"More frequently," he goes on to say, "it occurs in scrofulous families, that there are some affected in every generation, while others remain pure. The disease, or the tendency to disease, often descends indirectly and irregularly, occurring in uncles and aunts in one generation, and nephews and nieces in the succeeding. I should observe that Sir James Clark believes that the occurrence of scrofula in alternate generations will admit of explanation without supposing that the disease sleeps in one generation to re-appear in the succeeding. I be lieve this eminent physician considers these cases are explainable by the actual eradication of the disease in the generation in which it is absent, and its redevelopment when it appears in the following generation, by the agency of new causes. I submit, however, that there are sufficient reasons for the rejection of this latter doctrine. Such a kind of pathological atavism, or irregular development of disease, has always been so frequent, and so much a matter of common observation, as to be very generally believed. And further, we see the same thing happen with regard to physical organization. It frequently occurs that a child resembles one of its grandparents or an uncle or aunt, in growth, stature, temperament, and mental qualities, while it bears little likeness to its immediate progenitors." 13.

The weight of evidence and force of reasoning seem to us to be decidedly opposed to the opinions of the English Author, and in favour of those so strenuously advocated by M. Lugol. We cannot bring a clean thing out of an unclean; and how can the tree, that is corrupt, bring forth good fruit? So it is, most probably, in reference to the transmission of Scrofulawhich, be it always remembered, is not so much a disease as an unhealthy constitution or diathesis of the body. We are inclined, therefore, to agree with M. Lugol, that no thoroughly robust and healthy person is ever born of scrofulous parents: fortes creantur fortibus. As we have already said, the tendency to the development of the disease in the offspring is greater when the hereditary transmission is derived from the father, than when it is from the mother.

Treatment of Scrofulous Diseases.

It is certainly much rather by following out a judicious hygienic regimen than by the use of any direct medicinal agents, that we can hope to effect a salutary change in the constitution of scrofulous patients. M. Lugol does little more than merely allude, here and there, to the thera peutic part of his subject: his present work does not profess to embrace more than the etiology of the disease in question. He takes occasion, how. ever, in more than one passage, to reprobate with marked condemnation the common use of antiphlogistic and other lowering remedies in the maladies of scrofulous children, and the too-prevalent custom of localizing, in practice as well as in theory, the morbid action, without paying due attention to the general condition or diathesis of the system. He strongly enjoins free exposure to light and air in the treatment of most forms of the disease. "I have had frequent opportunities," says he, " of observing the bad effects of treating scrofulous Ophthalmia in dark chambers. It is not an uncommon remark with such patients, that they see better on those days when they are taken to the surgeon for advice." He then proceeds to point out the great importance of regular exercise, in the treatment even of White Swelling of the joints. "In my third memoir on the em ployment of Iodine, published in 1831, I dwelt at some length on the value No. 99.

18

of this mode of cure-viz. regular bodily exercise, (the patient walking, as a matter of course, on crutches,) along with the use, external and internal, of ioduretted preparations. Since that period, I have uniformly acted upon this principle; and the great success, that has attended my hospital practice, has been publicly testified by Professor Magendie and many others. .. Why is my practice not more generally followed? Simply because medical men persist in regarding this, and many other forms of scrofulous disease, as of a local nature, and not as the mere expressions of a constitutional Cachexy."

We must now turn to Dr. Smith, who enters much more largely into the subject of the treatment of Scrofula. We shall select a few mems, that may possibly amuse, as well as instruct, the reader.

He recommends the Solution of Gastric-juice or Pepsin-as it has of late years been called-not only as a stomachic remedy, but also as a tonic of great efficacy in many cases. He thinks it likely to come into general use: we much doubt it.

“I have,” says he, "been in the habit of giving the solution of pepsin about a quarter of an hour after every solid meal, giving a larger quantity after dinner than at any other time. There can be no doubt that it gives the stomach an additional digestive power; and besides increasing the general strength, I have seen it remove the gastrodynia, flatulence, and heat at the epigastrium, which is so common during digestion in delicate persons." 77.

With respect to iodine, Dr. Smith is adverse to the large doses in which it and its preparations are so often administered. He prefers giving them in minute doses, largely diluted, and upon an empty stomach.

"A drachm of the iodide of potassium, dissolved in an ounce of distilled water, and this solution given in doses of twelve or sixteen minims three times a day, in a tumbler of water, will bring the system under the effects of iodine in a few days. The peculiar determination to the mucous membrane of the nose, eyes, and fauces, will be established, the taste of iodine becomes perceptible in the mouth, and the odour of it in the increased mucous secretion. As another instance of the effects of still smaller doses of iodine in the prevention of disease, I may refer to a statement of Boussingault respecting the comparative frequency of goître among the inhabitants of different parts of the Cordilleras in South America. This chemist states that in certain districts, in which the population use salt impregnated with a very small quantity of iodine, the health of the inhabitants is good; while in others, where salt is used entirely destitute of iodine, goitrous diseases abound. Dr. John Davy, in referring to the above, says:— It is not improbable that the apparent increase of scrofulous and consumptive disease in recent times may be connected with the over-refinement of salt; that is, carried so far as to deprive it of its iodine principle, which seems intended by provident nature as a corrective of certain injurious causes productive of a terrible class of diseases."" 91.

But far more efficacious than Iodine, or any other medicinal or hygienic agent, is-can our readers guess ?-the royal touch.

"It is my intention," says our credulous author, "on the present occasion, to avow a firm belief in its power and efficacy. I cannot agree that a practice followed implicitly for the space of seven centuries in this country alone, besides its long performance in France, and which lived through our golden age of letters, could have been purely fictitious, and not have been demonstrated to be such beyond the power of appeal. Those who saw most of its operation were

the firmest of its supporters, and it frequently obtained the testimony of medical practitioners. Thus, Wiseman, serjeant-surgeon to Charles the First, a good authority in scrofula, as he himself practised in this disease, declared that the king cured more scrofulous patients than all the chirurgeons of London put together." 164.

Without recommending, in so many words, the re-adoption of the royal remedy, Dr. Smith wishes us, nevertheless, to believe that "no other mental remedy of equal efficacy was ever devised or practised; and certainly, as I believe, nothing of the kind can be resorted to at the present day which approaches it in power." What says he of the wonderful cures that have been and still are (so, at least, we are told, and that too in print) effected by the mere sight of holy relics, such as pieces of the true cross, bones of saints, the blood of our Saviour, and so forth? Are they not quite as authentic as any thing that has ever been recorded of his favourite mental remedy for Scrofula? It was only the other day that we read (in the Athenæum for Oct. 12th) of the marvellous cures that have been performed in the course of the present season, at Treves, by the mere exhibition of the real (as a matter of course) Holy tunic to the gaze of the poor ignorant beholders, who flocked in tens and hundreds of thousands to the shrine of the Cathedral of that city. The lame walked, the blind saw, and the dumb spake! Among the rest, the young Countess Jeanne of Munster, who had lost the use of her legs for upwards of three years, no sooner bent before the relic, and touched the sacred cloth, than her limbs were straightened, her figure became once more erect, and she quitted the Cathedral, leaving her crutches behind her in memory of her miraculous cure!! What will Dr. Smith say to this? Might not the display of such a precious piece of sanctity be still more effectual than even the touch of a royal hand? How far the re-institution of the regal prerogative, in the person of our gracious Queen and Governor, might serve to counteract the scrofulizing effects of the much abused new Poor Law, we must leave to Sir Robert Peel, or some other of our learned senators, to determine.

While this article was passing through the press, we received Dr. Ranking's translation of M. Lugol's Treatise. On the whole, it is well and ably executed; and the profession, we believe, will be pleased to have an English version of this somewhat remarkable work. We cannot, however, concur with Dr. Ranking, in his extravagant laudation of his author's researches" which," he declares to be," in extent of benefit conferred, and for advancement of rarely useful medical science, unequalled by the labours of any other individual in any other department of medicine." Few medical men will join in such an exaggerated statement, or agree with Dr. R. in many of his therapeutic rules and suggestions-which, as may be anticipated, are all based on the doctrines of the anti-scrofula physician of St. Louis' Hospital. In our opinion, the whole of the appended Essay on the treatment of the disease is vitiated by a most unwise over-estimate of the curative powers of Iodine and its preparations. For example, we are told that "the only system of treatment, which is really deserving of confidence (in scrofulous diseases of the bones and joints), is the internal and external employment of iodine, combined with such mechanical contrivances as shall enable the patient to be continually in the open air;" and Dr. R. assures us that "he has seen more than one patient, whom a

Lumbar Abscess was daily bringing nearer to the grave, gain appetite and flesh, and the discharge cease in less than a month from the time of commencing the medicine." He recommends, also, that scrofulous glandular abscesses should be opened by incision, as soon as fluctuation becomes distinct, and forthwith be injected with a solution of Iodine-a practice that few practical surgeons, we should think, will follow; even though it be followed by M. Lugol himself. In the treatment of Porrigo and the severer forms of Eczema and Impetigo, the internal use of the medicine is deemed almost indispensable; and in strumous Ophthalmia it constitutes, in Dr. Ranking's opinion, our sheet-anchor of hope ;-the Quinine, although a most valuable tonic, "having no special effect upon the tubercular constitution, and being therefore unable to prevent the liability to relapse." The Liquor Potassæ is regarded by him as equally defective in this point of view; the preparations of Steel are only incidentally mentioned; and the effects of warm clothing are scarcely so much as alluded to.

The only other topic that we can at present notice is the advice contained in the following passage:

"When, from the known peculiarities of the parents, an infant is suspected to be scrofulous, it should, unless the contamination be clearly confined to the father, be intrusted immediately to a wet-nurse. The mother ought not, in any case, to suckle her child, however well she may be prepared so to do, if she or her family exhibit the scrofulous diathesis." So unqualified a recommendation as this is surely most injudicious; and even were it not so, is it not obvious that it would be nearly impracticable? Where are the wet-nurses to be found for every child of every woman, in whom, or in whose family, there is a scrofulous taint? and what, pray, is to become of the nurses' own poor children deprived of their natural food, and thereby rendered subject to that very disease, which Dr. Ranking seeks, in rather a strange manner, to eradicate? Thank heaven, there is no occasion for the sweeping condemnation of suckling to so large a number of mothers, that is laid down in the paragraph which we have quoted. That scrofulous women should suckle their children less than those of a more robust constitution, we readily admit; but that they ought not, in any case, to do so at all, is an injunction that seems to us to be alike injudicious and unrequired.

MEDICAL REFORM.

I. ARTICLE ON MEDICAL REFORM IN QUARTERLY REVIEW. Volume Sixty-seven. 1841.

II. THE TOUCHSTONE OF MEDICAL REFORM. By Joseph Henry Green. 1841.

III. A STATEMENT BY THE SOCIETY OF APOTHECARIES.

1844.

IV. A BILL FOR THE BETTER REGULATION OF MEDICAL PRACTICE THROUGHOUT THE UNITED KINGDOM. 1844.

V. AN ADDRESS OF THE SOCIETY OF APOTHECARIES.

1844.

VI. A MANIFESTO BY THE MEDICAL AND SURGICAL ASSOCIATION OF THE BOROUGH OF MARylebone. 1844.

VII. A SPEECH DELIVERED AT DERBY. By Charles Hastings, M.D., President of the Council of the Provincial Medical and Surgical Association. 1844.

VIII. A LETTER FROM CHARLES CARTER, Esq., TO THE NORTH OF ENGLAND MEDICAL ASSOCIATION. 1844.

IX. AN EXPOSITION OF THE LAWS WHICH RELATE TO THE MEDICAL PROFESSION, with an ample Analysis of Sir James Graham's Bill. By John Davies. 1844.

X. SIR JAMES GRAHAM'S BILL REPUDIATED. By John Thomson, M.D.

1844.

A MOVEMENT in the medical world equal to the present has never been witnessed. It is no partial result of an objectless agitation, but the throe of a large and important body, wounded in its most vital parts. The vis inertia of the Profession has been overcome, and men are called out from that tranquillity and retirement which they love, and which in many instances they have well earned; for, it is to be observed, that the present opposition is joined in often times as keenly, although with more discrimination, by several senior practitioners whose prospects it can little affect, but who feel actuated by a laudable esprit de corps, as it is by those who have not long entered the Profession, and who believe their future prospects to be seriously menaced by the Bill. It is curious to observe the workings of the human mind throughout the thirty thousand medicos in this mighty empire, while agitating this question! A good many of the high aristocratic order, believing that their own pecuniary interest is but little concerned in the event, look on in apathy, and think little on the subject. Another good sprinkling of the Pures-medical and chirurgical, calculating on indirect gain, join in the cry against the project of the Home Secretary, in hopes of increased popularity. But the great body of GENERAL PRACTITIONERS, alarmed, and not without reason, that their income will be