of persons, in whom there is no reason to suppose there has been any defect or imperfection in the progress of vaccination, who afterwards, ordinarily, at some distant period of time, viz. about ten years, less or more, according to circumstances, have been attacked by small-pox. Although the virulence of succeeding small-pox in such persons appears to have been so much ameliorated by the preceding vaccination, as to dissipate all apprehension of danger, or of creating any necessary alarm; yet it might,' nevertheless, be prudent, especially in such persons whose apparent habit of body might indicate a more than ordinary disposition for receiving infection, viz. a peculiar fullness or impurity of habit, to repeat the operation of vaccination, provided such persons are liable to be exposed to infection from small-pox, which might afford a test of their security, or have the effect of eradicating such disposition, should any still exist in the habit. Moreover, should such danger of infection present itself, and no vaccine fluid to be obtained, it might be justifiable to inoculate with small-pox, under the usual precautions respecting regimen, &c. We sometimes hear of an instance, one I know of myself, in whom repeated vaccination has failed to produce the intended affection: this need be no matter of surprise, when it is recollected the same circumstance has happened in inoculation for small-pox; and that some persons have resisted the infection of small-pox, in the natural way, throughout life, although frequently exposed to it. In such a case, however, it would be prudent to vaccinate again at a dis-tant period, or to inoculate. Since nothing should be omitted which can tend to the security of individuals, and with a view to exterminate or annihilate small-pox, it might be advisable, at the distance of ten years or more, to vaccinate a second time, although no immediate danger of variolous infection might be present. Not The Surgical Editor of the Medical Journal, in a note at p. 475, respecting my paper on the removal of enlarged tonsils, by an improved mode of applying the ligature, suggests, that the method by excision with curved scissars, which he has practised, is preferable to the method by ligature. having had any experience in this mode myself, although I believe it to be in use with some practitioners, I can say: nothing as to the merits of it, the method by ligature only being what I have been accustomed to, and which I understand is still the most prevalent or general mode in practice. Moreover, the same gentleman mentions an instance of a young woman, whom he cured by excision, who had been dismissed the Oxford Infirmary, after an unsuccessful attempt by the method originally proposed by Cheselden, but which, I believe, is at present but little practised, viz. by conducting a double ligature through the base of the tonsil, and then including each half of the tonsil, by means of the two ligatures. With respect to this circumstance, having had no communication with the Infirmary for seven or eight years past, I can only say confidently, that no such operation was per formed, or attempted, during my residence there, to my knowledge. The mode I have recommended for applying the ligature. for the extirpation of enlarged tonsils, may be used with equal facility, I presume, in all tumours which require such an operation, when situated beyond the reach or command of the hand itself for performing it. I must confess, I think myself there is an eradicating effect produced, in consequence of the part sloughing away, when the ligature is duly applied, in extirpating enlarged tonsils, and such like enlargements, which may not take place by simple excision. Since my communication respecting loose fractures, another case of the same kind has presented to me, in which I have applied vesicatories with my former success, In this instance, (an oblique fracture of the leg,) to which I was called in, seven or eight weeks after the accident, the leg is so perfect, and the bone so smooth, notwithstanding the fre quent necessity of moving the limb, in consequence of the repeated application of vesicatories, that neither the eye nor finger can ascertain where the fracture was in the former instances, fitteen or sixteen weeks had elapsed before the application of blisters. I think from three to five blisters may ordinarily be sufficient. Oxford; Dec. 6, 1814, RICHARD WALKER, For the Medical and Physical Journal, Remarks on the various Forms of Quackery; by Mr. G. STEVENS, EING an old bachelor, very much at leisure, part, oft BEING cal publications: among the rest, the Medical and Physical Journal serves me for conversation with our village doctor, when I can get him to a rubber. When it is our turn, to set out, I have often remarked how much more lookers-on see of the game than those who are actually at play, This has suggested suggested to me the idea, that, if you will admit a paper from an unprofessional man, your readers may meet with hints which may not occur to your usual correspondents. A passage I lately met with in Baron Grimm's Memoirs, has furnished me with a subject. "The most celebrated practitioner that ever appeared at Paris, (says that entertaining writer,) was a private in the French guards. His only remedy was a tisane of hay boiled in water. He treated his patients en bêtes, and he judged rightly on the subject. This decoction of hay soon placed him in a situation to give good dry forage to two horses which were harnessed to a good carriage, in which he rode to visit his patients, whilst the then docteur regent of the faculty was making his rounds on foot through the boue de Paris. The faculty soon after made a complaint to the Marechal de Biron, to oblige this hay-doctor to lay down his equipage, and reserve all his forage for his patients." When I hear the learned part of your profession exclaim against quackery, I often wish to know which of them is guiltless, to cast the first stone. Was this private in the guards the only practitioner whose patients were taking an equally innocent tisane, and how many of those whose remedies were more powerful, were really succeeding better, and, after all, are we certain that there is no efficacy in a decoction of hay? Ought there not, therefore, to be cer tain lines fixed between the quackery of regulars; and the quackery of professed quacks? Nothing is more common than for a medical man, when he reads in the paper how much better my Lord or my Lord Duke has found himself by the attendance of Dr. or Sir, to remark" a good puff!"-" a good piece of quackery!" This is indeed now so well understood, that the officers of the revenue, I am informed, always demand the customary duty of advertisement on such paragraphs. But there is another species of quackery, in my opinion, much less excuseable, and much more artful. The trick ĺ allude to is the publication of half what the author means to tell the world. Thus, one writer informs us, that to distin guish certain complaints requires great discernment, long practice, a particular habit of attending to these subjects; in short, it is not difficult to see that he means " You must apply to me, and I do not wish to say too much; somet people may think lest I should render them as wise as myself; but the truth is, I know no more than you, and there fore do not chuse to expose myself."-One or both reasons must be the true one, and whichever it may be the quackery is the same. The The next species of regular quackery is the publication of a single volume on any subject, with the promise of compleating the work hereafter. On this occasion we have always an enormous deal of learning, ten thousand suggestions about the importance of certain questions, and the number of experiments and observations which the author found it necessary to make before he could satisfy himself in certain intricacies. The last thing in all these cases, and what the reader is anxiously looking for, is the treatment; but, when he comes to the end, he finds the author has not entirely made up his mind on some points, or that his various Occupations have not allowed him leisure to complete this part of the work to his satisfaction; he promises, however, that it shall soon appear: in the mean while, whom can the reader consult so well as this learned and experienced writer? As The last kind of professional quackery which I shall notice, is one which it is astonishing to me that the college has not hitherto noticed in their own body; this is the courage with which physicians, usually the youngest of the order, attempt to lecture on all the various branches of the art. they grow older they seem to be more modest, and to satisfy themselves with one branch only. This, Messrs. Editors, is a crying evil. Every man who undertakes to teach is presumed to have devoted his time exclusively to the science of his lectures; by these means he is not only more intimately acquainted with his subject, but learns also the best mode of teaching it. Can this be expected from any one in two such sciences as medicine and chemistry? The first considered, since the days of Hippocrates, as too much for a man's life, and the second improving so rapidly every hour, that the best chemists, whose whole time is engaged in such studies, not unfrequently learn the fallacy of those lessons which they delivered only a week before. I am told, that, when the college see any thing unbecoming in the conduct of their members, they usually send them an admonition: have they ever sent such admonitions to unfledged doctors, who undertake to teach at an age when their own education must be very incomplete, or who venture to lecture on more than one branch? Till these things are attended to, I think it as well to be cautious how the regulars, as they call themselves, talk of quackery. -Yorkshire; Dec. 1, 1814. GEO. STEVENS. For 23 For the Medical and Physical Journal. On the Functions of the Nervous System; by C. W.SMERDON, Member of the Royal College of Surgeons. Twhich are peculiar to man, and it is to the proper apthink and to compare are the operation of faculties plication of these that the human mind is indebted for its highest attainments. To draw conclusions on the nature of causes that are only known to us by their effects, by comparing them with others which are familiar to us, and whose effects are similar, is, I conceive, a very rational method of gaining knowledge: by this mode of theorising, the intricacy of science is considerably lessened; and, where phenomena do not admit of explanation by experimental inductions, we shall, by such means, approximate as near as it is possible to truth. From this source, natural philosophy has received the most considerable of its improvements. By the falling of an apple from a tree, the immortal Newton gained his first ideas of gravity, by which, by the curve which a body forms when thrown into the air, and by centrifugal power, the evolution of the planets around the sun, as their common centre, is very rationally explained. The simple experiment of pouring water on a body placed in a basin, proves the refractibility of the rays of light, and consequently explain the phenomenon of twilight; and, by reasoning on the resemblance which apparently exists between a common culinary fire and the sun, we are indebted for no inconsiderable portion of what we know of this luminary. In the following observations, some of the functions of the nervous system are attempted to be explained on this principle, nor can such a plan be considered as irrational, since we know that the anatomist, even after the most attentive dissection of the brain, is still left to wonder and to doubt; nor has any clue hitherto been discovered, which can lead to the physiology of that organ-the human intellect, that masterpiece of creative wisdom, is still enveloped in impenetrable mystery. It is an axiom which I think cannot admit of doubt, that all organic actions depend, first, on the living principle; secondly, on a peculiar structure; and thirdly, on stimuli: and it is equally clear, that actions are powerful in proportion to the quantity of stimuli applied. All matter animated with life, and possessing the property of contracting on the application of stimuli, seem to be endowed with a certain principal or spring of action, destined by nature to be exquisitely sensible to peculiar impressions: this principal is the irritability of the modern physiologist. The |