ness, fidelity and faithfulness to the interests of others, may largely depend the success of such enterprise, still we would also have physicians understand that it belongs to the whole of the medical profession, and its success or failure indicates rather the status of the profession than the ability of those who conduct its passage through the press. If the medical journal of a city is devoid of interest and of doubtful value, the profession are generally devoid of intelligence and their modes of practice unscientific and obsolete; it is in as great degree representative of the medical public.

It is with feelings of great satisfaction that we enter upon our new volume, and commence its labors. The interest manifested in its pages, and the support it is now so generously receiving from the profession are sources of pride and pleasure, and we have to thank our contributors and patrons in behalf both of ourselves and the profession for their efforts and aid, and to cordially and earnestly invite their continued support. Relying confidently upon this, we anticipate increasing prosperity and strength, and pledge our best efforts to deserve it.

Death of Dr. John Mason Warren, of Boston, Mass.

We see announced the death of the eminent surgeon, Dr. JOHN Mason Warren. He was the third of his family in direct descent, distinguished in medical annals. For nearly a century his name has been honored by his countrymen. The memory of that one of the name, noble physician and devoted patriot, who laid down bis life at Bunker Hill, is still fresh and cherished among us. But the three Warrens, in regular line, have also rendered the name illustrious on both sides of the Atlantic. We do not know whether another remains to bear and maintain, in years to come, the honors justly due the name.

Dr. Warren, at the time of his death, was not an old man. Even in his father's day, under the shadow of his great reputation, he gained distinction as a surgeon. Each year since has added to it, and of late he bore alone his honored name, with no diminution of its honest fame.

He had but just completed a work which will be a magnificent monument to his memory. His book records the surgical experience of his life, related with such candor and modesty, as to make it a model, while its merits will not only add to his just fame, as an able and skillful surgeon, but will create a feeling of national pride. It presents a great amount of excellent work, and will serve as a guide and encouragement in after years to many a surgeon in the perplexities and anxieties of his laborious career.

Those who had the pleasure of knowing Dr. Warren, or have been instructed by him, will remember the excellent qualities of the man, as well as the surgeon. They will recall his simple dignity and kindliness of manner, his freedom from ostentation, his conscientious labors. No more kindly face ever looked upon suffering, no more dexterous hand ever guided the knife for its relief. He was a man to be loved, respected, and honored. His professional life was such as most would choose to

lead, but not to all, possible. Raised by fortune above the necessity of labor, he yet devoted more than a quarter of a century to the relief of human suffering, with as much forgetfulness of self and selfish ambition, as is possible to most men. His life and labors were of a kind to adorn our profession and honor human nature.

L.

Books Reviewed.

The Science and Practice of Medicine. By William Aitkin, M. D., Edinburgh, Professor of Pathology in the Army Medical School, etc., in two volumes. From the fourth London edition, with additions, by Meredith Clymer, M. D., late Professor of the Institutes and Practice of Medicine in the University of New York, etc. Philadelphia: Lindsay & Blakiston.

In the plan of this work, the author has aimed at a fuller consideration of the pathology of disease and the philosophy of cure, than has heretofore been attempted in any of our text-books upon the Science and Practice of Medicine. In its range of topics it may be considered as the most comprehensive, fairly representing the existing state of medicine; while the vagaries and delusions of the past are carefully excluded from its pages. Designed especially to assist the medical student in the prosecution of his studies of diseases, the arrangement has been such, as to most fully promote this object.

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The introductory sections are devoted to consideration of the more "important elements of General Pathology," and the principles upon which a nosological division of disease has been founded. The outlines of general pathology in its various relations to individual disease is investigated most comprehensively, and the intimate relationship of pathology to physiology pointed out, the author truly stating that "just in proportion as our knowledge of physiology and pathology becomes more exact and extended, so will the cause of disease be appreciated, and the occurrence of disease on a large scale prevented." Again he says: physiology, therefore, in its most comprehensive sense, and to a knowledge of the natural and normal development of animal and vegetable beings, we must look for a further progress in pathology, while the means and the instruments which advance physiology will simultaneously advance our knowledge regarding the nature of diseases—a sound knowledge of which can only enable us to appreciate their causes," and so arrange measures for the prevention of many of them, based on the great truths of science. The anatomical changes exhibited in various tissues of the body are extensively and carefully described; the author's description of amyloid or lardacious degeneration being especially attractive. This peculiar degeneration has excited a deep interest among pathologists, on account of its permanent character, undergoing no softening, exciting no inflammatory action by its presence, and being but little, if any, absorbed; any organ therefore, becoming the seat of this disorganization, is permanently impaired in its functions in proportion to the extent of the same. It would appear from Dr. Aitkins' postmortem examinations, that this degeneration is of greater frequence than has generally been supposed, chiefly attacking the paranchematous structure of the liver,

the spleen or the kidneys, other structures being occasionally the seat of the de generation. The train of symptoms accompanying this degeneration have not yet been fully studied, although a cachectic state of the system depending either upon necrosis, syphilis, scrofula, or phthisis, when accompanied by a great wasting of the body, the voidance of large quantities of urine, of a sp. gr. of from 1.005 to 1.015, filled with hyaline casts, should excite the suspicion of its existence, and subject the urine to a microscopical examination and the iodine test, which, in the author's opinion, can alone be positive evidence of its presence or absence. The iodine test, based by Virchow upon a supposed resemblance of the amyloid products to starch, the evidence relied upon consisting in the peculiar change which iodine undergoes when brought in contact with this product and sulphuric acid; analogous results however are obtained with cholestrine, and in view of the great uncertainty in which the whole of this subject is involved, we would incline to the belief that the iodine test is not of so much value as the author would make it appear.

The author has arranged the work into three divisions. Division first treating of systematic medicine and nosology. Class i, zymotic diseases; class ii, constitutional diseases; class iii, diseases in the course of which lesions tend to be localized; class iv, developmental diseases; class v, lesions from violence tending to sudden death.

In division second, under the head of the Nature of Diseases, Special Pathology and Therapeutics, the writer has described the nature of each disease, considered as characteristic of its class. In so doing the writer says, "each disease or morbid process has been defined, not by a logical definition, but merely by stating prominently its leading characters, so that the student may at once distinguish the general feature of the disease, which he has to study, and which the physician has to treat. Having then established the position of each disease in its Nosological and Pathological relations, those principles are stated which guide its treatment, and in some instances definite details are given,"

Division third is devoted to the consideration of the Geographical Distribution of Health and Disease. This important study has heretofore never been introduced in any of our works on the practice of medicine, nor has hardly any allusion been made to it in the lecture rooms. The important relations which this science bears to practical medicine, cannot be overestimated, auanmuch of the value of the study of the nature of diseases and their distribution over the globe, has been lost, by not studying it, in relation to the physical condition of the earth's surface and the variation of their types in different regions of the world.

The realms or zones of diseases, the author says "are intimately associated with the temperature, and generally indicated by the regions of the tropical, temperate and polar zones;" for the better illustration of what is meant by the realms of disease, the map of Mr. Keith Johnston has been introduced. The tropical realm or zone, the author confines to Humboldt's mean annual isothermal line of 77° Fahr., north and south of the equator. The class of diseases characterizing this realm the writer considers as the most malignant forms of malarial (intermittent and remittent) fevers, associated more especially with dysentery, diarrhoea, cholera indica, VOL. 7, NO. 1—5.

specific yellow fever, hepatic affections and their results. The paludal fevers of this tropical disease-realm prevail in their greatest intensity in flat, low-lying countries, in the vicinities of marshes, the borders of lakes, shores of rivers and of the sea. The maximum intensity of dysentery, yellow fever, diarrhœa, malarial fevers, and affections of the liver, is observed in these countries which are situated under the line of the greatest annual mean temperature, namely, 82° Fahr., which is the equator of heat of the globe," the ratio of deaths being 53 per cent. up to the 23°, while from there to the 35° they cause but 14 per cent. of the whole of the mortality.

The second well marked realm is that in which varied forms of continued febrile disease take the place of the malarious or paludal fever of the torrid zone. The regions where diseases of this type prevail embrace realms to the north and south of the equator which may be generally described as in the north and south tempertae zone. The boundary of this realm extends between the 35° and 60°, embracing the healthiest parts of the globe, the prevailing causes of ill health being mainly due to the condensation of people in towns and the insalubrious and depressing conditions which necessarily arise from this cause. The third disease-realm extends to the north and south of the 60° or the mean annual isothermal line of 41° Fahr. In this realm the "catarrhal affections, influenza, scurvy, erysipelas, diseases of the skin and digestive organs, and various constitutional affections, more especially prevail."

We have thus given our readers a general outline of the plan of Dr. Aitkin's work; a work upon which the highest encomiums of the medical press have been bestowed. The American Editor, Dr. Meredith Clymer, has made numerous additions, which greatly increase the value of a work, whose teachings may be safely followed in the treatment of disease, and which will undoubtedly influence the practice of the profession for many years.

On the Action of Medicines in the System. By Frederick Wm. Headland, M. D., A. B., F. L. S., Fellow of the Royal College of Physicians, etc., etc. Fifth American from the Fourth London Edition. Revised and Enlarged. Philadelphia: Lindsay & Blakiston, 1867.

"Thus have I succeeded in solving the noble problem, viz: to find a remedy for a given disease." These, the coucluding remarks ef Dr. A. Pitcairn, in one of his works, serves to illustrate the almost utter ignorance, until quite lately prevalent among medical men, of the modus operandi of remedical agents, and no question in medicine appeared to them of an easier solution than the action and choice of a remedy in any particular case. Fortunately, these delusions have been gradually dispelled by our increased knowledge of therapeutical and physiological truths, and the questien formerly thought of an easy solution, has proved to be one of the greatest difficulty. Of late years much attention has been bestowed upon the therapeutical action of medicines, and various theories advanced, some of practical and scientific value, while others, especially those based upon the local tendency of medicines, are open to grave objections.

In the work under consideration, the author discusses the modes of action of

therapeutical agents when introduced into the stomach, in ten propositions, in in the first four of which the general conduct of medicines after their introduction into the stomach, and before their entrance into the circulation is considered, while the remaining six, treat on the behaviour of medicines after their entrance into the fluids of the body. In the first proposition the author affirms "that the great majority of medicines must obtain entry into the blood or internal fluids of the body, before their action can be manifested," which statement is proved: first, that when introduced into any other part of the body than the stomach, the action of the medicine is precisely the same; secondly, it has been ascertained by direct experiments, that a poison will not act through the medium of the nerves only, but that its passage into the blood is required; thirdly, the course of the circulation is sufficiently rapid to allow the most active poison or medicine to be absorbed and carried around the system before any of its peculiar symptoms can manifest themselves; and fourthly, with but few exceptions, all medicines have been detected, not only in the blood, but in the secretions formed from the blood. Having thus conclusively demonstrated the passage of medicines into the general circulation, the second proposition is devoted to the consideration of the laws, by which this transit is effected. The conditions necessary for the appropriation of agents so diversified in their physical properties, will be the presence of proper solvents. This condition is fulfilled for all substances, insoluble in water, either by the gastric, intestinal, biliary or pancreatic secretions, or all combined. But it has been found that a few substances are insoluble in any of the above enumerated solvents, and the question naturally suggests itself, how and in what manner do these affect the animal economy? An erroneous theory has, by some writers, been promulgated, in which they endeavor to demonstrate the actual passage of insoluble substances in a state of minute sub-division between the interstices of the animal membrane. Such a transition, the author, after careful experimental examinations, has repeatedly demonstrated to be a physical impossibility, since the highest magnifying power have failed to reveal even the minutest aperature in the prestine condition of the basement membrane; and although epithelial cells, exhibiting perforations, have been, of late, discovered by Köllicker and Virchow, the imperforate basement membrane would still bar the transition of foreign matter. In what manner, then, do insoluble medicines exert their peculiar action on the system? This query the author disposes of by stating that their action is purely local by irritation or otherwise of the mucous membrane, and that in a few instances these local actions may be succeeded by changes in distant parts, on the principle of revulsion. For example: kousso, male fern, santonine, etc., are employed as anthelmintics, which tend to directly destroy the parasite, while the carthartic given in connection is designed to expel them. Again, sulphate of zinc and copper causing, when coming in contact with the walls of the stomach, an irritation, by which the peristaltic movements of that organ is reversed, and its contents ejected without any nauseous feeling. Again, the soothing action of nitrate of bismuth, which can be administered in very large doses, (if chemically pure,) relieves the irritable condition of the alimentary tract, by affording a covering to the irritable mucous membrane, and not by any effect it exerts upon the nerves.