LWRARY I UNIVERr.lTY OF j CALIFORNIA J /^'^ - O/ tvl^ 'L^-- /^€^cH2c^/^i <^i-^fr^' ELECTEICITY BT W. E. STEAYENSON, M.D. Digitized by the Internet Archive in 2008 with funding from IVIicrosoft Corporation http://www.archive.org/details/electricityitsmaOOstearich ELECTRICITY AND ITS MANNER OF WORKING IN THE TREATMENT OF DISEASE A THESIS rOR THE M.D. DEGREE OF THE UNIVERSITY OF CAMBRIDGE BY W. E. STEAVENSON, M.D., M.E.C.P. M.R.C.S.ENG., L.S.A. HOLDER OF THE CAMBRIDGE CERTIFICATE IN SANITARY SCIENCE NATURAL SCIENCE PRIZEMAN OF DOWNING COLLEGE, CAMBRIDGE CASUALTY PHYSICIAN AND ELECTRICIAN TO ST BARTHOLOMEW'S HOSPITAL, LONDON; AND PHYSICIAN TO THE ALEXANDRA HOSPITAL FOR CHILDREN; AND FOR WOMEN AND CHILDREN TO THE ST GEORGE'S AND ST JAMES'S DISPENSARY FORMERLY HOUSE SURGEON AND HOUSE PHYSICIAN TO ST BARTHOLOMEW'S HOSPITAL; AND TO THE HOSPITAL FOR SICK CHILDREN, GREAT ORMOND STREET 1884 TO WHICH IS APPENDED AN INAUGURAL MEDICAL DISSERTATION ON ELECTRICITY FOR THE DEGBEE OF DOCTOE OF MEDICINE OF THE UNIVEESITY OF EDINBUEGH WEITTEN IN LATIN BY DE EOBEET STEAVENSON 1778 WITH A TRANSLATION BY THE REV. FREDERICK ROBERT STEAVENSON, MA. OF COLESBORNE, GLOUCESTERSHIRE LATE CLASSICAL SCHOLAR OF EMMANUEL COLLEGE, CAMBRIDGB LONDON J. & A. CHURCHILL 11, NEW BURLINGTON STREET 1884 LOAN STACK 33-23 f^ AS THIS VOLUME IS SOMEWHAT OP A FAMILY PRODUCTION I HAVE DEDICATED IT TO MY BROTHER JOSEPH LEWIS STEAYENSON OF 8HANT0CK HALL, BOVINGDON, HERTS. CAPTAIN IsT BATTALION ROYAL IRISH FUSILIERS (LATE 87th REGIMENT) AND TO THE EEV. ROBERT STEAYENSON OF NEWTON HALL, STOCKSFIELD-ON-TYNE GRANDSON OP THE LATE DR ROBERT STEAYENSON W, K 8TEAVENS0N, 206 ELECTEICITY MANNER OF WORKING IN THE TREATMENT OF DISEASE I HAVE taken as a model for this thesis one written more than a hundred years ago by an ancestor for the M.D. degree of the University of Edinburgh.* I have adopted the same title, and will endeavour to show the advance made in the application of electricity to medicine during the past century. The thesis to which I refer was one of the earliest dissertations upon medical electricity written by an Englishman, and at the time was a work of much repute. The whole science of electricity in its application to medicine has now changed. At the time when Dr Robert Steavenson wrote only statical electricity was * * Dissertatio Medica Inauguralis, de Electricitate et Opera- tione eju« in Morbis Curandis.' Robertus Steavenson, A.M. Britanniis ; Edinburgi, MDCCLXXViii. 8 ELECTRICITY known. Eight years later Galvani made his wonderful discovery of the presence or production of electric currents in the nerves of a frog,* and five years later stillt made his discovery known. This gave rise to the origin of galvanism. Forty years J after this our great philosopher Faraday discovered the secret of induction, which gave rise to what is now called faradism. These two forms of electricity are those which are now most frequently employed in the treatment of disease. The little advance we have made in the applica- tion of electricity to medicine is due to a variety of causes, but chiefly to the expense and cumber- someness of the necessary apparatus, the diflfi- culties connected with its administration, and the disrepute into which the science has fallen by the use made of it by unscrupulous and ignorant men. More quackery has gone on under the names of electricity, odic force, animal magne- tism, and similar phrases than perhaps in any other department of medicine. The reason is that electricity is a most powerful agent, and is known to do good both by those who profess to a knowledge of its action and by those who have sought relief by its agency. The professors of the art have generally been ignorant of its mode • 1786. t 1791. I 1831. BLEOTEIOITY 9 of action and unable or unwilling to distinguish the cases in which it should be used or the reverse, and have exaggerated its marvellous and all- heahng powers for their own pecuniary advantage. Ignorance of the mode of action of electricity would be excusable if acknowledged, for we are still ignorant of the cause of many of the effects it produces, but one of the characteristics of the ignorant impostor is the glibness with which he explains and attempts to demonstrate the mode of action. The former electrical treatment was of course purely empirical, a mere matter of chance, and intelligent medical and scientific men, appre- ciating this, and knowing of no laws or prin- ciples upon which the treatment could be applied, ignored its use entirely; and the knowledge of many of the wonderful effects derived by treat- ment with electricity a hundred years ago has now faded into oblivion and is unknown to the practitioner of the present day. But the art has been practised and preserved by quacks with the result of much imposition on the public. The latest accepted theory concerning the nature of sound, heat, light, and electricity is that they are all manifestations of motion — vibrations of a subtle imponderable material, called ether, which is supposed to pervade all 10 ELECTRICITY space and fill up the interstices left between the constituent molecules of all matter. The mole- cules of which all things are composed are of a spheroidal form, and therefore, however small and closely they may be packed, of necessity leave interstices. There is this difference in the production of sound and that of heat, light, or electricity. The vibration of elastic bodies only can produce the sensation of sound, and these vibrations have to be transmitted through some ponderaMe medium such as air, gases, vapours, liquids, or solids. The number of vibrations differs with the pitch. The number of vibrations necessary for the pro- duction of audible sound is much lower than the number of vibrations of ether necessary to produce heat, light, or electricity, and the range from the deepest to the most acute sound is according to Helmholtz from 30 to 38,000 vibrations per second. The vibrations of elastic bodies pro- ducing sound are transmitted to and produce a vibratory motion in the ponderable molecules composing matter, and these vibrations are com- paratively slow. In the case of heat it is assumed that the imponderable elastic ether, to which I have before referred, is in a state of rapid vibration, and that these vibrations, transmitted to material objects, set their molecules into more ELEOTRTOTTY 1 1 rapid motion and thus increase their temperature. When the motion of the particles of undulating ether approaches a rapidity of several hundred of millions of millions per second heat of various intensity is produced ; when the number of undu- lations increases up to about double the rate which produces heat we have the various tints of light which are capable of being appreciated by the optic nerve. " The optic nerve is insensible to a large number of vibrations. It can appre- hend only those waves that form the visible spectrum. If the rate of undulation be slower than the red or faster than the violet, though intense motion may pass through the humours of the eye and fall upon the retina, yet we shall be utterly unconscious of the fact, for the optic nerve cannot take up and respond to the rate of vibra- tions which exist beyond the visible spectrum in both directions." (Granot.) When lecturing before the Royal College of Physicians in 1847 Dr Golding Bird alluded to the possibility of electricity being dependent upon ether assuming vibratory movements dif- fering in amplitude and velocity from those pro- ducing light, heat, and photographic effects. Faraday upheld the molecular theory with regard to electricity, that is, that it is due to certain peculiar conditions of the molecules of bodies 12 ELECTRICITY that have been rubbed or heated or acted upon by light; or of the ether which is believed to almost surround these molecules. Since then Prof. Clerk Maxwell has proposed the theory that the phenomena of electric currents and magnets are due to rotations, streams, or other forms of movement in the particles of ether, while light is due to vibrations of it to and fro. In 1845 Faraday discovered that a ray of light polarised in a certain plane can be rotated by the action of a magnet so that the vibrations are executed in a different plane. If iron filings be magnetised they can be seen to rotate and place themselves endways ; they then act as a magnet until shaken up. ''There seems indeed reason to think that magnets may be merely made up of rotating portions of electri- fied matter" (Prof. Silvanus Thompson). The above theories of electricity and magnetism are very different to the old notion of fluids. Electricity, therefore, is not a substance, but an induced condition of matter and a condition which can be transferred from one body to another. To say the least, the relations between sound, heat, light, and electricity are so remarkable that one can never be excited without calling into existence one or all of the others. Heat produces electrical currents and by galvanic action the ELECTRICITY 13 most intense degree of heat hitherto known has been obtained. We are all at present conversant with the luminous properties of electricity. One of the most extraordinary relations between light and electricity was discovered in 1875. The metal selenium was found to change its electrical resist- ance under the influence of light. When properly prepared a sheet of selenium which offers a resist- ance of 300 ohms in the dark when exposed to the sunlight has a resistance of only 150 ohms. The greater the light the greater the reduction of resistance. This fact has led to the construction of the pJwtojphone, by which sound is transmitted to a distance by a beam of light. The sound of the voice is made to throw into vibration a thin mirror from which a beam of light is transmitted to a receiver, at a distance, made of selenium on which it falls with varying intensity, thus affecting the selenium, which is connected in circuit with a small battery and a Bell telephone in which the sounds are reproduced by the vibrations of the current. It has been recently realised that all true solid conductors of electricity must be opaque to light.* But electricity will also produce sound. When a strong electric current is passed through * The above facts have been obtained from Prof. Silvanus Thompson's work upon * Eleetricity and Magnetism/ 14 ELECTRICITY a rod of soft iron, a distinct sound is produced at the closing and opening of the current. This sound has been attributed to the vibratory motion produced in the molecules of the iron by their magnetisation and demagnetisation. All physicians recognise the influence exerted upon health and disease by heat, light, and motion in the form of exercise, but very little attention has been paid to the place which elec- tricity occupies in regulating the action of the vital processes. That it has a great influence upon the maintenance of health and the production of disease I shall try to prove by argument in a subsequent part of my thesis, but I must first apply myself to carrying out the task I have undertaken, that is, to show briefly the advance made in the application of electricity to medicine during the last 100 years. We have now more accurate means of measuring electricity and have a more perfect knowledge of its action, but although much has still to be learnt under this head, we are altogether in a far better position for employing its effects in the treatment of disease. ELEOTRIOlTy 15 Concerning the Manner of its Application. I have very little fresh information to add with regard to the treatment by statical electricity. The manner of its application is the same now as was employed at the time Dr Steavenson wrote his thesis and is therein fully described.* But this mode of treatment was used for many years after the introduction of galvanism and faradism as the most preferable, and long lists of cases were published in the ' Guy's Hospital Reports,' by Addison,! Golding Bird, J and Sir Wm. Gull,§ in which its use was followed by most satisfactory results. But now it has fallen very much into disuse, the constant and interrupted currents having been found so greatly superior in the ease with which they can be applied and also more beneficial in the treatment or relief of diseases dependent upon evident organic changes. But in those diseases which are only functional, and in certain abnormal conditions of the system {e.g. hysteria, nerve-prostration), I think that possibly statical electricity in the form of the positive electric charge || will be found very useful. JSTow * Op. cit., p. 5. t ' Guy's Hosp. Reports,' 1837, No. 2. + Ibid., 1841. § Ibid., 1852-53. II This method, in the thesis of 1778, is called Insulation. 16 ELEOTBIOiTt that the electroscope will show clearly the electri- cal condition of every patient, the indication for such treatment becomes at once intelligible and easy of application. In the application of galvanism and faradism the resistance offered by the skin to the penetra- tion of the current has to be taken into considera- tion. This resistance varies much in different individuals and at different times in the same individual, a warm moist skin conducting better than a dry and cold one. The average resistance offered by the skin has been stated to be equal to about 2500 ohms or about 76 miles of copper wire of one millimetre diameter. In the application of electricity this resistance can be very much reduced by well moistening the skin with warm water, and better still with warm salt water ; saline solutions conduct electricity much better than pure water. Where the skin is thick, as on the hands and soles of the feet, the resistance offered is much greater than in other parts of the body. If we want simply to influence the skin and do not want the current to penetrate to the muscles or deeper parts it is best to let the skin remain unmoistened. The body when immersed in water, as in an elec- tric bath, is a better conductor than the water surrounding it, and a current of electricity sent through the bath will penetrate and traverse the ELECTRICITY 17 human body, but if salt be added to the water, the solution will then become the better conductor and the current will traverse it and not enter the body at all. The weather also has a great effect upon the resistance of the human body, possibly by its effect on the condition of the skin. Lunatics, whose skins are in some forms of mental disease unnaturally harsh and dry, offer an extraordinary amount of resistance to the passage of an electric current. Very frequently patients say that the degree of paralysis and the sensation in a paralysed part are very much affected by changes in the weather, as is also the resistance. In warm weather or when a change takes place from cold to warmer weather an improvement in the paralysis is experienced ; and on the contrary when a cold day supervenes on warmer weather the paralysis is worse and the muscles feel stiff and contracted. When two electrodes are placed upon the body and a current is passed of sufficient strength to penetrate the skin, the current will pass from the positive electrode to the negative one, but in its passage it is diffused in the form of curves spread- ing out until a point midway between the two electrodes is reached, when it begins to converge again towards the negative electrode. The 2 18 ELECTRICITY greatest intensity of the current traverses a direct line between the two electrodes, but the farther they are apart from one another the more the current is weakened on account of its greater diffusion. To produce an effect upon an organ therefore the more the current can be localised the greater is the influence exerted. A weak and therefore often painless current can be used if applied locally, but if not so applied a much stronger current would be required to produce the same effect and one perhaps not able to be borne without an anaesthetic. Many of the good results of elec- tricity have been unattained and entirely dis- believed in because the current has been passed through the body in a haphazard way, often with the patient only holding the handles of some kind of electrical machine, which has produced most uncomfortable sensations and sometimes pain, with very little appreciable effect upon the organ it was wished to influence and which possibly was situated in some remote part of the body. Different methods are employed in applying galvanism and faradism according to the texture it is wished to influence and also for the effect it is desired to produce. Duchenne, who almost exclusively used the in- terrupted current, followed what is called " direct ELECTRICITY 19 faradisation; " that is, lie applied both electrodes to the surface of the muscle he wished to influence. If the electrodes were not large enough to cover the whole surface of the muscle he applied them successively to all parts of it. The ''indirect method" which was proposed by Eemak and carried out by Ziemssen, consists of placing one electrode on an indifferent part of the body and applying the other to the "motor point" of the muscle it is wished to influence. For diagnostic purposes, that is, for determining the electro-contractility of a muscle, a combina- tion of the two methods just mentioned is advisa- ble, namely, placing one electrode on the " motor point " and the other upon the muscle itself. When it is wanted only to influence the skin one moist electrode should be placed on an indifferent part of the body and the other, a dry one, should be applied lightly to the affected part, the skin also remaining dry. For general faradisation one electrode may be placed on an indifferent part of the body, or the feet placed on a metallic plate, and the whole surface of the body sponged over with the other electrode. In the use of galvanism for treatment two methods are followed; one the "stabile" when both electrodes are kept perfectly stationary, the 20 ELECTRICITY current passing evenly between the two points ; and the other the " mobile/' when usually the negative electrode is moved over the limb or the part it is wished to influence. In both methods it is usual for one electrode to be placed on an in- different part of the body. The most convenient electrode for this purpose is an oval plate of pHable metal such as tin with a layer of amadou to retain the moisture, and all covered by a piece of wash- leather or flannel with a waterproof back to pro- tect the patient's clothes. If the galvanic current be employed for stimu- lating muscle to contract, as when for diagnostic purposes it is required to ehcit the reaction of degeneration or prove its absence, it must be interrupted, for contractions only occur at the moment of making or breaking the current. The direction of the current is not of so much impor- tance as the position of the poles. The greatest chemical and thermal action taking place at the negative pole and, in healthy muscle, the strongest contraction also takes place at the point of the application of the negative pole. What is called " central galvanisation " consists in applying the negative electrode in succession to the nervous centres, the brain, spinal cord, and sympathetic in the neck ; the other electrode being placed on the epigastrium or some other remote ELECTRICITY 21 part of the body. This method of electrisation is generally employed when it is sought to influence the whole nervous system, as in states of great nervous depression or exhaustion after long ill- nesses, or in cases of nervous insomnia. I have omitted to mention the many applications of electricity to surgery as not coming within the scope of a medical thesis. Concerning its Manner of Working. A hundred years ago, when only statical electricity was known, it was suspected that it exercised some influence upon the human body other than that of a stimulant.* The electrolytic power of electricityt had not been discovered, although to it, possibly, was due many of the for- merly considered marvellous phenomena. The fact that the galvanic current decomposed chemi- cal compounds enabled Davy, in 1807, to isolate several additional elements, such as sodium and potassium. Since then numerous properties have been detected as belonging to electricity. Those affecting the human body have been divided into * ♦ De Electricitate/ 1778, p. 13. t In 1789 it was first discovered that water could be decom- posed by passing through it a series of discharges of statical electricity. 22 ELEOTBIOITY mechanical, physical, chemical, and physiological. The first three affect both organic and inorganic matter, but not in the same way, the presence of life modifies the action; but the physiological effects of electricity are peculiar to living beings, and are simply modifications of the ordinary vital processes. Electricity may increase, diminish, arrest, or otherwise modify their action ; it affects secretion and excretion, absorption, reflex action, and nutrition. The physiological action of the induced current is almost nil. The duration of the transit of the current is not sufficient to produce any of the characteristic effects of the passage of a current of electricity, and the currents are alternately in a reverse direction. They only produce a mo- mentary contraction of muscular tissue as is pro- duced at every make and break of a constant current. But the makes and breaks are so rapid that the muscle has not time enough to relax between each, and a prolonged tonic contraction results as long as the application of the electricity is continued, or until the muscle relaxes through sheer exhaustion. Although perhaps the induced current may re- duce the amount of blood flowing to a part during its application by causing contraction of the muscular coats of the vessels, there is no doubt ELECTRICITY 23 that after the application has ceased a re-action sets in and a warmth is experienced in the part of the body operated upon through dilatation of the vessels and the consequent freer supply of blood to the part. But the physiological action of the constant current is of a much more complex nature, and is not yet thoroughly understood. But it is probable that it does not produce relaxa- tion of muscular contractions and therefore cannot be said to have a distinctly opposite effect to the induced current. There is no doubt it induces an increased flow of blood to a part of the body in- cluded in the circuit, especially at the neighbour- hood of the application of the electrodes, and there must be a corresponding dilatation of the vessels to allow of this increased supply of blood. But whether the dilatation of the vessels is due to a relaxing influence the current has on their mus- cular coats or the chemical changes produced in the tissues supplied by those vessels and necessi- tating a freer supply of blood is an undecided question. The constant current does produce contraction of muscular tissue, just as the induced current does, at every make and break, but the redness of the part is produced if a moderate current as regards strength is allowed to flow continuously for a very short time, the previous or subsequent 24 ELECTRICITY making and breaking of the current appearing to have no effect upon it. It is probable that changes are induced in the ultimate tissue cells of a part exposed to a con- stant current of electricity analogous to the chemical action produced in the electrolysis of water. If the current is weak the process does not go so far as splitting up the watery parts of the cell into oxygen and hydrogen, but produces some sort of activity in the cell not present there before. It increases or alters the character of the secretion of the cells composing secreting glands as evidenced by the increase of saliva and metallic taste in the mouth produced by the application of a continuous current of electricity anywhere in the neighbourhood of the salivary glands. This probable increased cellular activity, the quickening of the building up and destruction of cells never- ceasingly going on in the living body, is sufficient to account for the increased demand for blood required for these changes, and the resulting increased supply afforded by the dilatation of the capillaries. The capillaries do not dilate by any power possessed by the constant current to cause muscular relaxation, but secondarily through nervous influence excited by the demand produced in the cells for more blood. The action of the constant current upon muscular tissue, if anything ELECTRICITY 25 beyond, besides inducing these probable changes in the ultimate muscular elements leading to increased activity in the ultimate cells, increased nutrition, and therefore increased tone (as it is called), is probably to induce contraction rather than relaxation. In considering these changes in the cellular elements of the body and in the blood supply the osmotic power of electricity must not be for- gotten. It has been found that if two fluids of difierent densities be divided by a porous dia- phragm and an electric current be made to pass through them osmosis takes place in the direction of the current. If the current passes from the lighter to the denser fluid the natural osmotic action is increased ; but if the current passes in the reverse direction the osmotic action is reversed, the denser fluid passing through the diaphragm into the less dense. The osmotic power of elec- tricity probably explains the influence of galva- nism in causing the absorption of fluid effused into joints or serous cavities when applied in such cases. In a recent paper on the formation of uric acid Dr Latham, the Downing Professor of Medicine in this University, has sought to prove that the presence of uric acid in the blood is due to the imperfect metabolism of glycocine, which takes place under certain conditions, one being an 26 BLEOTRICITY insufficient amount of exercise. When a proper amount of exercise is taken the glycocine is trans- formed into urea and normally eliminated by the kidneys. He has also sought to prove that this more-to-be-desired metabolisis is dependent upon a due amount of nerve force, and that the produc- tion of nerve force is encouraged by exercise. It has also been proved that the contraction of muscle produces electrical currents. After passing on to describe the electrolysis of urea carried out by Professor Dewar, also of this University, Professor Latham makes the interesting remark that "if there be any correspondence at all between nerve force and the electrical current, this experiment possesses great significance." As a matter of fact we do not know what nerve force is or what electricity is; they are both possibly modifications of motion as has been suggested is the case with heat and light. All we know is that the only distinctly appreciable change in a nerve during the passage of a nervous impulse is an electrical one (Michael Foster). It would be a happy result of the inquiries above alluded to if in the future we should be able to prevent gout by the application of electricity. In many cases, it seems to me, the natural nervous force or impulse, as it is called, is almost wanting or very much reduced in strength. ELEOTRIOITY 27 Sucli cases occur after very severe and prostrating illnesses, and also in persons wlio from some cause or other, such as mental strain, anxiety, grief, exhaustion from bodily exertion, and the like, are brought down to a condition which is called ''being below par." In some families this condition of health, or non-health, seems to be constitutional, many members being characterised by an apathetic phlegmatic temperament, to whom the performance of any of the active vocations of life seems a trouble; they want rousing and influencing by some unwonted stimu- lus to make them take an interest in, or do, anything. In many such people I have observed conditions which have led me to suppose that the natural nerve force or current is decreased in amount. Although their electro -sensibility is not impaired or the resistance they offer to electricity increased, it requires a much stronger current than usual to produce muscular contraction, and therefore I should argue, that it requires a much greater mental effort or a much greater excite- ment for the production of electrical separation (when artificial stimuli are not applied) to produce muscular contraction or mental activity of any sort. The normal amount of electrical separation going on in the body is reduced in quantity, or the centres for producing electrical separation (if 28 ELECTRICITY such exist) are not executing their function to the full extent. I can suppose that such a centre for electrical separation does exist and that it is most likely situated in the medulla. I have noticed this reduction in electrical excitability especially to follow severe cases of typhoid fever while patients are in that childish and semi-idiotic state which not so very infrequently accompanies con- valescence from that disease. And general gal- vanisation quickly restores such persons to a proper nervous and mental condition, gives them courage and buoyancy of spirits, and generally improves their nervous tone. But it is not neces- sary to demonstrate the presence of an electric centre in the human body to argue that electrical separation does, and is continually taking place. McKendrick, who denies the existence of such a centre to all but a few fishes and animals, allows that electrical separation takes place in the muscles at the moment of contraction and in the retina of the eye on the incidence of light, due in his opinion to chemical changes. All the vital processes of the body, the building up and de- generation of the tissues, digestion and secretion, are accompanied and carried out by the means of chemical processes, and in this human laboratory is it to be maintained that all these chemical re- actions take place without the production of ELECTRICITY 29 electrical separation? On the other hand, in reality, may not the body be looked upon as a collection of innumerable small batteries continu- ally splitting up electricity into its positive and negative components ? In living nerve there is always a natural nerve current which can be detected by a galvanometer. The only change we are at present cognisant of as accompanying a nervous impulse is a negative variation of this natural nerve current. It is not dependent on the nature of the stimulus which produces the nerve impulse, that is, it may be chemical, mechanical, or electrical, or from one of those modifications of motion known as sound, light, or heat. Of the nature of the action of organic or vital stimuli we know very little (Michael Foster). The rate of travelling of the negative variation along a nerve is 28 metres per second and is identical with the rate of travelling, of a nervous impulse. The negative variation passes in the form of a wave. The whole wave takes '0007 of a second to pass any given point of a nerve. The length of the wave is 18 milli- metres. Therefore a nervous impulse is a mole- cular disturbance propagated along the nerve in the form of a wave of the length of 18 millimetres and possessing a velocity of 28 metres per second. The experiments of physiologists of the present 30 tlLECTEIOI'TY day on the action of electricity upon nerves and the natural nerve currents have been confined to the action of dynamic electricity in the form of the constant current or the interrupted current. I can find no experiments as to the electrotonic condition of nerves under the application of statical electricity ; for example when a length of nerve is charged positively. When a constant current is passed we know that the normal nerve current is increased about the region of the positive pole. This corresponds to the observed action of a positive charge in improving the general nervous tone of the body. The negative charge produces a condition of body as of utter prostration, similar to that produced by blood-letting, and similar to those conditions I have described as accompanying great prostration from severe illness or other causes when the-irritability or normal con- dition of the nerves has deteriorated, the natural nerve current diminished, or the nerves are in a condition of permanent decreased excitability. The relationship between electricity and nerve force has given rise to much controversy. Sir John Herschel* hints at this relationship and supposes that the brain may be either the organ of secretion or at least of the application of the vis nervosa ; he remarks, " If the brain be an • ' Discourses on the Study of Natui-al Philosophy/ EtiBCTRIOiTY • 31 electric pile constantly in action, it may be con- ceived to discharge itself at regular intervals, when the tension of the electricity reaches a certain point along the nerves which communicate with the heart and thus to excite the pulsations of that organ." Dr Arnott also hinted at some such cause being the active agent in keeping up the regular pulsations of the heart. Dr Golding Bird did not believe in the identity of electricity and nerve force, but believed that as electricity will excite magnetism in a bar of soft iron so will electricity excite nerve force in the brain or nervous cords. Drs Beard and Rockwell in their work on ' Medical Electricity ' say that " between the behaviour of electricity in animal bodies (animal electricity), electricity in general (statical and dynamical electricity) and magnetism there are analogies so close and so consistent as to warrant the view that all are but different mani- festations of one force '^ Dr Yivian Poore says that " the inference has been, by some, too hastily drawn, that nerve force and electrical force are identical. That the two forces are related in so far that the one most readily excites the other there can be no doubt, and that they are very closely correlated there is every reason to believCj but that they are not identical the following reflections seem to show '- 32 ELECTRICITY " 1. The rapidity of the transmission differs — that of electricity being estimated at 462,000,000 of feet per second, and that of nerve force at only about 200 feet per second. " 2. Nerve force is not conductible along a metallic wire. " 3. Cold diminishes the conducting power of nerves for nerve force, whereas it increases the conducting power of solids or fluids for elec- tricity. "4. The crushing or compression of a nerve destroys its conductivity. It may be, however, that the crushing of a nerve is analogous to the breaking of the copper conductor in an insulated telegraph wire." To this it should be added that when a current of electricity is passed along a nerve it only travels at the same rate as nerve force. And the argu- ment that a ligature placed upon a nerve arrests the passage of a nerve impulse, and would not arrest an electric current, is not altogether true, for an electric current of low tension passed along a nerve can be stopped by the application of a ligature. Dr Michael Foster dismisses this question by asserting that " of the nature of the action of organic or vital stimuli we know very little." One of the most interesting facts connected with ELECTEICITY 33 the influence of electricity upon nerve force has been shown by experiments carried out by Dr Poore. He has proved that the passage of the continuous current through muscles or the nerves supplying them, increases their susceptibility to the stimulus of the will, and also their endurance for voluntary muscular action. He found that a weight of seventeen ounces could be held out in the hand at right angles to the body for double the time when a constant current was passed through the arm than when no electricity was used. He also found that the force of voluntary muscular action measured by the dynamometer could be very greatly increased by the passage through the arm of a galvanic current. It was found that galvanism increased the force of the squeeze of his own hand about eleven pounds. A greater increase was obtained in experiments upon other individuals. This property of the constant current in restoring the excitability of exhausted muscles has been called its refreshing effect. We have of late years begun to recognise the influence of the physical phenomena upon the conditions of health and disease. We know that the humidity of a locality as aff'ected by the subsoil drainage has more influence upon the prevalence of phthisis than any amount of hereditary predis- position or abundance of bacilli ; that the baro- 3 34 BLEOTBICITY metric pressure influences the blood pressure ; that electrical changes in the atmosphere, as on the approach of a thunderstorm, influence strongly many persons possessed of delicately strung nerves ; that sound in the form of music has also an influence upon the circulation, no doubt through the vaso-motor system, but how that system is afiected by music we do not at present understand. We also know that the varying vibrations of ether producing light of different colours have a great influence in the treatment of the insane. How these several influences act we are not as yet able to explain. The difference produced in highly sensitive or nervous people by sudden and marked changes in the weather, especially sudden changes of temperature to which this climate is so liable, is due to the electric changes produced in the individual. It is a well-known and recognised fact that a few hot days in succession so change the electrical condition of the surface of the earth that a thunderstorm is often necessary to restore equilibrium. It is impossible for human beings to remain at a position of zero with regard to electrical potential when the potential of every object around is varying. Induction alone would produce electrical separation. It is fortunate for us we live in a climate with the atmosphere so ELECTRICITY 35 charged with moisture that the varying electrical conditions can be more easily equalised. If such sudden changes of temperature took place in countries with a dry atmosphere the inhabitants would suffer considerably. Perhaps these climatic conditions have more influence in producing the peculiar characteristics of race than has been sup- posed. The self-possession and undemonstrative demeanour of an Englishman may be due to the more ready equalisation of electrical disturbances, and the excited and vivacious tendencies of the denizens of more southern climes to an absence of the chief means for restoring equilibrium. In those parts of the earth where the air is very dry the manifestations of animal electricity recorded are almost incredible to the inhabitants of these islands. Rubbing the feet a few times on the carpet will enable an inhabitant of the Southern States of America to light the gas by the spark which will pass when he presents his finger to the metal point of a gas burner ; and electrical displays are produced by combing the hair, which a moist atmosphere alone prevents us from perceiving in this country. There are good reasons for believing that the electrical conditions of the atmosphere influence health. I have deferred reading my thesis hoping to have had more leisure or opportunity for ob- 36 ELECTRICI'ft servation and experiment. I hoped to have been in possession of incontrovertible facts that electri- cal conditions of the atmosphere do influence health. I can now only argue from what has already been written that it is likely that they do so and show in what direction I hope to be able to prosecute inquiry. I have therefore to resort to the observations of others and can only draw deductions from the facts which they detail. But these facts in many instances bear out the state- ments of eminent observers quoted in my former thesis.* If they be compared with fche facts recently discovered concerning atmospheric elec- tricity and terrestial magnetism they will in many instances be found to correspond. But this result seems to me to be certain, that if differences in the electrical condition of the earth do take place and are continually taking place, a highly sensitive organism such as the human body must participate and take cognisance of these changes, and it is not too much to suppose that these changes have some influence upon health. To put my proposition in another way. All conditions of the atmosphere which have been noticed to influence health prejudicially are accompanied by a development or increase in the amount of negative electricity. Before a thunder- ♦ * Spasmodic Asthma,* 1879. ELECTRICITY 37 storm, when many people of a delicate nervous temperament assert that they feel indescribable "malaise" and oppression, the atmosphere in the neighbourhood of the earth is negatively electri- fied, and I have known ladies made to feel ex- tremely ill when attending a lecture on electrixjity accompanied by experiments when a large amount of free electricity has been produced. The posi- tive variety being more easily conducted away there remains an undue amount of negative elec- tricity. In my thesis on Asthma for the M.B. degree I hinted that possibly the varying electrical con- ditions of the atmosphere might explain the seemingly unaccountable conditions which in- fluence and produce an attack of the disease.* Since then the straggle for existence which young physicians have to maintain has prevented me devoting the time I could have wished to investi- gate this theory further, nor am I able to discover that very much additional knowledge has been obtained by those who have had time to prosecute investigation. " We know that the electrical potentials of different places on and in the earth differ considerably, sometimes to the extent of * ' Spasmodic Asthma.' A thesis for the M.B. degree of the University of Cambridge. By W. E. Steavenson. Cambridge : Deighton, Bell & Co. 2nd edition, pp. 9-17. 38 ELECTRICITt several hundred volts."* "We obtain this in- formation from the currents observed to flow through wires joining parts of the earth widely separated." t " Electrified masses of air moving at no great distance from the earth's surface are continually altering the distribution of electricity," " which is, however, generally found to be nega- tive on the earth's surface." Sir William Thompson found that the potential of the air varied very rapidly near the surface of the earth. Thus he has observed a difference of potential between the earth and the air nine feet above it, equal to 430 volts in ordinary fair wea- ther, and in breezes from the east J and north-east as great a difference as this per foot of air. The potential is perpetually fluctuating, even in fair weather. *' The potential of the air appears to be generally positive in fine weather, and negative only during broken or rainy weather." These recent observations point in addition to the suggestions I have made in my former thesis that the negative variety of electricity has a dele- terious effect upon health.^ I believe I have produced a fit of asthma by charging myself with * The electricity produced by one Daniell's cell=l-08 volts, t ' Electricity and Magnetism.' By Prof. Fleming Jenkin, F.R.S. X Thesis on * Spasmodic Asthma,' p. 16. § P. 9, ibid. ELECTRICITY 39 negative electricity. This was the result of acci- dent, as at the time I made the experiment I was under the impression that I was charging myself positively. The unpleasant result has not en- couraged me to repeat the operation. Another member of this University, who suffers from asthma, tells me that he experienced a similar result when charging himself with electricity in the Cavendish Laboratory.* In delicate individuals and persons of a nervous temperament the changes of weather, and espe- cially an east wind, are known by common obser- vation to act prejudicially. I know that attempts have been made to account for these effects in other ways. The recent observations of the daily variations of terrestial magnetismf accord very closely with the electrical changes by which I have tried to account for the periodicity and the exacerbations of dyspnoea in asthma. J * See also a case mentioned by Sir Thos. Watson in his lecture on " Asthma " in the ' Principles and Practice of Physic,' in which galvanism produced an attack of the disease. t 'Electricity and Magnetism.' Prof. Silvanus Thompson, p. 120, 4th edition, 1883. X Yide * Spasmodic Asthma,' pp. 9, 10. 40 BLECTBIOITT? Diurnal variations of positive electricity in the atmosphere. Ganot. Quetelet at Brussels. Stewart at Kew. Daily variations of the barometer.* Ist minimum 1st maximum 2nd minimum 2nd maximum Before sunrise, 3 to 6 a.m. 11 a.m. A few hours before sunset, 3 p.m. Sunset to 9 p.m. Midnight 8 to 10 a.m. 3 p.m. 6 to 9 p.m. 8 to 10 a.m. 7 to 10p.m. Lowest, 4 a.m. Highest, 10 a.m. Lowest, 4 p.m. Highest, 10 p.m. * The same in all latitudes, but difficult to detect in the tem- perate zones as they occur in conjunction with accidental varia- tions (Ganot). In our climate the south-west winds, which are usually warm and therefore light, cause a fall in the barometer, and they are also usually charged with moisture from evaporation from the vast expanse of ocean they pass over and are therefore charged with positive electricity. The east and north-east winds are cold and dry from passing over vast continents and are there- fore denser, and cause a rise in the barometer and are usually accompanied by an increase in the negative electricity. The predominance of positive electricity in foggy weather is the cause I have assigned for the ELECTRICITY 41 immunity then experienced from attacks of pure nervous asthma, though the ordinary dyspnoea accompanying bronchitis and emphysema is often increased. When we consider that every vital process is most Hkely accompanied by the production of free electricity in our bodies, — that the incidence of every ray of light upon the retina,* our every act of thought, and certainly our every muscular movement has been proved to produce electrical currents ; is it possible that the varying electrical conditions of the atmosphere can take place without influencing our systems ? The electrical separation taking place in the human body is of a kind intended to counteract as much as possible the changes likely to be induced by the atmospheric electricity so that the normal functions of the body may not be unduly interfered with or arrested. Although the earth and inanimate objects upon it are usually negatively electrified, human beings in a state of health are almost invariably found to be positive. When the body is insulated the elec- trical condition is easily made manifest by the use of a condensing electroscope. Dr Poore in his work on ' Electricity in Medicine and Surgery ' * Prof. McKendrick on * Animal Electricity,' before the Britisli Association for the Advancement of Science, September, 1883. 4 42 ELECTRICITY says, "It is remarkable that hardly any two persons are in the same condition electrically, and nervous irritable people are said to exhibit a more active electrical condition than persons of a phleg- matic temperament." Dr Golding Bird in his lectures before the Royal College of Physicians in 1847 attributes this existence of free electricity in the human body chiefly to evaporation and respira- tion and he sums up his observations on this point under the three following heads. That electricity exists in the human body : — "1st. In a state of equilibrium, common to aU forms of ponderable matter. " 2nd. In a state of tension capable of acting on the electrometer, giving to the whole body a gene- rally positive condition, and arising in all proba- bility from the disturbance of the normal electrical equilibrium by the process of evaporation and re- spiration. " 3rd. In a state of current, a dynamic condition, arising from the disturbance of equilibrium by the union of carbon with oxygen in the capillary sys- tem, and from other chemical processes going on in the body ; such currents, although suspected to be everywhere existing, having been actually detected between the skin and mucous membrane, the stomach and liver, and the interior and exte- rior of muscular structures." ELECTRICITY 43 The good results derived from the use of stati- cal electricity were probably misunderstood and did not depend upon the shocks given to the sys- tem of the individual but to the preliminary charging of the patient with the electric fluid which possibly counteracted the electric condition on which the illness of the patient depended ; the morbid condition depending on the presence of an accumulation of negative electricity. As a matter of fact most patients when charged were charged positively. Should I be able by future experiment to prove, what I very much suspect to be the case, that negative electricity exercises a baneful influence upon health and that many of the conditions of ill-health and depressed vital energy are associated with the development or presence of an increased amount of negative electricity in the human body, the form of treatment by statical electricity will again come into vogue and the electroscope will become an indispensable adjunct to the many in- struments now employed in physical diagnosis. 1)^Koii>:rt Stkavknson of NEWCA8TI^:E on TYIVK. [ at Berwick Born 1756.1 n. ^ Died 1828 ' -^ [-on-lweed. Arms as borne by Dr. ROBERT STEAVENSON, of Newcaftlcon- Tyne. Azure, on a bend Argent between two Lyons pallant Or, three Leopards' heads Gules. Granted unto John Stea'venfon of Stanton and Elton in the Peak, in the - County of Derby, and to his Deicendants, by Sir Thomas St. George Garter, and Sir John Dugdale Norroy, the 14th of Jinie, and 4th year of the Reign of King James the Second, Anno Domini 1688. See Lyfon's " Magna Britannia," Vol. V. Derbyfhire. London, 181 7. "Families extinft, or removed out of the County liuce 1500." DISSERTATIO MEDICA INAUGURALIS, D E Eledricitate et Operatione ejus in Morbis Curandis. Q^ U A M, ANNUENTE SUMMO NUMINE, Ex Audtoritate Reverendi admodum Viri, D. GULIELMI ROBERTSON, S.S.T.P. ACADEMIC EDINBURGEN2E Praefeai j NEC N O N Ampliffimi SENATUS ACAD EMI CI confenfu, Et nobiliflimae FACULTATIS MEDICiE decreto, Pro GRADU DOCTORATUS, SUMMISQ^UE IN MEDICINA H0N0RIBU3 AC PRIVILEGIIS RITE ET LEGITIME CONS E Q^UEN DIS J Eruditorum examini fubjicit ROBERTUS STEAVENSON, A.M. Britannus. Soc. Med. Sod. nee non Soc. Phyf. Chir. Soc. Hon. * Nil mortalibus arduum eft. * Coelum ipfum petimus ftultitia : neque * Per noftrum patimur fcelus * Iracunda Jovem ponere F u l m i n a. Q^ HoRAT. Carm. Ad diem 24. Junii, hora locoque folitis. E D I N B U R G I: Apud BALFOUR et SMELLIE, Academiae Typographos. M,DCC,LXXVIII. Juveni ornatiffimo GUALTERO OGILVY, A R M I G E R O, Filio natu maximo Joannis Ogilvie de Innerquharity, Equitis Aurati, Omnibus, ob morum comitatem, Illi, tarn ob familiaritatem, Dum in Academia Andreapolitana Philofophiae ftudio per triennium verfabantur, Quam ob amicitiam Qua libi inde devinxit, Chariflimo ; Nee non, Senator! illuftriffimo JACOBO WILKINSON, A R M I G E R O, In rebus publicis, ^que ac privatis adminiftrandis, Speftatiffimo, Ob morum fuavitatem et elegantiam, Ob vitae quinetiam probitatem, Infigni ; Denique, Eruditiffimo J O A N N I BURN, M. D. Artem Appollinarem apud Bervicenfes, Summo cum honore fuo, Et civium falute, Exercenti, JEquc ob praecepta in re medica, Dum, illo aufpice, aegros quamplurimos Per triennium vifitabat, Colendo Temper et venerando, Ac ob confilium amicitiamque, Quibus fe dignatus eft, Dum in academia Edinenfi, Per quadriennium ftudio medicinae incubuit ; Hafce ftudiorum primitias Laeto Animo dicat A u c T o R. DISSERTATIO MEDICA INAUGURALIS, D E Ele&icitate et Operatione ejus in Morbis Curandis. SI C U T genus humanum ex ftatu in- culto et barbaro, ad morum comitatem et urbanitatem progreditur fenfim, ita phi- lofophia ex primo quafi diluculo ad perfec- tionem procedit. Uno in feculo, cafus for- tuitus vel ingenium profundum diverfis arti- bus et fcientiis originem praebuit, feculorum autem fequentium induftria et experientia magnopere hafce excoluit. Tametfi non nobis videtur, antiques recentioribus inge- nio fecundos fuiffe, attamen hi fua experi- A entia 2 DE ELECTRICITATE. entia ad illorum Ingenium accedente, pluri- mis fcientiae partibus, et praecipue phyficis, illis longe praeeunt. Scientia ita fenfim ad ftatum cultum per- veniente, eleftricitas non nili in feculo prae- ienti in lucem prolata erat ; quamvis enim fcriptores antiqui corpora memorabant, quae poll frid:ionem corpora leviora ad fe adtra- hendi virtute praedita erant; nihilominus, hoc ex fluido jam eledirico didlo pendere omnino nefciebant. Fulgur, olim quafi Deo ipli facrum, et mortalium impiorum flagel- lum, ducebatur ; hodie autem per fyftema mundanum quaquaverfum dilpergi, et aegris lanitatem reddere, repertum eft ; ex fluido enim pendet eleftrico, quod aeque e terra excitari ac nubibus extrahi poteft, et per quod unumquodque fulguris phaenomenon imitari queat. Phaenomena quidem plurima ex hoc flu- ido originem ducere, quarum caufae -phi- lofophis feculi prioris omnino erant ignotae, jam recfte intelliguntur ; monftraverunt enim noftri auroram borealem, terrae motus, tur- bines. DE ELECTRICITATE. 3 bines, meteora, &c. a fluido eledtrico prorfus pendere. Eleftricitas multa praebet phae- nomena, quae ad animi obledlationem, quam ad vitae commodum, aptiora fuiffent, nili Franklin ingenio praeftantiffimas, fcientiam ejus de ele6tricitatis viribis ad fulguris id:i- bus periculo plenis obviam eundum, et Jalla- bert fuam ad morbos fanandos faufte con- verterant ; etfi autem plurimi cognofcuntur eleftricitatis effeftus, nobis tamen affirmare licet, multos adhuc tenebris involutes effe. Quamvis eled:ricitatem inter remedia max- ime poUentia hodie merito locum habere conceditur, vires adhuc, per quas ex corpore humano morbos toUit, baud fatis cognof- cuntur ; quamobrem empirice quali utitur. Statuimus igitur Modum Operandi ejus, quam optime poffumus, explicare et de- hinc Morbos enumerare in quibus curandis maxima poUicetur : Imprimis autem DE MODIS APPLICANDI, pauca funt dicenda. Fluidum eledricum plurimas poffidet qualitates maxime mira- biles. 4 DE ELECTRICITATE. bfles, quarum paucas attentione noftra prae- cipue dignas enumeremus, quia rationis ap- plicandi, et forfitan agendi explicationi, in- ferviant. \mOy Syftema terreftre undequaque per- vadit, adeo ut corpora omnia certam poffi- dent quantitatem quafi latentem, et hac fub conditione, corpora fluido eledirico latiari, et fluidum eledlricum aequilibrium et requiem tenere, dicuntur. 2doy Friftione quorundam corporum, e. g. cylindri vitrei, &c. aequilibrium et requies turbantur, et tunc temp oris excitari fertur. 3//<!?, Ex corporibus quibufdam extrahi et alibi deduci, in aliis accumulari et deniari, et in omnibus fitus mutari, poteft : Dehinc corpora, quoad fluidum eledtricum, in duas dividuntur clafles, nempe, Excitantium, quae Eledlricay et Deducentium, quae ConduBoreSy appellantur. Ad claflem pofteriorem per- tinent metalla, fluida vel humida, carbones et terrae micaceae ; corpora fere omnia alia inter eleftrica enumeranda funt. Porro, ob- fervandum efl, corpora quae fluidum eledtri- cum DE ELECTRICITATE. 5 cum excitant non id deducere, quam ob cau- 1am Non-conduBores, et ea quae ducunt haud excitare, atque adeo Non-Ele5frica de- fignantur. 4/^, Siquando aequilibrium turbatur, e. g. fi in corpore quovis fluidum eledtricum ac- cumulatur, five ex quovis tollitur, five in cujulvis corporis parte vel fiiperficie una ac- cumulatur et denfatur, dum ex altera ejuf- dem fiiperficie auferatur, (quod in experi- mento Lugdunenfi accidit) condudtore admo- to, infinita et pene incredibili velocitate ae- quilibrium renovatur. 5/0, Conftanter alios aliis anteponit con- dudioribus, etfi longe ex curfii redlo deflec- titur, e. g. carboni metalla, et fluidis ante- ponit carbonem ; proximis autem itineribus, (caeteris paribus) aequilibrium petit. 6tOy Subtilitate et mobilitate gaudet exi- mia, adeo ut corpora ducentia facillime per- vadit, atque EleBrtcis (e. g. vitro, &c.) infi- det, quamvis haec non pervadit. Exhifce proprietatibuseledlricitatis ad cor- pus humanumtres fiant applicandi modi, quo- rum 6 DE ELECTRICITATE. rum uno, qui Infulatio vocatur, fluidurti eledlri- cum excitatum interventu elecflrici, quo minus adcorporacircumjacentiatranfiret,prohibetur, unde neceffario in corpus humanum cumu- latur. Dum haec perficitur operatio, flui- dum eledlricum corporis latebras unafquaf- que intimas pervadit, et ad aerem externum gradatim celeritate pluri vel minore, pro hu- miditate ficcitateve aeris, per porum unum- quemque evolat, et fluida fecum ducit. Hic- ce modus applicandi, fluidi eledlrici excitati qualitates nativas exhibet, peripirationem afFatim adauget, cordis et arteriarum pulfa- tiones quodammodo accelerat, fudorem faepe elicit, et fecretiones univerias promovet. Si corpori infulato et fluido eledirico ex- citato plus jufto onerato Condudlor fubito ap- plicatur, fluidum redundans ilium maxima petit velocitate, et (dummodo accuminatus non fit) forma fcintillae luminofae vix cor- pus relinquit, atque parti dolorem et ru- borem per impulfum fuum infligit ; vel fi condudlori infulato et fluido onerato corpo- ris humani pars quaevis applicatur, fcintil- 1am DE ELECTRICITATE. 7 lam et idum accipit. Horum modorum prior eofdem pene ac infulatio edit effedtus, ftimulo topico mechanico conjundios, pofte- rior vix alium praeter ftimulum praebet to- picum mechanicum. Si igitur efFedlus ge- nerales aeque ac ftimulum topicum defide- ramus. Scintilla aegro infulato extrahenda eft ; fin autem ftimulum topicum folum volumus. Scintilla^ ei non infulato, danda. Si fluidum in fiiperficiem unam corporis * ele5lrici per fe ' difti, e. g. laminae vitreae vel phyalae accumulatur et denfatur, ex al- tera fiiperficie copia aequali pellitur; elec- trica enim non nifi nativam poflunt tenere fluidi quantitatem, quamvis locus vel diftri- butio ipfius mutari queat ; in fuperficie una igitur dic»remus fluidum, in altera, materi- am praeponderare. Quamprimum autem communicatio unam inter alteramque fiiper- ficiem applicatione condudloris conftituitur, aequilibrium velocitate plure aut minore, pro ratione fiiperficiei eleftrici, condenfationis fluidi, et conduftoris perfecftionis, et impulfii forti revocatur, velocitas enim et impulfiis fluidi 8 DE ELECTRICITATE. fluidi eleftrici, aeque ac aliorum fluidorum vi refiliendi gaudentium, denfatione augetur. Dum fluidum eledtricum in fuperficiem al- teram phyalae vel laminae vitreae cumulatur, Onerari fertur, et li corpus humanum (quod fluidum eledlricum non nifi ope humorum ducit) communicationemt unam inter alte- ramque fuperficiem inftituet, aequilibrium per corpus renovatur, corpus iftum accipit accerrimum vel SuccuJ/ionem, et phyala Explo- di fertur. Huic nomen Succujfus imponitur, et fluidum hoc applicandi modo fyflema partim tantum, maxima autem pervadit ve- locitate ; itinere enim reftiflimo aequilibrium et diffufionem petit aequabilem. Quoad igitur eledlricitatis ad corpus ap- plicationem, Infulatio plurimis in morbis fine periculo, et multis commodo, adhiberi potefl: ; Succufliis paucis tantum et in hifce fumma laepe prudentia. Scintillae quam Suc- cuflTus magis, quam Infulatio minus, frequen- ter admittendae funt. Dum conduftorum acuminatorum dotem, fcilicet fluidum eleftricum cumulatum filen- ter DE ELECTRICITATE. 9 ter et fine fcintilla e corporibus fubito extra- hendi, in animo verfabam, quarta applicandi forma, quae commodum poUicetur, mihi per- venit in mentem, quae, ut ab aliis diftingua- tur, Penicilla nominarem. Pundla fluidum excitatum avide attrahere apprime notum eft; fi igitur corpori humano infulato, et fluido elecftrico plus jure onerato, admoveatur con- duftor cufpidatus, fluidum exuberans, fine impulfii, fimul fine dolore, hac ex parte for- ma penicilli luminofi extrahetur ; unde co- pia et velocitas fluidi per partem quamcun- que placuimus tranfeuntis multum augean- tur, et fi fpatium per quod fluidum eftugit amplificaremus, tantum neceflarium erit mu- crones numero augere. Nulla adhuc feci ex- perimenta, quamvis mihi eft in animo quae- dam ad hoc fpedlantia inftituere ; probabile enim mihi videtur, quod ad tumores Schir- rhodeos folvendos, in quibus fuppurationem omnino praecaveremus, admodum utile fo- ret ; forfan etiam in quibufdam Phlegmafiis commodo adminiftrari pofl^et. B Antequam lo DE ELECTRICITATE. Antequam huicce diflertationis parti fi- nem imponamus, obfervandum eft, medicos eleftricitatis exhibitionem raro lat diligenter profequi ; baud enim oblivifci debemus, quod, etfi eleftricitas morbos quofdam fubito et quafi incantatione toUit, in aliis tamen diu- turna eft utenda perfeverantia ; et, quamvis poft fpatium bimeftre vel trimeftre nullum ex ilia aeger accepiflet commodum, nequa- quam tamen defperandus eft fticceffus ; mor- bos enim baud aliter curandos poft fex etiam menfes fuftulit*. ' Shenftone ' autem dixit * patience is a panacaea ; but where is it to * be found, and who can fwallow it.' DE MODO OPERANDI. Ex animadverfionibus hifce de applicandi modis, nobis conjicere liceat, elecSlricitatis o- perationem diverlam, fecundum applicationis diflimilitudinem, fore ; et revera compertum habemus, fuccuflionem nimiam eodem ac idlus vehementes modo vitam prorfus ex- tinxifle, * De Haen ratio medendi. DE ELECTRICITATE. ii tinxiffe, applicationes autem leniores mem- bra torpida et quaii mortua ad vitam revo- caffe. De Modo Operandi in duas abiere partes vifi docfli, quarum altera vult eledlricitatem pro ftimulo fimpliciter agere, altera autem plurimis argumentis ftabilire conata eft flui- dum elecSricum in corporibus viventibus fen- fationem et motum perficere, vel idem cum Fluido Nerveo effe*; et dehinc, fluidum elec- tricum paralyfin toUere, vis nerveae copiam augendo, et itinere fuo impedimenta mo- vendo, crediderunt. De priori autem opinione prius loquen- dum eft ; et ut illius in veritatem accurate inquiremus, ftimulantium, ut et eled:ricitatis, quibufdam in morbis effeftus fpedlemus. Stimulantia in fibram nerveam vel fenti- entem tantum agunt, quod ex nervi fenfibi- litate et quarundam fenfationum intoUeran- tia accidit ; et dehinc mufculorum, praecipue fanguinis circulationi infervientium, contrac- tiones aeque frequentia ac vi adaugent ; nul- lum ergo, nifi quoad ob acrimoniam corru- gant * Defliais a Montpellier. 12 DE ELECTRICITATE. gant vel rodunt, efFedtum in fibram non fen- tientem primarium edunt. Eledlricitas, e contra, Paralyfi medetur ; vires autem ejus ftimulantes hoc in exemplo phaenomena haud explicabunt ; nervum enim neque fenfiitione nee motu gauden- tern, et idcirco ftimulo non excitandum, fuf- citat, et hujufce fenfibilitatem et vires re- dintegrat. EledtricitasAmenorrhoeam amovet,et flu- orem menftruum fexus lequioris, fanitati maxime neceflarium, faepiffime reftituit, eo ut Franklin, qui multoties eledlricitate hoc in morbo ufus eft, affirmat illam raro expefta- tionem fuam fefelliffe. Stimulantibus au- tem fortiffimis laepe iaep;us pertinaciter re- fiftit Amenorrhoea, et medicorum conamina deludit ; lie, vinum et exercitium cordis et arteriarum pullationes, magis quam eleftri- tas, accelerant ; fi ergo hujulce efFed:us fti- mulo folo penderent, vinum, &c. magis ad hoc pollerent propofitum ; fed experientia hanc non ratam facit confecutionem. Tumores DE ELECTRICITATE. 13 Tumores * fcirrhodei fluido eledlrico in- terdum folvuntur, nequaquam autem per vim ftimulantem ; ex ftimulo enim fuppura- tio potius timenda foret, et revera fcintillae eleftricae, quae manifefte ftimulant, fuppu- rationem properant. •fCalculorum per ureteres tranlitum acce- lerat eledlricitas ; ftimulantia autem potius impedirent ; quicquid enim ureteres irritat, fpafmos inducit, et ureteris lumen anguflum reddit, atque idcirco hoc in morbo nobis vi- tanda foret. JEledirizatio calvitiem amovet, et capillo- rum incrementum promovet, quae vi ftimu- lanti haud tribuenda liint. Dehinc nobis concludere fas eife videtur, quod, etfi vim ftimulantem mechanicam ex momento ipfius pedentem, Elediricitati cer- to in modo applicatae haud recufemus ; qua- litates tamen aliae in calculum operationis fiiae font accipiendae, ut, Praxeos rationem praefinire, Indicationes idoneas ftatuere, et quibus * Med. Comment, v. 4. p. 82. t Wefley's defideratum. J Carmichael tentamen, p. 33. 14 DE ELECTRICITATE. quibus in morbis commodum ab illius ufu expecftandum eft praedicare, queamus. Cum ergo monftravimus, banc theoriam eledlricitatis effedtuum horum explication! imparem efle, fententiam a Deihais editam perfcrutemur, et argumenta ad opinionem fuam confirmandum allata confideremus. \mOy Dicit, coUifiones fluida inter et fo- lida animalium fluidum elediricum in corpo- re fponte latentemexcitare,et hoc manifeftum efle redditum per id quod animalium crinibus obtinet ; fi enim eorum capilli in tenebris fricantur, fluidum eledlricum ex hifce eviden- ter effugere. Obfervandum eft autem, hoc non a poteftate pendere animalibus viventi- bus peculiari, verum ab eledtrici (nempe crinum animalium) fricftione excitatum efl^e. 2^(?, Aflirmat nervos, prae aliis fyftematis partibus, fluidum eleftricum ducere ; quia, fi canem viventem, poftea quod grandem de- nudaveris et fecueris nervum, eleftrizares, radii luminofi ex nervo jaculantur. Hoc i- terum non ex intima nervi fabrica, verum humiditate qua obtegitur, et ex acuminato- rum DE ELECTRICITATE. 15 rum viribus nuper memoratis, pendet. Ner- vi eledricitatem imperfedle tantum ducunt*. ^tio, Exiftimat fluidum eledlricum, vel (quod fecundum ilium idem eft) nerveum ad cerebrum, Tadlus fenfationem ad communi- candum non redire, verum ad corpus quod tangimus tranfire. Huic autem refponde- mus, quod corpora aequali copia fluidi elec- trici gaudentia iibi invicem eled:ricitatem non communicant ; fluidum autem eledtri- cum inter corpora elediricis non disjundla aeque diflfunditur, et hac fub conditione, nulla elediricitatis oftendit figna ; rebus igi- tur fie fefe habentibus, neque corpus no- ftrum nee vicina fentire poflemus. Porro, obfervandum eft, quod energia ner- vea, aeque fi conduBore, ae fi eleBrico nervus ligatur, prorfus dirimitur. Argumentum, denique, quod banc theoriam ex toto fubver- tit adhuc reftat ; nam, fi hoc obtineret, et ex fyftemate vivente fluidum elediricum extra- heremus * Ab experimentis compertum habeo, nervos liccos haud omnino, recentes autem facile, fluidum eleftricum ducere, quamvis vix aeque ac corpus integrum. i6 DE ELECTRICITATE. heremus nativum, vim nerveam etiam tol- leremus, et, fi partim vim nerveam pro ra- ta parte minueremus, res autem neutiquam ita ftfc habet. Hifce ergo repudiatis, rationem Operatio- nis eleftricitatis timide et diffidentur attinga- mus, et ideam noftram hac de quaeftione in medium proferamus : Imprimis autem quaf- dam fluidi eledlrici qualitates, quae nobis actionem fuam in corpus humanum invefti- gantibus auxilium ferant, enumerabimus. Nemo eleftricitatis peritus ignorat, flui- dum eleftricum excitatum, fluidorum per tubulos Capillares tranfeuntium velocitatem plurimum augere ; dehinc plantarum fuccos et incrementum promovet. Per fubtilitatem et tenuitatem eximiam fyftematis humani vafa etiam minima pervadit; quapropter cre- deremus, fluidum eleftricum, cum per fyfte- ma copiofe tranlit, fluidorum per-va£ mi- nima progredientium velocitatem adaugere, abfque cordis et arteriarum auxilio. Nos non fallit haec opinio; eleftrizatio enim fim- plex DE ELECTRICITATE, 17 plex vel infulatio* perfpirationem pluri- mum auget, et fudorem copiofum interdum elicit, etli cordis et arteriarum pulfationes vix accelerat. Ex hifce fluidi eledirici excitati qualitati- bus, nempe, fubtilitate eximia, per quam cor- pora ducentia pervadit, velocitate immenfa, qua inter corpora femet uniformiter diiFun- dere proclivis eft, poteftate qua fluidorum per vala etiam minima tranlitum accelerat, et poftremo, ex proprietate per quam fluida Eleftricum Fluidum ducunt,Operationis fuae in Morbis Curandis explicationem conabi- mur. Ut inveftigationem banc ritu meliori pro- fequamur, atque ut Theoria noftra clariori luce appareat, quaedam de indole et cauia proxima morbi pertinaciffimi, (nempe Para- lyfeos), in quo fublevando eled:ricitatis vires experientia apprime fanciuntur, in medium proferamus neceffe eft. Paralyfis pro ortu fuo duas agnofcit cau- fas proximas diffimiles, fcilicet, fyftematis C nervei * Abbe Nollet, Phil. Tranf. V. lo. 384. i8 DE ELECTRICITATE. nervei Compreffionem, et ftatum qui Collap- fus vocatur. Eledtricitas Paralyfin ex collap- fu pendentem tantum tollit ; at, in plerifque ex compreffione originem ducentibus, nocet; coUapfus igitur naturam, vel nervorum in- dolem, ex quo pendet Paralyfis ' ex coUap- * fu didla/ praecipue indagabimus. Omnibus patet, languinis circulationem, et vaforum fanguiferorum tenlionem, ad Vim nerveam in fyftemate vivente gignen- dam et fervandam, aeque effe neceflarias ; quapropter cerebrum vaforum numero, et forfan horum divifione et diftributione inti- ma, prae caeteris longe eminet vifceribus. Fibrillae porro nerveae ubique vafculis mini- mis fuppeditantur languiferis, et, fecundum anatomia peritiffimum Monro feniorem, * ' The nervous cords have fuch numerous ' blood-veffels, that after their arteries only * are injecfted, the whole cord is tinged with * the colour of the injedted liquor.' Nervos vafis fanguiferis energiam fuam prorfusdebere,quotidiana monet experientia ; fie, • On the nerves. DE ELECTRICITATE. 19 fic,vaforum tenfione per Haemorrhagiam fub- lata, ianguinis per cerebrum et nervos circu- latio imminuitur, et vis nervea aequalem patitur diminutionem ; ulterius progrediente fanguinis effuiione, nervi vi fua privantur, et, fi fanguinis iter per artum qualemcunque impeditur, hoc membrum vim nerveam a- mittit, et paralyfi brevi corripitur. Vim nerveam, e contra, ad vaforum adlio- nes aeque necellariam effe fervandas, nemo negabit. Vis autem mufcularis vel nervea arteriarum, per vafa intervallo longiffimo ex corde diffita, fanguinis circuitum praefertim promovet ; haec enim ferme nullum ex cor- de accipiunt auxilium ; quaproper, li fibrae eorum mufculares vi nervea privantur, cir- culationem fuftinere non poiTunt : Dehinc, in quibufdam paralyticis brachio laefo deor- fum pendente ad carpum Arteriarum Pulfa- tiones deprehendes, quae, furfum ad perpen- diculum brachio elevato, prorfus evanefcunt ; et in omnibus fere qui hoc morbo tenentur arteriarum radialium puliationes in brachio paralytico, quam in fano vel alibi, debiliores fentiuntur. 20 DE ELECTRICITATE. lentiuntur. Quamvis igitur cordis vis inte- gra manet, fanguis in vala membrorum pa- ralyli laborantium minutiora haud propelli- tur, et vaia coUabefcunt. Quacunque de caula paralyfis originem ducit, pars morbo vexata vi nervea orbatur, et motus mufcularis tollitur ; dehinc fangui- nis per membra morbida circuitus plurimum debilitatur, et in vafis capillaribus, * praeci- * pue nervorum paralyticorum/ imminui- tur, vel prorfus deficit. Tametfi caufa quae primo paralyfi originem praebuit amoveatur, (fcilicet cerebri vel nervorum compreffio), pa- ralyfis nihilominus haud raro permanet, et deinceps ex collapfii pendere fertur ; ex lae- fione autem organica, vel partium nervos confl:ituentium non confliat ; eled:ricitate,enim laepe fubito amovetur, quae nervorum dila- cerationes fanare non fiibito potefl: ; collapfiis igitur Caufa Continens aliunde efl: petenda. Sanguinis circulationem et vaforum ten- fionem, in cerebro praefertim et nervis, ad fenfationem et motum conficiendum necef- farias efle ; circulationem quinetiam et vafo- rum DE ELECTRICITATE. 21 rum tenfionem in nervis paralyfi laboranti- bus penitus deficere, nuper monftravimus. Quamvis igitur caufa paralyfeos primaria tol- litur, adeo ut nervos quo minus munere fuo fungantur non amplius impedit, nervis ve- runtamen aliquid deeft, fine quo munera perficere nequeunt, nempe, fluidorum in va- iis fibi propriis circulatio, quae autem non redintegratur, vi nervea deficiente. Circu- lationis igitur defedtus in vafis nervorum propriis, paralyfeos ex coUapfu caufam proxi- mam conftituere videtur. Plurima morborum phaenomena fenten- tiae noftrae verifimilitudinem fuppeditant ; e. g. * artus ex quibus haemorrhagia pro- fufa evafit debiles interdum, vel etiam para- lytici, permanfere, licet fyflema generale fa- nitatem et vires priftinas recuperaverit. Rheumatifmus chronicus, artuum exte- nuatione concomitatus, ex vaforum debi- litate et circulationis defedlu manifefto pendens, paralyfi ex collapfu affinis eft, et hunc * Med. Comment, vol. 3. p. 202. 22 DE ELECTRICITATE. hunc in morbum laepe terminat ; nervi enim energiam ex vaforum fuorum tenfione im- minuta amittunt, et haec, tenfionem poft Haemorrhagiam, &c. propter vim nerveam imminutam, non recuperant. Si, rationem per quam natura efFedius fe- dantium vel fyftema nerveum debilitantium nocivos praecavet, animo contemplemur, Theoria noftra probabilitati adhuc confentanea videbitur. Caufae debilitantes (licut contagi- um, &c.) fyftemati applicatae, fi fortiffimae fiint, vitam fubito dirimere pofTunt ; fi autem non tantopere pollent, cerebri et nervorum energiam imminuunt, quae energia vix nifi per febrem vel vaforum adlionem crefcentem renovatur ; unde jure fufpicamus, cerebrum per fe, fine vaforum aufta acSione, energiam fuam reficere non poffe. Quaedam praeterea, ni fallor, apud auftores narrantur exempla paralyticorum ex morbo febre fuperveniente folutorum,et paralyfis *a collapfu didta/ cau- fis ex fedantibus (ficut venenis, &c.) faepe oritur. Iterum, fiquando paralyticus ex elec- tricitate DE ELECTRICITATE. 23 tricitate commodum accipit, prima valetudi- nis figna membrorum morbo detentorum molis incrementum cito confequitur, quod nutritionis acceffioni, quam fluidorum per artus circulantium augmini, non tantopere tribuamus. Ex hifce et plurimis aliis obfervationibus, nequaquam ambigi videtur, quin nervi ex vafibus fibi propriis aliquid, aeque ac cere- bro, energiae fuae neceflarium accipiunt, fine quo munere fuo fungi non pofTunt. Cum fyftema fanguiferum et nerveum in fefe mutuo agunt, et pro energia invicem alii aliis nituntur, fi utriufvis energia abole- tur, alterius etiam definere oportet ; neque cujulvis vires reftitui pofTunt, donee omnia quae reaftioni obflant fublata fint, et motus vel aftio in fyflemate alterutro inchoatus fuerit. Nervi autem, fine quodam accepto ex vafis fanguiferis auxilio, operationes fuas nee incipere, neque inceptas fervare, pofTunt ; quamvis enim ex Cerebro aliquid fenfationi ac motui ut rite perficiantur necefTarium, ex Vafis etiam fanguiferis fibimet propriis hifce func- 24 DE ELECTRICITATE. funcStionibus aeque neceffarium aliquid acci- piunt. Vafa e contra energia nervea orba- ta fluida per fe propellere non valent ; ner- vi idcirco a valis id cujus indigent non ob- tinent. Eledlricitas (licut fupra obfervavimus) qualitate fruitur peculiari fluida per tubulos, et praecipue capillares, celeriter devehendi : Cum ergo fluidum eled:ricum excitatum cor- poris vala minima pervadit, fluida per vafa minima fecum properat, et eorum lumina amplificat ; haec iterum elafticitate praedita fimplici contrahunt. Hifce reiteratis, va- forum aftiones et fluidorum circuitus reno- vantur, nervi ex vafis quicquid egent ad e- nergiam fuam recuperandam accipiunt. Energia nervea, eo modo renovata, fibris vaforum mufcularibus impertitur, quae ite- rum circulationem per fluidum elecSlricum inceptam fervant, atque ita vis nervea fl:a- bilitur et paralyfis amovetur. Si energia nervea tam per vala nervorum, quam cerebri corticem, quaquaverfum ingre- dientia DE ELECTRICITATE. 25 dientia fecernltur, ficut* MONRO celeberri- mus ' ferme procul dubio' comprobavit, dod:rina noftra eo clarior reddetur ; nam, li circulatio per nervos paralyfi affed:os (quod monftrare conati fumus) prorfus vel ferme impeditur, energia nervea nequaquam fecer- ni poteft ; quamprimum autem Eledlricitate circulatio renovatur, energia nervea iterum fecernitur, qua rurfus circulatio ferva- tur. \mo^ Nonne pendet morbi repentina liib- levatio, quae ab Eled:ricitatis ufu paralyti- cis interdum accidit, ex languine fluidum per eleftricum ad nervos proved:o ? Non- ne etiam fenfus et motus abolitio, faepe poft Eledtricitatem praemature defertam e- veniens, a circuitu rurfus deficiente pendet, propter energiam nerveam haud ufque adeo renovatam ut vaforum adiones fuftentare queat ? ^doy Nonne pendet artuum paralytico- rum incrementum magnitudinis velox, quod D dum * Praele6liones anat. 26 DE ELECTRICITATE. dum aeger utitur Eleftricitate locum habet, ex fluidis in vafa artuum capillaria per flui- dum elediricum devedlis ? Nonne igitur ar- tuum paralyticorum decrementum ex flui- dorum circulantium inopia et vaforum col- lapfii, plus quam ex vero nutriment! defedlu, pendet ? Quod, fi conceditur, argumentum hoc, Nutritionem per nervos perfici verifi- mile faciens, funditus fubvertit. Eledlricitas fluorem menftruum cito, inter- dum etiam dum eledtrizatur aegra, adigit, quod nifi accidit Leucorrhoea levis primo allicitur,et pofthac menftrua erumpunt. Hoc iifdem pendet ex principiis, nempe, fluido- rum in vafis minimis acceleratione et fecum tranflatione, eo modo fluidum eleftricum vaforum Uteri, ex quibus profluit fluor men- ftruus, lumina extendit. Forfan quibufdam in exemplis fluidum eledlricum, aeque vafo- rum ac uteri ipfius, Ipafmos folvit ; cum au- tem flrudturae qua mufculus i^it contrahere pollet, nofmet prorfus ignaros fatemur, ope- rationem fuam in Ipafmis folvendis nequa- quam explicare aggrediemur. Eodem DE ELECTRICITATE. 27 Eodem modo Calculorum ex ureteribus propullio exponitur. Calvitiem quinetiam amovet, fluidorum, per glandulas crines fe- cernentes, vel crinum bulbos, circulationem promovendo. Obfervationibus de Eleftricitatis in morbis tollendis Operatione peradlis, de Morbis in quibus cum utilitate jam adhibita fuit, et de hifce quibus tempore future Theoria noftra folamen pollicetur, nunc dicendum eft ; et imprimis, DE FEBRIBUS. Eleftricitas Febres curavit Intermitten- tes*; Wefley tertianas et quotidianas, et-f* Lindhoult quartanam pertinaciffimam, elec- trizatione amovebant. Intermittentes ex cerebri energia imminuta pendent, et quic- quid fyftematis tonum fuppeditat vel reficit, paroxyfmos impedit, morbumque amovet ; dehinc * Defideratum. t Memoire fur maux gueris par eleft. vide Med. Com. V. I. p. 372. 28 DE ELECTRICITATE. dehinc verilimile videtur, eleftricitatem mor- bum fufFerre fluidorum circuitum per vala cerebri et nervorum promovendo, atque ita energiam nerveam renovando. Nonne eo- dem modo Febres Continuas,praecipue Ner- vofas did:as, fubito tolleret ? Infulatio faltem tuto hifce adhiberi poffet. t C YNANCHEN TONSILLAREM ab- ftulit ; hie, mehercule, quodammodo ftimulo topico folamen retulit; Icintillae enim ex par- tibus vicinis extradiae erant,et fat compertum habemus, ftimulos, parti inflammatione vexa- tae proximae applicatos, inflammationem imminuere ; forfan autem aliquid commodi ex fluidi eledtrici fubtilitate emanabat, Ipatio enim temporis minimo morbum abripiebat. RHEUMATISMUS CHRONICUS maxi- mum ab eledtricitate accepit auxilium. Ex va- riishujufcemorbiphaenomeniSjproCaulaPro- xima,circulationis in valis minimis defeftum et horum irritabilitatem, cum majorum debi- litate, agnofcere nobis videtur. Eo ut hancce ideam t Fergufon's introd. p. 125. DE ELECTRICITATE. 29 ideam probabilem reddamus, caufas remo- tas,fymptomata, fequelas,et morbi medelam, Ipecftemus. Pro Caufa Remota vaforum partis affedae aftiones pernimium et diu audlas, quod in Rheumatifmo locum habet acuto, vel diftorti- onibus articulorum fubitis, vel contufionibus. Rheum. Chron. plerumque fatetur; mufculo- rum- autem exercitatio nimis diu protracfla, vel conatus vehementes horum debilitatem inferunt ; debilitas quinetiam irritabilitate faepe comitatur, praecipue poll Phlegmafiam. Symptomata funt pallor et frigiditas partium morbo detentarum, quae circula- , tionem debilem oftendunt ; corporis enim calor ad fanguinis circuit um palam alligatur arftiffimo nexu. Partium \v2s\xvcv Jiccitas^ etii corpus alibi fudore manat, languinem in vafa minima non propelli demonftrat. Articulorum rigor, crepitatio et dolor, fi quan- do moventur crura, fynoviae vel liquorum jundturas lubricantium inopiam indicant. Artuum extenuatio eadem ex caula (nempe circuitus in vafis minoribus defeftu) pendet. Dolores 30 DE ELECTRICITATE. Dolores laevi quibus aegri, port temperiem vel aeris gravitatem fubito mutatam excru- ciantur, vaforum irritabilitatem monftrant, ob quam diftenfiones vel contraftiones folito majores aegre ferunt. Sequelae funt jundlurae immobilitas, vel interdum anchylofis, ex cartilaginum aboli- tione, et paralyfis ex collapfu, caulas olim deiignatas agnolcens. Medela efficitur per medicamenta, i mo, quae fyftematis tonum revocant, et eo modo irri- tabilitatem amovent ; horum exempla funt cortex Peruvianus et balneum frigidum. 2doy Quae fanguinis per vafa circuitum promo- vent, dehinc rigorem, &c. tollunt ; inter haec funt ftimulantia,fria:io quae fluidorum circu- lationem mechanice promovet,et exercitium. Dehinc coUigimus, fluidum eleftricum Rheu- matifmum fublevare Chronicum, fanguinis per vafa debilitata circuitum promovendo, eo modo vim nerveam et mufcularem reno- vando. Nonne Penicilla in rheumatifmo acuto commodo, praecipue poft venaefec- tionem, adhiberi poffent ? AMENTIA DE ELECTRICITATE. 31 AMENTIA Phrenitidem interdum fequi- tur, et ex circuitus, in vafis cerebri inflam- matione praegrefla debilitatis imminutione, quibufdam in exemplis pendere videtur. Hie a priori expedlemus infulationem, circuitum promovendo per vafa minora, et forfan fcin- tillas vel penicilla partibus cerebro vicinis ab- ftrafta, prodefle. PARALYSIS. De eleftricitatis utilitate hoc in morbo alibi locuti fumus ; et ab antedicSis fpei locus eft, fi paralyfis ex collapfu pendebat, eleftri- citatem utilem fore. De Haen*, qui maxi- ma fedulitate et conftantia, ac qui eleftriza- tione fimplici vel infulatione plurimum ufus eft, plurima fucceflus refert exempla ; a-f Saunders quinque narrantur paralyfeos cafus per eleftricitatem curati, qui aliis nullum acceperunt remediis folamen, et JBrydone mulieri, quae per fex menfes Hemiplegia de- tenta * Ratio Medendi. f Medical Commentaries, vol. 3. { Whytt's Works. 32 DE ELECTRICITATE. tenta fuerat, fanitatem intra triduum reddidit. D YS P EP S I A a ven t riculi mufculor um debi- litate, et energia imminuta ex confeffopendet; eleftricitate ergo forfan levari poteft ; infu- latio fecretiones promovet, unde Digeftionem liquoris gaftrici copiam augendo adjuvaret. Cum nexus perlpirationem inter et cibi ap- petentiam arftiffimus locum habet *, eo ut quicquid perlpirationem promovet, cibi de- fiderium plerumque acuit, eleftricitatem limplicem vel infulationem Anorexiam a- movere, perlpirationem cum promovet, ftatuamus ; et -f-L'Abbe NoUet, qui juvenes per horas quinque limul eleftrizavit, cibi eorum appetentiam acui oblervavit ; JFer- gufon, denique, gaftrodyniam per fucculTus eleftricos amovebat. Cum fluorem menftruum excitat, forlan etiam CHLOROSI prodelTet. SPASMI eledtricitatis ufu faepe folvuntur; cum autem olim obfervavimus nofmet, quali llruftura * Cullcn's Firft Lines, p. 33. Sydenhami Opera, 125, 6. f Prieftlcy on Elcftricity, 137. J Introdudion. DE ELECTRICITATE. 33 ftrudtura mufculo fcih contrahendi vires fup- peditantur, prorfus ignorare, pauca tantum proferemus exempla Ipafmorum elediricitate folutorum, et morbum unum alterumve fub- jungemus, in quibus, a priori, eledricitatis ex ufu commodum expeftemus. TETANUS et TRISMUS inter fpafmos imprimis,aeque ob periculum quod aegro mi- nitatur, ac ob pertinacitatem qua remediis ob- ftant valentiffimis, recenferi merentur. Dr Watfon tetanum ex puella feptem annos, et Dr Spry trifmum ex altera od:odecim annos nata, eled:ricitate fuftulit. *De Haen CHOREAM St VITI elediri- citate faepe curavit ; "f-Lindhoult epilepfiam, et JWeiley hyfteriam fuftulit. Ex hifce operae pretium fore duco virium eledtricorum in §ASTHMATE SPASMODICO,inPertuffi, Colica, et Hydrophobia periculum facere. E Experimenta * Ratio Medendi. f Medical Commentaries, vol. i. 373. X Defideratum. § Mulier quae febre intermittente irregulari laborabat, afthmate correpta erat : Illuft. Dr HOPE eleaHcitatem adhiberi 34 DE ELECTRICITATE. Experimenta plurima elediricitatem aerem atmofphaericum in fixabilem convertere of- tendunt, hoc a phlogifton, e quo conftat, vel faltem quod copiofe continet, pendet : De- hinc probabile videtur, quod Tympanitidis et Emphyfematis curationem plurimum adju- varet, aeris abforptionem promovendo ; in ftatu enim aeris fixabilis folum per vafa lac- tea abforberi aer videtur. Infulatio vel pe- nicilla diu adhibita commodum hie pollicetur. Forfan analarcam amoveret, et rachitidi pro- deffet. * Contrafturam faepiffime abftulit, fluidorum lubricantium et fynoviae fecre- tionem promovendo. AMENORRHOEAM viribus eleftricis fere femper vinci, olim obfervavimus. Gutta adhiberi juffit, quae afthma fubito amovebat, et intermit- tentis ftadium frigidum inducebat. Paroxymo finite, afthma iterum fuperveniCDat, atque fecundo eleftricitate fugato intermittentis paroxyfmus redibat. Haec fuccef- fu pari facpius reiterata erant. Edin. Infirmary regifter, 1771. ♦ Lindhoult, Medical Commentaries, vol. 3. 371. Jallabert, p. 7, on Eledricity, &c. DE ELECTRICITATE. 35 •f- Gutta ferena. Odontalgia, Dyfecoea, Schirrus, et plurimi alii morbi, eledtricitate fublati fuerunt. * Decipimur fpecie re6li, brevis efle laboro, * Obfcurus fio : Seftantem gravia nervi ' Deficiunt animique. Horat. de arte Poetica. t Hey feptem narrat cafus aegrorum ex amaurofi eledlricitatis ufu folutorum. Lond. Med. Obf. vol. 5. p. I. 25. FINIS. TRANSLATION BY REV. F. K. STEAYENSON AN INAUGURAL MEDICAL DISSERTATION UPON ELECTRICITY, AND ITS MANNER OF WORKING IN THE TREATMENT OF DISEASE: WHICH BY THE FAVOUE OF THE SUPEEME BEIBTG, AND BY THE AUTHOEITY OF THE VEEY EEVEEEND D. WILLIAM ROBERTSON, D. D. PEINCIPAL OF THE TNIVEESITY OF EDINBUEGH; AND ALSO WITH THE CONSENT OF THE MOST HONOEABLE 8ENATUS ACADEMICUS, AND BY THE DECEEE OF THE MOST DISTINGUISHED FACULTY OF MEDICINE, FOR THE DEGREE OF DOCTOR, AND THE HIGHEST HONOUES AND PEIVILEGES IN MEDICINE EIGHTLY AND DULY APPEETAINING THEEETO ; ROBERT STEAYENSON, an English M.A. FELLOW OF THE MEDICAL SOCIETY AND ALSO HON. FELLOW OF THE SOCIETY OF PHYSICIANS AND SUEGEONS. SUBMITS TO THE CONSIDERATION OF THE LEARNED. * ** Nought is too high for the daring of mortals. Heaven's very self in our folly we storm. Never is Jove, through our guilty aspiring, Suffered to lay down the bolt we provoke." Odes of Hoeacb. On the 24th day of June at the usual houe and place. EDINBURGH: BALFOUR AND SMELLIE, PRINTERS TO THE UNIVERSITY. 1778. * Lord Lytton's ' Horace.* To that most accomplished young man WALTER OaiLVY, Esq.,^ Eldest son of Sir John Ogilvy of Innerquharity, Bart., Who was beloved by all On account of his courtesy, And especially by him, owing to the close friendship Which bound them together While they pursued the study of Philosophy For three years at St. Andrew's University ; Also To the most distinguished Senator, JAMES WILKINSON, Esq., Who is equally esteemed Whether in the management of Public or private affairs. And noted not only for the grace of his manners. But also for the uprightness of his life ; And, lastly, To the most learned JOHN BURN, M.D., Who practises Apollo's art at Berwick With the greatest credit to himself And benefit to his fellow-townsmen. Who is ever deserving of respect and honour Both on account of the medical knowledge Derived from him While for three years under his guidance He visited very many patients, And also on account of The advice and friendship With which he honoured him Whilst for four years he applied himself To the study of Medicine In the University of Edinburgh, THE AUTHOR Gladly Dedicates these firstfruits Of his studies. AN INAUGURAL MEDICAL DISSERTATTON ON ELECTRICITY AND ITS MANNER OF WORKING IN THE TREATMENT OF DISEASE. Just as man advances slowly and by degrees from the rude state of barbarism to cultivation and civilisation, so philosophy moves on from the first faint glimmer of dawn to the perfect light of day. In one century, some chance circumstance or some profound intellect gives birth to various arts and sciences, and the industry and experience of succeeding cen- turies brings them to a high state of perfec- tion. Though, in my opinion, the ancients were by no means inferior to the moderns in intellect, still the moderns by adding their experience 5i ON ELECTRICITY. to the others' knowledge, have far outstripped them in very many departments of science, and especially in Physics. As science advanced thus gradually to a state of cultivation, electricity was brought into prominent notice only within the present century. For though the ancient writers used to speak of bodies which after friction were endued with the power of attracting lighter bodies to themselves, they were nevertheless entirely ignorant that this power depended upon a fluid now called the "electric" fluid. The lightning was formerly considered to be sacred to God Himself, and the scourge of impious men ; but to-day it is well known to be distributed throughout the mundane system, and to bring healing to the diseased ; for it is produced by the electric fluid, which may be drawn from the earth and clouds alike, and can simulate every appearance of the light- ning. It is now well known that this fluid produces very many phenomena, which the philosophers of the last century were altogether unable to ac- count for. For our " savants " have proved that the Aurora Borealis, earthquakes, whirlwinds, ON ELECTRIOTTT. ^ meteors, &c., are produced entirely by the electric fluid. Electricity furnishes us with many pheno- mena, which would have been better calculated to amuse and interest the mind than to add to the comforts of life, if that most talented man Franklin, and Jallabert, had not happily and successfully turned their knowledge of the powers of electricity, the one to combating the danger of lightning- strokes, the other to the cure of disease. Still though very many of the effects of electricity are well understood, we may boldly assert that many are as yet enveloped in obscurity. Although it is conceded that electricity holds a place among the most efficacious remedies of the day, the forces by which it removes dis- ease from the human body are not thoroughly understood ; and so it is used somewhat empiri- cally. I have determined therefore to explain, as well as I possibly can, its Modus Operandi, and then to enumerate the diseases in the cure of which it is most likely to prove efficacious. In the first place, however, a few words must be said about the WAYS OF APPLYING IT. The electric fluid possesses very many ex- tremely wonderful qualities, a few of which I will 4 ON BLECTRIOITY. mention as especially worthy of our attention, because they help to explain the method of its application, and perhaps of its action. 1st. It pervades the terrestrial system in every part, so that all bodies have a certain quantity as it were concealed in them ; and thus it is that bodies are said to be charged with electric fluid, and the electric fluid is said to be in equilibrium and at rest. 2nd. The equilibrium and the rest are dis- turbed by the friction of certain bodies, e,g. a glass cylinder, &c., and then it is said to be in motion. 8rd. It can be drawn out of some bodies and conveyed elsewhere, in others it can be accu- mulated and intensified, and in all its position can be shifted. Hence with reference to the elec- tric fluid, bodies are divided into two classes, viz. the Exciting, which are called electric^ and the Conveying, which are called Conductors, To the latter class belong metals, fluids or moist substances, charcoal, and vitreous substances ; nearly all other bodies are reckoned among the electric. Moreover, it must be observed that substances which excite the electric fluid ON ELECTRICITY. 5 do not attract it, and for that reason they are called non-conductors, and those which attract do not excite, and therefore they are called non-electric. 4th. Whenever equilibrium is disturbed, e.g, if the electric fluid is accumulated in any substance, or is taken away from any sub- stance, or is accumulated and intensified in one part or surface of any substance, whilst it is taken away from the other surface (which happens in the experiment of the Leyden jar) immediately on the application of a conductor, equilibrium is restored with infinite and almost incredible speed. 5th. It invariably prefers some conductors to others, though it should have to go a long way out of the direct course; for instance, it prefers metals to charcoal, and charcoal to fluids ; but, cceteris paribus, it seeks equilibrium by the nearest way. 6th. It is possessed of an extraordinary power of penetration and mobility, so that it very readily passes through conductors, and fastens upon electric substances {e.g, on glass, &c.), though it does not pass through them. As a consequence of these properties of electricity there are three methods of apply- ing it to the human body, by one of which, 6 ON ELECTRICITY. namely Insulation, the electric fluid, aroused by the application of an electric substance, is prevented from passing to surrounding bodies, and therefore necessarily becomes accumulated in the human body. Whilst this operation is being performed, the electric fluid penetrates all the inmost recesses of the body, and gra- dually, with greater or less speed, according to the humidity or dryness of the air, passes through each pore to the outer air, and takes fluid substances with it. This method of application shows the natural qualities of the electric fluid when excited, largely increases the perspiration, somewhat quickens the action of the heart and arteries, often produces sweat- ing, and promotes all the secretions. If to a body which has been insulated and unduly charged with electric fluid which has been excited, a Conductor is suddenly ap- plied, the superabundant fluid makes for it with the greatest speed, and (if the conductor be not a sharpened one) with difficulty leaves the body in the form of a luminous spark, and gives pain and a redness to the part by the shock ; or if any part of the human body is applied to a conductor which is insulated and charged with fluid it receives the spark ON ELECTRICITY. 7 and the shock. The former of these methods produces almost the same effects as Insulation, combined with a local and mechanical stimulus, the latter does little more than give a local and mechanical stimulus. If therefore we wish to affect the body generally as well as to give a local stimulus, the sparh must be drawn from the patient after he has been insulated ; but if on the other hand we only wish to give a local stimulus, the spark must be applied to him without his being insulated. If the fluid is accumulated and intensified upon one surface of a body called " naturally electric,^^ e.g, a sheet of glass or a glass phial, it is driven from the other surface in an equal degree, for electric bodies can only contain their natural quantity of the fluid, though its position or distribution can be altered ; there- fore we should say that on one surface the fluid, on the other the solid part predominated. But directly a communication is established be- tween the two surfaces by the application of a conductor, equilibrium is restored with greater or less speed according to the nature of the surface, the condensation of the electric fluid, and the perfectness of the conductor, and it is restored with a sharp shock, for the speed and shock of the electric fluid 8 ON ELECTRICITY. is increased by condensation, like those of other fluids which possess the power of resi- lience. Whilst the electric fluid is accumulated upon one surface of the glass phial or sheet of glass, it is said to be Charged, and if a human body (which does not conduct the electric fluid except by the aid of moisture) should establish a communication between the two surfaces, equilibrium is restored through the body, the body receives a very sharp shock or Shaking, and the phial is said to be Discharged. This is called a Shock, and under this method of apply- ing the fluid it pervades only a part of the system, but it pervades that part with the greatest speed, for it endeavours to attain equilibrium and an equal diffusion by the most direct way. As regards then the application of electricity to the body. Insulation may be used in very many diseases without danger, and in many with advantage : Shock in only a few, and in these often with the greatest prudence. Sparks more frequently than Shock, less frequently than Insulation, may be allowed to be used. Whilst I was thinking over the property of sharpened conductors, that is their power of suddenly drawing the electric fluid ON ELECTRICITY. 9 which has become accumulated out of bodies silently and without a spark, a fourth method of applying it, which promises to be advan- tageous, occurred to my mind, and which, to distinguish it from the others, I would call the Pencil Method, It is very well known that pointed instruments strongly attract the fluid when once excited; if therefore to an insulated human body, unduly charged with electric fluid, a pointed conductor be applied, the superabundant fluid will be drawn out, without a shock and at the same time without causing pain, from this part in the form of a luminous pencil; whereby the volume and speed of the fluid as it passes through what- ever part we desire may be greatly increased, and if we enlarge the space through which the fluid makes its escape, it will only be neces- sary to increase the number of the points. I have at present made no experiments, though I have it in my mind to set some on foot in connection with this ; for it seems probable to me that it might be very useful in dispersing scirrhous tumours, in which we should seek to prevent suppuration above all things ; it might be applied with advantage perhaps even in some forms of Inflammation. 10 ON ELECTRICITY. Before we briDg this part of the dissertation to a close, it must be observed, that doctors seldom persevere in the use of electricity with sufficient diligence ; for we ought not to forget that, though electricity removes some diseases all at once and as if by magic, still in others it must be used with long patience ; and though the patient may have received no benefit from it after two or three months' use, still success is by no means to be despaired of ; for it has removed, even after six months, diseases which could not be cured otherwise.''^ But Shenstone said, " Patience is a panacea ; but where is it to be found, and who can swallow it ? '' ON ITS MODE OF ACTION. From these remarks on the modes of its application, we may conclude that the action of electricity will be different according to the difference of its application ; and we have it on record as a well-known fact, that an excessive shock just like violent blows has entirely de- stroyed life, while gentler applications have * De Haen, * Science of Medicine.' ON ELECTRICITY. 11 restored to life the torpid and half-dead limbs. With respect to its Mode of Action learned men are divided into two parties, one of which will have it that electricity acts simply as a stimulus, while the other endeavours to prove by many arguments that the electric fluid is the cause of sensation and motion in living bodies, in other words that it is the same as the Nervous Fluid ;* and hence, they believe that the electric fluid cures paralysis, by increasing the quantity of nerve force, and removing impediments in its course. We must first speak of the former of these opinions ; and in order that we may inquire properly into its truth, let us look at the effects of stimulants such as electricity, upon certain diseases. Stimulants act only upon the nerve or sen- tient fibres, a fact which is due to the sensi- tiveness of the nerve and its intolerance of certain sensations; and hence they increase both in frequency and force the contractions of the muscles, especially of those which are con- nected with the circulation of the blood ; there- fore they produce no effect in the first instance * Deshais, ' Extracts from Montpellier.' 2 12 ON ELECTEICITr. upon the non-sentient fibres, except in so far as they draw them into wrinkles or furrows by their pungency. Electricity, on the other hand, is good for Paralysis ; but its stimulating powers will not explain the phenomena in this case; for it arouses a nerve which has neither sensation nor power of motion, and therefore not capable of stimulation, and of this nerve it restores the sensitiveness and powers. Electricity removes Amenorrhoea, and very frequently has re-established the monthly dis- charge of the weaker sex which is so essential to their health, so much so that Franklin, who has made use of electricity many times in this complaint, declares that it has seldom belied his expectations. But Amenorrhoea very often obstinately resists the most powerful stimulants, and baffles the efforts of the doctors ; thus wine and exercise quicken the action of the heart and arteries more than electricity does ; if therefore effects of this kind depended upon stimulus alone, wine, &c., would be better calculated to bring about the desired result, but experience does not confirm this. ON ELECTRICITY. 13 Scirrhous tumours* are sometimes dispersed by the electric fluid, but not at all by its stimu- lating power ; for suppuration would have to be feared as the result of a stimulus, and as a matter of fact electric sparks which chiefly stimulate do hasten on suppuration. Electricity accelerates the passage of cal- culit through the ureters, whereas stimulants would rather hinder it, for whatever irritates the ureters brings on spasms and narrows the calibre of the ureter and therefore would be avoided by us in treating that disease. The application of electricity removes bald- ness { and promotes the growth of the hair, efifects which can scarcely be attributed to any stimulating power. Hence it seems just for us to conclude that although we may not deny to electricity when applied in a certain manner, a mechanical stimulating power, which is the result of its own momentum, still other properties must be taken into the calculation of its mode of action, in order that we may be able to deter- mine the lines upon which it works, to lay down adequate indications of its working, * ' Med. Comment./ v. 4, p. 82. t '.Wesley's Desideratum.' t * Oarmichael, Tentamen/ p. 33. 14 ON ELECTRICITY. and to say beforehand in what diseases benefit is to be expected from its use. Since therefore we have shown, that this theory about electricity is insufficient to explain these effects, let us carefully examine the opinion put forth by Deshais, and consider the arguments which he brings forward in support of his opinion. 1st. He says, that the striking together of fluids and solids excites the electric fluid which naturally lies latent in the bodies of animals, and that this is made clear by ' a certain property of the furs of animals; for if their hairs be rubbed in the dark, the electric fluid is clearly seen passing from them. But it must be observed that this does not depend on any power peculiar to living animals, but that it is excited by the friction of an electric body (to wit the fur of animals). 2nd. He declares that the nerves conduct the electric fluid in preference to other parts of the system; because, if you apply electricity to a living dog, after you have laid bare and cut the great nerve, luminous rays are thrown forth from the nerve. This again depends not on the inner substance of the nerve, but on the moisture by which it is con- cealed, and on the powers of sharpened ON ELECTRICITY. 15 instruments which we mentioned just now. The nerves act as conductors of electricity but imperfectly.* 3rd. He thinks that the electric fluid or (what according to him is the same thing) the nerve fluid does not return to the brain to communicate the sensation of Touch, but passes to the body which we touch. But to this we answer, that bodies which possess an equal quantity of the electric fluid do not pass their electricity the one to the other, but the electric fluid is equally spread among bodies which are in contact with electric substances, and under these conditions shows no signs of electricity; therefore, when matters are thus, we can neither feel our own body nor neighbouring bodies. Moreover, it must be observed, that the nervous energy is altogether destroyed, whether the nerve be bound up in a conductor or an electric substance. In fine, the argu- ment which totally overthrows this theory still remains; for if this theory were to be accepted as true, and we were to draw the natural electric fluid out of the living system, * I have found by experiments that dry and withered nerves do not perfectly conduct the electric fluid, but that nerves in full vigour do so easily, though scarcely so well as the whole body 16 ON ELECTRICITY. we should also destroy the nerve power, and if we partially diminish the nerve power according to a certain proportion the case becomes alto- gether different. Having therefore rejected these theories, let us cautiously and with diffidence take in hand the method in which electricity works, and bring forward our own idea on this subject ; but in the first place let us enumerate certain pro- perties of the electric fluid which may help us in our investigations into its action upon the human body. No one who knows anything about electricity is ignorant of the fact that the electric fluid when excited very greatly increases the speed of the fluids passing through hair-like tubes, and hence it promotes the flow of sap and the growth of plants. Owing to its extreme fine- ness and delicacy it pervades even the smallest vessels of the human system, wherefore we may believe that the electric fluid, passing as it does freely throughout the whole system, increases the speed of the fluids which pass through the smallest vessels, independently of the help of the heart and arteries. This opinion does not escape our notice ; for the application of electricity pure and simple ON ELECTRICITY. 17 or insulation* very greatly increases the per- spiration, and sometimes induces copious sweat- ing, though it scarcely accelerates at all the action of the heart and arteries. Having stated these properties of the electric fluid when excited, that is, its extreme fineness, by which it spreads through bodies which are conductors, its vast speed, with which it is prone to diffuse itself uniformly amongst bodies, the power with which it accelerates the passage of fluids even through the smallest vessels, and lastly the property owing to which fluids con- duct the Electric Fluid, and starting with these as our basis we will endeavour to explain its Action in the Curing of Disease. In order that we may prosecute this investiga- tion the better, and our Theory may stand forth in a clearer light, it is necessary to state certain things concerning the nature and proximate cause of that most obstinate disease. Paralysis, in the relief of which the powers of electricity have by experience been found largely useful. There are two acknowledged but dissimilar proximate causes which lead to paralysis, viz. Compression of the nervous system and * Abbe Nollet, 'Phil. Trans.,' v. 10, 384. 18 ON ELECTRICITY. the condition which is called Collapse. Elec- tricity only removes the Paralysis which follows upon collapse ; and is hurtful in most cases of that disease which result from compression ; we shall therefore especially investigate the nature of the collapse, or the condition of the nerves from which Paralysis " from collapse " results. It is evident to all that the circulation of the blood and the tone of the sanguiferous vessels are equally necessary for creating and main- taining nerve force in the living system; for which reason the brain far surpasses all the other viscera in the number of its vessels and probably in their minute division and distribu- tion. Moreover the nerve-fibres are supplied in all directions with very minute vessels, and according to that eminent anatomist the elder Monro* " The nervous cords have such nume- rous blood-vessels, that after their arteries only are injected, the whole cord is tinged with the colour of the injected liquor." Daily experience tells us that the nerves owe all their energy to their blood-vessels ; * ' On the Nerves.' ON ELECTRICITY. 19 thus, when the tone of the vessels has been lost owing to HaGmorrhage, the circulation of the blood through the brain and nerves is impaired, and the nerve force sustains a corre- sponding loss; if the loss of the blood con- tinues, the nerves lose their power, and if the flow of the blood through any limb is impeded that member loses its nerve power, and be- comes paralysed for a time. No one will deny, on the other hand, that nerve power is necessary for maintaining the action of the vessels. The muscular or nerve power of the arteries is the chief thing which promotes the flow of the blood through the vessels the furthest remote from the heart ; for they receive scarcely any help from the heart itself; wherefore if their muscular fibres be deprived of nerve power, they cannot keep up the circulation : Hence in some paralytics you will detect the pulsation of the arteries to the wrist while the affected arm is hanging down, but when the arm is raised to the perpendicular it altogether disappears ; and in almost all who are suffering from this disease the pulsations of the radial arteries are found to be more feeble in the paralysed limb than in the sound one or elsewhere. 20 ON ELEOTmOITY. Wherefore although the power of the heart remains unimpaired, the blood is not sent into the smaller vessels of the limbs of paralytics, and accordingly the vessels collapse. From whatever cause paralysis springs, the affected part is deprived of nerve power and muscular motion is lost; hence the flow of blood through the dead limbs is very greatly weakened, and in the capillary vessels, espe- cially of the paralysed nerves, it is impaired or fails altogether. Still though the cause which first gave rise to the paralysis be removed (viz. compression of the brain or nerves) the para- lysis itself nevertheless not unfrequently re- mains, and then it is said to be the conse- quence of collapse, whether arising from some organic injury, or injury of the parts which regulate the nerves, it is not certain ; for it is often removed all at once by electricity, which cannot all at once heal the laceration of the nerves ; wherefore we must look elsewhere for the moving cause of collapse. We pointed out a little time ago that the circulation of the blood and tone of the vessels, especially in the brain and nerves, are neces- sary for producing sensation and motion ; and that the circulation and tone of the vessels ON ELECTRICITY. 2] is altogether wanting in paralysed nerves. Though therefore the primary cause of para- lysis be removed, so that it no longer prevents the nerves from performing their proper func- tions, still something is wanting to the nerves without which they cannot perform their func- tions, viz. a circulation of fluids in their own vessels which is not restored as long as the nerve force is wanting. The want therefore of circulation in the vessels of the nerves them- selves, appears to constitute the proximate cause of paralysis from collapse. Yery many phenomena of diseases present to our minds the appearance of reality, e. g. *limbs from which excessive haemorrhage has taken place have sometimes remained weak, or even paralysed, although the general system has recovered its health and former strength. Chronic rheumatism, accompanied by wasting of the limbs, and resulting from weakness of the vessels and evident want of circulation, is closely akin to paralysis from collapse, and * ' Med. Comment./ vol. 3, p. 202. 22 ON ELECTRICITY. often ends in that disease ; for the nerves lose their energy owing to the tone of their vessels being impaired, and these do not recover their tone after haemorrhage, &c., owing to the nerve power being impaired. If we consider the way in which nature guards against the harmful eflPects of things which lower or weaken the nervous system, our Theory will still seem consistent with proba- bility. Weakening causes (like contagion, &c.), when appHed to the system, if they are very intense, are able to kill outright ; but if they are not so powerful as that, they impair the energy of the brain and nerves, which energy is with difficulty restored except by fever and the increased action of the vessels ; whence we may justly suspect that the brain alone, without the increased action of the vessels, cannot restore its own energy. And more than this, there are, unless I am mistaken, some examples recorded by medical writers of para- lytics being cured of their disease on fever supervening, and paralysis from collapse often arises from lowering causes (such as poisons, &c.). Again, whenever a paralytic ON ELECTRICITY. 23 receives benefit from electricity, increase in size quickly follows the first signs of returning health in the members affected by the disease, an increase which we are to attribute not so much to an accession of nourishment as to an increase of the fluids circulating through the limbs. From these and many other observations there seems to be no doubt that the nerves receive something from their own vessels, equally with the brain, which is essential to their energy, and without which they cannot discharge their proper functions. Since the arterial and nervous systems act and re-act on one another, and in turns strive for energy, if the energy of either is destroyed the energy of the other must also cease ; neither can the powers of either be restored, until everything which hinders a re-action has been removed, and motion or action has been set on foot in one of the two systems. For the nerves, are able neither to commence their work, nor to keep it up when once begun, without some help from the blood- vessels ; for although they receive from the brain something which is required for the proper development of sensation and motion, they receive also from their own blood-vessels 24 ON ELECTRICITY. sometliiiig which, is equally essential to these functions. The vessels on the other hand if deprived of nervous energy are not able to send fluids through themselves ; so the nerves do not obtain from the vessels that of which the latter are in want. Electricity (as we have observed above) pos- sesses the peculiar property of swiftly convey- ing fluids through small tubes, and especially through capillary tubes. When therefore the excited electric fluid pervades the smallest vessels of the body, it accelerates the passage of fluids through the smallest vessels, and en- larges their openings ; which again contract owing to their mere elasticity. And on this being repeated, the action of the vessels and the circulation of the fluids are restored, and the nerves receive from the vessels whatever they need for recovering their own energy. The nervous energy, thus restored, is imparted to the muscular fibres of the vessels, which keep up the circulation again set on foot by the electric fluid, and thus nerve power is estab- lished and paralysis is removed. If nervous energy is discerned as much by •the vessels of the nerves, as by those which enter the cortex of the brain in every direction • ON ELECTRICITY. 25 as that most eminent man *Monro proves almost without a doubt, our theory will become all the clearer ; for, if the circulation is alto- gether or almost stopped (as we have en- deavoured to show) owing to paralysed nerves, the nervous energy can by no means be dis- cerned ; but as soon as the circulation is restored by electricity, the nervous energy is again discerned, and by it the circulation is a second time kept up. 1st. Does not the sudden relief from their complaint, which paralytics sometimes expe- rience owing to the use of electricity depend upon the blood which has been imparted to the nerves by the electric fluid ? And does not also the failure of the power of feeling and motion, which often occurs when electricity has been prematurely abandoned, result from the circulation once more being wanting, owing to the nervous energy not being sufficiently re- stored to maintain the action of the vessels ? 2nd. Does not the rapid increase in size of the paralysed limbs, which occurs whilst * ' Lectures on Anatomy.' 26 ON ELECTRICITY. the patient uses electricity depend upon the fluids which are carried by the electric fluid into the capillary vessels of the limbs ? And there- fore does not the decrease of the paralysed limbs depend upon the want of circulating fluids and the collapse of the vessels, rather than upon real want of nourishment? And if this be conceded, it altogether overthrows this argu- ment which hints that nutrition is accomplished by the nerves. Electricity quickly brings on the menstrual flow, sometimes even whilst the patient is being electrified, and if this does not take place, slight leucorrhcea is first induced, and afterwards the menstrual flow breaks forth. This depends upon the same principles, that is, the electric fluid by accelerating the fluids in the smallest vessels and carrying them with it, enlarges the openings of the vessels of the womb so that the menstrual fluid flows out of them. Perhaps in some cases the electric fluid relieves the spasms both of the vessels and of the womb itself ; but since we confess that we are altogether ignorant of the mechanism by which muscle is able to contract itself, we shall in vain endeavour to explain its action in relieving spasms. OK ELECTRICITY. 27 In the same way the expulsion of calculi from the ureters is explained. It also removes baldness, by promoting the circulation of fluids through the glands which divide the hair, or the roots of the hair. Having completed our observations upon the action of electricity in curing diseases, we must now speak of the diseases in which it has already been used with advantage, and of those in which our theory promises that it will bring relief in the future ; and first, ON FEVERS. Electricity has cured Intermittent Fevers ;* Wesley got rid of tertian and quartan fevers, andt Lindhoult most obstinate quartan fever by the use of electricity. Intermittent fevers result from the energy of the brain being im- paired and whatever supplies or restores tone to the system, stops the paroxysms, and removes the disease ; whence it seems probable that elec- * * The Desideratum.' t " Notes upon Diseases cured by Electricity." See * Med. Com./ V. 1, p. 372. 3 28 ON ELECTRICITY. tricity removes disease by promoting the circu- lation of fluids through the vessels of the brain and nerves, and so by renewing the nervous energy. Would it not in the same way remove all at once continued fevers, especially those called nervous fevers? Insulation at least might be safely applied in the case of these. It has removed *Quinsey ; in this case, indeed, it gave relief by a kind of local stimulus ; for sparks were extracted from the neighbouring parts, and we know as a well ascertained fact, that stimuli applied to a part near to an in- flammation, lessen the inflammation ; but per- haps some relief resulted from the penetrating property of the electric fluid, for it spirited the disease away in the shortest space of time. Cheonic Rheumatism has received the greatest assistance from electricity. It seems reasonable to conclude from various phenomena of this disease that its proximate cause is a failure of the circulation in the smallest vessels and an irritability of these, together with a weakness of the larger vessels. * Ferguson's ' Introd.,' p. 126. ON ELECTRICITY. 29 And to show that this is a probable idea, let us consider the remote causes, the symptoms, the sequelse, and the means of curing the disease. It is generally allowed that the Remote Cause of Chronic Rheumatism is the excessive and overstrained action of the vessels in the part affected, which often happens in Acute Rheumatism or in sudden distortions of the joints or in contusions ; a too long protracted strain upon the muscles, or violent exertions bring on weakness ; and the weakness is often accompanied by irritability, especially after Inflammation. The symptoms are pallor and coldness of the parts affected by the disease, which show that the circulation is weak ; for the heat of the body is evidently closely connected with the circulation of the blood. A dryness of these parts, when the rest of the body is bathed in perspiration, shows that the blood is not sent into the smallest vessels. Stiffness of the joints, a creaking sound and pain, whenever the legs are moved indicate a want of synovial fluid or of the fluids which lubricate the joints. Wasting of the limbs depends upon the same cause (viz. a defective circulation in the smaller vessels). 30 ON ELEOTEIOITT. The sharp pains by which invalids are tor- tured after a sudden change in the temperature or the density of the atmosphere show the irri- tabihty of the blood-vessels, which causes them to be distressed by an unusual distention or contraction. The sequelas are a fixed joint, or sometimes anchylosis, arising from the obHteration of the cartilages, and paralysis from collapse which arises from the causes already mentioned. A cure is effected by medicines which in the first place, restore the tone of the system and thus do away with the irritability; such as Peru- vian bark and cold baths. 2ndly, which promote the circulation of the blood through the veins and thus do away with the stiffness, &c. ; among these are stimulants, friction which mechani- cally promotes the circulation of the fluids, and exercise. Hence we conclude that the electric fluid relieves Chronic Rheumatism by pro- moting the circulation of the blood through the enfeebled blood-vessels, and thus renewing the nervous and muscular force. Could not the Pencils be applied with advantage in acute rheumatism, especially after blood-letting ? ON ELECTEICITY. 31 Loss of reason sometimes follows Delirium, and seems to arise in some cases from the impairing of the circulation in the vessels of the brain which have been weakened by the preceding inflammation. In this case we may- expect a priori that insulation may be of service by promoting the flow of the blood through the smaller vessels, and perhaps benefit may be derived from electric sparks or the pencils acting on the parts which are near to the brain. PARALYSIS. We have spoken elsewhere of the usefulness of electricity in this disease ; and from what has already been said there is room to hope that electricity will be of service, if the para- lysis is caused by collapse. De Haen,* who has made the greatest use of electricity pure and simple and also of insulation with the utmost care and perseverance, relates very many instances of success ; five cases of para- lysis being cured by electricity are related by Saunders,t cases which derived no benefit from other remedies, and BrydoneJ restored to health in three days a woman who had been affected with hemiplegia for six months. * ' Ratio Medendi/ f ' Medical Commentaries/ vol. 3. + Whytt's Works. 32 ON ELECTRICITY. Dyspepsia confessedly arises from weakness of tlie muscles of the stomach and from im- paired vital power and so it may possibly be relieved by electricity ; insulation increases the secretions, and so it might help Digestion by increasing the quantity of the gastric juice. Since there is the closest connection between perspiration and the desire for food,* so that whatever increases the perspiration generally sharpens the appetite, we may say for certain that either simple electricity or insulation when it increases perspiration removes anorexia ; and t TAbbe Nollet, who applied electricity to young men for five hours at a stretch noticed that their appetites were sharpened ; and Fer- guson}: cured pain in the stomach by electric shocks. Since it promotes the menstrual discharge, perhaps it might prove of service even in Chlorosis. Spasms are often relieved by the use of elec- tricity ; but since we have observed on a former * * Cullen's First Lines,' p. 33, Sydenham's Works, 125-6. t Priestley, * On Electricity,' 137. J Introduction. ON ELECTRICITY. 33 occasion that we are altogether ignorant of the mechanism by which the power of contraction is afforded to the muscles, we will bring forward only a few examples of spasms being relieved by electricity, and add one or two diseases, in which, a priori, we may expect benefit from the use of electricity. Tetanus andTEiSMUS deserve to be mentioned first among spasms, both on account of the danger with which they threaten the patient, and also on account of the obstinacy with which they withstand the most powerful remedies. Dr. Watson cured of tetanus a girl seven years old, and Dr. Spry of trismus another girl eighteen years old by electricity. . * De Haen often cured St. Vitus' Dance by electricity;! Lindhoult cured epilepsy, and f Wesley hysteria. Therefore I think it would be worth while to make trial of the powers of electricity in § Spasmodic Asthma, in Whooping- cough, in Colic, and Hydrophobia. * * Ratio Medendi.' f * Medical Commentaries,' vol. 1, 373. X 'Desideratum.' § A woman who was suffering from an irregular attack of intermittent fever, was seized witli asthma ; the eminent Dr. Hope ordered electricity to be applied, which suddenly cured 34 ON ELECTRICITY. Yerj many experiments show that electricity changes atmospheric air into fixed air, this arises from the phlogiston* of which it consists, or at least which it very largely contains : Hence it seems probable that it might be of the greatest service in the cure of Tympanites and Emphy- sema, by promoting the absorption of the air ; for air seems to be absorbed through the lacteal glands only in the form of fixed air. Insulation or a lengthened application of the pencils promises relief in this case. Perhaps it might remove anasarca and be of service in rickets. It very often prevents! contraction by promot- ing the secretion of the lubricating and synovial fluids. We have remarked before that Amenorrhcea is very often overcome by the powers of elec- tricity. the asthma and brought on the cold stage of the intermittent fever. When the paroxysm was over the asthma again re- turned, and when it had a second time been driven away by the electricity, the paroxysm of intermittent fever returned. This was repeated in alternate succession several times. • Edin. Infirmary Register,' 1771. * A name formerly given to what was supposed to be pure fire fixed in combustible bodies. t Lindhoult, 'Medical Commentaries,' vol. 3, 371. Jallabert, p. 7, ' On Electricity,' &c. ON ELECTRICITY. 35 *Bliiiduess, Toothache, Deafness, Cancer, and very many other diseases have been re- moved by electricity. " Correctness' shade deceives us, in our aim " To be concise, we grow obscure again : " And lie who strives great smoothness to acquire, " May round his verses, but will lose their fire. Horace, Ars Poetica. * Hey mentions seven cases of patients being cured of amaurosis by the use of electricity. *Lond. Med. Obs,,' vol. 5, pp. 1, 25. THE END. 4 PRINTED BY J. E. ADLABD, BAETH0L03IEW CLOSE. Catalogue B] London^ ii, New Biirlingto7t Street November^ 1884 S E L EC T I O N FROM J. & A. CHURCHILL'S GENERAL CATALOGUE COMPRISING ALL RECENT WORKS PUBLISHED BY THEM ON THE my /r^D 3cie;nce of mb^dicine N.B. — As far as possible, this List is arranged in the order ir\ which medical study is usually pursued J. & A. CHURCHILL publish for the Mowing Institutions and Public Bodies:— H.M. STATIONERY OFFICE. VIVISECTION FORMS AND CERTIFICATES. A to F (6 at ^d. each). Application for Licence, hd. ROYAL COLLEGE OF SURGEONS. CATALOGUES OF THE MUSEUM. Twenty separate Catalogues (List and Prices can be obtained of J. & A. Churchill). GUY'S HOSPITAL. REPORTS BY THE MEDICAL AND SURGICAL STAFF. Vol. XXVI., Third Series (1883). Price 7s. 6d. LONDON HOSPITAL. PHARMACOPCEIA OF THE HOSPITAL. 3s. CLINICAL LECTURES AND REPORTS BY THE MEDICAL AND SURGICAL STAFF. Vols. I. to IV. 7s. 6d. each. ST. BARTHOLOMEW'S HOSPITAL. CATALOGUE OF THE ANATOMICAL AND PATHOLOGICAL MUSEUM. Vol. I.— Pathology. 15s. ST. GEORGE'S HOSPITAL. REPORTS BY THE MEDICAL AND SURGICAL STAFF. The last Volume (X.) was issued in 1880. Price 7s. 6d'. CATALOGUE OF THE PATHOLOGICAL MUSEUM. 15s. SUPPLEMENTARY CATALOGUE (1882). 5s. ST. THOMAS'S HOSPITAL. REPORTS BY THE MEDICAL AND SURGICAL STAFF. Annually. Vol. XL, New Series (1882). 7s. 6d. MIDDLESEX HOSPITAL. CATALOCiUE OF THE PATHOLOGICAL MUSEUM. ROYAL LONDON OPHTHALMIC HOSPITAL. REPORTS BY THE MEDICAL AND SURGICAL STAFF. Occasionally. Vol. X., Part HI. (August, 1882). 5s. MEDICO-PSYCHOLOGICAL ASSOCIATION. JOURNAL OF MENTAL SCIENCE. Quarterly. Price 3s. 6d. each, or 14s. per annum. ' PHARMACEUTICAL SOCIETY OF GREAT BRITAIN. PHARMACEUTICAL JOURNAL AND TRANSACTIONS. Each Week. Price 4d. each, or 20s. per annum, post free. BRITISH PHARMACEUTICAL CONFERENCE. YEAR BOOK OF PHARMACY. In December. Price los. BRITISH DENTAL ASSOCIATION. JOURNAL OF THE ASSOCIATION AND MONTHLY REVIEW OF DENTAL SURGERY. On the 15th of each Month. Price 6d., or 7s. per annum, post free. A SELECTION J. & A. CHURCHILL'S GENERAL CATALOGUE COMPRISING ALL RECENT WORKS PUBLISHED BY THEM ON THE ART AND SCIENCE OF MEDICINE. N.B.— /. <Sc A. Churchill's Descriptive List of Works 07t Chemistry, Materia Medica, Pharmacy, Botany, Photography, Zoology, the Microscope, and other Bj-anches of Science, can he had on application. Practical Anatomy : A Manual of Dissections. By Christopher Heath, Surgeon to University College Hospital. Fifth Edition. Crown 8vo, with 24 Coloured Plates and 269 Engrav- ings, 15s. Wilson's Anatomist's Vade- Mecum. Tenth Edition. By George Buchanan, Professor of Clinical Surgery in the University of Glasgow; and Henry E. Clark, M.R.C.S., Lecturer on Ana- tomy at the Glasgow Royal Infirmary School of Medicine. Crown 8vo, with 450 Engravings (including 26 Coloured Plates), i8s. Braune's Atlas of Topographi- cal Anatomy, after Plane Sections of Frozen Bodies. Translated by Edward Bellamy, Surgeon to, and Lecturer on Anatomy, &c., at, Charing Cross Hos- pital. Large Imp. Svo, with 34 Photo- lithographic Plates and 46 Woodcuts, 40s. An Atlas of Human Anatomy. By Rickman J. Godlee, M.S., F.R.C.S., Assistant Surgeon and Senior Demonstrator of Anatomy, University College Hospital. With 48 Imp. 4to Plates (112 figures), and a volume of Ex- planatory Text, 8vo, £\ 14s. 6d. Surgical Anatomy : A series of Dissections, illustrating the Principal Regions of the Human Body. By Joseph Maclise. Second Edition. 52 folio Plates and Text. ;^3 12s. Medical Anatomy. By Francis Sibson, M.D., F.R.C.P., F.R.S. Imp. folio, with 21 Coloured Plates, 42s, Anatomy of the Joints of Man. By Henry Morris, Surgeon to, and Lecturer on Anatomy and Practical Sur- gery at, the Middlesex Hospital. 8vo, with 44 Lithographic Plates (several being coloured) and 13 Wood Engravings, i6s. Manual of the Dissection of the Human Body. By Luther Holden, Consulting Surgeon to St. Bartholomew's Hospital. Edited by John Langton. F.R.C.S., Surgeon to, and Lecturer on Anatomy at, St. Bartholomew's Hos- pital. Fifth Edition. 8vo, with 208 Engravings. 20s. By the same Author. Human Osteology. Sixth Edition, edited by the Author and James Shuter, F.R.C.S., M.A., M.B., Assistant Surgeon to St. Bartholomew's Hospital. 8vo, with 61 Lithographic Plates and 89 Engravings. i6s. Also. Landmarks, Medical and Surgi- cal. Fourth Edition. 8vo. [/« the Press. The Student's Guide to Surgical Anatomy : An Introduction to Opera- tive Surgery. By Edward Bellamy, F.R.C.S. and Member of the Board of Examiners. Fcap. 8vo, with 76 Engrav- ings, 7s. The Student's Guide to Human Osteology. By William Warwick Wagstaffe, late Assistant Surgeon to St. Thomas's Hospital. Fcap. Svo, with 23 Plates and 66 Engravings, los. 6d. The Anatomical Remembran- cer ; or. Complete Pocket Anatomist. Eighth Edition. 32mo, 3s. 6d. ./. 4- A. CHURCHILLS RECENT WORKS. Diagrams of the Nerves of the Human Body, exhibiting their Origin, Divisions, and Connections, with their Distribution to the Various Regions of the Cutaneous Surface, and to all the Muscles. ByW. H. Flower, F.R.S., F.R.C.S. Third Edition, with 6 Plates.' Royal 4to, I2s. Atlas of Pathological Anr:tomy. By Dr. Lancekeaux. Translated by W. S. Greenfield, M.D., Professor of Pathology in the University of Edin- burgh. Imp. 8vo, with 70 Coloured Plates, ;^5 5s. A Manual of Pathological Ana- tomy. By C. Haxdfield Jones, .AI.B., F.R.S., and E. H. Sieveking, INI.D., F.R.C.P. Edited by J. F. Payne, M.D., F.R.C.P., Lecturer on General Pathology at St. Thomas's Hospital. Second Edition. Crown 8vo, with 195 Engravings, i6s. Lectures on Pathological Ana- tomy. By S. WiLKS, M.D., F.R.S., and W. MoxoN, M.D., Physician toGuy's Hospital. Second Edition. 8vo, Plates, i8s. Post-mortem Examinations : A Description and Explanation of the Method of Performing them, with especial reference to Medico-Legal Practice. By Prof. ViRCHOW. Translated by Dr. T. P. Smith. Second Edition. Fcap. 8vo, with 4 Plates, 3s. 6d. The Human Brain : Histological and Coarse Methods of Re- search. A Manual for Students and Asylum Medical Officers. By W. Bevan Lewis, L.R.C.P. Lond., Deputy Medi- cal Superintendent to the West Riding Lunatic Asylum. 8vo, with Wood En- gravings and Photographs, 8s. Manual of Physiology: P'or the use of Junior Students of Medi- cine. By Gerald F. Yeo, M.D., F.R.C.S., Professor of Physiology in King's College, London. Crown 8vo, with 300 Engravings, 14s. Principles of Human Physi- ology. By W. B. Carpenter, C.B., M.D., F.R.S. Ninth Edition. By Henry Power, M.B., F.R.C.S. 8vo, with 3 Steel Plates and 377 Woo<l Engrav- ings, 3 Is. 6d. Sanderson's Handbook for the Physiological Laboratory. By E. Klein, M.D., F.R.S. ; J. Burdon- Sanderson, M.D., F.R.S. ; Michael F'osTER, M.D., F.R.S. ; and T. Lauder Brunton, M.D., F.R.S. 8vo, with 123 Plates, 24s. Histology and Histo-Chemistry of Man. By Heinricii Frey, Pro- fessor of Medicine in Zurich. Translated by Arthur E. J. Barker, Assistant Surgeon to University College Hospital. 8vo, wilh 608 EngiJivings, 21s. A Treatise on Human Physi- ology. By John C. Dalton, M.D. Seventh Edition. 8vo, with 252 Engrav- ings, 20s. The Law of Sex. By G. B. Starkweather, F.R.G.S. With 40 Illustrative Portraits. 8vo, i6s. The Marriage of Near Kin, Considered with respect to the Laws of Nations, Results of Experience, and the Teachings of Biology. By Alfred H. HuTH. 8vo, 14s. Medical Jurisprudence : Its Principles and Practice. By Alfred S. Taylor, M.D., F.R.C.P., F.R.S. Third Edition, by Thomas Stevenson, M.p., F.R.C.P., Lecturer on Medical Jurisprudence at Guy's Hospital. 2 vols. 8vo, with 188 Engravings, 31s. 6d. By the same Author. A Manual of Medical Jurispru- dence. Tenth Edition. Crown 8vo, with 55 Engravings, 14s. -.. . Also. Poisons, In Relation to Medical Jurisprudence and Medicine. Third Edition. Crown 8vo, with 104 Engravings, i6s. Lectures on Medical Jurispru- dence. By Francis Ogston, M.D., late Professor in the University of Aber- deen. Edited by Francis Ogston, Jun., M.D. 8vo, with 12 Copper Plates, i8s. A Handy Book of Forensic Medicine and Toxicology. By C. MeymottTidy, M.D., F.C.S., and W. Bathurst Woodman, M.D., F.R.C.P. 8vo, with 8 Lithographic Plates and 116 Engravings, 31s. 6d. Microscopical Examination of Drinking "Water and of Air. By J. 1). Macdonald, M.D., F.R.S., Ex- Professor of Naval Hygiene in the Army Medical School. .Second Edition. 8vo, with 25 Plates, 7s. 6d. Sanitary Examinations Of Water, Air, and Food. A Vade- Mecum for the Medical Officer of Health. By Cornelius B. Fox, M.D., F.R.C.P. Crown 8vo, with 94 Engravings, 12s. 6d. Dangers to Health : A Pictorial Guide to Domestic Sanitary Defects. By T. Pridgin Teale, M.A., Surgeon to the Leeds (leneral Infirmary. Fourth Edition. 8vo, with 70 Lithograph Plates (mostly coloured), los. Dress : Its Sanitary Aspect. A Paper read before the Brighton Social Union, Jan. 30, 1880. By Bernard Roth, F.R.C.S. 8vo, with 8 Plates, 2s. How to Arrest Infectious Dis- eases. By Edcar C.. Barnes, M.D. Lond., Medical Officer of Health of the Eye Urban and Hartismere Rural Sani- tary Districts. Fcap. 8vo, 2s. 6d. J. 4' A. CHURCHILL'S RECENT WORKS. A Manual of Practical Hygiene. By F. A. Parkes, M.D., F.R.S. Sixth Edition, by F. de Chaumont, M.D., F.R.S., Professor of Military Hygiene in the Army Medical School. 8vo, with numerous Plates and Engravings. i8s. A Handbook of Hygiene and Sanitary Science. By Geo. Wilson, M.A., M.D., F.R.S.E., Medical Officer of Health for Mid-Warwickshire. Fifth Edition. Crown 8vo, with Engravings, los. 6d. By the same Author. Healthy Life and Healthy Dwellings : A Guide to Personal and Domestic Hygiene. Fcap. Svo, 5s. Hospitals, Infirmaries, and Dis- pensaries : Their Construction, Inte- rior Arrangement, and Management; with Descriptions of existing Institutions, and 74 Illustrations. By F. Oppert, M.D., M.R.C.P.L. Second Edition. Royal Svo, 12s. Pay Hospitals and Paying 'Wards throughout the "World. By Henry C. Burdett, late Secretary to the Seamen's Hospital Society. Svo, 7s. By the same Author. Cottage Hospitals — General, Fever, and Convalescent : Their Progress, Management, and Work. Second Edition, with many Plans and Illustra- tions. Crown Svo, 14s. Hospital Construction and Management. By F. J. Mouat, M.D., Local Government Board Inspec- tor, and H. Saxon Snell, Fell. Roy. Inst. Brit. Architects. In 2 Parts, 4to, 15s. each; or, the whole work bound in half calf, with large Map, 54 Lithographic Plates, and 27 Woodcuts, 35s. Manual of Anthropometry : A Guide to the Measurement of the Human Body, containing an Anthropo- metrical Chart and Register, a Systematic Table of Measurements, &c. By Charles Roberts, F.R.C.S. Svo, with numerous Illustrations and Tables, Ss. 6d. By the same Author. Detection of Colour-Blindness and Imperfect Eyesight. Svo, with a Table of Coloured Wools, and Sheet of Test-types, 5s. A Manual of Psychological Medicine. With an Appendix of Cases. By John C. Bucknill, M.D., F.R.S., and D. Hack Tuke, M.D., F.R.C.P. Fourth Edition. Svo, with 12 Plates (30 Figures) and Engravings, 25s. Idiocy and Imbecility. By W. W. Ireland, M.D., late Medical Superintendent of the Scottish National Institution for Imbecile Children, Larbert, N.B. Svo, with Engravings, 14s. Illustrations of the Influence of the Mind upon the Body in Health and Disease : Designed to elucidate the Action of the Imagination. By Daniel Hack Tuke, M.D., F.R.C.P., LL.D. Second Edition. 2 vols, crown Svo, 15s. By the same Author. Sleep-'Walking and Hypnotism. Svo, 5s. A Manual of Psychological Medi- cine and Allied Nervous Dis- orders. By Edward C. Mann, M.D., Member of the New York Medico- Legal Society. With Plates. Svo, 24s. Mental Diseases. Clinical Lectures. By T. S. Clouston, M.D., F.R.C.P. Edin., Lecturer on Mental Diseases in the University of Edinburgh. With 8 Plates (6 Coloured). Crown Svo, 12s. 6d. Madness : In its Medical, Legal, and Social Aspects. Lectures by Edgar Sheppard, M.D., M.R.C.P., Professor of Psychological Medicine in King's College. Svo, 6s. 6d. The Student's Guide to the Practice of Midwifery. By D. Lloyd Roberts, M.D., F.R.C.P., Phy- sician to St. Mary's Hospital, Manchester. Third Edition. Fcap. Svo, with 2 Coloured Plates and 127 Wood En- gravings, 7s. 6d. Handbook of Midwifery for Mid- wives : By J. E. Burton, L.R.C.P. Lond., Surgeon to the Hospital for Women, Liverpool. Second Edition. With Engravings. Fcap. Svo, 6s. Lectures on Obstetric Opera- tions : Including the Treatment of Haemorrhage, and forming a Guide to the Management of Difficult Labour. By Robert Barnes, M.D., F.R.C.P., Obstetric Physician to St. George's Hos- pital. Third Edition. Svo, with 124 Engravings, iSs. By the same Author. A Clinical History of Medical and Surgical Diseases of Women. Second Edition. Svo, with iSi Engravings, 28s. Clinical Lectures on Diseases of Women : Delivered in St. Bartho- lomew's Hospital, by J. Matthews Duncan, M.D., F.R.C.P., F.R.S.E. vSecond Edition. Svo, 14s. By the same Author. Sterility in Woman. Being the Gulstonian Lectures, delivered in the Royal College of Physicians, in Feb., 1SS3. Svo, 6s. J. ^ A. CHURCHILL'S RECENT WORKS. The Student's Guide to the Diseases of ^Women. By Alfred L. Galabin, M.D., F.R.C.P., Obstetric Physician to Guy's Hospital. Third Edi- tion. Fcap. 8vo, with 78 Engravings, 7s. 6d. West on the Diseases of "Women. Fourth Edition, revised by the Author, with numerous Additions by J. Matthews Duncan, M.D., F.R.C.P., F.R.S.E., Obstetric Physician to St. Bar- tholomew's Hospital. 8vo, i6s. Notes on Diseases of Women : Specially designed to assist the Student in preparing for Examination. By J. J. Reynolds, L.R.C.P., M.R.C.S. Second Edition. Fcap. 8vo, 2s. ^d. By the same Ant hoi'. Notes on Midwifery : Specially designed for Students preparing for Examination. Fcap. 8vo, 4s. Dysmenorrhcea, its Pathology and Treatment. By Heywood Smith, M.D. Oxon., Physician to the Hospital for Women, &:c. Crown 8vo, with En- gravings, 4s. 6d. Obstetric Aphorisms : For the Use of Students commencing Midwifery Practice. By Josei'H G. SwAYNE, M.D. Eighth Edition. Fcap. 8vo, with Engravings, 3s. 6d. Obstetric Medicine and Surgery : Their Principles and Practice. By F. H. Ramsbotham, M.D., F.R.C.P. Fifth Edition. 8vo, with 120 Plates, 22s. A Complete Handbook of Ob- stetric Surgery : Giving Short Rules of Practice in every Emergency. By Charles Clay, late Surgeon to St. Mary's Hospital, Manchester. Third Edition. Fcap. 8vo, with 91 Engravings, 6s. 6d. Schroeder's Manual of Mid- wifery, including the Pathology of Preg- nancy and the Puerperal State. Trans- lated by Charles H. Carter, B.A., M.D. 8vo, with Engravings, 12s. 6d. Influence of Posture on Women in Gynecic and Obstetric Practice. By J. H. Avelinc, M.D., Physician to the Chelsea Hospital for Women. 8vo, 6s. By the same Author. The Chamberlens and the Mid- wifery Forceps: Memorials of the Family, and an Essay on the Invention of the Instrument. 8vo, with Engravings, 7s. 6d. A Handbook of Uterine Thera- peutics, and of Diseases of Women. Hy E. J. Tilt, M.D., M.R.C.P. Fourth Edition. Post 8vo, los. By the same Author. The Change of Life In 1 lealth and Disease : A Clinical Treatise on the Diseases of the Nervous System incidental to Women at the De- clineofLife. Fourth Edition. 8vo, los. 6d. Ovarian and Uterine Tumours : Their Pathology and Surgical Treatment. By Sir T. Spenxer Wells, Bart., F.R.C.S., Consulting Surgeon to the Samaritan Plospital. 8vo, with En- gravings, 2 IS. The Principles and Practice of Gynaecology. By Thomas Addis Emmet, M.D. , Surgeon to the Woman's Hospital, New York. Second Edition. Royal 8vo, with 133 Engravings, 24s. Diseases of the Uterus, Ovaries, and Fallopian Tubes : A Practical Treatise by A. Courty, Professor of Clinical Surgery, Montpellier. Translated from Third Edition by his Pupil, Agnes McLaren, M.D., M.K.Q.C.P.I., with Preface by J. Matthews Duncan, M.D., F. R. C. P. 8vo, with 424 Engravings, 24s. Backward Displacements of the Uterus and Prolapsus Uteri : Treatment by the New Method of Short- ening the Round Ligaments. By W^IL- LiAM Alexander, M.D., M.Ch.Q.U.L, F. R. C. S. , Surgeon to the Liverpool Infir- mary. Crown 8vo, with Engravings, 3s. 6d. Chronic Disease of the Heart : Its Bearings upon Pregnancy, Parturition, and Childbed. By Angus Macdonald, M.D., F.R.S.E., Physician to the Edin- burgh Royal Infirmary. 8vo, with En- gravings, 8s. 6d. The Female Pelvic Organs : Their Surgery, Surgical Pathology, and Surgical Anatomy. In a Series of Coloured Plates taken from Nature ; with Com- mentaries, Notes, and Cases. By Henry Savage, M.D., F.R.C.S., Consulting Officer of the Samaritan Free Hospital. Fifth Edition. Roy. 4to, with 17 Litho- graphic Plates (15 coloured) and 52 Wood- cuts, ;^i 15s. The "Wasting Diseases of Infants and Children. By Eustace Smith, M.D., Physician to the King of the Belgians, Physician to the East London Hospital for Children. Fourth Edition. Post 8vo, 8s. 6d. By the same Author. Diseases in Children : A Practical Treatise. 8vo, 22s. Also. Clinical Studies of Disease in Children. Second Edition. Post 8vo. [/// the Press. A Practical Manual of the Diseases of Children. With a For- mulary. By Edward Ellis, M.D. Fourth Edition. Crown 8vo, los. By the same Author. A Manual of what every Mother should know. Fcap. 8vo, is. 6d. J. ^' A. CHURCHILLS RECENT WORKS. A Treatise on the Diseases of Children. For Practitioners and Students. By W. H. 13 ay, M.D., Physi- cian to the Samaritan Hospital for Women and Children. Crown 8vo, I2s. 6d. Infant Feeding and its Influ- ence on Life ", By C. H. F. Routh, M.D., Senior Physician to the Samaritan Hospital. Third Edition. Fcap. 8vo, 7s. 6d. A Manual for Hospital Nurses and others engaged in Attending on the Sick. By Edward J. Domville, Surgeon to the Exeter Lying-in Charity. Fourth Edition. Crown 8vo, 2s. 6d. A Manual of Nursing, Medical and Surgical. By Charles J. Cul- LINGWORTH, M.D., Physician to St. Mary's Hospital, Manchester. Fcap. Svo, 3s. 6d. By the same Author. A Short Manual for Monthly Nurses. Fcap. Svo, is. 6d. Notes on Fever Nursing. ByJ. W. Allan, M.B., Superintendent and Physician, Glasgow Fever Hospital. Crown 8vo, with Engravings, 2s. 6d. Manual of Botany : Including the Structure, Functions, Clas- sification, Properties, and Uses of Plants. By Robert Bentley, Professor of Bo- tany in King's College and to the Phar- maceutical Society. Fourth Edition. Crown 8vo, with 1,185 Engravings, 15s. By the same Author. The Student's Guide to Struc- tural, Morphological, and Phy- siological Botany. With 660 En- gravings. Fcap. 8vo, 7s. 6d. • Also. The Student's Guide to Syste- matic Botany, including the Classi- fication of Plants and Descriptive Botany. Fcap. Svo, with 350 Engravings, 3s. 6d. Medicinal Plants : Being descriptions, with original figures, of the Principal Plants employed in Medicine, and an account of their Pro- perties and Uses. By Prof. Bentley and Dr. H. Trimen. In 4 vols., large 8vo, with 306 Coloured Plates, bound in Half Morocco, Gilt Edges, ;^ii lis. Therapeutical Remembrancer. By John Mayne, M.D. Second Edition. l6mo, 3s. 6d. By the same Author. Notes on Poisons. Mounted and Varnished for the Surgery. 18 in. by 12 in. is. 6d. The National Dispensatory : Containing the Natural History, Chemistry, Pharmacy, Actions and Uses of Medicines. By Alfred Still^, M.D., LL.D., and John M. Maisch, Ph.D. Third Edition. Svo, with 3 1 1 Engravings, 34s. Royle's Manual of Materia Medica and Therapeutics. Sixth Edition. By John Harley, M.D., Physician to St. Thomas's Hospital. Crown 8vo, with 139 Engravings, 15s. The Student's Guide to Materia Medica and Therapeutics. By John C. Thorowgood, M.D., F.R.C.P. Second Edition. Fcap. 8vo, 7s. Materia Medica and Therapeu- tics. By Charles D. F. Phillips, M.D., F.R.S. Edin., late Lecturer on Materia Medica and Therapeutics at the Westminster Hospital Medical School. Vol. I — Vegetable Kingdom. 8vo, 15s. Vol. 2 — Inorganic Substances. 8vo, 21s. Binz's Elements of Thera- peutics : A Clinical Guide to the Action of Drugs. Translated by E. I. Sparks, M.B., F.R.C.P. Crown 8vo, 8s. 6d. Materia Medica. A Manual for the use of Students. By Isambard Owen, M.D., Lecturer on Materia Medica, «S:c., to St. George's Hospital. Crown 8vo, 6s. The Pharmacopoeia of the Lon- don Hospital. Compiled under the direction of a Committee appointed by the Hospital Medical Council. Fcap. Svo, 3s, A Companion to the British Pharmacopoeia. By Peter Squire, P'.L.S., assisted by his Sons, P. W. and A. H. Squire. 13th Edition. Svo, ios.6d. By the sa??ie Authors. The Pharmacopoeias of the Lon- don Hospitals, arranged in Groups for Easy Reference and Comparison. Fifth Edition. iSmo. [/;/ the Press. Bazaar Medicines of India, And Common Medical Plants : With Full Index of Diseases, indicating their Treat- ment by these and other Agents procur- able throughout India, &c. By E. J. Waring, C. I. E. , M. D. , F. R. C. P. Fourth Edition. F'cap. Svo, 5s. Tropical Dysentery and Chronic Diarrhoea — Liver Abscess — Malarial Cachexia — Insolation — with other forms of Tropical Diseases, &c. By Sir Joseph Fayrer, K.C.S.I., M.D. Svo, 15s. By the same Author. Climate and Fevers of India, with a series of Cases (Croonian Lec- tures, 1882). Svo, with 17 Temperature Charts, 12s. Family Medicine for India. A Manual. By William J.Moore, M.D. , C. I. E. , Honorary Surgeon to the Viceroy of India. Published under the Authority of the Government of India. Fourth Edition. Post Svo, with 64 Engravings, 12s. By the same Author. Health- Resorts for Tropical ' Invalids, in India, at Home, and Abroad. Post Svo, 5s. 8 J. ^ A. CHURCHILL'S RECENT WORKS. Spirillum Fever (Synonyms, Famine or Relapsing Fever), as seen in Western India. By H. Van- dyke Carter, M.D., Surgeon-Major I.M.D. 8vo, with Plates, 21s. Diseases of Tropical Climates, And their Treatment : With Hints for the Preservation of Health in the Tropics, By James A. Horton, M.D., Surgeon Major. Second Edition. Post Svo, 12s. 6d. The Student's Guide to the Practice of Medicine. By Mat- thew Charteris, M.D., Professor of Materia Medica in the University of Glasgow. Third Edition. Fcap. Svo, with Engravings on Copper and Wood, 7s. Hooper's Physicians' Vade- Mecum. A Manual of the Principles and Practice of Physic. Tenth Edition. By W. A. Guy, F.R.C.P., F.R.S., and J. Harley, M.D., F.R.C.P. With 118 Engravings. Fcap. Svo, 12s. 6d. Clinical Medicine : Lectures and Essays. By Balthazar Foster, M.D., F.R.C.P. Lond., Pro- fessor of Medicine in Queen's College, Birmingham. Svo, los. 6d. Clinical Lectures and Cases, with Commentaries. By Henry Thomp- son, M.D., F.R.C.P., Consulting Phy- sician to Middlesex Hospital. With Tem- perature Charts. Svo, 7s. 6d. Clinical Medicine : A Systematic Treatise on the Diagnosis and Treatment of Disease. By Austin P'lint, M.D., Professor of Medicine in the Bellevue Hospital Medical College. Svo, 20s. By the same Author, Phthisis : In a series of Clinical Studies. Svo, i6s. The Student's Guide to Medical Diagnosis. By Samuel Fen wick, M.D., P\R.C.P., Physician to the Lon- don Hospital. Fifth Edition. Fcap. Svo, with III Engravings, 7s. By the same Author. The Student's Outlines of Medi- cal Treatment. Second Edition. Fcap. Svo, 7s. Also. On Chronic Atrophy of the Stomach, and on the Nervous Affections of the Digestive Organs. Svo, 8s. How to Examine the Chest : Being a Practical Guide for the use of Students. By Samuel West, M.D., Physician to the City of London Hospital for Diseases of the Chest ; Medical Tutor and Registrar at St. Bartholomew's Hospital. With 42 Engravings. Fcap. Svo, 5s. The Student's Guide to Medical Case-Taking. By Francis Warner, M.D., F.R.C.P., Assistant Physician tc the London Hospital. Second edition. Fcap. Svo, 5s. The Microscope in Medicine. By Lionel S. Beale, M.B., F.R.S., Physician to King's College Hospital. Fourth Edition. Svo, with 86 Plates, 21s. Also. On Slight Ailments : Their Nature and Treatment. Second Edition. Svo, 5s. The Spectroscope in Medicine. By Charles A. MacMunn, B.A., M.D. Svo, with 3 Chromo-lithographic Plates of Physiological and Pathological Spectra, and 13 Engravings, 9s. The Contagiousness of Pulmo- nary Consumption, and its Anti- septic Treatment. By J. Burney Yeo, M.D., Physician to King's College Hospital. Crown Svo, 3s. 6d. Diseases of the Chest : Contributions to their Clinical History, Pathology, and Treatment. By A. T. Houghton Waters, M.D., Physician to the Liverpool Royal Infirmary. Second Edition. Svo, with Plates, 15s. The Operative Treatment of In- tra-thoracic Effusion. Fothergillian Prize Essay. By Norman Porritt, L.R.C.P. Lond., M.R.C.S., late Senior Assistant House-Surgeon, General In- firmary, Leeds ; and Senior House-Sur- geon, Infirmary, Huddersfield. With Engravings. Crown Svo, 6s. "Winter Cough (Catarrh, Bronchitis, Emphysema, Asth- ma). By Horace Dobell, M.D., Consulting Physician to the Royal Hos- pital for Diseases of the Chest. Third Edi- tion. Svo, with Coloured Plates, los. 6d. By the same Author. Loss of ^A^eight, Blood-Spitting, and Lung Disease. Second Edition, to which is added Part VI., "On the Functions and Diseases of the Liver." Svo, with Chromo-lithograph, ids. 6d. Also. The Mont Dore Cure, and the Proper 'Way to Use it. Svo, 7s. 6d. Croonian Lectures on Some Points in the Pathology and Treatment of Typhoid Fever. By William Cayley, M.D., F.R.C.P., Physician to the Middlesex and the London Fever Hospitals. Crown Svo, 4s. 6d. Diseases ot the Heart and Aorta : Clinical Lectures. By G. W. Balfour, M.D., F.R.C.P., F.R.S. Edin., late Senior Physician and Lecturer on Clinical Medicine, Royal Infirmary, Edinburgh. Second Edition. Svo, with Chromo-litho- graph and Wood Engravings, 12s. 6d. J. ^ A. CHURCHILL'S RECENT WORKS. Notes on Asthma : Its Forms and Treatment. By John C. Thorowgood, M.D,, Physician to the Hospital for Diseases of the Chest. Third Edition. Crown 8vo, 4s. 6d. Observations on the Treatment of nearly One Hundred Cases of Asthnaa. ByT.L.PRioHAM, M.R.C.S. Third Edition. 8vo, 2s.''6d. Manual of the Physical Dia- gnosis of Diseases of the Heart, inchiding the use of the Sphygmograph and Cardiograph. By A. E. Sansom, M.D., F.R.C.P., Assistant Physician to the London Hospital. Third Edition. Fcap. 8vo, with 48 Engravings, 7s. 6d. Medical Ophthalmoscopy : A Manual and Atlas. By William R. Cowers, M.D., F.R.C.P., Assistant Professor of Clinical Medicine in Univer- sity College, and Senior Assistant Phy- sician to the Hospital. Second Edition, with Coloured Autotype and Lithographic Plates and Woodcuts. 8vo, i8s. By the same Author. Epilepsy, and other Chronic Convulsive Diseases : Their Causes, Symptoms, and Treatment. 8vo, los. 6d. Also. Pseudo-Hypertrophic Muscular Paralysis : A Clinical Lecture. 8vo, with Engravings and Plate, 3s. 6d. Also. The Diagnosis of Diseases of the Spinal Cord. Third Edition. 8vo, with Engravings, 4s. 6d. Studies on Functional Nervous Disorders. By C. Handfield Tones, M.B., F.R.S., Physician to St. Mary's Hospital. Second Edition. Svo, i8s. Visceral Neuroses : Being the Gulstonian Lectures on Neural- gia of the Stomach, and Allied Disorders. By T. Clifford Allbutt, M.A., M.D. Cantab., F.R.S., F.R.C.P., Consulting Physician to the Leeds General Infirmary. Svo, 4s. 6d. Nervous Diseases : Their Description and Treatment. A Manual for Students and Practitioners of Medicine. By Allen M. Hamilton, M.D., Physician at the Epileptic and Para- lytic Hospital, New York. Second Edi- tion. Royal 8vo, with 72 Engravings, i6s. Nerve Vibration and Excitation, as Agents in the Treatment of Functional Disorder and Organic Disease. By J. Mortimer Granville, M.D. 8vo, 5s. Notes on Rheumatism. By Julius Pollock, M.D., F.R.C.P., Senior Physician to the Charing Cross Hospital. Second Edition. Fcap. Svo, with Engravings, 3s. 6d. Diseases of the Liver: With and without Jaundice. By George Harley, M.D., F.R.C.P., F.R.S. Svo, with 2 Plates and 36 Engravings, 2 is. Diseases of the Stomach : The Varieties of Dyspepsia, their Diagnosis and Treatment. By S. O. Hauershon, M.D., F.R.C.P. Third Edition. Crown Svo, 5s. By the sa/ne Author. Pathology of the Pneumo- gastric Nerve : Being the Lumleian Lectures for 1876. Post Svo, 3s. 6d. Also. Diseases of the Abdomen, Comprising those of the Stomach and other parts of the Alimentary Canal, Oesopha- gus, Coecum, Intestines, and Peritoneum. Third Edition. Svo, with 5 Plates, 21s. Gout, Rheumatism, And the Allied Affections ; with a Chapter on Longevity and the Causes Antagonistic to it. By Peter Hood, M.D. Second Edition. Crown Svo, los. 6d. Diseases of the Nervous System. Clinical Lectures. By Thomas Buzzard, M. D. , F. R. C. P. , Physician to the National Hospital for the Paralysed and Epileptic. With Engravings, Svo. 15s. Diseases of the Nervous System. Lectures delivered at Guy's Hospital. By Samuel WiLKS, M.D., F.R.S. Second Edition. Svo, iSs. A Treatise on the Diseases of the Nervous System, By James Ross, M.D., F.R.C.P., Assistant Physi- cian to the Manchester Royal Infirmary. Second Edition. 2 vols. Svo, with Litho- graphs, Photographs, and 332 Woodcuts, 52s. 6d. Fits : Diagnosis and Immediate Treatment of Cases of Insensibility and Convulsions. By John H. Waters, M.D., K.C.St.G.C, Surgeon to the C Division of Metropoli- tan Police. Crown Svo, 4s. Food and Dietetics, Physiologically and Therapeutically Con- .sidered. By F. W. Pavy, M.D., F.R. S., I'hysician to Guy's Hospital. Second Edition. Svo, 15s. By the same Author. Croonian Lectures on Certain Points connected ^with Diabetes. Svo, 4s. 6d. Imperfect Digestion : Its Causes and Treatment. By A. Leared, M.D. Seventh Edition. Fcap. Svo, 4s. 6d. Headaches : Their Nature, Causes, and Treatment. By W. H. Day, M.D., Physician to the Samaritan Hospital. Third Edition. Crown Svo, with Engravings, 6s. 6d. lO J. ^' A. CHURCHILL'S RECENT WORKS. On Megrim, Sick Headache, and some Allied Disorders : A Contribu- tion to the Pathology of Nerve Storms. By E. LiVEiNG, M.D., F.R.C.P. 8vo, 15.S. Winter and Spring On the vShores of the Mediterranean. By Henry Ben net, M.D. Fifth Edition. Post 8vo, with numerous Plates, Maps, and Engravings, 12s. 6d. By the same Author. Treatment of Pulmonary Con- sumption by Hygiene, Climate, and Medicine. Third Edition. 8vo, 7s. 6d. Also. Nutrition in Health and Disease. Third (Library) Edition, 8vo, 5s. ; Cheap Edition, fcap. 8vo, 2s. 6d. The Riviera : Sketches of the Health-Resorts of the Coast of France and Italy, from Hyeres to Spezia : its Medical Aspect and Value, &c. By Edward I. Sparks, M.B., F.R.C.P. Crown 8vo, 8s. 6d. The Principal Southern and Swiss Health-Resorts : their Cli- mate and Medical Aspect. By William Marcet, M.D., F.R.C.P., F.R.S. With Illustrations. Crown 8vo, 7s. 6d. Medical Guide to the Mineral 'Waters of France and its 'Win- tering Stations. With a Special Map. ByA. ViNTRAS, M.D., Physician to the French Embassy, and to the French Hospital, London. Crown 8vo, 8s. The Ocean as a Health-Resort : A Practical Handbook of the Sea, for the use of Tourists and Health-Seekers. By William S. Wilson, L.R.C.P. Second Edition, with Chart of Ocean Routes, &c. Crown 8vo, 7s. 6d. Principal Health-Resorts Of Europe and Africa, and their Use in the Treatment of Chronic Diseases. By T. M. Madden, M.D. 8vo, los. Handbook of Medical and Sur- gical Electricity. By Herhert TiBHiTS, M.D., F.R.C.P.E., Senior Physician to the West London Hospital for Paralysis and Epilepsy. Second Edition. 8vo, with 95 Engravings, 9s. By the same Author. A Map of Ziemssen's Motor Points of the Human Body : A Guideto Localised Electrisation. Mounted on Rollers, 35 x 21. With 20 Illustra- tions, 5s. Mechanical Exercise a Means of Cure : Being a Description of the Zander Institute, London ; its History, Appliances, Scope, and Object. Edited by the Medical Officer of the Institution. Crown 8vo, with 24 Engravings, 2s. 61I. Ambulance Handbook for Volun- teers and Others. By J. Ardavon Raye, L.K. & Q.C.P.I., L.R.C.S.I., late Surgeon to H.B.M. Transport No. 14, Zulu Campaign, and Surgeon E.I.R. Rifles. 8vo, with 16 Plates (50 figures), 3s. 6d. A System of Practical Surgery. By Sir W. Fergusson, Bart. , F. R. S. Fifth Edition. 8vo, with 463 Engravings, 2ls. Surgical Emergencies : Together with the Emergencies Attendant on Parturition and the Treatment of Poisoning. By Paul Swain, F.R.C.S., Surgeon to the South Devon and East Corn- wall Hospital. Third Edition. Crown 8vo, with 117 Engravings, 5s. A Course of Operative Surgery. By Christopher Heath, Surgeon to University College Hospital. Second Edition. With 20 coloured Plates (180 figures) from Nature, by M. LfiVEiLLfe, and several Woodcuts. Large 8vo, 30s. By the same Author. The Student's Guide to Surgical Diagnosis. Second Edition. Fcap. 8vo, 6s. 6d. Also. Manual of Minor Surgery and Bandaging. For the use of House- Surgeons, Dressers, and Junior Practi- tioners. Seventh Edition. Fcap. 8vo, with 129 Engravings, 6s. Also. Injuries and Diseases of the Jaws. Third Edition. 8vo, with Plate and 206 Wood Engravings, 14s. Outlines of Surgery and Sur- gical Pathology. By F. Le Gros Clark, F.R.S., assisted by W. W. Wagstaffe, F.R.C.S. Second Edition. 8vo, IDS. 6d. Regional Surgery : Including Surgical Diagnosis. A Manual for the use of Students. By F. A. SouTHAM, M.A., M.B., F.R.C.S., As- sistant Surgeon to the Manchester Royal Infirmary. Part I. The Head and Neck. Crown 8vo, 6s. 6d. — Part II. The Upper Extremity and Thorax. Crown 8vo, 7s. 6d. Surgical Enquiries : Including the HastingsEssay on Shock, the Treatment of Inflammations, and numerous Clinical Lectures. ByFuRNEAUxJORDAN, F.R.C.S., Professor of Surgery, Queen's College, Birmingham. Second Edition, with numerous Plates. Royal 8vo, 1 2s. 6d. On Dislocations and Fractures. By Joseph Maclise, F.R.C.S. Uni- form with " Surgical Anatomy." 36 folio Plates and Text. Cloth, £2 los. J. A. CHURCHILLS RECENT WORKS. II The Practice of Surgery : A Manual. By Thomas Bryant, Surgeon to Guy's Hospital. Fourth Edition. 2 vols, crown 8vo, with 750 Engravings (many being coloured), and including 6 chromo-lithographic plates, 32s. The Surgeon's Vade-Mecum : A Manual of Modern Surgery. By Robert Druitt, F.R.C.S. Eleventh Edition. Fcap. 8vo, with 369 Engravings, 14s. Illustrations of Clinical Surgery. By Jonathan Hutchinson, F.R.S., Senior Surgeon to the London Hospital. In occasional fasciculi. I. to XVI., 6s. 6d. each. Fasciculi I. to X. bound, with Appendix and Index, £1 los. By the same Atithor. Pedigree of Disease : Being Six Lectures on Temperament, Idiosyncrasy, and Diathesis. 8vo, 5s. Hernia : A Practical Treatise. By Joseph H. Warren, M.D. Second Edition. Roy. Svo, with Plates and 82 Engravings, 21s. By the sajue Author. A Plea for the Cure of Rupture ; or, The Pathology of the Subcutaneous Operation by Injection. 8vo, with Dia- grams, 5s. 6d. Treatment of Wounds and Frac- tures. Clinical Lectures. By Sampson Gamgee, F.R.S.E., Surgeon to the Queen's Hospital, Birmingham. Second Edition. 8vo, with 40 Engravings, los. Fractures : A Treatise. By Lewis A. Stimson, B.A., M.D., Professor of Surgical Patho- logy in the University of New York. 8vo, with 360 Engravings, 21s. Injuries of the Spine and Spinal Cord, without Apparent Me- chanical Lesion, and NERVOUS SHOCK, in their Surgical and Medico- Legal Aspects. By Herbert W. Page, M.A., M.C. Cantab., F.R.C.S., Surgeon to St. Mary's Hospital. 8vo, 12s. 6d. Lectures on Orthopaedic Sur- gery. By Bernard E. Brodhurst, F.R.C.S., Surgeon to the Royal Ortho- psedic Hospital. Second Edition. 8vo, with Engravings, 12s. 6d. By the same Atithor. On Anchylosis, and the Treat- ment for the Removal of De- formity and the Restoration of Mobility in Various Joints. Fourth Edition. 8vo, wdth Engravings, 5s. Also. Curvatures and Diseases of the spine. Third Edition. 8vo, with Engravings, 6s. Orthopaedic Surgery, And Diseases of the Joints. By L. A. Sayre, M.D., Professor of Orthopedic Surgery in Bellevue Hospital Medical College. Second Edition. 8vo, with Coloured Plate and 324 Engravings, 21s. Clubfoot : Its Causes, Pathology, and Treatment. By Wm. Adams, F.R.C.S., Surgeon to the Great Northern Hospital. Second Edition. Svo, with 106 Engravings and 6 Lithographic Plates, 15s. By the same Author. On Contraction of the Fingers, and its Treatment by Subcutaneous Opera- tion ; and on Obliteration of Depressed Cicatrices, by the same Method. Svo, with 30 Engravings, 4s. 6d. Also. Lateral and other Forms of Curvature of the Spine : Their Pathology and Treatment. Second Edi- tion. Svo, with 5 Lithographic Plates and 72 Wood Engravings, los. 6d. Spinal Curvatures : Treatment by Extension and Jacket ; with Remarks on some Affections of the Hip, Knee, and Ankle-joints. By PI. Mac- naughton Jones, M.D., F.R.C.S. I. and Edin. Post Svo, with 63 Engravings, 4s. 6d. The Orthopragms of the Spine : Curative Mechanisms applicable to Spinal Curvature, &c. By R. Heather Big(;, Assoc. Inst. C.E. Svo, with Engravings, 5s. On Diseases and Injuries of the Eye : A Course of Systematic and Clinical Lectures to Students and Medical Practitioners. By J. R. Wolfe, M.D., F.R.C.S. E., Lecturer on Ophthalmic Medicine and Surgery in Anderson's Col- lege, Glasgow. With 10 Coloured Plates and 157 Wood Engravings. Svo, ;^i is. The General Practitioner's Guide to the Diseases and Injuries of the Eye and Eyelids. By Louis H. TosswiLL, B.A., M.B. Cantab., M.R.C.S., Surgeon to the Exeter Eye Infirmary. Fcap. Svo, 2s. 6d. Hints on Ophthalmic Out-Patient Practice. By Charles PIiggens, Ophthalmic Surgeon to Guy's Hospital. Second Edition. Fcap. Svo, 3s. Essays in Ophthalmology. By George E. Walker, P\R.C.S., Surgeon to St. Paul's Eye and Ear Hospital, &c., Liverpool. Post Svo, 6s. The Electro-Magnet, And its Employment in Ophthalmic Sur- gery. By Simeon Snell, Ophthalmic Surgeon to the Sheffield General In- firmary, «Scc. Crown Svo, 3s. 6d. 12 J. S>- A. CHURCHILDS RECENT WORKS. The Student's Guide to Diseases of the Eye. By Edward Nettleship, F.R.C.S., Ophthalmic Surgeon to St. Thomas's Hospital. Third Edition. Fcap. 8vo, with 150 Engravings and a Set of Coloured Papers illustrating Colour-Blind- ness, 7s. 6d. A Manual of the Principles and Practice of Ophthalmic Medicine and Surgery. By T. Wharton Jones, F.R.C.S., F.R.S. Third Edition. Fcap. 8vo, with 9 Coloured Plates and 173 Engravings, I2s. 6d. Glaucoma : Its Causes, Symptoms, Pathology, and Treatment. By Priestley Smith, M.R.C.S., Ophthalmic Surgeon to the Queen's Hospital, Birmingham. 8vo, with Lithographic Plates, los. 6d. Refraction of the Eye : A Manual for Students. By Gustavus Hartridge, F.R.C.S., Assistant Physi- cian to the Royal Westminster Ophthalmic Hospital. Crown Svo, with Lithographic Plate and 84 Woodcuts, 5s. Hare-Lip and Cleft Palate. By Francis Mason, F.R.C.S., Surgeon to St. Thomas's Hospital. 8vo, with 66 Engravings, 6s. By the same Author. The Surgery of the Face. 8vo, with 100 Engravings, 7s. 6d. A Practical Treatise on Aural Surgery. By H. Macnaughton Jones, M.D., Professor of the Queen's University in Ireland, late Surgeon to the Cork Ophthalmic and Aural Hospital. Second Edition. Crown Svo, with 63 Engravings, 8s. 6d. By the same Author. Atlas of Diseases of the Mem- brana Tympani. In Coloured Plates, containing 62 Figures, with Text. Crown 4to, 21s. Diseases and Injuries of the Kar. By W. B. Dalhy, F.R.C.S., Aural Surgeon to St. George's Hospital. Second Edition. Fcap. 8vo, with Engravings, 6s. 6d. X^ectures on Syphilis of the Larynx (Lesions of the Secondary and Intermediate Stages). By W. M. Whist- ler, M.I)., Physician to the Hospital for Diseases of the Throat. Post Svo, 4s. Diphtheria : By Peter Eade, M.D., F.R.C.P., Senior Physician to the Norfolk and Norwich Hospital. Svo, 3s. Diseases of the Throat and Nose : A Manual. By Morell Mac- kenzie, M.D. Lond., Senior Physician to the Hospital for Diseases of the Throat. Vol. I. Diseases of the Pharynx, Larynx, and Trachea. Post Svo, with 112 En- gravings, I2s. 6d, Vol. II. Diseases of the Nose and Naso- pharynx ; with a Section on Diseases of the CEsophagus. Post Svo, with 93 En- gravings, I2S. 6d. By the same Author. Diphtheria : Its Nature and Treatment, Varieties, and Local Expressions. Svo, 5s. Sore Throat : Its Nature, Varieties, and Treatment. By Prosser James, M.D., Physician to the Hospital for Diseases of the Throat. Fourth Edition. Post Sv%, with Coloured Plates and Engravings, 6s. 6d. The Ear: Its Anatomy, Physiology, and Diseases. By C. H. Burnett, A.M., M.D., Aural Surgeon to the Presbyterian Hospital, Philadelphia. 8vo,withS7 Engravings, iSs. A Treatise on Vocal Physio- logy and Hygiene, with especial reference to the Cultivation and Pre- servation of the Voice. By Gordon Holmes, M.D., Physician to the Muni- cipal Throat and Ear Infirmary. Second Edition, with Engravings. Crown Svo, 6s. 6d. By the same Author. A Guide to the Use of the Laryngoscope in General Prac- tice. Crown Svo, with Engravings, 2s. 6d. A System of Dental Surgery. By John Tomes, F.R.S., and C. S. Tomes, M.A., F.R.S. Third Edition. Fcap. Svo, with many Engravings. [In the Press. Dental Anatomy, Human and Comparative : A Manual. By Charles S. Tomes, M.A., F.R.S. Second Edition. Crown Svo, with 191 Engravings, 12s. 6d. The Student's Guide to Dental Anatomy and Surgery. By Henry Sewill, M.R.C.S., L.D.S. Second Edition. Fcap. Svo, with 78 Engravings, . 5s. 6d. A Manual of Dental Mechanics. By Oakley Coles, L.D.S.R.C.S. Second Edition. Crown Svo, with 140 Engravings, 7s. 6<1. By the same Author. Deformities of the Mouth. Third Edition. Svo, with 83 Wood En- gravings and 96 Drawingson Stone, 12s. 6d. Mechanical Dentistry in Gold and Vulcanite. By F. H. Balk- ^VILL, L.D.S.R.C.S. Svo, with 2 Litho- graphic Plates and 57 Engravings, los. J. ^ A. CHURCHILLS RECENT WORKS. 13 Notes on Dental Practice. By Henry C. Quinby, L.D.S.R. C.S.I. 8vo, with 87 Engravings, 9s. Elements of Dental Materia Medica and Therapeutics, w^ith Pharmacopceia. By James Stocken, L.D.S.R.C.S., Pereira Prizeman for Materia Medica, and Thomas Gaddes, L.D.S. Eng. and Edin. Third Edition. Fcap. Svo, 7s. 6d. Dental Medicine : A Manual of Dental Materia Medica and Therapeutics. By F. J. S. Gorgas, A.M., M.D., D.D.S., Editor of "Harris's Principles and Practice of Dentistry," Professor in the Dental Department of Maryland University. Svo, 14s. Lectures on Dermatology : Delivered at the Royal College of Sur- geons, by Sir Erasmus Wilson, F.R.S. 1870, 6s. ; 1871-73, IDS. 6d. ; 1874-75, IDS. 6d. ; 1876-78, los. 6d. Eczema. By McCall Anderson, M.D., Professor of Clinical Medicine in the University of Glasgow. Third Edition. 8vo, with Engravings, 7s. 6d. Diseases of the Skin : With an Analysis of 8,000 Consecutive Cases and a Formulary. By L. D. Bulk- ley, M.D., Physician for Skin Diseases at the New York Hospital. Crown 8vo, 6s. 6d. Atlas of Skin Diseases. By Tilbury Fox, M.D., F.R.C.P. With 72 Coloured Plates. Royal 4to, half morocco, £^ 6s. On Certain Rare Diseases of the Skin. By Jonathan Hutchinson, F.R.S., Senior Surgeon to the London Hospital, and to the Hospital for Diseases of the Skin. 8vo, los. 6d. Diseases of the Skin : A Practical Treatise for the Use of Students and Practitioners. By J. N. Hyde, A.M., M.D., Professor of Skin and Venereal Diseases, Rush Medical College, Chicago. 8vo, with 66 Engravings, 17s. Parasites : A Treatise on the Entozoa of Man and Animals, including some Account of the Ectozoa. ByT.SPENCERCoBBOLD,M.D., F.R.S. Svo, with 85 Engravings, 15s. Leprosy in British Guiana. ByJoHND.HiLLis,F.R.C.S.,M.R.I.A., Medica] Superintendent of the Leper Ayslum, British Guiana. Imp. Svo, with 22 Lithographic Coloured Plates and Wood Engravings, £1 us. 6d. Certain Forms of Cancer, With a New and Successful Mode of Treat- ing it. By A. Marsden, Senior Surgeon to the Cancer Hospital. Second Edition. Svo, with Coloured Plates, Ss. 6d. Cancer of the Breast. By Thomas W. Nunn, F.R.C.S., Con- sulting Surgeon to the Middlesex Hos- pital. 4to, with 21 Coloured Plates, £2 2s. On Cancer : Its Allies, and other Tumours; withspecial reference to their Medical and Surgical Treatment. By F. A. Purcell, M.D., M.C., Surgeon to the Cancer Hospital, Brompton. Svo, with 21 Engravings, los. 6d. Sarcoma and Carcinoma : Their Pathology, Diagnosis, and Treat- ment. By Henry T. Butlin, F.R.C.S., Assistant Surgeon to St. Bartholomew's Hospital. Svo, with 4 Plates, Ss. By the same Attthor. Malignant Disease of the La- rynx (Sarcoma and Carcinoma). Svo, with 5 Engravings, 5s. Clinical Notes on Cancer, Its Etiology and Treatment ; with special reference to the Heredity- Fallacy, and to the Neurotic Origin of most Cases of Alveolar Carcinoma. By Herbert L. Snow, M.D. Lond., Surgeon to the Cancer Hospital, Brompton. Crown Svo, 3s. 6d. Diseases of the Urinary Organs. Clinical Lectures. By Sir Henry Thompson, F.R.C.S., Emeritus Pro- fessor of Clinical Surgery in University College. Seventh (Students') Edition. Svo, with 84 Engravings, 2s. 6d. By the same Author. Diseases of the Prostate : Their Pathology and Treatment. Fifth (Students') Edition. Svo, with numerous Engravings, 2s. 6d. Also. Surgery of the Urinary Organs. Some Important points connected there- with. Lectures delivered in the R.C.S. Svo, with 44 Engravings. Students' Edition, 2s. 6d. Also. Practical Lithotomy and Litho- trity; or. An Inquiry into the Best Modes of Removing wStone from the Bladder. Third Edition. Svo, with 87 Engravings, los. Also. The Preventive Treatment of Calculous Disease, and the Use of Solvent Remedies. Second Edition Fcap. Svo, 2s. 6d. Also. Tumours of the Bladder: Their Nature, Symptoms, and Surgical Treatment. Svo, with numerous Illustra- tions, 5s. Diseases of the Testis, Sperm- atic Cord, and Scrotum. By Thomas B. Curling, F.R.S., Consult- ing Surgeon to the London Hospital. Fourth Edition. Svo, with Engravings, i6s. 14 J. 8f A. CHURCHILL'S RECENT WORKS. Haemorrhoidal Disorder. By John Gay, F.R.C.S., Senior Surgeon to the Great Northern Hospital. 8vo, with Engravings, 2s. 6d. Hydrocele : Its several Varieties and their Treatment. By Samuel Osborn, late Surgical Registrar to St. Thomas's Hospital. Fcap. 8vo, with Engravings, 3s. By the same Author. Diseases of the Testis. Fcap. 8vo, with Engravings, 3s. 6d. Lithotomy and Extraction of Stone. By \V. P. Harris, M.D., Surgeon-Major H.M. Bengal Medical Service. 8vo, with Engravings, los. 6d. Fistula, Haemorrhoids, Painful Ulcer, Stricture, Prolapsus, and other Diseases of the Rectum : Their Diagnosis and Treatment. By William Allingham, Surgeon to St. Mark's Hospital for Fistula. Fourth Edition. 8vo, with Engravings, los. 6d. The Surgery of the Rectum. By Henry Smith, Professor of Surgery in King's College, Surgeon to the Hos- pital. Fifth Edition. 8vo, 6s. Diseases of the Rectum and Anus. By W. Harrison Cripps, F.R.C.S., Assistant Surgeon to St. Bar- tholomew's Hospital, &c. 8vo, with 13 Lithographic Plates and numerous Wood Engravings, 12s. 6d. By the same Author. Cancer of the Rectum : Its Pathology, Diagnosis, and Treatment. Crown 8vo, with Lithographic Plates, 6s. Lectures on the Surgical Dis- orders of the Urinary Organs. By Reginald Harrison, Y. R.C. S. , Surgeon to the Liverpool Royal Infirmary. Second Edition, with 48 Engravings. 8vo, 12s. 6d. By the sa?ne Author. Lithotomy, Lithotrity, and the Early Detection of Stone in the Bladder ; with a description of a New Method of Tapping the Bladder. 8vo, with Engravings, 2s. 6d. Morbid Conditions of the Urine, Dependent upon Derangements of Digestion. By Charles H. Ralfe, M.D., F.R.C.P., Assistant Physician to the London Hospital. Crown 8vo, 6s. Pathology of the Urine. Including a Complete Guide to its Analy- sis. By J. L. W. Thudichum, M.I)., F.R.C.P. Second Edition, rewritten and enlarged. 8vo, with Engravings, 15s. Student's Primer on the Urine. By J. Travis Whittaker, M.D., Clini- cal Demonstrator at the Royal Infirmary, Glasgow. With 16 Plates etched on Copper. Post 8vo, 4s. 6tl. Syphilis and Pseudo-syphilis. By Alfred Cooper, F.R.C.S., Surgeon to the Lock Hospital, to St. Mark's and the West London Hospitals. 8vo, los. 6d. Renal and Urinary Diseases. Clinical Reports. By William Carter, M.B., Physician to the Liverpool vSouthern Hospital. Crown 8vo, 7s. 6d. Genito-Urinary Organs, includ- ing Syphilis : A Practical Treatise on their Surgical Diseases, for Students and Practitioners. By W. H. Van Buren, M.D., and E. L. Keyes, M.D. Royal 8vo, with 140 Engravings, 21s. Lectures on Syphilis. By Henry Lee, Consulting Surgeon to St. George's Hospital. 8vo, los. Urinary and Reproductive Or- gans : Their Functional Diseases. By D. Campbell Black, M.D. Second Edition. 8vo, los. Coulson on Diseases of the Bladder and Prostate Gland. Sixth Edition. By Walter J. Coiilson, Surgeon to the Lock Hospital and to St. Peter's Hospital for Stone. 8vo, i6s. On Rupture of the Urinary Blad- der. Based on the Records of more than 300 Cases of the Affection. By Walter Rivington, F.R.C.S., Presi- dent of the Hunterian Society ; Surgeon to the London Hospital. 8vo, 5s. 6d. The Reproductive Organs In Childhood, Youth, Adult Age, and Ad- vanced Life, considered in their Physio- logical, Social, and Moral Relations. By William Acton, M.R.C.S. Sixth Edition. 8vo, 12s. The Medical Adviser in Life Assurance. By E. H. Sieveking, M.D., F.R.C.P. Second Edition. Crown 8vo, 6s. A Medical Vocabulary : An Explanation of all Terms and Phrases used in the various Departments of Medical Science and Practice, their Derivation, Meaning, Application, and Pronunciation. By R. G. Mayne, M.D., LL.D. Fifth Edition. Fcap. 8vo, los. 6d. A Dictionary of Medical Science: Containing a concise Explanation of the various Subjects and Terms of Medicine, &C. By ROBLEY DUNGLISON, M.D., LL.D. New Edition. Royal 8vo, 28s. Abridged Medical Account Books. The *' Expedite" Method. By J. Macnab, L.R.C.S.E. Imiex Ledger. Royal 4to., 15s. Visiting List. Cloth, 2s. 6d. ; Leather, i^s. 6d. Medical Education And Practice in all parts of the World. By H. J. Hardwicke, M.D., M.R.C.P. 8vo, los. INDEX. Acton's Reproductive Organs, 14 Adams (W.) on Clubfoot, 11 on Contraction of the Fingers, 1 1 on Curvature of the Spine, 11 Alexander's Displacements of the Uterus, 6 Allan on Fever Nursing, 7 Allbutt's Visceral Neuroses, 9 Allingham on Diseases of the Rectum, 14 Anatomical Remembrancer, 3 Anderson (McC.) on Eczema, 13 Aveling on the Chamberlens and Midwifery Forceps, 6 on the Influence of Posture on Women, 6 Balfour's Diseases of the Heart and Aorta, 8 Balkwill's Mechanical Dentistry, 12 Barnes (E. G.) How to Arrest Infectious Diseases, 4 Barnes (R.) on Obstetric Operations, 5 on Diseases of Women, 5 Beale's Microscope in Medicine, 8 Slight Ailments, 8 Bellamy's Surgical Anatomy, 3 Bennet (J. H.) on the Mediterranean, 10 ^on Pulmonary Consumption, 10 on Nutrition, 10 Bentley and Trimen's Medicinal Plants, 7 Bentley's Manual of Botany, 7 Structural Botany, 7 Systematic Botany, 7 Bigg (R. H.) on the Orthopragms of Spine, 1 1 Binz's Elements of Therapeutics, 7 Black on the Urinary Organs, 14 Braune's Topographical Anatomy, 3 Brodhurst's Anchylosis, 11 ■ Curvatures, Sec, of the Spine, 11 Orthopaedic .Surgery, 11 • Bryant's Practice of Surgery, 11 Bucknill and Tuke's Psychological Medicine, 5 Bulkley's Eczema, 13 Burdett's Cottage Hospitals, 5 Pay Hospitals, 5 Burnett on the Ear, 12 Burton's Midwifery for Midwives, 5 Butlin's Malignant Disease of the Larynx, 13 Sarcoma and Carcinoma, 13 Buzzard's Diseases of the Nervous System, 9 Carpenter's Human Physiology, 4 Carter (H. V.) on Spirillum Fever, 8 Carter (W.) on Renal and Urinary Diseases, 14 Cayley's Typhoid Fever, 8 Charteris' Practice of Medicine, 8 Clark's Outlines of Surgery, 10 Clay's (C.) Obstetric Surgery, 6 Clouston's Lectures on Mental Diseases, 5 Cobbold on Parasites, 13 Coles' Dental Mechanics, 12 Deformities of the Mouth, 12 Cooper's Syphilis and Pseudo-Syphilis, 14 Coulson on Diseases of the Bladder, 14 Courty's Diseases of the Uterus, Ovaries, Sec, 6 Cripps' Cancer of the Rectum, 14 ;— Diseases of the Rectum and Anus, 14 Cullingworth's Manual of Nursing, 7 ; ; — Short Manual for Monthly Nurses, 7 Curling's Diseases of the Testis, 13 Dalby's Diseases and Injuries of the Ear, 12 Dalton's Human Physiology, 4 Day on Diseases of Children, 7 on Headaches, 9 Dobell's Lectures on Winter Cough, 8 Loss of Weight, &c., 8 Mont Dor6 Cure, 8 Domville's Manual for Nurses, 7 Druitt's Surgeon's Vade-Mecum, 11 Duncan on Diseases of Women, 5 _ on Sterility in Woman, 5 Dunglison's Medical Dictionary, 14 Eade on Diphtheria, 12 Ellis's Manual for Mothers, 6 of the Diseases of Children, 6 Emmet's Gynaecology, 6 Fayrer's Climate and Fevers of India, 7 Tropical Dysentery and Diarrhoea, 7 Fenwick's Chronic Atrophy of the Stomach, 8 Medical Diagnosis, 8 Outlines of Medical Treatment, 8 Fergusson's Practical Surgery, 10 Flint on Clinical Medicine, 8 on Phthisis, 8 Flower's Diagrams of the Nerves, 4 Foster's Clinical Medicine, 8 Fox's (C. B.) Examinations of Water, Air, and Food, 4 Fox's (T.) Atlas of Skin Diseases, 13 Frey's Histology and Histo-Chemistrj', 4 Galabin's Diseases of Women, 6 Gamgee's Treatment of Wounds and Fractures, 1 1 Gay on Haemorrhoidal Disorder, 14 Godlee's Atlas of Human Anatomy, 3 Gorgas' Dental Medicine, 13 Gowers' Diseases of the Spinal Cord, 9 Epilepsy, 9 ISIedical Ophthalmoscopy, 9 ;— Pseudo-Hypertrophic Muscular Paralysis, 9 Granville on Nerve Vibration and Excitation, 9 Habershon's Diseases of the Abdomen, 9 ; Stomach, 9 Pneumogastric Nerve, 9 Hamilton's Nervous Diseases, 9 Hardwicke's Medical Education, 14 Harley on Diseases of the Liver, 9 Harris on Lithotomy, 14 Harrison's Lithotomy, Lithotrity, &c., 14 Surgical Disorders of the Urinary Organs, 14 Hartridge's Refraction of the Eye, 12 Heath's Injuries and Diseases of the Jaws, 10 Minor Surgery and Bandaging, 10 Operative Surgery, 10 Practical Anatomy, 3 Surgical Diagnosis, 10 Higgens' Ophthalmic Out-patient Practice, 11 Hillis' Leprosy in British Guiana, 13 Holden's Dissections, 3 Human Osteology, 3 Landmarks, 3 Holmes' (G.) Guide to Use of Laryngoscope, 12 Vocal Physiology and Hygiene, 12 Hood on Gout, Rheumatism, Szc, 9 Hooper's Physician's Vade-Mecum, 8 Horton's Tropical Diseases, 8 Hutchinson's Clinical Surgery, 11 Pedigree of Disease, 11 Rare Diseases of the Skin, 13 Huth's Marriage of Near Kin, 4 Hyde's Diseases of the Skin, 13 Ireland's Idiocy and Imbecility, 5 James (P.) on Sore Throat, 12 Jones' (C. H.) Functional Nervous Disorders, 9 Jones (C. H.) and .Sieveking's Pathological Anatomy, 4 Jones' (H. McN.) Aural Surgery, 12 Atlas of Diseases of Membrana Tj'mpani, 12 Spinal Curvatures, 1 1 Jones' (T. W.) Ophthalmic Medicine and Surgery, 12 Jordan's Surgical Enquiries, 10 Lancereaux's Atlas of Pathological Anatomy, 4 Lee (H.) on Syphilis, 14 Leared on Imperfect Digestion, 9 Lewis (Bevan) on the Human Brain, 4 Liveing's Megrim, Sick Headache, &c., 10 Macdonald's (A.) Chronic Disease of the Heart, 6 Macdonald's (J. D.) Examination of Water and Air, 4 Mackenzie on Diphtheria, 12 on Diseases of the Throat and Nose, 12 Maclise's Dislocations and Fractures, lo Surgical Anatomy, 3 MacMunn's Spectroscope in Medicine, 8 Macnab's Medical Account Books, 14 Madden's Principal Health-Resorts, 10 Mann's Manual of Psychological Medicine, 5 Marcet's Southern and Swiss Health-Resorts, ro Marsden's Certain Forms of Cancer, 13 Mason on Hare-Lip and Cleft Palate, 12 on Surgery of the Face, 12 Mayne's Medical Vocabulary, 14 Notes on Poisons, 7 Therapeutical Remembrancer, 7 Moore's Family Medicine for India, 7 Health-Resorts for Tropical Invalids, 7 Morris' (H.) Anatomy of the Joints, 3 Mouat and Snell on Hospitals, 5 Nettleship's Diseases of the Eye, 12 Nunn's Cancer of the Breast, 13 Ogston's Medical Jurisprudence, 4 Oppert's Hospitals, Infirmaries, Dispensaries, S:c., 5 Osborn on Diseases of the Testis, 14 on Hydrocele, 14 [Conttnited on the next pa^e I N DEX — continued. Owen's Materia Medica, 7 Page's Injuries of the Spine, 11 Parkes' Practical Hygiene, 5 Pavy on Diabetes, 9 on Food and Dietetics, g Pharmacopoeia of the London Hospital, -j Phillips' Materia Medica and Therapeutics, 7 Pollock on Rheumatism, 9 Porritt's Intra-Thoracic EflFusion, 8 Pridham on Asthma, 9 Purcell on Cancer, 13 Quinby's Notes on Dental Practice, 13 Ralfe's Morbid Conditions of the Urine, 14 Ramsbotham's Obstetrics, 6 Raye's Ambulance Handbook, 10 Reynolds' (J. J.) Diseases of Women, 6 Notes on Midwifery, 6 Rivington's Rupture of the Urinary Bladder, 14 Roberts' (C.) Manual of Anthropometry, 5 Detection of Colour- Blindness, 5 Roberts' (D. Lloyd) Practice of Midwifery, 5 Ross's Diseases of the Nervous System, 9 Roth on Dress : Its Sanitary Aspect, 4 Routh's Infant Feeding, 7 Royle and Harley's Materia Medica, 7 Sanderson's Physiological Handbook, 4 Sansom's Diseases of the Heart, 9 Savage on the Female Pelvic Organs, 6 Sayre's Orthopaedic Surgery, 11 Schroeder's Manual of Midwifery, 6 Sewill's Dental Anatomy, 12 Sheppard on Madness, 5 Sibson's Medical Anatomy, 3 Sieveking's Life Assurance, 14 Smith's (E.) Clinical Studies, 6 Disease in Children, 6 Wasting Diseases of Infants and Children, 6 Smith's (Henry) Surgery of the Rectum, 14 Smith's (Heywood) Dysmenorrhoea, 6 Smith (Priestley) on Glaucoma, 12 Snell's Electro- Magnet in Ophthalmic Surgery, 11 Snow's Clinical Notes on Cancer, 13 Southam's Regional Surgerj', 10 Sparks on the Riviera, 10 Squire's Companion to the Pharmacopoeia, 7 Pharmacopoeias of London Hospitals, 7 Starkweather on the Law of Sex, 4 Stilld and Maisch's National Dispensatory, 7 Stimson on Fractures, 11 Stocken's Dental Materia Medica and Therapeutics, 13 Swain's Surgical Emergencies, 10 Swayne's Obstetric Aphorisms, 6 Taylor's Medical Jurisprudence, 4 Poisons in relation to Medical Jurisprudence, Teale's Dangers to Health, 4 Thompson's (Sir H.) Calculous Disease, 13 Diseases of the Prostate, 13 Diseases of the Urinary Organs, 13 Lithotomy and Lithotrity, 13 Surgery of the Urinary Organs, 13 Tumours of the Bladder, 13 Thompson's (Dr. H.) Clinical Lectures, 8 Thorowgood on Asthma, 9 ; on Materia Medica and Therapeutics, 7 Thudichum's Pathology of the Urine, 14 Tibbits' Medical and Surgical Electricity, 10 Map of Motor Points, 10 Tidy and Woodman's Forensic Medicine, 4 Tilt's Change of Life, 6 Uterine Therapeutics, 6 Tomes' (C. S.) Dental Anatomy, 12 Tomes' (J. and C. S.) Dental Surgery, 12 Tosswill's Diseases and Injuries of the Eye, 11 Tuke's Influence of the Mind upon the Body, 5 Sleep-Walking and Hypnotism, 5 Van Buren on the Genilo-Urinary Organs, 14 Vintras on the Mineral Waters, &c., of France, 10 Virchow's Post-mortem Examinations, 4 Wagstaffe's Human Osteology, 3 Walker's Ophthalmology, 11 Waring's Indian Bazaar Medicines, 7 Warner's Guide to Medical Case-Taking, 8 Warren's Hernia and Rupture, 11 Waters' (A, T. H.) Diseases of the Chest, 8 Waters (J. H.) on Fits, g Wells (Spencer) on Ovarian and Uterine Tumours, 6 West and Duncan's Diseases of Women, 6 West (S.) How to Examine the Chest, 8 Whistler's Syphilis of the Larynx, 12 Whittaker's Primer on the Urine, 14 Wilks' Diseases of the Nervous System, 9 Wilks and Moxon's Pathological Anatomy, 4 Wilson's (Sir E.) Anatomists' Vade-Mecum, 3 Lectures on Dermatology-, 13 Wilson's (G.) Handbook of Hygiene, 5 Healthy Life and Dwellings, 5 Wilson's (W. S.) Ocean as a Health-Resort, 10 Wolfe's Diseases and Injuries of the Eye, 11 Yeo's (G. F.) Manual of Physiology, 4 Yeo's (J. B.) Contagiousness of Pulmonary Consump- tion, 8 Zander Institute Mechanical Exercises, 10 The following Catalogues issued by J. & A. Churchill will be forwarded post free on application : — A. J. 8)- A. ChurchiWs General List of about 650 works on Anatomy^ Physiology^ Hygiene^ Midwifery^ Materia Medica^ Medicine^ Surgery^ Chemistry., Botajiy, "^c, |r., luith a complete hidex to their Subjects., for easy 7-eference. N.B.— This List includes B, C, & D. B. Selection from J. <§- A. ChurchiWs General List., comprising all recent Works published by them on the Art and Science of Medicine. C. J. Sf A. ChurchiWs Catalogue of Text Books specially arranged for Students. D. A selected and descriptive List of J. 8f A. ChurchiWs Works on Chemistry., Materia Medica., Pharmacy., Botany., Photography., Zoology., the Mic?'oscope^ and other branches of Science. E. The Half-yearly List of New Works and New Editions published by J. ^' A. Churchill durijig the previous six months., together with particulars of the Periodicals issued from their House. [Sent in January and July of each year to every Medical Practitioner in the United Kingdom whose name and address can be ascertained. A large number are also .sent to the United States of America, Continental Europe, India, and the Colonies.] America. — J. 8f A. Chtirchill being in constant communication with various ptiblisJiing hotises in Bostofiy Nezv York, and PJiiladelphia, are able, notwitJistanding the absence of international copyiHght., to conduct negotiations favourable to Ettglish Authors, . ^ LONDON: NEW BURLINGTON STREET, -?>? {Paitn^iier R<nv, and IVint Office Court. Pardon dk Sons, Printers. I