nell, or Lord Glenelg for Mr. M'Kensie: position to conservative-that is, to conbut, like Shakspeare's wretched apothe- stitutional feelings. The total failure of cary, it was their poverty rather than their will which reduced them to deal in these poisonous combinations.

all the political changes miscalled reforms, either to accomplish their own promised objects, or to better in any degree the social condition of the peoplethe flagrant insincerity of professing patriots-the awful and exemplary lessons so widely inflicted by the recent riots and rebellions, and, in short, the tardy wisdom, which even the least cultivated intellects must gather from a series of unsuccessful experiments, will, we trust, have their due effect on the popular mind, and dispose that portion of it which has been the most disturbed, to be willing to return to a state of constitutional order. It is only in such a state that industry-the real and only permanent wealth of the masses of

But they have gone so far that, for them, there is no extrication-they are at a dead lock; of victory over the Conservatives there is no hope; of retreat from the Radicals there is no possibility. The more respectable members of their party, or rather of what was their party, exhibit increasing uneasiness and dissatisfaction. Some of them are already dropping off; and we can have no doubt that but for the foolish and unconstitutional engagements with the Court in which they have involved themselves, every man who has any share of talents or character amongst them would be glad to get safely out of a mankind--can develope itself and produce boat which they feel is rapidly approaching the falls! Lord John Russell can have no desire to face a motion for English inquiry similar to that which Lord Roden carried last session for Ireland.

the fruits of public prosperity, by the individual ease, comfort, and happiness of the laborious classes. They, after all, must raise and earn the bread they are to eat, and never can do so plentifully, But whatever becomes of them, the cheaply, and constantly, except under the gigantic engines of turbulence and de- shelter of public tranquillity. As the promoralization which their original indis- ducts of nature are deteriorated, dimicretion set in motion, and which their nished, or even destroyed by unseasonasubsequent weakness has rendered so for- ble vicissitudes and inclemencies of weamidable, will remain, we fear, for a time ther, by floods and by storms, so the at least, in full activity, and will impose working classes will find-we believe, inon whoever is to succeed to the manage-deed, that to a vast extent they are alment of affairs a task-not, we trust in ready convinced-that the necessaries, divine Providence, wholly impracticable, but one of the most awful difficulty; one which undoubtedly can have no chance of success, but by the happiest combination of vigour and discretion-the soberest, and, at the same time, the highest views- and the most indefatigable pa. tience, united with the most intrepid firmness, in those who are to govern; but even all this will not suffice without the most disinterested indulgence-the most generous confidence and the most zealous co-operation, and, we may say, partnership, in their labours and responsibilities, on the part of every man who has any spark of true patriotism, or any regard for the ancient institutions and constitution of his country.

There is one strong gleam of hopenot naturally a bright one, but cheering in the surrounding darkness. It is the intrinsic misfortune of popular constituencies, to be easily led astray: it is a compensating advantage that they are also susceptible of being, though certainly not so easily, reclaimed to the right way; and already we can see amongst the more numerous classes a strong dis

comforts, and enjoyments of their existence are rendered scanty and precarious by discontent, agitation, and disorderwhich are the blights, floods, and tempests of the social and political world.

'Order,' says the philosophic poet, 'is Heaven's first law; and the apparently accidental distinctions of birth, rank, or riches, like the not more natural differences of strength, stature, or talents, are inseparable parts of the general design of Providence, which the turbulence of man may for a moment disarrange, but which he never can permanently destroy.

We cannot better conclude these observations than with the same poet's beautiful adaptation of the whole system of the universe to the social state of man :—

THE

LONDON QUARTERLY QUARTERLY REVIEW,

No. CXXX.

FOR MARCH, 1840.

ART. I.-Medical Notes and Reflections., out of view the tedious apparatus of miBy Henry Holland, M.D., F.R.S., Phy-nute facts, from which he has deduced sician Extraordinary to the Queen, &c. the principles with which his work is fill&c. London. 8vo. 1839.

ed; and this, perhaps, constitutes no small part of its worth; for while the examples quoted are salient, and to the point, all that a well-educated physician may be supposed to know is not ostentatiously dragged forth. So far the volume is strictly addressed to the profession; but the subjects discussed are in many instances such as appeal to the curiosity

THIS book is one of a class extremely puzzling to us reviewers. It is, in fact, a collection of thirty-five reviewals, many of them capital ones, upon as many topics, almost all of them exceedingly important and interesting. Such chapters, being already the summaries of subjects, are found to trench on our craft, render- of all intelligent persons; and, for the ing an analysis of the essence of an essence not unlikely to end in the conversion of substantial fact and vigorous reasoning into thin and airy speculation.

most part, merely technical phraseology has been abstained from. For the reader who delights to fathom the 'mare mag num' of metaphysics there is scope enough The accomplished author informs us in the essays 'On Time as an Element of that he has been accustomed, during Thought in mental Functions,'-' On the twenty years of practice in London, to Nervous System,'-On Phrenology,'preserve not merely memoranda of parti- 'On Sleep,'-'On Dreaming, Insanity, and cular cases, but also of such general re- Intoxication,'-' On the brain as a double flections as were suggested to him by Organ,'-' On the Effects of mental Atactual observation. Twenty years is in- tention on bodily organs.' The valetudideed a large portion of that span of ex- narian, or the medical dilettante, may see, istence over which we all are hastening; in the chapter 'On the Abuse of Purgabut twenty years of sight and insight ex- tive Medicines,' some of the risks he pended on society, in all its multifarious runs; or he may fortify his privilege of working, as exhibited in this huge metro- hampering his doctor by adding to the polis, is a privilege of which few can judicious enumeration of the essay 'On boast;-and woe to him who, possessing Points where a Patient may judge for so precious a talent, shall have let the himself,' all the points where he ought winged hours speed away, leaving no not. Much curious information he may permanent fruits of benefit for mankind! cull from the discussion On the Influence Dr. Holland appears to have so con- of Weather in relation to Disease.' Both ducted his methods of inquiry as to keep patients and physicians will find an abun

relief.

All these things, familiar in practice in this country, make the situation and conduct of the physician in cases of dyspepsia hardly less difficult than in acute and dangerous diseases. Though the symptoms before him are not so critical in kind, they need sound moral management, as well as discreet methods of medical treatment. Forbearance and firmness are both required; and, together with these, integrity and good faith. The admirable precepts as to uprightness in practice, which came down to us under the great name of Hippocrates, obtain here their closest application; and may well be impressed upon all who are entering on a medical life. The mind must be fashioned early and strongly in these professional principles, as they are rarely attained afterwards, and even with difficulty preserved, amidst the many difficulties which beset the conduct of the physician.'—pp. 340, 341.

dant supply of material for thought inson or remedy where there is largest profession of the masterly chapter on Gout. Scarcely less excellent are those entitled 'Bleeding in Affections of the Brain,'- The Connection of certain Diseases,'-' The Use of Opiates,'' Of Diluents,'-' Of Emetics. Such is the variety of subjects handled with more or less of detail, that few readers, professional or non-professional, can fail to be arrested by trains of observation and reflection which they will be happy to pursue under the guidance of so full and able a master as Dr. Holland. Throughout, we may add, they will find a high tone of moral sentiment, worthy of his noble profession-a generous contempt of all mean practices and compliances-the dignity of a philosopher combined with the graceful illustration and extensive sympathy of a scholar and gen

tleman.

Not wishing to mock our readers with a catalogue raisonné of so many multifarious essays, we select for examination that entitled 'Diet and Disorders of Digestion,'-the rather because many of the topics, to which the author has allotted a separate head of discussion, readily find a place under the one we have chosen. There are few faculties of body or mind on which the influence of the nutritive process is not marked and incessant.

The father of dyspeptic medicine is undoubtedly John Abernethy; for, prior constitutional, that is, general treatment, to his time, the cure of local disease by was either little understood or little regarded. He professed, however, to derive all his principles from his master and idol, the great John Hunter. The singu lar felicity possessed by the pupil, of bringing to light all the treasures which lay hidden in the obscure depths of such an intellect as that of his early instructor, soon rendered the system of dyspeptic medicine so popular, as to put aside al. most every other mode of medical investigation. The principles which Abernethy brought into vogue were so simple, that few could fail in comprehending The habits of society among the higher classes, them; they were so universal, as to be and the influence of dyspeptic complaints on the shut out, in their application, from no mind, render the treatment of such disorders a mat- disease, whether mental or corporeal, heter of great interest, even in a moral point of view. reditary or accidental. And lastly, they They unhappily furnish an arena on which all the worst parts of medical practice find their readiest were enforced by a sum of personal quadisplay. Fraud, intrepid in its ignorance, here wins lities which carried away all who had the an easy triumph. Seconded on every side by pre- happiness of hearing this most original judices, fashions, and foibles, and taking advantage of lecturers. He awakened attention by of the mind and body in their weakest mood, it deals the flow and breadth of the richest Doric, out precepts and drugs with a pernicious facility; sometimes altogether at random; sometimes, and and he fixed it not more by the intrinsic even more injuriously, with one common scheme of worth of his statement than by his very treatment applied to the most variable and incon-uncommon dramatic and mimetic powers. gruous symptoms.

We are well pleased to quote in the outset such a passage as the following:

or

His illustrations were never trivial; often These abuses indeed, in their worst form, exist only on the outskirts of the profession. But it will profound, yet without ostentation be admitted by all who have candour and experi- mysticism. The anecdotes with which ence, that there is no part of medical practice where his lectures abound (he almost always knowledge and good faith are put to equal trial as in the management of dyspeptic complaints. Even educed his principles from examples) the effect of the disorder in obscuring the judgment, were usually not only very appropriate and rendering impotent the will of the patient, be. but exceedingly picturesque, for he was comes an embarrassment to the physician. If his a great master of the art of 'word-paintown judgment be slow and wavering, he is deprived of aid; if hasty and rash, of that control from the ing. They teemed with knowledge of opinion of his patient which is frequently needful. the heart; so that besides the point of The mind of the dyspeptic uncertain and fickle. scientific interest which was prominently He interprets falsely his own sensations, and the ef. set forth, there was a large margin for fects of the treatment employed; is unduly confident at one moment and under a new remedy; at another thought in his comments on human chatime as irrationally desponding; prone, moreover, to racter and opinions, as seen in action or change his medical adviser, and to resort to any per-recorded in books; to three or four of

which, and those of the highest order, they made practical medicine dependent he confined his reading. 'I go to Sterne,' on a few simple physiological principles, he used to say, 'for the feelings of hu- and blue pill-repressed inquiry in others. man nature, Fielding for its vices, John- But his success in tracing the influence son for a knowledge of the workings of of disordered digestive functions on all its powers, and Shakspeare for every-diseases, produced a cloud of works, and thing.' Though a keen observer on the a host of imitators; some of whom forgot humorous side of our foibles, which, to imitate his sense, when they affected however, he set down with naught of his singularities; while others thought malice, he possessed, like most men of a they were adding to the value and numsimilar cast of mind, much of the pathos, as well as the irritable humour of that species of muser, of which Jaques is the ideal.*

This rare union of qualities gave weight to opinions, which it would appear Abernethy had formed very early in his professional life, and which he retained without much addition or diminution to its end. These were one-sided and exclusive in this respect, that he did not himself follow up the improvements of his age-while his dicta, in as far as

ber of his principles, by reducing them to vulgar fractions. It is not very long since the minutest trifles were gravely expected to be written down for the guidance of those who seemed to have lost, with facility of digestion, every faculty of mind. The result was, that it afforded a fine field for all who knew and could take advantage of that feverish state of alarm induced by undue attention to trivial corporeal sensations. To those who would trace the effect of mental attention on the bodily organs, we recommend the 5th chapter of Dr. Holland, where they Lawrence's portrait gives one phasis of Aber. will not only find the rationale, but the nethy's aspect very happily; but who can paint example of this pernicious habit, as afanything of the manner which set off such a seem- fecting most of the vital organs of our ingly common little matter-of-fact as that told in these words? Local injury or irritation frequent-frame, one and all of which will soon ly produces a state of delirium, in which a man is transmit diseased sensations to that brain, utterly unconscious of his situation; he goes on which is predetermined to harp on them. imagining things, as in a dream, and acting in consequence of such imaginations. Delirium often takes place in consequence of an accident of no very momentous kind; it may occur without fever, or it may be accompanied with that irritative sym. pathetic which I described to you in the last lecture, and which is often the "last stage of all, that closes the sad eventful history" of a compound fracture. Delirium seems to be a very curious affection; in this state a man is quite unconscious of his disease; he will give rational answers to any questions you put to him, when you rouse him; but, as I said before, he relapses into a state of wandering, and his actions correspond with his dreaming. People who are delirious and suffer pain have generally uneasy dreams; but delirious patients seem often to have undisturbed and even pleasant dreams. Iverted to other objects.'-p. 66. remember a man with compound fracture in this hospital, whose leg was in a horrible state of slough. It is to avoid the injurious effects of ing, and who had delirium in this state. I have incessant watching over such symptoms, roused him, and said, "Thomas, what is the matter that Dr. Holland advises the dyspeptic to with you? how do you do?" He would reply, "Pretty hearty, thank ye, nothing is the matter dine from a simple and discreet table at with me; how do you do?" He would then go regular hours; but he well adds, that 'if on dreaming of one thing or another. I have this rule should bring him to a solitary listened at his bedside, and I am sure his dreams meal set apart for himself, more of ill than were often of a pleasant kind. He met old ac. quaintances in his dreams; people whom he re- of good results.' When the stomach is membered "lang syne;" his former companions, full, the less the mind has to do with it his kindred and relations, and he expressed his de- the better-a lesson on which all who light at seeing them. He would exclaim every endeavour to digest at the same time now and then, "That's a good one,' "" Well, I never heard a better joke," and so on. It is a curious tough chops and mental food of equal recircumstance, that all consciousness of suffering is sistance, in the shape of reports legal and thus cut off, as it were, from the body; and it can parliamentary, should ponder. There are not but be regarded as a very benevolent effect of few individuals more dyspeptic than those Nature's operations, that extremity of suffering should thus bring with it its antidote.-Abernethy's who pursue day after day the above regiLectures, p. 20. men, and fewer who are not surprised at

'A direction of consciousness to the region of the stomach creates in this part a sense of weight, oppression, or other less definite uneasiness; and, when the stomach is full, appears greatly to disturb the due digestion of the food. It is remarkable how instantly, under such circumstances, the effect comes on; a fact readily attested by experiment, which every one may make for himself. The symp. toms of the dyspeptic patient are doubtless much aggravated by the constant and earnest direction of the mind to the digestive organs, and the functions going on in them. Feelings of nausea inay be produced, or greatly increased, in this way; and are often suddenly relieved by the attention being di

the effect of only two mutton chops and | remedied this defect by a species of valve regular hours.'

"For the guidance of patients themselves, those rules of course are best which are most promptly and safely applied; neither harassing the mind by anxieties of choice, nor the body by encouraging wayward fancies as to methods of prevention or cure. If, for example, I were to specify any general maxims as to food, preferable to others from dis tinctness and easy application, and serving as a foundation for lesser injunctions, they would be the following:

First, that the stomach should never be filled to a sense of uneasy repletion. Secondly, that the rate of eating should always be slow enough to allow thorough mastication, and to obviate that uneasiness which follows food hastily swallowed. Thirdly, that there should be no urgent exercise, either of body or mind, immediately after a full

meal.

formed of the inner lining of the stomach itself, which, by jutting over the aperture, closed it, by simple apposition without adhesion; so that it could be readily pushed aside whenever Dr. Beaumont wished to have ocular demonstration of the process of digestion in a living man, or when he chose to insert directly into the stomach any of the articles of food.

Company, Dr.

In 1825 experiments were commenced; but as St. Martin decamped without his master's leave or knowledge, we must suppose that they were, we will not say unpalatable, but not agreeable to St. Martin. Four years elapsed ere he was heard of, during which period he had la"The simplicity and familiarity of these rules boured hard for his livelihood, had marmay lessen their seeming value; but in practice ried, and become the father of two childthey will be found to include, directly or indirectly, ren. It being by chance ascertained a great proportion of the cases and questions that he was in the service of the Hudwhich come before us. And many such questions, Beaumont, as, for example, those which relate to different son's Bay qualities of food, would lose great part of their dif- with most laudable zeal, succeeded, at ficulty were these maxims successfully enforced. great expense, in having the man and his When the quantity taken does not exceed the just family transported to him a distance of limit; when it comes to the stomach rightly prepared by mastication, and by admixture with the 2000 miles. St. Martin's health was persecretions of the glands which aid the first stage fectly good, although the aperture into of digestion; and when no extraneous interruption the stomach remained pervious. A seexists to the proper functions of the stomach in this ries of experiments were now tried on stage; the capacity of digestion is really extended as respects varieties of food, and tables of relative him, from August, 1829, to March, 1831, digestibility lose much of their value.'—p. 344. during the whole of which time he continued to perform the duties of a common servant in Dr. Beaumont's family. He then asked and obtained leave to go back to Canada, but once more returned in 1832, under the express stipulation of twelve months' further experimentation. The details have now been published by Beaumont, and commented on, among others, by Dr. Holland.

Latterly, a very remarkable opportunity has been afforded of verifying on the human subject much that was conjectural or incomplete in the doctrines and facts relative to digestion; and as we shall have to refer more than once to the results, we may as well sketch the extraordinary story of Alexis St. Martin.

Dr. Beaumont, a physician in the army of the United States, while serving in the Michigan territory, was called to see a robust youth of eighteen, who half an hour before had been desperately wounded by the accidental discharge of a gun, the contents of which entered the chest and passed in an oblique direction into the stomach, and out through the neighbouring integuments. There were therefore two perforations; an upper, from which a portion of the lung, and a lower, from which a part of the stomach protruded. The cure was protracted during a year, at the end of which time the orifice in the chest was completely cicatrised, while that in the stomach remained open to the extent of two and a half inches in circumference, permitting the food to escape unless prevented from so doing by the application of a pad and bandage. In another year (the spring of 1824,) nature

On pressing back the valve over the orifice into the stomach, the internal surface of that organ could be seen for the space of six inches, and the food could be perceived not only at the moment of its entrance, but during the whole period that it remained there; so that all the mechanism of a vital action hitherto known by indirect means alone was exposed to the senses. The time and circumstances under which the secretion of gastric juice took place, the motion of the stomach, the temperature necessary for the digestive process, the appearance in health and in disease of the mucous membrane lining the organ, and many other states and facts, were definitely made out by the accident of which Dr. Beaumont made such good use. periments were painless, and we add with much pleasure that they appear to have been conducted with a discretion

His ex