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The "Letter to Francis Jeffery, Esq." is a clever and rather imposing production. It is obviously the work of a Roman Catholic, who comes forth prepared to meet the Reviewer in the general field of controversy in regard to the continuance of miracles in the Christian church; and to argue the particular case of Hohenlohe's cures on the broad principles of Scriptural promise and ecclesiastical tradition. The question which is here placed at issue respects, we may observe, that intricate subject of enquiry which occupied so unprofitably the genius of Middleton, and the learning of Dodwell. The disputes of Protestants on a topic so extremely interesting afford to the Romanist the materials of a real triumph: and as almost all writers admit that supernatural powers were continued in the church for several centuries after the apostolic age, it is certainly by no means impertinent to ask, at what period they ceased to be enjoyed, and what was the change of circumstances in the condition of the Christian world, which rendered unnecessary a means of conversion so likely to prove effectual, and an evidence for the divine origin of our holy faith, so well fitted to put to silence the tongues of gainsayers. The pamphlet now before us is, we repeat, ably and plausibly written and although it fails to establish any particular case of miraculous interposition, it goes far to remove the common objections, or rather perhaps the common impression against the probability of its occurrence. Whilst Mr. Finlayson endeavours to make out that, certain individuals among the Roman Catholic clergy of Ireland have been engaged in a plot, in order to impose upon mankind the belief of a false miracle, the author of the "Letter" employs his talents in the more pleasant task of convincing the religious world that such events are still to be expected, even in the ordinary state of the church; and consequently, that it savours of an impious scepticism to be slow in admitting the evidence upon which they are revealed

to us.

ART. IX. Practical Observations in Surgery. By Henry Earle, F.R.S. Assistant Surgeon to St. Batholomew's Hospital, and Surgeon to the Foundling. 8vo. 230 pp. 8s. 6d. Underwood, 1823.

ART. X. Observations on Fractures of the Neck of the Thigh-Bone, being an Appendix to the Work on Dislocations and Fractures of the Joints. By Sir Astley Cooper, Bart. F.R.S. Surgeon to the King, &c. &c. 4to. 54 pp. 21. 2s. Longman & Co. 1823

ART. XI. Remarks, by the Author, on Sir Astley Cooper's Reply to his Critical Observations on Fracture of the Neck of the Femur, &c. &c. 8vo. 8 pp. Underwood.

1824.

Ir has occasionally been insinuated by the enemies of our fame, that The British Critic is over fond of controversy. This is so far from being the case, that we do our best to keep entirely out of its seductive vortex. We have, at least, twenty unnoticed controversies at this hour in our cabinet; whose parents and children, and various other relatives cease not to remind us that their writings are before the world, and that the judgment of the literary public is retarded by our inexcuseable silence. In spite of these flattering solicitations, we continue obstinately mute, and refuse to say a word more upon the subjects by which Christendom is divided. We have allowed the Plymouth Antinomians to run their course unmolested. We have had no hand in the chastisement bestowed upon Dr. Hawker. We have patched up a truce with Dr. Chalmers; and have not replied to Mr. Irving's remarks upon his "unregenerate reviewers." We have left Dr. Henderson to tell how the Bible Society has turned Mahometan and published the Koran in the garb of the Gospel. Nor are we sure that we shall be tempted by the forthcoming answer of Professor Lee, to bestow even upon this momentous question, the care and consideration which it threatens to require. In fact, we are heartily tired of squabbling. It has a bad effect on the temper-it spoils our nights' rest-it takes away our appetite-impedes our digestion, and sends us, precisely where we had rather not go— to the doctors. In this charitable disposition of mind, our notice was unluckily directed to the "Fractures of the Neck of the Femur," and we plunged at once into controversies, of which the very existence was previously unknown to us. We had supposed that these disputes were confined to religion and politics. We never dreamed of an othodox method of healing legs, or a heterodox stratagem for splicing them. We had heard with some incredulity of the odium theologicum-but had yet to learn the extent of the odium pathologicum. Willing to communicate recent discoveries, and to render our readers as much at home on these subjects

* See the Preface to the third edition of the "Orations," the most coxcombical and the least Christian production which Mr. Irving has given to

the world.

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as we are, we propose to make a few remarks upon interesting and important controversy, respecting fractures of the neck of the thigh. The dispute has been conducted by distinguished men; one of them has long stood in the foremost rank of his profession. The other is in the enjoyment of extensive and well merited reputation. They write upon a subject of very general interest; and it touches us more nearly every day we live.

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Looking forward to the time at which "our steps shall become vacillating, and our bones become friable," when we may expect a heavy fall, and a painful fracture, our first prepossessions, we must confess, were strongly in favour of Mr. Earle. Sir Astley Cooper had pronounced certain fractures incurable.-Mr. Earle undertakes to cure them. Sir Astley says, that he who breaks a certain portion of bone, must dispense with an inch or two of the original length of his leg, and wear a high-heeled shoe for life.-Mr. Earle promises to preserve the limb, and take away nothing but the shoe. Sir Astley maintains that the desired cure never has taken place, and never will take place.-Mr. Earle says, that if it has not, it nevertheless both may and shall. Out of their own profession, therefore, there can be no doubt which of the combatants will have most followers. Nil desperandum is the motto which drives men to the doctors; when they fairly tell us that they cannot cure us, we are wont as fairly to wish them a good morning.

It is not in our power to give a regular analysis of Mr. Earle's volume, an outline of his opinions may be seen in the following passages.

"I have the misfortune to differ in opinion from a highly eminent practitioner with regard to the possibility of union of the neck of the thigh-bone, when broken within the capsular ligament'; and as that gentleman has recently given his sentiments on this subject to the profession, I am particularly desirous to submit mine also to their consideration, that they may judge between us.

"Sir Astley Cooper, in his recent work on Fractures and Dislocations, has stated it as his opinion, that perfect union under such circumstances cannot take place, and that more or less deformity and lameness must be the inevitable consequence of these accidents.

"Such is the doctrine which he has for many years inculcated into the minds of his numerous pupils; and this doctrine is now gone forth into the world with the stamp of his name, and the sanction of his extensive experience".

* "In the 13th Number of the Medico-Chirurgical Review, Dr. Johnson obIt has been falsely stated that Sir A. Cooper has said that union of the

serves,

"It is with great deference, therefore, that I come forward to combat his opinion; but as I conceive it to be erroneous, and think it can be proved to be so, I am sure that the candour of that gentleman will justify me in his eyes; and my duty to the public and to the profession will be a sufficient answer to the charge of presumption in any other quarter: for it, must be obvious to every one, that opinions so confidently asserted, emanating from such high authority, must necessarily chill the spirit of inquiry, and consequently impede the progress of improvement.

"In proof of the justice of these remarks I may mention, that in a paper lately read before the Medico-Chirurgical Society, describing a very ingenious apparatus for fractures of the lower extremities, the author, an old pupil of Sir A. Cooper's, employs the following language in speaking of fractures within the articulation:

"On fractures through the cervix femoris it is unnecessary to make any remark, as, from the nature of the accident, let the limb be placed in either position, we shall meet with the same unfortu nate termination.'

"I have repeatedly heard similar sentiments expressed by other pupils of the same school, I might add, that the unqualified language of most of the reviews and journals has so far extended the influence of the opinions which have been broached by Sir A. Cooper, as to render it doubly necessary that some one should come forward to investigate the real merits of the case." Earle's Preface, p. vi.

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Such being the author's design, he proceeds to accomplish it by describing the anatomy of the thigh-joint, and the symptoms which attend fractures of the neck of the femur. Respecting the latter, he differs materially from the opinions, promulgated by Sir Astley, and there is much apparent reason in the grounds of his dissent: but on which side the truth really lies, we take not upon ourselves to determine. The principal points in dispute are alluded to in the following passage.

"Sir Astley Cooper, it is true, affirms, that he has never met with union by bone within the articulation, but that he has when the fracture was external to it. As many of Sir Astley's patients must have escaped any post mortem examination, the facts, in many instances, must rest upon his assertion; and as the diagnostics which he has advanced of the two cases appear to me to be

fracture of the neck of the thigh-bone was impossible,' It is true that Sir Astley has introduced a saving clause, in which he says, that to deny the possibility of such an occurrence would be presumptuous; but it is equally true that the whole tenour of his work conveys the impression that union will not take place, and that it is quite in vain to expect, or attempt to promote it; and the practice which he pursues, and which he recommends to others, is founded upon this principle."

incorrect, as indeed I have endeavoured to prove, it is quite legitimate to suppose that, in some instances, he may have treated one case for the other; and as, under the supposition of fracture external to the capsule, he would endeavour to favour the union by rest and extension, it is by no means improbable that he may occasionally have succeeded in obtaining bony union without being aware of his success.

"That Sir Astley Cooper may not in general have succeeded in obtaining bony union within the articulation, I can perfectly understand, from his own description of the accident, from the mode in which he has been led to view the case, and the treatment he recommends to be adopted. As I am now contending for a very opposite doctrine, I must rely on that gentleman's candour to excuse my making very free with his publication, and openly and candidly stating my objections. I might have done this under the mask of an anonymous reviewer, and thus have escaped the responsibility I am now incurring; but it is more consistent with my feelings, openly to avow my opinion of the causes of his want of

success.

"First, then, I believe, that, in many instances of fracture within the capsule, the examinations to which Sir Astley recommends that patients should be subjected, may have ruptured the remaining portion of the reflected layers of fibrous and synovial membrane, and thus have not only tended to insulate the head of the bone, but to increase the irritability of the surrounding muscles, and to create considerable inflammation in the synovial membrane. After describing the various directions in which the limb may be moved, and the different degree of pain produced by these various manipulations, he proceeds thus:

"In order to form a still more decided judgment of this acci dent, after the patient has been examined in the recumbent posture, let him be directed to stand by his bedside, supported by an assistant, so as to bear his weight on the sound limb; the surgeon then observes most distinctly the shortened state of the injured leg, the toes rest on the ground, but the heel does not reach it; the knee and foot are everted, and the prominence of the hip is diminished,'

"These indications are not, however, sufficient to satisfy Sir Astley, and therefore he proceeds thus:

"On ordering the patient to attempt to bear upon the injured limb, he finds himself incapable of doing so without considerable pain, which seems to be produced by the psoas, iliacus, and obturator externus muscles being put upon the stretch in the attempt, as well as by the pressure of the broken neck of the bone against the interior surface of the capsular ligament, and there will be a greater or less projection of the trochanter, proportional to the length of the fractured cervix femoris attached to it. A crepitus like that which accompanies other fractures might be expected to occur in these accidents; but it is not discoverable when

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