29. A System of Human Anatomy; translated from the fourth edition of the French of H. Cloquet, M. D. Professor of Physiology, &c. with notes and corrected nomenclature. By ROBERT KNOX, M. D. F. R. S. E. Lecturer on Anatomy, Fellow of the Royal College of Surgeons, &c. Edinburgh. 8vo. pp. 838. Maclachlan and Stewart, Edinburgh, 1828.

30. A Pocket Compendium of Anatomy; containing a correct and accurate Description of the Human Body. By E. WILL. TUSON, Lecturer on Anatomy and Physiology, &c. &c. 12mo. in the shape of a pocketbook, pp. 289, London, 1828.

* The plan of the present Compendium is new-and its execution good. To the Student attending the Hospitals and Lecture-Rooms, the work will be useful, being readily carried in the hand or the pocket, and looking exactly like an ordinary pocket-book.

31. A treatise on Nervous Disorders; including Observations on Dietetic and Medicinal Remedies. By THOMAS RICHARDS, Surgeon, 12mo. pp. 154. London, 1828.

*We fear that this Treatise is too professional for the populace, and too popular for the profession. It is free from all quackery, and contains no ad captandum appeals to the patient.

32. Chemical Re-Agents, or Tests; and their Application in Analysing Waters, Earths, Soils, Metalliferous Ores, Metallic Alloys, &c. Originally by F. Accum; improved and brought down to the present state of Chemical Science. By WILLIAM MAUGHAM, Surgeon, Lecturer on Chemistry and Materia Medica, &c. 12mo. pp. 452, one plate, London, 1828.

33. Pathological and Practical Researches on diseases of the Stomach, the Intestinal Canal, the Liver, and other Viscera of the

35. A Supplement to Myology; illustrated by coloured Plates, on a peculiar construction, containing the Arteries, Veins, Nerves, and Lymphatics; the Abdominal and Thoracic Viscera, the Brain, the Ear, and Eye, &c. By E. W. TUSON, Lecturer on Anatomy and Physiology, Member of the Royal College of Surgeons, &c. Nine plates, price 41. 10s. Gallow & Wilson, London, 1828.

*We have already, on several occasions, had reason to speak favourably of Mr. Tuson. On the present, we cannot resist the pleasure of expressing the very high opinion we entertain of his ability, ingenuity, and industry. These plates do him credit; they are happily conceived and as happily executed. The two representing the brain and gravid uterus in particular, merit the most commendation. To the student we recommend the work as serving, all that such delineations can-the assisting, not the superseding of dissection.

36. Nouvelle Toxicologie, ou Traité des Poisons, et de l'Empoisonnement, sous le Rapport de la Chimie, de la Physiologie, de la Pathologie, et de la Thérapeutique. Par GUERINE DE MANVERS, Docteur en Médicine, &c. &c. 8vo. pp. 412, Paris, 1828. **This is a very able work, and we hope to give an analysis of it shortly.

To Dr. BURROWs we have to apologize for not being able to notice his "Reclamation." We were led into an error, it appears, by a passage which we quoted from his work, and which stated that "all the causes, physical and moral, of insanity, have existed since the origin of man." This passage seemed to us to deny the springing up of new causes, from time to time, with the progress of civilization. But such is not Dr. Burrow's meaning; for, in another place, which escaped our notice, he traces the great source of mental alienation to the progress of civilization. The mistake or rather misapprehension on our part is not, we imagine, of so much importance as Dr. B. thinks it. It is now, however, rectified.

THE

Medico-Chirurgical Review,

No. XX.

JANUARY 1, TO APRIL 1, 1829.

I.

RESEARCHES INTO THE CAUSES, NATURE, AND TREATMENT OF THE DISEASES OF WARM CLIMATES, By James Annesley, Esq. Two Volumes, 4to.

1827-8.

[ART. III.-CHRONIC HEPATITIS, and ORGANIC DISEASES of the LIVER.]

Of all the diseases to which Europeans are particularly prone in Tropical climates, CHRONIC HEPATITIS is the most interesting to the HOMe departMENT of medicine in the British Isles. When the liver has taken on this form of disease, the invalid generally returns to Europe, where he continues to be, at once, a plague and a profit to every practitioner within his reach during the remainder of his life. As for Cheltenham and Leamington, their very streets are paved with the pagodas that have been purchased in the East at the expense of health in the West! But this is not all. It is suspected-nay, it is truly affirmed, that LIVER DISEASE is transmitted to the offspring of the ANGLO-INDIAN, with as much certainty and facility as pulmonary tubercles, gout, or mania. And why should not the hereditary disposition be transmitted in the one case as well as in the others? No reason to the contrary can be assigned, while observation is in favour of the affirmative side of the question. Considering the prodigious influx of oriental and occidental invalids annually in this country, most of them labouring under chronic disease of the liver, the evil would be most alarming, did not the nature of our cold and gloomy climate check the hereditary propagation of hepatic diseases, in the same way that the bright skies and fervid atmospheres of the Eastern and Western Indies retard the progress, or annul the propensity to pulmonary phthisis. But still the class of maladies under consideration is quite extensive enough to render its investigation a matter of very great importance among all classes of the profession in this country.

Few have had more ample opportunities of seeing the disease under consideration, on a large scale, than the author of the great work now before us; and, therefore, we propose to give a very full account of this portion of the publication, interspersed with original and collected information, wherever we see an opportunity for its introduction.

Chronic inflammation of the liver may occur as a primary disease, or take place as the sequel of acute disease.

"When chronic inflammation takes place primarily, it generally is seated in the internal texture of the organ, and often gives rise to but few local symptoms, and but little constitutional disturbance. But chronic is a term which conveys with it no precise idea, and merely signifies a slow state of inflammatory disorder, presenting every grade, from that state of disease which may be considered as only slightly deviating from the healthy action, and which may continue for a great length of time, giving rise to various organic changes, to that which runs its course rapidly, and terminates, either one way or another, in a very few weeks. When this form of inflammation remains after the more acute phenomena have been subdued, it has generally its seat in the substance of the liver, but not uniformly : it may be seated in the surfaces; for the active inflammation, which has been followed by the effusion of coagulable lymph upon the surface of the organ, and the formation of adhesions between it and adjoining parts, may be, to a certain extent, rekindled, after it has been altogether or nearly extinguished, and the vascular action reinduced may assume a slow and sub-acute form. It should also be recollected, that, although chronic inflammation of the liver may follow upon acute attacks, the latter may also supervene to the former, and actually do so on many occasions, particularly when the patients have been exposed to energetic exciting causes, or to an injudicious regimen and treatment. This should always be kept in mind during the treatment of both acute and chronic forms of inflammation of the liver, for it should be an object of importance with the practitioner to prevent active inflammation from degenerating into chronic, and the chronic from being converted into active disease." 470.

Chronic inflammation of the organ in question generally commences with, and must necessarily be accompanied by, deranged function of the same. The biliary secretion is either depraved in quality, or its flow into the duodenum obstructed. It is seldom in due quantity, though occasionally it seems over-abundant-a phenomenon which our author thinks is owing to a previous impediment to its free egress from the liver. The, diminution of the biliary secretion, upon the whole, predominates, as may be inferred from the appearance of the fæces, and the defective state of the digestive and assimilative functions.

As chronic disease of the liver varies, in grade, from active inflammation, down to the most trifling deviation from healthy function, we may readily conceive the great variety of symptoms which must present themselves, and the utter impossibility of delineating them all. Add to this, the complication of stomach disorder, intestinal irritation or torpor, nervous derangement, &c. which almost invariably accompanies the hepatic affection!

"The loss of flesh; the dyspeptic symptoms, particularly the slow and painful digestion, accompanied with acid and acrid eructations, flatulency, nausea, and sometimes vomiting, torpid state of the bowels, or dark-coloured, offensive, slimy, greenish coloured, tenacious, or watery and muddy motions; the frequent calls to stool, and the scanty and morbid state of the evacuations; the dark-coloured and disordered condition of the urine; the distension and oppression at the epigastrium and right hypochondrium; the occasional aching pain and weight in these situations; the uneasiness and pain about the right shoulder or shoulder-blade; the slight acceleration of the pulse towards evening, with an irritable beat, and considerable heat and restlessness through the night; the burning heat of the palms of the hands and soles of the feet in the evening, and chilliness in the morning; the white, foul, and excited tongue; the bitter or disagreeable taste of the mouth; the hardened state of the gums; the sallow and tallowy appearance of the countenance, and either yellow or pearly-white colour of the eye; the sickly and leuco-phlegmatic character of the body generally; and the elevation of the shoulders, are the principal symptoms by which we are guided in determining the existence of chronic inflammation of the internal structure of the liver." 472.

It is when any of the surfaces of the organ are engaged in the inflammatory