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tended eight hundred and ten labours, of which one (theseventh) was a triplet case, and seven were twin cases, one inone hundred and fifteen. I have no record of the smallnumber of times Dr. Jarvis used the forceps, or the vectis, orhad recourse to turning; but it is certain that he never lostbut one midwifery case, a Mrs. C-, from haemorrhage, onthe 12th of June, 1815, the day after her delivery.From the lst of January, 1816, to the 1st of January, 1849,

(thirty-three years,) in conjunction with Dr. Jarvis to the lstof January, 1827, and with the aid of a visiting assistant fromthat day, fourteen hundred and eighty-four labours were at-tended in my own practice, of which thirteen were twin cases,(one in one hundred and fourteen,) three were forceps cases, ’,two were vectis cases, and nine were turning cases, one ofwhich, a Mrs. B-, died from haemorrhage on the 21st ofJuly, 1819, two hours after her delivery. This is the onlymidwifery case I have ever lost.

Thus, from the 1st of January, 1788, to the 1st of January,1849, (sixty-one years,) 2294 women have been delivered (withonly two deaths) of 2316 children, (males, 1195; females, 1121;)and thus of the last 1484 labours, three, and three only, re-quired the use of the forceps, being rather less than one infour hundred and ninety-four.

Margate, Jan. 1849.

Reviews.

A Practical Treatise on the Domestic Management and mostimportant Diseases of Advanced Life. With an Appendix.By GEORGE E. DAY, M.D., Fellow of the Royal College ofPhysicians, and Physician to the Western General Dis-pensary. London: T. & W. Boone, 29, New Bond-street.1849. 8vo. pp. 342.

THE special peculiarities incidental to the maladies of infancy- and childhood sufficiently justify the distinctions which havebeen made by writers and practitioners in their discussionand treatment of these diseases. Science has profited thereby,for this judicious discrimination has shown in the powerfulinfluence of age sources of change and modification, which, inthe absence of such recognition, would have tended to createdoubt and embarrassment when similar diseases, occurring inmore advanced life, became the subjects of observation andtreatment. But if diseases are modified by the peculiaritiesincidental to early life, most assuredly they cannot be un-affected by those incidental to old age. If special physicalconformations, accompanied by the energetic operation ofthe organic functions present in infancy and childhood, impressthe diseases which affect the young with their specialities,certainly the not less modified conformations of old age, with itsdeclining or impaired processes of organization, cannot be with-out their peculiar operation on the diseases of the aged. And

yet, to see the numerous and elaborate treatises which we pos.sess on the one subject, and the almost total absence of writteninformation on the other, one would have supposed that thediseases of old age were considered unimportant, or, at least,so similar to those of antecedent periods that they needed nota special consideration. A review of English writers on thesubject impresses this feeling even more strongly on the mindthan does a similar examination of continental medicalliterature. Whilst we there find many monographs on parti-cular subjects, we have also some general standard works bothin French and German, the best of which is, probably, that oiCanstatt, published at Erlangen in 1839. In England, exceptan essay by Sir A. Carlisle, a chapter by Dr. Holland, and thearticles in the cyclopaedias and in the dictionary of Dr. Coplandwe hardly know of any treatise on the diseases of old ageThere is therefore room and ample space for a work like thatbefore us-and well, as timely, does it seem to occupy thaiplace. Pressed as we are by the numerous works sent fortlat this season, and anxious to do to all the justice of noticingthem, we cannot, however, enter as fully as we should wish t(have done on analysis of the contents of this volume. It contains much that is useful and instructive, and affords abundanmaterials for estimating the great attention with which theauthor has pursued his undertaking. Having carefully peruse(

it, we shall make some general observations on n, few of the

passages which have especially attracted our attention.Dr. Day classifies under the following heads his observations

on the changes produced by age in the structure and functionsof - First, the respiratory organs; secondly, the nervous

system; thirdly, the digestive organs; fourthly, the organsof circulation. Under one of these headings we find the fol-lowing practical and judicious observation:-

" In connexion with the functions of the nervous system, Iwould especially direct attention to a point which I believeto be of the highest importance in its bearings on the treat-ment of the diseases of old age-namely, to what we may termthe insulation qf the different organs. The bond of nervoussympathy, uniting the different organs into one living whole,seems weakened, and in some cases almost snapped asunder.In infancy, from the general sensibility of the system at large,a single lesion will give rise to numerous symptoms. In old

age, the symptoms are usually more confined to the morbidorgan, and even there they are often masked and obscure. Alung may be perfectly impermeable, or may even be entirelydisorganized, yet the heart may afford no indication, either by

its force or its frequency, that one of the most essential of thevital functions is fast ceasing."-pp. 16, 17.Hence the necessity of a careful examination of all organs

when any obscurity or doubt exists.The frequency of the pulse in the aged gives rise to an

observation not in accordance with the generally receivedopinion, which is, that it becomes slower as life advances." Physiologists seem to have considered it as an established

fact that the frequency of the heart’s action diminishes in ad-vanced life. This is a great and dangerous error; I find fromthe data afforded by 562 healthy women, whose mean age isseventy-three years, that the average number of pulsations isa fraction above seventy-nine in a minute; and that the ave-rage pulse of 197 healthy men of the mean age of sixty-eightyears is 72.5. Although the pulse is thus as a general ruleabove instead of below the pulse in adult life, we not unfre-quently meet with cases of very slow pulse in old age. Theseare, however, exceptional cases."-pp. 20, 21.As in middle life there is much variety in the frequency of

the pulsations of the heart in different individuals, so wesuspect that it will be found in the aged. The subject is onewell deserving further investigation. Passing over chapterswhich treat on the preservation of health in declining life, onthe medical treatment of advanced life, on climacteric disease,on senile marasmus, on the diseases most fatal to persons inadvanced life, we come to those chapters which refer to thespecial diseases included in that last enumerated. Theauthor gives a table, founded on the reports of the registrar-general, of the causes which were registered as producingdeath in a thousand persons above the age of sixty. At thehead of this list (next to old age per se) he finds diseases ofthe respiratory organs-bronchitis, asthma, consumption, pneu-monia, &c., placed in this order of frequency of occurrence. Dr.Day believes that pneumonia should take the first place. Heis led to this conclusion from the perusal of a memoir pub-lished by Prus, which is intended to show, that of 390 personsdying between the sixtieth and ninetieth year of age, 149 diedof diseases of the respiratory organs, and of these 149, seventy-seven died of pneumonia, eighteen of consumption, ten ofasthma, eight of bronchitis, the series being completed byother diseases. Dr. Day then believes that pneumonia is veryfrequently overlooked, both during life and after death, in theaged. He discusses the causes, progress, symptoms, andtreatment of the disease in a very satisfactory and instructivemanner, going in the same manner through the diseases ofthe various other systems, including, also, those of the urinaryand generative systems; he devotes a chapter each to thetreatment of skin diseases, ulcers of the leg, senile gangrene,gout., and rheumatism, and concludes with an appendix on thesubject of treating neuralgia, lumbago, paralysis, &c., by the"thermic plan," or, as it has been called, "firing"—that is,

. the momentary application of a warm or hot iron to the partaffected. ’With this practice the readers of THE LANCET wereL originally made familiar by a quotation from Dr. Corrigan’s

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observations on the subject, (vol. i. 1846, p. 497,) and somecases successfully treated by this plan were published in thesucceeding volume. Dr. Day has improved the mode of appli-cation, and gives the reports of several cases, which justifythe warm recommendation with which he advocates the prac-tice. Of the materials thus briefly set forth does the volumeon the Diseases of Old Age consist, and, as we have already

said, very useful and valuable is the information which itcontains. A careful perusal of its pages, and the adoption ofmany of the author’s suggestions, will very often be foundmost efficient in mitigating, or perhaps arresting, the suffer-ings of the aged in their progress to the resting-place of all.

A Treatise on Diet and Regimen. By W. H. ROBERTSON, M.D.,&c. Fourth edition. In two vols. Vol. II. London :Churchill. 1848. pp. 362.

Treatise on the Falsifications of Food, and the Chemical MeansEmployed to Detect them. By JOHN MITCHELL, M.R.C.S.London : Baillière. 1848. pp. 334.

IN a notice of the work first named, while publishing in parts,we took occasion to recommend an early portion of it as anuseful resum6 of dietetic, and especially of some branches ofhygienic knowledge.The same commendation may be extended to the concluding

volume, which embraces the consideration of subjects whichought to be of interest to all who value their own health, andwhose duty it is to take charge of the health of others. Nume-rous are the hygienic abuses which infest society; and asnumerous the absurd doctrines of diet and regimen now invogue. It consequently behoves medical men, as guardiansof the public health, to point out and to raise their voicesagainst errors and abuses interwoven with the artificial usagesof society; and it is chiefly by disseminating right opinions re-specting the subject of hygiene, that we may hope to ward offphysical degeneration. We fear that diet and regimen, alongwith the other topics of hygiene, obtain little attention frommost medical practitioners; such subjects have never beenplaced systematically before them in their studies; they haveheard or read only incidental allusions to them in lectures, orbooks on physic; and they carry on their practice with a fewundefined general notions, many of which are without anyproper foundation. Here, then, we see a breach throughwhich quackery may enter, and interfere with the avocationof the legal and orthodox practitioner; and it is one throughwhich it does enter. It is in this matter of hygiene thathomoeopathy and hydropathy find their stronghold; and it is,therefore, by a proper attention to it, that the profession mustmaintain itself against the assault of quackery.The subject matter of Dr. Robertson’s book is agreeably

conveyed; the author has evinced no inconsiderable industryin its collection and compilation, and the book presents uswith much information which we should otherwise have tosearch after in various writers. The description of the principalmineral waters, although necessarily brief, will furnish muchuseful information to medical men, who are often called uponby their patients to give some account of them, and who yetdo not deem it worth while to devote time to the reading ofspecial and larger treatises on the subject.A good reason for, and the utility of, the publication of Mr.

Mitchell’s treatise on the adulteration of food, is set forth inthe following quotation from the preface to the book:

"Nearly thirty years have now elapsed since the appear-ance of a work on ’Culinary Poisons,’ by Mr. Accum, in whichwas exposed the nefarious art of adulterating provisions, &c.Since then, however, as may well be supposed, many newadulterations have been introduced, and the science of che-mistry so much extended as to offer more ready and certainmeans of detecting the ordinary impurities in articles of food,at well as the extraordinary or newer frauds, so that even ifMr. Accum’s work were not out of print, another, containingthe required information, would be necessary, to check in somemeasure the growing evil."

It is with a view of supplying this want that the presentwork has been undertaken.The gross and injurious adulteration of most articles of con-

sumption is a matter of everyday observation, and yet is carriedon with unblushing boldness, and, in many instances, in spiteof various penal enactments. That such is the case arises in

part from the inefficiency of the law and its agents, and inpart from the seeming indifference of the public, who recon-cile themselves to the imbibition of non-nutritious, or even ofpoisonous matters, as if their food were naturally associatedwith such ingredients, and the matter were of little conse-quence. From this want of concern respecting the genuine-ness of their articles of subsistence the public need to beroused; the cry of Death in the pot!" must once more beraised in their ear ; and the whole mischievous system ofsophistication must be laid before their eyes in all its vileness,in order that they may see and know that their health and

happiness are marred by it, and their money misspent.For the purpose of more effectually checking this nefarious

system, the author proposes the appointment of "a well-consti-tuted and organized body of scientific men, to examine themany commodities in daily use, giving them full power toinspect the manufactories from which any adulterated articlehas been procured, and if any substance of a deleterious nature,similar to that discovered in the article which first led to the

search, be found, then let the party so offending be fined orimprisoned, according to the enormity of the offence."Such a plan would doubtless be advantageous, but there is

need to provide for the inspection of the articles vended- byretailers, who probably are more implicated in the practice ofadulteration than wholesale makers or dealers, and to effectwhich it would be necessary to put the execution of the super-vision under parochial management.Touching the substances generally:subject to adulteration

Mr. Mitchell enumerates " wines, spirits, beer, tea, coffee,sugar, bread, chocolate, milk, cream, pickles, oil, flour, cheese,mustard, pepper, confectionary, and vinegar;" but before en-tering upon a detail of the impurities of each of these articlesseverally, he devotes a section on " The Vessels in general usefor the Preparation and Preservation of Articles of Food,"from inattention to which, as to nature or cleanliness, nume-rous cases of poisoning are on record. The second section isoccupied by an account of water and its impurities; he thenproceeds to point out the adulterations practised with flour,and other amylaceous matters, as arrow-root, tapioca, &c., andthe mode in which they may be detected; he then brings theimpurities of bread under notice, and so proceeds with each ofthe substances above enumerated.

It is to be hoped that this exposure of the mercenarysophistications of food by manufacturers and traders may atleast check the audacity with which they in general practisethem, by arousing the attention of the public and legislatureto the vital importance of doing their utmost towards its pre-vention ; so that the poor man may get the due return for theoutlay of his hard-earned pittance, and that the health of theentire community may be no longer sacrificed to a thirst forgain, which seems to be only appeased by so precious anoffering.As well adapted to answer its purpose, we can cordially re-

commend this treatise of Mr. Mitchell, the utility of which tomedical men, even more than to the public at large, must, ona little reflection, be admitted. But, before taking leave ofthe subject of adulterations, we may remark on the grossnessof those practised on substances used in medicine, whichcause disappointment to the medical practitioner, and inflictinjury on the patient, and which particularly require severeexposure and punishment, as the most highly criminal.

GENERAL INFIRMARY, BEDFORD.—Dr. Witt, who has beenphysician to this institution for a period of twenty years, hasjust resigned the appointment.