might have thought themselves at liberty to save themselves the tedious labour of compiling an index as well as a "Classified Contents." The latter not only affords a very useful summary of the subjects elaborated in the body of the work, but serves also as a guide to the author's views on the classification of disease. Indeed, he has been true to himself, and we have little doubt that his cotemporaries and posterity will concede that his "attempt" " to arrest the attention, to engage it with an unflagging interest, to infix what is important or undisputed on the memory, and to carry on the mind, by an enlightened induction to a due recognition of pathological principles, and of therapeutical intentions and precepts," has been fully realised. Thirty years of his life have been devoted to the work by the author, and he has, we are told, laboured on it alone and unassisted. To him alone, therefore, belongs that full meed of praise which such devotion, such labour, such energy deserve.

ART. II.-On Amputation by a Long and Short Rectangular Flap. By THOMAS F. TEALE, F.L.S., F.R.C.S., Surgeon to the Leeds General Infirmary.-London, 1858. pp. 72.

FROM tables published at length by Mr. Teale, compiled from the reports for the last few years in the Medical Times' and 'Gazette,' it appears that out of 640 amputations of the thigh and leg for accident and disease, nearly one in every three proved fatal. In cases of amputation of the leg for accident, as nearly as possible one-half died. When we add to this statement the fact, that however much a compiler may be distinguished for carefulness and honesty of purpose, yet that the favourable cases find their way into his lists more readily than others, it must be allowed that a safer mode of performing amputations is a great desideratum. In the corresponding tables, published by Mr. Teale, where the amputations were performed according to his new method, the numbers are not sufficient to admit of comparison upon all points, but as far as they go they must arrest and command attention.

"The amputations of the thigh for disease present 3 deaths in 17 cases, or nearly in the proportion of 1 to 6. In the London hospitals the ordinary amputations of the thigh for disease show a mortality of 1 in 44. In the Provincial hospitals the mortality is 1 in 4.

"The amputations of the leg for disease (by Mr. Teale's method) show a mortality of 1 in 27, which contrast most favourably with the ordinary modes of amputating. In the London hospitals these amputations are attended with a mortality of 1 in 33, and in the Provincial hospitals of 1 in 4." (p. 21.)

The risk of a fatal termination is, however, by no means the only evil to which a patient who is unfortunate enough to lose a limb is subjected. It appears from the statements of those who have had most experience in the adaptation of artificial limbs, that the cicatrix has, as a rule, been adherent to the extremity of the bone, and that it has continued for years in an irritable condition. Thus, after amputation of the leg and thigh, the best mechanicians have been unwilling

to allow any of the weight of the body to rest upon the extremity of the stump. Moreover, in cases where no weight has been allowed to rest upon the extremity of the divided bone, but has been distributed by means of a bucket over the surrounding parts, yet has there been "tenderness and pain occasioned in almost every instance where the integuments pertaining to the stump are forcibly drawn upward." "The end of the stump is easily inflamed and abraded by friction." (p. 68.) In order to remedy these evils, Mr. Teale proposes his new plan of operating.

"The chief advantages of this mode of operating are: "1st. The avoidance of tension.

"2ndly. The formation of a soft covering for the end of the bone, consisting of parts free from large nerves.

"3rdly. The non-disturbance of the plastic process, and consequent placing of the large veins of the limb, as well as the smaller veins of the bone, in a condition the least likely to take up purulent matter, and putrid blood or serosity.

4thly. The favourable position of the incisions for allowing a free outlet for purulent and other discharges." (p. 10.)

The mode of performing the operation is by making two parallel longitudinal incisions, one on each side of the limb. These extend through the skin only, and are to be of the length of half the circumference of the limb. They are joined at right angles by two other transverse incisions which go down to the bone. The transverse incision for the upper or anterior flap is at the lower or distal extremity of the longitudinal incisions; the transverse incision for the lower or posterior flap is made so as to allow the flap to be one-fourth only of the length of the upper flap. The vessels and nerves are always to be left in the short flap. The flaps are dissected from below upward, and the bone is sawn through on a line corresponding with the upper extremities of the longitudinal incisions. The long anterior flap is then folded upon itself over the extremity of the bone. The reflected portion is connected with the other parts of the long flap, and also with the extremity of the short flap, by means of sutures, and the stump laid upon a pillow without dressing. The chief peculiarity of the stumps formed by this mode of operating "consists in their having a soft mass of tissues, devoid of large nerves, moveable over the sawn end of the bone, which enables them to bear pressure on their extremity." (p. 27.)

We heartily recommend Mr. Teale's mode of operating to the serious consideration of every hospital surgeon.

ART. III-A Manual of Photographic Manipulation, Treating of the Practice of the Art and its various Applications to Nature. By LAKE PRICE.-London, 1858. pp. 256.

THIS is one of the most compact and useful handbooks which have yet been published, with a view to giving students of the photographic art instruction on the subject. Mr. Price is well known as a

clever manipulator, and has probably acquired his dexterity at the expense of much time and in spite of frequent disappointments. For these all beginners must be prepared, but with perseverance they may attain to success, and they can have no better guide than Mr. Price.

ART. IV.-Demonstration of Diseases in the Chest, and their Physical Diagnosis. By HORACE DOBELL, M.D., Licentiate of the Royal College of Physicians, &c.-London, 1858. pp. 115.

ALL who have earnestly sought to master the physical diagnosis of diseases of the thoracic viscera, have probably experienced the difficulties which have led Dr. Dobell to present us with the volume before us, which is intended to enable the student to interpret correctly the signs offered by auscultation and percussion. Although no explanations or drawings can serve as a substitute for personal study at the bedside, the labours of the student may be much abridged by a clear enunciation of the acoustic principles involved, and by an exposition of the manner in which structural lesions induce deviations from the phenomena belonging to the normal state. Dr. Dobell professes to meet these two requirements, and we think that both his intentions and his execution deserve considerable praise. The first three chapters of the work are devoted to the consideration of the laws of acoustics so far as they are applicable to the physical examination of the chest; and it is important that the student should explain the phenomena he meets with by reference to these laws, rather than by regarding the former as indications pathognomonic of certain diseases. Having acquired a knowledge of the properties and conditions of matter necessary to the production of acoustic phenomena, he will be in a position to understand the relation that may be established between certain lesions and those purely physical effects. To employ the author's words

"Three conditions are essential to a knowledge of auscultation: 1. To understand the acoustic conditions necessary to the existence of different sounds. 2. To know these sounds when heard, and to connect them with their essential acoustic conditions so intimately that they shall stand to the mind as symbols of such conditions. 3. To associate the conditions thus symbolized with the processes of health and disease necessary to their existence in the human organism."

In order to promote the fulfilment of the third of these conditions, Dr. Dobell has adopted a plan that is novel in a work of this kind, of representing in a series of well executed coloured plates the actual lesions which are met with in the dead body, and which give rise to various deviations from the auscultatory phenomena recognisable in health. And although we quite agree with the author's remark, that a sound must be heard to be appreciated or remembered, we do not hesitate to say that the student who, after the examination of a patient, refers to this book, will have a much greater facility in understanding the rationale of the phenomena and of interpreting them correctly, than one who is satisfied with comparing what he hears to the descriptions of sounds given in handbooks, or to some typical

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sound pointed out to him by his teacher. The training of the understanding is as important in this department of medical diagnosis as in any other; and however valuable a powerful memory, it cannot be made in any way a substitute for the former.

From the title of Dr. Dobell's book, the reader might be led to expect a treatise upon all the diseases occurring in the chest. Only the more prominent forms of pulmonary disease are alluded to; diseases of the heart are not even touched upon; but what the author gives is well done and in the right direction.

ART. V. Fragmentary Remains, Literary and Scientific, of Sir Humphry Davy, Bart., late President of the Royal Society, &c.; with a Sketch of his Life, and Selections from his Correspondence.-Edited by his Brother, JOHN DAVY, M.D., F.R.S.-London, 1858. pp. 330. Ir is well now and then to be reminded of the debt we owe to the great men of the past by such memorials as the one which Dr. Davy presents to us to learn the marks by which the advancing waves of civilization may be traced in the history of human development, is an important duty which may not be neglected by those who care for the progress of mankind. Sir Humphry Davy was one of the master minds of the present century, whose name belongs not to the annals of chemistry alone, but deserves to be inscribed among the benefactors of humanity of all time. The present volume is a monument of the fraternal affection which bound Sir Humphry to his younger brother John, a physician whose independent researches have given him a high rank among the physiologists of the day. The editor brings before his readers a large number of letters, which possess almost throughout a double interest, attaching to the writer as well as to the receiver. Thus few will take up the book without being rivetted by the romantic sensibilities displayed in Coleridge's numerous epistles; while the wide scope of intellect, the depth and warmth of feeling, the poetic glow, which manifest themselves in all that emanates from Sir Humphry himself, enhance our admiration of the man which his achievements in science have already secured for him. The following extract from a letter written by Sir Humphry to Coleridge, whose admiration of him seems to have savoured of idolatry, will at once show the relation in which they stood to one another, and the estimate Davy had formed of his friend. The epistle was written before Coleridge's departure for the Mediterranean in quest of health :

"Years have passed since we first met; and your presence and recollections in regard to you, have afforded me continued sources of enjoyment. Some of the better feelings of my nature have been elevated by your converse, and thoughts which you have nursed have been to me an eternal source of consolation.

"In whatever part of the world you are, you will often live with me, not as a fleeting idea, but as a recollection possessed of creative energy, as an imagination winged with fire, inspiring and rejoicing.”

This is the very poetry of friendship; and what encouragement and

cheering comfort is contained in the following words, written on the same occasion:

"May you soon recover perfect health-the health of strength and happiness! May you soon return to us, confirmed in all the powers essential to the exertion of genius. You were born for your country, and your native land must be the scene of your activity. I shall expect the time when your spirit, bursting through the clouds of ill-health, will appear to all men, not an uncertain and brilliant flame, but as a fair and permanent light, fixed, though constantly in motion,-as a sun which gives its fire, not only to its attendant planets, but which sends beams from all its parts to all worlds."

Those who are familiar with the former memoirs of Sir Humphry, will remember the various pieces of poetry by his pen, indicating no mean talent in their author; we cannot evince our appreciation of Sir Humphry's poetic vein better, or place before our readers a more convincing proof of the justice of our praise of the man, than by transferring to these, it may be too unpoetic pages, the following lines; we premise merely that they were written after watching the eaglets at Loch Maree taking their first flight under the guidance of the parent birds :—

"The mighty birds still upward rose

In slow but constant and most steady flight,

The young ones following; and they would pause
As if to teach them how to bear the light,

And keep the solar glory full in sight.
So they went on till, from excess of pain,
I could no longer bear the scorching rays;
And when I looked again they were not seen,
Lost in the brightness of the solar blaze.
Their memory Teft a type and a desire;
So would I wish towards the light to rise,
Instructing younger spirits to aspire
Where I could never reach amidst the skies,
And joy below to see them lifted higher,
Seeking the light of purest glory's prize:
So would I look on splendour's brightest day
With an undazzled eye, and steadily
Soar upward full in the immortal ray,
Through the blue depths of the unbounded sky,
Portraying wisdom's matchless purity:
Before me still a lingering ray appears,

But broken and prismatic, seen through tears,
The light of joy and immortality."

The Fragmentary Remains carry their recommendation with them; willingly would we have placed more numerous extracts before our readers, but we must confine ourselves to thanking the learned editor for having undertaken the labour, doubtless a labour of love, of weaving them into the connected tissue of the present work.