lization of the latter enable it to embrace the properties of the former.

Longet has also pointed out a very simple, and therefore useful, means of distinguishing between albumen that has been digested from that which has merely been dissolved. If, for example, a small quantity of grape sugar be added to a simple solution of albumen, and then the sulphate of copper and potash test be employed for its detection, the presence of the sugar will be made manifest through the reduction of the red oxide of copper. On the other hand, however, if grape sugar be added in similar quantity to a solution of albumen that has undergone the action of the gastric juice, the same test applied in the same way will be found totally inadequate for its detection. The mixture, in the latter case will at the same time become of a beautiful violet colour. We may here mention, however, an important fact, which appears to have escaped the notice of our authornamely, that digested albumen is not the only substance which possesses the power of masking the presence of sugar, and giving to the mixture with sulphate of copper and potash a fine violet hue. Bernard has pointed out that gelatine, and Harley that casein and metaalbumen, possess the same property in a high degree.

營

We shall now briefly direct the attention of our readers to the summary on the digestive function as given by Funke. It need not detain us long, as digestion seems to be a study to which Funke has not specially directed his own researches. He says that all substances that are soluble in acidulated water are soluble in gastric juice. By this, however, he is not to be understood to mean that the action of the gastric juice is identical with that of an acid, for at p. 264 we find him saying that the action of the gastric juice on protem substances is very nearly allied to that of a ferment. Our readers will perhaps understand us better if we say that he adopts Liebig's fermentation theory of digestion.

It is well known, as we have already hinted, that all kinds of food are not digested in the stomach, some passing through it-such, for example, as fats-without undergoing any chemical change; others, again, being, only partially transformed there. The transformation of starch into sugar, too, may be cited as an example of a change which, although it occurs to a certain extent in the stomach, is not due to the action of the gastric juice, but to the swallowed saliva. Bouchardat and Sandras have likewise pointed out that cane is converted into grape sugar in the stomach; and, according to Funke, this is brought about neither by the action of the gastric juice, nor by that of the swallowed saliva, but by some element of the food taken along with the sugar. "Which it is, and how it acts, being still unknown." (p. 267.) Frerichs contradicted the statement of Bouchardat and Sandras, but it has been again confirmed by Lehmann and Harley. The latter of these gentlemen has, moreover, shown that the transformation of cane into grape sugar in the stomach is not due, as Funke

Longet, vol. i. part 2, p. 154.

supposed, to the action of some element of the food, but to the free acid of the gastric juice itself.

We just now said that fat undergoes no chemical change in the stomach; we might have added, however, that it is there brought into a state of fine subdivision by the combined action of the heat and motion of the organ. Muscular fibre, on the other hand, undergoes an important change; its connective tissue is dissolved away, and the fibres separate and break across into short segments. The fibre itself also gets clearer and paler, the striae occasionally entirely disappearing, and thereby making the fibre look like a piece of tendon. Frerichs said that, after weeks of artificial digestion, muscular fibres were not entirely dissolved. On this point our author remarks (p. 269), that although it be true that all the fibres of a piece of muscle are not completely digested in the stomach, Bernard is nevertheless wrong in stating that none of them are dissolved during their sojourn there...

Funke makes a statement regarding the muscle of fish which, it must be acknowledged, we read with some degree of surprise-namely, that its muscular fibres are more difficult of digestion than those of the mammalia. He further remarks that the flesh of old is not so readily digested as that of young animals. These views are opposed. we think, to those generally received. Fish, with the exception of salmon and a few others, has generally been considered as a light food; veal, on the other hand, a heavy one. Some substances, although they may remain in the stomach for an indefinite period of time, are still able to withstand the action of the gastric juice. Among these may be mentioned elastic tissue, hair, horn, vegetable cellulose, and spiral vessels, and, according to Funke, not improbably the cells of cartilage. Gelatine, again, although it is derived from cartilage, is speedily dissolved and transformed by the gastric juice into peptone (Longet).

While reading the chapter in Funke's Physiology' devoted to the consideration of the biliary function, we were struck with a very remarkable passage at page 278, where he says that we have no proof whatever that the bile, during its temporary stay in the intestinal canal, takes any share in the digestive process. He thinks, moreover, that as bile does not pre-exist in the blood, but is merely secreted from it by the cells of the liver, and as it is not reabsorbed into the circulation with its constitution unchanged-the blood of the portal vein containing neither the acids nor the colouring matter of the bile-it is highly probable that bile is not emitted into the intestines in order to take a share in the function of digestion, but is there merely as a secondary product (nebenproduct) of the hepatic blood-formation. Further, according to our author, it would appear that after the bile has been modified in the intestines-without, however, taking part in the digestive process-it is returned to the general circulation in order to perform a part in the metamorphosis of tissue. Few, we think, will be at present inclined to adopt this novel view of the biliary function. It is but a theory built upon the shifting sands of hypothesis; and, as such, is more likely to raise an evanescent smile than a persistent reflection. We feel almost inclined to return upon Funke.

as regards the bile, a remark which he has made upon Bernard— namely, that he totally misunderstands the nature and importance of digestion. The recent researches of Bidder and Schmidt having clearly shown that when bile is absent from the intestines, few fats are absorbed into the general circulation. And still more recently, Marcet has pointed out that bile acts by emulsioning the fatty acids of our food. Longet has adopted the general view, that the bile plays an important part in the digestive process.

Quitting the interesting subject of digestion, Funke next directs his attention to the function of respiration, and commences this subject with a chapter on the Histology of the Lungs. When upon the anatomy of the pulmonary organs, he takes no notice whatever of the epithelium lining the air cells; and, if we may judge from his silence, the names of Rainey, Clarke, and Hall must be equally unknown to him. On commencing the perusal of his remarks upon the chemistry of respiration, we found him recognising the fact that the whole process of nutrition depends upon the absorption of oxygen by the blood, and consequently expected to find him keeping pace with the literature of the day. But, alas! we are sorry to say that he still pertinaciously holds to the exploded doctrine of oxygen entering into no chemical combinations with the constituents of the blood. We would therefore take the liberty of recommending him to peruse an article upon that subject which appeared in this Journal in 1856, where he will find it proven by direct experiment, that no sooner has the oxygen passed through the walls of the pulmonary capillaries than it commences to enter into chemical combinations with various constituents of the blood, in order to prepare them for the part they are to play in the process of nutrition.

It was our intention to have reviewed our author's remarks on the nervous system; but having already expended all the space allotted to us for this review, we must delay the consideration of the rest of the volume until we find an opportunity of doing so in conjunction with some affiliated work.

In conclusion, we would strongly recommend to our readers the perusal of Longet's and Funke's treatises on physiology; and at the same time inform them, that although we have felt it our duty to criticise Funke's work rather severely on one or two points, we have not formed a poor opinion of it. On the contrary, we freely acknowledge that its perusal has been to us a fruitful source of pleasure and profit. And we think that if its author bestows a little more care upon the next edition, his work will not fail to acquire a very high place among the text-books on physiology.

"Bernard welcher überhaupt Natur und Bedentung der Magenverdauung gänzlich verkennt," p. 262.

46-XXIII.

.8

Lectures on the Diseases of Women. By CHARLES WEST, M.D., Fellow of the College of Physicians, &c. Part II. Diseases of the Ovaries, &c.-London, 1858, pp. 247.

WITHIN the period he mentioned, Dr. West has well and ably fulfilled his promise, and given to the profession his views on those varieties of female diseases which were omitted in his former volume. Our readers will remember, doubtless, the favourable opinion we expressed of that volume; and we are happy to state that our judgment has been fully confirmed by a perusal of the present. To a singularly easy and pleasant style, Dr. West adds a lucidity of arrangement without pretence, and a felicity of expression, which must necessarily make him a favourite with his readers; whilst he exhibits such a careful avoidance of exaggerated statements, and such a sober care in making deductions, that confidence follows as a matter of course.

The first subject, occupying the two first lectures, is what has been latterly termed pelvic abscess, the result of inflammation of the uterine appendages and the cellular tissue; and although there is nothing new, yet what was scattered before is here collected, with valuable additions from Dr. West's own experience, so as to present a very complete account of this frequent and troublesome disease. The treatment by leeches, poultices, &c., is in entire accordance with our own experience, and also Dr. West's cautious advice about puncturing the tumour. There is a short but graphic account of peri-uterine hæmatocele, contrasting it with the inflammatory pelvic tumours.

But the great bulk of the volume is made up of the lectures on Diseases of the Ovaries; and we feel bound to say that we know of no better essay on the subject-none so good in so short a space. The author commences with ovaritis, and very properly by a confession of the imperfect state of our knowledge on the subject; then he gives the pathology, such as we know it, of the disease, the symptoms which it induces; and lastly, the peculiarities of chronic inflammation of the ovary. We quite agree with Dr. West that many of the symptoms which have been supposed to indicate an inflammatory or sub-inflammatory condition of these organs are rather neuralgic in their character; but we do not quite concur in his opinion that it is so very difficult to cure. Chloroform alone, or chloroform and oil, camphor liniment with belladonna, and the tincture of aconite, are the remedies of which Dr. West speaks most favourably. #7, 902

Passing on to the consideration of ovarian tumours, Dr. West, following Mr. Paget's arrangement, divides them into 1, simple cysts; ! 2, compound or proliferous cysts; 3, alveolar or colloid cysts; and 4, cutaneous or fat cysts; and upon each subject we find accurate and sufficient pathological information. Of the two, we prefer Dr. West's i theory as to the formation of cysts from the Graafian vesicle, to Scanzoni's. As regards the possibility of a single cyst becoming a compound one, Dr. West observes:

"My belief, though I cannot adduce absolute proof of its correctness, is, that such a change may take place, and that a cyst originally barren may become proliferous; that its continuing simple is rather a happy accident than a condition on the permanence of which we can reckon with any certainty." (p. 72.)

In this we quite concur, and so far as a long clinical observation deserves the character of proof, we have had proof of it.

Of 415 cases, Dr. West finds that the right ovary alone was affected in 201; the left in 148; and both in 66 cases; and he has shown that the disease may occur before pregnancy but after marriage, during pregnancy, and after delivery. It has been our lot to see one case of pregnancy, notwithstanding the existence of a tumour of both ovaries.

In answer to the query of what is the course and tendency of these tumours, we are told that some-we fear but few-may be absorbed, or at least remain stationary; that others may be evacuated through the Fallopian tube, vagina, or intestinal canal, or into the peritoneal cavity. Many, the greater number probably, persist, and undergo the various changes so familiar to us in ovarian dropsy, and of which Dr. West has given an admirable description; ultimately proving fatal, either by pressure upon other organs, or by gradually undermining the health. The symptoms to which they give rise consist in disordered functions, or pain, effects of mechanical pressure, or general cachexia; with certain accidents or results of attempts at relief.

We strongly recommend to our readers the section on the diagnosis of these tumours. With the following remarks we fully agree:

"The difficulties which we encounter in the diagnosis of tumours of the Ovary vary according to the size of the growth and the situation that it occupies. So long as it remains principally within the cavity of the pelvis, it for the most part yields but an indistinct sense of fluctuation, even though its contents should be entirely fluid, and it may then be hard to distinguish between it and the results of inflammation of the broad ligament, or between it and a fibrous tumour of the womb, or the retroflected uterus itself, especially if the organ is enlarged by pregnancy. When the growth has ascended into the abdomen, the distended bladder, the pregnant uterus, the enlargement produced by ascites, by tumours of the uterus itself, or by tumours of other organs, as the liver, spleen, omentum, or mesentery, present so many separate sources of error, against which we need be on our guard; whilst last of all, the caution is not superfluous which warns us to be on our guard against imaginary tumours, such as are produced by flatus in the intestines, or by fat in the integuments or loading the omentum, or against those still more unreal swellings which have no existence at all save in the disordered fancy of the patient.” (p. 108.)

Or, Dr. West might have added, those phantom swellings which are due to none of the preceding causes, and which disappear under chloroform. That in many cases the diagnosis will be easy if Dr. West's directions are kept in mind is true, but some cases will prove a sore puzzle we are sure, and indeed this is proved by some of the instances given by Dr. West.

Dr. West's therapeutical division of ovarian dropsies is admirable; these are, 1, Cases which may be let alone; 2, Cases which must be let alone; and 3, Cases justifying or absolutely requiring interference.