Bath, Cheltenham, Leamington, &c., drugging and dieting him secundum artem; until he comes to the conclusion that no good is to be expected from them. Of course he next falls into the hands of quacks, who soon find out what a profitable patient they have got hold of, and manage to fleece him accordingly. He goes the whole round of the various forms of empiricism, catching at each new promise of cure as if he had never before been deceived; until at last his easy credulity receives a check from the discovery that he has been made the victim of a regularly organized system of imposture, of which his trusty valet has been the accomplice. Just in the nick of time, when he is in despair of relief, business brings him in contact with one of the intimates of his youth, a rural physician, who invites him to his cheerful home, the influences of which gradually dissipate his ennui, and restore him to health and happiness.

Such is a sketch of the story, from which our readers may judge of its plan; with regard to its execution we must confess that we cannot speak in as favorable terms as we should have been glad to do. Such a jeu d'esprit ought to be lively enough to carry the reader along without weariness; and where the scope of the treatment is limited by the constant prominence of one object, it ought not to be too fully amplified. The book would have been more readable if about half its present length.

ART. III.-Clinica Quirúrjica, ó Consideraciones sobre el Estudio práctico de la Cirujia. Por el Doctor RAMON FERRER Y GARCES.-Barcelona, 1849. 8vo, pp. 258.

Clinical Surgery, or Considerations on the Practical Study of Surgery, By Dr. RAMON FERRER Y GARCES.-Barcelona, 1849.

THE work before us is addressed principally to the pupils of the author attending his lectures in the medical school of Barcelona, which is one of the leading provincial medical colleges of Spain. It commences with some observations upon the importance of clinical or bedside study, and a short historical account of the progress of clinical tuition. The merit of establishing the first ward expressly for this purpose is awarded to Padua, a clinical ward having been opened in an hospital of that city in 1578. Le Boe, at Leyden; Boerhaave, and Van Swieten, adopted the system with such success, that it was followed in the schools of Paris, Montpellier, and most of the principal hospitals of Europe. But in Spain, from the time of the Arabs,

"Seville, Toledo, and Cordova possessed celebrated schools and hospitals, to which many young physicians from other European countries repaired for instruction; yet, in the midst of such copious sources of knowledge, scarcely any clinical study was carried on; since, far from endeavouring to obtain a profound knowledge of diseases, discussions were raised upon the most frivolous subjects, and interminable questions excited about them." (p. 24.)

At present the author laments that clinical tuition in Spain is far behind that of France, England, or Germany; but states that clinical establishments are numerous, and that the royal colleges of medicine and surgery of Madrid, Cadiz, and Barcelona, of medicine, surgery, and pharmacy at Pampeluna, with various other medical schools in different large towns, have given of late years a promise of great good to the profession in the

Peninsula. The causes which diminish the value and utility of clinical instruction, and the means of removing them, are sensibly treated; the author insisting that the number both of patients and students must be limited to prevent the danger of imperfect observations and confused impressions, and that in every medical school professors should be appointed for the express purpose of clinical tuition.

The following chapters are of no great interest; their subjects are diagnosis in general, and the method of examining the different organs of the head, neck, chest, abdomen, and extremities.

In his own classes, the author has been in the habit of assigning certain patients to a party of three or four students, one of whom is called the observer, who records and narrates the case before the others, who are expected to offer their opinion or suggestions upon what the observer has done or stated. The effect is said to have been excellent, a great spirit of emulation having been excited, the little controversies often showing extensive research and close observation. The author also proposes to unite the most diligent clinical students into a species of society of emulation, in order to collect histories of cases treated by different professors. This was done with great success by Corvisart, and except that the members are more advanced in the profession, is the principle of the Medical Society of observation, which has done so much under the direction of Louis.

A long chapter follows on prognosis in general, and in particular in the cases of wounds, ulcers, fistulæ, dropsy, hernia, aneurism, fractures and dislocations, and tumours. It is rather common-place.

Among some remarks which follow upon the treatment of surgical disease, the following may not prove inapplicable beyond the Spanish frontier.

"The practitioner should not be above examining if his prescription be well or ill prepared, both to assure the result of the method he employs, and to avoid the injury which might be produced by a badly-prepared medicine; yet I esteem it very improper and shameful that a physician or surgeon should establish a shop to distribute medicines to his patients, or the drugs which compose them." (p. 240.)

A few observations on the best method of writing histories of cases, concludes this work, which, although it might be considered among us as common-place in the extreme, yet it is not without its interest as a sign of the times (the Medical Times of course,) in Spain, and will, doubtless, prove useful to those to whom it is addressed. We have noticed it principally to show what is doing by our Spanish friends.

ART IV. Practical Observations on the Prevention, Causes, and Treatment of Curvatures of the Spine; with Engravings and Woodcuts, illustrative of the Cases. By SAMUEL HARE, Surgeon. Third Edition, revised and enlarged.—London, 1849. pp. 245.

Mr. HARE's book, although sensibly enough written, contains nothing but what every one knows; and in the whole 245 pages it would be hard to find a single new fact, or even a single new suggestion. Who, for example, doubts the necessity of cleanliness both to children and adults? who wants to be told that it is a good thing to sponge a child mourning and evening with tepid water, and then to wipe it dry; and who questions

that a "handful of salt" dissolved in water makes it more stimulating? Again, who is ignorant that stays äre very often badly made, and as often laced too tight? and whence the necessity of such a paragraph as this: "Cleanliness and temperance are equally essential to the enjoyment and preservation of health, as fresh air and active exercise." (p. 41.)? The wonder to us is, how people can be found willing to undergo the repeated infliction of such a dose of twaddle; one would think the author himself must be tired of it by this time.

With respect to the treatment of distorted spine, it is just the same old story over again. The spine does not become crooked without a cause, and without a considerable impairment of the general health; and if Mr. Hare's beautiful plates-for they are beautiful-show nothing else, they at least prove how wonderful is the change that a little rest, combined with a little gentle mechanical treatment, strict attention to diet, and a little judicious physicking are capable of producing in the worst of these cases. So far so good; but now the question rises in the mind-what is the object of the book? It cannot be to tell the profession what every member of it already knows; and there is but one other solution,—it must be written for the public, and to catch patients. Even the artist has combined in this object with Mr. Hare, and has helped to bait the hook daintily. Witness plates 9 and 10. For a long time we could not make out what had changed a seemingly idiotic boy into an intellectual-looking youth, there being something in the metamorphosis far greater than the difference between a straight and a crooked back; but after much study we discovered how a little shortening of the lips, a little addition to the forehead, and, above all, a different mode of arranging the hair, effected a change in the hands of our skilful limner, that was quite astonishing, and must have been most gratifying to the friends of the young gentleman.

Then, again, sometimes the patients tell their own stories. There is one lady who must be a perfect pathological phenomenon. Case XI.— 1816, very ill and confined to bed for some weeks; 1817, bore a child; 1818, another child, and in the most imminent danger; 1820, an inflammation of the lungs; continued very ill until 1822, then had another attack of inflammation of the lungs and bowels; 1825, a severe complaint in the bowels;" 1826, an inflammation of the brain; 1823, bore a fourth child after a most distressing labour; and now she had the good fortune to come under the care of Mr. Hare, and got quite well.

Besides this, our anthor does other wonderful things. In caries of the vertebra, he induces the bones to be kind enough to become anchylosed in the straight position, instead of the crooked one, which is the result with which most of us are simple enough to be contented.

There is one charming feature in Mr. Hare, and that is, the delicacy with which he tells us of his patients' improvement. It would not do to say they got fat-that's vulgar-so Mr. Hare says a considerable deposition of adipose tissue took place."

But after all-jesting apart-we are very sorry to see a respectable, and, we believe, a judicious practitioner descending towards the level of the puffing tradesman; and we take leave of Mr. Hare with the same remark as was made by one of our predecessors,-" The work before us has not added anything of the least value to our previous knowledge."

ART. V.-The Microscopic Anatomy of the Human Body in Health and Disease. Illustrated with numerous drawings in Colour. By ARTHUR HILL HASSALL, M. B. Part XV.-London, 1849. 8vo.

WE are happy to be able to announce the completion of Dr. Hassall's 'Microscopic Anatomy;' the long delay of which has not improbably led to the suspicion, that it would share the fate of too many other works published in parts, and not be brought to a conclusion until the earlier portions of it should be already antiquated. The present is a triple number, containing nine plates, and a considerable quantity of letter-press. The subjects illustrated in it are the ultimate structure of the thyroid and thymus glands, the supra-renal capsules, and the spleen; of the papillæ of the skin and tongue; and of various parts of the olfactive, visual, and auditory apparatus. Some of the delineations are very good, others but mediocre; on the whole, however, this concluding part well sustains the character of those which preceded it. We shall take an early opportunity of passing the entire work under review.

ART. VI.—An Exposition of the Case of the Assistant-Surgeons of the Royal Navy. By a Naval Medical Officer. Second Edition.-London, 1849. 8vo, pp. 28.

THE author of this temperately-written pamphlet so clearly and cogently sets forth the grievances of the class whose cause he has undertaken to advocate, and so triumphantly meets the objections that have been made to their removal, that we are at a loss to conceive on what ground a system, which is not only palpably unjust, but also (which we apprehend is a consideration of more weight with those in power) demonstrably impolitic, can be any longer persevered in. When the fact is made known, that notwithstanding the overstocked condition of our profession, the temptations of a pay of from seven to ten shillings a day, with the prospect of advancement, and the nominal rank of a lieutenant in the army, are not only insufficient to induce well-qualified young men to seek admission into the service, Sir W. Burnett having been obliged to go a-begging for candidates even as far as Edinburgh; but are inoperative to retain the best men in it, many quitting it for the army and the East India Company s service, and others (such as Dr. F. J. Brown, whose little tract on Naval Hygiène we noticed with approbation in our last Number) for private practice; it cannot but be obvious to all, that there must be "something rotten in the state of Denmark."

The main grievance, so far as the assistant-surgeons are concerned, consists in the degradation to which they are subjected in being compelled to herd with the midshipmen in the cockpit, instead of being admitted to an association with the ward-room officers, to which they are entitled by their nominal rank, their education, and the responsible nature of their duties; and in the want of a private cabin in which they can pursue their professional studies, or devote their leisure time to the acquirement of those other branches of knowledge which the assistant-surgeons of the navy are specially directed to cultivate. And we notice it on the present occasion, because the subject will ere long be again brought before the attention of the Legislature and since the aggrieved parties are debarred

by the rules of the service from uttering their own complaints, it is for those who feel, as we do, that the dignity of our profession is insulted, and its claims to public consideration trampled down, by the obstinacy (to use the mildest term) of the Admiralty authorities, to stir up our brethren to exert themselves in behalf of this injured class, that they may bring public and private influence to bear upon those who have the power to remove the grievance.

But we cannot leave this topic without expressing the surprise with which we have learned from the pamphlet before us, that this inferiority of rank and consideration extends into the higher branches of the medical service of the navy; for the whole Naval Medical Staff, from the DirectorGeneral to the Deputy-Inspector of Hospitals, have rank a step beneath that of their brethren in the army; so that Sir William Burnett does not rank with Sir James Macgregor, but with the subordinate Army-Inspectors. Nor can we omit to notice the mode in which the medical service, even of the army, is degraded by exclusion from the honours and rewards which are bestowed on those engaged in personal combat ; as if the exertions of the former were inferior in merit, or less important to the success of military operations. It is surely high time that our public bodies should bestir themselves in these matters, and endeavour to convince the world of our claims on its regard, by showing that we are not ourselves insensible to them.

ART. VII.-Ristretto Generale di tutti gl' Infermi nel Sacro Archiospedale di S. Spirito per lo scorso Anno 1847.-Roma, 1848.

General Return of all the Sick in the Great Hospital of Rome for the Year 1847.-Rome, 1848.

FROM this official return we merely extract the numbers treated in 1847, including those remaining on the 1st of January, and those entered during the year. We also give the proportion of deaths; the difference between the number of deaths and patients treated will give the number of those who left the hospital, and of those who remained on the 31st of December together. The daily average of patients treated in the Civil Hospital was 511, the deaths for the whole year 1108, exclusive of 9 medical cases which died on the day of admission. The only classification is as follows:

It must be observed that surgical cases are not in general sent to this hospital, another very large establishment in Rome being specially destined for wounds and diseases treated by the surgeon.

In the Military Hospital the numbers were as follows: