how essential a certain amount of moisture is to the proper performance of the process of respiratory endosmosis, we shall easily understand how that function must be impeded by any cause which reduces the moisture in the air below the amount which is necessary for its healthy discharge. Two facts mentioned by M. Jourdanet help to corroborate this supposition. In speaking of the change in the pathology of disease which occurs in Mexico annually on the advent of the rainy season, he remarks—

"The contrast is then the more striking, inasmuch as we pass from the most marked state of insalubrity to the best manifestations of public health. Bodily fatigue, respiratory embarrassment, vertigo, and dyspepsia give place to muscular activity, easy respiration, and to soundness of the nervous and digestive functions. The diseases of spring disappear, or lose as if by enchantment their epidemic character, and all for which this, the finest season of the year, can be blamed is the occurrence of a few cases of dysentery which appear during its latter days.”

An equally strong confirmation is found in the fact that if we ascend the mountains which surround the Mexican plateau, and get within the limits of the condensed vapour which always hangs about the upper strata of mountainous regions, the anæmia which is so characteristic an element in the physiognomy of the natives of the plain will be found to have to a very considerable extent disappeared, and the pathology of the inhabitants to have acquired a proportionately active type. Whilst speaking of anæmia, we may mention that M. Jourdanet states that the anæmia of the plateau, unlike the affection of lower altitudes, is quite unamenable to iron, and yields only to quinine.

One of the most interesting chapters in M. Jourdanet's work is that in which he describes the influence of the atmosphere of these high regions upon the development and progress of phthisis. So many contradictory statements have been published with regard to the comparative influence of increased or diminished atmospheric pressure on this disease, and such diverse methods of treatment have been founded upon the theories to which they have given birth, that we are glad to avail ourselves of the opportunity which M. Jourdanet's experience offers, for testing the operation of one of these two opposite agencies upon a more extended scale than the conditions of any European country will admit. In brief, the evidence of M. Jourdanet goes to show that pulmonary phthisis is excessively rare in Upper Mexico. In Puebla, where, as has been remarked, an admirable sanitary régime prevails, it is almost unknown, and in the city of Mexico, where it is less rare, it is almost exclusively confined to the lower classes, whose habits, diet, and dwellings peculiarly predispose them to its attacks. But the proof of the antagonistic influence which the climate exercises upon the development of the disease does not rest only upon the freedom from it which the native-born inhabitants enjoy. M. Jourdanet records numerous cases which have fallen under his own observation, and also brings the testimony of other medical men to show that strangers in whom phthisis has already decidedly established itself experience,

from the moment of taking up their residence on the plateau, an arrest of the affection, which, if not issuing in a restoration to perfect health, is at least very nearly equivalent to it. "I have the conviction," says M. Jourdanet, "which is shared by other worthy fellow-practitioners of mine, that the great majority of young persons in whom there is an hereditary predisposition to phthisis would escape the disease by a residence in Mexico." Without pronouncing positively as to the period during which it would be desirable to reside there before a return to the patient's native country could be considered safe, he inclines to the belief that a stay of three years is the shortest period which would be attended by any positive benefit.

Although we cannot endorse entirely the theory which M. Jourdanet proposes, as to the immunity from phthisis which these elevated regions enjoy being due to the imperfect oxydating properties of their atmosphere, we must admit that there is much to be said in its favour. There can be little doubt that whether the deposit of tubercle be in all, or even in the majority of cases, an inflammatory process or not, its maturation and disorganization are stages of its existence in which inflammation plays a very active part. That the non-stimulating properties of an atmosphere in which the proportion of oxygen is so notably diminished as in that of the plain of Mexico, should have considerable effect in checking the progress of these inflammatory processes is highly probable; but we are inclined to think that the dryness of the atmosphere, and the complete change in all the physical conditions of life which a phthisical patient arriving in these elevated plains from a low-lying locality would experience, must exercise no small influence in producing a general amelioration. At any rate, we can honestly say, that we know of no district, whether in the eastern or western hemisphere, which offers a better prospect of cure to the consumptive invalid than does Upper Mexico, if M. Jourdanet's statements are entitled to anything like a fair amount of credit, and we see no reason whatever for doubting them. The only drawback to putting them to a practical test is the unfortunate uncertainty both in respect of life and purse which at present prevails in that country. For a phthisical patient to be compelled to ride several hours in the coupé of a diligence on a sharp frosty night, in a state of nudity, to which the successive attacks of brigands had reduced him, as was the ill-luck of a recent traveller in these parts, would assuredly do more to expedite the termination of his malady than many months' residence there could do to arrest it. But whenever the long arm of a strong Government shall clear the roads of the banditti which now infests them, and render travelling even tolerably safe, we hope that the high claims which M. Jourdanet puts forward in behalf of the Mexican plateau, as a resort for those who are affected with phthisis, will have a speedy opportunity of being thoroughly investigated.

We had intended to refer to numerous other questions of interest which find a place in M. Jourdanet's pages, but we have already so exhausted the limits which we originally proposed to ourselves, that we cannot now do so. If the summary which we have given

of some of the more important portions of his work should lead them to invest in it for their own perusal, we can promise them that they will have little reason to regret it. Nor is it one of the least of M. Jourdanet's recommendations, that his volume is characterized by a terseness and elegance of style which has added much to the pleasure we have received in reading it.

REVIEW XI.

The Renewal of Life: Clinical Lectures Illustrative of a Restorative System of Medicine given at St. Mary's Hospital. By THOMAS K. CHAMBERS, M.D., F.R.C.P., Physician to St. Mary's Hospital, &c. -London, 1863. pp. 420.

THIS small octavo volume is assuredly a sign of the times. Twenty years ago, had it been conceivable, it would not have been conceived; had it been possible, it would never have happened. Had its author been a living fact, had the manuscript been revised and ready, the type would not have been forthcoming. The two introductory chapters would have insured its rejection by the publisher's reader. Of questionable shape and title, its "introduction" a metaphysical puzzle, its doctrine one of denial and denunciation, the Renewal of Life' would have scared the legitimate old world dealer in medical literature as a foreshadowing of chaos in the physic to come.

"Aliquid monstri alunt,-id quoniem nemine obstrude potest,

Itur ad me."

And in refusing the risk with the possible scandal of a book like this, the Churchill of 1840 would have been in his generation wise. But in the literature as in the practice of physic, there has been change since then, and ours is the gain. A clever, thoughtful book, such as that before us, however much out of rule with settled opinion, however defiant in tone, if only readable, is now-a-days safe to be read. In the philosophy of disease, solemnity of phrase is no longer a condition of sale and perusal. By the critic of published essay, lecture, or dissertation, count is held of the line and the letter as of the thought that goes with them. If the author's purpose be clear, earnest, and strong, it is expected that he shall take the trouble to make it known in words and sentences that match with his meaning and with each other. There is a fair range held free for illustration by analogy, an indulgence even for fancy, if it lend help to the facts; and the author is not liked the less for a casual impertinence of style or suggestion. Even in the narrative of cases the most complicated and serious, there may be a certain grace of arrangement with animation of style, and this without prejudice to their use by the working practitioner in the service of every-day reference.

The book before us, to begin with its outside, might be anybody's book, as it meets the eye on counter or library-table. On its plain stamped chocolate binding there is no register, by date of time or place,

of publication, no gilded blazon of the author's name: a small diagonal scroll alone is lettered with the mystic inscription of 'The Renewal of Life.' This contrived effect of announcement is novel, ingenious, sensational-successful it may have been; but is it professional? The Renewal of Life,' without phrase or condition! A challenge direct to the curiosity of all who live by their means and like to be alive. Who would not long, if only for a peep into the pages of a volume in which the great secret lies open for special and immediate use? Who would not take it home with him if he could? Renewal of Life! Words, if any, of awe and fascination! The world's one fixed wish, the mystery of all time to all inquirers in their widest range of thought, sentiment, or imagination! No wonder that the first edition passed away in two months of the autumn of 1862. And yet to many, the mystic and imaginative among its purchasers, what a vexed surprise, what aggravation of disappointment, when the leaves were opened, and they found themselves in presence of a "doctor's book." We confess to mirth and mischief more than is becoming, while mesmerist, spirit-rapper, electro-biologist, and other sectional mystics, gather round our fancy's lure, and, watching with closed eye, we send them fluttering into the decoy, where lurks the clinical professor of St. Mary's with physic at his side. To the illustrious and voluminous "strange story" teller, this titular equivocation must have seemed personal in its aim of annoyance. We looked for a dedication of this little volume to the ex-Secretary for the Colonies. Let him consider that by its endorsement of 'The Renewal of Life' the compliment is virtually paid.

There is, again we use the phrase-not ours alone-there is possible scandal to the profession in this the first page of a clever, useful, practical volume, by one of its most accomplished and responsible members. Already, and for some months past, in the rush of votaries to his shrine (the only one) of "restorative medicine," there must have been cause for painful misgiving to its presiding minister as to the nature of the impulse that brought them there. Life renewed under prescription by a "restoratist" physician from a "restoratist pharmacopoeia," and that physician not the administering patentee of an universal specific, but a London-hospital physician, a Court physician, and a Fellow of the Royal College of Physicians of all England! What a paradise of hope to the battered veteran of life's long struggle, to the languishing youth of both sexes, to the wrinkled jade of fashion, to the debauched elders of the mess-room and the London clubs! Who would consult with a practitioner of ordinary designation, a mere common-place M.D., or an M.R.C.P., when he might with our author exchange his guinea for the bonus of a "renovated existence"? With the cauldron of youth, even the fleece of gold! There are fees that smell. Again, as we turn the leaves in front of every page from preface to index, our password through the volume is no other than its title, The Renewal of Life.' Decidedly a scandal! We force it back upon the author-it has been unduly obtruded upon us. We tell him it is not safe to hold.

6

As guessed from its outside, this volume might have been a bundle of tracts for the Tabernacle. It is time for our readers to know that it is in truth an assortment of bedside teachings to the young gentlemen in attendance on the medical practice of Dr. Chambers in the wards of the Paddington Hospital. Of twenty-nine chapters enumerated in the list of contents, twenty-seven are strictly professional; well calculated in their present form of publication to bring credit to the physician whose practice they illustrate, and to the school at which, as clinical lectures, they were first made available to his pupils. They afford abundant and most gratifying proof of the variety and extent of remedial means which are placed at the disposal of the medical officers of our large London hospitals, as of the thoughtful care and refined humanity which he who knows how to use them can make known in their use. Baths, diet, nursing, bedding, medicines (in many cases of unusual character and cost), are employed by Dr. Chambers without hesitation or stint for the relief of all who may need them. So far it is well that his book is made light for the general reader, and that it is endorsed with a fanciful title. Allowance made for a certain affectation of manner, rather amiable than otherwise, and a somewhat feminine freedom of narrative, Dr. Chambers "reads well" as a clinical lecturer in the oral treatise before us. cases are well chosen and well told. They are sufficiently distinguished one from the other, and never overlay the principle which they are used to illustrate. He carefully inquires into the antecedents of each case, and considers it in all its symptoms and circumstances as a whole, providing, as far as in him lies, for all accidents, contingencies, and mixed results. Especially he individualizes his patients, and thus peoples his wards not merely with cases, but with men and women.

His

The ludicrous pretension of the title-page would have escaped much of the rebuke which it has encountered from the profession, had it not been followed by a preface and two introductory chapters conceived in the same spirit, and pitched on the same key. In October, 1862, Dr. Chambers proclaims a "system of therapeutics, which must daily become more and more the guide to practice, and which he makes bold to call Restorative."" The absolute "must," accordingly works its daily will, and is not many days about it. In December of the same year, its triumph already achieved by the early call for a second edition, it subsides, with complacent security, in a preface of two lines, into the "encouragement of a hope." Of the tone and manner in which the author addresses himself to his lofty self-imposed task, there is sample and to spare in the heading prefixed to the first "Introductory Chapter" :

66 THEORIES OF MEDICINE AT THE BEDSIDE.

'Necessity for a consistent theory of therapeutics-Examination of prevalent theories-Allopathy-Homœopathy-Evacuation-Counter-irritation— Stimulation, with tests of their applicability-Eclecticism and expectant medicine mere protests-The inherent error of these medical theories is the attributing a positive existence to disease-Disease truly a negation or deficiency of life-On this is grounded a proposal for a system of restorative medicine, and a consistent view of the aims of medical treatment."

63-XXXII.

7