development of its very first symptoms. The difficulty of cure increases in an immense ratio with the time allowed to elapse after the disease has commenced, and too often irremediable injury is sustained before any welldirected effort is made to arrest the disorder. We would, therefore, once more urge upon those with whom the responsibility may rest, the necessity of resorting to some institution prepared for the treatment of the insane, for the restoration of the unhappy object of their care and solicitude, upon the the first disclosure of the approach of mental alienation."-p. 16.

Harris's Dental Surgery.1

The object of Dr. Harris in writing the work before us was to promulgate the information, which he had obtained by an extensive experience, on mechanical dentistry more especially. We can recommend the work to the perusal of the members of the profession as capable of instructing them in the means and appliances employed in a part of the art of surgery to which they are in the habit of devoting but little attention, and on which they are, consequently, slightly informed.

The volume is illustrated with three lithographs, representing the mode of mounting and attaching artificial teeth.

Dr. J. B. Beck's Valedictory Address.*

Like every thing that proceeds from Dr. J. B. Beck, the present address exhibits much excellent discrimination. Its main object is to inculcate the necessity of mental discipline in the pursuit of medical excellence.

We extract the following remarks, respecting the truth of which there ought not to be one dissenting voice; neither would there be, were they, who give utterance to the sentiments animadverted upon, themselves imbued with true learning. Such sentiments are, indeed, commonly the emanations of a vain, meager, and uninstructed mind, incapable, from natural incompetency or habits of indolence, of attaining, the all-essential information which it deprecates:—

"Not merely, however, ought the student who aims at distinction, to have his mind properly disciplined by general studies; but he ought to aspire to the character of a man of learning in his profession. By this I do not mean that he should be well versed in the mere elements of his profession. This may be accomplished without much difficulty, simply by the study of a few text-books, intended to save the student the labour of thought and enquiry. Important as this kind of knowledge undoubtedly is, it is not worthy of the dignified name of learning. When I speak of learning as applied to medicine, I mean, that a man should be extensively read in the best authors who have written on the various departments of his profession. He should not confine himself to the writers of one age, or one country, or one language. In a word, he should have ranged over the whole field of professional knowledge, as he finds it embodied in the recorded labours and researches, not merely of the present, but of past generations. It is only in this way that he can justly hope to attain to the title of true learning. In pursuing

The Dental Art, a Practical Treatise on Dental Surgery, By Chapin A. Harris, M. D., Surgeon Dentist, (with a motto.) 8vo. pp. 384. Baltimore, 1839.

2 Valedictory Address to the Students of Medicine in the College of Physicians and Surgeons of the University of the State of New York. Delivered Feb. 28, 1839, by John B. Beck, M. D., Professor of Materia Medica and Medical Jurisprudence in the University of the State of New York. 8vo. pp. 24. New York, 1839.

this course it is not necessary that every book should be read, or that all books should be read with equal care. Lord Bacon says, 'some books are to be tasted, others to be swallowed, and some to be chewed and digested; that is, some books are to be read only in parts; others to be read, but not curiously; and some few to be read wholly, and with diligence and attention.' No rule is deeper laid in common sense than this. Whoever has run over, with an attentive eye and a discriminating judgment, any portion of professional literature, cannot but be forcibly impressed with the fact, that a large proportion of writers are the mere copyists of those who have preceded them. In a thousand different shapes and ways the same materials are wrought up, to suit the existing ideas of the day, without the addition of a single new idea. It is only now and then, and at immense intervals, too, that a work of profound and original merit bursts upon the view. Now, the practised student and the man of disciplined understanding will, almost at a glance, be able to seize upon the true value of a book, and extract from it what may be essentially useful. In this way a labour, apparently endless and hopeless, comes within the reach of ordinary industry and capacity.

"You will doubtless meet with many, even in our own profession, who will endeavour to persuade you that learning is of no great importance; you will be told that it may be an an accomplishment, but nothing more; that some of the best practitioners never read. Such notions as these are exceedingly prevalent, and unfortunately exercise an influence most extensive and fatal. They cannot, therefore, be too early counteracted. With regard to the objection, so startling at first, that good practitioners never read, I need not stop to tell you how mistaken such an opinion is. If the origin of it be traced, it will be found to proceed from men who wish to use it as an excuse for their indolence, or a cloak for their ignorance. You might as well say that a man may be a good practitioner who never thinks. Learning supplies the materials for thought, and the one is just as necessary to make even the good practitioner as the other. If you enlarge your views of the physician and consider him not merely as the practitioner, but as aiming at the extension and improvement of medical science, the importance of learning becomes still more apparent. It is only in this way that he can become acquainted with what has been actually done by those who have gone before him, and unless he possesses this kind of knowledge, he will continually be placed in the unenviable light of promulgating discoveries which have been made centuries before. Time and labour will thus be wasted in vain. But it is not merely knowledge that he will thus acquire. As he peruses the writings of the great masters who have advanced our science, he will make an acquisition still more valuable. He will become familiarised with their modes of thinking, and with the modes in which they investigated and ultimately arrived at the discovery of truth, and this is the capital advantage of studying the great and original authors in our profession. A summary of what these men wrote or discovered may easily be obtained from a common dictionary or encyclopedia, but this is not what you want merely. You want to study the mind and genius of the men, as displayed in the investigation and exhibition of truth. You want to do what the artist does, when he travels to foreign lands to study the great models of sculpture and architecture, in the hope that he may catch some of the spirit and genius of their authors. What I would then urge is, that you should not be content merely with the results of learning, as recorded in text-books, but aspire to become familiar with the modes in which great minds attained to these results. In doing this, do not confine yourselves to the moderns. Improved as medicine is at the present day, you will nevertheless find in the older writers much to reward all the labour which you may expend upon them. You will find unrivaled descriptions, extensive observations, and ingenious reasonings. Even from their errors you may extract much profit. You will find what the causes were, why men of such acute genius so frequently erred, and how their errors have been corrected by the introduction of a subsequent

and sounder philosophy. Every student, then, who aims at future preeminence, ought to make up his mind to go through an elaborate course of reading and study of the great masters of our art. The only way to accomplish this is to begin early. Youth is susceptible of impression and improvement, and it is then that the mind can receive its bias from study. Nor should the moral influence of such a course be overlooked. In taking up the writings of an author who has stood the test of time, and whose renown has only been augmented by the lapse of years, the student feels as if he were on hallowed ground, and his mind must inevitably become elevated and improved."-p. 16.

MISCELLANEOUS NOTICES.

Observations on the Nature and Treatment of Nævus. By FREDERICK TYRREL, Surgeon to St. Thomas's Hospital, and to the London Ophthalmic Hospital. Royal Medico-Chirurgical Society, Tuesday, March 12th, 1839.The author begins by observing, as the result of much experience in the treatment of this disease in the last few years, that, of the many plans of treatment which have been suggested by their inventors, none are exclusively applicable to every form of the disease. His object, therefore, in his present communication, is rather to point out the description of case to which each method is adapted, and to indicate the rationale of its action, than to offer any new plan of his own. With this view he considers-1st. The nature of the disease. 2d. Its varieties, pointing out the seat, the position, the progress and consequences of each form, if allowed to run its course. 3d. The different modes of treatment in present use; and, 4th. The proper application of these means. When the disease is purely cutaneous, not extending at all to the subjacent cellular texture, he recommends the forming a belt around its margin on the sound skin, by means of concentrated nitric acid, and afterwards imbuing the surface of the growth with the same liquid: at once, if small; but if of great extent, by repeated applications made to a small portion at a time. The author holds, however, that the use of escharotic applications should be confined to those cases which are purely cutaneous, since in those which extend more deeply, the agency of the acid stops short of the deeper-seated parts of the tumour, and, consequently, when the superficial part separates by the ulcerative process, hemorrhage may be expected to ensue. For the destruction of the subcutaneous form, as well as that of a mixed character, he recommends the injection into their substance of stimulating fluids; but he points out a very important preliminary step which, in his opinion, will prevent those accidents that have sometimes attended the too wide diffusion of the injected fluid; viz., suppuration and unsightly puckering of the skin after the cure. This plan consists in cautiously injecting a small portion of a saturated solution of alum into the surrounding cellular tissue, before any thing is done to the nævus itself, with the view of producing its consolidation, and thus preventing the extension of the disease by the excitement to be afterwards induced in the tumour by the injection of the stimulating liquid into its own substance, as well as the undue diffusion of the fluid. Cases are detailed of the successful employment of this practice. The author speaks highly of the ligature, as a means of relieving a great variety of forms of nævus, but expresses his fear that setons passed through the substance of the tumours may be productive of hemorrhage which, in young and delicate subjects, would be dangerous.

1 Lancet, March 23, 1839, p. 25.

Sir R. Brodie had treated small subcutaneous nævi, in situations where it was advisable to avoid the scars which would follow the use of the ligature or the knife, in the following way:-He melted some nitrate of silver in a platinum spoon, and dipped into it the blunt points of two or three probes, which, being withdrawn in the space of a few seconds, were found to be coated with the caustic; he then made one, two, or three punctures, according to circumstances, in the nævus, by means of a small instrument resembling a lancet, and into these punctures he inserted the armed probes, and allowed them to remain for a minute or two, until the nitrate became. decomposed by acting on the structure of the nævus; he had a little oil in readiness in order to counteract the too violent effect of the caustic. In this way inflammation was set up, and the tumour became consolidated. In general one operation was sufficient to effect a cure, in other instances the proceeding required to be repeated twice, or more frequently, the pain attending which was very slight. In the case of a child who had a large nævus extending over the greater part of the face, and in which a variety of means had been resorted to, the application of nitric acid among the rest, he had pursued the above plan in a part of the tumour; in the other portion he had broken up the net-work of vessels, by adopting the proceeding recommended by Dr. M. Hall. A perfect cure ensued, although an ugly scar remained on the part to which the nitric acid had been applied. He had also treated successfully, by this mode, a case of an ugly subcutaneous cellular nævus situate at the extremity of the nose. He punctured it in several parts, and then introduced the probes. Some slight puckering of the skin where the caustic had been inserted were the only marks which remained. Whilst speaking on this subject, he might also allude to another kind of marks very commonly found upon the face, and consisting of little stellated patches of blood-vessels. Generally speaking these went away when left alone, but persons in high life frequently complained of them as blemishes, and requested means to be adopted for their removal. When looking at these spots through a glass it was easy to discover one or two larger vessels entering into and supplying the net-work, which spread out like the web of a spider. Having found the supplying vessel or vessels, he placed on them the end of a small probe, and if he found that the red spot entirely disappeared, he proceeded thus: he divided the vessel by a minute puncture, and then destroyed it by inserting a piece of caustic potash, scraped to a very fine point; he then introduced a small quantity of vinegar, in order to prevent the caustic extending its influence beyond a certain limit.

Mr. Cæsar Hawkins, in allusion to the use of steel needles as recommended by the author of the paper, in the treatment of nævi by ligature, suggested that the old silver needles would not require the nipping off of their ends, and would not, therefore, be so likely to produce irritation. Nævi generally consisted of a mixture of arteries and veins; occasionally, however, they were entirely venous. He had seen a congenital case of this kind, in which the disease occupied the back of the head and neck, and extended down as low as the scapula,-the tumour consisted of branches given off from the post-aural, occipital, and lingual veins. There was no discoloration of the capillaries, and no pulsation. The child was now seven years of age, and the tumour increasing.

Mr. T. B. Curling rose to notice one of the objections which the author of the paper had advanced against the treatment of nævi by setons, and which consisted in the fear he entertained of the occurrence of dangerous homorrhage. Now he (Mr. C.) had used the seton in a great number of cases of nævi, no hemorrhage, except such as was readily stopped, taking place; he thought, indeed, the great advantage of the treatment by setons consisted in its freedom from the occurrence of hemorrhage. The treatment by ligature was objectionable; for, even though it might cure, it left an ugly scar, and was not free from danger. In a case in which the crossed

ligatures were applied, the child perished in a few days, from the occurrence of great constitutional irritation. The mode of treatment by injection, he believed was originally proposed by Mr. Lloyd. There was one source of danger from this proceeding, for as it was necessary that very strong caustic should be employed, there was fear of its making such an impression on the larger vessels as to be attended with danger. In a case treated on this plan the patient died almost instantly, probably from the above cause. In what way did Mr. Tyrrell guard against the occurrence of such an accident? Mr. Lloyd, for this purpose, had recommended the use of a piece of pasteboard with a piece the size of the disease removed from it.

Mr. Tyrrell considered that the explanation given in the paper, of the 'precautions he took for preventing the occurrence alluded to by Mr. Curling, was sufficient. He (Mr. T.) had there stated that he invariably consolidated the surrounding cellular tissue before he interfered with the tumour itself. In two cases in which he had employed the injection the disease was much reduced in size before he touched it, proving the influence of the consolidation around. He thought this plan quite as successful as the one recommended by Mr. Lloyd. He (Mr. T.) did not bring forward his plans as perfect, but merely as the result of his own experience. He regretted that in the reading of the paper the secretary had left out the most important case, which had been treated by the application of nitric acid. In this instance the nævus was cutaneous, occupying part of the superior eyelid, the whole of the left cheek, half of the upper lip, and extended up to the septum nasi. Tartar emetic had been employed, and part of the disease had been destroyed by it, but it was extending in other directions. He circumscribed the boundary line in this case, the nævus being very large, at two distinct periods. This proceeding was followed by no extension of the disease. He then painted over the surface, piecemeal, with a brush dipped in the acid, and touched the neighbouring portion to the last, at each successive application. In this way hemorrhage was avoided, and, after five or six applications, the disease, was removed, there being only here and there a slight contraction of the skin, consequent upon the use of the tartar emetic.

Medical Department of Cincinnati College.-The number of students in this institution during the last session was 112; of whom 52 were from Ohio; 14 from Alabama; 11 from Kentucky; 10 from Indiana; 2 from Illinois; 1 from New York; 1 from Louisiana; 7 from Mississippi; 5 from Tennessee; 4 from Virginia; 2 from Pennsylvania; 1 from Arkansas; 1 from Missouri, and 1 from England.

The number of graduates was 27.

Medical Department of Transylvania University.-At the last session 211 students matriculated; of whom 106 were from Kentucky; 25 from Tennessee; 19 from Alabama; 10 from Mississippi; 8 from Virginia; 7 from Georgia; 5 from North Carolina; 5 from Missouri; 4 from South Carolina; 4 from Maryland; 3 from Arkansas; 4 from Illinois; 3 from Indiana; 2 from Ohio; 2 from Louisiana; 2 from Pennsylvania; 1 from New York, and 1 from Texas.

The number of graduates was 54.

Great efforts are making by proper buildings, an infirmary, &c., to render the instruction in medicine even yet more effective.