695

attributes the recovery, which was complete in 38 in-stances : there were 16 deaths. In 17 instances recovery wasrapid; in 19 gradual; and in 5 followed by secondary fever. Itmay be worthy of note, that nearly all the cases of recoverywere but gradual on November 3rd and 4th. Of the deaths,one took place in six, two in seven, one in 11, two in13, one in 73, one in 87, and one in 135 hours from theperiod of attack. There is a significant note attached to thefoot of the table, relative to one of the cases. The patient,(No. 25,) aged 25 years, was " a carman, who brought somefurniture to the house. He had been suffering from diarrhoeafor two days previously, and on reaching the asylum was sud-denly seized with severe collapse." His recovery is reportedto have been " rapid" under the use of chloroform and brandy.

Reviews.

The Journal of Psychological Medicine and Mental Pathology,Edited by FORBES WINSLOW, 1B1.D. Vol. I. London : JohnChurchill. 1848. 8vo. pp. 704.The first number of this journal elicited from THE LANCET

(vol. i. 1848, p. 234) this remark, that in it there was "nolack of materials, no deficiency of interest or instruction."On the publication of a third quarterly number, with furtheropportunities before us of estimating the capabilities andprospects of our new contemporary, we spoke in still stronger i

terms of approval of the mode in which it had been con- Iducted, and of commendation to the notice of our readers,(THE LANCET, vol. ii. 1848, p. 313.) There therefore remainsnow very little more to do than to announce the publicationof the first annual volume, consisting of four quarterly num-bers of the Journal of Psychological Medicine, in a very con-venient and handsome form. It contains, under their re-spective headings, a series of elaborate analytical reviews oforiginal communications of interest and importance, on sub-jects connected with mental diseases; of translations fromforeign languages; of cases illustrating various points in thelaw of insanity; and a monograph on the cerebral diseases ofchildren, by Mr. W. C. Dendy; with some matters of minorimportance, including miscellaneous notices and correspon-dence, on subjects connected with the objects of the journal.It would be invidious to name particular essays or persons,where all obtain excellence. Suffice it, therefore, to say,that Dr. Winslow has proved himself qualified for the per-formance of the onerous duties which he has undertaken;and he has been very fortunate in the choice of his fellowlabourers. No one can doubt the necessity of devoting alarge share of attention to the investigation of cerebral diseases—a share beyond that which could be appropriated to theirstudy in the pages of the journals which include the extendedjield of pathology at large; there therefore is abundant roomfor occupation by a journal such as the one before us. This

place could not have been better filled than it is at present,and there can be no doubt that Dr. Winslow’s successfullabours will be suitably appreciated by all who take an interestin the pathology and treatment of diseases of the brain.

--.

The Serpentine " as it is," and "as it ought to be;" and the BoardOf Health " as it is," and " as it ought to be." By EDWARDof Health "as it is," and "as it ought to be." By EDWARDJOHN TILT, M.D. London: John Churchill. 1848. Pamphlet,pp. 67.

OuR readers will recollect some leading articles which appearedin THE LANCET of October and November last, that promi-nently set forth the extent of a frightful nuisance affecting thewest-end of the metropolis, in the state of the ornamentalwater in Hyde-park. We have been gratified to find that our ,,

remonstrances respecting the noisome state of the Serpentine- ably seconded as they have been by several other organs ofthe press-have promptly awakened attention in the properquarters, and that the Metropolitan Commission of Sewers,under the guidance of its Chairman, the President of theBoard of Health, has determined immediately to arrest the

baneful and growing evils of which we complained. THELANCET may fairly claim to have taken the initiative in draw-ing to this matter the attention of the slumbering conserva-tors of the public health, and obliging them to bestir them-selves to remedy a most abominable nuisance.

Dr. Tilt has adopted our before-mentioned leading articlesas the text of his pamphlet, adding thereto, however, manyother particulars, which show an intimate acquaintance withthe actual condition of the Serpentine; and coming, as his ob-jurgations do, from a neighbour of the pestiferous pool inquestion, corroborating our previous statements, it will be seenthat we had not exaggerated the extent of the evil. He hasadded a smart philippic for the Board of Health, showing theirshort-comings. It is probable that, but for his hint of the dis-agreement between that Board and the College of Physicians,(pp. 39, 40,) the public might not so soon have been favouredwith the publication of a correspondence (a part of which wascopied into our last number) displaying the indecent at-tempts of the Board of Health to rump the first medical bodyin the kingdom. There is a toadying journal which has latelythrown down the gauntlet for this same Board, which gagewe are quite willing to take up. The public, however, fondas they are of being mystified, do, we believe, accurately judgethat, in these cholera and typhus times, they may more safelyfollow the dicta of a College of Physicians than those of aBoard with only one medical appendage to its tail.The appendix to the pamphlet before us embodies both

useful and entertaining matters, and the whole pamphlet willprove interesting to both the medical and the general reader.

Medical Societies.

WESTMINSTER MEDICAL SOCIETY.

SATURDAY, DECEMBER 2. — MR. HIRD, PRESIDENT.

DISEASE OF THE TRICUSPID, AS ALSO OF THE MITRAL AND AORTICVALVES, CONSEQUENT ON RHEUMATIC INFLAMMATION.

DR. R. C. GOLDING showed to the Society a preparation ofthis rare form of disease, taken from a young woman, a dress-maker, aged 24, who died a few days back, of acute pleurisy ofthe right side, and bronchitis. The patient has been underDr. Golding’s inspection, and often treated for rheumatism byhim for more than three years. Dr. Child attended her duringher last illness, but with great courtesy invited Dr. Golding tothe autopsy. The cardiac disease has lasted for six or sevenyears: the cardiac symptoms have not materially varied sinceshe first came under Dr. Golding’s inspection. The health ofthe patient, when free from rheumatism, was tolerably good;and as great caution in diet and regimen was enjoined andpunctually observed, her life was prolonged, till the accessionof the pleurisy and bronchitis, for which Dr. Child attendedher. The physical signs indicated great hypertrophy of theheart, with double valvular disease of its left cavities. Dul-ness was appreciable along the lower half of the sternum, ashigh on the right of it as the cartilage of the third rib, and onthe left to the second rib. The apex was beating between theseventh and eighth ribs; three inches at least more externallythan in health. The sounds were feeble; the rhythm, underordinary circumstances, not impaired; the impulse strong; andthe pulse full and bounding. There was a double murmur atthe apex, and a very loud and rough diastolic one at the upperpart of the sternum, at its sides, and along the neck. Theautopsy revealed great thickening of the tricuspid, mitral, andaortic valves: the two former orifices formed perfect rings,and must have been patent during life: the pulmonary valveswere healthy; the calibre of the aorta above the valves weremuch contracted. The pericardium was thickened, but no-where adherent or unduly vascular. There was recent pleu-risy of the right side, great congestion of the lungs, togetherwith a little emphysema here and there. The gall-bladdercontained a few small calculi: nothing else was noticed irre-gular or morbid. Inspection of the specimen has been con-ciusive to all, that rheumatism was the cause of the valvularlesion in both cavities of the heart; that the same disease,influencing the valve in precisely the same manner, and rela-tively in the same degree, existed in both tricus) id and mitralvalves ; and that the perfect rings formed by the adhesion from