lard, it forms a very elegant ointment." Now, notwithstanding the experience of Galen and Cothenius, and the thoughts of Professor Duncan, we are satisfied that the itch is not to be cured by an internal remedy. An unhealthy state of constitution unquestionably favours the disease, and therefore internal remedies may act as powerful auxiliaries to topical applications, and in the majority of cases they are necessary; but no English practitioner, except the fee collectors of Oxford and Cambridge, would entertain thoughts of curing a local disease of the skin by internal remedies. For cutaneous affections, either as an internal or external remedy, the sulphur-ous acid will be found more beneficial than the sulphuric. COW-POX.-About three years ago, we gave the particulars of a fatal case of cow-pox, which occurred in the practice of Dr. Lucas, of Hatfield, a physician of great experience and scientific attainments. The Doctor, it seems, after taking three years to reflect on the case, has thought proper, probably to relieve his mind, to publish the case in the Medical Repository. The following is his own narrative of it:

"C-C-, son of the Rev. M-C-, aged seven months, having been in perfect health from the day of his birth, was vaccinated, June 26, 1819, with lymph obtained from the National Vaccine Establishment, and, as appears by particular inquiry since made, from an unexceptionable subject. Two punctures were made in each arm, all of which, except one on the right arm which missed, put on the most favourable appearance; and, at the end of the eighth day, afforded as perfect an example of the disease as could be seen. At this time one of the vesicles on the left arm was punctured, without drawing blood, and lymph taken, with which two elder children of Mr. C. were re-vaccinated, after an interval of some years, to afford a test of their security. On the following morning, an areola of inflammation, of the usual extent and appearance, surrounded the vesicles; and in the evening the child was taken rather suddenly ill with fever and uneasiness, with a slight expression of tenesmus. The arm was not again examined till the next morning, the tenth of the disease, when the inflammation extended from the shoulder to the wrist, considerable fever being present. Cold rose water was applied to the limb; and the child was purged well with calomel, antimonial powder, and rhubarb. On the following day, the inflammation had spread over the left breast, top of the shoulder, and shoulder blade; the pulse very rapid, about fifteen strokes in five seconds; and the child lay in a quiet, half comatose state, but crying much when disturbed; he, however, took the breast very freely, and occasionally a little gruel. The purgative was repeated with effect; and a warm lotion applied, with three parts of the liq. ammon. acet., one part of alcohol, and four parts of water. On the twelfth day, the inflammation having somewhat abated, the lotion was laid aside; but increasing again considerably in extent and intensity, on the thirteenth it was resumed. From this time, the inflammation continued to extend itself, gradually receding from the parts first attacked, until it successively covered the whole body and limbs, except the feet, and upper parts of the face and head;

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a degree of cedema following it, particularly affecting the scrotum and lower limbs. The bowels were kept open by the Epsom Salt; from six to twelve daily evacuations being procured through the whole course of the disease. These were greenish, curdly, and somewhat slimy; but not differing materially, as the mother said, from the usual evacuations of the child. The pulse continued rapid, never under twelve or thirteen strokes in five seconds; but the child continued to suck freely, and to take gruel at intervals, expressing little uneasiness except when moved. The symptoms continued in this state until the seventeenth day, when sickness came on, with some fulness of the belly; and on the morning of the eighteenth day, the child died, with every appearance of internal mortification; the abdomen being very tumid, with livid colour of the integuments in patches; and a great quantity of thin, dark-coloured fluid being dejected by vomiting through the mouth and nostrils. The body was not opened; but there is, I think, every reason to believe, that the same inflammation affecting the mucous membrane of the bowels was the immediate cause of the fatal event; as the child had outlived the external inflammation, which, however, did not entirely disappear until within twelve hours of its death. At what time the internal inflammation made its attack, is uncertain, as there were no exclusive symptoms to point out its existence; but it is probable that it commenced with the first attack of fever. About three days before its death, the child took several little boatsful of gruel with great avidity, probably from a sense of internal heat.

"The fatal disease was completely masked under the external inflammation, which had much the character of the reseola vaccina, as described by Dr. Bateman; the painful state of the surface accounting for the uneasiness expressed upon movement of the body; whilst the open state of the bowels, and exercise of the functions of the stomach, contributed to support the delusion.

"In similar cases, would it not be safer practice to abstain from all external applications, allowing the cutaneous inflammation to spend itself unchecked upon the surface, and using only the most diligent means to subdue the inflammatory excitement of the system?

"That in this unfortunate case, vaccination was the exciting cause of the disease which proved fatal, there can be little doubt; but as it must also be supposed, that the violence of the inflammation depended rather upon some peculiar constitutional irritability of the skin, than upon any virulent property of the vaccine fluid, it is to be hoped that it will not operate as a check upon the practice of vaccination."

It certainly appears to us most extraordinary, that a physician, who received his education in the schools of surgery and pharmacy, should introduce so ridiculous a question relative to the propriety of external applications. The only proper question in our humble opinion is, If topical applications had been resorted to when the inflammation shewed a disposition to extend itself beyond the usual limits, and had been steadily persevered in, would not the result have been different? Surely Dr. Lucas will not deny that the disease for some days was topical; and, if so, was not topical management necessary

when the inflammatory action was running unusually high? The fatal termination of this case is no doubt attributable to an unhealthy state of the constitution, and perhaps no local nor constitutional treatment would have prevented it; yet, however, we confess, in such a case, in an infant at the breast, we should have preferred purgative or alterative doses of calomel to Epsom salt, nor should we have applied a spirituous lotion to the inflamed part in a warm state. If in such an unhealthy subject so simple a disease as cow pox was capable of producing such serious mischief, what would have been the effects of small pox? We presume no medical man, however prejudiced he may be against cow pox, will say that the result of small pox inoculation would not have been equally disastrous.

MEDICINAL SPRINGS.-SIRS-I was present a short time since, where the conversation turned upon natural productions; and medicinal springs being alluded to, a person remarked, that it was strange, that although, by the assistance of chemical knowledge, the constituent principle and proportion of these waters had been ascertained, yet, however carefully they may be imitated, it is found that the artificial compound does not produce the same medicinal effects as the natural water. To this remark, a reply was made, that the peculiar and more valuable properties of medicinal springs arise probably from some secret condition of the water, occasioned by their formation in the large bulk and quantities which Nature fabricates in her exhaustless laboratory; and to strengthen this opinion by a familiar analogy, it was asserted, as a fact known to many, and particularly to seamen, that grog made with half a pint of rum, and a pint of water, is neither so pleasant nor so strong as if made in the quantity of three gallons of the spirit, with six gallons of water; and that the difference in strength is positively proved by taking the specific quantity of a portion of each mixture by the hydrometer. An inquiry into the true nature of this subject offers a very interesting field to the experimental naturalist; and I should feel particular pleasure, if any of your ingenious correspondents would communicate, through the medium of your Gazette, any knowledge they may possess, or any conjectures they may form relative to it.

London, May 20, 1820.

I am, Sirs,

AN INQUIRER. CHAMPOOING.-A correspondent inquires, if this operation is of modern invention, and asks, if it be really efficacious in the cure of diseases? It doubtless originally arose, and still exists, as a custom of some of the eastern countries, and was, by them, instituted more as a luxury than a remedy. The place appropriated for the purpose, is constructed of several apartments, each artificially heated to different degrees of temperature. After having gradually and progressively gone through the series of heated chambers, from the lowest to the highest degree of temperature, the person is carried to the bath, after which he is carefully and gently rubbed dry with materials of the softest fabric. He is then laid upon downy cushions, and is gently kneaded and pressed by a soft hand, over every part of the body; his joints are delicately, yet dexterously extended; his limbs flexed and rotated into their utmost variety of natural move

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ments; and the pleasing languor which the voluptuous enjoyment had occasioned having been dispelled, he rises with the suppleness and freedom of motion of youth itself. According to Father Hennepin, who was taken prisoner by the Illinois, and afterwards published a "New Discovery of a large Country in America," nearly a century and a half ago, the North American Indians have had, from time immemorial, a method of curing fevers, and other diseases, similar to the above; but certainly without its pleasures or its elegance. He says, "that his master, observing that I could not well rise without two or three to help me, ordered a stove to be made, into which he caused me to enter stark naked, with four savages. This stove was covered with the skins of wild bulls, and in it they put flints and other stones, red hot. They ordered me, by signs, to hold my breath time after time, as long as I could; which I did, as well as those that were with me. As soon as the savages that were with me had let go their breath, which they did with a great force, Aquipaguetin, the Indian Chief, began to speak with a loud and thundering voice; the others seconded him; and, laying their hands on my body, began to rub it, and at the same time to weep bitterly. I was like to fall into a swoon, and so was forced to quit the stove. At my coming out, I was scarce able to take up my habit of St. Francis, to cover me withal, I was so weak; however, they continued to make me sweat thrice a week, which at last restored me to my pristine vigour, so that I found myself as well as ever."

According to Captain Cooke, a similar custom prevails at Otaheite; for, being ill whilst he was there, Oberea ordered him to be stripped. and rubbed for some time by her servants.

Champooing has been but little used in this country, (but more in Ireland than in England, we believe); and, though Brighton possesses its Professor, who has commodiously fitted up his baths, &c. and obtains a respectable practice, it is unlikely that it will ever become a very general remedy, not because it is undeserving popular attention, but that it is expensive, in many circumstances inconvenient, and will never be adopted and practised by the medical profession at large. In chronic diseases of muscular and fibrous parts, such as rheumatism, contraction and rigidity of the limbs and joints, the effects of sprains, bruises, or other injuries, &c. &c., it is a valuable remedy; and we have heard many stiffened invalids speak with almost equal veneration of Mahomed of Brighton, as the Musselman devotees do of his sacred name-sake at Mecca.

ON THE STRUCTURE AND FUNCTIONS OF THE LIVER.-In concluding our observations on the several secretions of the body, (at page 107,) we promised to resume the subject at a future time, and to explain the physiology of the liver in particular. A correspondent having called upon us to redeem the pledge we then gave, we now comply, as far as the confined limits of the present number will allow us.

There is no organ of the body which has more engrossed the -inquiries and labours of the physiologist, or more engaged popular interest and anxiety, than the liver, The ancients, sensible of its

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Structure and Functions of the Liver. [JULY 1822.

importance, yet ignorant of its real uses, entered into the wildest hypotheses, and the absurdest fancies respecting it; most of which have been consigned to disregard, by the improvements in modern medicine. Such a general attention to this organ appears very natural, when we consider, that in bulk it is the most considerable viscus in the body; that its connexion with other parts of the system are numerous and important; that its functions involve a series of actions, not only of its own, but of various other organs, on the integrity of which, the well-being of the body depends; that its diseases are amongst the most common ailments to which we are liable; and that its derangements induce a morbid state of the most vital parts of the animal machine; the bowels, the lungs, the heart, and even the brain itself, becoming the victims of its overwhelming sympathies.

The liver is a solid mass, of a dark red colour, somewhat inclining to yellow, seated in the upper part of the abdomen, to the right side which contains the greatest portion of it; stretches across the pit of the stomach, and reaches, in a small degree, into the left side of the abdomen. Its exact position is better understood by thus describing its boundaries. Its superior surface is in contact with the diaphragm (the membrane which separates the belly from the chest,) whilst its inferior surface (covering the stomach and part of the intestines) does not extend below the margin of the ribs, unless near the pit of the stomach. It fills almost entirely the right side of the abdomen, rests upon the right kidney, touches the bottom of the breast bone, at the pit of the stomach, and at its posterior side reclines upon the spine. It is supported by the stomach and bowels, and the abdominal muscles, and is preserved steady in its situation by membranous ligaments attached to the diaphragm and to the muscles of the abdomen. The liver appears firmer than any other of the viscera ; but yet it is much more easily broken down and torn: this is owing to the weakness of the texture that binds its parts together. We have shewn, in a former number, that glands were bodies made up by contorted arteries; and we then hinted at a difference in structure between these glands in general and the liver, which difference mainly consists in this: that the latter, instead of being derived, like other secreting organs, from the arterial system, is principally formed by the venal. The veins which receive the returning blood from the stomach, the intestines, the mesentery, the spleen, the pancreas, and the omentum, having united and chosen a course toward the right side, again divide; and ramifying into millions of subdivisions, which are wound up into the most intricate mass, form that glandular body to which we have given the name of livert. The minute extremities

* Previous to birth, the liver occupies nearly as much of the left side as the right; but afterwards the proportion gradually lessens; and at five years old it occupies principally the right side, in the same relative degree that it preserves during the remainder of life. In the fœtus, also, it falls lower than the margin of the ribs.

It is not to be understood that this venous distribution constitutes the sole structure of the liver: it has necessarily component