I return once more to the nerves. What firm threads and dense knots do the sympathetics present! but if extension may explain the hard tunic of each little cord, the tractions of many cords may account for the solid coats of the ganglia. The great semilunar ganglia have each at times (Mr. Swan) large unmeaning rope's ends attached to the supra-renal bodies; may not these likewise be the useful and physical result of traction on tissue, though atrophied nervecord originally. There are peculiar and distinct signs of atrophy and tensions internally and externally in the supra-renal bodies.

The elasticity of small aneurisms is I think greatest remotest from the heart. The tissue of valves compared with their vessels is remarkable. The valve is the more rarely and the more violently used-it looks like a compound of atrophy and hardness. (See "Surfaces of Contact and Attrition on the Valves of the Heart," &c., Guy's Hosp. Rep. No. 10.) Various valves, arteries and veins naturally waste, without use*-the efficient cause of the persistence of others. The structure of vessels in different parts follows their use, while it indicates their need, as at the vertex and the foot. The casual and temporary changes of vessels have other causes. The inferior cava being obstructed, all below will be distended, but the next most open course for the blood will be the most liable to occasional or momentary reliefs, and it is that which becomes enlarged to good purpose.

Comparing the elastic saphena vein with the dense cava-considering them as parts of the same system and even of the same cord, nay, in evolution almost identically one and the same things, can we see any more likely cause for the peculiar texture of each than the physical circumstances to which each is subject. The one valveless, liable to reflux and distensions sometimes violent, and always -with good nutrition-firm and equal to its wants; the other, extremely elastic, emptied by every motion, subject to some stretching similarly to the elastic theca of the spinal marrow, but perhaps subject to no violence either within or longitudinally.

I may here glance at the state of varices which seem yet little understood. The disorder is one of daily over distensions and imperfect nightly repairs-of a chronic or rather of a variable character. The greatest exertion with due repair makes both tubes and valves equal to their offices. The time is gone for cure, when the veins, being too wide, thick, hard and deformed, the valves also deteriorated and useless, and the skin defective as support, we set about getting rid of the channels altogether. The incipient, variable and perhaps most painful stages, when some balance between distension and nutrition (as to degree and quality) might avail, never seem to have been noticed.

The varied texture in different muscles results from their degree of use. It may not at first sight appear that the fascia owe their permanent solidity to habitual tension as ligament does, yet we may compare their tension to that of other tissues, as dura mater. One source of stretching (the margins being fixed) is found in lateral pressure, which thus tends to elongate the tissue and to determine the course of its dense threads. Aponeuroses, like neurilema, are subject to counter-extension by their more moveable bony connections through the agency of muscle. It is certain that fascia in general are only developed by muscular efforts, and that in their rise, seat, substance, and arrangement they are strictly

The persistence of ductus arteriosus or cord gives the measure of the forces acting on it.

+ I have formerly endeavoured to shew how it is that unusually easy circulation in a part empties and relaxes and so enlarges the artery of supply, and I have intimated the effect of healthy blood in such a case. The new and free course of the blood after tying a great artery was represented as a very simple problem. (London and Edin. Monthly, July 1842.)

governed by muscular extensions-they are equal to the positive insertions of tendons or of muscles.

Whilst ligament depends on strong tension, elasticity seems to result from a force of extension which is more gentle, gradual, and guarded, and more limited in its range of variation.

Ligament may have the more complete temporary relaxation.

In conclusion it does not seem insignificant to remark, that while there is reason to infer that the blood takes up and deposits according to fixed rules of chemical attraction in dependance on the state of the circulating fluid, and on that of the organ or tissue nourished, we also discover manifest traces of other controlling or concurrent molecular forces. The state of repletion-compression of the fluids in the vessels, and the proportion of tension in particular tissues for the time being, manifestly affect the interchanges which the capillary blood undergoes. Changes of temperature depend on molecular changes, or vice versa, produce such changes. Elasticity of tegument is regulated by vascular supply, belongs to and is essential to health, yet with external cold it may almost disappear.

That pressure on the blood regulates absorption and deposit generally is doubtless true, so also is it that extravascular tensions decide similar changes locally.

SOME HINTS ON THE MOST EFFICIENT MODES OF ADMINISTERING MEDICINES. By A PRACTITIONER OF HALF A CENTURY.

Many of the most important discoveries and improvements in medical science are rendered comparatively useless, in consequence of being unskilfully applied to actual practice. In no department of knowledge is this defect more conspicuous than in therapeutics. Man, (and I believe the same remark applies to all created beings), is born with a kind of instinctive_antipathy to physick, which antipathy he retains from the cradle to the grave. Look at the ingenious spoons that have been invented to force physick down the throats of infants! Observe the mantel-pieces of sick chambers, and count how many phials are either uncorked, or only half emptied! How great a proportion of mankind hate the very name of physick! If the stomach is apt to turn at the thought of medicine, when we are in health, how much less capable is it to bear nauseous drugs in the various forms of disease, nine tenths of which affect the stomach sympathetically with squeamishness, nausea, and aversion to food as well as physick? The evil consequences of nauseous forms of medicine being used in sickness, are great beyond all calculation or belief. One result is, that medicine is not taken in sufficient quantity-sufficiently often-or for a proper length of time. What practitioner will fail to recognise the following picture of almost daily Occurrence. A medical man is in anxious attendance on a patient-say a lady after confinement, and threatened with some grave malady-peritonitis, for instance. He prescribes what he conceives to be active and efficient remedies for the night, and gives strict injunctions to the nurse. In the morning, when he calls, he meets the nurse on the stairs. Have you given your mistress the medicines punctually? Most punctually, Sir. Well, what has been the effect? "Brought everything up again Sir." What, all? "Every drop, Sir-and I

* It seems to me extremely probable that every valve and every ligament is developed in its proper place by the very physical force which subsequently demands such aid. The sites of venous valves in this respect are very remarkable. The valves and the tunics of lymphatics are all but equal, and so are their tensions; the currents being easy and rapid.

thought she would have brought her very heart up with it." After such intelligence, the feelings of the doctor, on entering the chamber, are not particularly enviable. Now all this is more frequently owing to the form than the substance of the medicine exhibited.

In chronic diseases, where the remedial process is necessarily chronic also, we are daily baffled by the repugnance-nay, the resistance of the patient to a protracted course of physic. Yet it might very generally be so contrived, that the patient would desire rather than loathe his medicines!

I am aware that in some acute diseases, the state of nausea itself is desirable, and salutary. But it is not the mere nausea or sickness which lessens the velocity of the circulation, opens the secretory vessels, and checks inflammation. These remedial processes depend much upon the quantity of medicine-say antimony-which the patient can bear in order to induce them. Thus double or triple the quantity of tartrate of antimony will be borne, before sickness is induced, if given in an effervescing draught, as compared with the same medicine given in plain water. And the remedial effects will be in proportion. This is a truth that should ever be held in mind, and the principle was well understood by Rasori, Thomasini, and others. The contra-stimulant effects of antimony are trifling during the nausea and sickness at the beginning:-it is when the tolerance is acquired that the inflammation or high fever is controlled.

But there is a large class of diseases in which the stomach is morbidly irritable, and where nauseating medicines are positively injurious. Putting aside the multitudinous forms of dyspepsia, we have affections of the uterus, the kidney, the liver, the pancreas, &c., where the stomach is prone to disordered function, and where it is of the greatest consequence to exhibit medicines in forms that will tranquillize rather than nauseate the stomach. Diseases and disorders of the kidney are now acknowledged to be much more frequent than they were formerly suspected to be-and these are very generally attended with gastric irritability. In these it is of great importance not to ruffle the stomach by medicines. In affections of the brain, now so exceedingly common in consequence of the advanced stage of civilization, and the operation of various perturbing moral causes, the stomach is often the organ most conspicuously deranged— and we are not seldom foiled in the exhibition and perseverance of proper remedies, from the sympathetic disorder of stomach.

Nine-tenths of the cures that are said to be performed by homoeopathy, result from the spare diet and the nullity, as it were, of medicine employed. Of all the medicines that are prescribed by the physician, the class of salines are the most generally beneficial, as opening the secretory organs, as the skin, the liver, the kidneys, &c., besides improving the state of the blood, and restraining febrile action in the constitution. These, when exhibited in an effervescing state, are far more palatable, as well as more efficacious, than when given in a plain form. Tonics, on which the routine practitioner so much relies, and which he exhibits with no sparing hand, are more frequently injurious than beneficial. They give a feeling of tone for a time; but they lock up the secretions, increase too much the appetite, and lay the foundation for future states of plethora, congestion, or indigestion.

Now saline effervescents may be made the vehicle for many of the most powerful tonics, and indeed the most potent medicines which we possess. The citrate of iron, colchicum, antimony, arsenic, quinine, iodine, &c. &c., may all be exhibited in a form that increases their remedial efficiency, and lessens their tendency to nauseate the stomach.

SENEX.