that has not been long since indicated in the writings of Pringle, Lind, Blane, and of Drs. Robert Jackson, William Fergusson, and James Johnson."

That certain trades and occupations are injurious to the health of artisans is not to be disputed; but the grand cause of the fearful ravages of disease in our manufacturing districts is unquestionably to be traced to the filth and wretchedness of their dwellings, the insufficient supply or the bad quality of their food, their want of cleanliness arising from a defective supply of water, and the vicious habits that so generally—we had almost said necessarily accompany personal and domestic discomfort. Some of the foreign governments have set an excellent example to ours in this respect, by the active sanatory regulations which they have established among their manufacturing and labouring classes; and amply have they been repaid for the performance of this most important duty, by the improvement in the state of the general health of their artisans. The cotton factories near Vienna are alluded to, as affording a striking illustration of the truth of this remark. Even in a mere financial point of view, it would be well if there was greater attention paid to the state of the dwellings and the general habits of our working classes. It is generally easier, and therefore cheaper in the long run, to ward off an evil than to remedy it, to prevent a disease than to cure it. If this be true in reference to private families, how much more is it in the case of large masses of men, crowded together in wretchedness and filth, without means of obtaining proper relief, and a consideration of the highest hygienic importance-each one of whom often becomes a new source of morbific diffusion. The following remarks, on "the various losses occasioned to the public finances by preventible diseases," are full of force and truth :

"It has been calculated that the total number of orphan children, on account of whose destitution relief was given from the poor-rates in the year ending Lady-day, 1840, was 112,000. Of the parents of this number, we are confident that accurate investigation would demonstrate, full one-half died of preventible disease. The loss to the industrious classes consequent on sickness alone, has been variously estimated. One of the lowest calculations, rates the number of days of sickness in the year, experienced by a man, his wife, and two children above 12 years of age, at 29 days, or about one-thirteenth of the entire year. Estimating the weekly earnings of such a family at 40s., we have here a great loss by labour alone, without medicine and other contingent expenses.' But this is vastly below the mark, although quite enough to prove how truly economical it would be in every way, to expend the same money upon airy, salubrious lodgings, conducive at once to health, morals, and respectability. In fact, there can be no doubt that the enormous sums spent every year in hospitals, infirmaries, and union workhouses, are incomparably greater than the expenditure necessary for preventing disease and pauperism." This I believe to be true and easy of proof indeed, we have only to turn to the singularly valuable 'Report' of Mr. Chadwick, to perceive as clearly as need be, how vast are the charges on account of sickness and mortality which are of easy prevention-how enormous the charges on the reduced duration of life-on the reduction by sickness of the periods of working ability or production-on the machineries for the suppression of much of the vice and crime, which comes within the province of the policeas well as for the relief of much of the destitution which comes within the province of the administrator's relief. According to the rate ascertained in eight Unions, Mr. Chadwick concludes that, in all the Unions, about 27,000 cases of

premature widowhood occur, and more than 100,000 cases of orphanage—all which may be ascribed to removeable causes. Mr. Hawksley estimates the loss in Nottingham alone, by the pressure of removeable causes of sickness and mortality at 300,000l. per annum.' It is quite unnecessary to pursue this subject farther. Innumerable details in proof are now before the public, and further description would but weaken the effect."

Mr. Martin, after shewing how much might be done by a system of more stringent parliamentary enactments and police regulations respecting the removal of all refuse and filth, the thorough ventilation of lanes and dwellings, the abundant supply of water for the purposes of washing as well as of food, the improvement of the sewerage, the removal of burialplaces to the environs, the establishment of public baths, and of parks and open play-grounds, &c., concludes his Report with some admirable observations on the reciprocal influence of morals on public health, and of destitution and defective diet on the moral character. We give a sample :—

"I have said nothing directly on the influence of morals on health—a large and pervading subject--on which, however, it is proper to touch, because it is proved by every day's experience, that, in the large majority of instances, immorality and its consequent diseases are but the results of physical destitution or depression. How commonly do we find that the deep and protracted distress of mind which necessarily accompanies aggravated states of bodily suffering, produces that diseased action and reaction-that reciprocal moral and physical disturbance—which, sooner or later, destroys the balance of health. It is this double action that is tearing up the nervous system of the operatives-that system which, from its highly endowed sensibility, receives the first impress of every morbific cause, whether acting primarily on the mind or the body. The more impressible character of the nervous system in females, rendered less apparent by the passive fortitude of their nature, and by their greater power of endurance, comparatively, brings upon mothers, and through them upon their offspring, a mass of suffering greater even than that which afflicts the more complainant father.

"I am here_stating important circumstances that have come largely under my observation. I have no desire to excite useless sympathy. It is proved that, by lowering the power of the nervous system, the mind is broken down even more rapidly than the body. It is proved that, so long as the physical powers are depraved and depressed, there can be no hope of moral improvement; and these facts, open to the observation of all, ought to be sufficient."

They ought indeed to be sufficient; and most fervently do we trust that the Government of this country will immediately enter upon the beneficent work of legislating for the hygienic condition of the poor, and may ere long have washed off the reproach-too justly made against us as a nation-of being more ready to punish crime than to reform the criminal, to deter by penal enactments than to encourage by the mild influences of paternal authority.

I. OBSERVATIONS ON THE GROWTH AND IRREGULARITIES OF CHILDREN'S TEETH, FOLLOWED BY REMARKS AND ADVICE ON THE TEETH IN GENERAL. By W. H. Mortimer. Small 8vo, pp. 129. Highley,

1845.

II. THE FORCEPS. Vol. I. 1844.

III. ON DISEASES OF THE JAWS. By Richard O'Shaughnessy. Octavo, pp. 100. Calcutta, 1844.

ALTHOUGH in every department of the Art of Healing the impudent charlatan and uninstructed pretender have managed frequently, by reason of the credulity and ignorance of the public, to obtain a footing at the expense of educated and conscientious practitioners, yet Dental Surgery is their realm par excellence, in which they have until of late held an almost undisputed sway. The pain of toothache is torturing, and endurable by few, the remedy by extraction is speedy, simple, and complete, and hence he who has acquired a reputation for manual dexterity is sought for, be his other qualifications what they may. The loss or great decay of teeth produces grievous personal disfigurement, and many other serious evils, and he who promises reparation or prevention is listened to just in proportion as he promises boldly and indiscriminately.

Nor can we feel much surprise that the public is bamboozled in this manner, seeing that the men of upright character and scientific acquirements in this branch of the profession have taken no pains to furnish it with any test of competency, while medical men in general possess little more knowledge upon the subject than do their patients. With the exception of those of Mr. Bell there have not been any courses of lectures delivered upon this part of medical science at any of our schools, at least not until quite recently; and the works of that gentleman and of Mr. Fox are the only ones of a standard character generally accessible. The crowds of patients who flock to the casualty wards of our hospitals, who might, under proper tuition, form an invaluable means of instruction, have, by being consigned over to the tender mercies of raw and unaided pupils, suffered a vast amount more of pain than they need have done, and yet have ministered little or nothing to the improvement of those who have operated upon them. The consequence is, that when the student enters into practice he finds himself, in nine cases out of ten, incompetent to give useful and satisfactory advice as to the prevention or removal of diseases of the teeth, and unable to adopt the best operative procedures fitting for the case when these become unavoidable. This should not be, for although the subdivision of employments in a large town may render the reference of such cases to an accomplished dentist possible, and certainly then advisable, yet the exigencies of country practice do not admit of this. The appointments which of late have been made in several of the hospitals are good signs of improvement, and we hope that speedily no medical school will be without its Professor and Demonstrator of Dental Surgery.

In the mean time we are glad to find the Dentists themselves are putting their shoulders to the wheel, and that, at least the well-educated portion of them, are protesting against the admission of persons to the practice of the art without examination or other guarantee of competency. They justly feel that, until some line of separation is drawn between the advertising quack or mere expert handicraftsman, the profession of surgeondentist can be scarcely said to exist. To this end they have established a journal, and although, in advocating their just claims, it has proved rather extreme in some of its denunciations and fanciful in some of its suggèstions, its general tendency is well worthy of encouragement. Among the recommendations urged by the Forceps is the establishment of a College of Dentists; but for this there exists neither materiel nor necessity. The new medical examining board may be empowered to insist upon peculiar studies, and a particular examination on the part of such as intend to devote themselves to Dentistry; and while it thus affords the public a guarantee of competency, will offer to the candidate a distinct professional status he can in no other way so effectually attain. It is truly stated in the publication in question, that the diploma of the College of Surgeons now held by many dentists, and which has been instrumental in procuring for some of them appointments, is no proof whatever of their skill or attainments in this branch of the profession. In the absence, however, of all tests of qualifications of any kind, it has proved some security to the public, that its holder has taken some pains to inform himself of the structure, functions, and surgical diseases of the human frame, and honourably distinguishes him from those who have not done so. We believe the interests of the public and of the dentist will be best consulted by insisting that his professional education shall, at all events in its preliminary stages, be the same as that of the members of other branches of the medical body.

Mr. Mortimer's little work is chiefly addressed to the public, and contains useful advice, some of which is not to be slighted even by professional persons. It is written in a high and proper tone, reprobating and exposing several of the quackish practices which are so much in vogue.

Lancing the Gums.-"I stated it will be recollected that the teeth were situated beneath the gums in each jaw, and that it was the pressure of the edge of the tooth on the internal parts of the gum that caused the irritation and pain. Now the depth the tooth has to perforate being considerable, it stands to reason that if the gums are lanced at the first period of inflammation, they will reclose, and as often as the irritation returns, the operation must be repeated; besides which the gums will become harder each time they re-unite. For, although not visible to the eye, a cicatrix is formed, which renders it still more difficult for the tooth to pierce them. The impropriety of performing the operation at this period must be evident, and will account for the bad practice complained of. But when the teeth are sufficiently advanced, so as to show their presence by a white mark, caused by their pressure on the internal parts of the gums; or when a tooth has partially perforated them, then the lancet may, nay ought to, be used withut delay; for the gums cannot again completely re-close, and the tooth will e through without giving any more pain. In all other cases the lancet d only be used when all other efforts have failed. But if, notwithstanding efforts, the inflammation and irritation continue, and cause excessive

fever--that frequent returns of the convulsions are apprehended; it must then be left to the sagacity of the medical attendant when he ought to lance the gums; and I have only in these cases to recommend that the wound may be as deep as possible, and directly over the teeth that are supposed to cause the pain."

We have extracted this passage to protest against the doctrine it teaches, and to express our regret that parents may hereafter quote the author's book in enforcement of the prejudices which they so often entertain against this simple yet beneficial operation. It is not the fact that lancing the gum renders the subsequent penetration of the gum by the tooth more difficult, the cicatrix in truth yielding more readily to the action of the absorbents than the original structure. So, too, deep incisions are of vast benefit in relieving the congested and tense condition of the gums long prior to the approach of the tooth to the surface, perhaps months before it is cut, especially when the salivation is not profuse; and surely the various accidents which the author admits depend upon this condition of the gum are most rationally removed by attacking the cause, rather than by first employing other measures.

Early Cleansing of the Teeth.-" Children sometimes experience toothache from the first teeth decaying before the others are ready to supply their place; but this is owing, in a great measure, to a want of cleanliness, in not using a toothbrush. I must here notice one of those prejudices which it is difficult to account for: viz., the obstinacy with which some mothers refuse to allow their children's teeth to be cleaned. I have no hesitation in saying, that as soon as it is possible to make the child open its mouth, the teeth it may have ought to be rubbed. In very early age, the sponge is sufficient. A child ought to be taught to brush his teeth as soon as he is taught to wash his hands and comb his hair; and a habit thus inculcated in early life will never be forgotten. As to the supposition, that the brush will wear the enamel away, it might be argued with equal truth, that the comb will wear the head away."

First Permanent Teeth-After cautioning against the premature removal of the milk teeth, and recommending two amalgams for the purpose of arresting their decay, Mr. Mortimer continues :

"At about six, the first teeth of the second set begin to appear. They are large double teeth, and are situated behind the last milk teeth at each extremity of the upper and lower jaw. When these teeth are perfectly formed, they serve, being paced one over the other, as a support to the jaw, while all the first set are being changed. These teeth, from the early age at which they appear, and from want of attention to cleanliness, almost always decay in early life, and very often shortly after they have made their appearance. During the progress, of dentition, no attention is paid to them, under the supposition that they are milk teeth, and that consequently they will be changed; if therefore they decay, no notice is taken of them until they give pain, when the child is taken to the Dentist to have them extracted.

"A medical gentleman brought his son to me some time since, begging me to remove one of these teeth that was in a very decayed state. When I complained of the negligence that had allowed his second teeth to decay, instead of having them stopped as soon as any caries appeared, he quite stared, declared it was a first tooth; and it was not until I had produced several anatomical preparations to support my argument, that he could be convinced to the contrary. Another medical gentleman, who had resided for some years out of Europe, brought five of his children to me, and we found that sixteen out of twenty of these teeth had