MEDICAL JURISPRUDENCE.

The connection between medicine and legislation had been perceived long before it was considered as a peculiar branch of study, or had even obtained a distinctive appellation. Since its importance has been recognized, it is known in Germany, the country in which it took its rise, by the name of State Medicine ; in Italy and in France it is termed Legal Medicine, and with us it is usually denominated Medical Jurisprudence, or Forensic Medicine. It is founded on the relations which ought to subsist between human nature and social institutions, and consists in the application of the principles of medical science to the administration of justice, and to the preservation of the public health. Its nature and objects will be best elucidated by a sketch of its progress.

HISTORY OF LEGAL MEDICINE.

Notwithstanding the importance of the objects which it embraces, and their intimate relation to the interests of society, the true origin of Medical Jurisprudence is of comparatively recent date. It is true that traces of its principles may be perceived in very remote times. In the Mosaic institutions the judges are enjoined to consult the priests, who were the sole physicians of that age and country, on the modes of distinguishing leprosy from other diseases, on the marks of defloration, and the examination of wounds. In the slight notices handed down to us of the ancient code of Egypt, attributed to Menes, we may observe one trace of the influence of medicine on legislation, in the law which forbade the infliction of corporal punishment on a pregnant female; but among the ancient states of Greece die principles of medical science, though successfully cultivated, seem scarcely to have been applied to legislation, except in certain questions respecting the legitimacy of children, a subject on which the notions even of Aristotle were not very definite. In the writings of Galen, however, we find more distinct traces of legal medicine; as in his various remarks on the difference between the lungs of a foetus and of an adult, in his treatise on simulated diseases, and in his observations on the legitimacy of seven months’ children.

The laws of ancient Rome were borrowed from Greece, and we could scarcely expect to find in them a more refined legislation; but it is worthy of notice, that the laws of the Twelve Tables fix on 300 days as the extreme duration of utero-gestation, the precise term fixed by the Code-Napoleon. Some writers contend that the Roman law authorized the inspection of dead bodies by medical men, because of the twenty-three wounds by which Caesar fell, the physician Antistius pronounced one only mortal; and because Tacitus has spoken of the marks of poison on the bodies of Germanicus and Agricoa: yet we have no proof that such opinions were required by any positive law, or that the judge was in the habit of demanding the assistance of the physician. In the Justinian code, however, we find more obvious traces of the relation between medicine and law; as in the titles De statu Hominum ; De Poenis et Manumissis ; De Sicariis; De Inspiciendo ventre Custo-diendoque partu; De Muliere quae peperit undecimo mense; De Impotentia; De Hermaphroditis; yet in the Justinian code it was not by the testimony of living medical witnesses that such questions were to be decided, but “on the authority of the learned Hippocrates.”

It was chiefly on questions of medical police, as to what regarded the salubrity of cities and stations, that the ancient Greek or Roman magistrates had recourse to medical assistance; and it appears that it was to such subjects that the public functions of the Archiater of the lower empire were confined.

Medical Jurisprudence, as a science, cannot date farther back than the 16th century. Various German emperors had in vain attempted the introduction of an uniform criminal code; but George, bishop of Bamberg, in !507, proclaimed a penal code, drawn up for his states by Baron Schwartz emberg, in which the necessity of medical evidence, in certain cases, was recognized: and though this improvement was for some time resisted by the greatest part of Germany, the emperor Charles V. eventually succeeded in persuading the diet of Ratisbon, in 1532, to adopt a uniform code of German penal jurisprudence, founded on that of Bamberg, in which the civil magistrate was, in all cases of doubt or difficulty, enjoined to obtain the evidence of medical witnesses; as in cases of personal injuries, infanticide, murders by poison or other means, pretended pregnancy, simulated diseases, &c. The celebrated Constitutio Criminalis Carolina was published in 1553; this must be considered as the true dawn of Legal Medicine, 1 and Germany the country which gave it birth. To the same country must be ascribed the glory of having first thrown the shield of medical science over the victims of a dark fanaticism. The belief in the powers of witches and sorcerers was in full force in the 16th century. It is computed that in Lorrain above 900 persons were burnt alive within 19 years, for the imputed crime of sorcery; and that in the Electorate of Trevers alone, within a few years, 6500 individuals had perished in the flames for the same imaginary crime. In Germany and France instances of pretended demoniacal possession were perpetually occurring; and at Freidberg public prayers were offered up to assuage that dire affliction. Weiher, physician to William, duke of Cleves, had the boldness to impugn these superstitious notions, in a tract published at Basle in 1568, and undertook to prove that witches and demoniacs ought to be considered as unhappy persons subject to hypochondriasis and hysteria, whose maladies should rather excite pity, than render them obnoxious to punishment; while he ridiculed the ordinary modes by which these unfortunate beings were proved to be guilty of the alleged crimes. This attack on a popular superstition aroused alike indignation and vengeance against the daring innovator; and, but for the powerful intercession of his patron, Weiher himself would have perished in the flames, from which he had tried to save others.

In the close of that century many treatises on different branches of Legal Medicine appeared in various countries. Ambrose Paré wrote on monstrous births, on simulated diseases, and a memoir on the art of drawing up medical reports. In 1598 Severin Pineau published at Paris the treatise De Notis Integritatis et Corruptionis Virginum; a book still quoted as an authority. The first system of Legal Medicine appeared about the same time in Sicily, in 1 the work of Fortunato Fidele De Relationibus Medicoum ; in which, as might be expected in his age and country, the opinions of the physician are too much warped by his servile deference for the canon law and its clerical expounders.

The rapid progress of anatomy in the commencement [7:14:491]of the 17th century now became apparent in the invaluable Quaestiones MédicoLégales of Paulo Zacchia, which appeared in successive volumes from 1621 to 1635; a work which will ever be regarded as a landmark in the history of Legal Medicine; and which, by its learning and its sagacious indications, in an age in which chemistry was in its infancy, and physiology very imperfect, places the medical acumen of the great Roman medicojurist in a very favourable point of view.

The noble discovery of the circulation of the blood gave a new light to physiological reasoning, which was broadly reflected on Legal Medicine: and to Harvey we also owe the idea how the application of Galen’s remark, resecting the difference between the adult and the foetal lungs, might be applied to elucidate cases of infanticide.

About the same time appeared two valuable treatises by Melchior Scbiz, De Notis Virginitatis, and Examen Vulnerum. In the first he maintained that the existence of the hymen was the real mark of virgin purity; an inference warmly denied by Orazio Augenio and Petro Gassendi: in the second he pointed out the importance of distinguishing between wounds incidentally and necessarily fatal.

In 1663 Thomas Bartholin, a Danish physician, carefully investigated the period of human utero-gestation, and proposed the Hydrostatic Test, or observing whether the lungs of the infant floated or sunk in water, as proving whether it had ever breathed. The rationale of this process was more fully explained by Swammerdam in 1677; but was first applied to practical use by Jan Schreyer in 1682; after having been investigated by Thruston and Rayger.

While these important steps were in progress, Germany set the example of the first public prelections on Medical Jurisprudence. About the middle of the 17th century, Michaelis gave the first course in the university of Leipzig: these were soon followed by the lectures of the celebrated Bohn, who, before the close of the century, had published his valuable works De Renuntiatione Vulnerum, et Dissertationes Medicinae Forensis, which were speedily succeeded by the tract De Officis Medici Duplici, Clinici et Forensis. The two first were nearly contemporary with the investigations of Welsch and Amman on the fatality of wounds, and the celebrated work of Licetus De Monstris ; and the latter with the valuable Sepulchretum of Bonnet.

The mode of conducting medicolegal investigations had attracted attention in France, from the time of Ambrose Paré, through the 17th century. French authors love to trace the rudiments of the science in their country from the 12 th century, in the rules given in the assizes of Jerusalem, for drawing up exemptions from certain civil and military duties, and in several subsequent ordonnances of their monarchs, for the inspection of wounds: enactments from which we may trace the institution of the Chirurgiens du Chatelet. In 1603 Henri IV. authorized his physician to appoint persons, skilled in medicine and surgery, to make judicial inspections and reports in all cities and royal jurisdictions. The difficulty of carrying this into effect induced Louis XIV. to create, in 1692, hereditary royal physicians and surgeons, for the same purpose, with various immunities and privileges; but their corruption and venality soon became notorious, and the office was suppressed in 1790.

Various decrees, however, of the parliament of Paris, from the middle to the end of the 17th century, were directed to the improvement of legal medicine; and that body acquired great celebrity by the general equity and good sense of its judgments. Notwithstanding this auspicious commencement, Legal Medicine did not then flourish in France; and the work of Gendry, Sur les Moyens de bien rapporter a Justice, shews how imperfect were the then approved modes of investigation; though it proves that the importance of the subject began to be acknowledged. No other French work on Legal Medicine appeared in that century, with the exception of Doctrine aes rapports en Chirurgie of Blégny, which was superseded in the beginning of the succeeding century by the more useful Eart de faire des rapports en Chirurgie of Devaux.

The 18th century commenced with happier auspices for our science, and the press teemed with important works on Legal Medicine. As early as 1700 the admirable treatise on the diseases of artificers by Bernardino Rammazzini appeared at Padua. In the following year Valentini published his Pandectae Medicoleg ales ; his Novellae appeared in 1711; and both were incorporated in the excellent Corpus Juris Medicolegale in 1722. This work contains a judicious view of all that had been done before him, and is a vast storehouse of medicolegal information.

Several professorships for teaching this subject were about that period founded in the German universities; and the succession of German writers becomes now so numerous that we cannot attempt to give a catalogue, far less to characterize their works. Zittman, Boerner, Kannegeiser, and Teichmeyer, each published systems of various yet acknowledged merit. The Institutiones Medicinae Legalis of the latter long formed the manual of the student: the clear and forcible reasoning of Storch in his work De Medicinae Utilitate in Jurisprudentia (1730), vindicated the high importance of this branch of knowledge: but the Systema of Alberti, professor of Legal Medicine at Halle, in six quarto volumes, was the most complete and laborious work ever published on this subject. The writings of this learned man are obscured by his attachment to the mysticism of the Stahlian school; yet the industry with which he has collected facts renders his work a precious mine of information. Curious additions to our knowledge were made by the smaller publications of Loewe, Richter, Budaeus, Troppan-neger, Fritch, and Wolff, Hermann, Clauder, Herzog, and Parmeon; which are chiefly valuable to those who may be called to exercise the profession in Germany. In the Bibliothèque Medicale of Plouequet will be found the names of those who have dedicated themselves to the illustration of particular branches of this extensive subject; and in the Collectio Opusculorum of Schlegel will be found some of the best detached treatises of the first three-fourths of the last century on the subject of wounds, poisoning, infanticide, utero-gestation, insanity, and the legal inspection of dead bodies. About the same time appeared the Anthro-pologia Forensis of Hebenstreit, the Specirnena of Furs-steneau, the Institutiones of Ludwig, and the Elementa of Fazelius. The lectures of Haller belong to this same period, though they were not published till 1781-2. Towards the close of the last century, the Germans were almost the only successful cultivators of Medical Jurisprudence. The Elementa of Plenck appeared in 1781, and the book is still considered a good introduction to the study. The Bibliothek of Daniel appeared in 1784; and in it we find the name of state medicine given to this branch of knowledge. Between 1790 and 1800, appeared the Conspectus of Sikora, the Handbuch of Loder, the System of Metzger, and the Entwurf of Müller.

During the last century little was done in Italy after the time of Rammazzini; and in France the subject had attracted little attention, until the celebrated case of Villeblanche called forth the memoir of Louis on the period of utero-gestation, in which he attacked the pretended instances of protracted pregnancy with powerful arguments, which were seconded by Astruc and Bouvart, but vehemently opposed by Le Bas and Antoine Petit. This controversy gave rise to many able publications, in which Pouteau and Vogel took part; but victory remained with Louis and his adherents.

Louis wrote also a valuable memoir on the anatomical examination of bodies found hanged; he pointed out the mode by which we are able to distinguish assassination from suicide in such circumstances. He applied them to the.
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celebrated cases of Calas, of Syrven, Montbaillet, and Baronet, in which are models of medicolegal investigation; and he may be considered as the first who publicly taught in France the just application of medical knowledge to jurisprudence.

The subject of poisoning was examined by Sallin, in a case where a person had been buried sixty-seven days; and he made a very ingenious attempt to investigate the effects of poisons; but has sometimes substituted speculation for facts.

In 1789 professor Chaussier read his excellent Mémoire before the Academy of Dijon; in which he shewed the necessity of careful inspection by the medical witness in all cases of death from blows or wounds, and gave admirable models of medicolegal reports. Next year he delivered a course of lectures on Legal Medicine to numerous pupils. The last year but one of the last century gave to the world the very excellent Traité de Médecine Legale of Foderé.

It may excite surprise that in this sketch we have made no mention of British authors. The fact is, that with the exception of the short Elements of Medical Jurisprudence published by Dr. Samuel Farr in 1788, which is little else but an abridgement of Fazelius, there was no treatise on Forensic Medicine in the English language.

It is true that some medicolegal questions are ably but incidentally treated in the writings of Mead, Monro, Denman, Percival, and John Hunter, and that an interesting Essay was published by Dr. Wm. Hunter “On the uncertainty of the signs of murder in the case of bastard children ;” but the importance of the study, as a whole, was not understood in this country till long after the publication of many valuable systems in Germany, Italy, and France.

In the present century France took the lead. The end of the last century was marked by the institution of three professorships of Forensic Medicine. Mahon was the first French professor, and his reputation as a teacher gave him a name, which the posthumous publication of his lectures has not sustained. The short Cours de Medicine Legale of Belloc appeared in 1802. Tartra’s excellent Essay on Poisoning by Nitric Acid was published in the same year, between which and the year 1810 various short treatises appeared, chiefly on detached branches by Ach-art, Drouard, Lavort, Masson, Faulaure, Desortieux, Vigne, Lamarre, Bane-Cave, Godemar, Raffenaut, De Lisle, and Faure.

In 1814 appeared the important Toxicoogic of Orfila, (a Spaniard naturalized in France), which has changed the face of this part of Medical Jurisprudence, by the number of experiments, the original views on the nature and action of poisons, and the disquisitions on the modes of detecting them, it contains. The French practitioner may consult with advantage the Manuel of Bertrand, published in 1817; and the admirable La Médecine Legale relative a l , art des Accouchemens of Capuron, has scarcely left as any thing to desire on this branch of the subject. In 1819 appeared the excellent Essays of Lecieux on Infanticide, of Renard on Medicolegal examinations of dead bodies, of Laisne on Perforations of the Stomach, and of Rieux on Ecchymosis, Suggillation and Contusion, in the same volume. Valuable detached essays by Foderé and Marc are contained in the Dictionnaire des Sciences Médicales: and we may close our French list with the Manuel of Briand and Brosson, republished in 1828; the Secours a donner aux Asphyxiées of Orfila, which appeared in 1833; and the useful Manuel Complet of Sedillot.

During the present century Germany has not been idle. We have good compends by Schmidmüller, Masius, and Willberg. Rose published a very valuable essay on Medicolegal Dissection> which has been translated and en larged by Marc, (Paris, 1808); and an excellent treatise on Pharmaco-chemieo-Medical Police, was given to the world by Remer. This last treatise has been translated into French by Lagrange and Vogel, in 1816. Among many works which have appeared in Germany of later years, connected with our subject, we may mention the curious collection of cases by Von Fuerbach, published in 1828, entitled Merkwürdiger Bcrbrechen — Remarkable Crimes; the little tract of Drs. Bunsen and Berthold, on the power of Hydrated Peroxide of Iron as an antidote for Arsenic, which appeared at Göttengen in 1834; the Contributions to Legal Medicine of Bernt; and the masterly analysis of various poisons, by Buchner and Herberger.

Only two medicolegal works of any consequence have proceeded from the press of Italy within the present century: the Instituzione di Medicina Legale, by Tortosa of Vicenza, and the Medicina Legale of Barzellotti.

Medical J urisprudence may fairly be said to have only commenced in Britain within the present century. The first lectures ever delivered in Britain were given in the University of Edinburgh, in 1801, by the elder Dr. Duncan; and the first established Professorship was conferred by government on his son in 1803, since which period it has been regularly taught in that seminary.

The first original British work on Medical Jurisprudence was Dr Male’s Epitome of Juridical or Forensic Medicine, for the use of Medical Men, Coroners, and Barristers, which appeared in 1816; and, though a short sketch, it contains interesting notices of English cases, and English law. Medical Jurisprudence, as it relates to Insanity, according to the Law of England, was published, in 1818, by Dr Haslam, in a little volume, illustrated by original cases. But the most valuable work then presented to the public, in an English dress, was the Principles of Forensic Medicine of Dr Gordon Smith; a volume commendable as an elementary treatise, less diffuse than most of the continental systems, and interesting to the British practitioner, by the numerous references to British cases and to our national codes. In 1820 Dr. William Hutchinson published his useful dissertation on Infanticide, in which its relation to physiology and Jurisprudence is very ably considered. These works were soon followed by the more costly publication of Paris and Fonblanque, in three octavo volumes; in which, among some matter little interesting to the general student, are important references to English Jurisprudence.

The last British work we shall mention is the admirable Toxicoogy of Professor Christison, which appeared first in 1829, and has since gone through a second and a third edition; a work the most philosophical and perfect which has yet appeared on the subject of poisons.

It would be improper to pass over the labours of our trans-atlantic brethren in this branch of science. In 1819 Dr Cooper of Philadelphia republished in America the treatises of Farr, Male, and Haslam, with the remarks of Mr Dease, intended for the information of juries and young surgeons; a letter originally addressed “to the Chief Justice of Ireland, by a surgeon of that country.” Dr Cooper added some notes, and a good digest of the laws relating to insanity and nuisance, for which his former station as a judge in the American courts well qualified him. Four years afterwards the American press presented us with the excellent work of Dr. Beck, which is a compend of all known on the subject. The author has freely availed himself of the writings of his predecessors, in many instances of their expressions and trains of reasoning; but his references to original authorities are copious and correct; and we must consider the last edition, recently brought to this country, as the best work, on the general subject, which has appeared in the English language.
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Medical Jurisprudence may be divided into two great branches, Forensic Medicine, and Medical Police. The first may be conveniently subdivided into, 1st, Questions affecting the civil rights, or social duties of individuals; 2d, Injuries to Property; 3d, Injuries to the person. The second part may also be subdivided into, 1st, Questions affecting the preservation of individuals; 2d, What relates to the health of men collected into communities.

It is obviously impossible, in the limits of a dissertation of this nature, to do much more than allude in general terms to most of the subjects included under these branches.

PART I—FORENSIC MEDICINE.

SECTION I. QUESTIONS AFFECTING THE CIVII. OR SOCIAL

RIGHTS OF INDIVIDUALS.

I— Development of the Human Frame The usual development of the corporeal and mental powers becomes of high importance in establishing personal identity, in determining criminal responsibility, and in giving validity to various civil contracts.

1. Infancy is the period from birth until the completion of the seventh year; and its progress is best determined by attention to the size of the body, the evolution of its proportions, and the state of the first teeth. Its conclusion is marked by the loss of the milkincisors, and coming of the first permanent teeth.

2. Childhood may be considered as extending from the last period to the 14th or 15th year, or the commencement of puberty. The expansion of the body, the state of the teeth, and of the genitals, are its principal characteristics.

3. Adolescence is marked by changes in the whole constitution, by the commencement of the beard in males, and of the eatamenia in females; this is of uncertain duration, but may be considered, with us, as extending to the 17th or 18th year.

4. Youth is the period between adolescence and the full perfection of the bodily powers. In it the generative function is perfected. We may consider it as terminating with the age of legal majority, though probably it should be extended to the 25th year, as it is with some nations.

5. Virility is that period during which all the bodily powers are perfect, and the mental faculties are matured. It has no definite bounds in man; but the perfection of the bodily powers of the female may be considered as bounded by the time when the catamenia cease, or woman is incapable of being a mother. That period is usually about her 45th year. It is during this period that all the bodily and mental faculties have generally acquired their full perfection in both sexes.

6. Old Age has no absolute beginning, fixed by nature, except in what we have just noticed of the female. It is exceedingly difficult to ascertain the age of persons of either sex in this period of life, so that no general rule can be fixed, and the limits of old age on either hand cannot be determined. Its general characteristics are stiffness of the limbs, wrinkling of the skin, loss of teeth, blanching of the hair, impaired vision, and decay of all the bodily faculties. Its approaches are often marked by the appearance of fanlike wrinkles at the outer canthus of the eye, by increased obesity, and by the shoulders becoming round.

i 7∙ Decrepitude is the last stage of human existence, in which the bodily vigour is decayed; the knees and spine are curved, from the inability of the muscles to support the weight of the superior parts of the body, or by alterations in the form of the cartilages; the senses are blunted; and the only refuge is the grave. The periods at which these various changes take place are accelerated and retarded by constitution, climate, food, habits, education, and occupation.

II.— Duration of Human Life. —The ordinary chances of human life are an important subject of inquiry, deduced from accurate comparisons of registers of births and deaths. On this is founded the system of annuities, the principles of benefit societies, and of insurances on lives. Unfortunately these registers have been so ill kept in Britain, that our own tables have generally been calculated from foreign registers, especially those of Sweden and Finland. It is well known that Dr Price’s calculations, from the Northampton tables, gave far too high a rate of mortality; and have caused much loss to the nation, in the payment of public annuitants. The later tables, calculated from the last Swedish and Carlisle registers, have proved this most decisively; and the labours of Messrs. Milne, Lyon, and Finlaison have since furnished us with surer data for our calculations of probabilities of survivorship, and the payment of benefit clubs. The important questions connected with this subject, and the light which a better system of registration is capable of throwing on many subjects connected with population, and the progress of medical knowledge, the important civil rights of individuals involved in the accuracy of registers of births, marriages, and deaths, should induce the government to take up the whole question of registration, and place it on a public and permanent footing.

III.— Personal Identity —To those little familiar with such inquiries, the danger of mistaking one person for another will not appear very considerable; but the fatal errors which have arisen from this source are too well known in the jurisprudence of every country. It becomes, therefore, of consequence to point out the circumstances by which personal identity may be rendered doubtful, and to indicate the marks by which it is best established. The first may include the effects of age, climate, aliment, habits, passions, wounds, diseases, &c. The circumstances which chiefly enable us to identify one long absent from his native country are, accurate observation of his likeness to his family; his resemblance to what he once was; in some instances his dialect; his recollection of past events; but, above all, the occurrence of scars, or naevi materni, known to have been on the individual in question.

IV.— Marriage. —Under this head the principal business of the medical jurist is with the nubile age, according to nature, and legislative enactments; and with physical circumstances affecting the legality of marriages, which may justify divorce.

1. The nubile age, with us, is not below fourteen for the male, and twelve for the female, that being the ordinary period of puberty in our climate; but young persons may after this age be prevented from marrying till the age of majority, by parents and guardians, in England, though this seems doubtful in Scotland.

2. The physical circumstances which may invalidate a marriage are, lunacy in either of the parties at the time, and physical inability to consummate. There are instances of this last being pleaded and sustained in our Courts. Certain diseases, such as epilepsy, are held in some countries to invalidate marriage, but not with us.

V.— Impotence and Sterility may arise from,

1. Functional Causes —Of these, habitual intoxication, excessive venery, and diseases which greatly debilitate, or affect the common sensarium, are the chief. They are generally temporary only. In females the same causes may produce sterility; to which may be added excessive leucorrhoea, dysmenorrhoea, anaphrodisia, &c.

2. The Organic Causes are malformation of the genitals in both sexes, or total deficiency of some of them. We must be careful, however, not to infer the want of testes, [7:14:494]because none are found in the scrotum. In some individuals they have remained through life in the abdomen, as occurs in the unripe foetus.

VI.— Pregnancy presents a wide field for medicolegal evidence.

1. The limits between which it is possible, belong to the province of the medical jurist. It may be limited to the period during which the catamenia recur; but this varies from under ten to more than fifty years of age. A few remarkable instances of impregnation after sixty are recorded; and instances of very early puberty also have occurred, even so early as about four years; but these are exceptions to a general rule, which should be kept in mind, in judging of imputed pregnancy.

2. The signs of true pregnancy should be impressed on the mind of the jurist; for he may be called to determine whether a capital sentence is to be suspended on this plea, or whether an accusation of pregnancy may not, from the effect of disease, be made against a virtuous female. It is in the early months that the principal risk of error lies. The usual signs are, the cessation of the catamenia, the darkening of the areola round the nipple, the general state of the breasts, the state of the os uteri, the form of the womb as felt over the pubes; and as the pregnancy advances, the tumefaction of the abdomen, and the motions of the foetus. At this period, the stethoscope, applied to the abdomen, affords a certain indication. The female, for this last examination, should be in bed, lying on her back, with a sheet drawn smoothly over the abdomen: place the stethoscope between the navel and the pubes, and an attentive ear will readily distinguish two sounds; a whirring one, synchronous with the maternal pulse; and the pulsations of the foetal heart, considerably quicker and of a sharper tone.

3. Limits of Vtero-gestation. Pregnancy may be protracted beyond nine months, or forty weeks, its usual term; but not so considerably as was once imagined. The Justinian and some modern codes were very indulgent in this respect. Ten kalendar months, or three hundred days, is the extreme limit allowed by the present French code; the Prussian extends it to three hundred and two days, a period sufficient to include every ease of protracted pregnancy. The law of England at present has no definite limit; but a ease beyond the usual term would go to a jury. The difficulty of any female ascertaining the precise period of her conception is the cause of the discrepant opinions of the physiologists on this subject.

VII. Parturition. This subject is also one of great delicacy, and involves several questions.

1. Whether it be approaching in general, may be known by indications described in all books on midwifery. The steps of natural, protracted, and preternatural labour should be familiar.

2. But the signs of recent delivery are more important to the jurist. These are, the bruised state of the genitals, relaxation of the vagina and of the uterus, the presence of the lochial discharge, the general appearance of the female, and the formation of milk in her breasts.

3. The viability of the child is very important, and is recognized by the perfection of its organs, the position of the median line, the appearance of its nails, and skin, the cry of the infant, and its capability of sucking. This is a subject of interest; because in some instances, if a child be born not viable, it may affect the succession to property, when the mother dies in childbed; and it may bear on certain eases of alleged infanticide. One other question connected with this subject is, when there is a considerable interval between the birth of twins, whether these are to be considered as conceived at the same time. Many deny the possibility of superfaetation, which in such cases is contended for by others; but it is a subject involved in much obscurity.

VIII. Monsters and Hermaphrodites. No living human birth, however much it differ from human shape, can be destroyed without committing a capital crime. The law states that monsters cannot inherit; but it has left us in the dark, as to what should be considered sufficient deviation from the human form to constitute a monster. Hermaphrodites are now considered as beings with malformations of the organs of either sex: and physiology does not admit the existence of true hermaphrodites with duplex perfect organs.

IX. Paternity and Affiliation become medicolegal questions when a considerable interval has elapsed between the birth of a child and the death or absence of its reputed father: ten kalendar months being the utmost limit to which modern physiology would extend the period of utero-gestation. This subject involves questions respecting children born during a second wedlock of the mother, the circumstances of posthumous children, the laws of bastardy, and the mode of treating alleged cases of suppositious children.

X. Presumptions of Survivorship.

1. When a mother and her new-born infant are found dead, important civil rights depend on the question, which lived the longest; as the husband’s right to be tenant to the curtesy, or the descent of property derived from the mother. The law of England in such eases admits such slender proofs of life in the foetus as would not be received elsewhere, and leaves much to the evidence of a medical witness. Elsewhere the child must either cry or look around, to constitute a quick birth; but in England a quiver of the lips has been received as a proof of life, in defiance of physiology.

2. When two or more persons perish by a common accident, without any but probable means of ascertaining who perished first, as in cases of shipwreck, or on a field of battle, the descent of property may become the subject of dispute. Sueh questions have been rarely decided in Britain; but probably should be determined on the principles laid down in ancient Roman law, or in the Code-Napoleon.

XI. Mental Alienation. This interesting subject presents a wide field for speculation to the medical jurist.

1. He should be familiar with the four forms of insanity, Mania, Monomama, Dementia, and Amentia, and be able to indicate the leading symptoms and the most judicious treatment of each. He should be able to detect feigned cases of insanity, and to prevent real lunatics from being treated as criminals.

2. The chief questions that may fall under his decision are, how to distinguish the disease, and to prove a man insane; if there be a real lucid interval; what period of life is most liable to insanity; what diseases are most liable to be confounded with it; whether it has increased in these kingdoms.

3. The nature and management of Lunatic hospitals are also in his province. It must never be forgotten, that, in such establishments, no more restraint should be employed than is necessary to prevent the unfortunate being from hurting himself or others: while the order and economy of the house is to be maintained by a mild but firm administration; rather like the authority of a parent over children, than the rigid severity of a task-master towards a dependant.

XII. The Rights of the Deaf and Dumb are secured by law; and if the intellect be perfectly sound, there is now no question of their perfect competence to enjoy all the civil rights of other subjects of the state. They can intimate legal consent by signs, or by writing; and should be considered as responsible agents.

XIII. Maladies Exempting from Public Duties belong to the medical man, both in his civil and military capacity. He may be called to decide whether a man be fit, [7:14:495]without imminent injury to his health, or danger to his life, to perform the duties of a juryman, of an officer of justice, or to serve in the navy or the army. In all such cases the certificate of health must be carefully drawn up, on an honest consideration of each case, and a fearless determination to do justice.

XIV. Simulated Diseases present a field of investigation, requiring caution and discrimination. It may be the duty of the medical man to aid the magistrate in the detection of the guilty impostor, or the military tribunal in consigning to merited punishment the pretended invalid. No questions require more professional skill, more self-possession, or more knowledge of human character.

SECTION II. INJURIES TO PROPERTY.

I. Nuisances from Manufactories, fcc. These may affect the property of our neighbour in different ways; or the nuisance may be a public one. The first is what is termed a private nuisance, and may be abated by an action for damages; the second is a common or public nuisance, and the proper remedy is by indictment. In certain cases the injunction of a court of equity will stay the nuisance in a summary manner.

It was at one time ruled, “that usefulness shall compensate for noisesomness, and that unless it could be proved deleterious to the health, a manufacture, however disagreeable, might be introduced into a town but by several later decisions of our judges, it is sufficient to prove that the nuisance complained of is very disagreeable, and renders the property of a neighbour less valuable, or diminishes in a marked degree the comfort of his life. In judging of such cases, a medical man is often on delicate ground, between parties deeply interested in the issue of the cause: but we may in general terms conclude, that what is very disagreeable to the olfactory organs of most persons is injurious to health; and now it is sufficient to prove the very offensive nature of the nuisance, to obtain its abatement or suppression.

The principal nuisances which are likely to become the subjects of an action are:

1. Establishments or manufactures in which offensive odours are either naturally given out, or generated by putrefaction, — such as the erection of privies, piggeries, cattle-pens, slaughter-houses, cemeteries, collections of decaying animal and vegetable substances, steeping of hemp and flax, starch making, dealing in various animal matters, as in the trades of the knacker and gut-spinner. 2. Manufactures which evolve noxious or offensive effluvia by the aid of heat, — as in sugar refining, dyeing, glue-makilig, hartshorn and ivory-black works, Prussian blue making, rendering of fat and tallow, boiling of whale and fish oil, leaf-horn manufactories, varnish making, soap works, acid making, alkali works, preparation of chlorine, smelting houses, coal-gas works, turpentine making, unconsumed smoke from steam-boilers, &c.

3. Manufactures which corrupt or pollute streams or springs, — as bleaching, dyeing, tanning, gas making, limeburning, and the like.

4. Establishments that become nuisances from their noises —as the business of the tin-plate worker, the copper-smith, the trunk-maker, the boiler-maker, tilting machinery, &c.

II. Arson. The crime of wilful fire-raising can rarely become the subject of medicolegal investigation, except when there is a doubt whether the alleged fire may have arisen from spontaneous combustion. Spontaneous combustion may arise in inert matter from

1. Friction or percussion, by which the latent heat of bodies is suddenly converted into sensible heat.

2. By fermentation of vegetable matter,—as in the firing of new hay, of collections of linen rags, roasted bran, and powdered charcoal; in which the heat excited appears to be owing to the rapid absorption of watery vapour, which, when condensed, gives out its latent caloric in sufficient quantity to cause ignition.

3. By chemical action, — as in the effect of drying oils on hemp, flax, cotton, and on some powders,—as that of charcoal, and black oxide of manganese; the action of nitric acid on essential oils, indigo, &c., or the mixture of oil with wool. Under this head also may be advantageously discussed the singular combustions of the human body, which have sometimes led to accusations of murder, when the event was due to spontaneous changes in the living body.

III.— Forgery and Falsification of Documents. —: This may be of two kinds:

1. Forgery of Engraved or Printed Bills.— The importance of preventing forgeries, in a great commercial country, where public and private bills form an immense portion of the circulating medium, has given rise to various contrivances for the prevention of frauds. This has been attempted by introducing peculiarities in the manufacture of the paper, as the use of water marks, and colouring the Îulp; but ingenious knaves have imitated both successfully, t has been also attempted by employing complicated designs, not easy of imitation. The most ingenious and successful effort of this kind is the multiplication of the same design, by Mr. Perkins’s machinery, through which the same figure cut on steel afterwards hardened, may be indefinitely multiplied, by being transferred to copper. The success of this method is proved by the very few forgeries which have taken place on the banks which have employed his plates. Substitution of one sum for another has sometimes been made. This is easiest prevented by the multiplication of the word or figures on the face of the note, and also by care in the manufacture of the printing-ink. It is found that an ink composed of lamp-black, Prussian blue or smalt,∙wi th copal varnish, is more difficult of erasure than common printer’s ink.

2. Falsification of Deeds, and forgeries of names, have been committed by the erasure of the common ink used in the signatures. Common ink is usually effaced by diluted nitric, or oxalic acids, by solutions of chlorine, by caustic alkalis, and by butter of antimony. All these substances soften or injure the texture of the paper, but the traces of this injury have been effaced by washing, sizing, and pressing the paper. If these steps have not been carefully performed, howèver, the writing may, in some instances, be restored; the erasure by acids, in that case, becomes manifest on the application of an alkali—the effect of alkalis by -acids; but chlorine may leave no trace of its employment, except the extreme whiteness of the paper. In deeds and writings of importance the best preventive would be to use as an ink a solution of copal in oil of lavender, coloured by lamp-black. The defect of this ink is, that it is apt to become thick, and not to flow freely from the pen; but it cannot be erased by the means already noticed.

IV.— Coining of False Money. —The care with which the die is prepared will not always secure against frauds of this sort, as the coin itself offers a ready means of obtaining a mould, of sufficient sharpness for the purpose of the coiner. The object of such persons is to pass off base alloys for pieces of gold and silver. These may be detected by deficient specific gravity; but, in the ordinary business of life, this is not a practicable test. Most of the base alloys are much less sonorous than the precious metals, and the sound is therefore employed to ascertain the genuine coin. All coin is alloyed with copper, which imparts hardness, and prevents loss in wearing : this quantity, in our mint, amounts to two parts of alloy for every twenty-two of pure gold or [7:14:496]silver, or l-12th. The simplest method of detecting the intermixture of too large a quantity of alloy is by the change of colour produced when a streak is made on touchstone, and compared with the streak formed by needles of metal of ascertained purity; but chemical examination is to be preferred.

1. Debasement of Gold is ascertained by dissolving a given weight of the alloy, cut into small pieces, in pure nitric acid. This will leave the gold, but dissolve the baser metals; and the weight of the residue, washed and dried, gives the quantity of gold present. The nature of the alloy may be found by different chemical tests. There is only one debasement of gold coin not to be thus detected. Gold coin has been debased by platinum. If the attempt be made to form an alloy, it spoils the colour of the gold; but at Rouen it was accomplished by plating the platinum with gold so nicely, as to give the piece its due weight. Cutting such a coin will detect the fraud. If an alloy has been made, it may be detected by the colour being greyish, or by dissolving the whole in nitro-muriatic acid; when the addition of muriate of potassa, or of ammonia, to the acid solution, throws down a yellow precipitate, if platinum be present.

2. Debasement of Silver is usually detected by cupellation. The weight of the button of silver left on the cupel gives the quantity of silver in the alloy. It may also be found by dissolving the alloy in nitric acid, and precipitating the solution by muriate of soda: the precipitate blackens by light, and affords the means of ascertaining the quantity of silver in the compound.

SECT. Ill INJURIES against the person.

These may be A. such as do not imply the loss of life; or B, such as usually endanger or destroy life.

A.

I.— Defloration —The signs of defloration are obscure. The state of the sexual organs have been chiefly relied on as indications of the loss of virginity, and in particular the rupture of the hymen; but the hymen has been found entire in some females who have had carnal intercourse with man, and is sometimes naturally wanting, or may be destroyed by disease. The appearance of the nymphae, and the size of the vaginal orifice, are not certain indications, any more than the appearance of the carunculae mystiformes, or the firmness of the mammae. It is only by considering all the signs together, that we can arrive at any just conclusion.

II.— Rape. —This crime consists in the forcible knowledge of a woman against her will; her resistance must be continued to the utmost, while she retains her senses or the power of struggling with the ravisher, unless she may have yielded to the immediate fear of death. It is not a rape, without these conditions being complete; the w oman otherwise is supposed to have consented to the act, which may indeed have commenced in violence, but have terminated with her consent. An infant, however, under ten years of age, cannot give legal consent; and whoever has carnal •knowledge of such an infant, either with or without her consent, is guilty of a capital crime. The proofs of rape, besides the consistency of the woman’s story, mainly depend on the marks of violence on her person. If a virgin hath been violated, the injury to the sexual organs, with the precautions mentioned under defloration, w ill be taken into consideration. If a married female be the victim, we must look for bruizes on her own person, or injuries she may have inflicted on the ravisher during lier resistance, which last are accessory proofs of no small importance. The crime may even be perpetrated on a prostitute. It is rape, if the act be forcible, and against her will. The slightest penetration is sufficient; emission is not now required to be proved. The physical signs of rape soon pass away; and unless the female be inspected within ten days after the alleged violence', we shall, in most cases, vainly seek for confirmation of the allegation from inspection. The charge of rape is not invalidated by the female conceiving, nor by the occurrence of syphilis in the w oman.

Ill— Mutilation. — Demembration, mutilation of the face, cutting or maiming, are capital crimes by Lord Ellenborough’s act. The extent of the injury may often be referred to a medical man; and in a case of slitting the nose, an English judge overruled the objection of the prisoner’s counsel, “that the nose was only cut” by stating, “the surgeon sware it was slit;” and that slit was anciently synonymous with cut. Castration was always, in Britain, considered as a capital offence, even when other mayhems (as mutilations are termed in English law) were punished by fine and imprisonment. In France, the perpetrator is condemned to hard labour for life, except where it has been “immediately provoked by an outrage against modesty.” Castration, long after the infliction, may be recognised by the cicatrix of the wound.

B.

IV— Criminal Abortion. —The laws of Britain recognize this crime only after the period of quickening, on the false idea that then only life enters into the foetus. Quickening is merely the mechanical escape of the gravid uterus from the pelvis into the abdomen, and usually takes place in the fourth month of utero-gestation. Before this has taken place, causing a woman to abort is not a crime in our code, though it be so in that of some other countries, as in France; and ought to be so; for quickening has nothing to do with the life of the foetus, which has been a living being long before. The chief means by which abortion is sought to be accomplished are, by blows and bruises on the abdomen, by the administration of drastic purgatives, or other medicines acting violently on the human frame, by repeated venesection, and by the introduction of pointed instruments into the womb. None of the means, except the last, are certain in their operation, but all are highly dangerous to the mother; and one who only essays abortion may thus commit a double murder. In cases of alleged abortion, the medical witness has to consider the involuntary causes which may produce it; as accidental falls and blows, strong mental emotions, errors of diet and regimen, or spasmodic diseases; and he should balance these against the marks of premeditated design.

V.— Infanticide. —By the laws of Britain, the mother who concealed her pregnancy till she was delivered of a dead child, or who, during labour, failed to cry ont foi-assistance, or whose infant disappeared after birth, was formerly held guilty of infanticide; and many convictions and executions took place on this cruel statute. In later times very moderate proof of these three circumstances was held sufficient to invalidate the capital charge. Even in England, in cases of the murder of bastard children, contrary to all the usual forms of justice, a statute of James I. threw the onus of proving her innocence on the mother; and it was not until the 43d year of George III. that this iniquitous law was repealed, and the same rules of evidence here applied as in other cases of murder.

This subject involves some very nice points of legal medicine. The proofs of the child being born alive enter into the case. It must be proved to have arrived at the period when there was a probability of its living; its body should be carefully inspected for marks of wounds or bruises; its cavities should be opened, lest there be traces [7:14:497]of injuries sufficient to have caused death, found in the head, abdomen, or chest; the state of the peculiarities in the foetal circulation, and of the organs of respiration, must be examined; and we must observe whether the lungs seem to have been dilated by breathing, or remain in the dense condition and backward position they have before respiration has commenced. This leads us to consider the celebrated docimasia pulmonum, or test by their sinking or floating in water, which was at one time regarded as indisputable proof of the death of the child, before or after birth, but has now been considered as ambiguous. If, however, we try the lungs together with the heart, with that organ separated, each lung separately, and also detached portions of the lungs, we shall generally find little difficulty in deciding the important question, especially if attention be paid to the quantity of blood in the lungs, and the state of the ductus venosus and d. arteriosus, the contents of the air-tubes, and of the alimentary canal. We must carefully distinguish between the effects of artificial insufflation of the lungs after death, and their floating from respiration, or from incipient putrefaction. In cases of artificial insufflation, the whole lungs will not float, and the air may be squeezed out of a cut portion of the lungs, so as to sink in water; whereas, it is not possible, by compression with the thumb and finger, so to free from air a portion of lung that has respired, that it will not float. Putrefaction may be distinguished by the smell, and the air not being in the cells, but in oblong globules in the cellular tissue uniting the cells.

Infanticide from strangulation, from drowning, and from mephitic air, may be distinguished by the marks to be mentioned under asphyxia. Infanticide may be produced by omission, as by neglecting to tie the navel string; in which case the body will appear bloodless, the great vessels near the heart, and that organ itself will be empty. The child may perish, if not removed from the discharges which accompany delivery; and the possibility of this happening, without any fault of the mother, must be taken into consideration. The infant may die from exposure to cold. If it be found in a remote or sequestered situation, that would be ground for suspicion. If there be meconium discharged from its bowels; if it exhibit marks of starvation, in the emptiness of its alimentary canal; or if it appear to have been fed, we may be sure that it was born alive, and probably perished from criminal neglect. Any artificial objects, such as articles of dress, found near the child, should be carefully preserved, as one means of identifying the exposer; and if foot-marks are seen there, they should be accurately measured and noted.

In cases of exposed infants, it is very important to ascertain the real mother. As such exposure usually takes place soon after birth, comparing the age of the infant with the signs of recent delivery on the suspected mother, is the best method of proving the connection between them.

VI— Homicide. —It is only with culpable homicide, and with murder, that the medical jurist has to deal. When a person is found apparently dead, a medical man may be required to inspect and report on the cause of death. He should, of course, first ascertain whether it be a case of real or only of apparent death. This sometimes is not easy. Singular instances of resuscitation from apparent death are noticed by Winslow, Bruhier, and others, which should make us pause ere we hastily pronounce a person dead, without evident causes for his death appearing on his body. Neither pallor of the face and lips, insensibility to stimuli, cessation of the organs of respiration and circulation, loss of heat, nor even stiffness of the limbs, are infallible criteria. Until, along with these, we have marks of incipient putrefaction or decomposition, we cannot be absolutely certain that a person is quite dead; and, in all cases of doubt, we should wait for incipient putrefaction ere we sanction interment. Where the symptoms appear at all equivocal, we should scarify, or apply hot oil to some parts of the skin.

Here it may be proper to describe the general method of carrying on the medicolegal examination of a body.

In cases where a person is found dead, the body should be carefully inspected for external wounds or marks of contusions. Any wound, however minute, should be traced with a probe, and followed to its termination by the knife. Blackish marks should be cut into, in order to ascertain whether they be the effect of the effusion of coagulated blood, or merely the consequences of that infiltration of the skin which takes place in the depending parts of bodies after death. The first is termed ecchymosis; the latter may be distinguished from the former by the name of sugillation. In the subsequent examination of the head, the hair should be removed, the scalp inspected, and afterwards divided from ear to ear, over the vertex; the skull-cap removed; the state of the brain and its membranes carefully marked, and especially any unusual appearances noted down. All should, on the spot, be committed to writing —nothing trusted to the memory, however tenacious. The inspection of the larynx, trachea, and gullet, is best performed by making a cut through the lower lip, and down the fore part of the neck and chest, to the xiphoid cartilage. Transverse cuts should then be extended from the longitudinal one, along the edges of the lower jaw and the collar bones, so as to enable us to turn back the integuments of the neck. The symphysis of the chin should then be sawed through, and the soft parts divided. We can thus separate the two sides of the lower jaw. When the tongue is pulled forward, the fauces, and upper part of the oesophagus and larynx, are freely exposed, and the introduction of acrid poisons, or of foreign bodies, may often be thus detected. The state of the cartilages of the larynx and trachea should be noted, as fracture or displacement of these has occasionally detected strangulation. A ligature should be put on the lower part of the gullet, and the tube divided above the ligature.

The abdomen may next be opened, by a cut through the skin from the sternum to the pubes. In new-born infants the whole skin and abdominal muscles may at once be cut through, along the cartilages of the ribs on each side, and thence to the anterior edge of the ileum, curving downward to the pubes. This will, when the flap thus formed is turned down, expose the abdominal viscera sufficiently, without disturbing the vessels of the umbilical cord. In the adult, we may first separate the skin of the abdomen from the muscles, in one line from the sternum to the pubes, and, as it is easily extensile, cut out a flap of the muscles of the abdomen, as above directed, so as to expose the viscera. The skin so divided makes a neater appearance when sewed up, than when the muscles and skin are divided together, as in the infant. A ligature should be put on the duodenum, and division of the intestines made below the ligature; so that we may remove the stomach and its contents, and reserve them for subsequent examination. The other viscera should also be carefully inspected. The thorax should be last examined; because this enables us the better to ascertain the descent of the diaphragm, and the arching of the chest, which takes place in asphyxia, than when we open the chest before the abdomen. The cartilages of the ribs should be divided as close as possible to the ends of the ribs, as thus a larger opening is made in the chest. The position and appearance of the lungs and heart should be noted, and their engorgement with blood, or the emptiness of the great vessels, ascertained. When it is necessary to examine the spinal canal, the body must be laid on a table with the face downwards: an incision is to be made [7:14:498] along the whole spine, from the occiput to the sacrum, the integuments are to be separated on each side, so as to expose the posterior portion of the vertebrae, which may be divided near the transverse processes by a saw, the rachi-tome, or by cutting plyers. A triangular piece should also be sawed out of the occipital bone at the foramen magnum. This will expose the whole spinal canal.

Homicide may be accomplished by several modes that may sometimes be ascertained by examination of the body.

Death by Asphyxia or suffocation may be produced by drowning, by hanging, by strangulation, and by mephitic air.

1. Drowning may produce the fatal effect in two different modes. In some the suddenness of the shock, or the surprise instantaneously arrests both the functions of circulation and of respiration; no struggle precedes death. This species of drowning has been justly compared to syncope; and hence has been by Desgranges termed asphyxia syncopalis. In others the circulation goes on for some time after the respiration has been interrupted; the animal struggles, makes vain efforts at inspiration, and portions of air are forced out of the lungs by a convulsive effort of the muscles of respiration. The circulation of unoxygenated blood through the brain seems to act as poison on that delicate organ; and the consequence is diminution of nervous energy over all the body, by which the play of the heart is enfeebled and the animal soon dies. In this case the brain is usually found congested with dark blood. This state has been aptly termed aphyxia congestiva. This difference in the phenomena may account for the great difference perceived in the bodies of drowned persons, and also for the difference in the chances of recovery after submersion. In the first species the pallor of the countenance is marked, and the features little altered. In the latter, the face will often appear swelled and livid, the tongue be protruded, the nose and air passages filled with frothy mucous, the brain and right side of the heart gorged with black blood. The body which has been sometime immersed is generally pale, the eyes are half open, and the pupils generally much dilated, the chest arched, and the diaphragm pushed down into the abdomen. These last signs are most conspicuous in those who have perished from asphyxia congestiva. When the person has retained his sensibility after falling into the water, the ends of the fingers are often found excoriated by his grasping at any object within his reach; and mud or gravel will often be found lodged below his nails. The blood in drowned persons generally remains fluid. These are the principal signs by which we can distinguish the extinction of life by drowning, from the cases in which the person has been thrown into the water after death. If we find in the stomach water containing any foreign bodies, such as fragments of straws or weeds, similar to those in the water in which the body was found, we may be sure that the person was living when immersed in the water: for no water will enter the stomach after death.

It may, however, be very difficult to distinguish a murder by drowning, from death by accidentally falling into water, or from a suicide. The most material circumstances will be, the marks of struggle near the spot where the body has been immersed, the obstacles in the way, the impressions of the feet of more than one person leading to the water. We must also pay attention to appearances of injuries on the body, which could not have occurred from simply falling into the water; such as marks of strangulation on the neck, or wounds inflicted by deadly instruments.

2. Hanging produces most of the internal appearances just described; such as turgescence of the vessels of the head, livor of the face, fluid black blood in the lungs and right side of the heart, protrusion of the tongue, and the nose loaded with mucus: but besides these, we usually find a mark round the neck; and when the person has undergone a public execution, especially when the drop is employed, there is often luxation of the neck, and fracture of the processus dentatus. Ecchymosis is generally found under the mark of the rope: sometimes this mark is not apparent until some hours after death, but dissection will shew the cellular tissue, beneath the rope, dry and compressed. The face is generally less distorted, the eyes less prominent, in those in whom luxation of the neck is produced by the drop, than when the struggle is more protracted. Recovery is hopeless in the first case, but has sometimes followed the asphyxia produced by mere strangulation, which seems to cause a stupor, that is, however, soon fatal, if the person be not soon relieved.

In examining the body of a person found suspended by the neck, we must determine whether this be really the mode in which life was extinguished, or whether the body was suspended after death. The absence of the usual marks of hanging, the position of the rope-mark on the neck, the presence of other mortal injuries, the appearance of the rope are all important objects of consideration. These become of the utmost importance in the difficult cases, where there is a doubt whether the person was murdered or committed suicide. We must rely for a solution of the problem on the indications just noticed, and the previous history of the individual.

3. Strangling coxy be accomplished by drawing a rope tightly round the neck, or by forcibly compressing the anterior of the windpipe, after the manner of Burke and his imitators. In the first, the mark round the neck will generally be nearly circular and not inclined to the ear or occiput. In the latter, marks of fingers will often be perceived on the neck, or a circular depression will be found on the front of the windpipe, and sometimes some of its cartilaginous rings will be broken or displaced. The signs of suffocation will be equally present, as in hanging; but if the mark of the cord be on the lower part of the neck, it cannot be a case of death by hanging.

Suffocation has sometimes occured from bulky substances sticking in the gullet, and compressing the trachea. Assassination has also been effected on infants, or on feeble individuals, by covering up the mouth and nose. This last mode leaves no external marks of violence, and can scarcely be detected, except by the appearances of suffocation found after death.

4. Mephitism i or death from irrespirable gases, often happens accidentally, but is seldom the mode of assassina-ation, except in cases of infanticide: and will be noticed under Toxicoogy.

In every case of suffocation our attempts at réanimation should be directed to renew respiration by inflation of the lungs, to restore the animal heat by exposure to warm pure air, and by assiduous frictions of the surface, to rouse by stimuli, and by brushing the soles of the feet and palms of the hands, to relieve cerebral congestion, when necessary, by moderate and cautious bleeding.

VII. Death from Starvation. Cases may occur where it is important to distinguish this from other modes of the extinction of life. In such cases the cutaneous veins disappear, the skin has become harsh and has a shrivelled look; the fat has disappeared, and the soft parts are. mostly wasted; the gums desert the teeth; the eyes are commonly more or less open and bloodshot; the tongue and fauces are dark and dry; the stomach shrunk, blackish and ulcerated on its internal surface; the intestines resemble a cord; the gall bladder is gorged with bile, which stains the intestines to a considerable extent; the heart is wasted, and the great vessels are almost empty; the body exhales a most offensive odour of putridity, even before life is extinct.

The period required to destroy life in inanition is very [7:14:499]various, and appears to be shorter in the young and vigorous than in persons of middle life, in men than in women. In some comatose diseases, and in persons reduced by previous illness, the life under inanition has occasionally been greatly protracted; and when there has been stupor with occasional intermissions, an astonishingly small quantity of liquid aliment has prolonged life for many weeks, months, or even years. Some of the published cases of fasting are apocryphal; but in others where the quantity of nutriment has been extremely small, the individuals may be considered as in the state of hybernating animals, where the diminished nervous energy renders the waste of the system exceedingly slow. Those who are deprived also of drink perish soonest of inanition; and those who are confined in dry warm air, than those exposed to a moist, cool atmosphere.

VIII. Death from Extremes of Temperature.

1. From, extremes of cold. After the sensation of tingling in the fingers and toes, exposure to extreme cold is soon followed by languor,,loss of sensation, and irresistible propensity to sleep, which is so oppressive, that even the known fatality of the indulgence while exposed to the cold is insufficient to prevent the sufferer to seek repose. Cold does not seem to produce a painful death. In arctic regions the best preservatives against extreme cold are, woollen garments next the skin, with furs and dressed leather over them, a free use of warm diluents, and avoiding wine and spirits.

2. From a much increased temperature, the fatal effects may be scalding or burning, according to the medium applied. This mode of extinction of life leaves very obvious traces on the body. Sometimes fire has been applied to the body after death, to conceal a murder. This fact suggests the propriety of the medical man examining a scorch-ed body minutely, lest there be wounds on its surface, inflicted during life. If the person has lived sometime after the scorching, in general there will be found a ring of inflammation surrounding the eschars: but this only takes place when the burning has not been so severe as to sink the powers of life beyond the capability of reaction.

An increased temperature may be insufficient to vesicate or destroy the skin, yet may prove fatal; as is well known in what is termed a coup de soleil. This is a species of apoplexy, chiefly induced by the direct influence of the sun on the head, and appears to be similar to the effect of the Khamsin or Simoon of the desert.

3. Death from lightning is not wholly to be attributed to the high temperature, but partly to the impulse or shock instantly affecting the brain, and paralyzing the heart: yet as the marks of singeing are often observed on the bodies of those killed by lightning, it may be here considered. The skin is sometimes discoloured in stripes or oblong patches; at other times the surface has no mark of injury, but the viscera have been observed more or less affected, and occasionally there is a small perforation on the skin. The blood is described in every case as remaining fluid, and the corpse runs rapidly to putrefaction.

IX. Wounds. The examination of wounds, whether filial or not, often becomes an important branch of legal medicine. Wounds are usually divided into contusions, lacerations, incisions, stabs, gunshot and poisoned wounds. Each kind requires to be minutely examined, and described, as they are in approved works on surgery. The degree of danger from each should be familiar to the jurist; and he should recollect that there is scarcely any wound which may not become incidentally fatal from improper treatment, or peculiarities in constitution. Punctured wounds or stabs require minute attention; for there have been instances in which death has been produced by an instrument not thicker than a pin, thrust into the brain, the spinal marrow, or the heart.

Poisoned wounds belong to Toxicoogy.

Wounds are more or less dangerous according to their locality.

1. Wounds of the head are always dangerous, especially if the blow has been considerable. The person so wounded may die without separation of the integuments or fracture of the bone; as happens in what is termed concussion of the brain. Contusions which do not divide the skin may fracture the skull; or the inner table of the skull may be fractured without the outer being broken or depressed. Even wounds of the integuments may prove fatal, from inflammation extending inwards to the brain. Punctured wounds of the head are more dangerous than cuts, as more likely to excite fatal inflammation. When the brain or its meninges are injured, all such wounds are generally fatal.

Wounds of the face or organs of sense are often dangerous, and always disfiguring. Malicious disfiguring of the face was made a capital felony in the reign of Charles II., by the Coventry act ; but the monstrous anomaly pointed out by Filangieri, that disfiguring with the intent to disfigure was punished with death, while the intent to murder was not capital, no longer disgraces our statute book. Wounds of any of the organs of sense are generally dangerous, and always produce serious inconvenience.

2. Wounds of the neck are always very serious wherever more than the integument is divided. The danger of opening large blood-vessels, or injuring important nerves, is imminent: even the division of a considerable vein in the neck has proved immediately fatal, from the entrance of air into the vessel, and its speedy conveyance to the heart. A blow on the side of the neck has instantly proved fatal, either from the blood being forced back into the brain, or from injury to the superior parts of the par vagum, the great sympathetic, or the other cervical nerves. Dislocations and fractures of the bones of the neck prove instantly fatal.

3. Wounds of the Chest are always serious, when the cavity is penetrated, though persons have recovered from wounds of the lungs, and have even survived for some time considerable wounds of the heart. This last is an important fact; because we are not always to consider the spot where the body of a person killed by a wound of the heart, and apparently remaining where he fell, is found, as that in which the death-wound was inflicted. Instances have occurred of persons surviving severe wounds of the heart for several days. Fractured ribs are never without danger; and the same may be said of severe contusions of the chest, from the chance of inflammation extending inwards. Wounds penetrating both sides of the chest are generally considered as fatal, though animals have recovered after having both sides of the thorax penetrated, and the wounds kept open for some minutes.

4. Wounds of the Abdomen, when they do not completely penetrate, may be considered as simple wounds, unless when inflicted with great force, so as to bruise the contents of the cavity; in that case, they may produce death without breach of surface, as sometimes happens from blows or kicks on the belly. Wounds injuring the general peritonaeum, or that duplicature of it investing the stomach and intestines, are highly perilous, from the risk of severe inflammation. Wounds of the stomach or intestines, or of the gall bladder, generally prove mortal, from the effùsion of their contents into the general cavity producing fatal inflammation. Wounds of the liver, spleen, or kidneys, are generally soon mortal, from the great vascularity of those organs.

5. Wounds of the Extremities, when fatal, may generally be considered so from excessive haemorrhage, from the consequences of inflammation and gangrene, or from the shock to the system, when large portions of the limb are forcibly removed, as in accidents from machinery, and it wounds from fire-arms.
[7:14:500]

X.— Toxicoogy. —This most important branch of legal medicine has been more thoroughly investigated than any other part of Medical Jurisprudence. A poison may be defined a substance capable of impairing or extinguishing the vital functions, in a great majority of cases. This limitation is necessary, because some of the most deadly substances, in small doses, may be taken not only with impunity, but with salutary effects; and habit renders doses of them innocuous, which would destroy an individual unaccustomed to their use. Some poisons act directly on the organs to which they are applied; others appear to act by their influence on the nervous system. Some appear to act merely as irritants or cscharotics; others by directly impairing vital functions; and some have a twofold action. The manner in which poisons affect the system appears to be either through their direct influence on the extremities of the nen es to which they are applied, or by absorption, and consequently by the circulating fluids. The rapidity with which some poisons, as hydrocyanic acid, act, favours the opinion that their influence is instantaneously conveyed to the vital organs by nervous communication. The detection of poisons, in some instances, in the blood, or in the exhalations or secretions, favours the opinion of the circulation being one channel by which they are carried to the system; a fact which is further confirmed, by the effect of ligature, or of division of vessels, in preventing the constitutional affection of the poison on the system. Some poisons exert their deleterious influence on one organ, or set of organs; others generally affect the system. Poisons, classed according to their effects, may be divided into irritants, narcotics, narcotiew-axrids, and septics. Their action is modified by the tissue to which they are applied, the constitution of the individual, the quantity of the poison, and its mechanical state.

The mode of treatment of poisoned persons depends on the nature of the poison. The first indication is undoubtedly to evacuate the poison as speedily as possible, by the stomach-pump or by emetics; the second, to administer antidotes, if any such be known for the particular poison; the third, to shield the stomach and primae viae against the acrimony of the substance; and, lastly, to obviate any violent or untoward symptoms they may produce, by all the resources of our art.

The evidence of poisoning may be presumptive, or positive, physical, or moral. The physical proofs are derived from the symptoms, from experiments on the lower animals, and from a chemical investigation of the ingesta or egesta. The symptoms, however, only supply us with probable evidence; but the most important inferences they afford are deduced from the simultaneous occurrence of similar symptoms, in more than one individual previously in good health, soon after a meal on the same articles of diet. Experiments on the lower animals with the remains of the ingesta, or portions of egesta, are not much to be relied on, as all animals are not equally susceptible of the same poisons; and what is deleterious to one is innocuous to another. Some poisons, however, such as arsenic and corrosive sublimate, are equally poisonous to all. Such experiments we consider as scarcely justifiable, except in the cases of some vegetable poisons, which cannot otherwise be readily detected. The evidence from chemical analysis of the stomach, of the ingesta or of the egesta, is the most unexceptionable. The refinements of modern chemistry have enabled us to detect surprisingly minute quantities of inorganic poisons, and even of some vegetable poisons. In such investigations, the contents of the stomach, or egesta, should be put into clean vessels; if too thick, diluted with distilled water, boiled, and when cold, filtered through muslin, and then through paper. If the filtered liquor contain much animal matter, this must be separated, as it obscures the various tests to be applied.

This in general is best done by acidulating the liquor with vinegar, by again boiling and filtering. Sometimes it requires to be further clarified, by the addition of animal charcoal, or of nitrate of silver, which separate all the animal or vegetable matter. To portions of the clear and colourless liquid thus obtained various tests are applied, the effects of which will decide the nature of the poison. Sometimes the whole poison may have been so evacuated by vomiting, or taken up by absorption, that not a trace remains in the contents of the stomach. In this case we can occasionally detect it, by cutting the stomach into pieces, boiling them in distilled water, purifying the liquid by some of the processes already described, and then applying the tests. Narcotic poisons are easiest detected by their smell; sometimes we can eliminate one or more of their peculiar ingredients by chemical means, but frequently we have no better means of detecting them than by the symptoms they produce, and the moral evidence of the case, or the morbid appearances on the body after death.

We are not to regard the livid appearance of the body as evidence of poisoning; it is not always present in cases of poisoning, and may arise from other causes. The rapid putrefaction of the body is as fallacious an indication. The very reverse is sometimes the fact. The classes of irritant and narcoticoacrid poisons are usually indicated by inflammatory appearances in the primae viae, but these are not invariably present; and cases often occur of which the moral evidence may be strong, yet the direct evidence may amount to no more than a probability.

The moral evidence of poisoning may sometimes be best collected by the medical attendant. He may be the only witness to the conduct of the accused; he may have observed him suspiciously active in removing every trace of the potion administered, or of the egesta in which a poison might be detected; he may have observed the guilty confusion of the suspected person, or heard his attempts to explain a fatal mistake, if the administration has been traced to him; or the physician may have been the chief depositary of the dying declaration of the sufferer. All these things it is his duty to note down, and to transmit to the proper authorities.

Poisons are derived from the inorganic or organic kingdoms of nature. The first class may be metallic, earthy, alkaline, and simple chemical substances, and gaseous bodies: the second vegetable and animal poisons.

I.— Metallic Poisons. —Of these arsenic, quicksilver, copper, lead, antimony, zinc, tin, bismuth, chrome, silver, gold, are the most important.

1. Arsenic is poisonous in all its combinations. Its most usual preparations given as poisons are, the blackish oxide or fly powder, the white oxide or arsenious acid, the sulphurete, and the combination of arsenious and arsenic acids with alkalis. All are very deadly, even in small doses, whether swallowed, introduced into the anus or the vagina, applied to the abraded surface, or even when extensively applied to the whole skin. The symptoms commence usually within an hour after the administration; and are, nausea, vomiting, great heat and pain in the stomach, purging, intense thirst, severe spasms in the limbs and body, prostration of strength, pallor of the face, a feeble pulse; sometimes convulsions precede death. In a few cases the symptoms of an irritant poison are wanting, and the arsenic appears to be fatal by immediately inducing paralysis of the heart.

The fauces, gullet, and stomach are often found marked by inflamed patches of a deep vinaceous colour, produced by blood effused under the villous coat of the stomach. Sometimes the villous coat appears corroded or thickened, but the stomach is seldom perforated. When the villous coat has suffered erosion, the poison has generally been given in the solid form, and grains of it may often be picked [7:14:501]off the surface of the stomach for analysis. The inflammation seldom reaches to the jejunum; but, though the greatest portion of the small intestines and the colon escape, marks of irritation are often observed about the rectum, especially if the purging has been violent. Various antidotes have been proposed, such as charcoal and magnesia; but the only substance that seems to deserve any reputation is the recently prepared hydrated peroxide of iron, promptly administered in large doses.

The means of detection, when the arsenic is solid, are easy. Introducing it, with charcoal powder if it be white arsenic, or with black flux if it be orpiment, into a small tube, and applying gradually the heat of a spirit lamp, will afford a blackish, shining, metallic crust, the interior of which is crystalline. A portion of this, exposed to heat, exhales as a white smoke, and gives out an alliaceous odour. Another portion, slowly heated in a tube open at both ends, is converted into minute tetrahedral crystals. When it exists in solution in the contents of the stomach, we have to clarify the liquid, by the means already mentioned, and to apply tests; of which the most approved is a stream of sulphuretted hydrogen, which throws down a lively yellow precipitate; the ammoniaco-nitrate of silver, which gives a yellow precipitate, that soon fades to a brown; ammoniacosulphate of copper, which gives a green precipitate. Either of these precipitates heated with black or soda flux, in a glass tube, will afford the crust already described. These indications leave no doubt of the presence of arsenic; and from the s⅞ σ or 3 ⅜θ of a grain may be converted into a sensible metallic crust. Arsenic seems to have a tendency to preserve from putrefaction the stomachs of persons poisoned by it; and it has been detected in bodies that have been from four months to two years buried.

2. Mercury or Quicksilver. — This metal in its pure state has been supposed innocent; but when in the state of vapour it is well known to be speedily deleterious, and to produce all the symptoms of mercurial poison. The most usual mercurial poisons are corrosive sublimate, or bichloride of mercury, its oxides, and sub-salts. The long-continued use of calomel is capable also of acting as a poison; but almost the only mercurial poison criminally administered is corrosive sublimate, though, from its detestable taste, it cannot be given by the mouth as a secret poison.

The usual indications arc a styptic taste, then burning of the throat, violent vomiting, great distress in the stomach and bowels, violent cholic and severe purging, blood mingled with the matter brought up by vomiting, or ejected by stool. The symptoms often simulate dysentery: the face at first is often flushed, the eyes sparkling; soon the powers of life sink, the voice is lost, cold clammy sweats bedew the surface, perception of external objects is lost, and convulsions close the scene. When the substance is given in small doses, or if the mercurial be a milder preparation, after dysenteric symptoms ptyalism supervenes; the person may sink from the violence of that affection, the fauces may become ulcerated, and gangrene may ensue. If ptyalism follow the administration of a single large dose of mercurial, it is always to be regarded as a formidable symptom. When the person survives, he may suffer from mercurial palsy.

The effects of mercurial poisons are indicated after death by the following appearances. The fauces 'are generally more affected than from arsenic, and the inflammatory appearances are more diffused over the alimentary canal. Destruction of the coats of the stomach are often observed, either the consequence of the escharotic power of corrosive sublimate, or of ulceration. Peritonacal inflammation is not uncommon; and irritation of the urinary organs, perceived during life, is marked by inflammatory indications found after death.

We possess in whites of eggs, milk, and gluten of wheat, very effectual antidotes for the poison of corrosive sublimate, provided they be given soon after the poison. The first is the most powerful. The secondary symptoms must be met by antiphlogistic remedies and venesection.

Mercurial poisons are easily detected when we obtain them in substance, but not so readily when mingled with the contents of the stomach. Corrosive sublimate is readily decomposed by several animal substances, and therefore we are not likely to detect it unchanged in the contents of the stomach. It is there usually converted into calomel, either in whole or in part. When held in solution, it is easily detected by Sylvester’s method, ?. e. by dropping a little of the suspected liquid, slightly acidulated, on a gold plate, or a gilt card, and touching the gold surface, through the liquid, with a piece of zinc or iron wire. Professor Traill employs a similar method to separate the whole mercury from its solution. He wraps a gold leaf round a slip of zinc, and immerses it in the suspected liquor, slightly acidulated—-the mereury is precipitated; and scraping off the gold and the tarnished surface of the zinc, he introduces them into a small tube, and the heat of a spirit lamp is sufficient to produce a ring of brilliant metallic globules. He has employed a similar method to separate arsenic from its solutions.

In all probability the mercurial will not be found in the stomach in a soluble state. In this case we have to form the contents of the stomach into a pulp, and to pass a stream of chlorine through the mass, when the mercurial present will be converted into bichloride, which may be separated by filtration; drive off the excess of chlorine by boiling the liquid, and then either precipitate the mercury, by introducing into the liquid a cylinder of pure tin, according to Devergie’s method, or by Traill’s combination of zinc and gold leaf. The tarnished surface of the metals in either ease is to be scraped, and the powder so obtained introduced into the tube and heated, as already described.

When we have much corrosive sublimate to operate on, we may try it by lime water, which throws it down of a deep yellow; by alkalis, which form with it an orange precipitate; by protomuriate of tin, which gives a slate-grey powder; and by hydriodate of potassa, which forms a splendid scarlet precipitate.

3. Copper. — The poisonous effects of the salts of copper have long been known; but though little likely to be used as secret poisons, they sometimes produce death from being accidentally mingled with food, as in the use of culinary utensils of copper. The symptoms are those of other irritant poisons, to which is added spasmodic rigidity of the limbs, in some cases amounting almost to tetanus. Salts of copper may produce salivation, and also jaundice. The morbid appearances are not very characteristic.

Albumen of eggs appears an antidote of some power against the salts of copper, and therefore, after evacuatino∙ the stomach, the whites of raw eggs should be administered. Inflammation should be obviated by antiphlogistic means.

The poison of copper may be sought for by boiling the contents of the stomach with acetic acid; this will dissolve every preparation of copper, and enable us to separate them from animal and vegetable matter by the filter. We may, if necessary, concentrate the solution by evaporation; and if the addition of ammonia give the solution a blue colour, we may be satisfied that it contains copper. A stream of sulphuretted hydrogen throws down a brown precipitate from the solution of copper; and if the quantity of copper be considerable, a piece of bright polished iron will become coated with a film of copper.

4. Lead. —The poison of lead is of considerable consequence, although never used as a secret instrument of revenge. Its oxides and salts all appear to be deleterious, but those from which accidents have most commonly happened are litharge, white lead, and sugar of lead. These [7:14:502] often find their way into the stomach, from little-suspected sources, and produce a species of poisoning with very peculiar symptoms. Leaden pipes and cisterns are acted on by water, especially by soft rain-water, and the carbonate of lead thus formed being soluble in an excess of carbonic acid, is liable to enter the human system with the food. Acescent articles of diet act on leaden vessels, and, when aided by heat, on the plumbiferous glazes of our earthenware. These are the most general sources of this poison; but persons engaged in works where white lead is largely used, smelters of lead ores, painters, and potters, arc liable to the same deleterious influence. The symptoms produced are obstinate constipation, severe tormina, with the symptoms commonly known by the name of painteds colic, colic of Poitou, and of Devonshire. After these have subsisted for some time, the person begins to have paralysis of the limbs, first of one or both arms; in general the extensor muscles suffer before the flexors, and the palsy may then become general in that limb, or extend to other parts. The preparations of lead, when given in large doses, appear to act as irritant poisons.

Orfila found that animals poisoned by sugar of lead had a preternatural whiteness of the villous coat of the stomach, if they perished speedily; but, if their death were protracted, the inner coat of the stomach was reddened. The stomach has often been found corrugated after death.

Frequent ablution of the surface is the best prophylactic for those much exposed to the powder of the preparations of lead; and when lead has been introduced into the system with the food, the best means of obviating the return of the evil is by rigidly excluding lead from all culinary and economic purposes. Hard water is less liable to act on lead than soft water, and hence the impropriety of lead cisterns for rain water. Mercury seems to have a beneficial effect in lead colic, especially when conjoined with opium.

Lead is easily detected. To whatever articles it is suspected to enter add vinegar, and boil; filter the solution and all the lead will be in the clear liquor. If in large quantity, it may be detected by the sweetish astringent taste of the liquid; part of which may be tried by the addition of a solution of sulphuretted hydrogen, or of hydro-sulphurct of ammonia, which instantly darkens the most dilute solution of lead; another portion may be tried by bichromate of potassa, which throws down solutions of lead of a brilliant yellow; a similar colour is formed with them and hydriodate of potassa.

5. Antimony is rarely a poison; because its most active and best known preparations are violently emetic, and thus counteract its effects. Emetic tartar, when given to the lower animals, if vomiting be prevented by tying the gullet, causes inflammation of the lungs and stomach; and this would probably be its effects on man. The lungs appeared a mixture of orange-red, and violet-blue, and they were gorged with blood, which prevented the usual crepitus. It was also fatal when applied to a wound. The stomach was violet coloured, thickened, and covered with tough mucus, the intestines empty, in a man killed by emetic tartar.

The best antidote for this poison is decoction of peruvian bark, especially of cinchona cordifolia.

The detection is not difficult: sulphuretted hydrogen throws down a rich orange-red precipitate. When the antimony is mixed with animal and vegetable matter, add first a little muriatic acid to precipitate the contaminating substances, and then tartaric acid to dissolve any antimonial present. This will afford by filtration a clear liquid for the application of the tests. The sulphuret is best reduced by Dr. Turner’s process; i. e. passing a stream of hydrogen over it when heated to redness in a tube.

6. The other metals, though affording some poisonous salts, scarcely require notice in this place. Zinc in solution may be detected by a stream of sulphureted hydrogen affording a whitish precipitate. The muriate of tin affords one of a rich purple, the powder of Cassius, with deuto-muriate of gold; and when strong, coagulates milk completely. Sub-nitrate of bismuth may be detected by calcining in a moderate heat the contents of the stomach, and adding diluted nitric acid to form a solution, from which water throws down a white precipitate. The soluble salts of silver are thrown down by alkaline and earthy muriates; and the precipitate is easily fusible into horn-silver. A plate of copper becomes silvered by immersion in the solution of silver. Gold may be detected by solution in nitro-muriatic acid; which solution affords the purple powder of Cassius with muriate of tin; and the neutral solutions of gold instantly gild silver or copper immersed in them.

π. Earthy and Alkaline Poisons.

1. Baryta. —Both the carbonate and pure baryta are very poisonous, as are the soluble salts of this earth. The symptoms are those of irritant poisons: the senses then become blunted, the respiration feeble, and convulsions close the scene. The stomach is found inflamed, and the brain shews congestive apoplexy. The antidotes are any of the alkaline sulphates, which instantly form with all the poisonous salts of baryta, insoluble, inert compounds. Sulphuric acid, or sulphates, are also the tests of this earth: but it might be confounded with strontia, the salts of which do not seem poisonous, except in as far as they are acrid. The best distinction is obtained by procuring a muriate of the suspected salt, and dissolving it in alcohol. The muriate of baryta imparts a yellow colour to the flame of spirit; the muriate of strontia, a fine red.

2. Lime is only poisonous as an acrid. The antidotes for it are phosphates of soda or potassa, and water impregnated with carbonic acid. The detection of the salts of lime is easy. Its properties when pure are alkaline: it forms with sulphuric acid a substance of little solubility; but phosphoric and oxalic acids precipitate it from all its soluble combinations.

3. Potassa and Soda. — The pure alkalis and their carbonates are poisonous. Several fatal accidents have happened from them. They act as strong irritant poisons, producing intense heat and pain in the abdomen, then cold sweats, tremors, and convulsive twitchings in the limbs, the stools are tinged with blood, and membranous flakes are mixed with the egesta. When the person lives some time, general peritoneal inflammation is observed after death. Nitrate, and chlorate of potassa are irritant poisons in large doses, producing dangerous inflammation of the stomach and bowels.

The best remedies are large quantities of mild oil. The tests of the alkalis are obtained from their combinations with different acids, and the manner in which they colour the flame of the blowpipe. When nitrate or chlorate of potassa can be had in the solid form, the first may be known by its ready deflagration with charcoal in a crucible; the second by putting a drop of sulphuric acid on a mixture of the salt with sugar, which it instantly ignites.

4. Ammonia and its salts. They all act rapidly as irritant poisons, and have besides a violent effect on the nervous system, especially on the nerves of the spinaI cord. This last effect is principally produced by pure ammonia and its carbonate. Convulsions are caused by the too long continued inhalation of the vapour of ammonia, which has several times proved fatal to man, terminating in severe bronchitis. For this species of poisoning, muriatic acid vapour is the best remedy. On the reception of carbonate of ammonia in the stomach, we should administer diluted vinegar instantly.

We detect the presence of ammonial vapour by the smell, and by a rod dipt in muriatic acid, which gives rise to white fumes of muriate of ammonia.

5. Alkaline sulphureis are all poisonous, chiefly from the [7:14:503] readiness with which they give out a large quantity of sulphuretted hydrogen gas, which is poisonous when inhaled, and when injected in quantity into the alimentary canal. The villous coat of the stomach, in cases of poisoning by alkaline sulphurets, resembles in colour the skin of a toad, and the muscular coat is congested with blood. The alkaline sulphurets act as narcoticoacrid poisons. Their presence is ascertained by a weak acid, and exposing a piece of paper dipt in sugar of lead to the fumes.

nr. Acid Poisons. The three mineral, acids are only poisonous from their corrosive qualities, destroying rapidly the tissues to which they are applied.

1. Sulphuric acid, when strong, decomposes and blackens animal matter by evolving their carbon. It disorganises the fauces, gullet, and stomach; when not speedily fatal it lays the foundation of stricture of the gullet, and the patient is long harassed by dysuria and constipation. It is a capital felony to throw acid maliciously in the face.

2. Nitric acid destroys the animal tissues, and gives them a yellow hue, especially in the fauces, and when applied to the skin.

3. Muriatic acid destroys the tissues also, but renders the fauces usually whitish, as if the Surface were of ivory. The symptoms produced by the three acids are similar, and the best remedies are the same for all, viz.—the copious use of mixtures of chalk or magnesia with milk.

The three acids destroy the clothes, corroding them when strong, and when diluted, staining them of a reddish brown. This circumstance becomes of importance in cases of maliciously throw ing acid on any person, when no part of the acid liquid has been preserved. The stained portions of clothes, soaked in distilled water, v√ill give out the acid; if sulphuric acid be present, it is best detected by nitrate of baryta, which gives a white precipitate, insoluble in pure nitric acid. Muriatic acid is detected by the addition of nitrate of silver, which throws down insoluble muriate of silver. Nitric acid is best recognised by its effect in destroying the colour of sulphate of indigo, when heated with it in a tube.

4. Oxalic acid is a most deadly poison. It differs from other acids derived from the vegetable kingdom in not containing hydrogen; being like the mineral acids, a binary compound. Its taste is so intensely sour that it cannot be employed as a secret poison; but it has been swallowed by mistake for sulphate of magnesia, so as to prove fatal. Its alkaline salts are almost equally poisonous, especially the binoxalate of potassa, or salt of sorrel, and they are speedily fatal when applied to wounds. Oxalic acid renders the tongue red and inflamed, and it corrodes the stomach; burning pain in the primae viae speedily come on, cold clammy sweats, a faint and fluttering pulse succeed, and palsy of the heart soon appears; proving that this substance is not only an acrid but a true narcotic. Unfortunately its effects are so violent and sudden that there can little be done by art to save the patient. Instant evacuation of the stomach, and the exhibition of chalk mixtures are the best means to be employed. Even when the person survives the immediate effects, he often dies of the inflammation or the corrosion of the alimentary canal.

The best mode of detecting oxalic acid is to precipitate portions of it by solutions of lime and magnesia. The precipitate by the first is not decomposable by any acid: sulphate of copper gives a precipitate with oxalic acid, insoluble in a little muriatic acid; and the precipitate with nitrate of silver, when dried, deflagrates with a gentle heat.

IV.— Simple Substances with Poisonous Qualities.

1. Phosphorus, even in very small quantities, is poisonous: two grains have proved fatal to a man. In that case there were sugillations on the belly and thighs, the scrotum was bluish and phosphorescent, the chest contained much' fluid, dark blood, and the muscular coat of the stomach appeared inflamed, with dark spots about the cardiac and pyloric orifices. Evacuation of the stomach, and the administration of mucilaginous, but not oleaginous substances, are all the means we should employ to give relief in such cases. When the patient lives for some time, it will be difficult to detect the poison, unless the morbid appearances above noted may be considered as characteristic. Solid phosphorus is easily detected, by its inflammability.

2. Iodine, and Hydriodate of Potassa, arc active substances, which, if given in excess, are apt to produce irritation of the system: vomiting, excessive languor, a feeble pulse, pains in the stomach, and cramps in the limbs; bilious vomiting and purging have followed large doses of iodine. It stimulates the liver, causes absorption of indolent glandular tumours; and, it is said, that its long-continued use has caused the disappearance of the testes and mammae.

In dogs poisoned by it, the stomach was found inflamed, with numerous ulcerated points on its villous coat. No antidote is known. Its detection is easy. Boiled solutions of starch are delicate tests of the presence of iodine, or of hydriodic acid, by the intense blue colour produced. If hydriodate of potassa be present, the colour is evolved, on adding to the starch a drop or two of sulphuric acid.

3. Bromine is more poisonous than the last substance, but it is so rare a substance, that it is unnecessary to describe its effects or mode of detection.

V.— Gaseous Poisons —Of these some are fatal from the irritation they produce, A; others arc narcotic, B.

A.

1. Chlorine. — This gas destroys life, if incautiously inhaled, by the irritation it produces. It causes violent constriction of the epiglottis, and severe pain in the chest, even when diluted. It disinfects air contaminated by animal emanations. Its solution in water kills dogs; and when injected into a vein, it speedily destroys life. It is most certainly detected by its smell.

2. Hydrochloric gas, or muriatic arid gas, is still more irritating and destructive. It is largely emitted in the manufacture of soda from salt, and is then most hostile to vegetation; 3 ∙ s ½ σ θ contaminating the atmosphere, so as to destroy plants.

3. Sulphurous acid gas is also most suffocating; is, even when much diluted, very destructive to vegetation; and has, as emanating from burning sulphur, sometimes been employed to commit infanticide. It renders the lungs very livid.

4. Nitric oxide, and nitrous acid vapour, are poisonous irritant gases, that cannot be respired, unless largely diluted. The attempt to respire the former nearly proved fatal to Davy. The fumes of the latter have accidentally proved fatal to individuals, producing burning sensations in the throat and chest, an expectoration of yellowish matter, and alvine dejections of a bright yellow colour. Before death the body becomes livid, the breathing laborious. Vapour of ammonia cautiously inhaled may relieve from the effects of this gas, of hydrochloric, and of sulphurous acid gases: but we have no means of detecting any of these poisonous gases, in the small quantity they ever can exist in the human chest, except by the sense of smell.

5. Ammonia is not only irritating when received into the lungs, but is, as we have already said, narcoticoacrid.

B.

6. Nitrous Oxide, the exhilarating gas of Davy, is narcotic, yet can scarcely be considered as poisonous, since it may be inhaled several times a-day without injury; but it seems to have a tendency to cause cerebral congestion [7:14:504]t l. Sulphuretted Hydrogen is one of the most poisonous of gases, destroying life when injected into die intestines, or into the cellular tissue, when received into the lungs, or even when extensively applied to the surface of the body. It is largely given out in the corruption of some kinds of animal matter. Many serious accidents from this gas have happened in clearing out the Parisian fosses daisance. The symptoms are instantaneous asphyxia, with discharges of bloody froth from the mouth, and convulsive movements of the limbs; motion and sensibility soon cease, the lips become livid, the eyes close, and lose their lustre, the surface becomes cold, the action of the heart is tumultuous, then feeble, and before death complete tetanus often comes on. Even when the gas does not kill, it produces severe tormina, nausea, and drowsiness. The body of one killed by it quickly becomes putrid; the skin is livid, and soon meteorized; the brain tender, and of a greenish hue. The proper treatment of persons suffering from this gas is to carry them into pure air, to dash cold water and vinegar over the body, to rub the surface diligently with warm flannels, but to admit air freely to the surface, while the palms and soles are to be strongly brushed. Lavements of cold water and vinegar should be first used, and then lavements containing common salt; when the heart beats violently blood should be abstracted.

This gas is well known by its smell resembling that of rotten eggs. Solutions of sugar of lead are very delicate tests of its presence in minute quantity.

8. Cαrburetted Hydrogen, of various qualities, is given out by stagnant waters. It is one of the results of combustion, and is abundantly produced in coal mines, where it is the formidable fire damp. When the atmosphere is much contaminated with it, it oppresses the breathing, and produces headache and giddiness. When mixed in the proportion of about ⅛ with the atmosphere of mines, it will explode on the approach of a flame; yet in such an atmosphere persons will continue to work for some time with impunity; but even if there be no risk of explosion, the narcotic effects of the gas begin to be perceived on those long exposed to it.

9. Carbonic Oxide, mixed with other gases, is given out by burning fuel, especially if moist, and burning slowly. It scarcely becomes an object to the toxicoogist in its pure state. It is inflammable, rather lighter than atmospheric air, and has a disagreeable smell. It may be respired when diluted; but produces temporary intoxication, and when injected into the veins gives the blood a brown colour.

10. Carbonic Acid. —This gas is well known to be heavier than atmospheric air, to be totally irrespirable when pure, and to be speedily fatal to animals plunged in it. It is always present in the air in minute quantity; but is largely given out by the burning of all sorts of fuel, is produced in every species of fermentation, is formed in the respiration of all animals, and, under certain circumstances, it is given out by plants, particularly in the dark. From these sources, the air, in confined situations, may become impregnated with it, in a proportion inconsistent with the safety of man. Numerous instances of its fatal effects have been observed in the neighbourhood of large fires, in breweries, in crowded apartments; and in rooms where many plants arc growing, it is unhealthy to sleep. When a confined atmosphere is much mixed with it, uneasy respiration is speedily felt, and the person may escape the danger by seeking the open air; but at other times drowsiness or stupor comes on, before any warning is given, and the individual loses the power of attempting his escape. When the gas is undiluted, it is almost immediately fatal to animals immersed in it; and even if the animal be made to respire pure air, while the whole body, except the head, is immersed in carbonic acid, life will be extinguished. After death from this gas, the features remain placid, the eyes open and brilliant, the body long retains its heat and flexibility. When the person has not been exposed long enough to extinguish life, the breathing may be stertorous and oppressive, the face flushed, the pulse feeble, the eyes prominent and wildly rolling about, the tongue swollen, and the saliva flowing out of the mouth.

The proper treatment consists in removing the patient into the open air, or into a well-ventilated room; the surface should be sprinkled with vinegar and water, and every few minutes rubbed dry with hot towels. If the valve bellows be at hand, the foul air should be first drawn from the lungs, and its place immediately supplied by fresh air, throw n in by the same machine. This alternation may be two or three times repeated, and then we should imitate natural respiration as much as possible, throwing in air by the bellows, and aiding the expulsion of the air by gentle pressure on the chest. Brushing the soles of the feet and palms of the hands with stiff brushes, stimulating the nose by a feather, or by ammonia, are useful auxiliaries. When animation is restored, it is time enough to put the patient to bed.

vi»— Vegetable Poisons. —These include most of the narcotic and narcoticoacrid poisons of Orfila. Narcotism begins with a sense of fulness in the head, then succeed a sort of intoxication, dizziness, headache, loss of voluntary motion, almost amounting to paralysis, sometimes convulsions, and finally, stupor and coma. These symptoms may not all be present; for each poison has its peculiar modification of the general symptoms. The post mortem examinations of those who perish by narcotic poisons do not generally throw much light on their mode of destroying life; and there are some diseases that bear considerable resemblance to narcotism. Thus, Apoplexy chiefly differs in there having usually been some warning before the fatal attack, and in coming on during a meal. Narcotism is generally perceived from half an hour to one hour, or more, after taking the poison. Narcotism is more gradual than apoplexy, and at first the person may be roused from his stupor. Apoplectics generally survive for a day, or often much longer. Epilepsy may generally be distinguished by the history of the case, by the abruptness of the attack, by the person being instantly rendered insensible, and by its rarely proving fatal on the first attack. One species of fatal syncope is more difficult to be distinguished from narcotism; and if it has not been witnessed, we do not know how it can be recognised after death.

1. Opium. — The deadly effects of this substance have been long known; and it was supposed to be a proximate vegetable principle, simple in its nature, and peculiar in its effects. Modern chemistry has shewn that opium, like many other active vegetable substances, owes its qualities to an alkaloid, which may be separated, by chemical processes, from many other ingredients. The first of these alkaloids was detected in opium about 1812; and the care with which this important drug has been since examined, has shewn it to be an exceedingly compound substance, consisting of not less than of thirteen, or perhaps of fourteen different vegetable principles, of which six are crystallizable. Of these, in a toxicoogical point of view, the most important arc Morphia and Meconic acid. These two ingredients appear to exist in combination in opium; and when magnesia is added to a watery solution of opium, an insoluble meconate of magnesia is formed, from which the morphia, sparingly soluble in water, is taken up by alcohol; or, if we add muriate of lime to the liquid, instead of magnesia, we obtain meconate of lime, as an insoluble precipitate, and a soluble muriate of morphia; which last, when purified by several nice chemical manipulations, is obtained in minute, white, silky crystals. This is the valuable pail [7:14:505]of opium to the medical practitioner, as it is powerfully hypnotic, and is less liable to cause headache, nausea, and itching of the skin, than crude opium.

When either this substance or opium are administered in an over-dose, the symptoms are drowsiness and insensibility, but this state is often preceded by a slight excitement: the face assumes a ghastly hue, the jaw falls, the eye-lids remain half open, the pupils are strongly contracted, stupor and complete coma succeed; convulsions are rare in adults, but often are seen in infants. Adults in general die easy from this poison. Opium produces its fatal effect, however introduced into the system, and even when applied to a raw surface, has destroyed life, Morphia is stronger than opium, in the proportion of 1 to 6.

The principal morbid appearances are great turgescence of the vessels of the brain, and sometimes serous effusion between its membranes, or in its ventricles; the lungs are gorged with blood, the stomach rarely appears inflamed, the blood is found fluid in the heart, and the body runs rapidly to decay.

Evacuation by the stomach pump, or by emetics, is the remedy chiefly to be trusted; and after the patient is roused, we must prevent him falling asleep while any tendency to stupor is perceived. Artificial respiration appears to have saved one person who was found comatose. No antidote is known.

The best tests of crude opium are those which shew the presence of morphia and meconic acid. The contents of the stomach, in a case of the poisoning with opium, may have the smell of that drug. The whole should be emptied into a clean mortar, and reduced to a thin pulp by the addition of distilled water; acidulate the whole with acetic acid, strain and filter, then reduce the liquor to the consistence of a syrup by a gentle heat: add alcohol gradually, boil, and filter when cold. The spirituous solution will contain all the morphia. Again, evaporate to the consistence of syrup, and add magnesia, which will throw down meconate of magnesia and the morphia in the form of a greyish powder, which may be freed from much of its colouring matter, by washing it with cold water, and then with cold proof spirit. The morphia may now be separated from the meconate of magnesia by hot strong alcohol: concentrate this last solution, which will have a bitter taste, which, on adding a drop of nitric acid, will strike an orange yellow colour, soon passing to golden yellow; and will give a duck-blue with permuriate of iron.

. The mcconate should be decomposed by muriate of baryta, which will form an insoluble meconate of baryta; from which the addition of very diluted sulphuric acid separates the meconic acid. This acid has a silky lusture in the state of crystals, and affords, with permuriate of iron, a very intense red. There is only one source of fallacy in operating with meconic acid from the human stomach, which must be guarded against, namely, that the sulphocyanates of the alkalis precipitate permuriate of iron of a red colour, and some of the secretions, as the saliva contain a sulpho-cyanate. If the solution of morphia be strong there is no danger of mistake; because of the intensity of the colour produced. Professor Forbes has also shewn that the two solutions affect the prismatic spectrum in a different manner; though perhaps this test is less applicable to medicolegal causes, where the quantity of ingredients is generally very minute.

2. Hyoscyamus niger. The whole plant is narcotic, especially the roots, which have several times caused fatal •effects, by being eaten instead of parsnips. The symptoms are active delirium, in which persons have danced and reeled about until stupor supervened. In persons fully under this stupor, stimuli cease to rouse, and the eye is insensible to light, or even to being touched. Emetics are the reme dies; but we have no particular tests of this poison.

3. Besides Hyoscyamus, other sdlaneoe are narcotic. This is especially the case with solanum nigrum and s. mammosum. Both owe their activity to an alkaloid, Sol-anea ; which is capable of exciting vomiting, hurried respiration and stupor.

4. Lactuca virosa is a poisonous plant, with a juice that is highly narcotic, and has the smell of opium. This juice, when inspissated, forms the lactucarium of the shops, which was at first derived from the lactuca sativa, but is obtained in greater quantity, and of precisely the same quality, from l. virosa. Stupor and coma follow an over-dose of lactucarium.

5. Hydrocyanic acid, or Prussic acid forms the poisonous ingredient in an important class of vegetables. It is yielded by the kernels of the bitter almond, and of several other species of that genus; by the leaves of the cherry laurel, or prunus lauro-ccrasus, by the prunus padus ; and probably is contained in the seeds of the pomaceae, and in all vegetable productions with the odour of bitter almonds. The acid, when concentrated, is the most deadly of all poisons; producing almost instant death, whether swallowed or introduced by a wound. Even the diluted hydrocyanic acid of the apothecary’s shop is fatal in a very moderate dose; and the essential oil of bitter almonds is not less so. An infusion of the leaves of cherry-laurel is a very deadly poison: bitter almonds have sometimes provedfatal; and thesame effect has followed on eating the blossoms of the common peach, prunus persica, in a salad. When the preparation is concentrated, the death is very speedy: the breathing immediately becomes laborious, convulsive movements of the limbs come on; in dogs it ends in violent tetanus. After death the eyes are glistening, the pupils dilated, the muscles of the spinal column stiff, the countenance pale and often composed, the abdomen drawn in; the veins of the brain are found to be loaded with black blood, and the blood in the heart and great vessels is generally fluid. In some instances the blood and cavities of the body have exhaled a strong odour of prussic acid; and the blood has been said occasionally to have exhibited a bluish tint when the strong acid has been administered. The bile has often been observed to be of a dark blue hue in such cases.

No remedy can be of service in poisoning by this substance, unless instantly administered: but ammonia appeal’s to have a great power in alleviating the symptoms when the quantity of hydrocyanic acid has not been very great. Ammonia diluted with water should be introduced into the stomach; its fumes sufficiently diluted with air allowed to enter the lungs, taking care not to excoriate the air passages by the too free use of the ammonia. Another very powerful antidote is chlorine. It is most advantageous to employ the vapour of water containing about one fourth part of its volume of chlorine gas. This may be inspired without risk; it has saved the lower animals when the poison had been administered for five minutes before its application, even after the convulsive stage had passed, and that of insensibility had supervened. In Orfila’s experiments, in ten minutes after inspiring diluted chlorine in this manner, the recovery of the animals was certain. Herbst of Göttingen states, that dashing cold water on the surface of the body, is a powerful antidote in such cases: it is most successful before the convulsive stage, but is useful during the spasms.

The tests of hydrocyanic acid are certain when we can obtain it in quantity: but when we must look for it in the body, the smell is its best criterion. The stomach and the blood will sometimes have its peculiar odour for more than three days after death; and if the body has been buried within twenty-four hours, the odour will occasionally remain till the eighth day. When we can obtain a little of the liquid acid; nitrate of silver is a very delicate test. A white precipitate is formed, which, when dried and heated [7:14:506]in a tube, gives off cyanogene, a gas that bums with a rose-coloured flame. If we add to the suspected liquid sulphate of copper, a rich emerald green solution is formed: and if to another portion of the liquor we previously add a drop or two of potassa, that test will throw down a greenish salt, which is partially dissolved by hydrochloric acid, leaving behind a eyanide of copper, which will yield eyanogene like the precipitate of silver. This test will detect prussic acid in 20,000 times its weight of water.

4. Substances yielding strychnia. The vegetable substances yielding this new alkaloid all act in nearly the same manner, and are very poisonous. The alkaloid was first obtained from the strychnos nux vomica, and $. lgnatii. One nearly similar in its properties is found in the bark of bruxea antidysenterica, to which the name of Brucina has been given. This substance is likewise found in nux vomica united to strychnia. Both are highly poisonous, producing convulsions and tetanus; both are intensely bitter. Strychnia is used in paralysis, with advantage, in doses from one-eighth to one-fourth of a grain. Now that it is an officinal preparation, it may be employed as a poison; but there is too sure a substitute, in malicious hands, in the seeds of the two plants from which strychnia was first obtained. A dose of fifteen grains of the powder of nux vomica has been fatal.

s The symptoms from this powder and from a much smaller dose of strychnia are similar. Spasms speedily ensue with anxiety and agitation, the limbs become stiff, the face and hands livid, from the impossibility of respiration, produced by the fixation of the muscles of the chest. These severe affections come on in paroxysms; the intervals exhibit nausea, a feeble pulse, and profuse perspiration: the repetition of the fits destroy life, and the victim seldom lives above an hour.

The best remedies, after evacuation of the stomach, appear to be the simple substances chlorine and iodine.

Where the death has been rapid there are little or no marks of inflammation to be seen in the stomach; but 'when it has been lingering, the stomach and intestines shew traces of violent inflammation; their colour is a violet, and incipient gangrene has been observed in some cases: serous effusion has been found in the head, the blood has remained fluid, and the body often retains, after death, the rigidity of the tetanus, in which the sufferer died; but in dogs poisoned by it the limbs are sometimes relaxed after death.

The powder of s. ignatii is stronger than that of s. nux vomica: both adhere obstinately to the villous coat of the stomach, and will generally be found there after death. They may be distinguished by their intense bitter taste, by becoming orange-red when nitric acid is added, a hue which soon passes to golden yellow.

The celebrated Javan poison is prepared from the antiaris toxicaria and strychιιos tieuté ; plants belonging to the natural order of the Apocyneae : another plant of the same family, cerbera langhin, is so deadly, that a single seed, it is said, will destroy twenty persons.

The wourali or wourara poison of South America is said to be derived from a strychnos ; but this cannot be, if what Humboldt relates be correct, namely,—that the South American Indians use it as a purgative. We have found it fatal to animals in very minute quantity when inserted under the skin.

The bark of a South American tree has proved poisonous, when administered instead of true Angostura bark, galipea officinalis, or bonplandia trifoliata.

When we suspect any substance containing stryehnia to be in the stomach, digest its contents with alcohol, and concentrate this tincture, which will be intensely bitter; precipitate by ammonia, and this precipitate, when a drop or two of nitric acid is added, will become orange-red if any stryehnia be present.

5. Tobacco is a well known narcotic, of which the detection will be difficult, except by the smell.

6. Atropa Bclladona, or deadly night shade, is a strong narcotic poison. All the plant is poisonous, especially the leaves and the fruit. The symptoms produced ard delirium, dilated pupils, and loss of vision. Sometimes it causes hysterical bursts of laughter, the lips, tongue and throat are parched, there is a great sense of sinking, with tremulous movements of the hands; but convulsions are rare. Many instances of poisoning have happened from eating the berries and the young shoots. The active principles is an alkaloid, Atropia. 7. Batura Stramonium is another poison sometimes employed on the continent to facilitate robbery or rape; and in this country it has been administered by mistake. It owes its activity to an alkaloid, datwria, which abounds also in d. tatula. The extract of stramonium produces dryness of the fauces, intoxication and active delirium, with cerebral congestion.

8. Various Umbelliferous plants are poisonous; such as conium maculatum, aethusa c,ynapium, and lactuca virosa. The roots and leaves contain a poisonous juice, and the symptoms are those of narcotics, with some degree of irritation. Various authors have spoken of the oenanthe crocata as very poisonous; but Dr. Christison gave it largely to dogs, vrithout killing them. Comum maculatum owes its activity to an oily alkaline principle, conia; which smells strongly of mice, and becomes, though a clear liquid when cold, opake on being heated.

9∙ Several of the Banunculaceae are aerid and narcotic, as the ranunculus sceleratus, r. flammula, r. bulbosus, r. lingua, r. acris, and r. arvensis ; but we have no mode of detecting their poison.

10. Aconitum napellus produces delirium and stupor, with burning in the throat, vomiting, and purging.

11. Hclleborus niger is a nareoticoaerid poison of great activity.

12. Several other poisonous plants may be mentioned, such as anemone pulsatilla, and cytisus laburnum ; the seeds of the latter are narcotic. In all these eases the best remedies are emetics.

13. Digitalis purpurea owes its activity to Digitalia, an alkaloid, which may be obtained from it. The chief characteristic of digitalis is its extraordinary power in reducing the force and frequency of the pulse; on which account it is used in medicine, but it is poisonous even in small doses.

14. The other narcotieo-acrid poisons of the vegetable kingdom we shall briefly notice, indicating such as have yielded alkaloids to analysis. Of these menispermum cocculus is one, the active principle of which is picrotoxia : delphinium staphysagria, the seeds of which yield delphinia; chelidonium majus ; arum maculatum ; juniperus sabina; veratrum alburn, which yields veratria, an alkaloid lately introduced as an external application, and nearly resembling another poisonous alkaloid, colchicia, obtained from Colchicum autumnale; bryonia alba, said to afford bryonina; euphorbia officinarum; hippomane mancinella; various species of jatropha, which yet by cooking yield wholesome food; the seeds of ricinus communis ; seeds of croton tiglium; cucumis colocynthis ; momordica elaterium; scilla maritima ; various species of daphne ; several species of rkus ; hcbradendron cambogioides ; convolvulus jalapa, and c. scammonea. To these some add narcissus pseudo-narcissus, gratiola officinalis, caltha palustris, and lobelia inflata.

15. Poisonous Fungi. Several of this natural order are poisonous, especially those belonging to the genera Amanita and Agaricus. Their poisonous qualities appear to depend[7:14:507] on two principles; one of which is volatile, and disappears on boiling, drying, or macerating in a weak acid. To this principle Le Tellier ascribes the irritant quality of poisonous mushrooms. The other is not volatile, is soluble in water, unites with some acids into crystallizable compounds, and appears to be an alkaloid now termed Fungia : on this the narcotic properties of these plants depend. The time in which the symptoms occur, after the fungi have been eaten, is very various; often not until twelve or even twenty-four hours. The sufferers are often relieved by vomiting; but if not, the surface becomes livid and cold, violent colic ensues, and death is preceded by delirium and deep coma. The corpse is livid all over, the blood fluid, and sanguine discharges are apt to flow from the mouth, nose and eyes.

16. Secale cornutum. The ergot of rye produces, when eaten in bread, many of the symptoms of mushroom poison. Decandolle ascribes this disease of grain to a fungus of the genus Sclerotium; and it has been found to yield a principle resembling fungia. The tendency of this substance to produce dry gangrene is generally admitted by German and French writers. There is a learned dissertation on it by Dr. Wiggers, in which its fungoid origin, and its peculiar action∙in promoting the expulsive efforts of the gravid uterus, seem to be established.

17. Alcohol and ECher may be here considered, as being derived by art from vegetable matter. They are well known narcotics, producing at first intoxication, and afterwards stupor and cerebral congestion. They are also irritants, the stomach of persons killed by them being often inflamed. When the moderate use of spirit does not produce death, it may give rise to delirium tremens. The smell of spirit is often perceived in the cavities of the chest and abdomen of those who have died from drinking. The stomach-pump and milk are the best remedies.

18. Camphor, a concrete essential oil, has pretty strong narcotic qualities. It is best detected by its peculiar odour.

VII. Animal Poisons.

1. Cantharides. An acrid poison, is contained in the body of the cantharis vesicatoria. It is found to reside in a whitish matter, resembling spermaceti in colour and consistence, which is united to three other marked principles. The first is a green oil, soluble in spirit, but not in water; the second a blackish matter, soluble in water, not in spirit; the third a yellowish viscid matter, soluble both in water and in spirit. This last is united in the insect with Cantharidins, and renders it soluble in water, which it is not when pure.

The symptoms of poisoning by cantharides are, intense burning heat in the primae viae, painful deglutition, pain in the stomach and bowels, bloody vomiting, painful micturition, and priapism, intense desire to void urine, and distressing pain in the whole urinary organs; frightful convulsions and tetanic spasms usher in the fatal termination. When the flies in substance have been swallowed, the fragments of their green elytra are found adhering to the villous coat of the stomach; and this has been observed even after the body has been buried for months. There is no antidote for this poison. Evacuants and mucilages are the best remedies. Oil given by the mouth increases the evil, by dissolving the cantharadine, but oil thrown into the bladder is useful in allaying the irritation.

2. Fish Poison. — This singular subject is little understood, except that, in certain seas, and in certain seasons, fishes, at other times wholesome, prove deadly poisons. This is chiefly the case with the yellow-billed sprat, the barracuta, the grey snapper, the sparus venenosus, and grey lαbrus of the West Indies; with several species of diodon and tetrodon, and with aplodactylus punctatus, of the South ern Ocean. The rapidity and fatality of the poison has been described by Chisholm, Ferguson, and Thomas. The symptoms are, irritation in the throat, tingling of the surface, burning heat in the stomach and bowels, colic, nausea, spasms, giddiness, coma, and death. It is said that persons have died whilst masticating a portion of the fish, ere any of it was swallowed. The juice of the sugar cane, and various sweet liqueurs, are said to be useful in the slighter cases.

Fishes in this country are sometimes poisonous; and muscles have occasionally, with us, produced death, with less rapidity, but with symptoms of the same kind. The cause of the poisonous quality of fish is, with some probability, attributed to their having fed on acrid mollusea.

The flesh of birds is occasionally poisonous; as happens to the phasinanidae of North America, when they have fed on the buds of the kalmia latifolia. The honey of the bee, in like manner, is poisonous, when they have fed on the sugar of the rhododendron and kalmia, as is described by Xenophon, Pallas, and Dr. Smith Barton. In the former case the honey produced a species of madness; in the latter, the symptoms were similar to what occurred to the soldiers of Xenophon.

3. Animals have a poison generated in them by disease, which is capable of infecting those who eat, or even touch their flesh. The best known instances of this is in the pestis bovilla or murrain among domestic animals, by which their flesh and juices become deadly poison to other animals. This appears somewhat analogous to the accidents that happen in dissection.

4. The bites of rabid animals belong to the same class of poisons. The bite, for instance, of a rabid dog, will destroy other animals; after some time they become delirious, then paralytic, and invariably die rabid. In man similar symptoms occur, to which is superadded hydrophobia;—a symptom never observed by Mr. Youatt in any animal except man. Excision of the wound, or destruction of the part by caustic, is the best prophylactic; belladona and Scutellaria lateriflora seem to have some preventive power, according to the same authority; and excessive bleeding seems to have arrested or cured the disease in India.

5. Bites of Snakes. —Poisonous snakes are provided with two or more teeth placed on a moveable bone, on each side of the upper jaw, and corresponding to the maxillary bones of other animals. These teeth or fangs are hollow, and have their roots connected with a duct, that conveys the poison from a bag placed under the principal muscles that close the jaws; so that when the animal bites, the poison is squeezed from the bag, and is instilled, through the hollow of the fangs, into the wound. The symptoms, in general, are in proportion to the quantity of the poison, compared to the size of the animal bitten, the smallest animals suffering most. The general symptoms are, pain in the part wounded, trembling, weakened respiration and circulation, and coma. The most poisonous snakes are the rattle-snake of America, and the cobra de capello of India; the viper of this country and of France sometimes produces fatal accidents. Excision of the part, sucking, or cupping the wound are to be tried; and both ammonia and arsenic given internally appear to have considerable power in curing the bites, even of the most deadly snakes.

6. The stings and bites of Araclinidm and Insecta, are poisons of a similar kind. The complex apparatus of the sting of the bee*and wasp convey poison to the wound, so acrid, that horses, asses, and also men, have died from numerous stings. The sting of the scorpion, and bite of scolopendra morsitans, as well as of spiders, are inflicted with a poisoned apparatus analogous in structure to the fangs of snakes.

VIII. Imaginary, Pretended, and Imputed Poi- [7:14:508]sonings, require much patience and attention on the part of the medical jurist; to them no general rule can be applied, but they must be treated according to the nature of each particular case.

PART II.—MEDICAL POLICE.

SECTION I. CIRCUMSTANCES AFFECTING THE HEALTH OF INDIVIDUALS.

I. Cleanliness This subject may be considered under three heads.

1. Personal cleanliness is valued by all nations in proportion to their advance in civilization, and exercises an important influence on the health of individuals. Most savage nations are disgustingly deficient in this virtue; but the polished nations of antiquity paid great attention to it, as is evinced by their general use of baths, the stupendous ruins of which still surprise us in the remains of their cities. In modern times, especially in Great Britain, warm and cold bathing are far less employed than is desirable; and we cannot help regretting the want of public baths for all ranks, especially in our manufacturing towns, where the Iuxury of warm or tepid bathing might be very cheaply obtained, by collecting the waste water from the condensing backs of steam engines. Bathing, by removing sordes and remains of perspiration, keeps the skin in a fit state for its important functions. Public baths should be established in every town, and all children should be taught to swim. The warm and vapour baths of northern Europe prove how cheaply such luxuries might be obtained for the great mass of the community.

2. Domestic cleanliness is perhaps better understood by the Dutch and the English than by any other nations in the world. This virtue has been long practised in Holland, but is comparatively only of late origin in Britain. The picture which Erasmus draws of English manners is not very flattering; and our own historians prove that it was not until after the civil wars of the 17th century that the English became a cleanly people. Now no nation can surpass them in domestic cleanliness, and none equal them in domestic comfort. The effect on the health of the inhabitants is shewn by the less frequent attacks of severe epidemic diseases in modern times, and perhaps also by the increased value of life annuities.

3. Ventilation of Habitations is one important part of domestic economy, now better understood; and Strutt, Sylvester, and Murray have taught us how ventilation may be combined with warmth. The renewal of the air, vitiated by respiration and combustion, is secured by simple contrivances, and the air admitted into apartments is warmed by passing between a close stove or cockle and an exterior covering.

II. Aliment —Under this head may be considered,

1. Preparation of Food. Alimentary matters are rendered more wholesome and nutritive by cooking; and the mystery of that art is not unworthy of consideration, even were it not also the means of economizing the sustenance, and increasing the gratification of man.

2. Culinary Utensils deserve attention here, because the wholesomeness of aliment often is materially affected by them. There is risk of cooking food, especially of the acescent or oleaginous kinds, in copper vessels, though the danger is diminished by keeping the utensils always bright, and not suffering the food to remain in them after removal from the fire. Vessels of lead and pewter should be entirely banished from the kitchen, as they are never without danger, from the ease with which they are acted on by acids. Tinning copper vessels renders them safe, as long as the coating of tin lasts; but the vessels usually made of pewter, an alloy that contains lead, should be replaced by those of block tin, or of tinned iron. The objection to the last kind of vessels is their little durability, and the lead solder with which they are put together. Vessels of iron are durable and cheap, but they blacken some kinds of food: this is best obviated by a coating of tin. Vessels of gold and silver arc far too expensive for ordinary use; but copper is often covered with a thin plate of silver, forming what is termed plated ware, which is excellent while the silver remains on the copper. A thinner coat of silver is applied, in some instances, by means of an amalgam of silver, and a similar process is commonly used to gild the inside of silver or of plated ware. Pottery is a valuable addition to culinary utensils. It is of all qualities, from the purest porcelain of China or of Europe, to the coarsest earthenware. The glazes which contain lead are objectionable, where acids are to be used, but if well baked, such glazes are not readily acted on. For chemical experiments the porcelain of China or of Germany, in which there is no lead, is always preferred, and it would be so also for culinary purposes, but for the expense. These glazes are made with felspar, or with mixtures of flint and alkalis.

3. Adulterations of Food may be accidental or designed. We have just stated how lead and copper may find their way into food, but there are other accidental adulterations. Farina, or flour, may be rendered unwholesome by the presence of the ergot, the smut of wheat, and the seeds of lolium ternulentum, which last act as a narcotic. Flour may also be mixed with sand, from the use of too soft millstones; with other impurities, from want of care in winnowing or grinding; or by fraudulent mixtures of chalk and gypsum. Bread may be mixed with chalk, magnesia, potassa, soda, or alum, to conceal bad flour; and it has been sometimes adulterated with white lead. These adulterations are easily detected. On rubbing down the bread into a pulp with water, the heavy particles will subside to the bottom, and may be collected; the alum, alkalis, or lead may be detected by chemical tests. Butcher meat may be unwholesome from disease in the animal, or by long keeping. Butter may be deteriorated by containing too much salt or water. Water may be unwholesome or disagreeable from corrupting animal or vegetable matter; from being too hard, that is, containing too much saline or earthy ingredients. Soft water may be adulterated by passing through leaden pipes, or standing in cisterns of that metal. Milk may be fraudulently mixed with water, or with magnesia and chalk. Malt liquors have been purposely adulterated by cocculus indicus, lolium ternulentum, &c., to increase their intoxicating qualities. Wines have been chiefly adulterated by brandy, to give them strength; by preparations of lead, to correct acidity, and impart astringency. This last ingredient is best detected by a test, consisting of a solution of tartaric acid, impregnated with sulphuretted hydrogen. The chief adulterations of spirit are by water, which is detected by the hydrometer; and by lead, accidentally introduced from the worms of the stills. Lead is readily thrown down by infusion of galls, which will convert new unwholesome spirits into good spirit. Vinegar is liable to contain lead and copper, from the pipes and cocks through which it flows. These metals are easily detected by sulphuretted hydrogen and ammonia.

III. Police of Apothecaries Shops. —The supply of good drugs is regulated, in many countries, by the government. Inspectors are appointed, who examine and report on the state of the drugs found in the premises of dealers, and any infringement of the laws is rigorously punished. In our country the inspections are a mere form, of little or no utility. They should be made by persons paid by the state, and competent to the task, whose office should be honourable.

IV. Clothing —The importance of paying attention to [7:14:509] the qualities of clothing is generally admitted. The advantage of flannel or cotton next the skin, to persons of a consumptive habit, or of otherwise delicate constitutions, and also to soldiers and sailors, or other persons whose occupations are laborious, is acknowledged. The use of linen next the skin is suitable for the young and robust; but as persons advance in life, cotton or woollen under-garments are advisable.

1. The Male dress should afford sufficient protection to the parts it covers, and should not impede the free use of the limbs. The covering of the head should defend the eyes from excess of light, and the head from the sun. Any thing tight about the neck is injurious. Those who take much exercise will find useful support from broad belts round the waist; especially as they advance in life.

2. The Female dress should keep the body comfortably warm. Compression of the chest and abdomen of females is far too general; and the ribs of most of our ladies are deformed by tight lacing. This practice diminishes the cavity of the chest; it confines the stomach and liver excessively, and has a tendency to contract the width of the pelvis. By the first, consumptive diseases are induced; by the second, the function of digestion is injured; by the last, ∙the perils of child-bed are increased. The practice of tight-lacing is ancient. It is severely stigmatized by Juvenal; and is condemned by all modern authors. Excessive exposure of the bust is also too general among women, and often lays the foundation of disease.

V. Temperance. —Its importance to health, to vigorous youth, and to honoured age, need not be insisted on. Gluttony is not less destructive, and is even more disgusting than drunkenness: both are sure to end in debasement of the mental faculties, and destruction of the bodily health.

VI. Exercise. —Regular exercise in the open air is highly conducive to health; and those who are interested in the improvement and happiness of the lower classes in our towns cannot help lamenting the little that has been done to encourage our artizans and shop-keepers to take out-door exercise in pure air.

The philanthropist must remark with regret the circumscription of the means of enjoying fresh air, which the enclosure of commons and of waste lands, near towns and villages, has produced, and the discouragement, by officious magistrates, of the out-door games and pastimes of the lower orders. Part of the sums, so frequently left to endow hospitals and alms-houses, would be more rationally expended on gymnasia for the encouragement of healthy sports in the open air, or on public walks for the recreation of our citizens.

VII. Prostitution. —In most parts of the Continent the state has interfered, not, as is falsely alleged by some, to raise a revenue from this polluted source, but to sceure the rising generation, as much as possible, against the fearful consequences of diseases, that sap the foundations of a nation’s strength, by impairing the sources of a healthy progeny. The unfortunate class of females, who may generally be considered as the victims of male licentiousness, are there regularly registered, and subject to domiciliary visits of the authorities, who send them to hospitals, when disease first makes its appearance. The arguments against this practice are not more rational than it would be to forbid the medical practitioner to lend his aid in other cases, where the imprudence of the sufferer was the cause of his malady.

VIII. Celibacy and Marriage. —In the most polished states of antiquity marriage was enjoined by positive enactments, and enforced by penal statutes; in modem times legislators wisely leave it to the sense and discretion of individuals. In fact the propensity to celibacy is so small in most persons, that marriage may be safely entrusted to individual will. The tendency to increase and multiply is so forcible that it will generally be found to produce a population up to the very limit of the means of providing for children. It was for advocating this philosophical truth, and for pointing out the natural checks to a redundant, and miserable, because destitute, population, that Malthus has been abused by sciolists and pretended philanthropists, who appear, from their senseless declamations, either never to have read his works, or not to have comprehended their import.

IX. Lactation and Care of Offspring —The important duty of rearing the helpless infant devolves by nature on the female parent; and in general it can never be so well performed by any other individual. In an artificial state of society, however, many females become mothers who are not able to nurse their children. In such cases we would recommend the employment of a wet nurse, as affording the best chance of rearing the infant. The child should not be long fed exclusively from the breast; because its stomach should be gradually accustomed to other food before it is weaned. The infant is totally dependent on the care of those around for its preservation. To retain ithealthy, it should undergo daily ablutions, have its clothes of suitable warmth, easy, and frequently changed. Its food should be chiefly of milk and farinaceous matter for the first two or three years. It should have regular exercise in the open air; and not be confined in its early years to too sedentary occupations. The dreadful mortality in foundling hospitals proves the importance of the circumstances alluded to under this head.

X. Effects of Profession and Trade on Health. This is a very important consideration, and may be divided into various heads.

1. Diseases incident to affluent idleness are chiefly such as arise from indolence and want of some definite object of pursuit; hypochondriasis, tedium vitae, dyspepsia, gout. For these the best remedies are, rural amusements, intellectual pursuits, mingled with sufficient inducements to take exercise in the open air.

2. Diseases of Literary Men are chiefly produced by want of attention to regular exercise in the open air, giving rise to dyspepsia and constipation; by inequalities in the time of eating and sleeping; and by excessive use of the eyes in artificial light. They are best obviated by abridging the hours of study, and mingling sedentary avocations with active and social occupations. Literary men, however, especially in France, have been a long-lived race.

3. Clergymen have a wholesome intermixture of sedentary with active duties; and, if their lungs be sound, they arc generally long-lived.

4. Lawyers, when their occupations are chiefly at the desk, are subject to the diseases of sedentary persons; but barristers, when not excessively harassed by toil, may generally be considered as engaged in a healthy occupation. Many of our judges attain extreme old age.

5. Medical Men, from the general activity of their pursuits, their knowledge of the causes that promote health, and the wholesome exercise of mind and body induced by their profession, are generally considered as a long-lived class: but in this, as in other learned professions, small account is made of those who die before they have become known, of those who pine away from penury and hope deferred, or whom a desire to better their condition sends abroad to perish on inhospitable or pestilential shores. Yet taking the whole together, the medical profession is certainly favourable to longevity.

6. Schoolmasters, Clerks, ^c. are subject to the usual diseases of sedentary persons, and to those produced by passing a great part of the day in vitiated air, with the sternum leaning on a desk. Such persons should live at some distance from the scene of their labours, that they may be compelled to take exercise in the open air [7:14:510]7. These observations apply also to Merchants, to Mastermanufacturers, and Shop-keepers. A British merchant has, when successful, an enviable life. The morning is dedicated to business, and the afternoon to his family and friends; while his home is usually remote from the crowded streets, in which his counting-house is necessarily placed.

8. The shopman, however, generally leads a very different life. He is late and early in the shop, the whole day is spent in serving customers, and in many instances his hours of rest are abridged by the duties of his business, which afford him no time to take exercise in the open air. This is peculiarly hard on young persons, perhaps sent from the country to be immersed in the smoky atmosphere of a crowded, narrow street. Multitudes of both sexes annually fall victims to this change.

9. Soldiers and Sailors, when they escape the perils of training to their laborious occupations, are often healthy, if temperate, and if care be taken of their health by their superiors. Their ailments often arise from their own intemperance, as much as from the casualties of their calling. Excessive fatigue is certainly unfavourable to longevity; and when we find very old persons in this class, we may attribute it in a great measure to the iron nature of constitutions, which have enabled them to resist the hardships to which they must have been subjected in their younger years. Soldiers on duty are more exposed than sailors to wet and cold, to unwholesome climates, and to bad fare. A sailor carries with him his provisions and his change of raiment; and in the British navy he has much attention paid to his health while on board his ship. Long marches are apt to produce diseases of the hip joint, and hernia, especially in young soldiers. The sailor is liable also to hernia from strains in the course of his laborious duty.

10. Agricultural Labourers have generally a very healthy occupation, when the returns of their industry afford them sufficient aliment and comfortable clothing. Their situation is much more favourable to health than that of the town-mechaħic. The same may be said of carters, postilions, and coachmen; except that the latter are often exposed at night to the inclemencies of the weather, and are not always remarkable for sobriety.

11. Quarrymen and Stone-masons are liable to serious injury, from the minute dust they create entering the air passages along with their breath. This often gives rise to a species of consumption; and such persons are seldom long-lived. It affects the stone masons of Scotland more than those of England: the former work under sheds, the latter in the open air. Marble-cutters for the same reason are unhealthy; and even the employment of a sculptor cannot be considered as a good one for a person of delicate lungs.

12. Carpenters and Joiners exercise healthy trades, because they require activity, and are freely exposed to the air in many of their operations. It is very different, however, with artizans whose trades are chiefly carried on in a vitiated atmosphere.

13. The trade of the Weaver is always rather unhealthy from his working in a confined space; but the introduction of machinery has reduced the pittance of the hand-loom weaver below what can support life with any comfort, and his habitation is proportionally wretched. There is in this occupation exercise to the limbs; but the breast leans again st the beam, which, with wretched fare and depressed spirits, render the trade of the weaver unfavourable to health.

14. Milliners and Tailors are confined in hot, and ill-ventilated rooms, they work too many hours in the day, and often have the natural hours of rest greatly abridged. Milliners are liable to become short-sighted, and the practice of biting the thread generally injures their front teeth. The lives of young females are often sacrificed to this business. Tailors assume a faulty position whilst at work; and the consequence is, that when they walk, they nave a peculiar strut; the increased power imparted to the muscles of the back, from long supporting the weight of the head, causes the shoulders to be preternaturally drawn back. They are also very subject to phthisis.

15. Shoemakers are more healthy; but the pressure of the last against the sternum and stomach is sometimes injurious.

16. Miners and Well-sinkers are engaged in laborious trades, in which they are exposed for considerable periods to breathe a vitiated atmosphere; and are further liable to the bad effects of inhaling dust, which predisposes to asthma.

17. Artizans working amidst putrid animal matters seem more liable to plague and typhoid fevers than most other classes.

18. Artizans exposed to inhale minute particles of dust are very liable to pectoral diseases. This is especially the case with knife and needle grinders. They are subject to the disease called grindeds rot, an incurable consumption, which renders this occupation most deadly. Currents of air, and interposed plates of glass, have been used to remedy which evil. Large magnets have been employed to arrest the iron dust, but it cannot abate that from the grindstone itself, which is not less fatal.

19∙ Workers in lead, brass, and copper, arc subject to disease, from those substances finding their way into the system, as already stated.

20. Bleachers and Dyers are liable to suffer from acrid fumes, in some instances, and also from sudden changes of temperature.

21. Snuff Makers and Millers are exposed to dust; and the former to the consequences of inhaling also a narcotic; but the effect is seldom very marked on either.

22. Chimney Sweepers are liable to consumption, and to a peculiar cutaneous disease, the chimney sweeper’s cancer, which chiefly affects the scrotum. Early excision removes it; but it is liable to recur.

23. Cotton, silk, and flax spinning by machinery expose the operatives to bad air, dust, and confinement in hot rooms. This is especially injurious to the young, who are much employed, from eight years and upwards, in such manufactories. The hours of work of all classes in them are too long. Woollen factories seem to be less unhealthy on the whole; but in them the employment of very young children, and too long hours of labour, are to be regretted.

24. Persons exposed to a high temperature, such as Cooks, Confectioners, Bakers, are liable to rheumatism, from sudden changes of temperature. Bakers were remarked to be the most general victims of the plague, at Marseilles, in the beginning of the last century. Sugar-refiners are exposed to much heat, and to sudden chills. Smelters of iron, and other ores, are subject to the same; to cough, from dust, especially if they be founders; and their eyes become weak, from he intense glare of the metal. Glass-blowers not only suffer from these causes, but also from the excessive exertions of their lungs, which often give rise to haemoptysis and asthma.

SECTION II. CIRCUMSTANCES AFFECTING THE HEALTH

OF COMMUNITIES.

I. Climate. —The effect of climate, the most general of these circumstances, depends chiefly on the temperature, the hygrometric state of the air, and the general force and direction of the winds. The temperature of any place is well known to depend, in a great degree, on its latitude. The inclination of the earth’s axis to the plane of its orbit has diffused the influence of the sun’s rays more extensively over the surface than if the same points had always a vertical[7:14:511] sun. The changes in temperature had been marked long before there was an instrument for measuring their extent, and hence the distribution of the earth’s surface into parallel zones denominated climates; but the invention of the thermometer shewed how ill this arrangement accorded with observation; and it was soon found that there were very different climates under the same parallels. The average or mean temperature is obtained by a series of thermometrical observations, carried on in the open air, and in the shade. Large springs and deep caverns usually have the mean temperature of the place where they occur; and it has been found that a series of observations made every hour through April, will give a pretty accurate mean temperature of that place for the whole year.

Temperature, however, is also considerably modified by longitude. Thus it is found that the mean temperature of any latitude in western Europe is higher than that of the corresponding latitude in eastern Asia, or in America, as may be seen by casting the eye over Humboldt’s chart of isothermal lines. A comparison of similar observations indicated to Sir David Brewster that there were, in each continent, certain meridians on which the mean temperature is the lowest in that parallel. These he termed the cold meridians, in approaching to which the mean temperature falls on either hand.

But the principal circumstance which modifies the effect of latitude is elevation above the sea. As we ascend mountains, the temperature falls; and in every region, if its mountains be sufficiently lofty, they are the abodes of perpetual congelation. The limit varies with the latitude: it is highest under the equator, and diminishes as we approach the poles: thus, at the equator, the point of perpetual congelation is more than 15,000 feet above the sea; in Britain it is about 5000. The climate of a place, then, varies with the latitude, with the longitude, and with the elevation.

Even when the mean temperature is the same, places may differ greatly in the extremes of heat and cold in summer and in winter. The chief agent in equalizing heat is the ocean, the temperature of the mass of which remains nearly the same in all latitudes. This renders the summers of islands less hot, and their winters less cold, than that of continents under the same parallels. The peculiarities of climate affect the vegetable productions of a country, and its salubrity is greatly modified by the nature of its surface. A region shrouded in forests is generally colder than one exposed to the rays of the sun; and the exhalations from swamps and marshes materially affect its fitness as a residence for man. Such countries are subject to violent intermittent and remittent fevers, especially when the marshes are acted on by intense solar heat; and in tropical regions such places are pestilential. Several other diseases appear to depend on climate, as the goitres and cretinism of the Alps, and other mountainous countries, the elephantiasis of Africa and the West Indies, and the strumous affections of cold climates.

All these peculiarities must be considered by those consulted on,.

II. Tire Sites for Towns and Habitations. —If the medical man be asked to give an opinion on any particular site, let him consider,

1. The purity and hygrometric state of the air —The average proportions of the cognizable ingredients of atmospheric air are,
[table]

The proportions of the gaseous ingredients are nearly the same everywhere; but the proportion of aqueous vapour varies greatly, according to the temperature and pressure of the atmosphere. It is the source of clouds, dew, fog, and rain, according to the suddenness of its precipitation. The quantity present in air may be estimated by Leslie’s hygrometer. The quantity of rain which falls in any place should be ascertained by the rain gauge; and the quickness of evaporation by experiment, or by observations with Leslie’s atmometer. The number of rainy days should also be noted; for the quantity of rain is not proportional to the number of wet days. In hot climates it rains more seldom, but more falls than in temperate regions. Thus, the mean annual rain in the West Indies averages 120 inches; at Calcutta it is=81; at Rome=39; at Liverpool=32; at Edinburgh=24; at Petersburgh=16. In any climate, more rain in mountainous districts than in plains. Thus, 50 inches fall in Argyleshire, whilst at Glasgow the rain is about=30; at Elgin=24 inches.

The changes in barometric pressure should also be noted. These arc extremely small within the tropics, or even in southern Europe, but fluctuate in northern Europe even to 1 1 c th of the whole column

2. A supply of potable Water is a most essential requisite. It should not be hard, it should be free of any peculiar taste or smell; and the nearer its specific gravity approaches 10002, to distilled water as 10000, so much the better. The capability of carrying water through pipes, to any station, is important, when a colony is to be founded. Running water of a good quality is also very important; but it should be recollected that stagnant water is not wholesome.

3. Fuel is another essential requisite, both for cooking and for warmth. A plentiful supply of wood, coal, or peat is indispensable where many human beings are to be congregated. Open fire-places are cheerful, but not economical modes of warming apartments; stoves are more frugal; hot-air-flues combine ventilation with warmth, but require considerable attention in their management; steam-tubes convey an equable temperature, but are less convenient than the circulation of hot water, in the apparatus devised by Mr. Perkins.

4. Vicinity of Trees is an important circumstance; but it must not be forgotten that a station buried in deep forests is seldom wholesome, and in hot climates is often pestilential.

5. Vicinity of Hills and Mountains is also deserving of consideration. If they be very lofty, in hot climates, the plains at their feet are often pestilential, producing black vomit and jungle fever ; yet removal to the mountains immediately relieves the sufferer, as is witnessed in the ascent from Vera Cruz to Xalapa, and from southern Hindustan to the Neilgherries.

6. Vicinity of Marshes, in every country, is to be shunned, in fixing on a site for human habitations. Marshes produce malignant remittents in hot seasons, and give rise to severe hepatic disease. The marsh fevers of Walchern, and the malaria of Italy, originate in stagnant water; and the fatality of some of our stations in the West and East Indies are to be attributed to swamps. Some of them, as British Guiana, have become more healthy as the country is more drained and cultivated.

7∙ Vicinity of the Sea is always an important element in choosing a station. In hot climates the sea-breeze mitigates the heat of day, and renders it endurable. This breeze, in summer, is very regular even at Gibraltar. The vicinity of the sea also mitigates the cold of winter. Sometimes it renders a station unhealthy, when the recession of the tide exposes a great extent of a muddy beach. This is especially the case at the mouths of great rivers; yet such stations, though unwholesome, are often politically important, as naval stations, or as keys to the back-country. Marshes, into which sea-water occasionally enters, are observed to be more pestilential than mere fresh-water swamps.
[7:14:512]

III. Drains and Sewers are important public works, on the proper construction of which the salubrity of a station may greatly depend. They should have such a fall as to carry off impurities, and to prevent an accumulation of stagnant water. The Greeks and Romans excelled in their attention to such works; but the unhealthiness of many places in Italy, in the present day, is Giving to the neglect of those useful structures.

IV. Paving of Streets, and Care of Public Ways, arc objects also worthy of the attention of the medical man, though chiefly in the province of the civil engineer.

V. Cemeteries. —Little attention has been, in this part of Europe, bestowed on the police of repositories for the dead. Burial in churchyards, in the midst of a crowded population, and even within churches, is still suffered to disgrace our cities. The French have set a good example; and the Turks have been long noted for the decent propriety, and judicious position of their cemeteries, which are always beyond their towns. The same is the practice of the Chinese, and of many nations whom we call barbarous. A better system is commencing among us, in the new cemeteries of Glasgow, Liverpool, and a few other places; and it is fervently to be hoped, that ere long our towns will cease to be infected with putrid emanations from crowded churchyards, and the temple of God to be polluted with the frail remains of mortality. The cemeteries of London are a disgrace to the metropolis: they are rather better at Edinburgh; but the cemeteries ought to have been removed altogether beyond the city; and the retired valley between Salisbury Craig and Arthur’s Seat, offers an admirable site for a spacious and magnificent necropolis. The best mode of sepulture is probably in the earth, without vaults; but anything is preferable to the horrid practice in Rome, of disposing of the carcases of the poor in huge caverns, often opening into the very churches.

VI. ITospitals. —The erection of hospitals is intimately connected with the subject of medical police. We cannot enter on a consideration of each sort of hospital, but state in general terms, that the wards should be lofty, with windows on one side, and galleries on the other for exercise to convalescents. Ventilation should be secured by some of the means already indicated; the wards should be provided with privies, and baths appropriated to each; the bedsteads should be of iron, as less liable to harbour vermin; airing grounds and convalescent rooms should be attached to all hospitals. In a lunatic asylum, each class of patients should have separate airing grounds; and occupations suited to their cases should be provided for convalescents. Foundling hospitals, from the mortality in them, even under the best management, seem to be amongst the most pestilent institutions of mistaken benevolence. Such considerations induced a German author to propose as an appropriate inscription over the gates of such establishments, “Children murdered here at the public expense.” Hospitals for the sick, military hospitals, and barracks, all may fall under medical police.

VII. Schools. —Seminaries for the instruction of youth merit more attention from the legislature than they have received. The rooms are often defective in ventilation; and the modes of warming them in cold weather are often very inefficient. In some schools too little attention is paid to vary the diet of children; and though seldom deficient in quantity, at large public and private schools, there often exists inattention to render it palatable, or to suit it to peculiarities of constitution. In many schools the hours of study, for very young children, are too long. The degrading practice of public flogging, even almost to manhood, in some schools, is brutalizing to the inflictor, and destructive of the delicate sensibilities of ingenuous youth. We must also stamp with our strongest disapprobation the practice of faTβwj∙> which prevails at some English schools, and is calculated to foster the vices of both tyrants and slaves. In female. seminaries the lessons are generally too long, the pupils too sedentary, too little in the epen air; and many female accomplishments, as they are termed, are apt to produce lateral curvature of the spine, as was fully proved by the late Mr. Shaw.

VIII. Prisons. —The state of our prisons is much improved since the time of Howard. The principal improvements are in the county prisons of England, in many of which much attention is paid to preserving the health of prisoners, by clean rooms, commodious airing grounds, and humane regard to their diet, and the cleanliness of their persons. In most of the prisons of this country, however, much is still defective, in what relates to the classification of prisoners, and separating juvenile delinquents from hardened offenders. In the county jails of Lancashire and Cheshire, much has been done to render prisons what they ought to be; but even in some of the best English prisons there are still no hospitals for the sick inmates; and the jails of Scotland are far behind those of the two counties alluded to in every respect. As far as lodging and diet go, there is no room for improvement in many British jails; and this humane attention is rewarded by the disappearance of jail-fever from our island. The subject of prison discipline is a wide field. The benevolent exertions of Mrs. Fry and her Quaker associates prove, that much good would flow from attention to the instruction and moral improvement of the unhappy inmates of our prisons.

IX. Lazzarettos and Quarantine Establishments are of Italian origin, at the period when the commerce of the East was engrossed by the free cities of Italy. The doctrine of contagion is not of modern origin, as has been ignorantly alleged. Notwithstanding the clamour of interested individuals, a few years ago, no rational medical man denies the contagions nature of the plague; and we have no doubt that the immunity of this island from that dreadful scourge, for 170 years, notwithstanding our multiplied relations with the East, is mainly owing to the rigour with which the quarantine laws have been enforced. Some of these regulations may err on the side of excess of caution; but this is far preferable to rash experiments, prompted by crude medical speculations, and supported, as they were attempted to be, by distortion of facts. The quarantine laws were revised in 1825, and the code is now, upon the whole, good. The quarantine stations for Britain are Standgatecreek, Deal, Milford-haven, Liverpool, Holyloch in the Clyde, and Inverkeithing bay in the Forth.

X. Punishments. —This subject, the last of the present dissertation, is worthy of the attention of the legislator and of the medical jurist.

1. Corporal Punishments, inflicted by sentences of our courts, extend to imprisoument, whipping, and forced labour.

Imprisonment is adjudged for several offences, and even for inability to pay a debt. When the health of a prisoner might suffer from confinement in a damp or unwholesome jail, the humanity of judges has frequently mitigated the severity of the sentence, on the representations of medical witnesses. It would be unjust to inflict a greater punishment than the law contemplated, by the mode of confinement; but in general our jails are far more comfortable, as far as lodging and diet are concerned, than the usual habitations of the very poor; and therefore imprisonment, in some instances, may have lost some of its salutary terrors in preventing crime.

Whipping is sometimes inflicted by sentence of the court, either publicly or privately; it is now generally applied to juvenile offenders in prison, and is far less frequently inflicted in public than formerly, especially since the abolition of the pillory for ordinary crimes. Flogging is still permitted to a limited extent both in our army and the navy. A medical man is always by on such occasions; and should he declare [7:14:513]the punishment enougn, even one ιash more, at that time inflicted, is a crime, and would subject the officer who ordered it to indictment for murder, should the sufferer die. Hard labour is now generally inflicted by the tread-mill, a contrivance by which the united weight of the prisoners condemned to it puts in motion a wheel, which moves machinery. The defect of this punishment is its inequality. To active persons, accustomed to walking, it is a light exercise; but to sedentary persons it is a most grievous punishment, giving intolerable pain to the muscles of the legs and the spine. To the disgrace of our country, it has been inflicted on females. Their muscles are too weak, and their habits little inured to such labour; and it is liable to induce prolapsus uteri, or miscarriage, if the prisoner be pregnant; or serious diseases of the female system, in various ailments of the sex. It arms, too, with a dangerous and tyrannical power ignorant justices and unfeeling magistrates. The law should forbid this infliction on females in all cases, and prevent the erection of tread-mills in all prisons not liable to the legal inspection of grand juries; which it seems houses of correction in England are not, they being “not under the jurisdiction of the sheriff of a county.” The beating of hemp was formerly with us the infliction for petty crimes; and in Holland it was rasping of dye-woods in the Rasphaus, which was always considered as a severe punishment. In America the penitentiary system of forced labour has been tried, and is still a subject of discussion. Solitary confinement has also been employed there; which some have considered worse than death.

2. Capital punishments. — In this country, excepting in cases of nobles for treason, hanging is invariably the mode employed by law. This is with justice preferred to any other mode of public execution, as the evidence of those, who have recovered after suspension, renders it probable that the person suffers very little pain, from his becoming speedily insensible; and when the drop is employed, the injury to the neck seems generally to extinguish life instantaneously.

Eeheading is in this country performed with the axe, in Germany with the sword, and in France with the guillotine; the prototype of which seems to be the Scottish maiden, still to be seen in the Antiquarian Society’s Museum in Edinburgh. The axe often requires a repetition of the blow; and the sword is liable to the same objection. The maiden chopped off the head by the descent of an axe loaded with lead. The guillotine slices it off, entering one side of the neck by an oblique edge. All sorts of beheading present a very ghastly spectacle, and habituate to the sight of human blood; besides which, serious doubts have been started as to the possibility of the head for a short time retaining its sensibility.

3. Pleas in bar of execution. — When a person is condemned to die, execution of the sentence may be deferred on three pleas.

Insanity may be pleaded by the relatives of the condemned, and a jury may be appointed to try the sanity or insanity of the prisoner.

The youth of the party is the second. There is no age fixed by British law, at which the perpetrator may not be executed for heinous crimes. In 1629 a child between eight and nine years of age was executed in England for an atrocious murder; one of ten years was condemned in 1748 at York; and a boy of thirteen was executed in this city, within the present century, for a murder. Blackstone states the lowest degree of non-age, by the practice of the English courts, to be seven years.

Pregnancy is the last plea admitted in our courts. When this is alleged, a jury of matrons is appointed by the judge to inspect the party, and if the allegation be found true, she is respited till after delivery. These persons are very incompetent to so delicate a task. It should be entrusted to accoucheurs, who, from the appearance of the mammae, and the application of the stethoscope to the abdomen in the latter months, will readily ascertain the truth or falsehood of the allegation. (J. J. J.)

Medicine, in its most extended signification, may be said to comprehend all the knowledge which can be useful in enabling us to prevent the occurrence of diseases; or which may assist us, when diseases have occurred, in conducting their treatment, with a view to their alleviation or cure. The knowledge subservient to these several purposes (the prevention, alleviation, and cure of diseases) may be comprehended under three general heads: 1st, an acquaintance with the human economy in the state of health ;—2d, an acquaintance with the various deviations from the healthy state, or, in other words, the various diseased, morbid, or pathological conditions to which that economy is liable ;— and 3d, an acquaintance with those agents or powers which are capable of inducing disease in the economy, when it is in a healthy condition, and with those which are capable, when it is in a diseased condition, of restoring it to a state of health; that is, an acquaintance with what are termed morbific causes and therapeutic agents.

It is necessary to consider medicine both as a science and as an art. To the science of medicine it belongs to collect all the facts that have been ascertained respecting the operations and phenomena of the economy in its healthy and morbid conditions, and respecting the causes and remedies of diseases; to compare these facts with one another, so as to discover their mutual relations; to arrange them in a convenient order, and to deduce from them the general conclusions to which they may seem to lead; and to point out where the knowledge of facts is imperfect, and to suggest the means by which such deficiencies may be supplied. The art of medicine, again, consists in the immediate practical application of the knowledge that has been acquired by observation and experiment, in the several departments enumerated, to the prevention and treatment of diseases.

In the following article it is proposed in the first place to take a brief view of medical science considered in reference to the three departments which medicine has been said to comprehend. A similar view will afterwards be taken of those divisions which convenience and custom have established in medicine considered as a practical art. It is in the susceptibility of the economy to be affected with diseases, and in the influence which certain circumstances and agents exercise in producing their removal, that medicine, both as a science and as an art, has its primary origin. Diseases and their remedies, accordingly, must have been the first subjects of medical investigation that engaged the attention of mankind. The importance of a correct acquaintance with thehuman economy in a state ofhealth could [7:14:514]come to be felt only after these practical branches had made seme degree of advancement. It is now, however, well understood that the extent of knowledge which can be acquired respecting the human economy in the state of disease, must in a great measure be dependent upon the knowledge that is possessed of that economy in the state of health; since the very ground-work on which all rational inquiries respecting diseases must ultimately rest, is the knowledge of the circumstances in which the economy that is disordered, differs from the same economy in a sound condition.

I. As the human economy consists of two distinct elements, an organised body and a conscious mind, which, whatever may be the nature of their connection, exercise most important influences on one another; andasboth of these elements of the economy are liable to experience deviations from their natural or healthy condition, a knowledge of the body and of the mind, in the healthy exercise of their functions, forms the essential foundation of medical science.

The study of the mind, in its healthy condition, has usually been regarded as constituting a particular department of philosophy (psychology) quite independent of medicine; but we shall afterwards find reason for believing that the consideration of its various phenomena, intellectual and moral, ought to be included under the same department of medical science that treats of the healthy phenomena of the corporeal part of the economy.

The knowledge of the organised body, in the state of health, is of a two-fold nature; first, as it relates to the structure of its several parts; and, secondly, as it relates to the use, purpose, or function which each part performs in the economy, and to the reciprocal dependence of the different functions on one another. The two branchesof medical science that treat of the structure and functions of the body, are comprehended, as every one knows, under the names of Anatomy and Physiology; branches which are, no doubt, most closely allied, and in some respects inseparably connected with one another, but which are at the same time sufficiently distinct in their objects and in their means of prosecution, and sufficiently extensive in the field of investigation which each of them presents, to admit of, or rather to require, separate consideration in any view of them pretending to be systematic.

To each part of the body capable of performing some particular function or purpose in the human economy, the name of organ is usually assigned; thus the eye is said to be the organ of vision; the stomach and intestines with the liver, pancreas, &c., the organs of digestion; and the muscles, bones and joints, the organs of voluntary motion. In examining the structure of the different organs of the body, it is found that they all consist of different anatomical elements; and whilst some of these elements vary in the different organs that are examined, others of them are met with in all the organs indiscriminately. Thus if we compare the structure of the heart and of the liver, we shall find in the former, layers of muscular fibres of which no trace can be observed in the latter organ; while in the liver, on the other hand, we find a peculiar arrangement of cellular matter, usually denominated parenchyma, to which nothing analogous is discoverable in the heart. In both of these organs, however, vessels, for the conveyance of blood and other fluids, and nervous filaments can be discovered; and these latter anatomical elements, the vessels and nerves, pervade, in greater or less number, all parts of the animal frame. Whilst each bone and each muscle may be said, in some sort, to have a separate existence, independent of every other bone or muscle of the body, every blood-vessel and every nerve, on the contrary, exists only as a part of a general system, all the ramifications of which are connected with one another through the medium of a central organ or part. Tho§e anatomical elements which vary in the different organs of the body, such as muscular fibre, cellular substance, mucous and serous membrane, &c., are denominated textures by anatomists; whilst those which are constant in all the organs, the blood-vessels, lymphatics, and nerves, are regarded as parts of their corresponding systems.

There are several different points of view in which the structure of the human body may be considered. 1st, We may examine the different classes of organs and the different systems, separately, confining our attention principally to the relations which the different organs of the same class, or the different parts of the same system bear to one another; the boncs, the muscles, the vascular system, the nervous system, &c., each being treated of under a distinct head. It is in this view chiefly that the structure of the body is considered in what has been termed Descriptive Anatomy. 2nd, We may consider the relations which the different organs and systems entering into the composition of any particular region of the body, bear to one another, as, for example, the relations of the muscles, blood-vessels, and nerves of the neck; or the relations of the parts of the perineum to one another and to the lower part of the bladder. It is this kind of anatomical knowledge, (the anatomy of the regions, as it has been termed), which is essential in the performance of surgical operations, and which has hence frequently received the name of Surgical Anatomy. 3d, We may examine into the minute structure of each of the different kinds of organs and parts of systems, as of the stomach, liver, heart, arteries, brain, nerves, &c., and endeavour to ascertain in relation to each, whether it consists of one or of several elementary substances or textures, what is the physical arrangement of each of the textures entering into its composition, and in what manner these are united and combined. To this minute investigation of the structure of the different organs and systems of the body, and of the textures entering into their composition, the name of General Anatomy has been assigned. 4th, We may compare the different parts of the human frame, as the nervous or vascular system, the respiratory or digestive organs, &c., with the corresponding parts of other animals, a comparison which frequently leads to an improvement and extension of our knowledge of the structure of the human body. To this field of inquiry the name of Comparative Anatomy has been given. And,5th, We may enquire into the progressive development which the body and each of its parts undergoes, during the embryo and foetal states, from its earliest period of formation to the time of birth; a branch of investigation which has received the name of the Anatomy of Development, and which is equally applicable to man and to the lower animals.

When we reflect on the length of time during which the structure of the human body has been the subject of investigation, the number of persons who have been engaged in the inquiry, and the enthusiasm with which it has been prosecuted, it may appear strange that there should be still many anatomical points respecting which we are aware that our knowledge is very deficient; and that from time to time facts are brought to light, in this department, of which no previous suspicion had been entertained. Anatomical discoveries, as appears from the foregoing observations, may relate to the textures, to the systems, to the organs, or to the regions of the human body; or they may relate to the structure of the lower animals, or to the gradual development of animal bodies during their foetal existence.

1. The anatomy of textures is comparatively a recent investigation, for though it cannot be said to have originated with Bichat, yet unquestionably it received from him the dignity of a separate branch of scientific inquiry; not only from his having contributed materially to its advancement by his own labours, but from his having by the ingenious and philosophical views which he took of the subject, rendered the medical profession more fully aware of the important advantages[7:14:515] to be derived from its cultivation. Butbesidesbeing of recent origin, the anatomy of textures is a subject attended with very considerable difficulties from the minuteness of the objects to be investigated. As illustrating these difficulties, we may refer to the various statements which have at different times been given respecting the primary structure of muscular fibre, of bone, and of nervous substance. And as the principal means by which we are assisted in overcoming them, may be mentioned in the first place, the employment of chemical re-agents, by which, in some instances the parts are rendered more fit for examination by being hardened, as is, for example, the case with the substance of the brain; and in other instances the structure of the part is ascertained by one texture being destroyed whilst another is left entire, as in the case of the bones and nerves. As a second means of overcoming the difficulties attendant on the anatomical investigation of textures, may be mentioned the use of the magnifying glass and of the microscope. The latter instrument, which was invented about 1620, seems to have been first applied to purposes of anatomical investigation by Malpighi, who was followed in this line of research by Hook, Power, Leuenhoeck, and Lieberkuhn. In later times it has become an essential part of the apparatus of the anatomist.

2. The discoveries relative to the anatomical systems, which have from time to time been made, and which may be expected to be still further extended, refer to the minute ramifications of the vessels and of the nerves; to the modes in which the different kinds of vessels, arteries, veins, capillaries, and lymphatics communicate with one another; and to the connections of the minute filaments arising from different nerves. The prosecution of this department of anatomy, in particular, has been most materially advanced by the invention of the art of injections. “In the latter part of the last century,” says Dr. I4unter, in his introductory lectures to his last course of anatomy, “this science made two great steps, by the invention of injections, and the method of what we commonly call preparations. These two modem arts have really been of infinite use to anatomy; and besides, have introduced an elegance into our administrations which in former times could not have been supposed to be possible. They arose in Holland under Swammerdam and Ruysch, and afterwards in England under Cowper, St. Andre, and others, where they have been greatly improved. And from England, they arc of late years spreading to all parts of the British dominions, to France, Italy, and other parts of Europe. I say,/row England, because the arts of making fine injections and preparations seem to have been almost peculiar to Holland and England, and the anatomists who have excelled in that way have generally made a secret of their methods and improvements, till within the last thirty years, when all these arts have been constantly taught in public courses of anatomy here”

3. The anatomy of the organs, and particularly of some of the internal viscera, as the brain, the liver, &c., notwithstanding the repeated investigation to which they have been subjected, still presents an extensive field of inquiry; for much remains to be ascertained as to the textures that enter into the composition of each organ, and as to the relations of these textures to one another, and to the ramifications of the systems with which they are more or less largely combined.

4. In the anatomy of regions, the objects of investigation are on comparatively a large scale, and consequently more easily discovered and appreciated. Yet structural arrangements modifying the progress of surgical disease?, and regulating the performance of surgical operations, still continue from time to time to be brought to light. The improved knowledge that is at present possessed of the anatomy of the parts concerned in hernia, and in the operations of aneurism and of lithotomy, bears honourable testimony to the diligence and skill with which this department has in modern times been prosecuted.

5. Comparative anatomy, though from the name it bears, it obviously originated in the comparison of the structure of the human body with that of other animals, has in its progress come to form a science in itself; and when we consider the number of animals already known, the additions that are from time to time made to these, by those who are engaged in exploring distant regions of the globe, and the increased facilities of obtaining specimens for the purposes of dissection, afforded by voyages of commercial or scientific enterprise, it is not wonderful that this department should every day be presenting a rich harvest of discovery to reward the industry of those who are engaged in its cultivation.

6. The anatomy of development, notwithstanding the zeal with which it has, in modern times particularly, been cultivated, still affords an extensive field for the collection of curious and interesting facts. From the ease with which observations may be made on the eggs of birds, during the progress of incubation, many anatomists have availed themselves of the opportunity thus afforded for studying the development of the foetus and its several organs. But it was not till a very late period that their observation was extended to the formation or evolution of the organs in the other classes of vertebrated animals. It is satisfactory to know that the more the structure of the ova of the different classes of vertebrated animals has been studied, the more perfect has the resemblance between them appeared to be. “Since our acquaintance with the development of the ovum has increased,” says a late writer on this subject, “the mode in which the organs of the foetus are produced, has been proved to be analogous in the different classes of vertebrated animals; and we are induced to believe that a knowledge of the simpler forms of these animals must greatly facilitate our study of the more complicated.” We may remark that there are two leading views, in conformity with one or other of which the investigation of this department of anatomy has been prosecuted. According to the one view, the impregnated ovum, or original germ, before the process of development has commenced, contains already formed all the parts which are afterwards to be found in the perfect animal; so that the successive appearance of the organs of the animal, which is observed during the progress of development, is owing simply to the evolution, or coming into sight, of parts which had previously been invisible, in consequence of their small size and of their transparency. According to the other view, the original germ, before development has commenced, is very simple in its structure, and does not, so far as can with the greatest attention be discovered, contain any part that can be compared to the foetal or adult animal, so that during the development of the foetus, its organs are actually formed, and not simply evolved. Those who entertain this opinion accordingly maintain, that several of the organs of the embryo can be seen gradually forming by the apposition of their parts. Closely allied with the anatomy of development is the inquiry relative to the various malformations or monstrosities which animal bodies occasionally exhibit; for according to the notion that may be adopted respecting the primitive condition of the germ, and the changes which it subsequently undergoes, will be the view entertained as to whether the occurrence of monstrosities is attributable to some peculiarity in its original structure, or to some imperfection or irregularity in its development. And in proportion as our knowledge shall be extended, of the relative periods at which the different organs are formed, and of the successive series of changes which they undergo, will we be the better able to analyse and comprehend the modes in which monstrosities are produced.

Besides the consideration of the functions of the corpo [7:14:516]real part of the economy, Physiology comprehends likewise, as has been already hinted, that of the phenomena of mind. All these phenomena, or operations of the human economy, corporeal and mental, it has been found convenient to arrange under three classes of functions, designated by Galen, the Natural, the Vital, and the Animal. Under the Natural are included those functions which are performed by all organised beings, plants as well as animals, and which are essential to the preservation of the individual, and the continuance of the species; the functions, namely, of nutrition and reproduction. The Vital class of functions comprehends two, which, in the higher orders of animals at least, cannot be suspended for more than a very short space of time, without putting a stop to life; the functions of circulation and respiration. The Animal functions are those by the exercise of which the animal creation is particularly characterized, but which vary in their degree and perfection, according to the place the animal occupies in the scale ofexistence; the functions ofsensation, thought, and volition.

On an analysis of all the phenomena which these several functions exhibit, it will be found that these phenomena are of three kinds. In the production of some, corporeal organs only are concerned; others are wholly of a mental character; and others, again, are partly mental and partly corporeal. The corporeal operations of the human economy, as regards their results, are physical or chemical, that is, they consist in changes in the relative situation of sensible particles, unattended with change in their composition; as when the blood is conveyed from the heart throughout the whole fabric of the body, and again returned to the central organ of circulation: or they consist in changes in the combinations and arrangements of elementary particles; as in those changes of deterioration and purification which the blood undergoes during its progress through the greater or systemic, and the lesser or pulmonic circulation. There are several operations of the economy, of which the present state of our knowledge does not enable us to determine whether they be properly of a physical or of a chemical character^ as, for example, those processes by which various fluids are separated from the blood, in the different organs of secretion. As regards their causes, the corporeal phenomena of the animal economy seem to be partly dependent on the common properties of inorganic matter, as gravity, weight, elasticity, chemical affinity, &c.; and partly on vital properties peculiar to animal bodies, more particularly the irritability of the muscular fibre, and the ener-getory influence of the ganglionic system of nerves.

With respect to the phenomena of the human economy that are wholly mental, “there is,” as was well observed by the late Dr. Thomas Brown, “a physiology of the mind as there is a physiology of the body; a science which examines the phenomena of our spiritual part simply as phenomena, and from the order of their succession, or other circumstances of analogy, arranges them in classes under certain general names; as in the physiology of our corporeal part, we consider the phenomena of a different kind which the body exhibits, and reduce all the diversities of these under the names of a few general functions.” A knowledge of the intellectual and moral powers, though their investigation forms the peculiar province of the metaphysician and moral philosopher, is essentially necessary to the physiologist, both from their own importance as parts of the constitution of man, and from the poaverful influence which they exercise over hisbodilyftmctions. It is obvious, likewise, that a knowledge of the mind in its healthy exercise must be equally necessary to a proper understanding of mental diseases, as is a knθλvledge of the body in the state of health to the understanding of its diseases. It is gratifying, therefore, to find that medical men are becoming more and more aware of the importance of acquiring such a knowledge of the operations of the intellectual faculties and moral feelings as may serve as a groundwork for the scientific study and humane treatment of mental diseases. The most interesting point of view, certainly, in which the mental phenomena present themselves to the consideration of the physiologist, is in their connection with the nervous system. It is well known that while some physiologists are content with recognising a general connection between the faculties of the mind and the brain, others have endeavoured to establish a more especial relation between particular mental powers and particular parts of the cerebral organ.

Of the phenomena of the economy in the production of which the mind and body are both obviously concerned, a part, those, namely, of sensation, originate in the body and are concluded in the mind; whilst another part, those, namely, of voluntary motion, originate in the mind, and are concluded in the body. In each of these two functions, the nerves seem to serveas the medium of communication between the brain, as the more immediate organ of the mind, and the different sensory and motory organs of the animal frame.

The progress of physiology is necessarily dependent on the advancement of other collateral sciences, particularly of anatomy and of chemistry, as well as on experimental research. A few illustrations of the advantages that have accrued to physiology from the improved and extended cultivation of each of these departments, may serve to place this dependence in a clear point of view.

1. As to the influence of anatomy on the advancement of physiology, we may observe, that to know the action or operation of a machine, it is essential to know its mechanism or structure; and to those conversant with this kind of inquiry, nothing in many instances is requisite but a knowledge of the relative situation and the connection of parts, to enable them to comprehend the general effect which will result from their combined action, and the particular share which each part contributes towards its production. There can be no doubt that the circumstance which first directed the attention of the illustrious Harvey to those investigations which terminated in the discovery of the circulation of the blood, the most important physiological discovery certainly that has ever been made, was his .desire to ascertain the use of the valves of the veins, the existence of which had been pointed out to him by his distinguished teacher in anatomy, Fabricius ab Aquapendente. It is obvious, too, how great a difference in the knowledge possessed of the function of assimilation must have been produced by the discovery of those absorbent vessels, the lacteals, as they have been termed, that convey the digested food or chyle from the intestinal canal along the mesentery, to the common trunk named the thoracic duct, which ultimately discharges it into the venous system. It Avas not till 1622 that the lacteal vessels were discovered by Gaspard Aselli at Cremona, and twenty-five years elapsed subsequently to this before Pecquet of Dieppe discovered, at Montpellier, the thoracic duct. Previously to that time it had been supposed that the chyle is conveyed by the veins of the mesentery from the intestines to the liver, and that it is the peculiar function of this organ to convert that fluid into blood.

2. Many illustrations might be given of the lights which chemical science has in modern times thrown upon the phenomena and functions of the animal economy. The reciprocal changes which the atmospheric air and the blood produce upon one another within the lungs, in respiration; the changes which the food undergoes from the action of the different fluids with which it comes in contact in its passage through the alimentary canal; and the composition of the different products of secretion, as the gastric juice, the bile, and the urine, are amongst the more remarkable objects of physiological inquiry, to the advancement of the knowledge of which chemistry has powerfully contributed.

3. Every function of the body furnishes a host of in [7:14:517]stances in which our knowledge of its mode of performance and of its reciprocal dependence upon, and influence over, the other functions, has been advanced by experimental researches. None of these researches, perhaps, are more important in the conclusions to which they have led and still promise to lead, or have been prosecuted with greater diligence and sagacity, than those which relate to the dependence of particular functions upon particular portions of the nervous system.

II. Such, then, are the two points of view in which it is necessary for the purposes of medical science to consider the human economy in the state of health; first, in relation to the structure of the body and its several parts; and second, in relation to the actions or functions of these parts, or the corporeal and mental phenomena of which the human economy is the field of operation. But it is in precisely the same points of view that it is necessary for us to consider the economy in the state of disease. There is a department of Morbid as well as of Healthy Anatomy, and a department of Morbid, as there is one of Healthy Physiology. These two departments considered separately, and in their relations to one another, constitute the branch of medical science denominated Pathology. As it is the object of Healthy Anatomy to make us acquainted with the structure, forms, dimensions, and connections of the several textures, systems, and organs of the body, in the state of health; so it is the object of Morbid or Pathological Anatomy to make us acquainted with the changes in all of these respects, to which the different parts of the body are liable in the state of disease. And in like manner, as it is the object of Healthy Physiology to make us acquainted with all the several phenomena, corporeal and mental, that are taking place in the human economy in its healthy condition, to trace the causes from which they originate, the mechanism by which they are accomplished, and their reciprocal dependence and influence on one another; so it is the object of Morbid or Pathological Physiology to ascertain to what deviations the several corporeal and mental phenomena are subject in the state of disease, and to discover what new phenomena are developed in that state, and by what powers or agents these deviations are occasioned.

No department of medical science, probably, ever received so large an accession of materials for its elucidation, in so short a period of time, as morbid anatomy has done, since medical men became fully aware of the benefit which Theoretical and Practical Medicine is capable of receiving from the investigation of those various morbid alterations of structure that occur in the different organs of the human body. There are three principal points of view in which the knowledge obtained by necroscopical examinations may be considered; and were we to trace the history of Pathological Anatomy, it would be easy to shew that the consideration of that knowledge in these different points of view, marks the successive epochs in the progress of this department of medical science.

1. Pathologists may endeavour to ascertain the various morbid alterations that occur in the structure of the different textures, systems, and organs of the body, in the progress of particular diseases, as of fevers and febrile eruptions, of tetanus or locked jaw, or of consumption, &c. The Observationes Medicae Pariores of Schenckius, published at Frankfort. in 1600; the Sepulchretum sive Anatomia Practica ex Cadavcribus morbo denatis of Bonetus, published at Geneva in 1679; and the Epistolae de Sedibus et Causis Morborum per Anatomen indagatis of Morgagni, published at Venice in 1761, though differing widely from one another in importance and merit, may be regarded as all belonging to this first period of Pathological Anatomy, seeing that they all consist, for the most part, of individual cases of disease, arranged in a systematic order according to die part of the body which had been principally affected.

2. They may consider each particular texture, system, or organ of the body, (as, for example, serous membrane, the heart and blood-vessels, or the stomach and intestines), separately, and without reference to individual cases of disease, in relation to the various morbid changes of structure which it is liable to undergo, (such as inflammation and its consequences, morbid degenerations and new growths,—and with a view to the effects which these changes produce on the performance of the functions of the particular texture, system or organ. As illustrations of this mode of considering Morbid Anatomy we may refer to the systematic works of Ludwig, Baillie, Conradi, Voigtel, and Otto. The recent investigations respecting the morbid alterations of structure that occur in the different portions of the nervous system, in the heart and blood-vessels and in the organs of respiration, are most creditable proofs of the diligence and success with which this department has been prosecuted in the course of the present century.

3. They may consider each particular kind of morbid structural change, (as inflammation, tubercle, cancer, &c.), as a separate subject of examination, in respect of the general characters which it exhibits from its first development till its termination or the death of the individual, in all the parts of the body in which it is liable to occur, and the modifications it exhibits in each particular texture or organ. It is by the greater degree of attention bestowed upon this department, that the pathological anatomy of the present day is more particularly distinguished from that of former times. But though great additions have recently been made to our knowledge of morbid structures, as for example, in what relates to the development of tubercle, by the works of Bayle, Laennce, and their followers; to the distinctions between scirrhus and fungus haematodes, or hard and soft cancer, by the writings of Hey, Burns, and Wardrop; and to the existence of morbid structures not previously known, such as melanosis; a great deal still remains to be accomplished before this branch of medical science can be considered as placed upon a satisfactory footing.

The means by which our knowledge of morbid structure has been extended, and may be expected to be still further advanced, are the same as those upon which the progress of healthy anatomy depends; frequent dissection of the dead body, and the employment of those physical and chemical aids to which we had formerly occasion to refer.

A circumstance which has materially assisted in diffusing a knowledge of the morbid alterations of structure which the different textures, systems, and organs of the body are liable to undergo, has been the formation in anatomical museums, of collections of specimens of diseased parts. These collections seem to have consisted at first, chiefly or solely, of such substances as could be preserved in a dry condition, such as macerated bones, calculi, &c.; but their value has been greatly increased in later times, by the collectors availing themselves of the art of making wet preparations. Within a still more recent period an important advancement has been made in the application of the pictorial art to the illustration of pathological anatomy. It is long indeed since it has been customary to represent in engravings, detached specimens of diseased parts, particularly of those which exhibit considerable change of form on the external surface of the body; and some valuable works had been published, in which particular branches of pathological anatomy had been considerably advanced by illustrations of this description. The “Series of Engravings, intended to illustrate the Morbid Anatomy of some of the most important parts of the human body,” which was published by Dr. Baillie at the beginning of the present century, is alike distinguished by the sound judgment displayed in the selection of the subjects, and by fidelity and beauty in their representation. But it has been of late years only that pathologists have called in the aid of colouring to assist in [7:14:518]conveying an idea of the changes which disease induces, not only on the surface of the body, but in each of its different textures, systems, and organs. And when it is considered how important an element colour forms in the characters by which the different morbid alterations of structure are distinguished, and how seldom it is possible to preserve any traces of it in preparations, it must be obvious how much coloured delineations are calculated to aid in communicating a knowledge of pathological anatomy, by conveying to the mind, speedily and precisely, through the medium of the eye, appearances of which the most lengthened verbal descriptions can enable the reader or hearer to form only a very imperfect conception.^[1. Professor Lordat of Montpellier, in his Essai sur l’Iconοlogie Médicale, ou sur les Rapports d’utilité entre l’art du Dessin et l’étude de la Médecine ( 1833), has given a brief but interesting outline of the connection which has subsisted between anatomy and the fine arts, particularly painting and engraving, in the successive periods of their progress; and has with great justice represented the art of engraving as having most powerfully contributed to advance the knowledge of anatomy. M∙ Lordat has thrown out some ingenious reflections, too, on the applicability of painting to the representation of what may be called the physiognomy of disease; that is, the changes it produces on the outward appearance of the frame. He does not, however, seem to have even dropped an incidental allusion to the applicability of delineation to the illustration and advancement of pathological anatomy. The advantage that might result from the application of coloured delineations to the representation of diseases was fully pointed out by Professor Delius, in his Meditatio de Iconibus PathologicoAnatomicis ad Naturam pictis, published at Erlangen in 1782, along with his treatise DeCldolelitkis, in which he gives a coloured plate representing gall-stones. ]

Of the light which the improved knowledge of morbid alterations of structure has thrown upon diseases and their treatment, we shall afterwards have occasion to speak; at present we may remark, that as morbid anatomy has been promoted by the gradually improving acquaintance with the anatomy and physiology of the body in the state of health, it has in its turn materially assisted in elucidating many obscure and difficult points in these two departments of medical science. The processes of disease, indeed, not unfrequently fulfil the same purposes as the experimental measures to which anatomists and physiologists are wont to have recourse, in prosecuting their respective investigations. Ofthis many striking illustrations might be found in the injuries and diseases of the different portions of the nervous system.

As an important ally of pathological anatomy, in the investigation of disease, it is proper to .mention pathological chemistry, or the application of the knowledge that has been acquired, respectingthe composition ofthedifferentsolids and fluids of the body, to the discovery of the morbid changes which they are liable to undergo. Our knowledge of the results of morbid action has already received very considerable and valuable additions through the means of this department of scientific research. Amongst the benefits for which we are indebted to it, may be mentioned the replacement of the vague and conjectural art of Uromancy, by a body of precise information relative to the various morbid changes which the urinary secretion experiences in the diseases of its own peculiar organs, or in those of other parts of the body.

Before proceeding further in this general view of that department of medical science which relates to disease, it may be proper briefly to state the import of two terms of which we shall have frequent occasion to make use, namely, symptom and proximate cause, and to point out the principal varieties of symptoms and proximate causes, as they present themselves to the consideration of the pathologist. By a symptom, then, is meant any phenomenon or circumstance which leads us to infér that some one or other of the functions of the economy is not exercised in its ordinary or healthy manner. Of these circumstances a knowledge may be acquired in three ways: 1st, through the information of the patient; 2d, by direct observation; or, 3d, by experimental investigation. Of each of these modes of recognizing or discovering symptoms, we shall offer a few illustrations.

1. We know that a person in health sees objects single, and does not experience any sensations of sound unless his ear be exposed to atmospheric vibrations. But if a patient tells us that he sees objects double, and has ringing in his ears, these we hold to be symptoms of derangement in the exercise of the sensory functions of the nervous system. It is only by the information of the patient himself that we can obtain a knowledge of the occurrence of these and similar symptoms, having a relation to the exercise of the function of sensation.

2. In a person in health, the colour of the skin exhibits a peculiar hue, known by the name of flesh-colour; and the two sides of the face are nearly or altogether symmetrical. But if the skin assume an orange yellow, or a scarlet hue; or if one side of the face is drawn over to the other, so as to give to it a twisted appearance, these unusual phenomena lead us to conclude that some parts of the economy are out of order; they serve us as symptoms of disease, and are obviously examples of that class of symptoms a knowledge of which we acquire by direct observation.

3. We know that in a healthy person the temperature of the surface of the body is about 97° Fahr., and that the frequency of the strokes of the pulse ranges within certain limits, corresponding with the age of the individual. If by trial or experiment we find that the temperature has risen above or fallen below the standard of health, or that the frequency of the pulse either exceeds or falls below the limits proper to the period of life, these deviations furnish so many symptoms of disease. Again, the fluid secreted by the kidneys, besides exhibiting certain physical characters obvious to the sight, has been found by experimental examination to possess a determinate specific gravity, and to contain certain chemical elements in determinate proportions. These, however, are subject to variations in the state of disease; and the ascertainment of these deviations by appropriate instruments, and by the employment of chemical tests and processes, furnishes us wdth important aids in detecting the existence of diseases, and in determining their nature. To the same class of symptoms, also, we must refer those which are furnished by the practices of percussion and auscultation; practices that have turned the attention of physiologists and pathologists to so many curious circumstances respecting the healthy and morbid actions of the body, particularly those of the organs of circulation and respiration.

It must be remembered, however, that there exists a considerable latitude in the mode in which the functions are naturally exercised in different individuals; and therefore that what may justly be accounted a symptom of disease in one individual, may in another be perfectly consistent with the state of health. The whole external appearances of different individuals, as their complexions, degree of corpulency, and of muscular vigour, furnish numerous illustrations of diversities in the exercise of the functions, compatible with health. The degree of ruddiness or of sallowmess, of corpulence or leanness, of strength or feebleness, which would mark disease in one individual, may be said to form a part of the natural constitution of another. In the same way, though there be a general correspondence in the frequency of the pulse of persons about the same period of life, yet exceptions are by no means unfrequent, so that the pulse of an individual in health may beat as quickly as that of another in a state of fever, or as slowly as that of a third person labouring under some affection capable of diminishing the frequency of the heart’s contractions.

By the term proximate cause, again, as employed in medicine, [7:14:519]is understood that morbid deviation from the healthy state of the economy, to which the morbid phenomena or symptoms of a disease are ultimately referable, the morbid condition or pathological state on which their occurrence depends; the conditions of the body, for example, in the cases of the symptoms adverted to, to which the double vision, the ringing in the ears, the yellow skin, the twisted face, and the increased heat or the frequency of pulse, are respectively attributable. Thus understood, proximate causes admit of being arranged under two principal heads. 1st, those in which there is an apparent change in the structure of some portion of the organised frame, as in scirrhus and cancer of the gullet, stomach, or intestines; 2d, those in which no appreciable change of structure can be detected, as in dyspepsia or indigestion, and some forms of dysphagia or difficult deglutition. If we follow out this division of the proximate causes of diseases into the organic and the functional, we find that the organic may be subdivided into those in which the parts naturally existing in the body are altered in their structure, and those in which an entirely new substance is produced. Thus inflammation produces various alterations in the structure of the lungs; butin pulmonary consumption a number of small bodies called tubercles are scattered through them, which form no part of their original substance. The functional proximate causes, again, seem referable to three classes; those in which the action of the diseased organ is increased, those in which it is diminished, and those in which it is otherw ise vitiated or perverted. The secretion of the kidney, for example, may be in excess of quantity, as in the disease termed diabetes; or it may be below the natural standard, or entirely suppressed, as in ischuria; or this secretion may want some of the ingredients which it usually contains, or contain some that are not usually found in it, as in some species of gravel. It is of importance to keep in mind, that when there occurs in the economy such a deviation from the state of health as to constitute disease, it seldom happens that only one proximate cause exists; but that there may be several different morbid conditions, and these even in different parts of the body, concurring to produce a particular disease. It must be kept in mind, also, that for the most part each proximate cause existing in the body gives rise not to one single but to several morbid phenomena or symptoms.

If we consider what idea we can form of any individual disease, such as pulmonary consumption or gravel, there appear to be two different conceptions which we may entertain. 1st, We may associate mentally that group of external phenomena, or symptoms as they are called, by which we are made aware that certain inward changes, not directly appreciable by the senses, have occurred in the organic system of our patients. Thus, in speaking of pulmonary consumption, it is the cough and expectoration, the gradual emaciation and debility, with alternations of feverish chilliness and flushings, which enter into our conceptions, as constituting or representing the disease. In speaking of gravel, it is the pains experienced in the region of the kidneys, and extending thence along the urinary passages and the parts sympathising with them, together with the appearance of crystalline or lateritious matter in the urine, which suggest themselves to our minds. But in the second place, we may form our conception of a disease from the alteration of structure or of function in which we suppose it essentially to consist; from that morbid condition or pathological state, in which the diseased economy differs from the healthy, the proximate cause of those external phenomena which we designate as symptoms. Thus pulmonary consumption, according to this view, we consider as consisting in the deposition of tubercles in the substance of the lungs, and in the series of changes which they undergo, or to which they give rise in the surrounding textures. Gravel we consider as consisting in a morbid action of the kidneys, in consequence of which the proportions of the constituents of the urinary secretion, are not duly balanced.

According to the former of these views then, a disease consists in a determinate group of symptoms observed to occur, in combination or succession, in a number of individuals; according to the latter a disease consists in a determinate deviation of some part of the economy from its healthy structure or function, in some determinate proximate cause.

Much has been said and written lately, in some medical schools, of the great superiority of the plan of investigating diseases with a view to the pathological conditions on which they depend, over that which principally occupies itself with the examination of the symptoms which they exhibit. It does not appear to us, however, that there is either necessity for, or justice in, depreciating the one branch of inquiry in order to exalt the other. It must be the object of an enlightened cultivator of medical science to obtain every information in his power respecting diseases considered both in reference to the symptoms which they exhibit, and to the pathological states, morbid conditions or proximate causes on which they depend. However great the difficulty may be of accurately marking the symptoms of diseases, that of referring them to their proximate causes is infinitely greater, and it is not therefore to be wondered at, that these two branches of inquiry are not equally advanced. But because we have become more sensible of the importance of being acquainted with those elementary changes in structure and function on which deviations from the healthy condition of the economy depend, we are by no means entitled to speak slightingly of the labours of those, who by their diligent and accurate examination of diseases, in reference to the more or less regular combinations and successions of symptoms, have demonstrated the necessity of, and prepared the way for, this other branch of medical inquiry.

In pathology, or the investigation of diseases, as in the other departments of inductive philosophy, the order in which those proceed who attempt to extend the limits of human knowledge, and that which is followed by those who are endeavouring to communicate to the uninformed the acquisitions that have already been made in this branch of medical science, are essentially different. In their original investigations, pathologists seek to advance from the knowledge of individual facts respecting morbid structure and morbid function, to the establishment of general principles; whilst in their instructions they commence with the exposition of general principles, and descend from these to the enumeration of the particular facts which these principles connect, or which, to use the ordinary language, they serve to explain.

If we carry ourselves back in imagination to the earliest ages of medicine, we shall be sensible that it was only in the examination of individual cases of disease that the pathological studies of the practitioners of those days could consist. But by comparing the cases that fell within their observation, they would be led to notice various circumstances in which they resembled or differed from one another. If we could suppose them to have attempted to record the histories of these cases, they must have found that the work involved them in a great deal of repetition, from the similarity of the symptoms which presented themselves in a number of different individuals; a similarity that must have appeared the greater to these early observers, from its being only the outstanding or prominent features of the cases to which their attention would be given. On the observation of such a similarity amongst individual cases, must have been founded the recognition of particular diseases, such as ague, rheumatism, apoplexy, pleurisy, and dysentery, a specific name being given to every combination or series of morbid phenomena that was observed to occur with considerable regularity in a number of different persons, just on the same principle as a specific name is given to every other [7:14:520]group of objects which exhibit a general correspondence in their qualities or characters. It must have been in this way that the transition was made from the consideration of individual cases of disease to that of particular diseases, and that the pathologist of those early times, instead of confining himself to drawing up an account of each single case in all its minutest details, would be led to generalize the results of many similar cases; first, perhaps, in relation to particular circumstances of their history, and afterwards in relation to their whole course or progress, so as ultimately to produce a delineation exhibiting those more prominent and more important characters in which the whole group of cases agreed, without its being overloaded with the trivial and accidental circumstances peculiar to each.

To designate that branch of pathology which is occupied with the detailed description of particular diseases, (the Prima Medicina sive Historia Morborum of Baglivi,) no more suitable term perhaps has been invented than that of Nosography, employed by Μ. Pinel. The marking of those phenomena and circumstances by which particular diseases are especially characterised, has long been considered as a peculiar branch of medical inquiry under the name of Diagnosis.

But the processes of comparison and contrast which were necessary for establishing and describing particular diseases, must have called the attention of medical men to a number of points in which different diseases correspond with or differ from one another; and thus have opened up to them views of disease extending not only beyond the consideration of individual cases but even beyond that of particular diseases. Thus, when it was found that the same individual symptom, such as quickness of pulse, headache, cough, vomiting, or purging, may occur in several diseases, which in other respects differ very essentially from one another, this observation would suggest an inquiry as to the different conditions of the economy in which each particular symptom of disease may occur; and in this manner would be established a general doctrine in medical science, having for its object to consider individual symptoms of disease in all their various relations; a department of inquiry to which the names of Semeiology or Symptomatology have been assigned.

To the friends of the sick it is naturally an object of great anxiety, at as early a stage of their malady as possible, to be able to anticipate its ultimate result as well as general progress, and the more striking phenomena which it will exhibit in its course: and the skill of the medical practitioner is in a great measure estimated by the bystanders, according to the accuracy of his predictions on these subjects, or, as it has been termed, of his prognostics. To be able particularly in the early periods of diseases, from the contemplation of the present to anticipate the future, when to the unpractised eye every thing seems involved in general obscurity and doubt, has accordingly been at all times a very favourite object with medical men; and those who are acquainted with the writings of the father of medicine must know how large a share of them is occupied in laying down rules to guide the practitioner in the formation of his prognostics, principally founded on the results of his own extended observation. No portions of his writings, indeed, more fully justify, than those which relate to Prognosis, the eloquent observation of Μ. Prunelle, that “the works of Hippocrates present the most striking application of that philosophic method, which, creating axioms out of observations, and transforming the results of particular facts into general rules, furnishes the human mind with the most active instrument for perfecting the sciences.” The anticipations of the medical practitioner respecting the future progress of individual cases of disease must, it may be remarked, be founded on the occurrence of particular single symptoms, or of particular combinations of symptoms, and must be influenced in many cases by the constitution of the individual affected, or by the external circumstances to which he has been or is subjected, such as the prevailing atmospheric constitution, or the character of the reigning epidemic.

It must soon have been found that it is not individual symptoms only that are liable to occur in several different diseases; but that certain determinate combinations of symptoms may be common to diseases which nevertheless are marked as different from one another by the other symptoms with which, in each of them, these common phenomena are combined. Such, for example, are the particular groups of symptoms by which fevers, inflammations, haemorrhagies, dropsies, &c., are characterised, each class compre-hendinganumberof diseases, which all correspond to a certain extent in the symptoms by which they are accompanied, and at the same time all differ widely from one another in other respects, according to the particular organ which may be the more immediate seat of disease. The observation of such general analogies or resemblances in the symptoms of different diseases, and the employment of general terms to designate them, would suggest to medical men the idea of classing diseases in more or less numerous families or groups, such as those which we have just named. Other grounds of classification would be found in the resemblances or differences of particular diseases in regard to their general course and ultimate result, suggesting such distinctions of diseases as those into acute and chronic, continued and intermittent, mild and malignant, &c. It has been, however, in comparatively recent times, that the classification of diseases, combined with their nomenclature and definitions, has been erected into a separate department of medical science under the title of Nosology.

In watching the various preternatural phenomena which the several functions of the economy are liable to exhibit in the state of disease, medical men are naturally led to consider what the changes in the internal conditions of the corresponding organs of the body can be, which give rise to those deviations from the ordinary exercise of the functions, that constitute the symptoms of diseases. The attempt to ascertain the internal conditions of the economy on which the external phenomena or symptoms of diseases depend, or, in other words, to ascertain the Proximate Causes of diseases, though it has unquestionably involved medicine in much unprofitable, or rather injurious speculation, is as legitimate and necessary a subject of investigation as any other department of the science. It has been in the attempts of medical men to arrive at extensive generalizations of the proximate causes of diseases, whilst their observations were still too imperfect and too inaccurate to serve as a foundation for such attempts, that the various systems of medicine have had their origin, which have at different times been proposed. A very slight analysis of these various systems, would, we believe, be sufficient to shew that however great may be the diversity of opinion which they seem to embrace, they are all founded upon a few leading assumptions which may perhaps be expressed in the following propositions:

1. That diseases depend upon morbid changes in the chemical composition of the different parts of the body, and particularly of its fluids. This principle forms a prominent feature in the doctrine of the four humours entertained by Hippocrates; in that of salt, sulphur, and mercury, adopted by Paracelsus; in that of ferments, suggested by Van Helmont; in that of acid and alkali, maintained by Sylvius; and of those other doctrines founded upon the more accurate knowledge of chemical elements that has been obtained in modern times, which have been proposed by Baumes and others.

2. That the physical conditions of the solids and fluids of the body, furnish the proximate causes of diseases. This has served as the principal groundwork for the doctrines of the medicoor iatro-mathematicians, Borelli, Bellini, Baglivi, [7:14:521]&c.; but it may be traced back to a much earlier origin in the Methodic school of medicine, founded on the corpuscular or atomic system of philosophy; in the hypothesis of Asclepiades respecting the dependence of disease on the relative proportions of the pores and of the circulating fluids; and in that of Themison, who regarded all diseases as depending on a lax or a strict condition of the solids of the body.

3. That the primary agents in the production of morbid phenomena are those peculiar vital powers different from the physical and chemical properties of inorganic matter, with which the living animal economy is endowed; sensibility, irritability, and an influence supposed to be exercised by the nervous system over the organs by which the natural and vital functions are performed, which some have designated animal power, cerebral action, or energy of the brain, and others innervation or innervatory influence. Of this doctrine Hoffmann seems first to have opened up the leading principles. The researches of Haller and of Whytt, and the pathological speculations of Cullen and Bordeu, gave it a still farther extension; and in the hands of Brown it received, what it has in some medical schools retained, the form of an exclusive system.

4. That in addition to its known vital, and to its physical and chemical properties, there is implanted in the animal economy one great, superintending, independent power or principle which regulates all its actions both in the state of health and of disease. Such has been supposed to be the principle denominated nature or innate heat by Hippocrates; pneuma, or spirit, by Athenaeus and the other members of the Pneumatic school; archeus, by Paracelsus and Van Helmont; and vital principle by Mr. Hunter in this country, by Μ. Barthez in the school of Montpellier, and by their respective followers.

It is not easy to say whether we ought to include under the last of these assumptions the animistic doctrine of Stahl, or to consider it as resting upon a separate and fifth assumption, viz. that the phenomena of the human economy, in the state both of health and of disease, are under the immediate government or control of the soul. When the term soul is employed as synonymous with the rational mind, as it seems to be by Stahl, the animistic doctrine must obviously be considered as distinct from all the other assumptions; but when the soul is spoken of as governing the functions of the body without the exercise of reason, the doctrine seems to ally itself with the principles mentioned under our fourth proposition.

Respecting the different theories of disease, it may be remarked, that each of them has varied in its outline and details at different periods, according to the general state of knowledge and the prevailing system of philosophy. It must be kept in recollection, also, that whilst in some systems one of the assumptions above enumerated serves as the sole basis or foundation of the doctrine, in other systems two or more of them are combined. Thus Hippocrates united in his system the doctrine of nature or innate heat with that of the four humours; Athenaeus that of the four elements with the pneuma; Paracelsus that of the body being composed of salt, sulphur, and mercury, with the doctrine of the archeus; and Hoffmann the influence of the nervous system, with the doctrines of the iatromathematicians. “In reviewing,” says Buffalini, “the different theories or systems of pathology that have successively prevailed during the long period that has elapsed from the age of Hippocrates to our own time, we cannot tail to be struck by two circumstances; the first, that almost the whole of these systems are founded not on observations relative to the animal economy, but for the most part on the prevailing doctrines of the schools of philosophy; the second, that all of them (perhaps without exception) have had their origin in a very small number of fundamental errors, which, from being differently clothed and adorned, give the appearance of great variety, where in fact there exists a great similarity, of opinions.”

The ancient systems of medicine are now very generally regarded as being so many attempts, founded on very partial and often erroneous observation, to reduce the whole physiological and pathological phenomena of the economy to a few primary principles; a simplification which it is hopeless to expect to attain, at least till these phenomena are much better understood separately, and in their relations to one another, than can for a long period be expected. The more correct views that at present prevail respecting the peculiar properties of animal bodies, for which medical science is so much indebted to the labours of Haller; and the extended knowledge that has been obtained respecting the morbid changes liable to occur in the physical and chemical conditions of the solids and fluids of the body, have certainly tended much to introduce a greater degree of precision than was formerly judged necessary, into the notions which pathologists entertain relative to the proximate causes of diseases.

It is in an order of advancement such as we have endeavoured now to trace, as having necessarily been followed by the early cultivators of medicine in regard to the deviations of the economy from its healthy condition; that is, in advanc-ingfromthe consideration of individual cases to that of particular diseases, and from these, again, to general views of disease, that those must proceed who seek to improve the science of pathology. But where the object is to convey to others the results of the acquisitions that have already been made in the knowledge of disease, the order that may be most advantageously pursued is directly the reverse of this. Our view of diseases should commence with explaining the general principles that have been established respecting morbid structure and morbid function, considering each change of structure or function as constituting in itself a specific object of investigation, in all its possible effects, and in all its possible modes of production. It is in this way that we should be prepared to enter on the consideration of those combinations of symptoms which constitute or rather which mark particular diseases; to view each disease in respect of the course which it runs, the symptoms which it exhibits in its successive stages, and by which it is characterised and distinguished from other particular diseases; the nature and seat of the morbid actions, and of the morbid alterations of structure from which it may arise, or which it is liable to produce; and the circumstances which indicate a favourable or unfavourable termination to it. With a knowledge of particular diseases, in these various relations, such as is to be acquired from books and from lectures, the student is prepared for being conducted by an experienced practitioner to the bedsides of the sick, and for having his attention directed to the phenomena of diseases as they present themselves in individual cases.

From this sketch, slight and imperfect as it has been, it is apparent that the consideration of the economy in its diseased states, or the department of pathology, presents itself to the cultivator of medical science under three general aspects: 1st, that of the general doctrines of morbid structure and function, or general pathology, a branch of medical science which, though too long kept in the back-ground in the medical schools of this country, in consequence of its having been associated, in the courses of instruction, with other very interesting and very extensive departments, is now beginning to vindicate its due share of attention; 2d, that of the history of particular diseases, nosography or special pathology; and, 3d, that of the examination of individual cases of disease, or clinical medicine. And whilst the business of the teacher commences where that of the original investigator terminates, in the consideration of general principles, it terminates where that of the original investigator commences, in the investigation of individual cases of disease.
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III. Besides an acquaintance with the human economy in its healthy and in its morbid conditions, we have said that the science of Medicine includes an acquaintance with Morbific causes and Remedial powers. The advancement of medical men in the knowledge of these two classes of agents, and their modes of considering them respectively, must have keptpace with theirprogress in the investigation of diseases.

1. "Whilst the attention of the pathologist was confined to the examination of individual cases of disease, he would naturally be led to inquire into the morbific agents, single or combined, by the operation of which each individual case had been produced; and in like manner, in combining groups of similar cases under general denominations, so as to establish particular diseases, it would be noticed that each disease, beside corresponding in the phenomena which it presented to the observer, in the different individuals in whom it occurred, also corresponded very generally in respect of the cause or causes by which it had been excited. On further investigation, however, it would be found that different diseases may arise from the same cause, as that rheumatism and pleurisy may both be produced by the operation of cold; and that different causes may produce the same disease, as that intense heat and intense cold may equally excite inflammation and gangrene. Medical men would then naturally be prompted to inquire what are the circumstances of correspondence and difference among the different causes of disease upon which it depends, that in their operation on the economy, similarity or identity of effect may arise from diversity of cause, or diversity of effect from similarity or identity of cause; and a foundation would thus be laid for the consideration of morbific causes, or what is usually termed Aetiology, as a general doctrine in medical science.

It is the province of actiology, therefore, to ascertain what are the various powers that are capable of exercising an injurious influence on the human economy; to arrange these powers according to the most commodious classifications; to inquire into the channels through which those of them that are exterior to the body find their way into it; to ascertain upon what part of the constitution each of them primarily acts; and what is the nature of the change or changes in the economy, organic or functional, to which each of them gives rise. The study of actiology presents, indeed, a very wide field of investigation; for there is scarcely any agency in nature,, material or mental (not excluding even those agents by which, under ordinary circumstances, the economy is maintained in a state of health, and those by which it is restored from a morbid to a healthy condition) that may not, under some circumstances or other, contribute directly or indirectly, immediately or more remotely, to induce the state of disease.

Independently of the material morbific agencies, physical, chemical, and vital, by which the human body is surrounded, and of the injurious influence which mental emotions may exercise upon it, there are frequently inherent in its own constitution, conditions that exert very important influences in the production of diseases and in the determination of their characters; conditions which, as marking deviations from the healthy standard, might be in some degree regarded as proximate causes of disease, but which, .from the deviations being too slight to manifest themselves by any symptoms sufficiently characteristic of their existence, pathologists are wont to consider not as actual states of disease, but only as predispositions to disease. It is to this head of predispositions that medical men refer the diversities of temperament, constitution, or diathesis which different individuals exhibit, and which appeal’ in some instances to be "born with them, and in others to be acquired in the progress of life.

As the pathologist regards the symptoms of diseases as the consequences or effects of deranged conditions of certain portions, of the economy, so he regards those morbid conditions in their turn, as the consequences or the effects of the operation of morbific agencies; and as the term proximate causes is employed to designate the morbid conditions, structural or functional, which give rise to the symptoms of diseases, so the term remote causes is used to denote the agencies by which these morbid conditions or proximate causes are themselves produced. The agency of the remote in exciting the proximate causes of diseases, mùst ever be a leading object of investigation to the scientific physician; since it is obvious that his power of arriving, in particular instances, at a knowledge of the proximate cause of a disease, must be materially aided, if, in addition to the judgment which he forms as to its nature from a consideration of the existing symptoms, he can also form a judgment upon this subject from a consideration of the causes by which it has been induced. Thus, for example, an acquaintance with the various effects which mental emotions are liable to induce in the economy, frequently enables the medical practitioner, (as in the case of affections of the heart), to correct the judgments which, from a consideration of the symptoms alone, he would be disposed to form of the nature of the diseases with which his patients are afflicted.

The extent of the difficulties that are experienced in endeavouring to trace the influence of morbific agents in inducing disease, may be inferred from the many points which, as is well known even to unprofessional persons, are still matters of doubt and controversy, relative to the origin or production, and to the diffusion or propagation of those two morbific powers which have been denominated specific, viz. terrestrial miasm or malaria, and human contagion. That an acquaintance with the laws which regulate the operation of the other agencies or influences that induce disease (the general or common morbific causes) must be still more difficult of attainment, may reasonably be presumed; since, whilst each of the specific agents uniformly produces, whenever its operates, one determinate or specific form of disease, each of the common exciting causes, on the contrary, may produce various forms of disease, according to the degrees and combinations in which it is applied to the human economy, and according to the particular circumstances in which the economy may at the time exist.

The term Hygiene has long been used as synonymous with the art of preserving hea!th, to designate the consideration of the means which ought to be employed for maintaining the economy in a sound condition. It was justly remarked by Dr. Cullen, however, that there is truly no other means of preserving health, but what consists in the prevention of diseases; and that this again can be effected only by the avoidance of their exciting, or by the correction of their predisposing causes. Aetiology, as treating of the sources of the exciting causes of diseases, and of their modes of action, is the necessary foundation of that part of hygiène which relates to their avoidance; whilst the correction of predispositions is really and truly, as Dr. Cullen observed, the removal of diseases; and the means of accomplishing it are no other than the remedies we employ in curing diseases, so that they may with propriety be comprehended under the. title of therapeutics.

It is on the consideration of morbific agencies, as acting upon large masses of men, that Medical Statistics are founded; this branch of investigation having for its principal object to ascertain the influence which peculiarities of climate, of diet, of occupation, &c., exercise on the populousness of different regions; on the liability of mankind to disease; on the characters of the maladies to which they arc subject; and on the age to which they attain. To a country like this, holding such extensive colonial possessions in very different quarters of the globe, and having its own population engaged in so many kinds of employment, civil and military, agricultural, manufacturing, commercial, and maritime, medical-statistical inquiries are both interesting and important.
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2. In considérifig the action of Remedial powers, the attention of medical men, it may be supposed, would first be directed to the effects produced by particular remedies in individual cases of disease. When they had advanced to the recognition of particular diseases, they would be encouraged to make use of those remedies which had proved beneficial in one case, in the treatment of other cases of what they regarded as the same disease; and lastly, when they had formed some notions of the internal morbid conditions, or proximate causes, on which different diseases depend, they would extend the employment of those remedies which seemed to have assisted in removing a particular proximate cause in one disease, to all diseases in which there seemed reason to suspect the existence of similar pathological conditions.

The measures which are in use for the prevention, cure, or alleviation of diseases, may be referred to three heads: First, those which relate to the management or regulation of those circumstances that are included under the head of regimen, such as the diet of the sick, the temperature and other qualities of the atmosphere in which they live, their clothing, and their exercise, bodily and mental,—comprehending, obviously, what used, in the language of the schools, to be called the non-naturals; second, the various operations requiring manual skill or dexterity, which it is necessary to perform for the relief either of internal or external diseases, such as the application of bandages, the operation of bloodletting, &c.; and, third, those substances which by experience have been found, when introduced into the system, to exert some influence on the economy that tends to restore it from some one of its diseased states to a healthy condition; as, for example, those substances which remove spasm and allay pain, (anti-spasmodic and narcotic medicines, as they are termed), and those which increase the alvine or the urinary evacuations, either when the action of the organs by which these evacuations are effected is deficient, and it is desired to restore them to their natural vigour, or when it is wished to increase their activity beyond its ordinary degree, laxative or purgative, and diuretic medicines.

An acquaintance with the substances which exercise beneficial influences on the diseased economy is obviously of essential necessity to the practitioner of physic. Of these substances some are derived from the vegetable, others from the mineral, and a few from the animal kingdom; and hence arises, in part at least, the importance to the medical practitioner of being acquainted with the sciences which treat of these several departments of natural history. But whilst some medicinal substances are employed as they exist in nature, or after undergoing some slight and unimportant manipulation, others can be obtained only by long and elaborate processes, many of them involving a knowledge of the principles of chemical science; and here again we see, in part at least, the cause why chemistry, since its earliest dawnings,has been regarded as essentially allied to medical science. “Every substance,” as was observed by the late Dr. A. Duncan, jun., “employed in the cure of diseases, whether in its natural state, or after having undergone various preparations, belongs to the materia medica, in the extended acceptation of the words. But in most pharmacopoeias the materia medica is confined to simples, and to those preparations which are seldom prepared by the apothecary himself, but commonly purchased by him, as articles of commerce, from druggists and chemical manufacturers.” It is the province of Pharmacy to consider the preparation which medicinal substances require in order to fit them for the purposes of the medical practitioner; whether these changes shall be of a mechanical or chemical nature; whilst the consideration of the effects which medicines and other remedies are capable of producing on the different systems and organs of the economy, constitutes that department of medical science usually denominated general Therapeutics. All these various kinds of knowledge relative to medicines, their natural history, their pharmaceutical preparation, and their therapeutical powers, it has been by some proposed to include under the general title of Pharmacology.

The improvements that have been made, or that remain to be made, in the department of materia medica, may consist either in making additions to, or subtractions from, the number of substances employed for medical purposes. Additions may be made to the number of medicines either from the discovery in substances already known, of powers or virtues which they were not known to possess, or from the discovery of entirely new substances possessing therapeutical powers. The baneful influence of spurred rye in producing gangrene has been long known, but it is only of late that attention has been particularly called to the power which that substance is by some alleged to possess of exciting the contraction of the muscular fibres of the uterus. The noxious influence of the different acetates of lead, when internally administered, has likewise been long known, and particularly their effect in exciting colicky pains, but it is of late only that their influence in suppressing excessive intestinal evacuations, and in restraining haemorrhages, has particularly attracted the attention of medical men. Iodine, on the other hand, may be mentioned as an instance of a substance which within a short time after its discovery, acquired a high character in the estimation of many practitioners, for its therapeutical virtues. The history of the croton oil, the powerful action of which upon the intestinal canal is now familiar to every one, affords a remarkable example of a medicine the knowledge of the powers of which has been very slowly diffused among medical practitioners. It would appear that the seeds of the croton tiglium have been in use among the natives of the East from time immemorial, and that they were formerly known in Europe as a drastic purgative, under the name of grana molucca or grana tiglii. They had fallen, however, into oblivion, when the attention of the profession was again called to them by the observations in Sir Whitelaw Ainslie’s Materia Medica of Hindostan, that gentleman having been induced to point out this medicine to the particular notice of the medical men of India, from finding that it was highly prized by the Hindoo doctors, and extolled in various sastrums or professional tracts. It appears, moreover, that the oil, in which the purgative virtue resides, was first prepared and used in medicine by the Dutch surgeons in India, about a century ago, a single drop taken in Canary wine being employed as a common purgative. It is only, however, within these few years that the use of the croton oil has been introduced into Europe.

The difficulty that is experienced in arriving at a sound judgment with regard to the medicinal powers of the remedies which every now and then are obtruded on public notice, with lofty and but too often exaggerated panegyrics, renders it very necessary to rid the pharmacopoeia from time to time of inert and useless substances. The expulsion from our pharmacopoeias of a great many substances of this description within the last century, and the much greater degree of reserve with which new substances are admitted into them, than was formerly practised, afford a gratifying proof of the steady advancement of correct discrimination in this department of medical science.

The progress which has recently been made in chemical knowledge has contributed very materially to improve the department of pharmacy. This improvement is particularly conspicuous in the preparation of vegetable medicinal substances. The employment of steam instead of fire in the preparation of vegetable extracts, presents an elegant though simple illustration of a pharmaceutical process improved upon chemical principles. The separation from many vegetable substances of the principles on which their medicinal virtues depend, so as to allow of these being administered free from a quantity of useless and possibly hurtful matter, (as the separation, for example, of quinine from bark), affords [7:14:524]an illustration of a still more elaborate and not less important application of chemistry to pharmaceutical science.

If it be reasonable to expect that medical men are to be aided in the treatment of diseases by an improved knowledge of their nature, therapeutics cannot fail to derive benefit from every advancement that is made in pathological science, and particularly in the knowledge of the proximate causes of diseases. But the action of remedies in restoring health is so dependent upon, and so mixed up with, the natural or spontaneous operations of the economy, as to render it at all times a matter of the utmost difficulty, for the most careful and candid observer, to determine or even conjecture what part of the result is attributable to the one, and what to the other of these joint influences. It must be confessed, indeed, that we are still far from knowing what nature accomplishes in different diseases by her own unassisted efforts towards the restoration of the diseased body to a sound or healthy condition; what she accomplishes when judiciously assisted by medical art; and what she does not effect either singly or with all the aid that medicine is able to render her. These are the great problems in therapeutics, for the solution of which it must be the main object of scientific practitioners to furnish the necessary materials. There can be no doubt that morbid anatomy, by the light which it has thrown upon the proximate causes of diseases, has contributed very much to correct and extend the views of medical men as to what is curable and what is incurable in disease, as well as to guide them in forming their therapeutical indications. Thus, it may be remarked, that to the success of medical practice, nothing is more important than the power of discriminating when a stimulant or rcpleting, and when an antiphlogistic or depleting mode of treatment ought to be pursued. The knowledge that has been obtained, by means of dissections, of the circumstances under which inflammatory affections are liable to develope themselves in the different organs and textures of the body, in the progress of various diseases in which their occurrence is apt to be overlooked, has been of great use in assisting medical men to discriminate the cases in which these two plans of treatment are respectively to be preferred.

In reference to the progress and present state of therapeutical science, it deserves to be noticed, that in proportion as medical men have become better acquainted with the operations of the economy in its healthy and morbid conditions, the number of medicinal agents reputed to be possessed of specific therapeutical powers, that is, to be capable of exercising a beneficial influence in curing particular diseases, without any external manifestation of their immediate mode of operation, on which their beneficial influence may be supposed to depend, has gradually diminished. This may be attributed, perhaps, in part to medical men having been able to ascertain the particular actions which these supposed specific medicines exert upon the economy; and partly to their being less credulous in admitting the efficacy of remedies, of whose mode of operation they are unable to form any conception.

Such is a slight view of the three departments into which we have said that medical science admits of being divided; —that which considers the human economy in tire state of health; that which considers the same economy as affected with disease, and that which investigates the powers or agents by which health may be banished and disease produced, or on the other hand, disease dispelled and health restored. But besides those branches of knowledge that are to be regarded as more strictly medical, there are others, an acquaintance with the principles of which is most important or even essential to the cultivator of scientific Medicine. It is to these that the well-known observation of Celsus is applicable, “Quanquam multa sint ad ipsam artem proprie non pertinentia, tamen eam adjuvant, excitando artificis ingenium: itaque ista quoque naturae rerum contemplatio, quamvis non faciat medicum, aptiorem tamen medicinae reddit.” Amongst the sciences auxiliary or accessory to medicine may be justly reckoned natural or mechanical philosophy, chemistry, and natural history.

A knowledge of mechanical philosophy is indispensible to a right understanding of the actions of several of the organs of the body in the state of health, and consequently of several of the deviations from the healthy state to which these organs are liable in disease; and this knowledge is necessary also to the right comprehension of the action of several external agents upon the body, both in the state of health and of disease.

Though the higher phenomena of the human body arise from its being endowed like the bodies of other animals with peculiar vital properties, and from its being associated with a rational mind, yet it must still be regarded as a piece of mechanism of the nicest and most elaborate construction; and it is impossible to arrive at correct or enlarged notions with regard to its structure without possessing an adequate knowledge of the principles of mechanics. Hence it is, indeed, that the language of anatomy is replete with terms derived from mechanical science. The study of animal mechanics, or what may be termed structural physiology, that is, the consideration of the mechanical contrivances discoverable in the. construction of the different parts of the body, a branch which furnishes so ample a field of illustration to the student of natural theology, essentially requires to be combined with the study of anatomy; since without it the latter would be only a dull and uninteresting record of names, forms and dimensions. Thus, for example, to give an interest to the study of that extensive portion of the animal frame which is subservient to voluntary motion, it is essential that each muscle, bone and joint should be considered in its mechanical relations: and nothing certainly can be more calculated to excite admiration than, in contemplating the arrangements of these parts in reference to the properties of the lever, as constituting respectively the moving power, the resistance and the fulcrum, to become sensible of the advantages that are obtained in respect of elegance of form and rapidity of movement, by the sacrifice of a portion of that force with which the muscular fibres have been so largely endowed.

It would be easy to adduce many illustrations to shew how essential a knowledge of mechanical principles is to the comprehension of the vital and natural functions of the animal economy. The inquiry as to what the powers are by which the blood is moved through the body, is one which cannot be properly prosecuted without an acquaintance with the laws of hydraulics. It is to the too frequent ignorance on the part of physiologists, of the principles of mechanical science, that must be attributed much of the doubt which still prevails on many points relative to the function of circulation, and particularly as to whether the motion of the blood depends wholly upon the propelling powers of the organs within which it is immediately contained, or with which these are themselves surrounded; or whether it be not partly attributable to the pressure of the atmospheric air over the whole surface of the body, acting in co-operation with the production of a vacuum at the central organ of circulation. From finding themselves unable to refer all the various motions that are observed to occur in the solid and fluid parts of animal bodies, to the known properties of inorganic matter or of organic structure, some physiologists have been led to imagine that there exists in these bodies a secret or unknown principle capable of giving rise to various physical motions, as well as of producing other phenomena, in the economy; and to this principle they have given the name of the vital power. It seems reasonable, however, to hope that in proportion as we shall obtain a more precise knowledge of the motions that actually occur in animal bodies, and of the principles or [7:14:525]sources of motion that are in operation throughout organised and unorganised nature, the occasion will cease for employing this ambiguous and uninstructive term. It is proper indeed to keep in mind that within no very great length of time, several different kinds of motions occurring in inorganic bodies have been brought to light, which probably exercise considerable influence on the functions of organised beings. To these may be referred the motions performed by extremely minute particles of solid matter, whether obtained from organic or inorganic substances, when suspended in pure water or in some other aqueous fluids; and which from their irregularity and seeming independence, resemble in a remarkable degree the less rapid motions of εome of the simplest animalcules of infusions. We have another example of a recently discovered principle of motion in endosmosis and exosmosis, or that power or property in virtue of which there takes place a reciprocal transmission through all organic membranes and some inorganic laminae, of fluids which are in contact with their opposite surfaces, and which differ from one another in certain physical conditions. An analogous principle of motion has also been found to operate in the case of gases and to regulate their diffusion. It would be out of place to inquire here what particular phenomena in the animal economy have received, or may receive, elucidation from these or other sources of physical motion of which we have recently arrived at the knowledge. But it is obvious, that besides these, there may be yet undiscovered sources of physical motion, operating in the production of those phenomena in the economy of living beings, which physiologists, from not being able to refer them to any of the known sources of motion, have been wont to regard as the effects of a peculiar vital principle.

There are many problems in pathology also, for the solution of which-it is absolutely necessary to appeal to the principles of mechanical science. Thus it has been of late only that pathologists have sufficiently turned their attention to the physical considerations which it is necessary to keep in view in any explanation that may be attempted of the conditions of the encephalon, (that is, of the brain and the solids and fluids connected with it), upon which the production of coma or insensibility depends, viz. first, the unyielding nature of the cranium, or bony ease of the encephalon; second, the exemption of the encephalon, so long as its bony case remains entire, from the pressure of the atmosphere, except in one direction, the aperture at the base of the skull, through which the spinal marrow passes; and third, the impossibility of the entire encephalon or any of its parts, undergoing a sensible degree of compression from any force to which they can be subjected during the continuance of life. Again, in surgical pathology, we have an illustration of the benefits to be derived from a knowledge of mechanical principles, in the light which they have thrown upon the variations in the effcets produced by penetrating wounds of the chest, according to the proportion between the size of the wound and of the aperture of the glottis; and according as the substance of the lungs has or has not itself been injured, so as to allow of air passing from the respiratory cells into the cavity of the pleura. Those who require more immediate illustrations of the applicability of mechanical science, to practical purposes in the removal of disease, may find many such in the contrivance and application of surgical instruments and apparatus. The advantages to be derived in many diseases from the observance of the horizontal posture, and from bandaging, simple as these means appear, would probably be more duly appreciated than they are, were medical men more in the habit of considering the physical influences to which the body is subjected.

Of the applicability of chemistry to the several branches of medical science, notice has been taken in speaking of each of these branches successively. We need not repeat how important an acquaintance with chemistry is to the practitioner of pharmacy. The anatomist derives assistance from chemistry in the prosecution of his researches. The physiologist finds that many of the phenomena occurring in the animal economy depend on processes of combination and decomposition; and are as strictly of a chemical nature as any which are conducted in the laboratory of the chemist on unorganized substances. The pathologist has learned that from various circumstances these chemical processes are liable to be deranged, so that the products are different from what they should be; and the therapeutist has hence been led to enquire what are the appropriate remedies by the administration of which the natural composition of the products may be restored. From the light which has been already derived from this branch of science, since it was first applied to the investigation of the phenomena of the animal economy in health and disease, we are warranted in anticipating that it will still powerfully contribute to elucidate many points in medicine which are at present involved in obscurity. “The imperfection of pathological chemistry,” says Μ. Prunelle, “obliges us to refer to the vital forces, a host of diseases which necessarily depend on lesions of mixture. A great number of physiological and pathological phenomena which we consider at present as dependent upon the vital forces, will pass under the domain of the chemical and the organic forces, in proportion as the laws of these forces shall be better known and more generalised.”

With regard to the applicability of a knowledge of natural history to purposes of medical science, it may be remarked, that whether we consider the human economy in the state of health or of disease, or turn our attention to the operation which morbifie or therapeutic agents exert upon it; in each department important aid may be derived from an acquaintance with the three kingdoms of nature.

How much assistance we receive in attaining an accurate knowledge of the structure and functions of the human body, from tracing through the successive series of animals, the instruments that are subservient to their several functions, and the manner in which these function^ are exercised, there has already been occasion to remark. It seems reasonable to expect, that as the study of the lower animals has contributed to improve our knowledge of the anatomy and physiology of man, so, in like manner, much benefit should accrue to pathology from similar comparative investigations. Morbid anatomy, for example, ought certainly to be prosecuted to much advantage in the inferior animals, not only from the parts being, in some eases at least, upon a larger scale, but from our having an opportunity, by putting the animals to death, to trace the effects which the action of different morbifie causes produces upon the structure of their different textures and organs; as well as to examine the changes which diseases induce in the successive stages of their progress. The experiments and observations that have been made with regard to the development and progress of cysts and tubercles in the lungs and other organs of some of the lower animals, besides suggesting some interesting views respecting the series of changes that occur in morbid structures, have given rise to important considerations respecting the circumstances under which these morbid changes of structure are most liable to take place. The liability of animals kept in confinement to undergo diseases from which they are exempt, or to which they are less subject in their natural condition, suggests another hint that may prove serviceable in the study of morbific causes. A very direct source of interest in veterinary mcdicine arises to the physician, from the fact that some of the diseases depending on specific contagions, to which the lower animals are liable, are capable of being communicated to the human subject It is to the observation of a fact of this kind that we are indebted for that most invaluable discovery, the protection against small-pox afforded by having [7:14:526]passed through a disease which, whatever may be its pri- f mary source, is best known as occurring upon the udder of the cow. The other diseases which are liable to be propagated from brute animals to the human species, such as hydrophobia, glanders, pustule maligne, &c., we know only by the injurious effects which they produce.

From the correspondence of many of the diseases of the lower animals with those of man, it seems obvious that animals may be made the subjects of therapeutical as well as of physiological and of pathological experiments. The use of the cautery, for example, particularly in diseases of the joints, has probably been advanced in surgical practice from the experience which veterinary surgeons have obtained of the beneficial effects of firing upon the horse.

It may be remarked too, that whilst a large portion of the animal kingdom is rendered subservient to mankind in the way of food, and a few animals supply remedial agents, there is a considerable number which produce, in various ways, noxious or poisonous effects upon the economy. Certain animals secrete, when in the state of health, noxious fluids which serve them as means of attack and of defence, on account of which power they are designated under the common name of venomous animals. These animals, of which the mammalia and birds do not present any species, are found principally among the serpents, insects, and zoophytes. It has been alleged that some fishes also are capable of communicating a venomous character to the wounds which they inflict with their prickles. But fishes and some species of mollusea are better known for their poisonous qualities when employed as articles of food. Of poisonous fishes, again, there are some which are essentially poisonous, that is to say, they are so at all times, although they are not distinguished by any anatomical character from those which are most salubrious; whilst other fishes which are in general more or less healthful and agreeable as articles of food, become hurtful only accidentally; whether their noxious character then depends, as some have supposed, upon the season, or, as others have imagined, upon their having made use of a particular kind of nourishment; or, as others again have conjectured, is attributable to a particular morbid state, and the consequent formation of a poison sui generis, that is diffused over the whole substance of the animal. It is sufficiently obvious that for the acquisition and extension of this species of knowledge, and for the power of turning it to account in the different circumstances in which they may be placed, medical men must be dependent on an acquaintance with zoology.

The most important benefit, certainly, which medicine derives from the knowledge of the vegetable kingdom is in relation to the purposes of the materia medica, and to the investigation of poisons. Botany, however, is not without its use in the elucidation of the functions of the animal economy. In plants we have an opportunity of witnessing the performance of two classes of functions, those essential to the preservation of the individual, and those necessary for the continuance of the species, under the most simple conditions in which they can be executed. And, independently of any resemblances that might be traced in the functions of circulation and secretion as performed by plants and by animals, those which have been ascertained to exist between the chemical processes attendant upon germination and vegetation in plants and on respiration in animals, afford a very interesting analogy between the operations of these two classes of organised beings.

The benefits to be derived in scientific medicine, from the investigation of the inorganic kingdom of nature, arc not less than those which result, as we have endeavoured to shew, from the study of the other two kingdoms. The connection between epidemic diseases and particular kinds of weather, whether as occurring regularly at particular periods of the year, or as varying in different years without any fixed rules, is a subject of medical consideration which may be expected to receive some light from the science of ' meteorology. The influence of climate upon the human economy, and particularly in the production, modification, and removal of diseases, confers a great share of importance on the investigation of all those circumstances upon which the character of a climate depends; the atmosphere, the soil, and the waters which flow from it, or with which it may be surrounded. A knowledge of the principles of meteorology and of geology is essential therefore to any correct views of Medical Topography.

The fascination exercised over many minds by those various branches of natural knowledge, which we have here represented as the auxiliary sciences of medicine, have led some to regard with much jealousy, invitations or recommendations to medical men to engage in their study. This jealousy, however, seems to arise from a total misconception as to the manner in which they ought to be prosecuted when considered as branches of a medical education. To acquire a knowledge of the details of any one of them is probably sufficient to occupy the time of a person of ordinary application; and would consequently be to most persons inconsistent with the prosecution of studies of a more strictly medical character. But without the sacrifice of any knowledge essential to his profession, a medical man may attain a competent acquaintance with the general principles of these auxiliary sciences sufficient to enable him to understand their bearings upon medicine. In possessing a knowledge of these principles, he holds an instrument in his hand by which he may be able to work out any part of the details of these sciences that may seem capable of throwing light upon any point of medical doctrine or practice to which his attention may happen to be particularly called. To the extent that we have hinted, therefore, a medical education cannot be considered as complete which does not comprehend an acquaintance with these several auxiliary sciences. “It is not possible,” says an intelligent author, whose country is apparent from his illustrations, “that a medical man should know botany like De Jussieu or Richard; chemistry like Vauquelin, Thénard, and Bouillon La Grange; physics like Biot and Gay-Lussac; mineralogy like Haüy; and natural history like Cuvier and Dumeril: but a knowledge of the elements of these sciences is indispensable to him; and immense as is the domain of medicine alone, he may very well, if he chooses, find time to make some excursions on neighbouring territories.”

In the exercise of Medicine as a practical art, the second point of view in which we have said it must be considered, three branches of the profession independently of pharmacy or the preparation of medicinal substances, have long been recognised; surgery, physic, and midwifery. To the domain of Surgery have been referred, besides injuries produced by agents operating on the external surface of the body, those diseases which, in addition to the ordinary means of cure, require the assistance of the hand, and are thence called chirurgical or surgical diseases; and to that of Physic, those diseases which may be cured, without the employment of manual operation. An attempt has been made to identify this division of diseases into surgical and medical, with those into local and constitutional, and into external and internal diseases. But it must always be remembered that the different textures, systems, and organs of which the human body is composed, are arranged so as to form an entire whole, the various parts of which act on, and are reciprocally aeted on by one another. Although, therefore, some morbid affections occurring on particular parts of the external surface of the body, and consequently regarded as surgical, may produce no disturbance of the general economy, or attended with constitutional symptoms too slight for observation, yet there are external or local diseases which [7:14:527] often produce constitutional effects of the most alarming and fatal nature. Symptomatic and hectic fever, locked-jaw, convulsions, and epilepsy, may be mentioned as some of the more remarkable constitutional affections which are produced by the action of local diseases. And on the other hand, internal and constitutional diseases, which are consequently regarded as falling under the province of the physician, occasionally become attended in their progress with external or local affections requiring surgical interference; as when abscesses occur in the progress of fever, or fistula in the progress of consumption; or when pleurisy terminates in empyema, or disease of the liver in ascites or oedema. “It is in the knowledge of these and of similar diseases, that the boundaries which divide physic from surgery meet and are lost in each other; for whatever distinctions convenience or custom may have introduced among the practitioners of the healing art, there is no foundation for these distinctions either in the nature of diseases, or in the knowledge that every medical practitioner should possess of the appearances which different diseases exhibit, and of the means by which they are to be removed. Division of labour may, indeed, in medicine as in the other practical arts of life, be attended with many advantages to society; but in learning and in teaching the elements of physic and of surgery, it must never be forgotten that they are branches of the same art, have had the same origin, are governed by the same principles, and pursue entirely the same object.” It is not, indeed, in the kind or in the extent of their knowledge, that the physician and surgeon of the present day are to be distinguished; but in the latter’s being possessed of, and accustomed to exercise those powers of head and hand upon which the skilful performance of difficult or dangerous operations must depend.

No topic ever gave rise to more acrimonious controversies, than the question as to the necessity or expediency of physic and surgery being practised as separate and distinct professions; and, where such a separation has been made, as to the proper relation of the practitioners of these professions, to one another. But, whilst the practitioners have been engaged in discussing, the public has settled the matter on its own judgment, and in the manner best suited for its own convenience. Every thing seems to intimate that at the present day there exists a strong disposition on the part of a large portion of the public, to entrust the charge of their health, and of that of their families, under whatever kind of malady they may suffer, to some one practitioner in particular; and in the event of there appearing obscurity, or reason for apprehension in the complaint, then to avail themselves of the additional advice or assistance of some person or persons supposed to have directed their attention in a particular degree to cases of a similar description. Accordingly, it is only in cities that are the residence or the resort of large numbers of people, that any medical men can attempt to confine their practice to the treatment of medical or surgical cases exclusively; and even in such situations, the great bulk of practitioners must, like their brethren in smaller towns and rural districts, to a greater or less degree, combine the exercise of all branches of practice. It is by having sagaciously perceived, and judiciously availed themselves of this disposition on the part of the public, that the apothecaries of England have obtained so extensive and firm a footing in medical practice in that country.

Under the department of Midwifery, is included every thing connected with the process of child-bearing, and the diseases to which women are subject, both during gestation and after parturition: and as the class of practitioners who occupy themselves especially with the practice of midwifery, are favourably circumstanced for becoming acquainted with those diseases peculiar to women, which are unconnected with child-bearing, as well as with the diseases of infants; it has become usual to include these diseases also in systematic views of this department of medical practice.

It is satisfactory to find that the medical corporations of this country have at last extended the right hand of fellowship to the practitioners of midwifery. Nothing, indeed, could be more ridiculous than the grounds upon which they have hitherto held its exercise to be a disqualification for corporate association. If there be any class of practitioners, of whom, more than another, it is desirable that to great practical skill, and to an extended acquaintance with all departments of medical science, they should unite the greatest delicacy of feeling, and refinement of manners, it certainly must be those engaged in this branch of the profession. It would be strange, therefore, if the public, for the gratification of some absurd notion of professional etiquette relative to manual operation, were to sanction with its approbation the affixing a stigma to a profession in which such qualifications are desirable.

In reference to medical practice considered as an object of legislative regulation, it may not be out of place to remark here, that there are two principal modes in which legislatures have endeavoured to improve the profession of medicine. The first of these has been by making arrangements for the conferring of distinctions upon persons, who, from the education they have received, and the examinations they have undergone, may be considered as competent to exercise the different branches of the art. The second mode, and that which it has hitherto been the great object of all plans of medical reform in this country to enforce, has been the suppression of unlicensed and incompetent practitioners, by penal enactments. That the pointing out the competent is a just and expedient interference on the part of the legislature, does not seem to admit of doubt. But the suppression of the incompetent seems not only questionable in respect of justice, but incapable of being enforced in a country politically constituted like this, so long as there exists a taste for quackery in the public mind. It is as regards the employer rather than the employed, that the justice of this interference may be doubted; for there seems no good reason why, if a person prefers the doctor of nature, as the quack is supposed to be, to the doctor of the schools, the legislature should control him in his choice. It has usually been pretended, indeed, that the object of such enactments has been the protection of the poor and the ignorant against the unskilful. But the exception generally made in favour of gratuitous practice, suggests a doubt whether those at -whose instigation the legislature has sanctioned such enactments, may not have been influenced in demanding them by other less ostensible motives. Experience seems to have shewn that the prosecution of quacks, particularly when this has been conducted at the instance of medical corporations, so far from suppressing has rather had a tendency to strengthen the public taste for quackery. The only mode in which it can be expected that this taste will be overcome, is by disseminating among the community sound views of health, disease, and remedies, so as to enable them to appreciate the pretensions of those who profess to accomplish things which it requires only a little information to know to be impossibilities. So long, however, as the taste shall continue to prevail, it is surely much better that it should find vent in the employment of professed quacks, than be directed to the corruption, we would say prostitution, of regular practitioners. The legitimate means by which unlicensed practitioners may be discouraged by the legislature, are, first, their not being allowed to hold public appointments; second, their having no legal claim to remuneration; and, third, their being punished in case of their assuming a title -which they have not legitimately acquired. Further than these measures, it is not to the legislature that the medical profession should look for assistance in suppressing quackery and quacks.
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It is impossible to allude to the interference of the legislature in matters relating to medical education and practice, without congratulating the medical profession and the public in general, on the very full inquiry recently instituted into these subjects under the authority of the House of Commons. The number of contending interests, real or supposed, requiring to be consulted, and the jealousy felt by some of the parties, of undue partialities being entertained in influential quarters, in favour of their competitors, rendered it proper to receive a mass of oral and written evidence of so great extent that some time has necessarily been consumed in its digestion. We venture to hope that the intelligent and indefatigable chairman of the committee, (to whose extraordinary perseverance in expiscating information, and patience in receiving what was offered, we have much pleasure in bearing our humble testimony,) will ere long propose a system of medical legislation in which the principles shall be fully recognised, that whatever distinctions or divisions, political or medical, may formerly have existed, or there may still in some minds be the wish to maintain, the different branches of medicine form only one science, and the different parts of the British dominions only one empire.

In the intercourse of society, many questions arise which, though not bearing immediately on the treatment of diseases, are yet so connected with the consideration of the human economy in its healthy or diseased states, that the advice and opinions of medical men are very frequently required respecting them. Of these, some relate to the means of detecting crimes; others to the capability of individuals for discharging the social or civil functions of life; others to the means of preserving the public health, and so forth. It is the object of Medical Jurisprudence to explain at least the general principles by which medical men should be guided in forming their opinions on the particular points that may be referred to their decision. For the proper cultivation of this branch of study, there is no single department of medical science a knowledge of which is not necessary. Chemistry, materia medica and pharmacy, anatomy and physiology, surgery, physic and midwifery, must all contribute their several lights for the elucidation of many of those medicolegal questions on which the medical man is called to pronounce a judgment; and we have but too often reason to lament the deep and painful obscurity in which, notwithstanding all possible assistances, many of these questions are still left involved.

No branch of medical jurisprudence has made more rapid progress than that which relates to the power of detecting, by chemical reagents, the presence of poisonous substances, not only in the various media in which they may be administered, but also subsequently to their introduction into the body, and their diffusion through its different fluid and solid parts. But whilst toxicoogy, or the consideration of poisons, has been thus greatly advanced by the improvement and extension of chemical knowledge, it has likewise received most important contributions from branches more strictly medical. The symptoms to which poisons give rise during life, and the changes which they produce upon the surfaces with which they come immediately in contact, as well as on more remote organs, and which are discoverable after death, have been investigated with great attention, with a view to their discrimination from similar symptoms and changes occurring as consequences of disease.

Morbid anatomy has rendered important services to medical jurisprudence by directing attention to those appearances in the different textures and organs of the body, which are the consequences of changes occurring subsequently to death or immediately previously to it, and by teaching medical men to distinguish these pseudo-morbid appearances from those that are the genuine products of disease, or o r injury inflicted during life.

To surgery medical jurisprudence looks for a determination as to the amount of external violence of different kinds by which death may be occasioned; and particularly for ascertaining the circumstances upon which it may depend, that injuries apparently trivial in their degree may give rise to most injurious or even fatal consequences. It is the province of the surgeon also to endeavour to judge, in cases of injury depending on external violence, as to the nature of the means or instrument by which the injury had been produced.

The medicolegal questions which fall more particularly under the consideration of those who are engaged in the practice of midwifery, are many of them of an extremely delicate nature in a moral point of view, and extremely difficult of determination. As illustrations of these may be mentioned the questions as to the variations in the length of time during which gestation may continue in the human species; as to the earliest period of its uterine existence at which a human foetus can live, when separated from its mother naturally or by artificial means; and as to the marks by which it can be determined whether an infant found dead, had or had not survived the period of its birth.

No class of medicolegal questions proves more frequently perplexing than those in which it is necessary to pronounce a judgment on the mental sanity or insanity of an individual; to determine whether he labours under such a degree of mental weakness or aberration, as to be incapable of managing his own affairs, or unfit to be trusted with the control of his own actions, or as to render some restraint upon his proceedings proper or necessary for the safety of others. The difficulties in cases of this kind are most materially increased by the circumstance that the mental aberration may implicate only one small portion of the intellect, the individual speaking and acting rationally except in so far as he may be misled by a single hallucination; and they are greatly augmented also by the circumstance, that persons thus insane upon particular topics, not unfrequently possess the power, when suspicious of being objects of attention, of concealing the particular delusion under which they labour.

So far as medical jurisprudence bears on the preservation of the public health, it must, like hygiène, of which, indeed, when viewed in this light, it forms a part, be dependent on the study of actiology. The circumstances under which human contagions or terrestrial miasmata are engendered; the laws according to which their diffusion is regulated, and the means best suited for preventing their propagation; the influence which other effluvia exert upon the economy, as, for example, those produced in the operations of manufactories of different kinds; the circumstances under which particular provisions become unwholesome or poisonous;— these and many other actiological questions, medical men are constantly liable to have referred to them by the public authorities, either with a view to the adjustment of private rights, or to the preservation of the health of communities.

The whole range of Medicine, it thus appears, may be divided into two parts; the scientific or theoretical, and the empiric or practical. The theoretical part again naturally divides itself, so far as regards the study of the human economy, into four branches: 1st, a knowledge of the structure of the body in the state of health, or Anatomy; 2d, a knowledge of the functions of the economy in the state of health, or Physiology; 3d, a knowledge of all that relates to diseased structure and diseased function, or General Pathology; and, 4th, a knowledge of the powers of remedies, or General Therapeutics. The practical part of medicine may also be marked out into four divisions: the 1st, comprehending Surgery, or the consideration of external diseases and injuries; the 2d, Physic, or the consideration of internal diseases; the 3d, the principles of Midwifery; and [7:14:529]the 4th, the application of medicine to police and jurisprudence. To the several articles Anatomy, Physiology, Pathology, Therapeutics, Surgery, Nosology, Midwifery, and Medical Jurisprudence, we must refer our readers for further information on each of these branches of medicine.

We cannot conclude this brief outline of the different branches of Medicine considered as a science and as an art, better than in the language of one whose words we have already several times had the pleasure to quote. “A person may possess,” says Μ. Prunelle, “extensive information in medicine, and still not be able to treat a disease. This in itself establishes an essential difference between the science of medicine and the art of curing, the latter of which consists in the talent of applying that science to the preservation or to the restoration of health. The science exists, therefore, independently of the art; and the art is exercised, sometimes without serious injury, by persons to whom the science is almost unknown. The true physician combines in himself the knowledge of the man of learning and the skill of the practitioner. Imbued with the true principles of the science, accustomed to reflect on what he sees or hears, he is not contented with perceiving the outward phenomena of diseases; he remounts to their causes; he connects these causes with the phenomena which they have produced; he seeks amongst these phenomena for those which suggest the employment of curative means; and if he does not succeed in rendering himself a reason for all parts of his conduct, a kind of instinct, a secret presentiment, warn him at least of what he ought to do. The mere practitioner, on the contrary, I should rather say the empiric, imitates, without scrutinizing the reasons for it, all that he has seen practised; he is guided by an analogy frequently deceitful, to treat on the same plan diseases which have the same external appearance; he considers, as it were, only their bark, and if the habit of seeing, joined with a natural talent for observation, enable him sometimes to imitate successfully, he is unconscious of what he is himself accomplishing; he is never struck with those sudden inspirations that are the privileges of medical genius, which nature reserves for those only who are able to unite with learning, the facility of promptly analysing all the elements of a disease, and calculating all its probabilities.”

(l l.x l.)