dies, which, however, is not the case. We shall offer the following quotation from his arguments.

"The extent, however, to which the process is carried, and the nature of its results, are modified by the previous condition of the wood, the degrees of heat, and, probably, by interior arrangements in individual ships. When a ship recently built arrives at the hotest season of the year, continues for weeks in harbour, and when, as happened in the Rattlesnake, the holds are cleared, and high temperature kept up in them by means of stoves, the process will be rapid and complete. The fever will appear early, and proceed rapidly; but when it ceases, it will cease finally. Men fresh from Europe entered on board such a ship, after the fever has ceased, if they avoid the cause of disease on shore, will continue as secure from West Indian fever as if they served in any other part of the world. On the other hand, when a ship arrives during the cooler months, is kept much at sea, and stoves are not let down into the holds, the process will often be slow and imperfect: in some cases it may never take place. In such ships there will not be severe and sweeping visitations of fever; but then there will never be security. Men will continue to fall under the influence of the disease, till the last day of the ship's term of service on the station. These things are frequently exemplified in different ships in the West Indies."

154.

It is acknowledged by all, that mangrove banks and shores are peculiarly productive of the cause of fever, wherever they are found. The following description of the mangrove production and decay is certainly favourable to the ligneous doctrine.

"The mangrove grows and runs to decay rapidly. The branches, after rising a few feet, bend towards the root, on which they engraft themselves; from the bough thus formed other branches spring up, which, in like manner, insert their extremities into different parts of that from which they grow, and so on, till an impenetrable dwarf forest is spread over the surface of the water. While the lower part of this water forest is undergoing rapid decomposition, the upper part is in a state of luxuriant growth and beautiful verdure, so that the appearance of the whole is singular and striking: it looks like a piece of basket-work supporting a shrubbery. From its structure and habits, the mangrove appears destined to speedy decay, to which surrounding circumstances are highly favourable. In consequence of the rise and fall of the tides, part of it is alternately wet and dry, and the whole is exposed to the influence of high temperature; hence, whatever deleterious product is furnished by decomposed wood, must be furnished abundantly here." 164.

MEMOIR THE FOURTH.

We must pass over this memoir, without being able to offer any specimens from the work. The question is, whether the yellow

fever of the West Indies is a disease of a peculiar characterone, in fact, sui generis, or merely an aggravated form of the usual epidemics and endemics, the bilious remittent and intermittent fevers? Dr. Wilson is clearly of opinion that the latter supposition is false-and that the disease" arises directly and solely from inanimate matter close to the persons whom it af fects, and is as incapable of being produced by any other agency as ague or goitre." He cannot, however, subscribe to the doctrine, that it is a mere aggravation of intermittent fever. The author adduces numerous and very powerful arguments in support of his opinions, and these should be consulted by all who are destined for the West Indies.

FIFTH MEMOIR.

This memoir is on a subject nearly as obscure as the hitherto inscrutable miasma of yellow fever-namely, the modus operandi of this cause on the human frame. The difficulty of this investigation may be easily imagined, when we consider that we are called upon to trace the action of a thing totally unknown on functions of which we know exceedingly little. All we can do, in the present state of things, we believe, is to accurately note the obvious phenomena which follow the application of this incognizable miasma, without attempting much of the rationale of its operation on the living machine.

After re-enumerating the symptoms of the apoplectic or congestive species of yellow fever, Dr. W. asks" is there not here debility in the strictest sense of the word; and is it not positive and direct, rather than secondary and apparent?" He then goes on to observe, that this debility cannot result from any direct agency of the cause of fever on the vascular system; but through the medium of the nervous system. We agree with Dr. Wilson--and have to remind him that this was the view taken of it by Cullen, and by many writers before Cullen-it is the view of it which is now taken by all the best writers and the most accurate observers. The following passage will convey some idea of Dr. Wilson's views of the modus agendi of the febrific miasm.

"It is probable, that in some cases the nervous power is abstracted, in others only obstructed.

"The first condition is induced, I believe, in pure congestive fever, (for a certain degree of congestion happens in all,) and the extent of congestion is commensurate with the quantity of abstraction. In the worst form of congestive fever, it would appear that

the nervous power is so completely withdrawn, and receives so little supply, as to be unequal to the carrying on of the functions of life; that it is so subverted, as to be unsusceptible of repair, and that death is the effect of direct exhaustion, and consequent stagnation. In the slighter forms, it appears, though the nervous power is abstracted to a certain extent, that sufficient remains to supply sensation, and something essential to vital action, till, in favourable circumstances, the loss is repaired, and derangement appears chiefly in the vascular system.

"On the other hand, when the nervous power is only obstructed by the febrile cause, the inflammatory form of fever will follow, the force of inflammatory action being proportioned to the extent and duration of the obstruction. In this form of the disease, as in the other, the first step of derangement in the vascular system will be congestive, but greatly different in its nature and results. Here, as soon as the cause of obstruction is exhausted, or rather perhaps arrested, by some inherent power of the living body, reaction takes place, various in degree in various instances; in some rising to the most intense inflammation, destroying organs essential to life, by a process somewhat like gangrene, in others proceeding with less violence, to a regular issue in suppuration, and in others affecting chiefly the investments of viscera, and with tendency to terminate in effusions of serum and coagulating lymph." 201.

We do not clearly understand what is meant to be conveyed by the term abstraction of the nervous power. The fumes of charcoal--a certain dose of prussic acid--a concussion of the brain-the ablation of a limb by a cannon ball-nay, a powerful mental impression will arrest more or less completely the supply of nervous prower from the sensorium to the heart and all other organs of the body, occasioning most of the phenomena produced by a great dose of the febrific miasm in a concentrated state, as seen in the apoplectic, species of yellow fever. This, we imagine, is as good an illustration of the modus agendi of the cause of yellow fever as we can have-and it points out the danger of incautiously abstracting blood in such a condition of the system, as forcibly as any thing can do. The reaction which follows is generally proportionate to the depression that precedes. If reaction do not follow at all, Dr. W. seems to call this abstraction of the nervous power. If reaction succeed, then it was only obstruction of the same. The following passage is interesting, whatever we may think of the explanation with is attempted to be given.

"I have seen a remarkably stout young man, of sanguine temperament, labouring under the first impression of fever, which literally struck him down in an instant. With a rapid, weak, irregular pulse, sunk eye, haggard countenance, and cold skin, he lay prostrate in great distress, but incapable of describing his sensations,

There were languor and feebleness, which he tried in vain to resist; confusion of thoughts; tremors, not like the rigor of intermittent fever, but an affection like that which arises from alarm; a feeling of extreme, but unspeakable suffering, extending from the spine to the umbilicus, involving the abdominal contents in tumult; and a state of the skin in which reduction of temperature was not the most striking, though most easily defined deviation from that of health. When the hand was applied to the surface, there was communicated a sensation similar to that which is experienced by touching the scalp, when separated from the subjacent muscles, a sensation of want of vital connexion with the parts beneath. And yet in two hours all those signs of diminished vitality had disap`peared, and the most furious inflammatory action followed. The case was a fatal one. Blood-letting and other means of reduction were urged to the uttermost, without making more than momentary impression on the disease. The force of the circulation was for an instant abated, and then rose again to the height of its former violence; and thus, over and over again, till the structure of the brain was subverted.

Now, in contemplating such a case, we are first of all struck with the two great stages into which it is divided, and then with the necessary connexion between them. In the first we see the nervous power obstructed, or suspended in its operation, not arrested in its source or abstracted from the system; and, in the second, we observe, when the suspending or obstructing cause is removed, the force accumulated by inaction and continued supply, poured forth with irresistible impetus, and giving rise to such intensity of inflammatory action, as puts to defiance all our means of staying its course. At least, in comparing the two phases of the disease, the subsidence of its first, and the rising of its second stage, the conviction is forced upon us, that they are not fortuitous and inconsequential, but are necessarily connected the one with the other, as cause is with effect; and moreover, that in the origin and progress of this disease, there is something essentially different from what happens in congestive fever.

"There we observe, as in the first stage of this, failure of nervous, and feebleness of vascular power, but of a much deeper and more enduring character. In the inflammatory form of fever, the stage of exhaustion, connected with nervous obstruction, is always short, sometimes imperceptible, or rather, in the common routine of complaint and inquiry, is not perceived. But in the congestive form, arising from the abstraction of nervous power, the exhaustion lasts long, in the worst forms, till the last. There is, analogous to what happens in inflammatory fever, failure of nervous power and vital action; but, unlike what happens in that form of the disease, the reparation is slow and scanty, or altogether wanting. In some there is no supply consequent on abstraction, in others there is supply, but it is always slow in accession, often inadequate in quantity. It is, when compared with the overflowing energy of inflammatory fever, as a summer brook to the force and celerity of the Ganges."

We have greatly overstepped our intended limits-led on by the interest of the subject, and the talent and observation displayed by the author of the work under review. The minute and accurate details of medical topography-the forcible and faithful delineations of fever in its various forms between the Tropics-the ingenious speculations on its etiology--the rational modes of practice inculcated--and the extremely important suggestions as to prevention, which Dr. Wilson has presented to the public in a small and modest octavo, are so highly creditable to the author, that he has deserved, and will obtain, an elevated niche in the temple of medical fame. Were we destined once more to visit the western Tropics, and obliged to limit our library to a single volume, we should have little hesitation in taking with us the five memoirs of Dr. John Wilson.

VIII.

Reports of Medical Cases, selected with the View of illustrating the Symptoms and Cure of Diseases, by a Reference to Morbid Anatomy. By RICHARD BRIGHT, M.D. F.R.S. &c. Lecturer on the Practice of Medicine, and one of the Physicians to Guy's Hospital. Quarto, pp. 231, with 15 Plates, coloured, including a great number of Figures. Longman's, 1827. Price four guineas, boards.

THIS is, beyond all comparison, the most splendid production which this country has ever given rise to, in regard to morbid anatomy. The plates of Baillie, Farre, Hooper, Willan, Bateman, &c. &c. shrink into comparative insignificance, as to accuracy of delineation, and beauty of execution, when placed along side of those now before us. The task which Dr. Bright has imposed on himself (for this is only the first of a series of volumes) is truly Herculean, both as respects the labour and the expense. The undertaking is national; for if the author continues "equis passibus," he will not only immortalize himself, but reflect honour on his country-and especially on his own profession. From our Government we cannot-or, at all events, we need not expect, that any reward, honorary or pecuniary, will flow for such meritorious works as this of Dr. Bright; but we do think that if the learned heads of departments in our profession obeyed the dictates of zealous hearts, they would hold out encouragement for enterprises like this, by conferring some mark of distinction on those who