Imagens das páginas

lengthened inquiry on this subject; and from the facts collected by him, he is led to conclude that the uterine organs suffer largely from, or participate in the effects of, syphilis upon the female constitution; and that such derangement is variously manifested by lesions of innervation, of menstruation, of mucous sècretion, and of reproduction; whilst, in its progress, lesions of the mucous membrane and of the structure of the cervix are met with, the exact relations of which to syphilis are less obvious, and cannot so specifically be determined. Whether the views of this writer are correct to the extent he has contended for, is a question which further inquiries must determine; but the subject in itself is one of great social and scientific importance, and well worthy of the consideration of those who, like our author, are professedly engaged in sifting and determining the value of medical evidence.

With this exception, very little indeed that is practically useful in contemporaneous medical literature appears to have escaped the attention of our author, and we are glad to find that in his commentaries upon some of the more recent novelties introduced into uterine practice, his opinions are in harmony with our own. Thus the value and pathological importance of inflammation and ulceration of the cervix uteri are reduced to their legitimate limits; the mechanical means proposed for the cure of various flexions, versions, and obliquities of the uterus are accepted with becoming qualification; and the indiscriminate division of the cervix uteri for the relief of certain forms of dysmenorrhea is justly represented as a hazardous and doubtful proceeding

ART. II.- On the Prevention and Treatment of the Sheffield Grinders'

Disease. By J. C. Hall, M.D., Physician to the Sheffield Public

Dispensary, &c. With six Illustrations.—London, 1857. AMONG the numerous arguments that may be adduced in favour of allowing our beards to grow instead of wasting our time every morning in scraping them off, not the least is, that it would render unnecessary the use of razors, and consequently, pro tanto, diminish the Sheffield grinders' disease. Dr. Hall brings good evidence to show the fatality among the men employed in grinding razors and other cutlery, owing to a form of chronic pneumonia produced by the inhalation of fine particles of steel given off in grinding Much may evidently be done to diminish the danger inherent in the occupation by protective appliances: thus we find that the average age of grinders at death at the works of Messrs. Rogers is 42, while in the Suffolk Works it is 38, owing to the difference in the arrangements at the respective manufactories. A characteristic feature in the expectoration, and in the lungs themselves, is the presence of large quantities of black matter, both disseminated through the organs and accumulated in globular spots over the surface. No steel appears to have been found in the lungs; but it would be interesting to know whether these lungs contain any unusual amount of iron, as it is not improbable that the steel inhaled might be altered

by oxidation, and thus in part give rise to the black deposit. The greater part of this must be regarded as a secretion from the blood, especially that found in the bronchial glands, which are also in a melanotic condition.

We recommend this contribution to the history of industrial pathology to the attention of all who are interested in this important subject, whether on scientific or on philanthropic grounds.

ART. III.The Asylum Journal of Mental Science. Published by

authority of the Association of Medical Officers of Asylums and Hospitals for the Insane. Edited by John CHARLES BUCKNILL,

M.D.-London, April, 1857. THE Association of Medical Officers of Asylums and Hospitals for the Insane is, it appears to us, admirably represented in the 'Asylum Journal,' of which we now have the twenty-first number before us. The general tendency of the periodical is one that maintains and fosters the vital connexion existing between the science of medicine at large, and its offspring, the science of mental disease. As long as derangements of the mind were regarded simply as a mysterious dispensation of Providence, offering no analogy with other forms of disease, it could not be expected that great advances would take place in our knowledge of their intimate nature. The fatalistic view was a barrier to all progress. A very able article, by Dr. Bucknill, in the April number of the * Asylum Journal,' is devoted to the consideration of the relation of mental pathology to the physical agent of the mind. The path which the author pursues is, to our appreciation, one of legitimate induction; and we cannot but think that the physiological principles upon which he builds his superstructure are correct in the main. The essence of his views may be given in his own words :

“Mental health is dependent upon the due nutrition, stimulation, and repose of the brain; that is, upon the conditions of the exhaustion and reparation of its nerve substance being maintained in a regular and healthy state; and that mental disease results from the interruption or disturbance of these conditions."

This doctrine receives considerable development, and is very ably supported, so as to merit the special attention of all who are interested in the study of the human mind, in its healthy or diseased manifestations. We meet with Dr. Bucknill again in the same number, discussing the important question of asylum architecture and arrangements.

Dr. Wood, formerly the medical officer for Bethlem, brings forward strong arguments for the establishment of a State Asylum. The present condition of criminal lunatics appears to be one calling for speedy reform :

“Monstrous as it must appear to all who ever give a thought to the subject, the acquittal, of whatever offence, on the ground of insanity, leaves no alternative. The unfortunate offender may not now be dealt with but as the most atrocious villain who ever disgraced our nation. Of gentle, or it may be noble birth, it matters not that he may up to this moment have pursued a virtuous, honour

able, and useful career; the law recognises no distinction between such a one and the convicted felon who has become insane while undergoing his punishment.”

The principle upon which the reform should be carried out is mani. fest. We trust that Dr. Wood will not be deterred by the difficulties that meet all innovators from pushing forward his propositions until they are realized.

Dr. Tuke supplies a paper on the various forms of mental disorder, and Dr. Boyd furnishes one on epilepsy ; both deserving of careful perusal. Reviews and Retrospects complete the number.

ART. IV.The Functions and Disorders of the Reproductive Organs in

Youth, in Adult Age, and in Advanced Life, considered in their
Physiological, Social, and Psychological Relations. By WILLIAM
ACTON, late Surgeon to the Islington Dispensary, and formerly
Externe to the Venereal Hospitals, Paris.- London, 1857.

pp. 108.

WE doubt whether, among our human relations, there is one that exerts a greater influence upon most of us than that which draws its impulses from the sexual feelings. Indirectly, it governs the whole life of the female, from the time at which she dandles her first doll to the time when she teaches her grandchild“ pattycake, pattycake;" — the vices and the virtues of the sterner sex-less confessedly, perhaps, but no less really-result from the vagaries and dreams of boyhood, or the waywardness or resolution of adult age, that are prompted by the sexual instinct. No Draconian law can fetter the strongest impulses of our nature, and yet from the commencement of society, religion and social morality have enjoined the necessity of restraint; the highest rewards being the necessary lot of those who keep their body in subjection, while the train of evils, physical and moral, which inevitably pursue the Claudios of society, are almost identical with the miseries that surround us on every side; and yet, though so fertile a source of wretchedness,-though

“Our natures do pursue,
Like rats that ravin down our proper bane,

A thirsty evil," – what has been done, beyond passing certain enactments, which all but connive at the wide-spread taint, to check the social plague, and to spread a knowledge of the laws which bind together the physical and moral duties of man? The youth is left, in the most important question of life, to learn by sad experience-experience that often is synonymous with ruin- what he ought to have aroided; he is introduced by the very men who most should guard him and guide him, to the debaucheries of heathen mythology; and the silly prudery wbich ignores the sexual feelings of the adolescent, allows him to revel in the prurient tales of Lemprière. But who shall teach the guides and open their eyes? We have here one additional argument to the many that have already been urged, for the spread of a knowledge of physiological

laws among the laity. Let the teachers of youth be able fully to appreciate the bearings of the questions at issue; let them know that the enemy must be met by an acquaintance with his wiles and pitfalls, and by self-control, and there is no doubt that, their eyes once opened, they will discover the proper means and occasions for giving the necessary information to those committed to their charge. With Mr. Acton, we would raise our protest against

“Allowing men of a larger growth to remain in their present profound ignorance of all appertaining to sexual matters, except such as they may gather from experience, or the equally vague and erroneous conversation so often heard in smoking-rooms, at supper parties, or that equivocal and unscientific information read with such avidity in newspapers--as disclosed in divorce cases and actions for crim. con."

Sexual excesses are the monster evil of the present, no less than of former times; it is not, except in particular forms, a subject for legislation, because legislation cannot reach it; but it is essentially a subject for the clergyman and the schoolmaster to deal with. It is folly to ignore what every man who has been at a school must know to prevail. It is wisdom to avail ourselves of the holiest aspirations of the youth to enable him to shun evil, not from fear-though from fear, if need be—but from a just appreciation of the immutable laws which may be traced equally in Holy Writ and in natural theology. We think Mr. Acton has done good service to society by grappling manfully with sexual vice, and we trust that others, whose position as men of science and teachers enable them to speak with authority, will assist in combating and arresting the evils which it entails, and thus enable man to devote more enduring energies and more lofty aims to the advancement of his race, and to the service of his God.

With these few remarks we would specially introduce Mr. Acton's book, which forms a separate edition of a part of the third edition of his larger work 'On the Urinary and Generative Organs,' to the favourable notice of our readers. We would desire to see its subject made a matter of meditation by many out of the profession, and especially by the teachers of our young generation.

“The continent student will find reasons for continuing to live according to the dictates of virtue. The dissolute will be taught on positive and irrefragible grounds the value of self-control. The married man will find advice and guidance, and the bachelor, who is often placed in a trying social position, will glean consolation from observing that not only are his sexual sufferings appreciated and understood, but that rules are given him for their mitigation.”

These words, which we quote from the preface, indicate truly the scope of the work. Although it contains some passages which we think might be advantageously omitted, we are of opinion that the spirit which pervades it is one that does credit equally to the head and to the heart of the author.

[ocr errors][merged small]

ART. V.-Medical Examinations and Physicians' Requirements Con

sidered. By THOMAS Mayo, M.D., F.R.S., President of the Royal

College of Physicians.—London, 1857. Pamphlet. The character of examinations ought necessarily to vary with the objects for which they are instituted. As the introduction of competitive examinations into the Civil Service has roused public attention to the question, Dr. Mayo enters the lists to do battle in favour of the system hitherto pursued at the College of Physicians. Although we are not aware that the mode of examination followed by that ancient body has been impugned beyond the College doors, and do not therefore perhaps quite appreciate Dr. Mayo's motive for defending the system, we think with him, after considerable personal experience in the matter of examinations, that it is on the whole well adapted to determine the qualifications of candidates who desire to receive the stamp of the highest medical corporation of the country.

It would appear that the College of Physicians proposes, by its examinations, to ascertain whether a candidate for its license possesses a large practical acquaintance with disease, and a mind imbued not only with classical taste, but with that power of observing nature and appreciating vital and morbid phenomena in all their phases, which in itself is a proof of a thoroughly well-trained mind. If there is one thing wanting to render the examination of the College complete, it is that a further test should be applied of the practical tact and knowledge of the candidate, by allowing him to prove his aptitude at diagnosis and treatment at the bedside. Dr. Mayo, who is desirous to prevent the introduction of competitive examinations into the College, observes very justly, that

“Nothing can be more fatal to the evolution of continuous thought, than at the age at which ultimate habits are forming, to be involved in the preparation of four or five departments of severe thought against an examination. Neither time nor occasion to master them, but every inducement to adopt the perfunctory process, which will secure well-compacted answers to probable questions, the mind leaving each part of the subject as soon as this point is gained. Such, I believe, has been the state of things, and its result, in many cases of University honours. The candidate grasps his prize before the subjects of it have had time to settle into his mind, and the books which he had for that purpose lie cold on his table for the rest of his life.”

The tendency of competitive examinations is to induce the candidate to pay special attention to subjects which, however important in themselves, are more calculated to impart scientific distinction, than those qualities which are most required to fit the individual for the practice of his profession. Dr. Mayo's pamphlet in no way conveys that he underrates classical and mathematical attainments, and the study of the vast range of sciences auxiliary to medicine; he merely explains the grounds upon which he is opposed to the introduction into the College of Physicians of competitive examinations, and of examinations repeated at varying intervals.

The author concludes his observations with a graceful tribute to

« AnteriorContinuar »