man. The misfortune is, however, that a diseased condition of the economy, which perhaps years of misconduct have entailed upon the sufferer, requires at least months of a carefully adapted and diligently pursued course of medical treatment to produce any alleviation, and a still longer period to prevent the likelihood of a relapse. The patient soon gets tired of this, and flies from practitioner to practitioner in the hopes of finding a readier road to restoration, until, at last, he throws himself in despair into the arms of quackery, which promises him every thing he requires, and, by the influence upon the mind which bold assertions, that no respectable practitioner would hazard, produce, such promises even may sometimes be realized. Few practitioners of credit have these cases long enough under their care for the full operation of the remedies prescribed; and some of those which the author concludes were cured by the judicious means he recommended, because they did not apply to him again, may probably have sought assistance elsewhere. * * While upon this subject, we may observe that the manner in which some of the cases are narrated is somewhat unusual for publications intended solely for the profession, and gives the work somewhat of an appearance which we feel sure the author never intended it should put on. Thus the symptoms and progress of the case are often related by the patients themselves, just as we find they are in empirical publications. For example, one begins-"Sir, I have been induced, by the perusal of your paper in a number of the Lancet, to seek your opinion and advice. An abject and degraded being, (for whom language has no name,) I could not consult you personally, and feel that I owe you an apology for addressing you on such a subject. * I am, Sir, your obedient servant, H. I. Address Post-office, C--h street." Again-" Sir, I have lately taken up a number of the Lancet, in which it appears that you have treated successfully that disease which I had almost given up in despair as absolutely incurable, namely, a case of impotence, arising, to a certain extent, from early depraved use of the genital power. Pray advise me under similar circumstances. * * * I am, Sir, your obedient servant, R. S. I. Post-office, Ct street." And then we have repeated notes detailing the various symptoms, effects of remedies, &c. Now, when we consider that these papers appeared originally in the Lancet, a work which professes to circulate much among the lay-public, we think this graphic style of narration might advantageously have been exchanged for one more simple, and certainly more usual, quite as convincing, and involving much less repetition of details, which at the best do not form the most agreeable reading. Dr. Smyth believes that the intimate connexion of a diseased condition of the generative organs and disorders of the intellect is not sufficiently appreciated. "The constant association of sexual disorder, and more or less of generative incapacity, with mental derangement, whether as cause or effect, is a remarkable fact, and one which appears to me not to be very generally known; yet I will venture to say, that every insane individual, whether male or female, is at the same time also the subject of some sort of procreative disability, defect, or disorder, either impotence or sterility, or both; and the removal of the one affection (most frequently, I apprehend, the mental) would often seem to prove immedi ately curative of the other. I have seen several instances of insanity accompanied by impotence and barrenness in both sexes, in which such, certainly, appeared to have been the case, in which, by the adoption of a similar mode of treatment in each case, the return of reason, and the resuscitation of the sexual powers, were so strictly concomitant, that it was impossible not to infer but that either the one disease was the cause of the other, or that both affections depended upon one common cause." 173. One of the offices of the seminal fluid is thus stated : "The spermatic fluid, which every one knows it is the office of the testicles to secrete, every one should at the same time be aware is not, as it is too commonly supposed, an excrementitious fluid, and intended, like the urine, to be eliminated from the body; but, on the contrary, (except during an occasional act of generation), to be received into the circulation, and thence distributed to every part of the system. It is the presence of the semen in the circulatory fluids of the male, and the accumulated influence of unexhausted ovaria in the system of the female, which gives to the countenances of the continent and chaste the peculiar expression of energy and vigorous health which generally characterise them, and which, though the features themselves should not be fashioned to the lines of beauty, never fails, notwithstanding, to impress the beholder with a sense of admiration, and some feeling of respect." 177. Dr. Smyth sets a high value upon Plummer's pill, as an alterative after due purgation in certain cachectic conditions of the economy. "In cases in which the pathology is not a thing of morbid relievo, positive, and substantial, but more a condition the reverse, a condition altogether of degree of physiological imperfection, the proximate causes of the affections consisting, for the most part, in weak and languid circulation generally, and tardy and defective performance of all the vital functions-Plummer's pill, as an alter, ative, rightly timed and apportioned, is without an equal. It seems to me to enliven and excite, in a peculiarly salutary manner, all the nutritive actions of the economy, and also to leave upon these, after its administration has been discontinued, a somewhat persistent impression of its virtue. No simple or compound medicinal substance, that I am acquainted with, possesses the power to such a degree, of developing animal heat generally throughout the system, without the weakening accompaniment of perspiratory moisture; on which account, perhaps, it is that I have found it an exquisite tonic and deobstruent, in cases of dyspepsia, of general cachectic debility, and of amenorrhoea, in persons of cold phlegmatic temperament. Sometimes alone, and occasionally in more or less quantity in union with myrrh and aloes, (as in the pill of aloes with myrrh of the Pharmacopoeia,) I have found it successful in the cure of amenorrhoea, after chalybeates and a variety of other emmenagogues had been tried in vain. I have also witnessed its good effects in the cold species of chronic rheumatism. It is, unquestionably, I think, the mildest and most delicate alterative we have." 215. On the DeCREASE OF DISEASE EFFECTED BY THE PROGRESS OF CIVILIZATION. By C. F. H. Marx, M.D. and R. Willis, M.D. &c. London, 1844. WITH the contents of this little volume we have already been made acquainted, as they appeared very recently at different times in the pages of the London Medical Gazette. We think Dr. Willis has done good service, not only to his professional brethren but to the public generally, in bringing it out in its present form. We fully concur with the Doctor in regretting that physicians have no place in the body politic, and in thinking that it would be well for humanity if they had. It cannot be denied that, since the revival of letters in Europe, medica men have been foremost in every undertaking whose object has been to extend the boundaries of knowledge and to exalt mankind. No class of men know half so much of the wants and the wishes, of the joys and the sorrows, of the community-they it is, who are the friends and comforters, in adversity especially, of persons in every grade of life-from the sovereign and the peer to the wretched outcast in the street. They it is, who follow in the field through the thickest of the fire, not that they may aid destruction in her work, but God-like, that they may staunch the wounds she makes. "Oh!" feelingly exclaims Dr. W. "let society cherish and exalt its medical community; let it become aware that if science cannot aid it in its struggles with disease, neither can ignorance; that nothing can by possibility be known to the quacksalver and empiric that is not familiar to the educated physician; that a youth of preparation, and a life, however protracted, of ceaseless devotion to his art, are all too little to familiarize him with all the varieties of disease, and the means of meeting them successfully; and that there is no access to the temple of medicine, save through an intimate knowledge of the laws by which we live and move, and have our being." It is a frequent complaint that the present times, however rapidly they advance in an intellectual point of view, still fall short, physically and morally, of what they ought to be; that mankind are obnoxious to many more diseases now than formerly. There is much that, on a hasty survey, seems to countenance such complaints; in especial, the excessive refinement of manners, and the luxuries attendant on civilization; whence effeminacy and debility-the swelling nomenclature of diseases, and the endless variety of means of cure. The authors of this volume consider such a view, however, as wholly without foundation. They undertake to shew that, with the increase of civilization, the sanatory condition of states and smaller communities has undergone an actual improvement; that diseases, on the contrary, have rather been falling off in number, and decreasing in intensity; and that every onward step in the path of knowledge and true refinement has had a beneficial influence on the entire corporeal being of mankind. It cannot be denied, that, with the progress of civilization, not only does population in general increase, but that the length of individual life is augmented, whilst the liability to sickness, and to the sufferings to which every individual born is obnoxious, are lessened. Epidemical diseases, formerly regarded as necessary evils, and inseparable from humanity, are now known within civilized nations only by name. Though perhaps disposed to consider that a life spent in tilling the ground, in fishing, and in hunting, must afford the greatest number of hours for undisturbed enjoyment, still we must draw the distinction between that intercourse with nature which is taken as pastime, and that which is taken as a means of supporting life. The peasant, the fisherman, and the hunter have other tales to tell besides those connected with pleasure and felicity. In the absence of all occupation for the higher faculties the soul dreams on but too readily in a slumbering or half-waking state. To real, to perfect health, harmony of the corporeal and spiritual aptitudes is indispensable. The cultivation of the higher powers is not necessarily coupled with anything that is pernicious. The requirements of society, so often opposed to reason, are constant causes of a more passing or more permanent interruption of the sense of well-being: but with a little prudence and reason, the legitimate fruits of good education, the prejudicial influences of such circumstances may be greatly diminished, or entirely superseded. In virtue of the support derived from cultivated intellect, man becomes capable of giving successful battle to all the external influences that tend to its detriment-the enlarged views engendered under the influence of social co-operation, tend to arouse the corporeal energies. Good sense and moral equilibrium present themselves as the means best adapted for achieving elasticity under the sorest bodily inflictions. Some travellers, who have lived long among uncivilized people, speak of but few diseases as prevalent among them. The authors ask, and very justly ask, are those rarities real? is not the reason to be sought rather in the inhumanity of the natives, in some sort commanded by necessity, and sanctioned by custom, and in the insufficiency of the remedial means with which they are acquainted? It is difficult to conceive a life similar to that said to have been led by man in his earliest state, as either peculiarly pleasant in itself or advantageous to health. The olden poets tell us that the first races of men knew nothing of disease; this is somewhat like the assertion that before the Fall the earth was without poisonous plants, and the rose without thorns. We find another of the poets of antiquity with much more truth, ranking it among the blessings conferred by Prometheus on primitive men, that he taught them physic -"when prostrate with disease, And means were none of cure,-no quickening drink, Though it must be admitted that many of the usages and habits, many of the apparently inevitable and prejudicial influences of our present social state, are the results of refinement and civilization, the means of meeting and confining them within narrow bounds are developed in like and even in greater proportion. With respect to the question whether has insanity increased under the influence of high mental culture, the authors truly observe, that to regard the culture of the mental powers at large, or of one or more among them, as a ground of their derangement or destruction, is a somewhat hasty procedure. It is not culture, but half culture that has a pernicious influence upon the mind. The more numerous and the better the educational institutions of a country are, the less numerous are the insane. The more the whole of the mental faculties are brought into play, the more certainly will imperfections be set aside. Inaction occasions derangement more frequently than activity. How rarely do we see men of letters who labour in peace and due measure become insane! It is not even intense application of the higher faculties that overthrows the mind, but passion and the vicissitudes of life, against which elevation of soul supplies the truest remedy. Whether the relative number of insane persons is actually greater now than it was in former times, cannot be precisely ascertained. Probably the increased attention now paid to the insane, the effect of the progress of civilization, makes the number of such patients appear greater than they did at former times, when the subjects of insanity were commonly concealed in the private parts of dwelling-houses, on various pretexts: now, to conceal the family misfortune-the disgrace as it was held-and again to escape the public interference with relatives. In the present day insane persons are almost invariably placed in establishments especially destined for their reception. The more we advance in our knowledge of insanity, the greater the number of forms which it assumes do we distinguish. We must not infer from this, however, that the same diversity did not exist formerly. On the contrary some shapes of mental aberration indicated by our predecessors seem to have disappeared altogether, others to be becoming rarer and rarer. With respect to the deaf and dumb, civilization certainly cannot be charged with having had any share in causing this abnormal condition of the senses; far otherwise, the sole alleviation for the evil that can be had, comes from her hand. The deaf and dumb were formerly a heavy burden on society. With the exception of a very few favoured by circumstances, the great majority were left to their own incapacity, to the unmitigated wretchedness of their isolation, in a state of moral and physical degradation. How different at the present time, when brought up and educated in public institutions devoted to the purpose, instructed in reading and writing, their understanding is enlightened, means for communicating with the world around them are supplied, and a substitute is found them for their mute and unavailing organs of hearing and of speech! The same may be said of all the establishments for the blind, the deformed, the halt and the lame. It would be easy to prove that the improved civilization of the present day is distinguished not only by seeking to remedy corporeal and mental evils by every means at command, but also by its unceasing efforts to destroy the very germs of disease. Commencing with infancy, we see the present time distinguished by an increasing attention to the physical wants of that state, and a diminution of its mortality. The solicitude commences even before children see the light, and is active the moment they do so: the relations between nature and art in the process of parturition are now better understood than formerly; well-timed interference is constantly saving the threatened life of both mother and child-the necessity of proper nursing is now much better understood. Much also has been done to guard against the temptation to commit child-murder. In the educa |