be effectually answered by experiments instituted for the express purpose, and a most respectable medical committee was accordingly selected for the execution. A number of children, who, it appears from their registers, had gone through the proper vaccine disease from two to four years before, were inoculated with variolous matter. Above fifty cases were treated in this manner. The progress and result of the experiments are detailed with the greatest accuracy, and were completely satisfactory in establishing the permanent security which the vaccine inoculation gives against the variolous contagion. "If these experiments do not produce conviction, and enable the authors of the contravening statements to perceive that the ground of their error consists either in their subjects in reality not having undergone the cow-pock, or in their having had some eruptive complaint, mistaken for the small-pox; we at least justly demand that our example be followed in reinstituting the trials on an equal number of persons, who can be proved by authentic and fully adequate evidence to have gone through the vaccina.-Also, that in case of eruptions attending, supposed to be the small-pox, such supervening eruptive disorders be shewn from full and authentic evidence to have been the small-pox. Without the imputation of inaccuracy, inattention, or blamable ignorance in those who declared that the cow-pock does not produce incapability of taking the small-pox, at least that it does so only for a limited time; we feel ourselves justified in believing that they have deceived themselves, and of course we cannot admit the cases as evidences of the small-pox at any period whatever, subsequent to the cow-pock." To this candid, but decisive declaration we perfectly assent; we, however, conceive that no unprejudiced person can peruse this report without feeling convinced, that the objections of Mr. Goldson have received a complete refutation. We think this publication does great credit to the gentlemen under whose direction the experiments were conducted. They meet every objection, and seem to remove the only serious obstacle which has occurred to retard the progress of a discovery, which in its consequences we consider more beneficial to the interests of humanity, than any within the records of modern science. The opinion which we have formed of Mr. Goldson, induces us to believe that he will not be able any longer to resist the weight of evidence which has been brought against his opinions'; and we exthat his candour will induce him to pect make the recantation of his errors as public as his avowal of the errors themselves. ART. V. ATreatise on Madness and Suicide, wib the Modes of determining with precision mental Affections, in a legal Point of View; and containing Objections to Vomiting, Opium, and other Mal-practices, &c. &c. By WILLIAM ROWLEY, M. D. Member of the University of Oxford, the Royal College of Physicians in London, Physician to the St. Mary-le-bane, Infirmary, and public Lecturer in the Theory and Practice of Medicine, excluding false Systems, Sc. c. pp. 162. THIS treatise contains some judicious observations, combined with much vague hypothesis and inconclusive reasoning, delivered in an abrupt and antiquated style. It commences by a definition of the disease. "Madness, or insanity, is an alienation of the mind, without fever. "It is distinguished into two species; melancholy, or mania; furor, or raving mad ness. "The former is known by sullenness, tariturnity, meditation, dreadful apprehensions, and despair. "The latter is attended with a violent and inordinate desire often to do mischief; ury, vociferation, impetuosity of temper, an ndomable turbulence and vehemence; an angry and wild staring look in the eyes, acions rashly attempted, and as suddenly re linquished; obstinacy, perverseness, immodesty, are amongst its characteristic signs." The second paragraph is evidently erroneous; the author seemingly intended to contrast the two species, and to give the Latin and English names for each; as it now stands, it would appear as if mania were intended for the translation of melancholy. After a few remarks upon the prevailing modes of practice, which he condemns as neither scientific nor judicious, he proceeds to give an account of the appearances upon the dissection of persons who have died insane. A variety of phanomena are mentioned, but without stating the authorities, and he afterwards gives the following result of his own experience. From these appearances he deduces his leading idea, that a distention of the venous system of the brain is the immediate cause of insanity. "Passions, or meditation," he observes, "certainly force a greater quantity of blood to the brain than usual." When this operation is too often repeated, the veins are kept in a constant state of distention, their coats are weakened, and at length the sinuses themselves become over-distended. The increased flow of blood through the arteries, and its stagnation in the veins, is supposed at length to change the nature of the blood, and to produce vitiated, acrimonious fluids in the brain; the presence of these fluids causes insanity. This we believe will be found a fair statement of Dr. Rowley's theory; it will be seen to be entirely hypothetical, and the forcible objection may be urged against it, that cases of insanity frequently occur, preceded by no apparent irregularity in the distribution of the blood, and in many instances, after death, no morbid appearance can be detected in the brain. The power of the will in increasing muscular exertion is a subject which has long exercised the acuteness of the metaphysician; but our author easily resolves the difficulty, by supposing that we possess a voluntary power of determining an unusual quantity of blood to the head, and retaining it there for some time. It is not only an increase of muscular action, which he supposes is produced by this change in the distribution of the blood, it also may cause "According to the pleasure of the will, either stronger, sublimer ideas in the mind, or an increase of bodily strength in all the muscles destined to voluntary motion." Thus does Dr. Rowley attempt to ex plain that hitherto inexplicable connexion which subsists between mental exertion and corporeal structure. We are led to inquire, first, whether his hypothesis is in any degree supported by fact; and secondly, whether admitting its existence, it affords us any real information upon the subject. To both these questions we confess, we are inclined to answer in the negative. The author, feeling more confident as he advances in his subject, next under takes the still more arduous task of attempting to account for the different dis Positions, which manifest themselves in different individuals, and which, when carried to excess, often constitute insa nity. "Whatever may be the pleasure or object in view, there is in the mind a proneness of propensity, either through choice, necessity, or hopes, according to the various tastes of the parties, for its acquirement, which may aptly be called mental attraction." Asacontrast to these mental attractions, we are afterwards informed that there are corporeal attractions, the meaning of which term is thus more fully ex plained. "Corporeal attractions, are the assimilations and adhesions of constituent particles frot nutrition, and their conversion into certain individual, the effect of which is likewise states of the blood and body peculiar to each called idiosyncrasia." This new doctrine of corporeal attrac tions is illustrated by supposing, that fat people attract from their food the oily particles; thin people, the earthy and glutinous particles, &c. Hence it fol lows, that the difference between the mental and bodily qualities of different individuals depends upon the aggregat: difference of their mental and corporeal attractions. On this hypothesis we shall remark, that the first part is merely a substitution of the new term, for the or dinary form of expression, and the se cond, an assumption without a shadow of proof. It still, however, remains to be deter mined, how the supposed alteration in the quality or quantity of blood in the brain can affect the mental faculties. In or der to the due investigation of this point, the author urges a number of arguments against the existence of a nervous fluid, in which we certainly think him success ful. He notices the connexion which subsists between arterial action and the state of the temperature, and concludes that the operation of the nervous system, which he denominates the soul, has an important agency in directing and controlling the action of the corporeal organs. The soul, it is supposed, can act upon all points of the body, and among others, upon the heart, and can impel a greater or less quantity of blood to the head, for either mental or bodily exertion." It appears, however, that though the soul has such consider able power over the system, it can only act properly when the organs are in proper order; so that when the increased quantity of blood in the brain has injured the texture of this part, the soul is no longer able to produce the proper effect, even though the blood was sent there by its own effort in exciting the contraction of the heart. This train of reasoning is contained in a string of distinct propositions; some of which are extremely hypothetical, and which in general have very little dependence upon, or connexion with, each other. Among other strange fancies which they contain, the author conjectures in the 33d, that "light perhaps, is the nervous principle." This idea of the reciprocal action of the blood vessels and the brain upon each other, leads Dr. Rowley to form a number of conclusions on the cause of madness. The leading idea is the distention of the vessels of the brain, caused by the transmission of an unusual quantity of blood by the arteries, producing congestion, principally in the veins. and sinuses. We shall quote one of the concluding propositions. "Madness, then, is nothing but the effects of distended vessels, a checked vicious circulation, and changed fluids opposing or perverting the soul's regular action or power in the medullary substance of the cerebrum and cerebellum; in which perception, reasoning, judgment, imagination, and memory reside; as well as the nervous powers over the body, for performing voluntary and involuntary motion," &c. The first step in the cure of madness must evidently depend upon a removal of the exciting causes when they can be discovered, or are removable. If suppressed evacuations have produced the disease, we are to endeavour to restore them; and if any particular acrimony exists in the constitution, we are to remove it by the appropriate remedies. The distention of the vessels may be of two kinds; distention produced by an excess of force in the heart and arteries, and distention arising from a relaxation in the coats of the vessels, while the power of the heart remains the same. The first species he names tonical, and the second atonical distention. The cure of the tonical distention consists in bleeding, drastic purgatives, and "extreme dry diet." Upon this last remedy he places great dependence, and conceives, that he is enabled by it to deplete the over-distended vessels. The cure of atonical insanity, he remarks," will be comprehended from its opposition to the former species." He, however, insists equally on dry diet. The author totally condemns the employment of opium in insanity, because the sedative properties of this medicine will be more "likely to fix," than to remove the disease. If it diminish the action of the circulating system, he conceives it must retard the flow of the blood, and consequently produce a tendency to its stagnation. Except the recommendation of "extreme dry diet," and the condemnation of opium, we do not discover any originality in the practical part of this treatise. How much confidence our readers may be disposed to place in Dr. Rowley's skill in the treatment of insanity we know not, but he appears himself to be perfectly well satisfied with his attainments, for he concludes this part of his work by the following remarks: "Thus have been explained, and communicated, many new doctrines concerning madness, its causes, and cure. The data or facts on which these principles have been constructed, are anatomical inquiries, the most certain of all, and inductive reasonings from the morbid appearances of parts, constituting many new lights on insanity. Several inethods of cure, hitherto unattempted, are above thirty years constant and extensive ex◄ drawn from the foregoing reasonings, and perience and reflection on the powers of medicine in every branch of the art. "If the curative modes recommended should, as they must, in several instances, fail; yet the causes of this failure, from contemplating what is here advanced, will be better understood, than heretofore. The next useful knowledge to curing diseases, is, to comprehend, and give the reasons, why cures should not be expected. This is the distinguishing mark of real medical learning, contrasted to rash boasting, and delusive empiricism." Dr. Rowley not unfrequently takes occasion to refer to his other publications, and more than once speaks of his medical lectures, from which he informs us all false systems are excluded. We have no doubt that, like every other lec turer, he adopts the system which he thinks true, and avoids those which he disapproves; but if by the expression he means to convey the idea that his lectures are peculiarly free from speculation cr hypothesis, we must remark that they differ very widely from the work before us. al. of to human actions is so uncertain, in con sequence of the difficulty which we ways have in determining what part of our knowledge we acquire by means this principle, that we should greatly prefer the use of reason in all these cases. By this means, if any thing really val able is suggested by instinct, it will not be disregarded. ART. VI. Discourses on the Management of Infants, and the Treatment of their Diseases, written in a plain and familiar Style, to render it intelligible and useful to a'l Mothers, and those who have the Management of Infants. By JOHN HERDMAN, M. D. pp. 127. WHEN we reflect "that more than one quarter of the human race die in infancy," we are led seriously to inquire whether this great mortality is the necessary operation of unavoidable causes, or whether it ought not to be imputed to some mistakes in our treatment of child. ren. Our author is confident it proceeds from this latter cause, and even thinks it impious to conceive that the author of being should doom so many of his creatures to a premature death. Without dwelling on this mode of reasoning, which, when pushed to its utmost extent, would prove that pain and death ought not to exist in the world, we are more inclined to rest satisfied with his second argument, viz. that among savage nations, whose customs with respect to children materially differ from ours, this great mortality does not prevail. The deduction, however, is not quite clear that if our children were treated like those of the savages, they would equally escape the perils of infancy. A part at least of their danger is derived from the constitution of their parents, debilitated by luxury, and tainted by the maladies of their ancestors. The prime source of the evil, with respect to our management of children, is conceived by Dr. Herdman to originate with the nurses and midwives; a tribe ignorant and prejudiced, who, in consequence of their supposed experience, are permitted to direct the mothers, and, in consequence of their influence in society, are often permitted to direct the medical practitioner. We think his remarks are in general true, but we cannot acquiesce in the remedy which he has pointed out, viz. that we should entirely disregard their direction, and, in short, all previous experience, and should be guided by instinct alone. Without entering into any metaphysical disquisition about the meaning of the term, we may be allowed to remark, that the application of instinct After the preliminary observations, Dr. Herdman enters more immediately upon his subject, by considering "the management of the infant from the pe riod of his birth, till the period in which he is about to suck." Several reasons, not without foundation, are offered a gainst the usual practice of washing the child immediately after birth. "He (the child) suffers from no less than five causes. First, from exposure to co Secondly, from being tossed and tumbled about the nurse's knee. Thirdly, frosa upon ly, from the nature of the cleansing sub friction by her rough and rude hands. Founistance. And fifthly, he suffers, and he s fers most severely, from the excoriations inflammations which follow this officious cleansing of his skin." In place of this operation, the auther simply recommends that the body be wiped dry with soft cotton, then wrappe! up in a loose warm garment, and placed in the bosom of its mother. His objections to the tight clothing f infants, to the swaddling bands and fillets with which they were invested. "more in the form of an Egyptia mummy than a living and feeling being, are what every one must admit to just; indeed the practice in this respect has of late years undergone so consider able an alteration, that we hope remarks upon this subject will soon cease to be necessary. Another practice which Dr. Herdman strongly condemns, is giving the infant a purgative immediately after birth, in order to remove the meconium from its bowels. We agree with him in thinking it not only useless but pernicious, and we also acquiesce in his next subject of remark, that it is, for the most part, wrong to give the child any food until its mother's milk be ready for its nutrition. We believe that the officious interference of nurses on these two points often lays the foundation for serious complaints in the stomach and bowels. Dr. Herdman next proceeds to consider "the management of the infant from the period in which he is applied to the breast till towards the period in which he should be weaned." We were not surprised to find the author a strenuous advocate for the custom of all mo thers suckling their own children. He is indeed extremely earnest in his appeal, but on a subject which has been so frequently and so ably canvassed, we cannot expect to meet with any thing novel. A good deal of stress is laid upon the temperature at which children should be kept during the first weeks of their existence. He disapproves of the use of cold bathing and frequent exposure to the cold air, which are had recourse to from an idea of their hardening or bracing the child; an idea founded upon a false theory, and actually productive of bad consequences. The terms air and exercise are in the mouth of every one. These powers are prescribed at all hands to the young, the old, and the middle aged; the weak and the strong; the diseased and the healthful; the infant and the adult, without the least regard or consideration of circumstances. The infant is sent abroad to air and exercise in the most inclement season, and even in the cold est day one can scarcely turn round without being shocked by the sight of an infant carried starving and motionless in his nurse's arms." “But to send an infant abroad in the view of exercise is truly ridiculous; for where is the exercise of being carried motionless in a woman's arms? The exercise is to her and not to the infant. By the exertion of walking, and of carrying the infant, the heat of her body is preserved, her feelings are kept agreeable, and she receives no injury, while the poor helpless innocent, motionless in her arms, is losing heat every moment; is starying alive as it were; is suffering all the pains and injurious effects of cold." These remarks, though, perhaps, rather carried to the extreme, are, we think, deserving of serious consideration. With respect to the period of weaning, the author lets it, in some degree, depend upon the progress of the child's teeth, conceiving that until it has some power of mastication, it ought not to be de prived of its mother's milk. The process of weaning ought, he thinks, to be brought about very gradually; many of the diseases which frequently accompany this period of life, he attributes to the sudden alteration in the diet and habits of the child. From this abstract our readers will conclude that the work before us is not undeserving of the attentive perusal of those engaged in the management of children. The doctrines which it inculcates are, for the most part, plain and sensible; the language, though occasionally coarse, is in general clear and forcible. ART. VII. Morborum Puerilium Epitome. Auctore GULIELMO HEBERDEN, Regi Reginaque Britanniarum Áledico Extraordinario. bvo. pp. 72. THE style and composition of this treatise will confirm the character which the author has already acquired, as an legant and accomplished scholar. He eems to have imbibed no inconsiderable portion of the spirit and manner of Celsus, whose simplicity and terseness of expression he has happily adopted. The propriety, however, of locking up ar information in a dead language, and especially on a subject of which a great and important part would be most beneficially conferred on those whose edu cation precludes them from any acquaintance with those languages, may be very questionable; and it seems equally doubtful whether Dr. Heberden's object in writing this treatise, which is to restore this department of medicine "ab anicularum et indoctorum ineptiis ad severiorem artis disciplinam," will be most effectually accomplished by these means. Those precepts which relate to the diet, and to the prevention of diseases in children, would, perhaps, be most usefully delivered to their mothers and • Besides it often happens that infants suffer distortion by being carried so much in one ANN. RE. VOL. III. Position. 3 E |