sion Mediate.' Paris, 1828. This improvement consists in interposing between the point of the fingers and the chest, a small plate of ivory on which the percusion is made: and from which circumstance the inventor has, in imitation of Laennec, given the name of Meinte Percussion to his method. The ivory plate (which has received the name of Pleximeter or Plessimeter, from the words wλnow, Í strike, or πλnğıs, percussion, and μérgov, measure, (is of a circular or ovoid shape, from an inch and a half to two inches in diameter, and about one sixth of an inch in thickness. It has either a raised edge or rim, or projecting handles, on its upper side, to permit its being held between the finger and thumb of the left hand, while it is struck with the right. In making use of this instrument, all that seems essential is to apply it accurately, closely, and consequently, parallel to the surface. As in simple percussion, the blow may be made with one or more fingers, and must be rapidly executed, with the points but not the nails of the fingers: on this account the nails must be kept short. The pleximeter may be applied immediately on the skin or over some portion of the clothes; and, as in the case of the stethoscope, it is necessary on some parts to interpose a small pledget of lint or soft linen, to ensure its accurate apposition.

"The following are the principal advantages which mediate percussion has over direct or simple percussion:-1. Owing to the diffusion of the impulse of the blow over a much larger space, and the impulse necessary to elicit sound being itself less, percussion by means of the pleximeter can be applied on parts that are inflamed or painful, as in the case of a blister or issue, in eruptions, &c. &c.; for the same reasons, there is no fear of painfully affecting or injuring by the concussion communicated to the walls of the chest, the diseased parts within, a circumstance not unfrequently observed in cases of pleurisy both acute and chronic. 2. It permits a more extensive application of the process; as, by means of the pleximeter, we can percuss every part of the chest, on an intercostal space or superficial muscle for instance, as well as a rib. 3. In using the pleximeter, we need not be solicitous, as in the case of direct percussion, of selecting precisely similar points on the two sides of the chest, for comparison. 4. Mediate percussion is easier than the old method; as having in the pleximeter always a perfectly level surface, we can with much more facility impinge our fingers with the requiste perpendicularity, than we can do on the uneven surface of the chest. 5. It is also more simple than immediate percussion; as we uniformly employ the same process on every point of the chest; whereas in the method of Avenbrugger, we must sometimes strike across the ribs and sometimes parallel with them. 6 Mediate percussion is more precise and minute in pointing out the limits of the diseased part, as the sound elicited from the pleximeter is derived exclusively from the point struck. We may have a familiar illustration of this in placing the instrument (or any thin flat solid) upon the side of the face, so as partly to rest on the inflated cheek, and partly on the cheek-bone: in tapping the plate in this position, we shall find that the difference of the subjacent parts is accurately pointed out by the difference of sound. In like manner, in the case of pleuritic effusion or hydrothorax, we can trace with the utmost precision the upper level of the fluid within the chest. For these and other reasons it cannot be doubted that Mediate Percussion enables us to obviate several of the difficulties and imperfections of the old method, and that it is therefore well entitled to the attention of practitioners. It has, moreover, the great and peculiar merit of being applicable to the diseases of the abdomen. For ample details on every point relating to this method, I refer the reader to M. Piorry's very valuable work. Different things have been used as pleximeters, and, among others, the horn cap, which is now commonly affixed to the auricular extremity of the the stethoscope, M. Piorry objects to this, on account of the liability of horn to warp, and also on account of the perforation in its centre Dr. Williams, however, seems to con sider this last as no objection, but recommends the inner surface of the cap to be lined with soft leather, to prevent the clacking noise produced by the impulsion of the fingers. (Ra tional Exposition, p 22.) My own experience is against the use of the perforated pleximeter; exclusively of an objec ion I have to the cap of the stethoscope being so made as to be easily removed. With the view of making the instrument conveniently portable, one variety of M. Piorry's pleximeter might be made to fit to the pectoral extremity of the common stethoscope." 24.

It is known to all auscultators, that the FIRST of the two immediataly successive sounds heard in exploring the heart, is ascribed by Laennec to the contraction of the ventricles, and the second, to the contraction of the auricles; while the interval of silence after the second sound is, of course, considered by him as a pause between the termination of the contraction of the auricles and the commencement of that of the ventricles. On this explanation, Dr. Forbes has the following note.

"In a memoir just published in vol. iii. of the Transactions of the Med. Chir. Soc. of Edinburgh, p. 205, Mr. Turner has called in question the accuracy of this account of the motions of the heart, and, consequently, the accuracy of the relation of the sounds heard by the stethoscope, to these motions, as described by Laennec. Mr. Turner has shewn the general opinion of physiologists to be, that the contraction of the auricles immediately precedes that of the ventricles, and that the interval of repose is after the contraction of the ventricles, and not after that of the auricles, as was the opinion of our author. Mr. Turner states that this opinion is further supported by his own personal observation of the phenomena of the circulation in men and animals; and he comes to the conclusion that the last of the two sounds, accompanying the motion of the heart, is produced by some other cause than the contraction of the auricles. The systole of the auricles he considers either as productive of no sound, or of a sound which is blended with that of the ventricles. He conjectures that the second sound may be accounted for by the impulse occasioned by the falling back on the pericardium of the relaxed heart in its diastole, after it has been elevated or moved from its place in the systole.' I regret that the publication of Mr. Turner's paper, only just as the present edition is going to press, prevents my investigating this point which must be considered of the very first importance in a practical point of view. For, as Mr. T. justly observes, if his views be correct, it is obvious that an error pervades the otherwise valuable description given by Laennec of the actions and diseases of the heart.' I may here add, that it has on several occasions occurred to me, in practice, to find it very difficult to reconcile the explanation of the action of the heart, as given by Laennec, with the phenomena before me; although, at present, I cannot think the explanation of Mr. Turner the true one. I recommend this subject to the especial notice of Dr. Williams." 559.

"We cannot occupy more of our space at present with further extracts from this most valuable work; but we cannot conclude without recommending it to our readers in the strongest terms, and for the third time, but, we hope, not the last, as the most comprehensive and valuable work which has ever been published on the pathology and diagnosis of diseases of the chest,

XI.

NAPOLEON A SAINTE HELENE.

OPINION D'UN MEDECIN SUR LA MALadie de l'EMPEREUR NAPOLEON, ET SUR LA CAUSE DE SA Mort; OFFERTE A SON FILS, AU JOUR DE SA MAJORITE. Par S. Hereau, Ancien Chirurgien de Madame Mere, et Premier Chirurgien de l'Emperatrice Marie Louise. 8vo. pp. 228. 228. Paris. 1829.

Je meurs prematurement, assassine par l'Oligarchie Amlaise et son sicaire," Testament de Napoleon.

And left a name, at which the world grew pale,

To point a moral or ado, na 'ale Johnson.

NAPOLEON at St. HELENA, 1829'! Be not alarmed, gentle reader, with the idea that we are turning from sober science to the "ROMANCE OF HISTORY." Although there is no other branch of science or literature so intimately connected with morality—or, in one word, with a knowledge of human nature, as is the practice of medicine; yet we have rarely digressed into what are considered the proper provinces of the DIVINE and the PHILOSOPHER. Neither shall we trespass far on the confines of these reverend and sage personages, on the present occasion, though there is ample scope —and even some excuse for such digression. The work at the head of this article was in our possession some months before we determined to notice it and we should not have introduced it to the attention of our readers, had we not observed that almost the whole of the French periodical press (medical) has yielded implicit credence and assent to the facts and conclusions contained in M. Hereau's book. In no one instance have our Continental or Transatlantic cotemporaries accused us of national prejudice or narrow-minded partiality-and when we bring to bear on the work before us, the stern dictates of reason, and the calm deductions of medical philosophy, we shall probably shake to their centre some of those gorgeous fabrics erected by political bias, heated imagination-and (what should never enter into medical discussions) national antipathy!

We do not deem it incumbent on us to agitate the question respecting the wisdom or policy of our Government in consigning NAPOLEON to St Helena. After what took place at Elba, it was evident that the Ex-EMPEROR could not be trusted at large-and we should be glad to know how he would have liked to be locked up in the Tower of London, to be gazed at with the other lions of that place? Had Napoleon ended his days in the Tower, we should have had whole volumes descriptive of the insalubrity of that dreadful prison. The exhalations from Billingsgate, the dripping damps of father Thames, the abominable smell of tar from the ships, the everlasting din of drunken sailors, joined with the foggy atmosphere of London, would have afforded more materials for the TRISTIA of the Bonapartists, than Ovid ever found on the banks of the Euxine! No spot on the face of this globe would or could have pleased Napoleon, as a prison; and no man who dreaded universal war and all its dire consequences, could have thought of leav ing that warrior at his liberty. Of St. Helena itself we shall have occasion to speak presently.

When the news of Napoleon's death reached Paris, in July 1821, it was currently reported, and almost universally believed, that the Ex-Emperor had been put to death by violence. Some said a scuffle had ensued between Sir Hudson Lowe and Napoleon, and that the latter was assassinated others, that the illustrious prisoner had been enticed to the edge of a precipice and then burled over-that he had been shot-smothered, &c. &c. But the report which gained the most credit, and lasts till this hour, was, that Napoleon had been slowly poisoned, by order of the British Government, and through the instrumentality of Sir H. Lowe!!* It is to clear up these doubts and to investigate the real cause of Napoleon's death, that the volume before us has been written. After a most laborious inquiry, the author arrives at the conclusion, that the late EMPEROR was neither poisoned, shot, nor hurled over a precipice; and as we believe that no one, on this side of the Channel, will doubt the correctness of these conclusions, we shall not enter into the negative arguments and data on which they are founded † His affirmative conclusions appear to be, that the death, de ce grand homme," was effected by three series of causes-the insalubrity of St. Helena-the ignorance of the English doctors-and the cruelty of Sir Hudson Lowe-the latter cause including, of course, a host of moral affections, as chagrin, grief, resentment, hope deferred, blasted ambition, &c. &c. &c.

Among the causes of death which were bruited about at the period in question, one was, that the Emperor had poisoned himself by means of a deadly drug, which, like Hannibal, of old, he always carried about with him. M Hereau brings forward a document little, if at all, known in this country, shewing (if it be authentic) that Napoleon nearly effected suicide at Fontainbleau, just before his abdication. The poison appears chiefly to have been prussic acid,

In the second chapter of the work, our author inquires into the grounds of the opinion, once prevalent, that Napoleon died of a disease hereditary in his family-CANCER OF THE STOMACH. He decides in the negative. It was reported, but not, he thinks, proved, that the Emperor's father died of the above disease. Be this as it may, none of the brothers or sisters of Napoleon had any complaint of the kind; and M. Hereau denies that the disease in Napoleon's stomach was of this description. He informs us that Bonaparte lived on the most simple aliments, and always fell in with the diet of the country where he happened to sojourn-contrary to the habits

*The author of the volume acknowledges that he himself was a believer in the story of poisoning, till he investigated the whole history of Napoleon's exile.

At page 10 and 11 the author plainly avers that the conduct of the British Minister, for the Foreign Department, the manner in which the Ex-Emperor was entrapped (la maniere dont on s'etait saisi de sa personne") the plan of exile, the spot of imprisonment-and, above all, the character of the jailor, fully authorized all and every suspicion of murder which could possibly be spread on the occasion!! The whole of the French medical journals reecho these base insinuations against our Government and country! Is it not wonderful that, with all the superlative penetration aad talent of Napoleon, so lauded by his partizans, he should have been so infatuated and blind as to trust himself in the hands of the English? This piece of oversight is not once alluded to by our illustrious confrere, M. Hereau! For our own parts, we entertain a very different opinion of Napoleon's sagacity. His life would not have been worth three weeks' purchase, had he not made his escape in the Northumberland to the shores of his oldest and most decided enemy.

of his most distinguished generals, who, in the wilds of Russia, took care to have the wines of Spain, and the ices of Italy on their tables. It is certain that, while in Egypt, he contracted a cutaneous affection (affection dartreuse) which never entirely disappeared till the battle of Wagram. On that memorable field of his glory, he was exposed for days and nights to cold and wet. The eruption disappeared, feverishness, pains in the head, and various other symptoms of a repelled eruption supervened. For these, the celebrated Frank and Corvisart were consulted. The former thought ́seriously, the latter very lightly of the complaint. The fact is certain, that, from the time of this repulsion, the emperor was affected with attacks which were represented by some as epileptic, and by others as of an apoplectic character. At St. Helena the cutaneous complaint returned, especially upon the thighs; but the principal infirmity under which Bonaparte laboured, and which he often predicted to be the ultimate cause of his death, was a dysuria, which commenced before the Russian campaign, and was productive of excessive sufferings. He was often heard to say-"C'est la ma partie foible! C'est par la que je perirai!" In this prognostication he was deceivedand, considering the slow and dreadful death resulting from diseases of the bladder and urinary passages, Napoleon was probably fortunate in being carried off by a disease which occasioned very little suffering.

We now come to that chapter of the work where the question is agitated whether or not the climate of St. Helena was sufficient to produce the disease under which the Emperor succumbed? It is some 22 years since we examined with a critical eye, the medical topography and natural scenery of St. Helena, during a short stay at that island, on our return from the East Indies and our sentiments respecting it are on record.* We hesitate not to assert that, if the whole surface of this globe were examined, there could hardly be found a spot of equal extent, presenting so many features of the sublime and beautiful as the calumniated island of St. Helena.

Rising abruptly to the height of nearly 3000 feet above the surface of an ocean that is never ruffled by a storm, and where the South-east breezes have blown with undeviating course since the deluge, the island in question presents the picture of desolation to the wondering mariner, while approaching this summit of some huge ante-diluvian Alp--" girt with a chain of inaccessible precipices." The ship steers within pistol-shot of rocks a thousand feet in height—not merely perpendicular, but actually overhanging the "murmuring surge" that chafes, and foams, and frets against the adamantine barrier below. No indication of human or even vegetable existence is perceived in any direction; when suddenly the scene changes, and every crag is seen bristling with men and cannon. A narrow fissure in the stupendous wall of rock, formed by some convulsion of the earth, discloses a crowded town between two gigantic precipices, opening a zig-zag path to

* When Dr. Johnson's description of St. Helena, as published in the "ORIENTAL VOYAGER," was shewn to Napoleon, the Emperor demurred to the fidelity of the portrait, observing that he could not see the beauties of the scenery, as there delineated. It requires but little insight into human nature to know how very differently the same objects are viewed by a traveller full of youthful emotions, and an exiled prisoner, hurled from the throne of his ambition to finish his days on an insulated rock in the midst of a vast ocean! It is but fair to say that Napoleon never had an opportunity of seeing the beautiful parts of the island on which his bones repose.

† Oriental Voyager.