On the Treatment of Cancerous Affections of the Cervix Uteri; and especially on Amputation of that Part. By M. Lisfranc. With numerous Cases On the Treatment of Varicose Ulcers, with Cases and Commentaries Cases of Paraplegia, which were supposed to be Epidemic in Paris Dr. Anderson's Report on Fractures, with Cases and Observations M. Lallemand on Visceral Abscesses (Purulent Depôts) after Traumatic Lesions Cancer of the Tongue-apparently fatal Effects of Arsenic exhibited for the Cure, Dr. Ballingall on the Treatment of Fractures and Dislocations A. Case of double Fracture of the Tibia B. Ununited Fracture of the Humerus C. Dislocation of the Elbow-joint D. Dislocation of the Radius backwards CHRONIC AFFECTIONS OF THE JOINTS On the Removal of Loose Cartilages from the Knee-joint. By Charles Averill, Esq. 181 Gastric and Diaphragmatic Perforations; with Medico-legal Remarks 259 Observations on one of the most frequent Causes of Abortion. By Madame Boivin, 234 Grossly erroneous Report of a Case in St. George's Hospital MEDICAL JURISPRUDENCE. THE NEW LONDON UNIVERSITY. Sketches of the Introductory Lectures of Bell, Conolly, Davis, Pattison, Thomson, Watson, and Turner; with general Remarks on the Objects, Tendency, and probable Consequences of this Institution New Curriculum of the Apothecaries' Company, with Explanations and Comments 189 Insurance on Lives-Medical Certificates-Medical Evidence-Remarks on a recent The AGE of LIBEL-COOPER v. WAKLEY; with a Critical Examination of the Evi- dence, Arguments, Verdict, and Moral Consequences of this Trial N. B. The Periscopic and Clinical Articles are arranged separately. THE Medico-Chirurgical Review, No. XIX. OCTOBER 1, 1828, тo JANUARY 1, 1829. I. INSANITY. COMMENTARIES ON THE CAUSES, FORMS, SYMPTOMS, AND TREATMENT, MORAL AND MEDICAL, OF INSANITY. By George Man Burrows, M.D. &c. &c. 8vo, pp. 716. Underwood, 1828. It was high time that England should produce a work on INSANITY which would concentrate the lights that have been thrown on that dreadful malady by various pathologists and practitioners, during the last twenty years. Till the appearance of the work at the head of this article, there was no systematic treatise on the subject of mental derangement, in the English language, which was at all on a level with the progress of pathology in Europe, and therefore Dr. Burrows' attempt to supply the deficiency is meritorious, and the result will be beneficial to the profession in this country. In-, sanity is a disease so obscure in its nature, and so untoward in its manifestations, that the great mass of medical practitioners consider it as one of those which ought to go at once to the asylum, and, therefore, they do not study it with that care which is expended on the common diseases of routine practice. This circumstance may have contributed to retard the progress of mental pathology in this country-for, it is not to be concealed that medicine, in all its branches, and in this one particularly, is become a trade as well as a science here. How few professed oculists, aurists, or dentists, publish on the subjects of their especial pursuits-except in the Newspapers, or in works where the means are concealed, though the end occasionally becomes manifest!!* What information, on the interesting subject of insanity, have we derived from the accumulated experience of the numerous physicians and surgeons in these islands, who devote their time and talents exclusively to this melancholy class of afflictions? Dr. Haslam, on resigning the seals (or at least the scales,) of Bedlam, favoured the world with some observations on sound and unsound mind; but there was rather too much of philosophy and metaphysics mixed up with the Doctor's practical remarks, *By the expression "few," we admit some honourable exceptions to the general rulea rule which applies still more strongly to the treatment of insanity than to the treatmen* of any other class of affections. to render them as useful as they might have been, considering the field which had been open to the author for investigation. Since Dr. Haslam's book appeared, there has been nothing published in this country which deserves particular notice, although many valuable monographs issued from the press on the Continent, during that period. Pinel, Esquirol, Georget, and many other writers, have greatly enriched this field of medical science, which has lain nearly waste in the land where insanity is said to thrive better than in any other region of the world. COUP It is well known that Dr. Burrows, more than ten years ago, issued proposals for the publication of a large work on Insanity. We know not whether to congratulate or condole with the author, on an accident which happened to his manuscripts when nearly ready for the press. By one "coup DE MAIN" of a thief, the whole of his literary researches were swept away! We should have liked to see the PHRENZY of the SPOLIATOR, on opening the large desk, with which he leisurely marched out of the front door of the Doctor's house, in open day. Instead of BANK-NOTES, he only found "NOTES on MADNESS!" To what purpose these notes were afterwards applied, has never been ascertained :-But we verily believe that both the author and the public will be benefited by the operations of the thief. Learning may have lost-but knowledge has been gained by the accident. Dr. B. could have had but little personal experience, ten years ago, as compared with the present, in the science and treatment of insanity. The loss of his manuscripts has thrown him more on his own resources; and it would be well for MEDICINE if a thief were always in the way, when an author first steps out to have an interview with that important personage, the printer! Dr. Burrows has divided his work into five parts, and each of these parts are subdivided into commentaries. We can see no real necessity for the division into PARTS, because there are no natural distinctions between them -the commentaries being quite sufficient for localising the various points of discussion. THE FIRST PART, occupying 245 pages of letter-press, and embracing the important subject of ETIOLOGY in all its various bearings, together with commentaries on the states of the nervous and vascular system-hæmorrhages, complications of insanity with other diseases, metastases, consequences, &c. would, in strict justice, demand an entire article in this Journal. Fifteen years exercise has not opened to us the ROYAL ROAD in REVIEWING. We cannot despatch a large volume in two or three pages according to the modern " MARCH of INTELLECT," which indeed is more like the aerial flight of a balloon than the sober pace of literature or science. In these gazeous excursions, the land may be distinguished from the water-the mountain from the valley-or perhaps the city from the country; but all other and minute features of the scene are veiled from the sight. It is so with MODERN REVIEWING. Instead of exhibiting the minute features of a work, not even the leading characters are portrayed. In short,-to eulogise or condemn a publication, unread-if not unseen-is no uncommon practice in these days of venality, licentiousness, and personal rancour. We shall not dwell on the "INTRODUCTION" to the work, nor enquire whether "madness is one of the curses imposed by the wrath of the Almighty on his people for their sins." Dr. B. we understand, has been censured for this expression, having forgotten to give his authority (Deuteronomy) for it, and consequently appearing to give it on his own. With all due respect for the Doctor, as well as for Deuteronomy, we do not believe that the Almighty ever afflicted one of our fellow-creatures with madness, the Heathen authority to the contrary notwithstanding : Quem DEUS vult perdere prius DEMENTIT. The antiquity of madness is pretty high, since SAUL was in that condition, and appears to have been cured of melancholia by the music of David's harp. That the disease had multiplied between the days of David and Horace is sufficiently evident from the satirical allusions ("insanire omnes") of the Roman Poet. But these matters must be all left on one side, while we proceed to more important considerations. After exposing the absurd attempts to investigate the nature of insanity as a purely mental disorder, Dr. B. quotes a passage from BACON, which shews that HE clearly saw the true path of investigation. Speaking of disorders of the mind, the absolute source, if carefully developed (says he) will be found to exist in corporeal changes, or the effects of external agents acting on the gross machine, and not primarily on the immaterial principle, as has, unfortunately for the subjects of disease, been too commonly apprehended."* It is rather mortifying to think that, even in the year 1827, it was publicly maintained in some of our best medical societies of this metropolis-and by men who are charged with the instruction of medical youth-that insanity might exist as a purely mental disease, and quite independent of corporeal disorder!! This fact proves how ill understood is the subject of insanity, even among the better informed classes of the profession. COMMENTARY THE FIRST-MORAL CAUSES. The causes of insanity are now pretty generally agreed to be moral and physical. "Every impression on the sensorium, through the external senses, and every passion in excess, may become a moral cause of insanity. Thus all, however opposite, act as exciting causes, and will produce this result: joy and grief, anger and pain, love and hatred, courage and fear, temperance and ebriety, repletion and inanition, application and indolence, may have the same effect. Vices, also, which occasion changes in the physical constitution, act as remote moral causes, and induce mental derangement." 9. All moral impressions affecting the feelings act first on the brain and nervous system-then on the heart and vascular system, which latter re-act on the former : "Hence there are two impressions: the one primitive, affecting the sensorium; the other, consecutive, but simultaneously affecting the heart. Thus the nervous and vascular systems are both implicated; and in this manner moral impressions become causes of insanity. The moral cause, therefore, is always the remote cause; the physical, the proximate, or that state of the cerebral functions which immediately precedes the peculiar action denominated maniacal." 10. * Novum Organon, |