Happy the practitioner who has the sense to recognise in time the two first classes of cases; not that we mean that absolutely nothing is to be done, as many inconveniences may be removed as possible, but the tumour is not to be experimented upon-“ Quieta non movere.”:

We do not gather that Dr. West has any faith more than ourselves in the power of medicine, internal or external, in the removal or even diminution of these tumours. It must be our object that they be not irritated.

No one, we suppose, regards tapping as more than a temporary remedy, although in some few cases the cyst does not refill; and our general impression is, that it merely postpones the fatal termination in the best cases, whilst in the worst it may hasten it. Dr. West considers in detail the various modifications of this operation which have been proposed, such as tight bandaging, subcutaneous puncture, puncture per vaginam, keeping the cyst empty or open, and the employment of medicated injections. He does not seem to have much confidence in the first four of these plans; upon the fifth, iodine injections, he has entered into full details. After quoting the experience of others, he adds eight cases of his own. No case proved fatal, and in three there was no constitutional disturbance. Three of the cases were cured as regards the first cyst; in one there was "possible retardation;" in another, "marked retardation;" in one, “slight improvement;" and in two, "no benefit." But, as Dr. West modestly observes, if these cases are too few to justify any decided conclusion, they at least show ground for a more extended trial. He is decidedly opposed to the use of very strong solutions, and to permitting them to remain permanently in the cyst.

There remains still for consideration the one great remedy about which opinions are so much divided-viz., ovariotomy, and on this we shall let Dr. West speak for himself:

"Some points, indeed, must be left unsettled; but still there appears to me to be ground sufficient for some conclusion, and that I fear must be unfavourable to the performance of ovariotomy.".

And for these reasons:

"1st, The rate of mortality from the operation does not appear to be in course of diminution, as the result of accumulated experience and increased dexterity gained by its frequent repetition; 2ndly, Unlike most operations in which anything like the same rate of mortality occurs, it is scarcely admissible in the doubtful or desperate cases to which the Hippocratic axiom ad summos morbos, summæ curationes,' applies. The cases in which it may be hoped that 'the disease, if left alone, will advance tardily or become stationary, those in which something may be anticipated from other less hazardous forms of interference, are the very cases that yield the successes on which it has been sought to establish the merits of ovariotomy. It is proved to be very hazardous indeed in the young; it is believed by some very competent surgeons to be attended by so much danger in those past the middle period of life, that they have proposed to regard the operation as counterindicated in all women who have exceeded the age of forty-five years. The compound cysts, the cysts with solid matter, the malignant, the quasi-malignant growths-those, in short, whose rate of progress is commonly most rapid, which are the most burdensome to the patient, are attended by the greatest suffering and admit of the least

palliation by other means, are precisely the cases in which the surgeon shrinks most from ovariotomy. In the table drawn up by Mr. Humphrey, who himself is an advocate of the operation, cases of this description yielded when operated on, 19 deaths to 20 recoveries; in my own table, deduced from a rather larger collection of facts, 56 deaths to 62 recoveries. 3rdly, Not only is the operation so hazardous in those very cases where it is really most called for, that many surgeons shrink then from its performance; but even in instances that may be selected as the most favourable, we have no sure grounds on which to rest our prognosis as to its issue." (p. 172.)

We are not quite prepared to endorse Dr. West's judgment in this matter, and we cannot help hoping that an improved diagnosis, by enabling us to select the more suitable cases, will lead to a diminished mortality. Dr. West's investigations of the subject are so detailed, and elaborated with such laudable care, that they demand most respectful attention from all who are called to treat such affections.

The remaining portion of the volume has its peculiar interest; but our limits only allow us to commend the whole to the careful attention of the reader.

REVIEW IX.

Euvres d'Oribase; Texte Grec, en grande partie inédit, collationné sur bes Manuscrits, traduit pour la première fois en Français: avec une Introduction, des Notes, des Tables et des Planches. Par les Docteurs BUSSEMAKER et Daremberg.-Paris, Imprimé par Autorisation du Gouvernement à l'Imprimérie Impériale. Tome I., 1851, pp. lx. et 692; tome II., 1854, pp. xii. et 924; tome III., 1858, pp. xxviii. et 724.

The Works of Oribasius; the Greek Text, partly hitherto unpublished, corrected by the collation of MSS., translated for the first time into French: with an Introduction, Notes, Tables, and Plates. By Dr. BUSSEMAKER and Dr. DAREMBERG.

JUST ten years ago (April, 1849) we gave a short account of Dr. Daremberg's projected Bibliothèque,' or collection of the old Greek and Latin medical writers. The plan was at that time suspended, in consequence of the political and social embarrassments which then prevailed in France; and, indeed, the difficulties that have arisen to thwart the execution of the work would have been more than sufficient to discourage any ordinary editor. But Dr. Daremberg is a man of no ordinary zeal and perseverance; and accordingly, after repeated applications to successive Ministers for their assistance, and after repeated disappointments, in consequence of the overthrow either of a ministry or a government, he has at last had the satisfaction of seeing the work, which was commenced under the auspices of Louis Philippe, completed (or at least in a fair way of being completed,) "par autorisation du Gouvernement à l'Imprimérie Impériale."

But the progress of the Bibliothèque,' from its commencement to its partial completion, deserves to be related rather more in detail; both because of its literary importance, and also because of the

peculiar differences it exhibits from our usual English mode of conducting similar undertakings. It was as far back as 1843 (sixteen years ago!) that Dr. Daremberg, who was already favourably known by his inaugural dissertation on Galen's knowledge of the nervous system, conceived the idea of publishing a collection of the ancient medical writers, more comprehensive than Kühn's, and more carefully executed. After consulting MM. Littré and Andral, by whom the plan was favourably received, he applied to the Minister of Public Instruction, which post was then filled by M. Villemain; and at his request submitted to him a plan of the work, which received his official approbation, November 28th, 1844. He was then sent by the French Government on a mission to Germany to examine MSS. relating to the work; much in the same way as Dietz had, with a similar object, visited most of the great European libraries at the expense of the Prussian Government. After his return, in 1846, at the request of a fresh Minister, he submitted his plan to the Academy of Inscriptions and the Academy of Medicine, both of which learned Societies expressed their approbation, and recommended it to the favourable notice of the Government. He was in consequence sent on a literary mission to this country, where he visited the principal libraries at London, Oxford, and Cambridge. On the 22nd of February, 1848, he received an official assurance that the Government would assist his work by bearing part of the expense. "But on the morrow," says he, "many other hopes besides mine were overturned." However, towards the end of the same year, in consequence of a fresh application to another Minister, the Republican Government authorized the printing of his edition of Oribasius at the National (no longer the Royal) press. In the early part of 1849 he paid a second visit to England, in company with Dr. Bussemaker, more especially for the purpose of collating a MS. of Oribasius in the library of St. John's College, Cambridge;* and, towards the end of the same year, he was sent by the Government to visit the libraries in Italy. In 1851 the official promise of assistance was once more ratified, and the first volume of his work appeared.

Among the large number of writers to be comprehended in his 'Bibliothèque,' it was a matter of comparatively little importance which author should be published first; and accordingly Dr. Daremberg was induced to commence with Óribasius by his meeting with Dr. Bussemaker, who had already published a portion of this writer's principal work, and who was then occupied with preparing a complete edition of it. (Tome i. p. v.) Upon the whole, we think the choice of Oribasius a very judicious one. Though less known to the medical world than Hippocrates, Galen, Dioscorides, Aretæus, and Celsus, and therefore perhaps less generally interesting, this writer's works are much more rarely met with, and also offer much greater opportunities for the

The results of his two visits to this country are partly given in his 'Notices et Extraits des Manuscrits Médicaux Grees, Latins, et Français, des principales Bibliothèques de l'Europe. The first part contains a catalogue raisonné of the Greek medical MSS. now existing in England, with the exception of those in Caius College Library, Cambridge, which will be noticed in the second part of the work.

improvement of the text by the publication of numerous inedited passages taken from MSS. which had never been examined. But before saying anything more about the manner in which Drs. Bussemaker and Daremberg have executed their task, perhaps we may as well give a few particulars of Oribasius himself; and as the editors (by what appears to us a strange oversight,) have omitted all notice of his personal history, we shall have recourse to Dr. William Smith's Dictionary of Greek and Roman Biography,' which contains a tolerably full account of a life more than usually eventful and interesting.

Oribasius was born either at Sardes or Pergamus, probably about A.D. 325. He belonged to a respectable family, received a good preliminary education, and early acquired a great professional reputation. He became acquainted with the Emperor Julian before he ascended the throne, and was almost the only person to whom the young prince imparted the secret of his apostasy from Christianity. He accompanied Julian into Gaul, A.D. 355, and it was about this time that, at his command, he began the compilation of his principal medical work. He is supposed to have been in some way instrumental in raising Julian to the throne, A.D. 361, and was in consequence appointed Quæstor of Constantinople, and sent on a mission to Delphi to endeavour to restore the oracle of Apollo. He accompanied the Emperor in his expedition against the Persians, and was with him at the time of his death, A.D. 363. By the succeeding Emperors he was banished from Constantinople, his property was confiscated, and he was even in danger of his life. The cause of his disgrace is not known, but we may conjecture that he had made himself obnoxious, either in the discharge of his duties as Quæstor, or by his enmity against the Christians. In his exile, Oribasius exhibited proofs both of his fortitude and of his medical skill, and is said to have gained such influence and esteem among the "barbarian Kings" (as they are called), that he became one of their principal men, while the common people looked upon him as almost a god. It is supposed that his banishment did not last many years. After his return he married a lady of good family and fortune, and had by her four children, one of whom was probably his son Eustathius, for whose use and at whose request he made an abridgment of his prineipal medical work, which is still extant. He also had his property restored out of the public treasury, and lived to a good old age, as he was alive as late as the year 395.

6

Of the personal character of Oribasius we know little or nothing; but it is clear that he was much attached to Paganism and to the heathen philosophy. He was an intimate friend of Eunapius, who inserted in his Vitae Philosophorum et Sophistarum an account of his life, in which he praises him very highly. He was the author of several works, of which we possess three that are generally considered to be genuine-viz., 1. The Zuraywyai 'Iarpurai, Collecta Medicinalia, sometimes called Eßdoμnkovтáßißλos, from its consisting of seventy (or seventy-two) books; 2. The Zuvois, Synopsis, consisting of nine books, addressed to his son Eustathius; and 3. The Evróρiara, De

fucile Parabilibus, in four books, addressed to his friend Eunapius. It is the first of these that is now being published by Drs. Bussemaker and Daremberg, and to this we will confine our observations. A It contains little original matter, but is a judicious collection of extracts from Galen and Dioscorides, and other writers whose works are no longer extant. It had become scarce, on account of its bulk, as early as the time of Paulus Egineta, in the seventh or eighth century. It was translated into Arabic in the ninth century; but in the following century, though Haly Abbas was aware of its existence, he says he had never seen more than one book out of the seventy. More than half of the work is now lost, and (with respect to practical medicine) the most valuable and interesting portions, The state of the Greek text before the present edition may be briefly noticed, and we will at the same time mention the amount of hitherto unpublished books and fragments which are now for the first time brought to light. The first fifteen books were published by Matthaei at Moscow, in 1808, but with the omission of all the passages taken from Galen, Dioscorides, and Rufus, as these were already to be found in the published editions of the works of those writers. As, however, the present editors have undertaken to publish the work of Oribasius as nearly as possible in the state in which he left it, all these passages: have very properly been restored to their respective places, with the important exception of the whole of the eleventh, twelfth, and thir teenth books, which, being simply a transcript of the descriptive part of the Materia Medica of Dioscorides, are omitted altogether. Of the sixteenth book a short fragment is published for the first time,["

With respect to the subject matter of these sixteen books, it may be enough to state generally that the first four treat of the different: kinds of food; the fifth, of drinks; the sixth, of exercises and gymnastics; the seventh and eighth, of bloodletting, purging, and other evacuations; the ninth and tenth, of climate, localities, baths, and other external remedies; the eleventh, twelfth, and thirteenth, of materia medica; the fourteenth and fifteenth, of simple medicines and their properties; and the sixteenth, of compound medicines. The seventeenth, eighteenth, nineteenth, and twentieth books appear to be entirely lost. Sixteen chapters belonging to the twenty-first and twenty-second books (treating of general physiology, and of the function of generation,) are published for the first time. These are followed by forty-five chapters, which are evidently in confusion and out of their proper place and order, and which treat of bygiène, general pathology and symtomatology, and physiology. Dietz considered all these to belong to the twenty-first and twenty-second books, but the present editors (for reasons which appear to us to be sufficiently convincing,) have preferred styling them extracts from uncertain books: they have never before been published. The twenty-third book is lost. The twentyfourth and twenty-fifth books, treating of descriptive anatomy, had been published twice before, but are here reproduced in a corrected and somewhat enlarged form. One of the happiest discoveries made by the editors was the finding, at Heidelberg, a MS., which they have