it is the business of metamorphosis to keep up, any more than there can be too exact an obedience to law and order. "The most active metamorphosis of the body possible, the highest possible development of life in every part is HEALTH. "The complete cessation of metamorphosis is DEATH. "The partial cessation, or arrest, is DISEASE. "In death the flesh goes on being decomposed as during life; but not being renewed, the form is lost entirely. In disease, decomposition goes on, but renewal flags, and the decomposing tissues are not sufficiently pushed out by new-formed substance. They are retained as part of the imperfect body-a sort of "death in life "—and are rightly termed by the pathologist "degenerate." They are generated, but not re-generated; they are generated in an inferior mould of form. "Take as an example what happens sometimes to voluntary contractile fibre. We all know that if an animal's limbs are duly employed, the muscles keep up their shape and their vigorous power of contraction; their tissue is of a rich bright-red colour when the animal is fully grown, and is firm and elastic. Examine it under a microscope, and you will find it made up of even parallel fibres, each fibre seeming to be engraved over with delicate equidistant cross-markings, like a measuring-tape very minutely divided. The more the muscle has been used in a wellnourished frame, the more closely it conforms to the typical specimen of the physiologist : "Use, use is life; and he most truly lives Who uses best.' "But suppose this muscular fibre has been unworked-suppose it is in the biceps of an Indian fakeer, who has fastened his arm upright till it has become motionless, or in the gluteus of a soldier's amputated leg, or the calf of a Chinese belle, or in a paralyzed limb-then the flesh is different in aspect; it is flabby and inelastic, of a pale-yellowish hue, and makes greasy streaks on the knife that cuts it. Sometimes even all traces of fibres have disappeared, and it is converted into an unhealthy fat. Sometimes you may trace fibres under the microscope, but their outline is bulging and irregular, the cross-markings are wanted, and you see instead dark, refracting globules of oily matter in them. In short, the muscle is degenerating into fat, retaining in a great measure its shape, but losing its substance. Such is, by God's law, the penalty of not using His gifts for four or five months." There are four lectures on Fever. The author assumes the term typh-fever as indicative of any low continued fever. He insists on the great benefit of watching, nursing, and giving nourishment. His sys tem of treatment is simple and plain: a well ventilated apartment, tepid sponging, a regular and systematic supply of food, given in small quantities, and repeated every two hours night and day, with an alternate dose of hydrochloric acid, which, given with sugar, affords a grateful, pleasant drink, and at the same time supplies a want which exists in the system: "You have been taught in the systematic course on medical pathology, that ammonia, which is always being formed and given off from the animal body, is found much more abundant in certain conditions than in others, and that these conditions are those in which nutritive metamorphosis or growth was deficient as compared with destructive metamorphosis, or those in which there is retention in the blood of the products of that destructive metamorphosis. Thus, more ammonia is found in the breath after toil than after rest; more than usual in those who hurt their digestion by smoking tobacco; a great deal in uræmia, where the urea cannot escape by the kidneys; but above all in typh-fever is this exhalation of decay noticeable, as you will find in Dr. Richardson's valuable work on the coagulation of the blood, where the phrase 'super-alkalinity of the blood' is applied to this condition. Dr. Richardson goes so far as to attribute to this super-alkalinity the special typhoid symptoms, and to suggest that the absorption of ammonia in excess may intensify fever in those who contract it from exposure to decaying organic matter, or human exhalations. He supports his hypothesis on the experiment of inducing the symptoms, or something resem bling them, by the injection of ammonia into the veins of an animal. The word 'super-alkalinity' is expressive, and quite unobjectionable, so long as it is understood that the superabundance is not absolute but comparative. For it is not shown that there is more alkali in the body than there is acid to neutralize. 'Sub-acidity' would be a synonymous term, and would be more suggestive of the means we have at our disposal for remedying the defect. "Very difficult indeed would it be for the eliminator to get this alkali out, but it is easy for the restorist to get acid in. The acid I have always given is hydrochloric." We give below the results of Dr. Chambers' treatment, which are very flattering. In the first table will be found those treated on general principles during the first six years from 1851 to 1857; the second table contains those treated by diet and hydrochloric acid, in the six subsequent years. Richardson on the "Cause of the Coagulation of the Blood," Appendix I. Edit. 1858.) "Each series is very nearly continuous; all the first-named 109 (with five purely accidental exceptions*), occurred in the six years before September, 1857, and all the latter 121 in the six years since. No fallacy can, therefore, arise from a selection for special treatment having been made intentionally or unintentionally. They are spread over a considerable number of years; thus both sets include sporadic cases, as well as the produce of epedemics. "The only opening for error that I can discern is the bare possibility of a change of type in fevers having taken place at the very time when I changed the treatment, and of its having lasted for six years-possibilities which the records of other metropolitan hospitals during the same period reduce to nothing. "That the severity of the disease in the two classes differed but little may be shown by the near equality of the periods of convalescence. The mean time of stay in the hospital of the sick who recovered was, in the first series, 29-2 days; in the second, 26-7 days; being a difference of but 2 days. The ages, also, of the two series differed but little, the mean age of each being between 22 and 23 years. These averages are cited merely to show the general similarity of the two series, and not to demonstrate any pathological fact. Of the first series (viz., those treated on general principles), 9 are entered as Typhus, and of these there died 4 0 2 25 are entered as Typhus, and of these there died Of doubtful or unrecorded type 2 Total 4 "For purposes of comparison in a therapeutical inquiry, it will probably be considered right to exclude from the first table two deaths, and from the second table one death, which occurred within two days of admission; "Three of these exceptions were treated on general principles by a colleague taking my duty during my absence, and unaware of the experiment I was trying; in one case I made a wrong diagnosis, having mistaken typh-fever for acute hydrocephalus, and treated it with iodide of potassium till too late; of the fifth I have no record, the patient having died within two days, and the clerk's notes being imperfect, except to the fact of its being a case of fever. for the exhaustion caused by the journey to the hospital in severe fevers allows but little scope for judging of the action of treatment during that period. This leaves the average mortality under general treatment 21 in 10719 per cent., or nearly 1 in 5;* under the second method of treatment, by continuous nutriment and hydrochloric acid, 3 in 121= 21 per cent., or only 1 in 40. I cannot, therefore, avoid the conclusion that the means employed in the cases on the second list are very efficient in preserving life; and that out of every 100 persons attacked by continued fever, from 16 to 17 more may be saved thus than by treating them on general principles." We have given considerable space to the consideration of this allabsorbing subject, and therefore cannot extend our notice further than by recommending Dr. Chambers' book freely and with confidence to our professional brethren, as the work of a great mind, practical in its bearing, and simple to the understanding of all. Materia Medica for the use of Students. By John B. Biddle, M.D., Professor of Materia Medica in the Jefferson Medical College. Philadelphia: Lindsay & Blakiston. Montreal: Dawson Brothers. This work is written in a peculiarly plain, and practical manner, so that its contents may be easily mastered by a junior student. Brevity seems to have been an axiom of our author, for throughout his volume he describes everything in the fewest possible words. This we would rather commend, than condemn, for as a rule authors err the other way. But we cannot help thinking there are some articles of the Materia Medica so important that a little more space might have been devoted to their examination. We mention as such, opium, belladonna, chloroform. Dr. Biddle divides the articles of the Materia Medica according to their effect upon the system, such as Tonics, Narcotics, Anti-spasmodics, &c. Altogether we consider the volume a very valuable one, and although we could not advise a student to make it his text book in preference to such works as Pareira, Christison, Wood and Bache, yet we feel that it will be of great use as a book of reference to him during his close attendance upon lectures, or to a practitioner closely following the general practice of his profession. The work has many illustrations, and is got up in the usual substantial style of all the works issued by Lindsay & Blakiston. This mortality is higher than is usual at special fever hospitals, being about the same as at the other general hospitals in London. PERISCOPIC DEPARTMENT. Medicine. ON THE FUNCTIONS OF THE CEREBELLUM. BY DR. DICKINSON. This paper was founded partly upon experiments made on a great variety of animals, chiefly of the lower order, and partly upon observations on human pathology. There were tables before the meeting, which gave the details both of the experiments and the cases. In the experimental part of the inquiry two classes of observations were made. The first consisted in a comparison between two similar animals, in one of which the cerebrum and cerebellum had been removed, in the other the cerebrum alone-so that the only difference between them was in the possession of the cerebellum. The powers which one animal had more than the other were believed to represent the functions of the organ. The general results were as follow: 1. The addition of the cerebellum to the medulla oblongata gives an increase of voluntary motive power in the four limbs-to the posterior in a greater degree than to the anterior. The power thus obtained is distributed in such a way as to produce even and balanced movements, and often appears to be exercised in a continuous and automatic manner. ment. 2. The removal of the cerebellum has an effect upon the muscles of the limbs, which increases in proportion as the organ increases in size. It consists in a diminution of voluntary power and of muscular adjustWhen an inequality of effect can be noticed the loss is greater in the posterior limbs. There is a loss of habitual activity. From the effect of lateral injuries it must be assumed that each lateral half of the organ has an influence on both sides of the body, but to a greater extent upon that opposite to itself. 3. The removal of the cerebellum has no effect upon superficial sensation, on any special sense, on the action of the involuntarily muscles, nor on reflex movements. 4. In the human being it appears there is no constant effect from loss or alteration of the cerebellum, but failure of voluntary muscular power. Disease, or deficiency of the whole organ, invariably lessens voluntary power in the limbs, especially in the lower. The loss of one lobe produces its effect more on the opposite side than on its own. Disease confined to the cerebellum has no effect upon superficial sensation, on the intellectual powers, nor on the action of muscles supplied by the cranial nerves. Hence it appears |