Mr. Wilde is of opinion that the climate of Teneriffe is in no wise inferior to that of Madeira-indeed it is much drier. He thinks it admirably adapted to bronchial affections, with much expectoration. The towns are infinitely cleaner than Funchal-wheel-carriages can be more readily used-and great variety of climate can be easily obtained, by ascending some of the neighbouring hills. But it wants good accommodation! We must now take leave of Mr. Wilde's highly amusing volume, which is pleasingly written, and full of information. REPORTS OF THE PENNSYLVANIA HOSPITAL FOR THE INSANE, FOR THE YEARS 1841 and 43. By Thomas S. Kirkbride, M.D. THE Hospital for the Insane is an offset from the General Hospital, nearly two miles West of the City, and only began to receive patients in January, 1841. In reports of this kind there must always be a large portion of what is called "parish business"-but there is almost always something to interest the professional reader, however distant from the locality in question. The Pennsylvania Hospital appears to be well ventilated, heated by air, and supplied with good water. Being a recent construction, it has all the advantages of modern improvements. A considerable space round the buildings is dedicated to pleasure grounds for the recreation and health of the inmates. All classes-curable and incurable-are admissible, upon securing the payment of a reasonable sum for board-from three to five dollars per week. In a large proportion of the recent cases some bodily disorder was cognizable, and the general health being restored, many of these recovered promptly from the mental aberration. In some, however, no bodily indisposition could be detected, and no indication appeared for medicine. All patients, unless for reasons to the contrary, are expected to take a warm bath at least once a week, for cleanliness; and there are all kinds of baths for medicinal purposes. The diet, except where bodily disease requires regulation, is ample-indeed we might say unlimited, both animal and vegetable. Considering, as we do, that insanity is more or less connected with, or dependent on, corporeal disease or disorder, we apprehend that the above-mentioned scale of table pleasures is somewhat too liberal. The patients are treated in a mild and conciliatory manner, and "roughness or violence is never tolerated." Among employments and amusements, out-door labour stands pre-eminent. A farm, attached to the establishment, furnishes the means of exhibiting this valuable remedy. A workshop, has lately been constructed, which affords useful labour to particular classes, especially when the weather will not permit of outdoor employment. The Sabbath is strictly observed, and the influence of religion over the minds of the insane is remarkably illustrated on that day. Bodily coercion is not entirely relinquished in this Hospital. "Simple seclusion in chambers properly secured, has been resorted to during the past year, in by far the greater number of cases that have appeared to require restraint of any kind. In others, leather wristbands, secured by a belt around the body, or mittens of the same material, or of canvass, have been employed, in rare cases, with a soft band about the ankles, and two patients have occasionally been kept on their beds with much advantage, by an apparatus also of leather, but admitting of much freedom of motion." Among the numerous tables in this volume the following is a very interesting one. TABLE-Showing the supposed Causes of Insanity in 176 Patients. Of sixty-one patients who had been discharged, or who died in one year, we find that 30 were cured-that 5 were much improved-that 6 remained stationary-and that 9 died. Among the nine deaths, one was a case of typhus fever, the delirium of which was mistaken for insanity-the second was from dysentery -the third from chronic inflammation of the bowels and stomach-the fourth from phthisis-the fifth from meningitis-the sixth from hydrothorax-the seventh from erysipelas-eighth and ninth from suicide. From a Second Report, for the year 1843, we shall make a few short extracts. "Restraint.-Although the means heretofore detailed, and the aid of a vigilant and efficient corps of assistants, have enabled a large number of the patients to enjoy the privileges which I have mentioned, almost from their first entrance; it is not to be concealed, that we always have in our family, some with that unfortunate temperament, that blackens the fairest scenes,-distorts the purest motives, and misconstrues the kindest actions; and that many require some more decided restraint, until the violence of their attack has subsided.” And again "Restraint of some kind is one of the means for treating insanity, which, to a greater or less extent, will always be required; but all that is proper, does not necessarily imply the use of apparatus, to which the term has generally, but with great impropriety, been restricted. The amount of restraint at all justifiable is still so little understood in many sections of country, that the subject cannot be too frequently referred to, in the reports from Hospitals for the Insane. "I have stated in a previous report, and have seen no reason to change that opinion, that it is quite possible to dispense with all restraining apparatus, in a well-constructed Hospital, properly supplied with an efficient corps of attendants; but that, under certain circumstances, the use of the milder means may be a comfort to the patient, and much less annoying, than constant struggles with, or even the presence of, the best instructed and most humane attendant. These cases, however, are not common. Having no exclusive views on this subject, apparatus has been used, here, in every case, where I saw a rational indication for its employment. "The only means of the kind we ever employ in this Hospital, consist of an apparatus which effectually retains a patient on his bed, while admitting of considerable motion; leather mittens or wristbands, secured by a belt around the body; and a strong cloth jacket, with continuous sleeves." We are thoroughly convinced that a mild mechanical restraint, in obstinate cases, is less irritating to the patient than the personal efforts of keepers to effect the same object. RESEARCHES INTO THE PHYSICAL HISTORY OF MANKIND. By J. C. Pritchard, M.D. &c. &c. Vol. the Fourth, 1844. THE goal of this stupendous work is within the view of its author. One more volume will complete an undertaking that has no parallel in the English or in any other language. No similar work will be attempted for ages to come. No author could hope to equal, much less surpass, the researches of Dr. Pritchard. An imitation could only be a series of plagiarisms, or a tissue of errors. To attempt an analysis of a work of this kind would be fruitless. Besides, the investigation is equally interesting to every class of readers, though not strictly adapted for extensive notice in a journal of practical medicine. There are certain portions of this volume, however, which are peculiarly attractive to the medical reader, and from these we shall select a few characteristics. 1. Physical Characters of the Persian Races. Sir J. Chardin, in particular, asserts that the Persians are an ugly ill-favoured race; and he ascribes this to their non-intermarriage with the neighbouring Circassian and Georgian females. It is true that the Southern Persians are darker coloured than the Northerns; but this may be accounted for by climate and other causes. The numerous sculptures of the Medes and Persians on the walls of Istakar and Hamadan, prove that the Persians were amongst the most beautiful of the human race. Actual observation in modern times, has proved that their descendants have not sensibly degenerated, in this respect, from their ancestors. They have not, indeed, the fine intellectual countenances of the Greeks; but they display features of the Indo-European style, with long faces and high foreheads. 2. Physical Characters of the Native Indians. This race embraces such a multitude of genera and species, that it is next to impossible to sketch any thing like a general character. It has been asserted that the Aborigines of Hindostan were a tribe of Negroes with woolly hair and the African features. Dr. Pritchard once leant to this hypothesis, but has, long since, abandoned it. As far back as historical records reach, the Indians had straight or lank hair, and features very unlike the Negroes. Herodotus describes them accurately, as divided into castes as at the present day. Dionysius, the Geographer, is much more particular as to the physical character of this ancient people. "The inhabitants are swart, and in their locks betray the tint of the black hyacinth." In general the Hindoos have small foreheads-the face thinner and more meagre than Europeans, and they are much inferior to them in strength. They are lean, feeble, and incapable of supporting hard labour and fatigue. So says Dubois, but he is mistaken. The Hindoos will bear fatigue in their own country which would overwhelm and destroy the European. In Bengal the greater number are below the middle stature; but in the upper provinces it is very different. Some of the Hindoos are as black as the Negroes, which surprised Bishop Heber much. But, in fact, the shades are endless, from nearly white to jet black. Their gesture and garb smack of the maidenly or even the effeminate; with sly countenance, yet smiling out a glozed and bashful familiarity. 3. The Chinese. This wonderful people, now more interesting to us than ever, form a peculiar group of nations, who boast a civilization of their own, a development and cultivation of intellect-a growth of arts, knowledge, and religion, independent and indigenous, deriving nothing from the aid of foreigners, either in the earlier or later ages of the world. Almost as separate from the countries of Central Asia as were the civilized nations of Peru and Anahuac, the Chinese lived under the patriarchal rule of powerful Emperors long before their name or country were heard of in Europe. For centuries afterwards, they were only known as possessors of a country which produced the most splendid manufactures of the East. The poetical Greek Geographer describes them as— "barbarous tribes who use Nor oxen hides, nor wool of fatted ewes ; Robes bright of hue as flow'rs that deck the mead, Of finer texture than the spider's thread." The physical character of High Asia seems, in the Chinese, to be softened down and modified into the European type. Customs, habits, laws, and language combine to amalgamate the various tribes of this extensive empire. Dr. P. cannot venture to consider the Chinese, Japanese, and Koreans as belonging to one race or family, because their languages are not referrible to one original. "Yet they are, if we regard their physical characters, one sort or stock of people. No human races bear a stronger resemblance to each other than these three people. They all have the same physical type." Whether the same type was originally impressed upon them, or resulted from long-continued influence of external agency, will never now be ascertained. In either case, the effect is the same. LINNEUS has characterized the Chinaman as-" Homo monstrosus, macrccephalus Chinensis." This is a monstrous exaggeration. The small eye, elliptical next the nose-high cheek bones-pointed chin, are prominent features in the Chinese countenance, while the shaving off the hair gives to the head the shape of an inverted cone. The natural colour of the skin is between a fair and a dark complexion-or that of a European brunette, becoming brown in the labouring classes from exposure to the sun. Many females in China, among the better classes, would pass for beauties in Europe. They are of the middle stature-small hands and feet-face flat-nose smalleyes prominent-hair black and stiff-scanty whiskers and beard. The women, in general, are far inferior to those of Georgia, and some other parts of Asia. But we must conclude with these few specimens of Dr. Pritchard's highly interesting volume. When he has completed the fifth tome, he may well ex claim 66 Exegi monumentum aere perennius." ON THE OCCURRENCE OF SARCINA VENTRICULI ALONG WITH ACETIC, LACTIC, AND CARBONIC ACIDS IN WATER-BRASH. By George Wilson, M.D. Lecturer, &c. Edinburgh. In this paper the attention of pathologists is directed to some curious phenomena accompanying certain forms of morbid digestion in the human subject. Of these the most remarkable is the appearance of a microscopic cryptogamic plant (Sarcina Ventriculi), and of acetic, lactic, and carbonic acids, in a liquid ejected from the stomach. Mr. Goodsir published the first case of these in the Edin. Med. and Surgical Journal for April, 1842. In fact, five cases of sarcina have occurred very recently and within a very short space of time; which renders it not improbable that the development of this organism is no uncommon accompaniment of certain derangements of the digestive functions. Dr. Wilson here presents us with the more important particulars of the cases already seen, with some observations on the manner in which the chemical and microscopical phe nomena are related to each other, and to the state of the system which attends their manifestation. The first case occurred in a young man of 19, who had been suffering for months from what he supposed to be water-brash. He stated that it attacked him on awakening in the morning with a feeling of distention of the stomach; that without any effort of vomiting, a quantity of fluid, varying in volume from two thirds to a whole wash-hand basinful, passed up from his stomach; that after this he was quite relieved, and experienced no further inconvenience till the evening of the same day, when, without decided distention, sounds as of a fluid boiling or bubbling, and proceeding from the region of the stomach, were perceptible to himself, and to those around him; that he slept well enough, but was generally attacked next morning-the fluid ejected by this patient "smelt like fermenting worts, with a faint acid odour. It appeared, after standing for a few hours, moderately transparent, and of a light brown colour. It deposited in the bottom of the basin a quantity of a ropy matter of a granular appearance, and on the surface was a mass of froth like the head of a pot of porter." On examining the fluid with the microscope, the sarcina was at once detected and was found to present the following characters. In every instance the organisms presented themselves in the form of square or slightly oblong transparent plates, of a pale yellow or brown colour, and varying in size from the 800th to the 1000th of an inch. They were made up of cells, the walls of which appeared rigid, and could be perceived passing from one flat surface to another as dissepiments. These dissepiments, as well as the transparent spaces, were from compression of contiguity rectilinear, and all the angles right angles; but the bounding cells bulged somewhat irregularly on the edges of the organism by reason of freedom from pressure. These circumstances gave the whole organism the appearance of a wool-pack, or of a soft bundle bound with cord, crossing it four times at right angles, and at equal distances. From these very striking peculiarities of form, Mr. Goodsir has proposed for it the generic name of SARCINA.* The ejected fluid was thick and viscid; on standing, it deposited a large quantity of ropy matter mixed with portions of undigested food, and when filtered through paper had a pale brownish yellow colour and was quite transparent-it contained much animal matter in solution, and gave a copious precipitate with infusion of galls-it also precipitated nitrate of silver densely, and when evaporated to dryness, and exposed to a full red heat in a platina crucible, left an ash containing much chloride of soda-it reddened litmus and effervesced sharply with alkaline carbonates. It was found also by neutralizing the fluid, after distillation, with lime water, and decomposing the salt thus formed by means of sulphuric acid, that it contained acetic acid. After distilling all the acetic acid, it still reddened litmus; this was owing partly to the presence of a little free muriatic acid, but chiefly to lactic acid. The most remarkable feature in this case was the large quantity of acetic acid present. Mr. Bell's patient was a girl aged thirteen, who was subject, after her meals, particularly dinner, to enormous distention of the abdomen, accompanied by a gurgling noise and fetid eructations. From this she was relieved by vomiting "a thinnish, moderately transparent fluid, with a thicker and more tenacious portion, like gruel, at the bottom of the vessel-the surface sometimes covered with froth." In this, Mr. Goodsir found the sarcina in great abundance. The liquid from Mr. Bell's patient was found to correspond with that from the first patient. The frothy appearance depended on the presence of carbonic acid, which was proved by experiment to be present in the liquid ejected by the second patient. The frothy appearance in the liquid given by the first patient may fairly be presumed to depend on the same cause. Thus, then, the liquids from both patients contained, besides undigested food, salts and animal matter, much acetic, * Sarcina, a wool-pack. |