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1847]

Comparative Anatomy.

239

motion, so that impulses on the lining membrane of the viscera, when sufficiently strong, are responded to, and the contraction of the muscular coat takes place. For these purposes it has a peculiar conformation, which differs more or less from the other parts of the nervous system. Although it communicates with several cerebral nerves, it assimilates most to the fifth and spinal nerves. From these and their centres it probably derives some of their essential or diffusive influence for fortifying its vital powers, but admits only just as much of their faculties as corresponds with the functions of the parts it supplies."-P. 4.

The comparative anatomy discloses some interesting facts. In the first place the plan of distribution, making allowance for diversity in the form of the body," preserves a very great similarity, because it corresponds almost entirely with the fifth and spinal nerves;" the general principle is that, there is one ganglion to each pair of spinal nerves, but these may either remain distinct from each other, as in the cervical region of birds, where there is a small ganglion attached to each cervical nerve; or they may be massed together, as in the superior ganglion of the neck in man, which comprises in reality several distinct ganglia. The presence of large and active extremities makes it larger, especially its ganglia. Then as to texture, in the higher animals, the ganglia are close and fleshy, whilst in other classes, as in many reptiles, they are thready or plexiform; and Mr. Swan believes that the powers and excitability of the latter are inferior to those of the former.

As regards the "innate faculties" of the sympathetic, as Mr. Swan terms them, he conceives, that there are two distinct powers-" a diffusive influence, and a perceptive and motive faculty;" the former, "which forms the element of the material portion of the nervous system, the sympathetic has the power of deriving from, and through, the cerebral and spinal nerves. It can have its powers depressed or exalted; they are depressed when those of the brain and spinal marrow are low, and especially when the spinal marrow has been permanently injured; they may be exalted in any increased vital process, whether sound or morbid." As to "the perceptive and motive faculties, they are concentrated in, and have their specific powers limited to, any particular region by a ganglion or plexus;" the quality of the perceptive faculty likewise depends on the structure of the ganglia, although its powers are capable of being further exalted or depressed by the state of the diffusive influence."-L. c., pp. 17, 18.

As it would exceed our limits to enter into the details of this inquiry, we shall merely extract the summary which the author has drawn up of his views.

"The sympathetic nerve has several properties peculiar to itself, and some resembling the faculties of other nerves. It is, to a certain extent, an independent system, and is a source of peculiar power. It derives its general diffusive influence, or nervous element, from the other parts of the nervous system its branches communicate with. It has appropriate faculties, and is perceptive, and not sensitive, except in pain. Its ganglia have a power according to their structure, and a capability of receiving and answering impulses. It excites involuntary motion primarily. If the impulses are strong, but still amount only to a perception, the ganglia can transmit them to the spinal marrow, and thence directly to the voluntary muscles; but if the impulses be stronger, and amount to pain, they may pass from the spinal marrow to the brain, and excite voluntary

motion; or they may pass from the ganglia to the stomachic plexuses, and from these by the par vagum to the oblong medulla, and thence to the spinal marrow and its nerves, and produce vomiting. It, and especially its ganglia, have a peculiar circulation of blood by minute vessels, derived from contiguous parts, which is quiet and gentle, and increased by the activity of the organs its branches supply; it may also be increased by excitement communicated through the nervous influence, or tracts, or nerves, from the brain, and other centres, the intellect, passions, and external senses. It presides over, and connects in action the whole arterial system, particularly in the brain, spinal marrow, and nervous system generally. It belongs principally to the heart itself, but through connections with branches of the par vagum, combines the nerves of this organ with those of the lungs, and those of the muscles of the chest. It combines the abdominal viscera, and these with the abdominal muscles. It animates and combines the reproductive organs; also the urinary organs, and connects these with sentient and voluntary nerves. It combines various other nerves and parts, through minute and intricate branches. It excites the organs it supplies, to separate from the blood and food such things as are prejudicial, whilst the absorbents retain the beneficial. As its ganglia have so much power over the circulation, they, with other nerves and processes, tend to the production of heat; they, also, through a somewhat similar influence, to that in the heart, tend to the persistence of action and want of weariness, even in the voluntary muscles of birds. It determines the effect that local injuries shall excite in the heart and bloodvessels, and the extent and power of constitutional irritation for their reparation." P. 47.

We must leave our readers to form their own judgment of the value of these conclusions; only observing for ourselves that, whilst concurring in several of them, which cannot however lay claim to much novelty, from others we entirely withhold our assent.

In connexion with this inquiry, we may state that Mr. Beck, in a late number of The Lancet, contends that the sympathetic system is distinct from, and independent of, the cerebro-spinal system; each having its proper anatomical structure, its distinct physiological acts, and being subject to its distinct diseases. In his former paper (see Med.-Chir. Rev., Oct. 1846) he endeavoured to demonstrate the perfect distinctness of the two systems in origin, course, and distribution; and the principal object of the present contribution is to shew by the effects of ether on the uterus, that whereas the influence of this agent is upon the cerebro-spinal system, and that as the reflex functions of the spinal marrow are in abeyance, whilst the action of the uterus continues unimpaired, the inference is, that this organ must depend on some other influence than that of the cerebro-spinal system, on that namely of the sympathetic, which mainly supplies the uterus with

nerves.

HOUSEHOLD SURGERY, OR HINTS ON EMERGENCIES. By John F. South, 12mo. pp. 340. Cox, 1847.

THE Translator of Chelius, late Professor of Surgery to the College of Surgeons, a Member of its Council, and one of the Surgeons of St. Thomas's Hospital, here makes his appearance in a new character, that of

1847]

South's Household Surgery.

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Gossiper on Surgery with the non-medical public, and in that capacity has sent forth a very objectionable book. Popular works upon medical subjects are produced under two different influences: the one a desire on the part of the author to write himself into notice as a remarkably successful practitioner in the class of diseases he has chosen for illustration; the other in a foolish belief that the public at large possess sufficient intelligence and discrimination to successfully apply knowledge which it has taken a long special training to acquire-that there is, in fact, a royal road to the diagnosis and treatment of disease which has only to be pointed out to be pursued. However different may be the moral position of these two classes of authors, the mischievous effects of their proceedings are much the same; and it may be safely said that the world has suffered as much from the blunderings of fools as from the machinations of knaves. We cheerfully acquit Mr. South of any of those puffing designs which have presided over the production of so many Chest-books, Skin-books, Pox-books, and the like, and only charge him with a mere act of simpletonism-a charge which, small as is the space we have at our disposal, we doubt not being able to make good.

It seems the work originated in some popular lectures which its author delivered some time since to a rural audience. He says,

"Though the subject might seem an odd one to select for a village auditory yet there was no difficulty in rendering it amusing as well as instructive, and I believe that I may justly say that I did not fail of attaining my object. On accidentally mentioning the circumstance to one of my friends, who, by means of the printing press, furnishes food to a hungry and never-satisfied public, he said, 'Why do you not make a little book of it? Do so; and I will print it.' So we struck hands, and here appears my small volume."

We are not much accustomed to the admeasurement of the risible faculties of village boors and Lady Bountifuls; but if they found anything amusing in the lectures, it must have been derived from the manner of the lecturer (but no: certain dreamy recollections of the theatre of the College of Surgeons forbid this conjecture), or it must have been of so subtle a nature as to ooze out during the process of printing; for nothing of the kind do we discover. As to the instruction aimed at, a pretty wide field has been embraced, if not compassed. The author commences his work with enumerating the various contents of what he terms "The Doctor's Shop" with which a family in the country should be provided, and among the "few simple family medicines with which no house should ever be unprovided,” we find the following, calomel, tartar-emetic, iodide of potassium, bluepill, opium, and croton oil; and among the formulæ given are those for making Goulard and Sugar of Lead Wash, Black-wash, Washes of Nitric Acid, Chlorine, and Oxide of Zinc; Croton-oil Embrocation; Red-precipitate, Iodide of Potassium, Lead, Gall, Zinc, and Sulphur Ointments; and these directed to be used for the eyes,' 'sluggish sores," sluggish sores with stinking discharge," "stinking ulcers or sloughy wounds," "cracked skin of the legs," "scabbing of large ulcers," stimulating wounds or ulcers," "to lap up the discharge," "for enlarged glands of the neck," "for piles," "as a certain cure for the itch," as the case may be. When treating of Bleeding, the author judiciously enough recommends, in the case of obstinate hæmorrhage from a leech-bite, that the orifices be

NEW SERIES, NO. XI.-VI.

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taken up by means of a sewing-needle, but he adds that, in some constitutions, " even after the removal of the needle and thread the bleeding will continue. Nothing then remains but to thrust into the bottom of the wound a bit of thin iron wire heated white-hot, which I have never known fail to stop the bleeding." We would simply ask him whether he has ever met with a case requiring this, and if so, sufficiently often to justify his placing such a recommendation in such a book? Cupping, we are told, has "the advantage of being easily learned," and, we may add, as easily forgotten unless constantly practised. To enable his amateur to acquire it, Mr. S. furnishes diagrams of the instruments and process. With regard to general bleeding, he does not consider the uninstructed should venture to bleed from the arm, but he may work away at the foot safely enough. The art and mystery of Tooth-drawing, whether by key or forceps, is dispatched in four pages (with appropriate diagrams), and then we come to a chapter upon "How to put on a Roller." We allow that the knowledge of this may be useful to many persons; but we would suggest that one practical lesson from the surgeon who recommends its employment would do more than all Mr. South's pages and diagrams; at all events we feel certain that we could never have learned to roll a leg from his description. The T bandage, "for keeping a poultice on the seat," is a simpler matter, and his lady-readers will understand his diagram well-enough. Of the mode of lancing the gums with a "gum-fleam” we have also an illustration: but, although we agree with Mr. South that the child will often in an hour or two afterwards derive immense benefit from the operation, we doubt whether the anticipation of this will induce it to hold its head erect and unsupported as here depicted. We do not know whether the following passage was intended for a moral hint to his rustic auditory, or as a specimen of dry humour.

"The greater number of persons who get a black eye deserve it, and so far as I am aware there is no remedy save warm-bathing which will hasten its removal; but it is often a very tedious business. The only thing to be borne in mind is not to get a black eye; if you do, you must be content to bear the disgrace for a few days if you deserve it. But if it have been an accident, there is nothing to be ashamed of, and a small draught of patience will be a sovereign remedy."

Believing ourselves that a black-eye may be got quite undeservedly, and that its persistence is to be deprecated, we recommend our readers to discard our author's temporizing procedures, and continuously to apply slices of bryony root, or a coagulum formed of alum and white of egg between muslin, which will often rapidly dissipate it.

But we approach more serious matters. Thus we have detailed directions for treating Wounds of all kinds, whether a "clean stab," a "bruised cut," a "torn or rent wound," "pricks or punctured wounds," and wounds from serpents. For a bite from a mad-dog, the author is energetic enough, but not too much so, when there is no doubt of the animal's rabid condition. "Let a probe or piece of stick be passed down to the bottom of the wound, and insist upon the operator cutting around the wound, and so deeply as to bring out the probe or stick covered with the part cut out as with the finger of a glove.' "I do not think I am wrong in advising, where the finger has been bitten, and there is no possibility of medical assistance, to chop it off, which any one can do with a mallet and chisel."

1847]

South's Household Surgery.

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The variety of wounds might have been supposed to sufficiently tax the attention of the amateur surgeon; but no: he is here taught, and shown by woodcuts, the modes of treating rupture of the tendo-Achillis, nearly all the varieties of Fracture (compound and simple), and the mode of reducing Dislocations, from that of the jaw to that of the hip. In respect to Hamorrhage, we have directions for treating hæmoptysis (free bleeding among them) and hæmatemesis, for taking up arteries in wounds, and the compression of the large trunks. For operating for Rupture, the presence of a surgeon is admitted to be necessary, but, in the mean time, the taxis, the application of cold, bleeding to faintness, and turning the patient topsyturvy may be resorted to.

We have enumerated nothing like the whole of the contents of the book. The various forms of " 'Stifling" by carbonic acid, drowning, hanging, &c. are treated of diffusely, and there are chapters on Things in the Gullet, Windpipe, Nose and Ears. A chapter is added upon the dress, diet, and exercise of children, in which these subjects-the only ones almost the public can be advantageously addressed upon-are most superficially treated; and another treats of the prevention of infectious fevers by ventilation and the non-crowding of the sick, in which nothing is said which has not been better said a hundred times before.

In fine, we may state of this book, that most of the subjects it embraces are utterly unsuited for general description and illustration: and those which admit of these the author has shewn himself incompetent to treat of. It were unjust, however, to dismiss it without adverting to an excuse he offers for its publication. He explains the addition of the portions which relate to wounds and broken limbs, &c. by the suitableness of such information to persons at sea or in commencing colonies, unprovided with medical advice. We are not prepared to say that a pamphlet addressed to this comparatively small class of persons might not have its uses; but this book bears no designation of the kind, and was doubtlessly intended for circulation in this country, in no part of which is medical aid unattainable. The author has some misgivings of the reception which awaits him ; for he says:

"It is very possible that some observations may be made on a Hospital Surgeon writing a book of this kind, intended for general use. I am very careless on this point, as I have had no unworthy object in view. The way in which, and the purpose for which the book has been written, are my apology, if any be needed, which I do not admit; and if I desired precedent I need scarcely remind my readers how many of the ablest persons in science and art have held it no degradation to their high standing to render their particular branch of knowledge accessible, not only to adults but even to children, by cheerfully written works, in simple language, often accompanied with homely illustration."

We do not admit that good intentions form a sufficient excuse for injurious actions. If they exculpate the individual from moral reprobation it is at the expense of his capacity. Nor will the precedents here alluded to hold good. Many of the objects of science and art admit of familiar and popular illustration; and the worst result which can ensue from their partial comprehension is the generation of smatterers and ridiculous pseudosavants; but it is a graver matter with regard to medicine. In the first place the facts are more difficult of summary communication and compre

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