tical work, intended to convey as much information as possible within a moderate compass. It abounds also in peculiarities of diction which sound strange to Cis-Atlantic ears; but to these we suppose we must not take exception, lest we become involved in philological controversy. The book is very free from typographical errors, and the illustrations, though not of first-rate excellence, are sufficient for their purpose. Taken as a whole, we can recommend Dr. Morland's Compendium as a very desirable addition to the library of every medical or surgical practitioner.

Dr. Hassall's publication is in all respects of a very different character from the preceding, though we have associated the two in this article because both have relation to urinary disorders. The author states in his preface that

"The object of this little work is to afford an explanation, as simple as possible, free from all unnecessary detail and complication, of the physical properties, composition, and uses of the urine; of the functions of the kidneys; and more especially of the principles of treatment of the chief urinary disorders."

And he hopes that, by the assistance here rendered,

"The student and practitioner will be enabled, with little application or chemical knowledge, to become acquainted with the chief facts, scientific and practical, connected with the urine."

He considers this as an object of some importance, because

"It is certain that the great majority of medical men neglect to acquaint themselves with this class of diseases, being frequently deterred by the elaborate manner in which the subject is treated, and especially by the extent of the chemical inquiries and reasonings intermixed with it." ́

In short, Dr. Hassall seems to think that the greater part of the profession, knowing little on this subject, and not aspiring to any profound acquaintance with it, will be glad to take up with just so much information as may carry them through the routine of practice without loss of credit; and this modicum of learning he proposes to impart to them in the small volume now before us. We are of opinion that Dr. Hassall here makes a very erroneous estimate both of the knowledge and of the aspirations of his professional brethren, and we believe there are few of them who do not know more than his book could teach them. Indeed, if it had been put forth merely as an outline, intended to convey to the mind of the young student some general notion of the matter, preliminary to the perusal of more comprehensive works, it must have been pronounced in many respects defective; but when it is gravely presented to a majority of the medical profession as a remedy for their alleged ignorance, we can only wonder at the assurance of the writer.

Let us look a little into this book, which is to supply all that is needful to those who eschew application and chemistry. At p. 7 we have an analysis of the urine-namely, that of Berzelius, published between twenty and thirty years ago. On this Dr. Hassall remarks, that "the above analysis does not include all the substances contained even in healthy urine, some of the most important being omitted;"

and he proceeds to enumerate several of these, as well as some others which are found only in morbid conditions. An analysis which professedly does not exhibit all the known constituents of the matter analysed, must be allowed to be rather an original and humorous conception. We might have hoped that the analysis of Berzelius, together with Dr. Hassall's codicil thereto, might have furnished us with a reasonably full enumeration of the constituents of the urine; but such hope would have been vain, for we still miss some eight or nine of the substances generally admitted by chemists of the present day as entering into the composition of this fluid.

Under the head of " Anatomy of the Kidney," we do not meet with enough to satisfy even an inquisitive general reader; yet, in the short space allotted to this jejune description, the writer contrives to find an opportunity of contradicting himself. At p. 13 he says,

"By the disposition of the parts just described, the blood from which the excretion is formed is brought into close relationship with the truc secretory structure of the kidneys-namely, the epithelial cells which line the tubules."

While, in the very next page, he tells us that,

"It is very questionable whether the kidneys are to be regarded as true secretory organs, or whether they do anything more than separate from the blood certain salts and substances previously existing, ready formed, in that fluid."

At p. 41, Dr. Hassall states his conviction that structural diseases of the kidneys are more prevalent now than formerly, especially in cities; but the circumstances he adduces to account for the alleged fact seem altogether inadequate to that end.

"The health of persons living in cities is, as a class, much deteriorated; and whatever tends to lower the health predisposes to organic disease, and especially of those organs whose functions, like those of the kidneys, are both important and active. The causes operating to the deterioration of health it is unnecessary to dwell upon at any length: they are, insufficient air and exercise, impure air, unwholesome and adulterated food, late hours, unhealthy occupations, dissipation, and intemperance." (p. 42.)

While these may be admitted as reasons why renal, in common with other diseases, should be more frequent in cities than in the country, they fail entirely to account for their greater prevalence now than at any former period. The inhabitants of our cities in the present day are less intemperate than their forefathers; and many who formerly might have passed their lives almost without seeing the face of Nature, have now abundant opportunities, of which they are not slow to avail themselves, of making excursions by land and sea; add.. to which, that all the provisions of medical police are much more effectually carried out, and the means of personal cleanliness more liberally supplied. Unhealthy occupations and late hours have ever been a bane of large communities, but are not more so now than in. times past at least, certainly not the former; and with regard to adulterations of food, we suspect they have always been dangerously prevalent, though there has not always been a Hassall to bring them

to light. On the whole, we think it probable that there was, in prothink it pro renal disease, if not more, portion to the population, quite as much renal disease, if not more, formerly than there is at present though no doubt it was less fre quently detected; for example, prior to Bright's discovery, how many cases of chronic disease of the kidney passed under the name of "decline," and "decay of nature," and other equally vague designations? The following is an interesting case of albuminuria apparently unconnected with structural disease of the kidney: iw no mota:

"I have now under my care a very remarkable case of this description-a youth, aged about eighteen years. To my own knowledge his urine has contained, for the last two years, such a large amount of albumen that, when boiled, it becomes white, and sometimes almost solid, like white of egg egg and yet, with this persistent condition of the urine, and this enormous drail upon the system, in place of being stunted and contracted, he has grown up to be a well-developed and rather fine young man, although not, of course, robust and hardy, yet capable of considerable physical exertion. In this case the urine often smells of the food consumed; and, nearly throughout, it has preserved its normal specific gravity." (p. 61.)

If Dr. Hassall's enumeration of the constituents of the urine in health be, as we have seen, extremely defective, not less so is his de scription of the morbid deposits and products which are met with in the same fluid. In a work like that under review, omissions might be excused in respect to substances of infrequent occurrence, which had not been found to bear relation to any particular diseased states. But surely we should here have had some mention of leucine and tyrosine, in their connexion with typhus, the exanthemata, and hepatic disease. The eurious discovery of the presence of acetone in the urine and the blood in cases of diabetes, should also have found a place. And why should purpurine or urerythrine have been excluded? It is not only a very common deposit, but has very interesting pathological relations, being never found in connexion with diseased kidney, but almost invariably in acute rheumatism, and sometimes in intermittent fever and affections of the brain, very largely also in pericarditis, and most abundantly of all in some organic affections of the liver. dod

In the concluding observations on the "Treatment and Diagnosis of Stone in the Bladder," the author expresses himself strongly in favour of attempts to dissolve the calculus, especially by injections thrown into the bladder; but his observations on the subject are far too general to be at all satisfactory, and he does not appear to speak as if from any experience of his own.

9 He adverts to the use of the microscope as a means of deteremining the composition of a calculus, while yet contained within the bladder.lomex ment to Ila 1 enistros dydiso bug In general, but few attempts are made by the surgeon to determine, either during the existence of a calculus, or prior to an operation, the chemical composition of the calculus, and yet the microscope affords a ready and satisfactory means by which this object may generally be accomplished. Thus, the composition of the stone may frequently be determined with considerable accuracy by ascertaining, by means of the microscope, the ordinary deposit or deposits occurring in several consecutive samples of the same urine. (p. 81.) avig

This is so obvious a means of diagnosis, that few, we should suppose, omit, to avail themselves of it; but Dr. Hassall does well to mention it, because, strange to say, it is not generally alluded to by surgical writers.o

The style of this little work is in general rather good (though, by the way, the foregoing extract cannot be cited as an example), and there is a clearness and simplicity in the author's manner of conveying information which make us regret that he has not more satisfactory information to convey.

The work is illustrated with twenty-four plates, affording microscopic views of crystalline and other urinary deposits. These have already appeared in the Lancet,' but here present an improved aspect from being on better paper. They are well executed, and give upon the whole very faithful representations.

In conclusion, we do not think that "the great majority of medical men" will feel themselves either much flattered or much enlightened by the perusal of this book. After all, is it for medical men that the book is chiefly intended? We confess we have a misgiving on this head. It seems strange that any writer should attempt to commend himself to the attention of a highly informed body of men by an unceremonious announcement of their ignorance; and it seems equally strange that he should endeavour to dissipate such presumed ignorance by so bald and meagre a production, destitute even of some of the commonest points of information. Our doubts are not dispelled by a certain section on 66 'Spermatorrhoea," which looks as if it were addressed quite as much to patients as to doctors. We may be wrong, however, and we sincerely hope that the suspicion which has here forced itself upon us may be without real foundation. The public and the profession are much indebted to Dr. Hassall for his able and useful exertions in one important field of inquiry-the detection of adulterations in food and drugs. We do not think he has been equally successful in his dealings with urinary disease; and assuredly the present brochure is directly calculated to diminish any reputation which he may have acquired in this department.

Medico-Chirurgical Transactions. Published by the Royal Medical and Chirurgical Society of London. Vol. XLI., 1858. 8vo. pp. 468.

THIS volume is nearly double the size of its predecessor; and in the quality of its matter it is inferior to none hitherto published by this Society. It contains twenty-one papers, all of them extremely interesting and original. Seven communications are devoted to Surgery and Surgical Obstetrics; Morbid Anatomy and Pathology are represented by a similar number; Teratology and Development are illustrated by four, and Therapeutics by three. But following, as is our custom, the order in which the papers are arranged in the volume, we proceed to give a short analysis of each,

I. An Account of a Case of Arterio-venous Aneurism of the Temporal Vessels, which was treated by Ligature of both the Artery and Vein. By CHARLES H. MOORE, Esq.-The subject of this case was a labourer, sixty years of age, in whom a direct communication had existed for thirty-six years between the temporal artery and vein. The wound was originally made by a surgeon in opening the temporal artery. An abscess ultimately formed in the diseased parts, and the spontaneous bursting of this abscess was followed by such dangerous hæmorrhage that active surgical interference became at once necessary. The operation consisted in tying, first, the vein on the cardiac side of its communication with the temporal artery, behind and a little deeper than the ramus of the jaw, a little below the external meatus of the ear; secondly, the temporal artery, displaced by tortuosity, was tied near the posterior edge of the masseter muscle. The pulsation in the vessels in the temporal region and in the vein previously tied at once ceased. The jugular veins also at once diminished in size, and a pulsation and a thrill previously obvious in them could no longer be detected. With judicious after treatment the case progressed favourably the discharge from the abscess rapidly diminished, and the ligatures separated on the tenth and thirteenth days; the ulcers assumed a healthy appearance, all oedema of the scalp disappeared; and when the patient left the hospital no pulsation existed in any of the diseased temporal vessels.

II. Case of Communication with the Stomach through the Abdominal Parietes, produced by Ulceration from External Pressure; with Observations on the Cases of Gastro-Cutaneous Fistula already recorded. By CHARLES MURCHISON, M.D.-This is an interesting and valuable paper, written in a clear and pleasant style. Were it nothing more than an account of the vagaries of a hysterical female, it would still be a most important addition to medical literature. We have here a remarkable instance of that morbid mental condition where misdirected volition led the unfortunate sufferer to inflict the most serious and

unnatural injuries upon her person. Her purposes of partial selfdestruction she patiently accomplished by the most persistent and prolonged methods of injury, designed with peculiar but characteristic cunning, and carried into effect with no less characteristic obstinacy. The case, however, is related and connected with 24 other cases of gastro-cutaneous fistulæ in a tabular statement, embracing the following considerations: 1. The causes of such morbid communications; 2. The situation, size, and character of the external opening; 3. How the food swallowed by the mouth escaped through the unnatural aperture; 4. A statement as to the duration of such fistula and the possibility of curing them; 5. An account of the general health of those who have suffered from gastro-cutaneous fistula; and lastly, we have a notice of the contributions to our physiological knowledge regarding the stomach and its functions afforded by experiment and observation upon such cases.