that their full discovery in almost every part of the human subject, as well as of various other animals, is owing.

Mr. Goodlad, in this essay, has confined himself principally to the treatment of scrofula, a disease which seems to be extending its ravages in this country, and at the same time to be hereditary. Our remarks will be directed, first, to the structure and course of the absorbent vessels, and the mode of treatment which has been usually adopted; and, secondly, to those points wherein Mr. Goodlad's practice varies from that of other surgeons.

It is sufficient to observe, that the theories of scrofulous absorbent glands have been various.

“W. Hunter describes the king's evil to arise from a peculiar acidity in the serum of the blood, which, when it lights upon a glandule, coagulates and hardens; if this acid humour be simple, the disease is a simple struma; if joined with a malignity or any other tumor, it makes a mixed tumor, as a malignant

struma.

"Le Clerk, says, it is a tumor in the glands of the neck, as also in all the other glandular parts of the body, and consists of a very malignant nature.'

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Billoston, in his Hospital Surgeon, says, 'that scrofulous cases are very difficult to cure, and very few remedies affect their cause; they frequently occur in some climates and nations, and are not seldom the inheritance of our ancestors' irregularity; their source is in the blood, their seat in the glands and joints. The acid which causes their cold coagulations is exceedingly difficult to be destroyed.'

"It has been long confessed, that mercury alone is capable of working a thorough cure of these disorders, whether by liquifying, dissolving, and putting in motion the liquids, or by destroying the acids and viscous ferments, which occasion the lymph to coagulate, &c.

"Astruc says, that scirrhous disorders arise from a humor of the conglobate glands, or at least a tumor that approaches very near to the nature of scirrhus, from whence it is plain, that they are occasioned by a thick lymph stagnating in the glands. "The king's evil proceeds from a thick phlegm, which is sometimes acrimonious and salt in those which are painful. "Turner's definition, after a relation of many cases, is, that the glands are the seat of the malady is beyond all controversy; but the manner of its production, out of what juices, and by what vessels conveyed, is not easy to determine.

"Mr. Hunter says, the scrofulous virus when thrown on the surface, so far resemble the cancer, that it is inclined to spread to a considerable extent.

"Underwood says,

'these scrofulous swellings are the effect

of a peculiar constitutional taint, as yet unknown, and of which no certain opinion can be given.'

Its bad

"Dr. Kirkland represents this disease as sui generis. primary cause being one of those secrets in nature that has not been unveiled; and in the second vol. of Medical Surgery, page 46, is the following remark- The different termination of glandular swellings of a cancerous scrofulous venereal nature, authorizes the presumption of specific ferments or virus, which dispose the accumulated matter to contract such or such a kind of alteration.'

"Dr. William Hunter and Mr. Crookshanks say, that, from the universal swelling immediately under the skin of scrofulous patients, the lymphatics take up something from the atmosphere,*> and our old master, Dr. Cullen, endeavoured to reduce this theory into a system, and almost universally succeeded. He remarks, "It seems to be a peculiar affection of the lymphatic system, and this, in some measure, accounts for its connexion with a parti cular period in life. Probably there is, however, a peculiar acrimony of the fluids that is the proximate cause of the disease.'

"He classes it therefore with siphylis, scurvy, and jaundice, with the order of impetigenes, or with those diseases which depend, for the most part, upon a depraved state of the whole of the fluids, producing tumors, eruptions, or other preternatural affections of the skin."

We shall beg leave to remark, that all the opinions of the most eminent practitioners in this disease, which we have quoted, appear lamentably inconclusive.

LA

When the powers of assimilation in an animal body are comtemplated, when the miraculous effects of the secretory organs are considered, in transmitting the properties of whatever enters a lymphatic gland; when we are informed that the most simple aliment will produce the most poisonous excretions; when we know that the venom of the rattle snake and of the cobra di capello, in the minutest quantity, will produce a speedy death to other animals, but not less so than some vegetable secretions; it will seem that there is little reason to enquire further, whether such chemical changes can be produced by means of the glandular lymphatic system. One of the experiments of Dr. Beddoes, seems so illustrative of the point in question, that we cannot refrain from briefly stating it.

It is known by all how innocently mercury may be applied to the mouths of the external lymphatics, but previous to the following experiment, it could never have been anticipated in what manner an animal would be affected, if an atom of the same semi-metal should be abruptly introduced into the venous system.

The case was as follows:-An incision was made into the vein of a dog's fore-leg, and a grain of quicksilver was introduced, the orifice being confined a short time, the dog was suffered to do as he had been accustomed; on the second day he appeared mopish and dispirited; and on the third he shewed less desire for food than usual; this disinclination increased to about the seventh day, the pthisicky cough came on, which increased for three or four weeks, in which time he was considerably wasted: this state was accompanied with difficult respiration, the desire to take food increased the irritation of the lungs and the atrophy augmented, the dog died in the sixth week. On inspection, the lungs were discovered to have on their surface numerous tubercles, similar to those which often appear in patients who die of consumption. On more accurate observation, each tubercle was found to contain a subdivided granule of quicksilver perfectly unchanged, as if the quicksilver had passed the right ventricle of the heart, and being thrown through the Arteria pulmonalis into the extreme branches of the bronchis, the mouths of the vessels appear to have proved too minute to admit of their reception, and therefore caused the perpetual irritating cough.

From this fact it may be inferred, that though there are various matters which may be infused into the blood without prejudice, such as Jalap or Ipecacuanha; there are yet many which when introduced in an unnatural unprepared state, cannot accommodate themselves to the purposes of the circulating fluid. Amongst these is mercury, and we believe culinary and other salts, which prove fatal by similar experiments. With reference to the foregoing theories, it is probable that such changes may take place in lymphatic glands purely from obstruction, which again may have their source in external cold, and glands deficient of natural energy. This might in some measure account for the difficulty of commuting and impelling their contents. The remedial processes attended with most success, are external warmth and manual friction, combined with the administration of chalybeate tonic medicines: these will generally disperse tumors of this kind, and ultimately effect For it does not appear that the inoculation of scrofulous matter will take any specific effect.

cures.

Our author does not apparently recommend any particular medicine for this disease; he seems to think well of the Cinchona as a tonic; and he depends upon the usual antiphlogistic remedies during the state of excitement, at the same time prefering the opening of abscesses very early; but the most remarkable passage in the detail of his mode of treatment we transcribe in the author's own words.

"In the early stages of the disease, this medicine (the Cinchona) will have little effect, and can be given only with advantage where the appetite is defective, and the power of the stomach is impaired;by restoring this organ to a proper tone, it gives strength to the system, and enables the practitioner to adopt a more active local practice, than he would otherwise be énabled to use. But when the disease is protracted, where ulceration has taken place, and especially when the diseased skin is thrown off, and the wound is covered with a slough, or is filled with granulations, which are broad, pale, and flabby, the bark will often give immediate strength to these actions, and should be exhibited in as large quantities as the patient can bear. "In very irritable habits, granulations will shoot forth, which though rounder and paler than is desirable, give reason to believe that the sore will soon heal. If the surgeon gives bark in considerable quantity, it will disorder the bowels and the grapulations will on a sudden be destroyed, leaving the ulcer of a greenish colour, with perhaps one or two points of granulations. sprouting on its surface.

"This will sometimes happen without any perceptible cause, and is particularly to be dreaded if mercurial preparations be injudiciously given.

"When bark has been long administered it loses its effect, in which case preparations of iron or arsenic may be combined with, or substituted for it: but metallic preparations too often disorder the bowels. The sulphuric and other mineral acids are also useful, if the patient have thirst, night sweats, or febrile paroxisms.

"A generous and nutritious diet is useful in every stage of Scrofula; but it is particularly necessary when the lost parts are to be restored; the truth could not be more strongly verified, than it has been in the manufacturing poor in this part of Lancashire, during the late high price of provisions, and depressed state of commerce.

.

." In almost every case where an ulcer was formed, whether from accident or disease, the healing process has been slow, and in many instances obstinate from the want of a proper supply of animal food; whilst cicatrization has become rapid under the same local treatment, if the patient got admittance into a neighbouring Infirmary where the diet is sufficiently nutritious.

"Cicuta Conuim maculatum, was recommended by Dr. Stork of Vienna, as a remedy in Scrofula: but it has fallen into comparative disuse, for practitioners in this country have by no means found it to deserve the celebrity which it attained in consequence of being recommended by that respectable physician, It is however a useful auxiliary to other medicine, and will often prevent them from disturbing the functions of the stomach and bowels in cases of very great irritation it may be given alone; but it is perhaps more useful to combine it with calomel or preparation of iron, when either of those remedies are indicated.

"I have already observed, and the fact cannot I think be too

frequently repeated, or too strongly enforced, that every scrofulous ulcer requires the greatest attention, and the most accurate discrimination. It is necessary to keep in view at the same time the state of the gland of the cellular membrane which surrounds, and of the skin which covers it; for though each of these parts has different powers of resisting disease, and of recovering fresh effects; they are as mutually dependant on, and as certainly affected by, each other, as the enligaments of the head are affected by disease of the cranium, and of the dura mater. I urge these considerations more strenuously, because a search after specifics has almost universally superseded this attention; and because the disease may not only be simplified, but as it appears to me, con→ trolled, by adopting the practice which I have ventured to recommend.

"But where several enligaments exist, or when several ulcers have been formed, and are in different stages of their course; it requires few arguments to prove that almost every application will be injurious to one, exactly in the same ratio that it will be beneficial to another. We must either check the progress of those ulcers which are disposed to heal unlike others, which are irritable, have become inactive, and until the glands which are enlarged, have ceased to increase; or we must allow the most favorable to pursue their progress, and palliate the remainder until cicatrization is secured."

We have thus furnished an abstract of Mr. Goodlad's mode of cure for Scrofula; and though we do not mean to depreciate the value of his volume, (for it contains many faithful observations relative to practice, and possesses sufficient merit to sanction the bestowal of the distinguished honor it has received) we yet cannot but regret, that in the strides with which the science of surgery has advanced of late years, more experimental truths should not have determined a less vacillatory practice for a disease, which has proved such a scourge to the poor, and those who have inherited it in the higher ranks of society.

It is very remarkable, that there are many countries in which this disease is not known. In America it very rarely seizes an individual who has no hereditary taint., ha az

This publication contains many chirurgical cases, which we think have been very judiciously treated, with a detail of some capital operations, amongst which, that of an aneurism of the femoral artery affords a striking example of great judgment and expertness.

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On the whole, our readers will find many practical remarks worthy of attention; and, as a judicious surgeon and accurate observer, Mr. Goodlad has an unquestionable claim to our full approbation.

T.