he recommends a mixture containing the extract of Belladonna, Oxymel of Squills, Kermes Mineral and Orange-flower Water.

In Hooping-cough also he again mainly trusts to the internal use of the Belladonna, in the form of its powdered root. This remedy was employed with very marked success by Wetzler during a severe epidemic of this disease that prevailed at Augsbourg in 1810; and it was about seven years afterwards that our author first gave an extensive trial to it. The dose of the powder must, as a matter of course, depend upon the age of the child, its constitution, the character of the existing symptoms, and so forth; but, if we state that a third of a grain should be given to a child twelve months old, twice or thrice a day, it will not be difficult to apportion the doses to other ages. When the fits of coughing are usually followed by vomiting, the powder should be given very soon after this has ceased. We need scarcely say that, if symptoms of inflammatory irritation be present, these must be subdued by the appropriate remedies, before recourse is had to the use of the Belladonna powder.

In accounting for the failure of his favourite remedy in the hands of several medical men, who have recently published the results of their experience with it, Dr. D. alludes, with much judgment, to some of those causes or influences which should always be attended to in estimating the virtues of a medicine in any epidemic disease, and the neglect of which, in the present day, has induced such striking discrepancy of opinion on various practical points among different writers, as is anything but creditable to the sagacity of professional men.

"Before," says he, "any one can fairly and satisfactorily determine the medicative virtues of Belladonna, or indeed of any other remedy, in Hooping-cough, by the effects which it may produce in any particular epidemic, it is absolutely necessary that he should imitate the example of such observers as Sydenham and Stoll, and have first carefully noted the type and genus of the epidemic itself, in order that he may know in limine whether it be inflammatory, or catarrhal or bilious, &c. in its nature. He should moreover have attentively ascertained the character not only of the medical constitution of the season, but also of the prevailing diseases of the preceding as well as of the current year, so that he may be able to determine, if possible, their cor-relations and mutual dependencies. If the existing epidemic proves to have an inflammatory character, it is scarcely necessary to say that the use of antiphlogistic measures is an indispensable preliminary in the treatment; whereas, if it has a bilious type, we must trust more to the use of emetics and purgatives, before having recourse to the exhibition of the Belladonna."

Before dismissing the subject of Coughs, we may state that Dr. Debreyne very strongly recommends the internal use of the extract of Belladonna, in the form of mixture, in most coughs of a nervous nature occurring in adults. He mentions the case of a woman, who had been afflicted with a violent convulsive cough for upwards of twelve years, that was speedily relieved by this remedy-dose, one grain two or three times a day. It is equally serviceable in the cure of obstinate Hiccup, and of any spasmodic constriction of the throat and larynx.

An ointment, composed of four parts of the extract and twelve or fifteen of spermaceti ointment, may be most advantageously used with much benefit in many cases of contraction of the anus, and painful affections of

the cervix uteri; also in various neuralgic complaints of the bladder and urethra.

We now proceed to notice some of the most common gastric and intestinal affections, for the purpose of explaining our author's therapeutic views; and first of all we take the subject of―

Vomiting. In the vomiting that may be considered to be nervous or spasmodic in its nature-i. e. when it is not connected either with inflammation or any bilious disturbance of the stomach-he recommends very highly the use of Colomba powder: it possesses, he says, a sort of specific virtue in such cases nearly as great as Bark does in Agues. He gives it in doses of from 15 to 20 grains in two or three spoonsful of red (French) wine, before meals. The addition of a few grains of magnesia, or of a minute dose of opium, may be necessary, if much acidity or gastralgia be present; and, should the patient be feeble and anæmic, the subcarbonate of iron may be very advantageously combined with it. Opium is freely used by Dr. D. in various abdominal affections, after the state of the intestinal secretions has been ascertained to be tolerably healthy. The following quotation will shew how highly he rates its value.

"We treat all internal pains whatsoever, and more especially those of the abdomen, with some preparation of opium-provided always they are not connected either with acute fever, or with inflammation, or gout. We may, indeed, make a still more general assertion, and say that it is to the use of opiumwhich is the antidote of pain-that we mainly trust for the relief of all painful chronic diseases. If, along with the element of pain, there should happen to be co-existing a rheumatic principle-whether this shew itself externally or in some internal organ-we associate the use of rubefacients and other appropriate medicines along with that of opium. Without this most valuable drug, there could be no possible medication for a multitude of chronic diseases. If we were deprived of it, we should ourselves instantly abandon the practice of the healing art. Sydenham thanked God for His gift of opium to mankind for the cure of so many of the ills to which we are liable; and we can safely affirm, as far as relates to our own practice, that never a day passes over that we have not occasion to exhibit opium in some form or another. How admirably it acts, almost as a specific, in most cases of Dysentery, not to enumerate a host of other maladies."

Phthisis. Although Dr. D. classes this too-frequent scourge of France among the chronic Phlegmasiæ, he expressly says that he does not regard it as at all of an inflammatory character in its early stages. During the course of the disease, there is a strong tendency, as every one knows, to the frequent occurrence of a pneumonic and pleuritic attack; but this is to be regarded only as an epi-phenomenon, and not as a necessary symptom. With respect to Treatment, we find that our author has almost entirely renounced-after the experience of their utter inefficacy-the employment of nearly all remedies, save and except the insertion of a seton in some part of the chest, and the persevering use of Iceland-moss jelly in large quantities, not forgetting the Opium or Belladonna once or twice in the course of the 24 hours. He recommends the same line of treatment in those cases of chronic purulent Catarrh, the symptoms of which so closely resemble those of genuine tubercular Phthisis; and, in not a few instances,

has a cure taken place under their use, when the case had seemed to be utterly hopeless.

From the Chest we pass on to the Stomach. After delivering some excellent remarks on the mode of distinguishing gastralgic from gastritic pain, our author exposes, with no less truth than severity, the melancholy mistakes that have been committed of late years by so many of his countrymen, since the prevalence of the Broussaian doctrines. He shews that the existence of an inflammatory state of the stomach may generally be diagnosticated by observing the effects which different kinds of food have upon the gastric pain. If, for example, farinaceous and milky substances can be taken well, while those of an animal nature give rise to a sense of uneasiness, we may very generally presume that there is a greater or less degree of actual gastritis. If the reverse be the case, and if light animal food, such as chicken-tea or mutton-broth, be borne best, we may feel assured that there is no inflammation, however troublesome the gastric uneasiness may be. The diet may therefore be regarded as a most useful exploratory means of diagnosis.

"It often happens that the epigastric pain does not yield to leechings and low diet; and woe be to the physician who pertinaciously seeks to combat it by continuing the use of the same means, and who has not learned to modify his treatment according to the varying condition of each case. For the relief of the gastric pain, which resists the application of leeches, &c., opium is often an excellent remedy: a light preparation should always be preferred, and it will be well to exhibit it in some mucilaginous vehicle. If, however, this does not succeed in the course of a day or two, we should then have recourse to a volant blister. Should this also fail, we shall have good reason to believe that the epigastric uneasiness is more or less dependent upon an atonic state of the stomach; and this we can generally determine by having recourse to the explorative diet of which we have spoken. Should such be found to be the case, we must allow the patient more nourishing food, and we should try the effect of an infusion of Rhubarb or Colomba-root, to which may be added a weak opiate, if deemed necessary."

In Chronic Hepatitis, our author strongly recommends the use of emollient poultices on the hypochondriac region, applied every night, and also during the day, if the patient keeps his bed. They produce a local diaphoresis, which is often very serviceable in relieving the internal congestion. The occasional use of a tepid bath at the same time will much promote the cure; for the skin is generally very dry and lichenous in chronic liver complaints. Emollient aperient enemata are also very useful. Saline purgatives, dissolved in a large quantity of herb-tea, to be followed by repeated doses of rhubarb—which has long had the reputation

A table-spoonful or two to be taken twice or thrice a day.

of directly promoting the flow of the bile-are always more or less necessary.

In various chronic hepatic affections and visceral obstructions, the following formula has been found by Dr. D. to answer exceedingly well.

Zij. In pil. 120 divide.

Dose-From two to six pills in the course of the day.

If these pills do not prove to be sufficiently purgative, the patient should be instructed to drink some aperient mineral water to aid their action.

Erysipelas." The treatment which we usually adopt in recent cases of this disease, before the formation of pus has taken place, is the abortive and empiric plan followed by Dupuytren, and which he derived from the practice of M. Petit of Lyons. This method consists in applying a volant blister to the very centre of the inflamed part. The object, which we have in view by this bold and seemingly not very rational mode of treatment, is to arrest the internal inflammatory action, and to cause it, so to speak, to abort, by drawing to one circumscribed spot of the skin all the violence and raptus of the existing disease. It is quite true that this powerful concentration and sudden localisation of the inflammatory action may, in consequence of being excessive, induce gangrene of the blistered part; but this accident is of very rare occurrence indeed. Out of between 30 and 40 cases treated by us, we have only met with a single instance of it; and this occurred in a cachectic patient, whose constitution was altogether unhealthy. The application of a blister to the knee was, in this case, followed by the formation of a gangrenous eschar in the part, and the eventual consequences were extensive detachment of the surrounding skin, and considerable suppuration. Of late years, however, it would seem that this unpleasant result of the vesicatory treatment has been observed several times in the Hôtel Dieu, at Paris, and that antiphlogistic measures have been on the whole very successful; whereas, during the years 1813, 1814, and 1815, it was remarked, by all who followed Dupuytren's practice, that bleeding, &c. produced but little benefit, while blisters seemed to be quite a specific remedy."

Chronic Cutaneous Diseases.-Our author, without troubling himself with the divisions and subdivisions of these diseases adopted by most dermatological writers, groupes them together under the general appellation of dartres, and lays down some general therapeutic directions that may be applicable to all. A mild unirritating diet, more vegetable and milky than animal, emollient refreshing drinks-one of the best of which is wheyand the more or less frequent use of warm-baths, should never be omitted. Dr. D. throws overboard, as being utterly useless, the farrago of what have been called depurative remedies, such as the infusion of Fumaria, Dulcamara, Bardanum, Saponaria, Scabiosa, &c. &c. and he supports his own opinion on this point by quoting that of Alibert. The only internal remedy that he uses is the following:

Ziv.
3j.
gr. xij.

M.

To be divided into 40 powders, of which one is to be taken twice a day.

The external treatment is, according to his experience, of much greater importance than any internal remedy. As a matter of course, as long as there is any irritation present, the more simple the baths and other external applications are, the better; but when this has been subdued, we should as early as possible have recourse to such as are slightly stimulant and exciting. Of these a sulphur bath-prepared by adding five or six ounces of sulphuret of potash to an ordinary bath-will be found very convenient. The use of this should be continued steadily for two or three months at least. If the dartrous affection is limited to the legs, as is often the case, it may be sufficient to use a partial sulphur bath to them alone from one to two ounces of the sulphuret may be added to the requisite quantity of water. This is a far better application than all the ointments and lotions that are so generally in use. "If the local atonic dartres prove very obstinate and will not yield to sulphuretted baths and lotions, we are in the habit of trying an ointment-composed of ten drachms of the sulphuret of potash to six or eight ounces of lard, flavoured with oil of thymeand usually with good effect: the strength of the ointment must be varied according to the degree of irritability in the affected parts." Dr. Debreyne tells us that, for the last five and twenty years, he has made use of no other application than the sulphuretted ointment-weak or strong, according to circumstances -in the numerous varieties of Tinea, or Scalled-head.

Of the Asthenic class or division of chronic diseases, none is of such frequent occurrence, and therefore so important in the eyes of the practical physician, as atonic Dyspepsia, or, as our author designates it, Gastro-atony. The following remarks are picked out from the description which he gives of it.

This disease is of very frequent occurrence, especially among women who are subject to leucorrhoeal and chlorotic affections. Its most obvious symptoms are loss of appetite, uneasiness and sense of distention after eating, flatulence and often nausea and sickness, a feeling of sinking weakness and craving, more rarely of dragging, pain about the stomach; constipation; tongue white; taste more or less depraved, but without being bitter or clammy, as in bilious derangements; loss of muscular strength; tendency to nervous ailments, and these usually accompanied with great irritability of temper. Very generally (and this remark, by the bye, it is especially important to attend to) an invigorating animal diet agrees better than a farinaceous and vegetable one-a circumstance that is very significant, and obviously excludes the idea of any phlogistic or irritative element being present. The mere circumstance of there being some degree of pain in the epigastrium, even although this be increased on pressure, is by no means a sufficient reason for suspecting the existence of any inflammatory action; for this pain may be truly called an atonic pain, and can be relieved neither by opiates nor antiphlogistics, but only by appropriate tonics.

With respect to the treatment of Gastro-atony, the mere regulation of the patient's diet will often suffice to relieve the milder and less chronic forms of it. He should avoid the use of much vegetable or farinaceous food, and live chiefly on animal meat and good bread, with or without an allowance of a light sound wine, according to circumstances. The drinking of large quantities of hot drinks, such as tea, coffee, &c. is most