case, however, sooner or later, I had to resort to an emetic, and change the plan of treatment. Rheumatic, and dropsical affections, torpid liver, dyspepsia and a broken constitution, are too often the sequela of bilious remittent fever treated with mercural purgatives.

In the more aggravated fevers such as what are called congestive, malignant or pernicious, mercurial purgatives persisted in are equally, if not more inadmissible.

But the greatest objection is to the plan of treatment adopted by so many physicians in country practice at the South, and in the great valley of the Mississippi; I mean when calomel is relied on as a specific, and ptyalism as a rule must be established. In the first place, all symptoms are disregarded, and the disease is treated by name and by rule. In the second place, the mortality is greater than by almost any other plan of treatment. Thirdly, if it effects a cure, it leaves the constitution shattered, and entails diseases almost as bad as the original one. It would be considered incredible, were I to relate some of the deplorable effects of this mercurial plan of treatment which I have witnessed and heard of. Some have died from the destruction of the jaw bones and other bones of the face, and sloughing of the gums and edges of the tongue. Others have wasted away and perished with mercurial fever, brought on by the attending physician, but which it was out of his power to arrest; while a much larger number have escaped death to wear out a miserable life with a broken down constitution and obscure forms of chronic disease.

Such being too often the lamentable effects of the salivating curative plan in the fevers in question, humanity, as well as common sense, should preclude its use, if there is any milder and safer treatment that can be adopted. And that there is, we have in this city the most abundant proof, while in the medical journals we continually meet with cases of fever of the gravest character treated successfully without the use of

mercury.

It may be well to state that salivation can be arrested by washing the mouth several times in the day with a saturated solution of acetate of lead, in two parts of water to one of vinegar, and with the addition of laudanum, say a drachm to four ounces of the solution. The earlier this is used, the better. If the gums are spongy and denuded, the application is very painful for several successive times the solution is used. Of course, care must be taken not to swallow any portion of it, and hence it would be unsafe to use it with young children. I have used it for many years without failing in a single instance. The idea was first suggested to me by Dr. Chapman in the session of 1823-24 at Philadelphia. When lecturing on colica pictonum, the Dr. observed that if calomel is an antidote for the lead in this disease, why should lead not be an antidote for calomel. Some years afterwards I met with the prescription as already given, in one of the New York Medical Journals, taken from a Prussian Journal. It produces a black deposit on the tongue and gums, and even colors the teeth black; this deposit should be scraped off every day with the handle of a silver spoon.

It is probable in this case that the greater part of the mercury is in the salivary glands, and becomes decomposed in the form of a black oxide. A gentleman of veracity assured me that he had scraped off this black

deposit, and exposed it to the sun for several days, when globules of quicksilver could be distinctly seen. I have used this remedy in a great number of cases, some of which were recent and slight, and others again very severe and of several days duration, but I cannot recollect a single instance in which the constitution subsequently suffered in consequence of the mercury that had previously been taken, I therefore recommend all to give it a trial, who are at a loss for a remedy to arrest salivation.

Part Second.

REVIEWS AND NOTICES OF NEW WORKS.

I.-A Treatise on Diseases of the Air Passages: Comprising an Inquiry into the History, Pathology, Causes and Treatment of those Affections of the Throat called Bronchitis, Chronic Laryngitis, Clergyman's Sore Throat, etc., etc. By HORACE GREEN, A. M., M. D. Formerly President and Professor of the Theory and Practice of Medicine in the Castleton Medical College; Vice President of the New York Medical and Surgical Society, &c., &c. New York and London. Wiley and Putnam. 1846. pp. 276.

We had heard much of this work before we were honoured by its reception, which was but recently, and now that we have examined its interesting contents, we regret that our engagements will not allow us to give as ample a notice of it as we think it merits. As a literary production, its pretensions are quite moderate, but the author's apology, that it was "prepared amid the pressure of constant and constantly accumulating professional engagements," should have due weight; for it must be exceedingly difficult to write carefully and well when harassed with business. This work deserves commendation as an American production, for it may not be generally known, that European authors, especially in Paris, command far greater facilities for making books, than the writers of this country. There, if we have been correctly informed, an author, not having time to write himself, has only to shadow forth the grand idea and leading features of the desired book, the references and number of pages; and in due season his publisher furnishes it prepared secundum artem. He then has only to revise the work and see that he is made to express what he means. Here, it is altogether different; we have to do every thing ourselves, there being neither a sufficient number of authors nor competent assistants to render available the short and easy method of attaining literary distinction. We there. fore feel inclined to extend every encouragement to native authors, giving due credit for originality and practical utility, and making proper allowances for imperfections in composition.

When Dr. Green's work first appeared it was severely criticised, and the author accused of appropriating to himself the credit due to MM. Belloc and Trousseau, of France, for discovering the virtues of nitrate of silver in ulcerations of the larynx and pharynx. Dr. Green settles the difficulty by saying, "while I claim no credit for having originated the

practice myself, I, on the other hand, give these authors none, for having, so far as I am concerned, suggested it, for I had been in the practice of cauterizing the larynx nearly two years before I had ever heard of Trousseau and Belloc." Their work was published in this country in 1841; whereas, Dr. Green says he took the idea of applying the nitrate of silver within the larynx, from a conversation he had with Dr. James Johnson, of London, in 1838, and after returning home he put into successful practice what had been deemed hitherto impracticable. Indeed, its practicability was denied on theoretical grounds, even after Dr. Green had made many most remarkable cures. He has now the gratification of appending to his volume, the complimentory testimony of Drs. Charles A. Lee, Alfred C. Post, J. Bryan, S. C. Foster, and Abm. L. Cox, of New York.

His work consists of 10 chapters, under the following heads, viz: 1. Anatomy of the Larynx, Trachea and Bronchi; 2. Physiology of the Mucous Follicles; 3. Pathology of the Throat, Larynx and Bronchi; 4. Follicular Inflammation of the Throat and Air-Passages; 5. Malignant Follicular Disease of the Air-Passages; 6. Pathology of Follicular Disease of the Air-Passages; 7. Causes of Follicular Disease of the Air-Passages; 8. Symptoms of Follicular Disease of the Air-Passages; 9. Of the Treatment of Follicular Disease; 10.

The same.

Each of these subjects is treated in a lucid and practical style. The treatment, particularly, is illustrated with a variety of interesting cases. The title on the back of this work would indicate that bronchitis was the principle disease treated of; but such is by no means the case. It is devoted almost entirely to the consideration of follicular inflammation of the fauces and larynx. Dr. Green says this is apparently a new disease; at least, that it is only within the last twelve or fifteen years that its distinct history has been given. We extract from the work the following:

Description of the Follicular disease of the Air-passages.

"This peculiar malady consists essentially, in its formative stage, of an inflammation of the mucous glandulæ; which is sub-acute in its character; and which may result, as above stated, in hypertrophy, ulceration, or induration of these glandulæ, or in a deposition of tuberculous matter into the substance of the follicles, themselves.

"In its simple and uncomplicated form, the affection commences, invariably, in the mucous follicles of the fauces and pharynx; and is extended thence, by continuity, to the glandulæ of the epiglottis, larynx and trachea; and in some instances to those of the œsophageal membrane.

"So insidious, frequently, is the onset of this disease; and so gradual its progress, that in some instances it will be found to have continued many months, and to have made considerable advance before the presence of any prominent local symptom shall have called the attention of the individual to the existence of the affection. He then, perhaps, becomes aware of an uneasy sensation in the upper part of the throat, accompanied by a frequent inclination to swallow, as if some obstacle in the passage might be removed by the act of deglutition; or, more frequently, there is an attempt made and often repeated to clear the throat by a kind of screatus or hawking, and to relieve it of a sensation of "something sticking at the top of the wind-pipe." About the same time, there is observed an alteration in the quality or timbre of the voice, there is experienced in the vocal organs, a loss of power and a hoarse

ness is present, which at first is hardly perceived in the morning or after a full meal, but which is increased towards evening, and after speaking or reading longer or louder than usual. The mucous secretion, which in a healthy condition of the glands is bland and transparent, becomes viscid, opaque, and adherent, and is increased in quantity. Frequently there is a slight soreness felt about the region of the larynx, but seldom is any cough present at this stage of the disease. In this condition the symptoms may remain for a long period; sometimes for years; nearly disappearing at times, and then again being greatly aggravated by vicissitudes of temperature, increased exercise of the vocal organs, and by various other morbific causes.

"If we inspect the throat and fauces during the progress of the above symptoms we shall find the epithelium, which in the healthy state of the mucous tissue covers its surface, more or less destroyed; its absence being manifested by the slightly raw or granulated appearance which the membrane presents; the mucous follicles will be found hypertrophied, and will appear distinctly visible; especially those studding the upper and posterior part of the pharyngeal membrane. (See plate I.) If the disease has been long continued, a portion of the follicles may be found indurated, or in some instances filled with a yellowish substance having a. resemblance to, and presenting the physical characters of tuberculous matter, whilst striæ of opaque adhesive mucus, or of a muco-purulent secretion, may be seen hanging from the veil of the palate or coating the posterior wall of the pharynx. As the disease advances, and the follicles situated at the root of the epiglottis and in front of the arytenoid cartilage, and the still more numerous glandulæ of the laryngeal mucous membrane, become involved in the morbid action all the above symptoms appear greatly aggravated; the hoarseness is much increased, and is constant; speaking or reading aloud is attended with great.difficulty; and when continued for any period is followed by pain and increased soreness in the region of the larynx; and by a sensation of extreme languor, not only about the vocal organs but throughout the whole system. In some cases where the disease affects the glands situated in the ventricles of the larynx and near the vocal chords, the voice becomes completely extinguished; or if, by great effort, the patient essays to speak aloud, the vocal resonance is uneven, harsh and discordant.

In such cases, notwithstanding the situation and extent of the disease, there is seldom present any decided or troublesome cough; and in this respect follicular disease differs essentially from all other equally grave laryngeal affections. Cases have fallen under my observation, repeatedly, where the affection had advanced until the symptoms present indicated extensive disease of the follicles of the larynx and of the membrane covering the vocal ligaments; -until the ulceration of these glands situated at the root of the epiglottis could be felt upon the laryngeal surface, and yet the patient would remain free, or nearly free from a cough, notwithstanding an abundant acrid secretion, poured out by the diseased follicles, would occasion an incessant hawking to clear the upper part of the wind-pipe and the pharynx of this tenacious mucus. "As illustrative of many points in the above description of uncomplicated follicular disease, I have selected the following cases."

From these cases we select the following as among the most interesting.

"K. H. E. Esq., a lawyer of eminence in this city, aged 38 years, suffered from an attack of acute bronchitis, in April, 1840. Under the most active treatment he recovered from the disease and resumed his professional duties. In 1841-2, he was a member of the Common Council, and in addition to the duties of a full practice, which necessarily involved much public speaking, he was frequently engaged in the exciting debates of the honourable body of which he was a member.

"Early in 1842 he began to be sensible of a slight huskiness of the voice, and of an uneasy sensation in the throat, after public speaking. These symp