In tinguishing between facts and suppositions.

the cold stage of a febrile paroxysm, is the cause stimulates the heart to augmented effort, by which of all the subsequent phenomena. The doctrine the blood is again driven into the extreme vessels, assumed, in the second place, that this primary dilating them and producing a feeling of heat on cause is to be found in the weakened energy of the the surface, and next perspiration, is also an admitbrain, occasioned by the application and action ted fact. It is thus made manifest, that Dr. Culupon it, of certain sedative influences or agents. len, according to the prevailing doctrines of our Then it was further assumed, that this diminished own times, so far based his theory of fever on energy of the brain, produces a state of debility facts, supposed then, as now, to be indisputable. in all the functions of the body, but especially in What, then, becomes of our author's charge of "asthe heart and arteries, and in the extreme vessels; sumption." The unavoidable inference from this in consequence of which, it was again assumed, blundering criticism is, that he is incapable of disthat these vessels become the seat of spasm. consequence of the cold stage and of this spasm In his rage for using his critical scalping-knife, of the extreme vessels, it was finally assumed that our author not only assails the above named great the heart and arteries are excited to increased ac- men, and professor Cooke, and Doctors Miller, and tivity, and by this activity, the spasm of the vessels Gallup, and others of the regular profession, but is overcome, the energy of the brain is restored, he descends to animadvert upon the doctrines of and the series of morbid actions thus entirely de- Hahneman and Samuel Thompson, the two most stroyed." Here are five gratuitous assumptions, notorious quacks of modern times. It is greatly according to our author, without a shadow of foun- to be regretted, that a gentleman of his respectadation. To us it appears that but one of the posi- bility and standing in the profession, should have tions is assumed and unfounded; viz: that of the demeaned himself by noticing such miserable sysspasm of the extreme vessels. Of this, unques-tems of imposture. Quackery has always existed, tionably there is no proof. Paleness of the skin and will continue to flourish, until medicine becan be observed, arising no doubt from retrocession comes a perfect science; and the community beof the blood to the internal parts of the body; but come more enlightened respecting its true princiit is much more probable that this proceeds from ples. But there is no better mode of assisting weakness of the great propelling power, the heart, quacks in their devastations upon suffering humanthan from any increased resistance, caused by ity, than for physicians of character to show that spasm of the extreme vessels. As to the other they think them deserving of attention. It is imfour positions, they not only were regarded as facts mediately ascribed to envy and to jealousy of true of every day occurrence, in Cullen's time, but they merit. Although physicians know, that they do are still viewed in the same light by a large ma- not deserve this imputation, it is impossible to conjority of our best medical writers. It is generally vince the public that they are disinterested; and admitted, that the remote cause of a fever produces consequently, the better plan is, to leave quackery the feeling of debility and malaise, which precedes to pursue its course, and die a natural death. the chill, for a longer or shorter time; and that this feeling and the chill arise from the remote cause acting upon the nervous system, of which the brain is the common sensorium. This is the "progressis languore, lassitudine, et aliis debilitatis signis," of Cullen's nosology, quoted with approbation as an admitted fact by our best writers. It is not denied, that the remote cause of fever is a poison of some description, which acts as a sedative upon the nervous system, and depresses the vital energies; and although we cannot, in many instances, discover its presence, or lay hands upon it, and analyze it, we are, nevertheless, as confident of its existence as if we could subject it to experiment. We cannot perceive the effluvia of small pox when they pass into the air; but we have no doubt of their extensive circulation, in various ways, because we see their effects. That the feeling of debility In his second proposition, the author contends, proceeds from diminished energy of the brain, ne- "that each separate class of facts, can be ascercessarily follows from the fact, that all impressions tained only by observation, or experience, (exupon the nerves of sensation are transmitted to this periment,) and that they cannot be deduced or incentral organ; and it is granted by all pathologists. ferred from any other class of facts, by any proThen, that the accumulation of blood in the inter-cess of induction or reasoning independent of obnal parts, increases the respiratory action, and also servation." He repeats, again and again, “usque

Our author's first proposition is, that "all medical science consists in ascertained facts, or phenomena, or events; with their relations to other facts, or phenomena, or events; the whole classified and arranged." We have already shown that this proposition is absurd, when applied to physical science; and the same arguments prove its absurdity, in its application to medical science. He insists, that medical philosophers make this science to consist in the "inductive or reasoning process, superadded to the facts and their relations, more than in these latter themselves;" and he laments the evil effects which have resulted from this spurious philosophy, and these vicious or imperfect modes of investigation. Medicine, he thinks, has suffered to a vastly greater extent from these causes, than any other science.

and nauseam," that "the feeling has been almost the established facts of physiology, however great universal, and it still continues so, that the seve- may have been the difficulty of their discovery } eral classes of phenomena and relationships con- Look at the grand discovery of Sir Charles Bell, stituting medical science, are somehow so allied to of two different sets of nerves, the one for motion, each other, that a knowledge of one class may be, the other for sensation. A large number of exto a greater or less extent, deduced from a know- periments had to be performed, to make certain ledge of the other classes. The prevalent idea these important facts; and can there be a more is, that this connexion between the different beautiful illustration of the doctrine of final causes! branches of medical science is of such a character, For ages, physicians were puzzled to explain the that a knowledge of one branch may lead, by some cases of paralysis of motion, without the sensideductive process, as it is called, to a knowledge bility of the parts being disturbed. Now we know of other branches. We are constantly told, for that one set of nerves may be affected, while the instance, that physiology is founded upon anato- integrity of the other is preserved. So of the my; that pathology is founded upon physiology; brilliant discovery of Doctor Marshal Hall, of the that therapeutics is to be deduced from pathology, reflex function of the excito-motory system of and so on." He then proceeds to the details, nerves. Why it was, that the function of respira which he supposes demonstrate the incorrectness tion was continued during the unconscious state of of these views of medical science; and he first sleep, while volition has so great a control over it asserts, that "our knowledge of anatomy is not in the waking state, was a problem which was not dependent upon our knowledge of other branches satisfactorily solved, until Doctor Hall proved that of medical science; and that our knowledge of one there is a set of nerves passing from the lungs to branch of anatomy does not include the knowledge the medulla oblongata, and back to the muscles of of any other branch." Who is it controverts these respiration, the afferent branches of which are positions? Who is it denies that our knowledge of constantly stimulated by the venous blood in the anatomy is to be obtained in the dissecting-room, lungs, and transmit impressions to the medulla obby the diligent use of the knife and forceps? Not longata; while the efferent, or those passing from only so, but since the discovery and description of all that these instruments, directed by the naked eye, can show, the microscope has been brought to our aid, and in a short time we will be in possession of all the knowledge to be gained by this means. Again, who has affirmed that any amount "of knowledge of the conformation of the brain, will make us acquainted with the conformation of the liver?" Such preposterous suppositions are idle and ridiculous. No such absurdity has been perpetrated by any anatomist.

that body to the muscles of respiration, supply them with motory power, and excite them to action. This is altogether independent of volition, which acts in the waking state, by means of its appropriate nerves; and this is the manner of supporting respiration, a function essential to life, which cannot be suspended for even a few minutes, without death being the consequence, during the insensibility of apoplexy and epilepsy, as well as in the unconsciousness of sleep. I might thas go over the whole of ascertained physiology, and In the next place, we are informed, that "our show the application of the doctrine of final causes knowledge of physiology is not deducible from our to each particular function of the body. How knowledge of anatomy." It has never been held could it be otherwise, when Infinite Wisdom dethat all our knowledge of physiology is thus ob- signed it all? It is, therefore, evident, that part of tained; otherwise, the thousands of experiments our physiology is deduced from anatomy; of which upon living animals, of Magendie and others, would the course of the lymph in the lymphatic vessels be altogether nugatory. But that a portion of it presents another example; and it is equally plain, has been obtained, even our author is obliged to that our author's efforts to get over these cases of admit. He, however, attempts to explain away opposition to his dogma, serve only to involve him these cases, and says, "they can hardly be regard-in greater absurdity. ed as an exception to the doctrine which I wish The next statement of our author is, that "pato set forth." His mode of doing this, affords one thology is not founded upon physiology. The of the best examples of superficial thinking and latter is not the basis of the former. The one inconclusive reasoning, it has been our fortune to does not flow from the other. Our knowledge of meet with. He refers these cases to the "doc- the one, does not presuppose our knowledge of the trine of final causes, or the great principle of the other." These assertions are so directly opposed to adaptation of means to ends." He instances the the common doctrine upon this subject, that it becirculation of the blood, which was deduced from comes necessary to show their truth and soundness, the anatomy of the heart and blood-vessels. This, by a somewhat full development and illustration. no doubt, is an admirable example of the adapta-"His function," he informs us, "is not only to tion of means to ends, and also of the physiology speak the truth, but also, and especially, to make being derived from the anatomy. But does not this truth felt and believed." Here again we inthis doctrine of final causes equally apply to all 'quire, who is it says that pathology is founded upon

does not relieve the patient, or makes him worse, they try another; and repeat this process, either until they discover something which is beneficial, or the patient dies under the experiments. The rationalist school says, endeavor to ascertain the cause of the disease, and the mode of its action; and whether it affects the entire system equally, or some one organ more especially. If the latter, find out, by a post-mortem examination of those

physiology? We venture to assert, notwithstanding | employment of remedies to cure diseases, solely the air of originality and profundity with which upon experience. They try a medicine, and if it this long chapter is imbued, that it consists entirely of the merest truisms; and that there is not a well educated physician to be found, who does not think precisely as the author says he ought to think and believe. No one asserts, that, from a knowledge of the normal action of the capillary arteries and veins, we would presuppose their liability to inflammation. No one asserts, that, by being aware of the readiness with which inflammation attacks one organ or tissue, we can infer the susceptibility who die, what alteration from the normal structure, of other organs or tissues to this morbid condition. has been produced by the disease; and always Neither does any one assert, that an acquaintance adapt your remedies to the new action which has with the progress and termination of inflammation been superinduced. in one organ or tissue, gives us information of the To show the superiority of the method of the mode of progress and termination in others. All rationalists, over that revived and recommended by these, and numerous other monstrous suppositions, this author, let us examine a few diseases, and see are the figments of a riotous imagination. If this what inference, as to their treatment, can be decharge was true, we could not instance the suffer- duced from a knowledge of their pathology. Whating and death of many of the most distinguished ever theory of inflammation we may adopt, as to members of the profession, in their zealous prose- the condition of the vessels of the inflamed part, cution of morbid anatomy and pathology. Can whether that of increased or diminished action, it the author be acquainted with the labors of Louis is manifest, that the febrile excitement of the heart and Andral, of Carswell and Bright, and scores is the morbid state, which chiefly demands our atof others, in nearly every part of Europe; to say tention. If we can, in any manner, lessen the nothing of our own countrymen, who have acquired force with which it propels the blood into the incelebrity in this field of inquiry? In order to in- flamed part, we give immediate relief. Bloodvestigate the pathological condition of the differ- letting and tartarised antimony, if nothing contraent parts of the organism, it is essential that we indicates, are the appropriate remedies for this purfirst know what is the healthful or physiological pose. Dysentery is now known to be an inflamcondition. Having ascertained this, we are pre-mation of the larger bowels. Aware of this, our pared to observe deviations from it, and to decide remedies can easily be made to suit such a state of upon the nature of the lesions which caused the things. To cure tetanus, every possible variety of morbid appearances. So a knowledge of normal treatment has been tried; and the empirical plan anatomy is indispensable to qualify us for pointing of our author, has been fully carried out, in relaout what is anormal. All this the author admits. tion to this dreadful disease. Some recovered; a But he, nevertheless, reiterates, time after time, great many were killed. When the warm bath that the common doctrine is, to infer the pathology did not relieve and cure, the cold was prescribed, from a knowledge of the physiology. This, we and the patient was taken out dead. Now that say, is a false charge brought against his brethren, we know the seat of the disease to be the spinal for which he merits the sharpest rebuke. To ex-marrow, and that it is irritation and inflammation, pose all the weakness, common-place, and incor- one or both, of that organ, we can direct our treatrect averments of this chapter, would require as many pages as the chapter itself contains. The seventh chapter is likewise devoted to proving what no one denies, as far as we know, viz: that "our knowledge of the causes of disease, is the exclusive result of observation."

ment to the seat and nature of the disease; and at least do no harm. Delirium tremens presents itself to our notice under two different aspects, viz: one from the discontinuance of the accustomed stimulus in the old drunkard; the other, from the drinking of a large quantity of liquor, in a The eighth chapter is more open to objections, short time, by those unused to it. Morbid anatothan all which have preceded it. He here asserts, my and pathology point to the brain as the part that "therapeutics are not deducible from patholo- chiefly affected, and teach us, that, in the former, gy;" and avows himself as a member of the an- we should stimulate the patient, and, in the latter, cient school of the empirics, as contra-distinguish-depress action, and allay irritation, by the employed from that of the rationalists. He now quotes ment of tartarised antimony and opium. It is not physicians of character, to show that the doctrine a valid argument against these views, although which he assails is held by them; and he proves employed by our author, with his ordinary tact for that he is not, as is his habit, setting up a man of confounding things essentially different, that a straw for the pleasure of demolishing him. large number of mild cases recover, if left very The empirical school bases its therapeutics, or much to the unassisted efforts of nature. Violent

cal science. This, however, we affirm, cannot justly be attributed to any want of industry and zeal, on the part of physicians; or to the adoption of a false method of philosophizing. It arises from obstacles, almost, or altogether, insuperable, in the science itself; and perhaps inseparable from it.

attacks, in the persons of old drunkards, and also there is still room for vast improvement in mediof those who occasionally drink hard, will not be removed, without the use of the proper remedies. Acute laryngitis in the adult, and croup in the child, are diseases which, in their symptoms, bear a close resemblance; but morbid anatomy and pathology designate a material difference, which makes the employment of emetics highly pernicious in the former, and extremely beneficial in the latter.

The reader, it is presumed, will now be able to form a sufficiently accurate opinion of the characWe might thus go over the whole catalogue of ter of this " essay." A disposition to see nothing diseases to which the human system is liable, and good or beautiful, over the wide domain of both show that, in proportion as our pathology is certain, physical and medical science-to show that he, our therapeutics are precise and successful. Of the author, alone possesses the true secret of scithe pathology of many diseases, we as yet know entific investigation—and that, when he dies, wisbut little. The changes produced in the blood, dom will perish with him;-in a word, to exalt during the progress of a fever, are, to a great ex- himself, at the expense of the whole scientific tent, concealed from our view; and in consequence, world, is manifest throughout the work. Nothing our practice, as far as that fluid is concerned, is can be more reprehensible, than the spirit in which as empirical, as our author could desire. Doctor the book has been composed. Instead of furnishStevens has endeavored to prove, that, in some ing us with new facts, the result of his own dilicases, the loss of a considerable portion of the sa- gent inquiries and untiring industry; and with new line ingredients, is one of the prominent morbid principles, or theories, founded on them, by a cauconditions; and bi-carbonate of soda, and chlorate tious induction, he does nothing but find fault with of potash, are thought, by him and others, to be the labors of other men; and attempts to prove indicated. Andral has made numerous observa- them all barren and unprofitable. It is a safe rule tions on the state of the blood, in various diseases, of conduct, and we commend it to the notice of and has obtained some valuable results. Much, our author, that if we accomplish but little ourhowever, remains to be discovered. When the selves, let us not undervalue the efforts of others. time arrives, at which we shall have made out the diversified pathological changes of this important portion of the organism, not only in fever, but in all other diseases, we can prescribe for them with a rational prospect of doing good, instead of administering potent medicines, under the guidance of a blind empiricism.

The thought that this doctrine of the ancient empirics, is adopted and acted upon, by any physician having charge of the health and life of his fellow-creatures, is calculated to excite melancholy reflections; but it is still more lamentable to find, that such a dangerous principle is promulgated by a teacher of medicine in one of our most ancient schools; from which a number of young men go out annually, believing the doctrines inculcated by their instructors to be preferable to all others; and resolved to apply them in practice, without a doubt as to the successful issue.

We have already remarked, that mathematical demonstration has been applied with the most happy effects, by means of the infinitesimal analysis, to the higher astronomy. Medicine not being one of the exact sciences, never has been, and probably never will be benefitted by this method of proof. This is the source of much of the discrepancy observed in medical writings. When we remember, too, the infinitely diversified circumstances, in which disease is presented to our observation, and the difficulty of discriminating true facts from false ones, it is not at all surprising that

SAMUEL ANNAN, M. D. Professor of General Pathology, and of the Special Pathology and Treatment of Diseases of the Chest, in the Washington University of Baltimore.

THE OLD OAK TREE.

Yon Old Oak Tree, that to the sky
Flingeth his crooked branches high,
Hath blasted been by the lightning's stroke,
And withered now is that brave Old Oak:
Nor might ye dream of the fate he met,
For all alive seems the old Tree yet.
The robe he wears he hath worn before,
When his arms were stout and mailed o'er;
And velvet leaves of the vine are seen
Wrapping him 'round, with a mantle green.
The Blue-birds whistle right merrily
Around their nests, in that aged tree;
And often do maidens young and fair
Mingle in many a pastime there ;—
While he proudly stands as once he stood,
Braving the storm as a warrior should,
Daring the winds with a stubborn will—
Shattered and scarred, but unconquered still!

Oh, long may'st thou stand, old riven tree
That I played beneath in infancy!

I have slumbered oft in the grateful shade
Thy waving branches at noontide made ;
And I've dreampt, as the low wind murmured there,
That some spirit was whispering in the air,
While peacefully I sank to rest,
Cradled on my mother's breast.

My sisters have brought sweet flowers there,
And playfully wreathed them in their hair;
And I've listen'd there to the soft low tone
Of whispered love from a winning one,
'Till my heart, like thy leaves by zephyrs stirred,
Was trembling with joy at every word.
Long may'st thou stand, in the garb of green,
That hiding thy blackened trunk is seen!
E'en tho' thou'rt like a face that's clad
In wreathed smiles, when the heart is sad;
Yet, long may'st thou stand, old riven Tree,
That I played beneath in infancy!
Memphis, Tennessee.

LINO.

REMINISCENCES OF ITALY.

66

mortal scenes, and sought a surer friend in Heaven! My ruminations were interrupted by a summons to share the rural breakfast of fruit, milk and biscuit, with which we had provided ourselves. On this luxurious domain are artificial cascades and grottoes, fountains of every description, an Amphitheatre and a superb lake. Seated on its borders, we partook of our repast, and in defiance of sentiment and romance, did it ample justice,-thanks to our early promenade and Italian zephyrs! Vegetation prospers long in so bland a climate; and on that 9th of October, 1827, we rambled through verdant thickets and tripped over turf enamelled with flowers! While we were in the Amphitheatre, an old man, who acted as cicerone, slipped unperceived by us into a closet behind a marble figure, representing a shepherd blowing his flute, and turned a wheel; immediately, (as if the statue of Memnon had been transported from Egypt,) dulcet sounds issued from that before us, accompanied by the murmur of a hundred little water-spouts which sprung from the ground like magic, played while the music continued, and with it, gradually melted away. Among the various inhabitants of the poultry yard were snow-white pea-fowls. They were not comparable in beauty of plumage to those of “What a delightful day for roving!" I exclaimed, the usual colors, but they strutted about with quite on opening mine eyes, one brilliant morning, and be- as much vanity. Two buildings, in the form of a holding the golden sun-beams illuminating our plea- miniature temple and tower, afford shelter to them sant room. Awake, awake, Ismelda, my sweet and their feathery companions when necessary. companion, and let's be going." We were quickly The interior of the Villa does not correspond with dressed and on our way, with a party of friends, to the decorations without. We were surprised at its the Villa, Doria-Pamphili. Oh, the exhilarating plainness; its coarse brick floors and faded, ordimonth of October! how we enjoyed our walk and nary furniture. Some ancient chandeliers, howgreeted with lightsome hearts the flowers and ever, were remarkable; and we admired several of breezes, which regaled us at every step. (Bree-its numerous old paintings and mutilated statues. zes which re-galed us—a tolerable pun-but really From the roof, we enjoyed a fine view of Rome I did not intend to make one.) We soon reached and its environs, and quite feasted our eyes upon the Villa, for it is but three-fourths of a mile from an adjoining grove of stately pines :-they told of Rome. Its grounds are extensive and magnifi- “dear native home." The Villa occupies the site cent, and peculiarly interesting from the numbers of the Emperor Galba's gardens, and was conof ancient tombs, inscriptions and statues scat-structed in the 16th century, for Prince Pamphili, tered about-above all, from some excavated cat- by Alexander Algardi, a distinguished architect and acombs within its precincts. Surrounding every sculptor of Bologna. apartment of these catacombs, are rows of small The present princess, Doria, is a beautiful creaarches, each of which encloses a cinerary urn in a ture, of majestic mien, and noted for her charity perfect state, although centuries have elapsed since and religious zeal. During the celebration of the it was deposited in its sombre niche. As we sur- Holy week, we witnessed the washing of the pilveyed these memorial antiquities, that solemn fiat-grims in the establishment appropriated to the fe"Dust thou art, and to dust thou shalt return," males, and there we saw her bending over a pail came forcibly to mind, for here the Good, the of water and bathing the feet of an aged crone, Brave, the Beautiful, the Proud, the Wicked, re- with the humility of a Magdalen. She is exceedduced to heaps of earth, painfully illustrate its ingly popular, and proves how lovely piety is in power and truth. I thought, too, of the probable woman. It is carried to superstitious excess by struggles of many of them, for that alluring and both sexes in Italy. Shrines dedicated to the deceiving meteor, worldly Fame! What availed Virgin Mary adorn every road-side, and are seltheir efforts? Here, unknown, repose their ashes, dom destitute of votaries kneeling before them, while their virtues, or their crimes, their very telling their beads" and imploring her protection names, like their frail bodies, are buried in oblivion. and favor, to conciliate which and to evince their Happy those, whose wishes soared beyond these devotion, even the poverty-stricken will spend their

VOL. XI-78