He gives a table of the probability of life among the Romans, taken at different ages, for the purpose of making certain calculations. But its results being so widely different from those of any well-authenticated tables, it must certainly be confessed that no importance can possibly be attached to them.

According to the researches of Marshall, it would seem that the probable life among the inhabitants of London has increased by about seven years within the last century, and the average life, during the same time, by about five years; the latter being, in 1728-39, 25 years; and in 1820-29, 30 years.

A still greater augmentation than this seems to have taken place among the inhabitants of Geneva, where life has gained, it has been calculated, nearly 40 years in the course of two centuries. This very rapid increase is however doubtless attributable, in part at least, to the cessation of the plagues and famines which used frequently to devastate this republic.

At Berlin also, the value of life has, it is calculated, increased by 4 years in the course of half a century.

We must not forget to mention here the important discoveries of Mr. Finlayson on this subject.

This gentleman has found that the mortality throughout England has singularly diminished during the past century; but that this diminution has not been equal at all the epochs of life, nor to the same extent in the two sexes; for, while the mortality among youths and adult men seems to have remained nearly stationary for the last, fifty years, that among girls and women has decidedly decreased.

Mr. Finlayson has also compared with great care the average duration of life in persons who had insured during the 17th and during the 18th centuries, and he has found that in the course of 96 years there has been a gain of

These results shew that the easy and affluent classes in England have during the last century made immense progress in what the Greeks would call MacroLiotechnie.

This progress however, has been, as indeed might be expected, much greater among the inhabitants of large towns than among the residents in the country. We may also add here, that the average duration of life in the whole human race will probably never exceed 33 years or thereabouts, and that it will need many ages of progress still to come, before even this ratio is attained.

Before concluding our remarks, we shall add a word or two on some of the causes which have probably operated in enhancing the value of life in modern times. Not to dwell upon the comparative infrequency of pestilential maladies, the partial—would that we were not obliged to use this epithet-subjugation of the small-pox, the superior cleanliness of our large towns, the numerous modes and appliances of relief to the destitute and sick, it may be reasonably believed that the improved condition of the healing art has contributed somewhat to the prolongation of human life.-Bulletin Medical Belge.

ON THE TREATMENT OF ENCYSTED GANGLIONIC SWELLINGS.

M. Baudens, one of the leading military surgeons in France, prefaces some remarks on the treatment of such tumors, by alluding to the remarkable occasional increase and decrease in the frequency of certain diseases, which cannot be supposed to be at all dependent upon atmospheric vicissitudes.

"There are," says he, "some maladies which seem to disappear entirely from the nosological catalogue for three or six months at a time, and again to make their appearance in groups of four, five, or more at a time, without our being able to assign to such phases any epidemic cause. We may account for the occasional prevalence of such diseases as erysipelas, typhus, small-pox and so forth: but no condition of weather can well be supposed to influence the frequency of fractures, sprains, hydroceles, sarcoceles, &c. such as during the last two years we have observed in this hospital, (at Lille)-at longer or shorter intervals of time, and sometimes in the number of five or six on one day of clinical admittance." This remark holds true of encysted swellings also, aneurysms, and many other surgical disorders.

M. Baudens then gives the following description of the mode of development of ganglionic swellings :

If the sheath of a tendon, which has been subjected to strong muscular efforts or to any prolonged compression, happens to give way at one point of its circumference, either spontaneously or from ulceration or from some other cause, the synovia escapes into the surrounding cellular texture, and a swelling, not unlike to an incipient aneurysm, follows; and according as there is a rupture or only a mere dilatation of the enveloping tissues, so is the swelling either circumscribed or diffused. It is more than probable that the bursa is in almost all cases merely dilated, and not ruptured; as we know that the most successful practice in dispersing ganglionic swellings is to cause their contents to be effused into the adjoining cellular tissue. These contents, while still within the cyst, sometimes undergo considerable changes: by either becoming thicker, and gradually acquiring a steatomatous consistence, or by hydatidiform nodules being slowly developed in the fluid. The latter change is often indicated by the tumor acquiring a peculiar crackling sensation on being squeezed between the finger, or when pressed on; this arises from the rubbing of these nodules, the one upon the other.

Treatment. If ganglionic swellings form quickly, and especially if they be attended with pain and uneasiness, the application in the first instance of a few leeches, and subsequently of mercurial ointment, may suffice to dissipate them. Of late years, M. Baudens has succeeded in dispersing the synovial tumor in almost every instance, when the disease has been more chronic, and has resisted these measures, by having recourse to acupuncturation, in such a manner that the contents become diffused in the surrounding cellular texture. When the contents of the sac are too thick to permit its ready escape in this manner, we should then use in place of the needle a cataract knife, which may be introduced readily under the skin, and with which the walls of the cyst may be freely divided in numerous directions. The admission of air into the intetior of the sac is thus altogether prevented. The part should then be immersed in cold water for several hours, and firm compression be afterwards kept up by means of compresses and bandage.

This practice is very much preferable to the incision, or the extraction, of ganglionic swelling the former of these methods being not unfrequently followed by most troublesome symptoms, and the latter being very unnecessarily severe. It is of great consequence to avoid the risk of severe inflammation attacking the tendons on which the ganglions have formed; as their free movements are after such attacks almost always most seriously injured. When the

ganglion forms under the transverse ligament of the carpus, it is sometimes necessary to divide this across, before a cure can be effected. Before however having recourse to this operation, we should give a fair trial to the gentler one of opening the sac freely under the integuments with a cataract-knife, as recommended above.

M. Baudens has repeatedly adopted the practice of rupturing ganglionic tumors by firmly squeezing these between the fingers, or striking them smartly with a book. He prefers, however, the plan of puncturing them with a needle, or with a small cataract-knife.-La Lançette Française.

CASE OF MILKY URINE, WITH ITS CHEMICAL ANALYSIS.

A lady, born in the Isle of France, observed in her twenty-fifth year, for the first time, that her urine was remarkably milky. This peculiar state continued for nearly three weeks, during which her general strength diminished very sensibly. From this period of life to the age of seventy-five, the urine was every now and then of a milky aspect, or glairous and viscid, occasionally becoming almost gelatinous, and not unfrequently having a good deal of blood mixed with it. Whenever this unnatural condition of the secretion was present, her strength and appetite decayed. When seventy-six years old, she left the Isle of Bourbon and visited France. For a twelvemonth previously, the urine had been natural, and her general health good. During the voyage to Europe, however, the water became thicker and whiter than it had ever been before, and her strength was much reduced. When she reached Paris, she had several inflammatory attacks on the chest. During these it was always observed that the urine was clear while the diet was low, and became milky, glairous and blended with blood, when the patient took any nourishing food.

From this time, her health became much more enfeebled, and the system was seldom or never free from a feverish irritation. Bark, steel, and various astringents were administered; but not with any success. More benefit was obtained from morphia than from any other remedy.

M. Quevenne, who carefully analysed the urine, has appended the following conclusions to the account of his experiments.

1. The urine exhibited none of the characters of milk except its whitish aspect; and, when examined with the microscope, no traces of fatty globules or of caseum were discoverable.

2. The white appearance of the urine in the present case cannot be attributed to the admixture of purulent matter, as the microscope displayed only a very few globules which could possibly be taken for those of genuine pus ; and moreover the urine, when allowed to stand, remained quite opaque and homogeneous -which would not have been the case if there were any purulent admixture with it.

3. If we consider that the urine in this case exhibited under the microscope sanguineous globules, and also that the fatty matter blended with it was in a peculiar state of suspension or combination not recognisable by the microscope -a condition to which we find an analogous one only in the chyle-we are naturally led to the idea that this fluid, the chyle, had probably found its way into and become blended with the urine. In this way we can account for the superabundant secretion of fatty matter, and for the marked diminution in the proportion of the usual salts found in healthy urine.

These analytical conclusions agree well with the numerous observations reported by M. Rayer in his Memoir on the Hæmaturia of the Isle of France, and also with the experimental remarks of M. Guibourt on the case related in the Journal Experience for May, 1830. (Vide Medico-Chirurgical Review, July, 1839.)-Journal des Connoiss. Medicales.

CLINICAL REVIEW.

TWENTY-FIFTH AND TWENTY-SIXTH ANNUAL REPORTS OF THE DIRECTORS OF THE GLASGOW ROYAL ASYLUM FOR LUNATICS, 1839, 1840.

We hail the appearance of these Reports from various Lunatic Asyla with feelings of unmitigated satisfaction. They are at once the evidence of improvement effected in the management of the insane, and the guarantees of continued progress in the same direction. We shall draw attention to them upon fitting opportunities, and notice whatever seems to merit it.

1. In the first of the Reports before us, (the Twenty-fifth) we are informed that, of the patients whose treatment has, in the course of the year, been concluded by dismission or death, the cured amount to 47 per cent., the dismissed uncured to 38 per cent., and the dead to 14 per cent.

Several of the cures were highly satisfactory. For example:-one of the female paupers had been for seven years a patient in the Asylum. She had, in the course of that time, been several years subject to paroxysms of fury, and afterwards (in place of these paroxysms) to severe attacks of tic doloureux; but in the course of the last six months of her treatment, she recovered completely from all her ailments, both of body and mind.

To be able, say the Reporters, to arrest attention by any motive, or any impression sufficient to counteract delusion, is often the first symptom of convalescence, whether we choose to consider it as a cause or as a consequence; and in several cases it was not a little interesting to observe the means whereby a patient sometimes seemed to be aroused from his insane dream. In one case, in which a female patient had taken the most violent and groundless dislike to her family, the tidings of the death of a son in a foreign country, excited in her the desire to see her surviving children. This desire recalled all her parental affection, instantly sweeping from her mind her insane antipathies, and restoring her at once to right feeling and to reason.

Suicide. The propensity to suicide existed in no fewer than 29 cases, viz. 12 males, and 17 females, all of them requiring no small degree of vigilance. The attempt at starvation is often persevered in with the greatest obstinacy, and compulsory feeding was resorted to in seven cases. It was remarkable that no fewer than six of these seven patients were females, probably because the principle of imitation operates more powerfully with them than with males; and whensoever the feeding apparatus is in any case employed, the use and object of it are unavoidably known throughout the ward to all the other patients who are capable of any degree of rational reflection. In one case the operation had to be performed twice daily, and sometimes oftener (for the exhibition of wine and medicine, as well as of food), during the long period of six weeks; in others, from a few days to two or three weeks. Some were speedily convinced of the folly of resistance, and resumed, in the course of a day or two, the natural use of their powers of swallowing.

Mortality. The number of patients who died, and the denomination of the diseases which proved fatal, were as follows, viz.—

Coercion." In connexion with other improvements in the treatment of the Insane, we, at an early period of our Institution, made it our especial study to render the means of coercion, when necessary, as gentle and as little irritating as possible; but some degree of personal restraint is in many cases indispensable, and howsoever gratifying the idea may be to the speculative philanthropist, the entire abolition of coercion is too often compensated by concealed severity. When we hear a vulgar and uneducated keeper boasting that, by a glance of his eye, or the turn of his finger, he can control a whole ward of the insane, we can guess pretty well how this seemingly mysterious power was acquired; and it would be well if those who visit madhouses would carefully study the countenances of the lunatics when the keeper approaches, and when he turns his back to the patient. An attentive observer might thus sometimes discover a strong and instructive contrast between the subdued and counterfeited expression in the one case, and the suspicious and revengeful scowl in the other."

There is much good sense in this. We observe that at some of our public institutions a great parade is made of the abolition of coercion. The gratifying fact is advertised in all the papers, and the public press rings with the humanity and skill of the doctors. But experience is yet wanting to confirm both, and to prove that a dangerous extreme has not been plunged into. Every body acquainted with the insane, is aware of the pernicious self-pollutions which too many are addicted to, and the injury both to body and mind which they must of necessity give rise to. We should pause, therefore, before we give our unqualified assent to the total, or nearly total, abolition of restraint, and wait for time to set its seal on the discretion of those who counsel it.

Divine Worship." In our last, as well as in numerous former Reports, we bore testimony to the good effects of Divine Worship on the minds of the insane, and our further experience continues to warrant our former sentiments. In many instances, the personal and private, as well as public, ministrations of our worthy Chaplain have carried comfort and consolation to the minds of many of our patients, who are occasionally much troubled with distressing apprehensions on religious subjects. We subjoin, in his own words, a statement of the success which continues to attend his labors in the pulpit, and of the manner in which these labours are conducted: The exercises of Divine Worship, in which many of our patients have the privilege of engaging, are attended with the most beneficial results. This is evident from the deep interest they take in the discourses delivered to them, and the fact that these are the means of withdrawing their attention, for a short time, from their prevailing illusions. The sermons delivered in the chapel are adapted, as much as possible, to the peculiar circumstances of the audience. Everything that is conceived to have a tendency to agitate their minds is carefully avoided, and pains taken to present them with the most soothing and practical views of Divine truth. Two very important advantages, then, are derived to our patients from the institution of Public Worship;-it is of use in alleviating the malady under which they