blood cells, is conveyed into the most minute interstity of the organism by the capillaries; here the oxygen brought by the blood seizes upon some hydrocarbon with which to unite, giving rise to molecular change-to currents of electricity; these currents are collected by the nerves always accompanying the vessels, and serve to feed the nervous system; at the same time, some portion correlates into animal heat, &c. It is then to feed the nervous system that this tissue-change, beyond that really required for repair, is constantly going forward, and so much carbonic acid is excreted from the lungs. It is not, then, a wilful waste, this apparent carbon; on the contrary, life could not last without it-nervous energy would lessen, the extremities and skin would get cold-circulation would become sluggish, and death eventuaily ensue" (p. 82).

It is, certainly, a somewhat novel view to regard the carbonic acid given off by the lungs as wasted material, seeing that that gas is commonly regarded as a deleterious product of the decay of some, and the metamorphosis of other tissues, and of the reduction of the carbon of the food, which reduction has especial reference to the maintenance of animal heat. No question of physiology has been more carefully and successfully investigated than that of the sources of the carbonic acid given off from the lungs, and its relationship to the amount and quality of food taken, and of the degree of metamorphosis going on in the different tissues of the body; but Mr. Lobb appears to ignore altogether the results of the researches on this question. Mr. Lobb, moreover, does not seem to be aware that the electrical conditions arising from changes going on in the intimate structures of the body, particularly in the nerves and muscles, have been made the subject of most successful experimental research by M. E. de Bois-Raymond and others, and that, in consequence, theories upon this subject which are not based upon experiment, are neither necessary nor admissible. When Mr. Lobb makes use of the expression "correlates into," e. g. "some portion (i. e. of the electricity) correlates into animal heat" (p. 83); he betrays a singular misapprehension of the signification of the term correlation.

In the second part of his work, Mr. Lobb treats of "certain affections of the nervous system, the symptoms of which are obscure, and which, if not alleviated, would develop themselves into organic degeneration, fatal disease, or

three miles and back to my house, and passed tranquil nights. The external part of the tumor was then, and is now, the size of a nut, and hard; the tracheal portion has entirely disappeared; the aortic aneurism seems to have made but little progress, and, with the exception of attacks of neuralgia in the face and head, and a chronic cough which troubles her every winter, she has been in good health since. She gave up the instrument more than ten months ago. Before she began to use it, a surgeon of great experience told me he expected the external tumor would burst in a day or two, and Dr. Laycock was of the same opinion. Of course, I cannot hope to avert the fatal termination we must always expect in thoracic aneurisms; but I am convinced, and so is the patient, that the compression of the vessels beyond the aneurism was attended with marked benefit, and was the direct cause of its hardening and subsequent rapid decrease in its size.

The Enlarged Prostate, its Pathology and Treatment; with Observations on the Relation of this Complaint to Stone in the Bladder. By HENRY THOMPSON, F. R. C. S., M. B., Assistant Surgeon to University College Hospital, Consulting Surgeon to the St. Marylebone Infirmary, &c.

This work is of a thoroughly sound and practical character. It contains a large amount of new matter and original thought, and it fairly and fully states what had been done by previous investigators in the same subject. It is a work, indeed, with which few readers can be dissatisfied.

The anatomy of the prostate, and the anatomical characters of the enlarged organ, form the subjects of the first two chapters; and here we find the result of not less than seventy original dissections and a careful examination of the dissections contained in the different metropolitan museums. What these results are may be seen by turning to the abstract of a previous paper which will be found in a former volume (xxv. p. 153), and here we will only say that the two points upon which most stress is laid are-first, that the "third" or "middle lobe" is a diseased and not a natural portion of the prostate; and, secondly, that there is an analogy between enlargement and tumors of the prostate and those of the uterus.

The alleged causes of senile enlargement of the prostate are treated of in the third chapter, and here, after stating the views generally entertained on the subject, enlargement of the prostate and uterus are shown to be identical in their nature, and probably in their causes.

"There is but one other organ in the body which is similarly constituted, as regards the nature of the constituent tissue, and in the manner of its aggregation. The uterus, like the prostate, is composed of the inorganic muscular tissue distributed in thick strata, so as in either case to form a thick mass, not in thin planes, as found in all the other organs in which this tissue appears. The tendency to become the seat of local and general hypertrophy, of isolated tumors and outgrowths of a special character, which both organs equally manifest, has also been demonstrated. Starting from this remarkable fact, it is difficult to resist the inference that this tendency to overgrowth, this disposition to generate fresh elements identical in character with those proper to the structure of the organs, has a source common to both, and perhaps inherent as a kind of structural, or perhaps functional necessity. The capability of this structure for exhibiting rapid and enormous increase under certain circumstances, is admirably exemplified by what happens to the gravid uterus. A dormant force is awakened through the presence of the impregnated ovum, and the weight and bulk of the organ is in a few months increased tenfold. Active determination of blood is coincident, and doubtless supplying the materials of nutrition, but not venous congestion, nor any one of the numerous alleged causes of prostatic hypertrophy already referred to. But the uterine function having ceased temporarily or permanently, the organ diminishes and returns sooner or later nearly to its original size. During the latter moiety of the term of reproductive activity, the uterus is exceedingly prone to develop formations, identical in structure with its own, but more or less isolated from the parent tissues, either in the form of tumors or outgrowths, and these are

at former periods, they have never been subjected, by attention, to a reflex mental process. Undoubtedly, under these latter circumstances, numberless thoughts, and reasonings, and ideas of external occurrences, pass forever from the consciousness; but this is far from being always the case; again and again will they return, without any systematic identification. And are not most of the phenomena cited by Dr. Carpenter in support of his theory of unconscious cerebration explicable by these laws of spontaneous thought, according to which our mental operations are frequently unremembered when repeated. 'Of the thoughts which occur to us suddenly, and which appear to us purely spontaneous, not a few are reminiscences, more or less faithful, of what we have before read, heard, or thought; and, consequently, they proceed from a preparatory fact, which we do not remember.' (Balmez.)

"And yet this recovered thinking, when attentively regarded, will sometimes seem to have the lucidity and perfection of a special revelation, and may well seem as though it were the product of some unconscious operation of the mental organ. Still, by careful consideration and examination, we shall at times procure demonstration of the contrary. In composition, we frequently hit upon an idea, or a word, or the turn of a phrase; it strikes us as a happy thought, and appears to be the spontaneous evolution of our own minds. We afterwards discover, possibly by an accident, that we had heard or read it, yet we had forgotten all about it, and had believed it to be our own. And can we doubt that, in the same way, we sometimes recall our past thinking, deeming it to be new, because we have no conscious remembrance of it? Through ignorance of these laws of thought, or inattention to them, unjust accusations of plagiarism are sometimes made; but a writer is not a plagiarist, although he makes ideas his own which have originated with others. And it is often true that man imagines he creates, when he only recollects.' (Balmez.)

"In more particular illustration of these phenomena, it may be noted that a book shall be read and soon laid aside; the reader may then pass on to something else, and in a very brief period be unable to render any very clear account of what he has read. Some months afterwards, when the subject of the work becomes a topic of conversation, he is probably surprised that he has derived considerable information from it. How do we explain facts of this kind? Why, in many of such cases, the person situated as supposed in this illustration will discover, upon attentive self-examination, that in his passive musings the contents of the book had been in his spontaneous thoughts; and that, under such circumstances, an acquaintance with its subject had been gradually, but still consciously, perfected. This mental process may probably be with some accuracy designated involuntary and inattentive thinking, but not with justice an unconscious action of the brain. I am decidedly of opinion myself that the explanation now offered of these well-known phenomena will more or less cover all the psychical processes that have been cited to establish a doctrine of unconscious cerebration" (pp. 95-99).

Illustrations of the Constituents of Urine, Urinary Deposits, and Calculi.
By LIONEL J. BEALE, M. B., F. R. S. (London: Churchill, 1858.)

Dr. Beale has conferred a boon upon the profession by the publication of this work. The drawings are accurate and very numerous, the descriptions of the general characters of the deposits are clear, and the work is compact, and it will prove to be a valuable aid to the practitioner and student in examining the urine microscopically.

The Unity of Medicine; its Corruptions and Divisions as by law established in England and Wales, with their Causes, Effects, and Remedy. By a Fellow of the Royal College of Surgeons. (London: R. Bailliaire, 1858.)

A Fellow of the Royal College of Surgeons treats learnedly of the corruptions and divisions of medicine in England and Wales, investigating their causes and effects and seeking their remedy. He regards the existing division of the medical profession into physicians, surgeons, and apothecaries, as arising from three great periods of corruption in medicine. The first great period of corruption began with the invasion of medicine by priests and monks, during the

the treatment of retention of urine from enlarged prostate, enlargement of the prostate from inflammation, malignant disease of the organ, tubercular disease and cysts, the bar at the neck of the bladder, prostate concretions and calculi, form the subjects of successive chapters. There is much valuable matter under each of these heads, but we would especially instance the remarks upon the effect of enlarged prostate upon micturition, upon malignant and tubercular disease, and upon diagnosis and treatment. The last two subjects, indeed, are in every respect deserving of attention.

The last chapter is devoted to a careful consideration of that important, but not uncommon complication of enlarged prostate, stone in the bladder, and especially of the best modes of successfully applying lithotrity as a means for its removal.