rain pelts against the windows, it penetrates through the sashes, and runs down upon the window-seat. "The drafts from the windows are dreadful. Thus you hear of cricks in the neck from sitting upon the window-seat. It is not from above, alone, that these drafts prevail, although constant puffs of smoke do unceremoniously make their entrée. The legs and feet are also exposed to a cold air-bath from drafts which come under the doors, and which make the carpet, if it be not fastened with nails, dance up and down. The drawing-rooms are somewhat more comfortable; but then, when a party breaks up for the night, it is cruel to mount two pair of stairs to go to a miserably cold bed-room. The gusts of wind in ascending the stairs are sufficient to blow out the candle. Then, if there be no warming-pan, the dread of the cold ague-fit which awaits you between clean fresh mangled sheets, is ever before your thoughts at night. When once warm in bed, I cannot imagine how it is that human nature can muster up courage enough to leave it, considering what awaits it upon doing so, as when you hear the rap at your chamber-door in the morning- Your shaving-water, sir,' and you must get out of bed to take it from the intruding hand. How is it that, in spite of all this, I see so many rosy faces, such colour, such health? It is all attributable to fresh air and cold water.' "But then poor Amelia, where is she? Since the commencement of the cold weather her cough has much increased, and I fear she will share the fate of her sister and younger brother. I shall persuade her friends to try a winter in St. Petersburgh, and the effects of Russian warm rooms. If my cough does not get better soon, I shall myself return, for I cannot stand the cold of this climate." 19. The means the Russians adopt to secure their constantly equable temperature are the careful exclusion of the cold external atmosphere by double doors and windows and thick walls, and the generation of artificial heat within, whose dispersion is prevented in the same way. The latter is effected by means of stoves placed in the rooms and especially in the halls, which, contrary to what prevails with us, are the warmest parts of the house. The humbler peasant caulks the spaces between the logs of which his hut is composed with moss or oakum, so as utterly to prevent air penetrating any crevice however small. His door is well closed, and his window-frames double. He has his stove in the corner of the room, the smoke escaping at the roof. The heat generated would be quite insupportable to those unaccustomed to it, and may be judged of by the fact, that "the flies, congregated in some corner, hang down like a swarm of bees, happy and buzzing in the Winter season.' When the Russian quits his hot-house temperature for the external air, he covers himself with the warmest furs, and the greatest number of pelisses, &c. his means allow him to possess, or the severity of the temperature demands. His bed-room is warmer in Winter than Summer, he can undress at leisure, and finds himself amply covered by a common quilt and single blanket. Before regretting the absence, and considering the propriety of imitating these contrivances in our own country, we must observe that it is placed in different circumstances to Russia. In Russia, a Winter of dreadful severity, and a long, unvaried, continuance of a very low temperature, are the evils to be provided against, and present death and destructive disease would prevail if ampler means of doing this did not exist there than with But the adoption of such means are attended with disadvantages. us. The Russian, of all men, is the most susceptible of cold, owing to the hot-house temperature he accustoms himself to, and is far less able to resist its influence, and is obliged to fly to protective clothing far sooner than the inhabitant of temperate climes does at even the same temperature. Upon a large scale, the same effect is produced as with us results on a small scale, from coddling by excessive precaution. The least exposure unprotected is followed by serious evil, and that this is not the case in Russia arises from the care with which such exposure is carefully guarded against. Again, the impurity of the air which this system engenders is obvious. The great object of the Russian is to exclude the external air as far as possible, and he prefers continuing to respire vitiated air to the freer admission of a colder and purer atmosphere, so that among the lower classes asphyxia is by no means uncommon, and, in all, the rooms have a close, and, what we should call, unhealthy smell. It is true the rich man can have his house so constructed as to admit a sufficiency of air through his heated hall and corridors, so that it arrives in his sitting and bed-rooms in considerable quantities, but this cannot be the case with the majority. In England we have to provide against not a long-continued severity of climate, but a great variability. If, by the heated rooms of the Russians, we augmented our susceptibility to the influence of cold, we should only increase our liability to disease, seeing that we know not when a change to a lower temperature may take place, and are often unable to provide for it by artificial heat or appropriate clothing. We doubt not that the vicissitude of our climate is a leading cause in the production of consumption, but we do not believe its operation would be less prevented, but, on the contrary, increased by adopting this hot-house mode of life. More is to be even gained by accustoming ourselves to the varieties which in ordinary active life are unavoidable, and even the drafts of common dwelling-houses in this way have their advantage, and would be attended with much less evil if women, who form the majority of victims of phthisis, would cover the upper parts of their persons more completely, and their feet more warmly, than is customary. It is the neglect of this and their inactive habits that render them so extremely susceptible. Still, with the delicate and affluent, who can devote their whole attention to their health, and whom circumstances do not oblige to risk the vicissitude of the external air, when threatened by consumption, the adoption of the warm-air rooms or a visit to Russia for the Winter, where certainly housewarming is in perfection, may be desirable; and in traversing our passages the Respirator is as necessary for such as when they go into the open air. In spacious houses, having halls and passages, stoves are very useful in mitigating the change of temperature in passing through them, and might easily be rendered available for warming all the air which enters the house. But the introduction of stoves into sitting-rooms we consider objectionable, as they do not secure that ventilation which is necessary for health, and when made too warm, augment the susceptibility to cold upon exposure to it. We believe that much of the healthful appearance and superior health of the English people depends upon their free exposure to pure air; and pallid countenances and a proportionate increase of mortality are found to prevail in localities where such exposure is impossible or limited. Upon the Fire-place, Dr. Reid has the following observations. "The peculiar advantages of a fire-place are not merely its power of warming an apartment, the circulation of air which it induces, its accessibility, and the influence of the air which it evolves: but the very grateful effect which it produces, after the body has been chilled by any special cause, whether in-door, or out of-doors, stimulating it and exciting the circulation to the greatest degree which may be considered agreeable, and permitting each individual to adjust the distance which is most suitable to his own constitution, and the previous exposure to which he may have been more immediately subject. The light, also, is not to be considered a mere nominal advantage, but a real and positive benefit, affecting the whole system by its physical action, independently of the cheerful impression which its liveliness is calculated to excite; and which, to many, is so engaging, that they feel as if they were not alone when they have the company of a glowing fire. These considerations will probably always sustain the open fire-place, in countries where fuel can be procured with sufficient economy: but its disadvantages, in other respects, compared with the stove, are marked, particularly its expense, its local action, the dust it is apt to produce, and the frequent attendance it requires.” 201. Dr. Reid observes that, where much iron is employed around an open fire, it robs it of so much of its heat and communicates it by conduction to the air passing up the chimney, that the fire rarely burns brilliantly. To this author's observations upon the ventilation of the House of Commons, and other large edifices, we can only refer as containing a masterly demonstration of the subject, which, owing to the profuse illustration by diagrams, (these are found, indeed, in great abundance at almost every page of the book,) becomes easily intelligible to even an unprofessional reader. The first chapters of Sir George Lefevre's little work, treating of the benefits of greater attention being turned to warming rooms, and the employment of appropriate clothing, of the regimen and climate for those threatened with consumption, and of the value of the stethoscope, contain very useful information, calculated to be of use to the general reader. But we consider he has committed a mistake in appending the last; viz. observations upon the treatment of Pleurisy. Not but that this chapter contains matters good in themselves, but very improperly placed. This is, in fact, the error of most writers who address the public upon subjects relating to medicine; for, not content with addressing admonitions frequently invaluable as to the prevention of disease, and which we have alluded to with pride at the beginning of this article, they must also learnedly discourse on the treatment of diseases, and the various appliances of medicine, which a professional education is required for comprehending, much less acting upon. If attempted to be acted upon by the public, every one must see that danger must result; and if the public are expected not to meddle with them, why place them in their way. But, as we have said, although we object to comprising in a book, professing to give popular hints for preservation from coughs, colds, and consumption," observations upon pleurisy, aqua laurocerasi, and tinct. digitalis, yet the observations themselves, are very useful, and must, therefore, be rescued from their ill-assorted company. In the opinion expressed of the limited use of the stethoscope in gene ral practice we agree, believing, that, for practical benefit to be derived from it, its use must be limited to a few consulting practitioners, possessed of frequent and constant opportunities of keeping up and improving their knowledge of its powers. In the hands of some it has been made an instrument of gross quackery and pretension. "Constant practice can alone make perfect in this particular; and how is this to be obtained by the generality of practitioners, who have not the advantage of hospitals or large bodies of patients, upon whom they can prosecute their inquiries? Moreover, it appears to me, that a delicate sense of hearing, such as many do not possess, is a sine qua non for the investigation. The susceptibility to variety of sounds is not the lot of all, and those who do possess it, cannot do so at all times and under all circumstances. "Professional mistakes, with respect to the termination of lung diseases, have been at all times common, but perhaps the public may think them less warrantable, where those means of investigation have been employed to which they attribute more importance than is really due to them: for many look upon this procedure as infallible, and elevate the instrument to the dignity of a mariner's compass. The ear may be of great use in the diagnosis of disease, and should certainly be employed in all cases where it can be fully depended upon; but we were pleased with the observation of one of the most distinguished members of the British faculty, and one perhaps more consulted than any in the metropolis, who stated to us, that he employed the stethoscope rather to confirm his preconceived opinion of a case, than to form one by this means. I am not disposed to disparage-nay, I must avow that I have witnessed the most brilliant feats in the field of diagnosis, from a thorough acquaintance with mediate auscultation, and I believe that no practitioner stands higher in reputation of this kind than Dr. Seidlitz of St. Petersburgh, the advantage of whose superior abilities I enjoyed in consultation during my residence in that capital: but, I do believe the instrument is calculated to do harm to any but adepts; and that long study, continual practice, and certain physical advantages are indispensable to employing it with advantage." Pleurisy, &c.-Although the author states consumptive diseases are rare in Russia, inflammatory affections of the lungs and pleura are very common. He believes them to be more tractable than they are in our latitude, on account of the equable warmth of the apartment in which the patients are kept, preventing any currents of air; but, on account of the great contrast of the temperature of the apartments to the external air, the convalescence is a very tedious one-so that a patient attacked by serious disease at the commencement of Winter, seldom finds himself well prior to the ensuing Spring. Sir George employs bleeding in modeation, but speaks very approvingly of the German remedy, muriate of ammonia, in pleurisy, subacute inflammation of the lungs, and chronic congestions of the mucous membrane. The following is the formula the author has frequently employed it in, with very great advantage. B. Ammonia Mur. 3j. Ex. Glycyrrhiz. 3iij. Aq. destillat. 3 viij. coch. 1 2dis horis. When nausea appears, the antimony is to be withdrawn, and is often not required at all. Stomach-coughs are benefited by it; where the. tongue is loaded it soon cleans it. Many affections of the mucous membranes, as sore throat, enlarged tonsils, relaxed uvula, &c. are benefited by it. For catarrhal affections, especially in children, the following is useful. B. Syr. Althææ 3ij. Vin. Antimon. 3ij. Teaspoonful or two every hour or two. In aggravated cases of cough, with little expectoration and much dryness of skin, the following combination is a good one:B. Træ Digitalis, Liq. Ant. Tart., Aq. Lauro-ceras. aa 3j. Dose from 30 to 40 drops, four or five times a day, in a pectoral tea prepared from various simple herbs. The Germans have the same prejudices against the use of purgatives as the French. They employ tartar-emetic very successfully as a counterirritant. A drachm mixed with Burgundy-pitch is spread on leather, and applied to the chest or between the shoulders. It produces intense irritation. The aqua lauro-cerasi is much used by the Germans, and is deservedly esteemed by them, acting as a calmant in spasmodic affections. The dose may be increased from 10 to 60 drops. It is very useful in spasmodic affections of the stomach, in hypochondriac uneasiness, in hysteria, combined with pain of the uterus. Some mental affections from overexcitement are much relieved by it; I have found it very useful in calming the pain arising from the passage of inspissated bile and small biliary calculi." The following caution is worthy of imitation by us. "The druggists in St. Peterburgh are compelled to retail all medicines which are poisonous in small doses, in dark blue bottles, and all the labels are of the same colour. A piece of paper upon which is printed for external use,' is pasted upon the foot of the phials containing liniments, lotions, &c." The author concludes with the following observations upon the German therapeutics. "German therapeutics hold a middle rank of action between the French and the English, being more energetic than the former, and less so than the latter. The Germans boast of a simplicity of prescription, and have a horror of contrarieties, carrying this to a ludicrous nicety and an unmeaning orthodoxy. Thus, a solution of sulphate of magnesia in an infusion of roses, or the combination of a laxative with an astringent, meets with the severest criticism from those who profess as much abhorrence of a contresens in prescription as Nature does of a vacuum. 66 Unless in form of decoctions, which contain certainly the essence of a large proportion of the vegetable kingdom, and are favorite remedies, a German prescription rarely boasts of more than two or three ingredients. Nothing is considered inert unless it be distilled water, and if active remedies are administered in a variety of other menstrua, the latter are not chosen indifferently, but with a specific view, and to perform a part in the operation of the whole. One carminative water cannot be substituted with impunity for another, it being granted that each has a specific action upon the system. In respect to the influence of minute doses, the Germans countenance the practice of homœopathists. Their ideas (well or ill-founded as they may be) of infinitesimal doses, are illustrated in the preparation of a decoction much esteemed for the cure of eruptions which disfigure female beauty, and which is administered freely in the Spring. It is composed of sarsaparilla, dulcamara, tops of the pine, beetroot, buds of the beechtree, &c.; but the most active ingredient is a small piece of glass of antimony tied up in a muslin bag, and boiled for a limited time only in the decoction, |