which, together with the largeness of the pupil, always gives a very marked character to the eye of an individual, in which scrophula, if we may so say, abounds.

A strumous disposition is very generally indicated, though not invariably, by a redness and constant tendency to inflammation in the eye-lids; and we are disposed also to lay much stress on the inclination, during infancy, to glandular swellings of the neck, to hardness and a knotty feel in the abdomen, and a tendency to the generation of worms.

The make of the body, also, is of much consequence in assisting our decisions on consumptive tendency. Narrowness in the chest is very properly noticed, by Dr. Southey, as one of the marks of scrophula; but in a person disposed to consumption there is something very singular in this narrowness. Besides a want of full sweep in the form of the ribs, there is a remarkable shortness as well as an upward direction in the collar-bones, which occasions the shoulders to stand prominent and high, and gives to the shoulder blades the appearance, as Dr. Beddoes aptly describes it, of wings just raised from the body, and about to expand for flight.

Mere narrowness of the chest, however, sometimes exists in a high degree without affording any real ground for apprehension, as it is not seldom indicative of a feebleness of frame, which is not of a scrophulous kind; and here, it may not be unseasonable to observe, that we think the author just mentioned has not made out his case, in attempting to generalize scrophula into a state of mere debility. Weakness it certainly is; but it is weakness of a peculiar kind, and affects principally one system of organs. Dr. Cullen has, perhaps, best characterized it by calling it a peculiar state of the lymphatic system,' and had we space to pursue the investigation, it might easily be shewn in what manner every mark of the state in question, might be satisfactorily accounted for, upon the principle of peculiarity in lymphatic action.

Dr. Southey, in the twelfth page of his work, well observes, that 'There is a form of pulmonary consumption, in which the mucous membrane, lining the air cells of the lungs, seems af'fected in the same manner as the similar membrane, lining the urethra, is, in Gonorrhoea Virulenta.' Surprise is sometimes expressed, by professional men, at recoveries from consumption after true pus had been expectorated for some time; but we believe these would be found to be cases in which the diseased action had been confined to the mucous membrane in question, and had not extended itself to the cellular portion of the lungs, the residence of those bodies which are termed tubercles, of which it is now in place to say a few words respecting their structure and origin.

It is in the second division of his treatise, that Dr. Southey engages in the consideration of tubercles in connexion with consumption; but we do not find any thing in this part of the work, at least so far as the question of tubercle is concerned, that prefers much claim to notice.

There is, confessedly, a great obscurity in the theory of tubercular production. We believe that these bodies are very seldom found to exist except where scrophula is present; and from this circumstance, as well as from their similarity in appearance to hard and tumified lymphatic glands, it was a sufficiently natural supposition, in the first instance, that they were diseased glands. This, however, has been demonstrated to be an erroneous notion. Tubercles,' says Dr. Baillie, consist of rounded, firm, white bodies, interspersed through the substance of the lungs. They are, I believe, formed in the cellular structure which connects the air-cells of the lungs together, and are not a morbid affection of glands as has frequently * been imagined. There is no glandular structure in the cellular connecting membrane of the lungs, and on the inside of the < branches of the trachea, where there are follicles, tubercles have never been seen.'

The presence of these bodies, we have just stated, is almost peculiar to scrophulous habits; but the precise manner in which they are formed and deposited in the lungs, to which we think Dr. Southey, in a treatise on consumption, ought to have given a little more attention, seems to require some further investigation. It would appear, that any irritation, of whatever kind, which may take place in the pulmonary organs of a scrophulous subject, has more or less power in creating these mischievous productions; they are scrophulous deposits from inflammatory

action.

Dr. Haighton and others have, however, ascertained, by experiment, that a foreign matter, artificially introduced into the blood-vessels, may be made productive of precisely the same effect. Dr. H. injected running quicksilver into the crural vein of a dog. The fluid metal being circulated along with the blood found its way to every part of the body. The animal 'did not seem to be disagreeably affected during the first day. It then became feverish, and afterwards laboured under diffi'culty of breathing. A cough succeeded. These complaints went on increasing till the death of the dog. In the lungs 'were found tubercles, of which many contained matter.. That these tubercles had been produced by the injected mercury 'was demonstrated by cutting into their substance, from which 'it appeared that each contained a particle of metal.'

We do not profess ourselves friendly to those views of pathology, which look, for the explication of diseases, into the mass

of circulating fluids, for we think the changes which these undergo, are subordinate to, and conscquent upon, other changes in the organization. The above experiments, however, would seem almost to force upon us the inference, that the blood of scrophulous individuals has in it something of peculiarity, which pulmonary inflammation of a particular kind has the faculty of withdrawing and depositing in the cellular substance of the lungs. Or is it, that this kind of inflammation is peculiar to' scrophulous habits, and that, provided it did take place in other subjects, the effects would be exactly similar?

We have enlarged on this head, rather more, perhaps, than is consistent with the limits of a review; and we have done so from the conviction, that towards the prevention of pulmonary consumption, in those whom nature has disposed to it, much depends upon keeping a careful watch over those slight and apparently trivial affections of the chest, which shall appear in the shape of cough; and which, though scarcely, perhaps, deemed of sufficient moment to attend to, will be depositing tubercle after tubercle; till, in process of time, and at a phthisical age, a slight exciting cause will be sufficient to make the malady break out with all its formidable, and now irremediable and fatal force. It cannot, we think, be too strongly impressed upon the public mind, that much preventive power is in the hands of intelligent and attentive parents. Let these, then, never forget, that in those who are consumptively disposed, a 'little cough,' even at an early age, may, if neglected or ill-treated, become the cause of a great disease;' and that the mischief of protracted affections, though it may not shew itself immediately, may come to do so eventually.

Dr. Southey, at the end of this chapter, alludes to an instructive case which came under his care, and which terminated fatally, after almost every usual symptom of the disease had shewn itself, excepting that the expectoration was never puru'lent.' Pus was formed in this case; but in consequence of the abscesses from which it proceeded not having communicated with the air-cells, it could not be expectorated. We call this an instructive case, because the absence or presence of purulent specta, is too apt to be received by medical men and others, as an infallible criterion of the degree in which danger exists. It had already been remarked by the Author, that a purulent discharge might take place while the disease was confined merely to the membrane, lining the air-cells of the lungs, forming the catarrhal phthisis of Dr. Duncan; and by the last mentioned case it is shewn, that a true tubercular and purulent state of the lungs may exist, and the patient be nevertheless expectorating only common mucus.

We now pass on to the 'predisposing and exciting causes of consumption.'

Dr. Southey, in this chapter, presents us with the result of an investigation, conducted with a great deal of labour and nicety, for the purpose of ascertaining the parts of the world which are more or less exempt from, or obnoxious to, phthisical affections. Next to our own country, some parts of Germany, Vienna in particular, France, and the south of Europe, seem to be the regions most frequently visited by the disease; while other parts of Europe, in a more northern latitude, and a colder climate, enjoy a comparative freedom from its ravages. What has always appeared to us deserving of especial notice on this head, is, that the Dutch, with an otherwise sickly climate, are proverbially free from consumptive ailments. This circumstance, connected with the statement, that in Canada, where intermittent fevers are pointed out as prevalent, while consumption is not noticed, might seem to favour the inference of Dr. Wells, who has conjectured and endeavoured to establish the fact, that in parts of our own country, where agues are common, consumption is infrequent. This hypothesis, however, of Dr. Wells, is not supported by the experience and observations of others; and we are left to look out for another reason of the comparative immunity just referred to.

Τινες αι τῶν κακών πηγαι ; Scrophula it has already been said is the grand germe of the complaint in this country; and in the seeds of Scrophula we are to look for the predisposing causes of consumption. The great object of inquiry then is, how to trace the origin of, and obviate the tendency to, the scrophulòus diathesis. We shall here make a rather long extract from Dr. Southey's book, bearing upon this point.

Whoever has attended much to the diseases of the poor in any part of England, and more particularly in the metropolis, must have observed the very large proportion afflicted with the different forms of scrophula. To what can this be attributed but to the want of the common comforts and necessaries of life? to deficient food, clothing, and fire. In regard to diet some of the labouring classes are better off than others, and we find those so circumstanced, the least disposed to scrophulous diseases. The late Dr. Beddoes collected some interesting facts on this subject. Butchers, who are of course well supplied with animal food, seem of all classes the least liable to consumption. Dr. Withering, in a letter to Dr. Beddoes, says, "The only classes of men I have yet observed exempt from this disease are butchers and cat-gut makers. They both pass much of their time amidst the stench of dead animal matter. The former live chiefly on animal food, and are much exposed to the inclemencies of the season, whilst the latter live as other manufacturers, and work under cover in close and rather warm buildings." A Gentleman was employed to examine the butchers of Bristol, with regard to the

healthfulness of their calling. The following specimens of the answers obtained to this person's interrogations may serve to give an idea of the whole: a butcher thirty years in business does not recollect any man dying in his service. He has had three or four apprentices at a time; they live well, have hot meat for breakfast, with broth and onions; knew a boy die next door, in the slaughter-house, but in consequence of ill usage. He never had any thing the matter with himself. Another, fourteen years in the trade, had never heard of a man dying of a consumption who was a butcher. Dr. R. Pearson made similar inquiries at Birmingham, and states, that he finds the complaints to which butchers are most subject, to be obesity, hepatie. obstructions, and apoplexy; those to which they are the least liable are consumption and typhus.'

After giving other examples of a similar kind, the Author continues,

The same observation seems to have been made in other coun tries. The author of a dissertation on the propriety of placing phthisical patients in slaughter-houses, tells us he was led to the idea by observing the healthiness of the butchers, their wives, and families, at Montpellier. The Scotch fishwives, who live chiefly on animal food, are found to be little subject to phthisis, or any form of scrophula. Among the Cornish fishermen, who live chiefly on animal food, Davy found a similar immunity from consumption. Stable-boys, grooms, and dragoons, are enumerated among the favoured classes. They are likely to be well fed, and pass a good deal of their time on horseback; and the equal temperature of the stable may make them less liable to catarrhs.

• Let us now consider (our Author goes on to say) those circumstances which seem peculiarly unfavourable to the consumptive, and examine among the lower ranks of society how those individuals are situated who suffer most from this disease. From Sir John Sinclair's statistical reports, the general conclusion may be drawn, that consumption and scrophula occur most frequently in those places where the inhabitants are the poorest, i. e. where they are the worst fed and clothed. In many parts of Scotland, where consumption is now prevalent, the old people affirm, that it was unknown before the warm Scottish plaiding was exchanged for the fine, thin, cold, English cloth, and woollen for cotton. So in the vale of Keswick it has been remarked, that consumption has increased with the increased use of cotton, among the women, instead of worsted, flannel, and stuffs.' pp. 56 to 62.

To the impartial feelings of Reviewers, who are not anxious to defend or enforce any system, there may, perhaps, still remain some obscurity on the question of exemption, by particular callings, and in particular regions, from consumptive complaints. Still, however, enough is made out to establish the fact, that where good clothing, regular exercise in the open air,