ounces of infusion of Senna, given as frequently. Compound powder of jalap may also be used in teaspoonful doses every hour, in syrup. Rochelle and epsom salts, &c., are quite available in many instances.

Probably a part of each dose of any of these medicines will be retained, although vomiting continues. The quiescent condition of the stomach, immediately succeeding the act of vomiting, is the best time to give the medicine. By persevering in giving the medicine, notwithstanding the rejection of the most of it, changing from one of the above mentioned articles to another as the patient becomes tired of any one of them, we may, generally, in the course of twenty-four hours-sometimes sooner, sometimes a little later-procure free purgation of fluid fæces, when our patient will be much relieved. Conjointly with the administration of medicines per orem, we may introduce them per anum. After we have made some peristaltic impression on the bowels, and not before, I think, will it be worth while to trouble the patient with injections. Judging from my own experience, we need not commence them in less than twelve or eighteen hours after we begin with the cathartics. Much the most effectual way of using them is to pump through a tube a large quantity of warm water high up in the colon; say from a half to a gallon at a time, with epsom salts dissolved in it, or oil floating on it. One of these injections, well-timed, will shorten the duration of suffering many hours, in the most of cases. It will be seen that the purgatives recommended are hydrogogues, such as induce serious infusion from the intestinal tube. This, I think, is a subject of no small importance, as they operate with more facility, and relieve by furnishing the fluid in which to suspend the dry, hardened fæces, and thus provide for their easy expulsion.

Many practitioners rely on the salts of opium to allay the irritation of the stomach before they commence the purgative plan. But, although I have used them, I do not now-and, when I did, have in every instance regretted having done sofrom the fact that they have failed to have the effect, in the most of cases, and always rendered the bowels difficult to move. Yielding to the appetite for strong drink, some practitioners— among whom I may mention my friend Dr. DeBruler, for whose opinion I have the greatest respect-allow whisky, wine, or brandy, ad libitum, at the same time they give the saline cathartics; epsom salts and whisky being, as they say, all that are necessary to the cure. Others rely upon large and frequently repeated doses of calomel, because less easily rejected from the stomach, while it effectually operates upon the bowels.

But the bad effects of a protracted salivation, which I have seen follow this plan, and sometimes even worse effects, have deterred me from using this mineral with such freedom. An ingenious and (according to Dr. Bacon, its originator) highly efficacious method of treating the early stages of this disease, is to administer large boluses of blue mass-so large that they cannot be ejected on account of the weight and size. One every half hour or every hour until free discharges are procured. And if there is more than ordinary delay in their action, the Doctor punches a hole in the centre of the boluses, introduces a drop of croton oil. Dr. B. tells me he does not fail to get free evacuations in less than twenty-four hours by this plan. Antacids, though apparently indicated, are of little use until after evacuations have been produced, when they are grateful, and help relieve the burning in the stomach. In the subsequent management, the bowels he kept free by medicines which produce thick and consistent operations. A pill, of equal parts of rhubarb, aloes, and capsicum, is one that answers the purpose very well. If the liver should fail to act with the bowels, a little blue mass is all that I have found necessary. It is often the case that the stomach does not regain its vigor for some time, and will need some aid from the bitter infusions, quinine or some of the ferruginous preparations. Ordinarily, the above treatment will be sufficient to conduct the patient through a simple attack to a speedy recovery. But, in grave cases, and where they have not been treated early, it is often otherwise. When the bowels begin to move, although the stomach is somewhat relieved, the distress in a great measure continues, there is tenderness on pressure over the epigastric region, and inflammation as the result of intense or protracted irritation. Under these circumstances, mucilaginous drinks, cooled with ice-water, and a blister over the stomach, will assist very much in the case. It is always best in these cases, as far as practicable, to keep the bowels open by injections, instead of using cathartics by the mouth. In another set of cases there is great debility, indicating the use of stimulants. The carb. of ammonia will often give great relief; but egg-nog, brandy, and sul. ether often become necessary, and should be freely used with animal broth, &c. We may support the circulation, too, by blisters to the extremities, when these are cold. In the inflammatory form, while attending to the treatment essential to the simple form, it will also be necessary to take blood to an extent sufficient to subdue arterial reaction or inflammatory complications, being guided by the general principles governing this condition in other circumstances, strong pulse, heat of the

surface, &c. Much activity and energy and treatment are the only conditions of success in the congestive form.

Injections into the bowels, of warm water, and, in the more algid and prostrate cases, brandy and turpentine should be added. To injections into the colon of the size and character above mentioned, put two ounces of the oil of turpentine and the same quantity of brandy. At the same time, friction of hot oil of turpentine to the extremities, or large sinapisms, if the coldness and prostration be great, may be applied so as almost to cover up the legs and arms with them. If these are not at hand, or in conjunction with them, hot bottles of water, the steam bath, hot bricks, or irons, applied all around the limbs and body of the patient, will aid materially in giving energy to the almost overwhelmed functions. Internally, it will be well to make warm whisky or brandy toddy the vehicle for the administration f the purgative medicines so necessary in the treatment. Should we succeed in bringing about re-action, and reducing, by external and internal stimulants, the case to either the simple or inflammatory form, the treatment must be conducted in the manner described above, It is not uncommon, in cases of this kind, for the head, chest and abdomen all to be preternaturally warm, while the extremities are cold. In such, internal stimulants are not well borne. The external, however, may be used as above directed, while cold water and ice will advantageously succor us, when applied to the trunk and head. As palliatives during the progress of disease, soda, lime water, chalk, &c., when they can be used without interfering with the more necessrry remedies, will be very agreeable. Yeast is also said to be very grateful to the patient, and useful in allaying vomiting. This was a favorite remedy with the late Dr. Traf ton, of this place, who attributed effective curative virtues to it. It is but a just tribute to the memory of the late Dr. Wm. Trafton, to say that more is due to him for the successful management of mik-sickness, than any other man in this part of our State.-Nashville Journal of Medicine.

BOOK NOTICES.

An Introduction to Practical Pharmacy: Designed as a TextBook for the Student, and as a guide to the Physician and Pharmaceutist, with many Formulas and Prescriptions. By EDWARD PARRISH, graduate in Pharmacy, &c., &c.; with two hundred and forty-three illustrations. Philadelphia: Blanchard & Lea.

We are glad to receive this excellent work. It will supply a want long felt by the profession, and especially by the student of Pharmacy. A large majority of physicians are obliged to compound their own medicines, and to them a work of this kind is almost indispensible.

The volume is divided into parts, the contents of which will be understood from the following extract from the preface:

"In part I. are grouped several chapters of a preliminary character, among which, metrology, including weights and measures, and specific gravity, holds a prominent place; it is treated with an effort at simplicity, which should attract the student to its careful study.

Galenical Pharmacy occupies Part II.; the mode of preparing each of the various classes of permanent vegetable preparations prefaces a tabular statement of the relative strength, doses, and relative properties of the individual members.

This compact form of displaying the leading facts of the subject will be observed as a conspicuous feature of the work, and is designed to adapt it particularly to the use of the student. For making the officinal preparations, distinct and definite formulas are omitted, being given in the Pharmacopoeia, which, as now published in a cheap form, it is presumed every physician and apothecary will possess and use. Unofficinal preparations are treated of more in detail, and hence occupy relatively a larger space. The order in which the preparations are introduced, is that which experience in the School of Practical Pharmacy' has indicated as best for the student; those most easily prepared are first treated of, and by gradations the more complex are brought forward; the whole arrangement of Galenical preparations being thus founded primarily upon the several processes of pulverization, solution, maceration, displacement, evaporation, and distillation, and secondarily upon the menstrua used in making them, their medical properties and

uses.

Part III. is devoted to the classification of plants, giving in extensive syllabi almost all the leading articles of the materia medica, arranged on the basis of chemical composition.

The vague and uncertain analysis of many plants, and parts of plants, and our ignorance in regard to the real composition of many of their active principles, takes from this part of the work much of the value it would otherwise possess. Advantage is taken of these headings to introduce a variety of secondary organic products of great interest and importance, among which are the entire class of vegetable acids and alkaloids.

In part IV. the essential facts in regard to the inorganic medicines are briefly stated, and shown also in syllabi.

Part V. contains practical directions for prescribing, selecting, combining and dispensing medicines, illustrated by a considerable number of formulas or prescriptions variously written in Latih and English, abbreviated and unabbreviated. The attention of physicians is asked to this part of the work as showing many of the best modes of prescribing many of the more important drugs; it will be observed that in the selection of prescriptions for publication in this connection, I have availed myself of the skill of numerous practitioners of medicine, some of whom are well known, besides introducing many standard extemporaneous preparations which the physician often finds occasion to prescribe, and the pharmaceutist to prepare and dispense.

The work is certainly a very valuable addition to our professional literature, and we commend it to the favorable consideration of both physicians and students.

For sale by Keen & Lee.

J.

Clinical Lectures on Surgery: By M. NELATON, from notes taken by Walter F. Atlee, M. D. Philadelphia: J. B. Lippincott & Co., 1855.

As an exponent of the practice of M. Nelaton, this work will be read with interest by the Profession in this country. The notes were taken during the years 1851-52-53-54-and may be regarded as a fair expose of Prisian surgery, at least so far as it goes.

We have marked a few passages. M. Nelaton treats fractures of the patella by applying bandages soaked in plaster, taking care that the parts are previously in apposition, and retaining them there by pressure till the plaster hardens. In a case reported, bony union was believed to have taken place.

In a case of ununited fracture of the humerus, of four years standing, we find the following remarks of M. Nelaton, together with his treatment and its results:

"A great number of means have been proposed for the purpose of curing false joints. Here, it was plain that the simple application of an apparatus to keep the parts at rest would not be sufficient. The ancient method, employed by Celsus, was to rub the fragments roughly, one against the other; but this is