large quantities indicates the rupture of a vessel in the lungs ; that which is spit up in small quantities mingled with pus indicates ulceration. In forming his prognosis, Galen was regulated principally by the species of the disease, its magnitude, and its peculiar character. Thus, continued fevers are always dangerous, especially when malignant; intermittent are generally without danger. The part affected, the constitution and age of the patient, the cause of the disease, the season of the year, and the situation of the place, were all taken into consideration. The probable duration of a disease he inferred from its progress, combined with its general character and severity: if this be rapid, the disease will soon terminate; if slow, it will continue longer. Ephemeral and simple continued fevers terminate favourably in a few days; continued, putrid, or malignant terminate fatally in an equally short time. Diseases occasioned by heat or cold are of shorter duration than those occasioned by moisture or dryness; those which are occasioned by the blood or yellow bile are acute or short; those by the pituita or black bile, are chronic or long. The manner in which a disease will terminate, whether by an oppression or a loss of strength, may be prognosticated from the state of the disease and of the patient if the progress of the disease have been slow, it is likely that the humours will be matured gradually; if rapid, that the disease will terminate by a crisis, particularly if, at the approach of the critical days, the patient become increasingly restless. And the kind of crisis may be conjectured from various circumstances: if the pulse be full and frequent, but soft and wavy, the crisis will consist in perspiration; if the belly be raised and there be much rumbling, in diarrhoea; if the patient be red in the face, and think that he sees red colours, in hæmorrhage, of which he gives a curious instance in a young man who was about to be bled had he not interfered, saying that although the treatment was correct, nature was about to render it unnecessary, when the young man leapt from his bed, declaring that he saw a red serpent, soon after which ensued a violent and long continued hæmorrhage. If a patient have been long languishing, and there have been great hæmor rhage and diarrhoea, it is likely that he will die of exhaustion; if he have had no such evacuations, of oppression. Galen wrote minutely and at great length on the pulse, which he defines as a particular action of the heart and arteries serving to maintain the heat of the body, occasioned by the alternate dilatation and contraction of the heart and arteries. He describes a great variety of pulse arising from many causes, from temperament, age, sex; from food, exercise, and repose; sleep or watchfulness; from the passions; from particular diseases, their causes and symptoms. These varieties of the pulse he employed much in forming his prognosis; and was so impressed with the importance of the subject, as well as its difficulty, that although he devoted to it sixteen or seventeen books, he asserted that it would occupy an entire life to acquire a full knowledge of the pulse. His practice was founded on the principle expressed by the words contraria contrariis curantur; any instance of successful treatment on an opposite principle he ascribed to the accidental intervention of something in accordance with this law. But he admits that its application requires great care, lest by giving too much of the opposing medicine we induce an opposite disease, or by giving too little we fail to effect our intended object. Moreover, in complicated diseases complicated remedies are indicated, though the principal disease requires the principal attention, and the chief aim should be directed to the removal of the cause; nor should the physician ever be contented with the disappearance of the symptom, though cases may occur in which it is necessary to heal the symptom, as when it may lead to an increased disease or to a diminution of the patient's strength. An important indication of treatment is the strength of the patient, which indeed does not indicate the remedy, but the quantity. When the strength is small, a disease which in other circumstances should be met by violent remedies must be treated by more gentle; and the degree of vital power may actually afford an opposite indication to that of the disease. On the strength of the patient depends the effect of all remedies; it must therefore be so tended as to last through the disease. The treatment is further modified by the natural constitution of the patient, including under that term the temperament, age, sex, habits of the individual, as well as by the particular state and character of each part: thus a part naturally hot attacked by a disease of a hot character does not require such powerful remedies as a part naturally cold attacked by the same form of disease, the morbid condition being less removed from the natural; by its importance in the animal economy, as the liver and stomach, which always require fortifying remedies, being the organs on which the whole constitution depends;-by its sensibility, the more delicate (as an inflamed eye) being less able to support violent medicines; and by its consistency, the dense or thick or hard parts requiring more penetrating medicines than the soft. Nor in this point of view must the nature of the surrounding air be left out of consideration. He employed the ordinary resources of bleeding, cupping, purgatives, opiates, with occasional specifics, as the ashes of crabs in hydrophobia, following generally the rules observed by Hippocrates. Though he sometimes abstracted large quantities of blood, he in general preferred repeated small bleedings, and avoided the practice with children under 14 years of age. Purgatives he used more freely than Hippocrates, perhaps from being acquainted with a greater variety. He made little use of sudorific medicines, but employed the bath and frictions. We do not enter at length on the consideration of the anatomical views of Galen, though it is greatly to his eminence in this respect that he owes the position which he occupies in the history of medicine, because to do so with any adequate degree of accuracy and minuteness would lead us into too great prolixity. He appears occasionally to have dissected the human subject, but not very frequently, for he has recourse to animals supposed to resemble the human form most nearly in their construction. We have seen the spirit of elevated devotion with which he enters on the exposition of the human frame. About the same time as Galen, lived Lucius Apuleius, better known perhaps as the author of a satirical work called the Golden Ass, but who was also engaged in the study and prac tice of medicine, though somewhat inclined to superstitious rites, which brought upon him the charge of magic, and exposed him to the censure of the Christian writers. Also Marcellus, who wrote forty-two books on medicine in heroic verse, in which he treated of a disease called lycanthropia, in which the patient supposed himself transformed into a wolf; Posidippus, accused of having occasioned the death of Lucius Verus by an unsuitable bleeding, and several others, among whom may be mentioned Glauco, an oculist, who cured the disease called hypopion by seating the patient on a chair, and then shaking his head violently till the pus descended to the lower part of the eye, which Galen says he himself saw. Papilius, Alexander and Sanctus were Christian physicians who suffered martyrdom for their faith in the persecution raised by M. Aurelius, L. Verus, and Commodus. ON MESMERISM. BY J. RUTHERFURD RUSSELL, M.D. It is impossible for any sane mind to be brought in contact with the world of mesmerism without being dismayed at the dismal disorder which reigns over the whole region; one feels as if quitting the familiar earth for Tartarus, and exchanging the diffused light of day by which we recognise the colour, form and distance of objects, for the fitful corruscations of the aurora borealis or gleams of vivid lightning, that dazzle the sight rather than reveal the things around us. We feel that all our conscious experience is opposed to the phenomena we seem to witness or of which we are told; and while we dare not refuse the evidence of our senses or the testimony of trustworthy witnesses, we are equally unwilling to receive as truths appearances or statements utterly at variance to all probability. A little reflection, however, will convince us that this discrepancy is apparent rather than real. The experience by which we try mesmeric phenomena is all derived from our waking state. Mesmerism. is a state of sleep. Our sleeping experiences are not recollected, and we cannot bring them to bear upon the subject. If we could remember all that passed in sleep we might find nothing extra ordinary in the acts of a person in a mesmeric condition. The neglect of this fundamental distinction seems to lie at the root of the confusion of the matter; and the only hopeful method of advancing into the labyrinth is by starting from the most obvious and familiar of the phenomena of sleep. To enable us to do this at all successfully, we must first disentangle sleep from certain other states into which it is often confounded. Sleep is frequently spoken of as a state of negation,—and as such related to stupor or fainting; but a little careful attention will dispel this error. A faint is an arrest of all the animal functions: the heart ceases to beat, the lips grow pale, there is total insensibility, there is in short temporary, at least apparent, death; hence in German called scheintod. In stupor, although the heart continues to beat, it does so languidly and laboriously, there is no sensibility as in sleep to any stimulus that can be applied to the system, there are no dreams, and there is no sense of refreshment on recovering from it. It is a dead, unnatural, unwholesome calm,-not a living natural sanative repose. Stupor and faint are morbid states, sleep is essentially a healthy one. 66 Sleep, Death's twin-brother, knows not death." Hence it is a misnomer, and one which has done much mischief from the erroneous idea it involves, to call those poisonous substances which produce stupor, hypnotics. Narcotics or soporifics they are, but sopor and narcosis are not synonymous with somnus. Sleep, then, we believe, along with some of the best physiologists who have written on this subject, to be a positive condition of the system, beginning in all probability before birth, and continuing till death. For there is great probability that the fœtus in utero floats in its little ocean fast asleep, and only slowly after birth enters the full state of wakefulness.† Its * See Burdach's Physiologie, vol. v, p. 185. † It may be somewhat too fanciful for a scientific paper to suggest that if the child be asleep before its birth, it may in that sleep be visited by dreams, and those dreams may take their character from the emotions of the parent: and one might even imagine that some very vivid dream might be faintly |