those which enclosed the hydatids were smooth and had the appearance of a mucous membrane. We thus found in these lungs hydatids and tuberculous matter, which would seem to prove, that these bodies, though very different in their physical qualities and their organization, have many affinities in common, in regard to the causes which determine their formation, and the manner in which these bodies alter the pulmonary tissue.' * 47.

We shall not enter upon the train of commentaries which Dr. Baron has made on the above, and some other analogous cases. We cannot but think that comparatively few readers will feel interested in them.

Among domestic animals, none are more frequently affected with tuberculous diseases than sheep; and it was from these animals that Dr. Baron drew many of his descriptions in his former work. M. Dupuy has given many cases of this kind, from which our author has selected a few, and they will be found in page 60 of the Illustration.

Farcy has been thought, and apparently with justice, to bear the same relation to glanders, (which is the tuberculous phthisis of the horse,) that scrophulous affections of the extremities bear to the same disease in the human subject. Dr. B. thinks, that farcy is unquestionably connected with that condition of the system which gives rise to the formation of tubercles, whether in the lungs or elsewhere.

"Farcy seems clearly to be generated by disease of the lymphatics of the limb. The buds, as they are called, appear at first in the shape of small tubercles or buttons, which have the same organization, and go through the same changes that mark the progress of tubercles in the lungs. This disease seldom confines itself to the extremities. It generally advances towards the chest, attacks the membranes of the nose and lips, the glands under the jaw and in the neck, and finally developes itself in the shape of tubercles in the lungs, and then it constitutes the glanders. This, however, is not to be considered as the usual progress of the last-named disease, for it often begins in the lungs, and runs its course without any appearance of farcy whatever." 61.

In the third chapter, our author goes back to the father of physic, and, in the writings of the divine old man, thinks he sees almost all the knowledge of the moderns.

"The whole of what he has said respecting the diseases of the chest, bears wonderful testimony to the extent and accuracy of his observations, and it probably may demand all the knowledge that modern enquiries have unfolded, to enable us to do justice to his labours." 64.

"De l'Affection Tuberculeuse, par M. Dupuy, p 269."

Our author has discovered, what was never denied, that Hippocrates used percussion and auscultation in exploring diseases of the chest. He seems in admiration at the extent of the Coan sage's knowledge when he points out the existence of tubercles in the ox, the dog, and the swine, what every butcher's boy in the island of Cos knew as well as Hippocrates. The divine old man's theory of the formation of tubercles from bile or pituita, our author considers as not a fair subject of criticism, therefore we shall say nothing on that head.

"It is quite sufficient to prove that he was aware of the existence of such bodies, and of the consequences they produce." 64.

Now if Hippocrates was so well acquainted with the existence of tubercles, and the consequences they produce, he ought certainly to be acquainted with the symptoms which they give rise to. We ask Dr. Baron what kind of tubercle, and what stage of it, gives occasion for the following symptomatology of Hippocrates?

"Tuberculum in pulmone. Quum tuberculum in pulmone natum fuerit, tussis tenet et erecti cervicis spiratio, et dolor ad pectus acutus, et ad latera et usque ad quatuordecim dies ita afficitur. Nam plerisque per tot dies tuberculi affectio inflammatur. Sed caput dolet, et videre non potest, et corpus subvulvum fit, ac venis impletur." De Morbis II. L. 1.

We believe it would puzzle Dr. Baron or any other admirer of Hippocrates to find out what this fourteen day tubercle is which takes away the sight, and works so many other strange miracles. Our edition of Hippocrates not being the same as Dr. Baron's, we are unable to follow him through his numerous quotations, without a trouble which would be very badly repaid. Dr. Baron, if he wished his arguments to have as much effect as possible, might have avoided the pedantic display of so much Greek, and given the Latin version of Hippocrates, which would have been more generally understood. It is not, however, of very material consequence; for we apprehend the work will have a very limited circulation, except among the higher class of pathologists.

Dr. Baron considers it a remarkable thing that so few of the older writers should have mentioned these observations of Hippocrates. They are obscurely referred to by Galen, and entirely passed over by Celsus. In this we think they shewed their sense. There is no reason to believe that Sydenham had any accurate knowledge of tubercular consumption. In fact, we much doubt whether Sydenham ever opened a body in his life, with the view of ascertaining the seat of a disease-at least we have never seen any indication of post

mortem researches in his works. It is rather more rémarkable, however, that Boerhaave has no allusion to them in his aphorisms. Even Fothergill (Med. Obs. and Enq.) makes no mention of tubercular disorganization in his pathology of consumption. The following passage from the 38th epistle of Morgagni, makes it evident that the Italian pathologist had some opinions respecting the hydatid origin of tubercles corresponding with those of Dr. Baron.

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Finally,' he observes, read over again what I have formerly written to you, of hard granules or tubercles being prominent on the internal surface of the peritonæum or pleura; as water was even then extravasated in the great cavities, which those membranes surround, you will certainly find the series of successive changes, which I have described. It happened some years ago in a woman, that had been taken off by ascites; the external coat of the intestines was found to be distinguished with very frequent tubercles. Part of the small intestines was brought to me, that I might judge what these tubercles were. When I first examined them, they resembled small turgid lenticular glands; but they were without an orifice and solid, and seemed to be made up neither of a glandular nor of a fleshy substance, but to be of a middle nature, as it were betwixt both. Í judged that I could determine on nothing more probable with regard to them, than to suppose that they were the remains of ruptured hydatids contracted into themselves, but not to so great a degree at present as to be dry and hard.'" 73.

As we fear we shall not be able to give such an account of the work before us as may be satisfactory either to the author or reader, (since it is almost entirely a tissue of medical polemics,) we shall here insert an extract, shewing Dr. Baron's matured creed and doctrine on the subject under review.

"On the whole, from the most attentive consideration of all that has been adduced now, as well as in my Enquiry, respecting peritonæal tubercles, or those which may be found in any other part, different though they may be in size and appearance, there can, I think, be no doubt as to the identity of their origin. All the gene. ral remarks which were formerly delivered, when we were treating of pulmonary tubercle, are applicable to kindred disorganizations, when they occur in the abdomen. A small number spread over the peritonæum, or in the mesentery, may exist without doing much injury. A greater number may produce universal accretion of the viscera, the extinction of the nutritive process, and a complete impediment to the functions of the alimentary canal. Should one or more of them grow from the ovaries or the uterus, or any other portion of the abdominal surface, they may increase till they attain a very great size, and then we may either have what has been denominated encysted dropsies, or ovarian dropsies, or tumours with different contents, and of different shapes, according to the transmuta

tions which the hydatids may have undergone, or their collocation in the diseased structure. Again, should these bodies take their growth in any of the viscera, a series of the same changes may be detected, but the symptoms and the appearances will, of course, be modified by the part where they may happen to be generated." 79.

Into the 4th and 5th chapters, occupying nearly 120 pages, we shall not enter. They are entirely composed of criticisms on Bayle, Lænnec, Broussais, and Abercrombie. Dr. Baron weighs the opinions, statements, and even the words of those who come before his tribunal, with a balance so nice that we verily believe it would turn with the twentieth part of a minim of hydrogen gas! Heaven help medical authors, if Dr. Baron should ever conduct a medical review! He would grind them into dust. And, after all, for the life of us we cannot discover of what material consequence it is, whether a tubercle be originally a hydatid or a bit of cheese. We know that sometimes it grows larger, sometimes it remains stationary; sometimes it continues hard, sometimes it gets soft; sometimes its contents remain encysted, sometimes they break into the bronchia and produce purulent expectoration; sometimes these cavities heal, but much more frequently they continue to discharge, like an ill-conditioned ulcer, till death closes the scene. These things we know, and these things it is useful to know; but to enter into whole volumes of disputes respecting the origin of tubercles, (which, like the origin of all things, is veiled in mystery,) seems to us a waste of time that might be far better employed. The only thing of a useful or practical nature which we can see in the discussion is the question whether or not the growth of these tubercular disorganizations depends on a process of inflammation. Even this question does not appear to us to receive any light from the litigated point respecting the origin of the tubercle. Whether it be an invisible hydatid at the first moment of its formation; or an inorganized speck of some unknown material, still the process of its growth is to be decided (at least we think so) by far other evidence than that which is concerned in ascertaining its primitive form or nature. We shall give our author's sentiments respecting the question of inflammation.

"From a due consideration of all the phenomena of this, and other kindred diseases, I contend, that an inflammatory process is not that by which they are generated. There is the most conclusive evidence that cysts and sacs are not fashioned by the effusion of coagulable lymph around a diseased mass, or that the various appearances of these cysts, whether they be thick and firm, or slender and transparent-whether they be ossified, or show no signs of such a state-whether they contain a clear and watery substance, or a Vol. III. No. 12. 5 K

thick gelatinous purulent-looking matter, or be half-fluid or wholly so, or exhibit any of the above enumerated appearances in any variety of combinations-there is, I repeat it, the most conclusive evidence that such occurrences are not the result of any process analagous to inflammation. Further, I maintain, that whether there be one such body, or more than one, whether it be large or small, whether it be attached to the membranes or be imbedded in the brain itself, that all have one origin, and that it is common to the whole class of similar disorganizations in every part of the body." 188.

Our author guards his readers against confounding the growth of tumours themselves, with the effects produced by their presence in the surrounding structures. The latter may be of an inflammatory nature, while the growth of the tumour is of quite a different character. Indeed we have never been able to bring ourselves to the doctrine that the growth of a tumour, not even the pulmonary tubercle, was a species of inflammation. It appears far more probable that tubercles and tumours, especially of the encysted kind, are organized substances endued, unfortunately, with the power of drawing the nutriment of their growth from the surrounding parts, or from the blood itself. And we think it by no means improbable that their original or minutest cognizable form is that of a vesicle or hydatid, which may undergo many transformations in the progress of its growth, according to the structure in which it is placed, and various other circumstances. Nor is this doctrine inconsistent with the fact that, in tuberculated lungs, every catarrhal inflammation generally accelerates the growth of the tubercles; since it is evident that these last must draw the pabulum of their nourishment and growth from the neighbouring vessels, which vessels will be better able to afford this supply when gorged with blood, than when in their ordinary state of inactivity. The afflux of blood also to a tuberculated lung may act as a stimulus or excitement to that power by which the tubercle carries on its growth. This, we believe, is pretty nearly the doctrine of our author; and we really think that he would have had a thousand times more converts than he has, if he had taken far less pains to prove his point by such endless discussions and obscure reasoning-yes, obscure reasoning; for, notwithstanding all our author's attention to language, and censures on the language of others, we have seldom had occasion to peruse a work which has cost us so much labour to understand as the one now open before us. We can assure Dr. Baron that, however clear his ideas may appear to himself, he has not the happy art of always rendering them very clear to others. The import of the following passage, however, is sufficiently obvious.