SURGICAL AND PRACTICAL OBSERVATIONS ON THE DISEASES OF THE HUMAN FOOT: WITH INSTRUCTIONS FOR THEIR TREATMENT. TO WHICH IS ADDED ADVICE ON THE MANAGEMENT OF THE HAND. By John Eisenberg. 4to. pp. 252. Renshaw, London, 1845.

THIS is a book on an attractive subject. We have seldom met with a person of either sex, however deeply absorbed in the serious pursuits of this world, who, if possessing small and well-turned feet, or white and neatly-shaped hands, were not proud to display and careful to preserve them, and everyone recollects the vain notion of our great and titled poet, of the size of hands as indicating birth, his own being aristocratically small.

John Eisenberg, who dedicates his work to Dr. Marshall Hall, seems to have felt the necessity of showing good cause for writing a book, and, like most authors, is desirous of impressing the public with the importance of his subject. Accordingly, after contrasting the neglect which the human teeth, and the diseases of horses formerly experienced with the attention now paid to these subjects by educated men, he expresses a hope that, before any great length of time has elapsed, Chiropodists will be admitted to their place in the social system, and that, as in the large towns of Germany, the staffs of our hospitals will be increased by dignified professors of an art, who, to the author's surprise, now rank, in this enlightened country, only as humble corn-cutters.

In a society consisting of persons either too fastidious or too indolent to cut their own corns, a necessity may exist for this class of operators, and we have no objection to their assuming the euphonious title of Chiropodists, and as such, taking their proper place in the social system; but we most strenuously resist any invasion of our province as Surgeons by any of these special professors, whether native or foreign, and, although our author takes some pains to convince his readers to the contrary, we must take the liberty of stating that every sensible surgeon perfectly understands the structure of corns and bunions, and their causes and treatment, as well as the management of some other small affections, such as the "growingin of the nail into the flesh," as it is termed, warts and chilblains, which our author seems anxious to take out of our hands. It is really time to extinguish these pretensions, for if we give up to advertising Aurists and Oculists, Dentists, Chiropodists, Orthopædists, Skin-doctors, and Bathproprietors, all they would claim, there will be very little left to the charge of the general Surgeon.

If a large and handsome volume can confer dignity on his subject our author has fully availed himself of the advantage. This book is of quarto size, printed in large type, with ample margins and handsomely bound in blue cloth with gilt-edged leaves. It is indeed, as the author no doubt intended, an elegant drawing-room book. We shall content ourselves with gleaning such practical remarks and hints as may seem likely to interest or to be useful to our readers.

The author does not coincide in the general opinion that corns are the result of pressure. He remarks:

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"It has been erroneously asserted that pressure upon the epidermis is the sole cause of corns; that its vessels, becoming injured and hypertrophied, throw out a larger quantity of lymph than is necessary; and that the consequence is the generation of layers, which become interwoven. Were pressure the sole cause of corns they would not be confined to so small a surface, they would necessarily embrace a much larger portion of the foot, and we should find the heel, where the greatest pressure exists, the most frequent seat of disease. Some persons are annoyed in a most extraordinary degree by corns, who are the most careful in the selection of their shoes, whilst many who are in the habit of wearing such tight shoes as to be almost incapable of walking, and who seem to wish to resemble, in their incapacity for movement, the Chinese ladies, are totally free from them; besides which, infants have been known to have striking excrescences. There is no doubt whatever that the pain and uneasiness attendant upon a corn are exacerbated by the pressure of a tight shoe, and that instantaneous relief attends a change; but this is easily explained. A new boot sometimes is said to have been the cause of the mischief, whereas the corn has not only long existed, but has formed for itself, in boots that have been worn, a cavity. We constantly find that those who live in towns are more subject to corns than those who live in the country, although the materials of which their boots and shoes are made are so much harder and rougher. It is not at all an uncommon thing for a person who has been afflicted with serious excrescences to lose them altogether whilst in the country, and again to be burthened with them on his return to London. The alteration of structure, wherever corns exist, is of the most decided character. No longer can it be considered as organized texture, for the laws of vitality have altogether ceased within its immediate range; vessels no longer circulate through it their normal fluid; nor does the rete mucosum furnish longer that mild lymph which lubricates the superior surface of the cutis vera, and the inferior surface of the epidermis, but in its place there is an exudation of a serous-like fluid, which rapidly hardens and thickens, layer accumulates upon layer, a corneous substance is formed, which gradually insinuates itself either amongst the muscular fibre, or the minute arterial vessels enter into the softer and spongier parts, assist in giving here and there vitality, and become the source of that exquisite pain which is often complained of by the sufferer." P. 15.

The preceding observations will make very little impression on our readers. The pathological remarks are too absurd to merit notice, and the character of the book will be understood when we state that the author magnifies the difficulties and dangers of removing corns by operation, and dwells on the disastrous and even fatal consequences of a badly-performed operation. On the subject of callosities, the author remarks:

"It is a curious fact that those who ride on horse-back and are amongst the foremost in the chase, are strikingly liable to these affections. We have known men who are remarkable for their love of hunting, who have no other rural pursuit to which they are partial, who neither shoot nor fish, and who, when in town, take little but carriage exercise, suffer in a singular degree from hard, thickened, callous indurations around the heel, and they are not unfrequently exceedingly sensitive. The whole epidermis is in such cases unusually dry, ragged, and small papulæ in groups cover its surface; those who are advanced in years seem to be more subject to the rapid advance of these indurations, and they seldom can check them unless they have frequent recourse to the pediluvium of a high temperature, followed by rubbing the surface for some considerable length of time with a rough dry towel; indeed many persons have found their only relief from following this plan systematically for a considerable length of time, and even if they have abandoned it, from the total absence of the callosity, they have found it to return and to become even more troublesome than before." P. 126.

NEW SERIES, NO. IV.-II.

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The following is the plan recommended for the treatment of warts. "The hydrochlorate of ammonia dissolved in water, and the hydrochlorate of lime are the most certain means of destroying them; the process, however, in both instances is very slow, and demands perseverance, for if discontinued before the proper time, no advantage is derived. The warts are to be kept constantly moist with the solution of one or other of these neutral salts, small folds of linen are to be soaked in it and applied at night, but this must be duly attended to. It must not be the practice for two or three days and then laid aside; it must be followed up for a month, at the end of which time it will be found that the excrescence no longer exists, and it will not again return. Success almost always follows upon this plan, and therefore it is the one I would urge as that upon which the greatest reliance can be placed. The most obstinate warts, that had baffled the attention of the most skilful, and that had re-appeared after other treatment, completely yielded to this; and since it has become under ordinary circumstances the plan I recommend to be pursued." P. 147.

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Those who suffer from immoderate perspiration of the feet are recommended to use a solution of the chlorate of lime or of soda for its prevention, more especially if it be attended with any fætor, which sometimes occurs, but more generally as an indication of constitutional disorder than of local affection. The sponge, moistened with equal parts of camphor julep, of Mindererus' spirit, with a few drops of spirits of lavender, will often put a stop to the most disagreeable effluvium which arises.

The author treats chilblains on the feet with cold applications. He observes :

"The production of cold, by the evaporation of ether, by the use of spirit, or the immediate application of ice, not only gives temporary relief, but permanent, if it be persevered in for some time; compresses, dipped in cold lotions, should be unremittingly kept upon the part affected until the redness, heat and swelling have disappeared. The warm fomentations, such as decoctions of poppies, of chamomile flowers, of turnips, are occasionally successful, but I by no means recommend them, for I have been uniformly successful in the removal of chilblains in their inflammatory stage by means of cold lotions." P. 188.

We must here conclude our notice of this work. It is scarcely deserving of even the brief attention we have given to it. The object of the author, it is too obvious, was that of making a book to serve the purpose of advertising himself, and we must express our regret that a distinguished physician should have sanctioned such a proceeding, by permitting his name to appear on the first page of a work of so questionable a character.

THE COLD-WATER CURE, ITS USE AND MISUSE EXAMINED. By Herbert Mayo, M.D. F.R.S. 12mo. pp. 85. London, 1845.

HOWEVER pleased at hearing a medical brother's shattered health has undergone restoration, we can but regret that the same process has converted the cidevant respectable surgeon of the Middlesex Hospital into the doctor of a hydropathic establishment. Any alliance of this kind inflicts disgrace upon the profession by imparting undue sanction to quackery. It is true Dr. Mayo is not an

implicit follower of the charlatan Priesnitz, and notices not a few instances of the evil resulting from indiscriminate employment of the various appliances. He believes that, by variations in the mode of application, very various results are produced, and that, to appreciate these, preliminary medical information is required. He desires to employ hydropathy co-operatively with other medical means, not exclusively.

"I do not adopt and use it without modifications which Priesnitz would repudiate as hostile to the spirit of his method. But I take its elements and employ them my own way. Perhaps, if the prescribed routine had suited my own case, I might have been misled by it. But my own case was too serious, and could not be cured by the system with its errors; it happened to require and admit of a part only of the routine treatment; and in following this view, and looking to see how much each individual case of serious disease requires, the system has disappeared, and in the place of the cold-water cure, I discern only a more extended and scientific use of cold-bathing."

Doubtless Priesnitz would assert that if the author had entirely, instead of partially, followed his system, he would have been by this time completely cured, instead of being, as he is, only so in part. Having been for some years a victim of rheumatic gout, he repaired, at the advice of Sir J. Clark, to the hydropathists in 1842, and after douching, stewing, and sweating for a couple of years, feels himself much better, and thus winds up his account of his case, which we suppose is set down as a cure!

"In September I found myself almost suddenly much better; my feet and ankles, which up to this time had regularly by the evening become large and heavy, ceased to swell, and were hardly larger at night than in the morning; my knees at the same time became reduced in size, and I could stand every day, and most days could walk a few steps. As I expected, I have since fallen back a little; but I can now always stand without support on both legs, and I am confident that next Summer I shall make the remaining step of walking. In general strength I palpably improve every quarter of a year; the rheumatism burns out more slowly."

The various means at the command of the hydropathist may, according to our author, be made to operate in four different modes. 1. The tonic course, consisting of cold bathing, friction, and exercise, and cold water drank in moderation as a "stomach bath." This is applicable to cases of general debility, feeble circulation, deficient innervation (as in hysteria and mental depression, certain forms of palsy, &c.), threatening or incipient scrofula, muscular rheumatism, and regular gout in certain habits. 2. The reductive course, consisting in the induction of profuse sweating, "with just enough cold bathing afterwards to prevent the debilitating effects." This, according to Mr. Mayo, is seldom indicated, and he gives various examples of the evil resulting from its employment. 3. The alterative course. This is applicable to many cases, and consists in antagonizing the sweating and cold bathing processes, so as not on the one hand to reduce, or on the other to stimulate the patient; but, to give tone to his system by exciting a moderate action of the skin. Over-taxing of the bodily or mental powers, general disorder of the system, threatening head-disease, dyspepsia, irregular gout, or chronic rheumatism are cases for its use. 4. The sedative course consists in maintaining a prolonged application of cold water to prevent re-action taking place, and is applicable to cases of fever, inflammation, spasm, mental excitement, &c.

The conclusion we arrive at from the perusal of this pamphlet is, that there are various cases of dyspepsia and broken health, proceeding from gormandizing, idleness, anxiety, &c. which are greatly to be benefited by the change of air and scene which has been so long and so frequently recommended for them; and that, in some of these, the cold-water discipline might prove an useful auxiliaryprovided it were administered under medical inspection. But we believe the

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present rage for its adoption is dangerous in the extreme, and that while fancied ailments have been by its agency frequently converted into real diseases, and slight ones have been frequently rendered serious, not a few lives have been sacrificed at this new shrine of empiricism. The vast majority of diseases to which the system is applied are more easily and more safely curable without it; and if the rough practices it sanctions have worked a happy revolution in the constitutions of some old or young debauchees (which class constitute a large share of Priesnitz' patients), more delicate frames, which, under judicious treatment, might often have been renovated, have succumbed to them. Again, therefore, we regret that any professional man, so well-known by his former labours as Mr. Mayo, should have given his sanction to practices so questionable in their therapeutical tendencies.

It must be a bad book that furnishes no useful hints; so, in parting with this one, we may inquire of our reader if he ever suffers from headache, defective digestion, or a slow action of the bowels. If so, let him seat his nether-end in a tub of cold water from five to thirty minutes, and the benefit be will thence derive, especially if he can command a rapid renewal of the fluid during the seance, will be surprisingly great. For ourselves, we are so liable to headache and weariness in pursuing some portion of our critical duties, that we feel grateful to the author for his panacea, and only regret that we were not in possession of it a little earlier, as we should like to have tried the experiment of reviewing "The Cold-water Cure" in a "Sitz-bath."

CONTRIBUTIONS TO THE MEDICAL HISTORY AND TREATMENT OF SEXUAL DISEASES. By John Hey Robertson, M.D. Octavo, pp. 80. Glasgow,

1845.

THE first part of this brochure, treating of M. Ricord's practice in the Venereal Hospitals of Paris, was published by the author in a local journal as far back as 1833; and if he thought it worth while to reproduce it, he should have corrected its loose, rambling style, quite inexcusable in a re-print. Dr. Robertson is an enthusiastic admirer of the practice of inoculation, but yet inconsistently enough never employs it. He says

"We have no means as yet of making an accurate diagnosis but by inoculation-but, since it can do the patients no harm, and may do them a great deal of good, there can be no reason why they should not submit to this very simple, and not in the least painful, process, equally for the surgeon's assistance, the benefit of science, and their own safety. (Notwithstanding this, I have never yet in this country done such a thing, or even proposed it !”)

M. Ricord, however, inoculates in three places on the inside of each thigh in every case of suspicious sore or gonorrhoea, repeating the operation again and again if it fail. The healing of the original chancre takes place more quickly than when this practice is not adopted, the inoculated one also disappearing in a day or two afterwards. Sores on the glans or pudenda, which will not produce their like on inoculation, and which are very common, are termed Herpetic by M. Ricord. The outrance to which M. R. carries his opinions concerning the diagnostic value of inoculation is exhibited in one case, although not cited by the author to such end. A woman with sores was inoculated no less than ten times and in 60 places, without any effect whatever. The Professor, somewhat staggered at this at first, afterwards solved the difficulty by declaring "that he regarded this as a very extraordinary specimen of true syphilitic disease, as no less than a primary sore having passed into a secondary, without the constitutional affection!" M. Ricord having observed that gonorrhea sometimes commu