bably be the effects of this scepticism on society in general. His reply was this :-" the doctrines we are now discussing are, like the liqueur we are now drinking ;-safe and even pleasant to us, who know how to use, without abusing them;-but dangerous, deleterious, and intoxicating, if either the liqueur or doctrines were broached in the open streets, or exposed to the discretion of the mob." Experience has now taught us that though bolts and bars may keep noyeau from the multitude, they are quite inefficient in confining sceptical doctrines, which are too volatile for such imprisonment. It may be urged, (as it has often been urged,) that the promulgation of truth can never be ultimately injurious to society. But how are we to ascertain the truth of these doctrines to which we are objecting? They are but speculations, and whether true or false, their promulgation is attended with bad effects in the mean time. We have often wondered how medical men, who daily witness the benign influence of religion in mitigating the miseries of sickness, and disarming the terrors of death, can bring themselves to broach doctrines subversive of all those consolations which the afflicted derive from the belief of a superintending Deity, and another and better world! We cannot but think that this wanton trifling with the feelings, the hopes, and the fears, of so large a portion of mankind, is little indicative of philanthropy in the breast, or good sense in the head, of the writer. It has been well observed that-" in literature our taste will be discovered by that which we give, and our judgment by that which we withhold." It would be for the benefit of society, and the credit of the medical profession, if such of its members as held sceptical opinions were to keep them confined within their own bosoms till the multitude are as great philosophers as themselves, and as capable of discussing metaphysical subjects.

God forbid that we should be advocates for fettering the human intellect, and checking the liberty of discussion. But while indulging ourselves in the full freedom of thought, we have no right to issue words or writings that may be preju dicial to the community of which we are members, and to which we owe our safety. There are many and cogent reasons why the medical philosopher should avoid, as much as possible, those metaphysical discussions that involve religious or political tenets. By the profligate, licentious, and factious portion of society (no inconsiderable portion) his speculations will be adopted only to turn them to the worst of purposes. By the fanatical portion, and by the intolerant or crafty part of the priesthood, they will be converted Into engines of persecution against himself-while by the truly

philosophic portion of society (which is comparatively small) the promulgation of these doctrines will be condemned, even if the principles they contain should be embraced. If indeed we look back into the records of the past, we shall find that an absolute freedom in discussions involving religion, morals, and politics, never yet existed in any age or country. It is one of the dreams of modern philosophy. The superstition of the Lacedemonians prohibited all enquiry on the subject of religion-and in Athens, the ancient city of intellect, the lives of Eschylus, Socrates, Alcibiades, and many others, demonstrated that neither genius, learning, courage, nor the softer virtues, could screen their possessors from the persecutions of an implacable priesthood. In Rome it was toleration, not freedom. In Europe, wherever freedom has been allowed, licentiousness has followed. We would therefore recommend to our brethren a close adherence to the legitimate subjects of our own science, (where unhappily there is but too much to be yet accomplished) leaving all metaphysical speculations to those whose lives are spent more in the closet than in society-in contemplation than in action -in ascertaining the attributes of the soul, rather than in watching the diseases of the body.

II.

Lectures on the Structure and Physiology of the Male Urinary and Genital Organs of the Human Body, and on the Nature and Treatment of their Diseases; delivered before the Royal College of Surgeons in London, in the Summer of the Year 1821. By JAMES WILSON, F.R. S. Professor of Anatomy and Surgery to the College; Lecturer on Anatomy and Surgery at the Hunterian School in Great Windmill Street; and one of the Vice-Presidents of the Medico-Chirurgical Society of London. One Vol. 8vo. pp. 438, three Plates. London, September 1821.

THIS is the third and final volume of Mr. Wilson's Lectures before the College of Surgeons. It is, also, not the least valuable and interesting of the three. We are happy to find, that the opinion which we expressed of its two predecessors, has been amply confirmed by the profession at large-their reception by the public having been most favourable. The present work is dedicated to Henry Cline, Esq. one of the Patriarchs of Surgery, whose extensive knowledge adds lustre to the profession, and is only surpassed by his liberality of sentiment and integrity of principle. Happy would it be

for the faculty, if the junior members would look to the examples of those distinguished individuals who are at the head of the profession, and imitate their conduct to each other, and to the public at large! We hope and trust, that there is a growing spirit of urbanity and magnanimity diffusing its genial influence among the ramifications of medical society, and which will one day harmonize its members, to an extent far beyond what is contemplated by those, who keep their eye fixed on the dark side of human nature, and neither hope nor strive to brighten the prospect.

It is evident, that lectures, delivered before such a body as the Royal College of Surgeons, must be divested of opinions founded in ignorance, and secured from the pernicious effects resulting from empirical practice, however artfully and speciously disguised. They come, therefore, in a shape and garb, (independently of the character, experience, and industry of the author,) which render their reception doubly welcome, since it has but too often happened, that these subjects have been presented to the public and to the profession, enveloped in the mystery with which ignorance, knavery, or quackery, chose to clothe them.

The work consists of fifteen lectures, and embraces an amazing range of important matters, which it would be impossible to even enumerate, much less analyze, in an article of this kind. We must, therefore, be very concise, as well as desultory in our extracts, and notices of the contents of this volume.

In the first lecture, after some introductory observations, Mr. Wilson presents a neat analysis of what has been written on the subject of urine itself, by Wollaston, Bostock, Brande, Marcet, Prout, Berzelius, &c. He then takes up the anatomy of the kidney, ureters, and bladder, which occupy the first and second lectures. In the third lecture, Mr. Wilson enters on the anatomy and physiology of the genital organs, viz. the scrotum, spermatic chord, and testicles. The fourth chapter treats on secretion generally-on the structure of the testicle-on its first formation; and on its descent to the scrotum. The fifth lecture is on the vesiculæ seminales, prostate gland, and Cowper's glands. The sixth lecture delineates the structure and functions of the various parts composing the membrum virile, and here ends the strictly anatomical and physiological part of the course, into which we could not, for obvious reasons, enter in this article. We need hardly observe, that Mr. Wilson's anatomy is rigidly correct, while his physiology is that which is founded on the best authenticated facts hitherto discovered, and the opinions of the best physiologists who have written on these subjects.

In the seventh lecture, Mr. Wilson commences the pathology of the genito-urinary organs, and first of all, offers some general remarks on calculous concretions. So much has been introduced into this Journal, of late, on the subject of urinary calculi, that we shall pass over this part of Mr Wilson's work, remarking merely, that the best information is drawn from various and respectable sources, and condensed into a narrow compass. We shall extract the following case, shewing how a calculus, and that of the mulberry species too, may lie for many years in the bladder without causing much inconvenience at least in the organs immediately concerned.

"Several years ago I examined, along with Mr. Cruikshank, the body of a gentleman who died of a dysentery at the advanced age of eighty-one. For some years before his death he was a constant attendant on the lectures delivered by Dr. Baillie and Mr. Cruikshank in Windmill Street, when I was the demonstrator of anatomy in that I frequently, at that time, dissected bodies for him; and, before his death, received a paper from him with a detailed account of all the symptoms of disease which he could remember as having occurred to him during the last forty years of his life, with a view of having the parts affected by them examined by Mr. Cruikshank and myself after his death, he having inserted a clause in his will to that purport. I mention this, particularly as among the various parts of the body he had named, neither the kidnies nor bladder were alluded to; and as he had long been professionally attended by Mr. Cruikshank and myself, had any difficulty of passing his urine occurred, it would not have been concealed from us. Notwithstanding this, a very dark coloured oxalate of lime or mulberry calculus was found in his bladder, the bladder itself exhibiting no particular diseased appearances. The projections from this calculus were rather long spicula with blunted points than tubercles; and probably from their shape, preventing at any time the whole surface of the calculus from touching the sides of the bladder, allowed the urine to pass into the urethra, so that no obstruction to its flow ever took place. could have prevented such calculus from irritating and bringing on the other symptoms of stone I know not; but I have met with other instances where the oxalate of lime calculus has produced but little comparative irritation, although, I believe, it is a generally received opinion that it produces the greatest." 236.

What

A recent case of this kind occurred in the practice of Dr. Paris and Mr. Chilver. The patient was walking in St. James's Park on the 6th of April, 1820, and feeling fatigued, went to sit down on one of the benches, which, from its unexpected lowness, gave him a considerable shock, that probably dislodged the calculus from the sac in which it had reposed. He was immediately seized with painful dysury, which continued till his death, six days after the accident. In this patient, the existence of a calculus was never suspected,

till Mr. Wilson passed the catheter after the accident happened, and struck against the stone. A calculus of the mulberry kind, weighing 631 grains, was taken from the bladder after death. The interior surface of the bladder was found much inflamed, and a sac was discovered in which the stone had lodged.

The following is the pathological state of the bladder, after the long-continued irritation of a calculus.

"The constant irritation of the coats of the bladder produces a considerable thickening in their substance, but principally in the muscular coat, the packets of its fibres becoming very large, and incapable of that dilatation which they formerly possessed; their irratability however increases, so that they are excited to contract upon a few drops of urine; and thus, by pressing the stone against a part already too sensible to pain, an almost constant state of suffering is kept up. The bladder in time becomes more diseased, the inner coat more constantly inflamed and sometimes ulcerated, all the unfavourable constitutional symptoms increase; and unless an operation. is performed which removes the stone, the patient's sufferings are only ended by death." 239.

Mr. Wilson here introduces a brief view of the treatment of calculous complaints, chiefly compiled from the writings of Brande, Marcet, Prout, and the best modern authors. In respect to the high operation, Mr. Wilson does not give a. decided opinion. He seems to think that the high and the lateral operations have been attended with nearly equal

success.

We may here be permitted to make a short digressive allusion to the subject of the recto-vesical operation of Vacca, described in our last number. Since that paper was printed, we have been informed by Sir Astley Cooper, that the opera tion, as detailed by Vacca, was performed by him at Guy's Hospital, twelve years ago, and the man died. It was also performed at the London Hospital, by Mr. Headington, and the wound never closed afterwards. We have also been in-formed by a very eminent surgeon of this metropolis that, in the lateral operation, he, by accident, during a jerk of the patient, carried the external incision into the rectum, and the consequence was, a fistulous opening into the urethra at that part, which continued, in spite of every means which could be employed to close it. We throw out these hints, not to discourage a trial of the operation, but to put surgeons on their guard. Perhaps, the precaution which Vacca used, of touching that part of the wound which corresponds to the incision of the rectum, and that portion which remains in the perineum, with lunar caustic immediately the danger of inflammation is over, and suppuration is established, may have