complied with, there will be the less necessity for forcing the bowels with medicine.

“When iron is adapted to the case, the good effects are first observed, in the decline of the dyspeptic feelings: the calls of appetite become more frequent; the food digests with more ease, and acidity and flatulence cease to be painful. At this time the colour of the face improves, and grows florid; and the skin, from being sallow and dry, becomes better coloured, soft, and perspirable; the alvine fæces are commonly tinged during the use of iron. With these changes, strength of body and alacrity of mind soon appear. In delicate females, some weakening sexual symptoms quickly decline.

"The indisputable good effects, which have so often resulted from a trial of Bath waters, in many varieties of these diseases, render it almost certain, that these have been produced by the ferruginous principle which they possess; but which is only effectual at the fountain, as it soon precipitates, and cannot be preserved. As we perceive this metal, when artificially ma naged, to effect surprising changes in the animal economy, it is but fair to allow, that much more may be expected from the fine chemistry of nature. It is in vain to deny this, because the Bath water contains an extremely minute portion of iron, discovered on analysis: the effect must rest on the activity of the ingredient, whether in the state of oxide or not, not on its quantity. The sensible qualities of the water, when drank on the spot, are highly ferruginous; and the stimulant power is so perceptible, that in some habits of body, it is dangerous; inducing temporary fever and vertigo, and in some instances apoplexy. The torpid habit is, therefore, most relieved by them; persons worn down by the diseases and excesses of tropical climates, and those debilitated by luxurious and hard living at home. The regular hours, correct manners, and elegant pleasures of the company at this fashionable place of resort, become the best antidotes in life against licentious drunkenness: no wonder then the enervated debauchee should return healthy, and sometimes reformed, from a course of Bath waters. But when nervous, bilious, and dyspeptick complaints. depend, as they often do, on a gouty diathesis, Bath waters are a sovereign remedy. The energy which they quickly impart to the chylopoietick organs, is soon extended over the whole frame; and all those anomalous symptoms, usually called flying gout, seem to rally to a point, and cease when the affection comes to be fixed in the extremities. I am thus induc

ed to mention these salutary springs, under the method of treatment."

In general, the scope of the practical part of this popular work is to recommend, by precept and example, temperance and exercise to all persons of a nervous temperament, directing the attention of the physician and the patient to a due attention to the affections of the mind, no less than to those of the body. As the work is written in an agreeable manner, devoid of technical expressions, we think it well calculated for attaining its object. It may be especially useful to those who, though not of the profession, are fond of dipping into medical books, and they are very generally persons of the nervous tem perament.

A Treatise on the Process employed by Nature in suppressing the Hemorrhage from divided and punctured Arteries; and on the Use of the Ligature; concluding with Observations on secondary Hemorrhage: the whole deduced from an extensive Series of Experiments, and illustrated by fifteen Plates. By J. F. D. JONES, M. D. Member of the Royal College of Surgeons of London. 8vo. pp. 237. London. R. Philips. 1805.

THIS work, notwithstanding the length of time it has been printed, and the celebrity it has acquired in Great-Britain, is little known in this country. We should have noticed it in our first number, but could not procure a copy sufficiently early, notwithstanding all our endeavours for that purpose; we will now gratify our readers with an abstract of the important information it contains.

The author states, in the advertisement prefixed to the work, that though small, it is the fruit of much labour and expense. Of this we have no doubt, as he has completely verified by ex

periment every fact which he states, and every conclusion which he draws. Our limits preclude our laying his experiments before our readers; we can state the results only, referring those who wish to peruse the former to the work itself.

In the first chapter the author treats "of the process which nature employs for suppressing the hemorrhage from divided arteries." In the first place he gives the following sketch of the various hypotheses which have prevailed upon this subject.

"Mr. Petit conceived that hemorrhage, from a divided artery, is stopped by the formation of a coagulum or clot of blood,* which lies partly within and partly without the vessel. The external portion is formed, he thought, by the last drops of blood which issue from it; the internal portion, by the blood contained just within its divided extremity; the former he called the Couvercle;' the latter, the Bouchon.' The clot, he said, afterwards adheres to the internal coat of the vessel, to its orifice, and to the surrounding parts. To this he added, that when hemorrhage is stopped by the application of a ligature, a clot is formed above the ligature; and the coagula, under these different circumstances, differ only in figure. This view of the subject led him to recommend compression to support the clot, that it may not be pushed away by the impulse of the blood."

"In the year 1736 Mr. Morand published a Memoir, in which he added many very interesting remarks to those which had been made by Mr. Petit. He admitted that the formation of a coagulum had some effect in stopping hemorrhage; but contended that the changes which the artery undergoes also contributes to that effect. These changes he described to be a sort of corrugation or plaiting of the circular fibres of the artery, by which its canal is diminished; and a shortening and consequent thickening of its longitudinal fibres, so as nearly to fill it up: this latter effect he conceived to be produced, when an artery is completely divided, and that it constitutes the principal means by which, in such cases, the hemorrhage is stopped. He added, that the corrugation, or puckering of an artery may take place, so as to obliterate its cavity, provided pressure be made round it; as by a ligature."

"Mr. Sharp, nearly at the same period, supported the same doctrine, as may be found in the second edition of his Opera

*"Caillot de Sang."

tions of Surgery, published in 1739. It is more concisely and better expressed than Morand's; thus: 'The blood-vessels, immediately upon their division, bleed freely, and continue bleeding till they are either stopped by art, or at length contracting and withdrawing themselves into the wound, their extremities are shut up by the coagulated blood.'-This doctrine Mr. Sharp gives incidentally; leaving it unsupported by experiment or observation; so that it does not appear whether it is his own, or borrowed from another. It is not comprehensive enough; but, as far as it goes, it accords with the truth.

"The next theory which I am to notice is Mr. Pouteau's. It is prefaced with many very judicious observations, peculiarly applicable to the subject; and from which one might have expected that he had completely exhausted it, and had left nothing for future inquirers to discover or confirm. Le desir si louable de découvrir le vrai, doit être dirigé dans sa marche par un grand nombre d'experiences: pour se persuader qu'on a bien vu, il convient d'avoir regardé long tems et sous differents points de vûe."*

"Mr. Pouteau denied that a coagulum is always to be found after the division of an artery; and when it is, he thought it should be considered only as a feeble and subsidiary means towards the suppression of hemorrhage. The retraction of the artery, he said, has not been demonstrated; and that, at any rate, it is not more effectual than the coagulum. He asserted, that the tumefaction of the cellular membrane, at the circumference of the cut-extremity of the artery, forms the principal impediment to the flow of blood; and the application of a ligature to an artery is useful, by promoting a more immediate and extensive induration of the cellular substance."

"Mr. Gooch, Mr. White, and Mr. Aikin, considered the experiments and observations of Mr. Kirkland quite conclusive in confuting the doctrine of a coagulum, and in establishing the contraction of the arteries as the means which nature employs in the stoppage of hemorrhage from divided arteries. In justice, therefore, to the subject, and to Mr. Kirkland, I shall extract some of the most important of those observations on arteries which he had the opportunity of making.

“Mr. Kirkland, considering that, when the impulse of the blood is abated by the swooning of the patient, it is very common for considerable arteries to be closed by their natural contraction; and convinced by experiment,' that the close contrac

* "Melanges de Chirurgie."

tion observed in arteries to which agaric has been applied, is owing to the firm adhesion of the agaric to the artery, by which its mouth is shut, was led to determine the effect of a temporary pressure sufficient to stop the flow of blood from an artery. The conclusions and opinions drawn from his experiments are here gathered, and brought into one point of view, viz.

"That hemorrhage from a very considerable artery is easily and effectually suppressed by only making a perpendicular pressure upon the end of the vessel for a few minutes.

"That the pulsation, at first, is very plainly seen at its extremity; but after some time it becomes less perceptible.

"That the bleeding is not suppressed by congealed blood, but by the vessel being quite close contracted for near an inch or more from its extremity: that by removing the pressure from time to time, it is easy to discover this contraction taking place by a gradual decrease of the stream of blood.

"That the artery collapses and gradually closes itself up to the nearest lateral branches, as the resistance towards the ligature abates from the blood passing through those vessels. It appeared to Mr. Kirkland even self-evident, that nature always took this step to suppress the hemorrhage from divided arteries, upon reflection, that the same circumstance constantly happens when the umbilical vessels are divided at the birth of the fœtus.

"That the impulse against the end of the artery immediately becomes less, and soon entirely ceases from the blood, upon meeting with resistance, dilating and passing through the nearest lateral branches; and this he thought evident from the gradual decrease, and, at length, the total disappearance of pulsation.

"That the contraction of the artery, and the alteration in the course of the blood is not long in taking place; after which it probably, like the umbilical vessels, shrinks into a perfect cord, and becomes impervious.

"That intercepting the passage of the blood for a while is all that is required from art."

"The last theory which I have to notice, is that lately published by Mr. J. Bell, who, after freely criticising those which I have already mentioned, confidently asserts, that, when hemorrhage stops of its own accord, it is neither from the retraction of an artery, nor the constriction of its fibres, nor the formation of clots, but by the cellular substance which surrounds the artery being injected with blood.' It is to be regretted,