quired copious depletion. When he was convalescing from this attack, he was suddenly affected with acute pain in the right wrist, succeeded by swelling of the same, and considerable constitutional disturbance. Thirty leeches were applied to the part, and fomentations to encourage the bleeding. But this brought no relief, and another 30 were applied, with poppy-head fomentations. The following day shewed a similar inflammation and tumefaction of the other wrist, without any diminution of the inflammation in the joint first attacked. Leeches were here applied, but the disease seemed to laugh Dr. V. to scorn, and pursued its course. The skin was hot-the pulse quick and irregular-the tongue dry. Dr. V. was afraid of farther sanguineous depletion, and had recourse to compression, on the principle of Velpeau in the treatment of phlegmonous erysipelas. A bandage was, therefore, applied, from the fingers to the elbow. The pain was considerably increased by this measure, and the patient begged to have the bandage removed; but the Doctor persevered. keeping the linen wet with an emollient lotion, which tightened the bandage, but did not increase the pain. The compression commenced at 10 o'clock in the morning, and, by 1 o'clock, the pain ceased. Dr. V. now applied a bandage to the other wrist, and the same augmentation of pain ensued, with complete relief in a few hours. The patient now, for the first time, fell into a refreshing sleep, of two hours duration. When he awoke, the pain had returned, but not in so violent a degree as before, and he passed a tolerable night. Next day, the constitutional symptoms had nearly disappeared. The bandages were re-applied, having become slack-the redness and swelling being considerably diminished, Next day his appetite returned. The bandages were continued for eight days, when the cure was complete. Three or four other cases, presenting similar results, are detailed by our author. We confess that we do not attach much importance to any topical measure, capable of suddenly removing the pain or swelling of articular rheumatism of the acute kind, knowing, as we do, the severe effects which so frequently succeed to rheumatic inflammation of the joints, when rudely interfered with by any local mode of treatment. This treatment by compression we believe to be one of those processes which may give a temporary eclat to the medical attendant, but may not be very profitable, in the end, to the patient. We should prefer a very moderate application of leeches to a joint in this state, followed by tepid evaporating lotions, and such internal remedies as gently open all the secretions. without violently or abruptly checking the course of the disease by any heroic remedy whatever.

We see, by this paper, that Dr. V. is about to publish a work on purulent ophthalmia, in which, he says, the surprising efficacy of the solution of chloride of lime will be demonstrated. Since he commenced using this application, he has lost no eyes; whereas, the treatment by other methods was very unsuccessful. This hint will probably be acted on by some of our surgical readers before the Doctor's work appears.

14. ENDERMIC MEDICATION.

[M. Martin. Hotel Dieu.]

In spite of all the controversies which have taken place respecting the existence of a capability in the vessels of the skin to absorb substances applied to them--the general conviction, supported now by incontestable facts, is, that such absorbent power does actually existespecially when the epidermis is removed. The method of introducing medicinal agents through this channel is by no means a mere matter of physiological curiosity. It may be turned to great advantage in many cases, where there are strong objections to the administration of medicines by the mouth. Thus, a person may become the subject of ague while labouring under chronic inflammation of the stomach or bowels-and, consequently, where bark or arsenic would be injurious. In such a case, the sulphate of quinine may be applied to the denuded surface of a blister, and the ague will be stopped, without any irritation being given to the stomach or bowels. Again, in cases of children, who have a natural repugnance to medicines, and especially to bitter medicines, the endermic medication offers a very convenient resource.

In a late Number of the Revue Medicale, the younger Martin has published several cases of intermittent fever, treated, at the Hotel Dieu, by sulphate of quinine, applied with cerate to blistered surfaces. At first, he applied the powder over the denuded cutis, but it occasioned too much irritation, and the paroxysms were not stopped. He then mixed the quinine with cerate, and the object was obtained, without any local inflammation or pain being produced. A single case in illustration will be sufficient for our purpose.

Case. Leon, a soldier, of the 1st regiment of Light Infantry had been in the hospital upwards of four months, when M. Martin took his turn of duty, on the 1st of December, 1826. He had had a pernicious remittent fever, attended with several relapses, by which he was reduced to a state of great debility and emaciation. He was also affected with dry cough, and was compelled to keep his bed, from the general state of marasmus to which he was brought by his disease. By proper means, the cough was mitigated, and the patient began to recruit a little, when, on the morning of the 20th December, he was seized with a regular fit of ague, which left the cough in a state of exasperation. The next day, being apyrectic, a blister was applied to his arm. On the third day, in the morning, the blister was removed, and the surface dressed with cerate, in which was incorporated six grains of the sulphate of quinine. That day the paroxysm was much milder, and at somewhat a later hour. The quinine was continued, six grains daily in the cerate, and fever returned no more.

We need not multiply cases, as the foregoing presents an example that will be easily imitated, where it is deemed necessary. We apprehend that this plan may be applicable to a great many morbid conditions of the system, where the inter administration of remedies would be inconvenient.

15. ON GYMNASTICS.

By Dr. Cassimir Broussais, Physician to the Civil and Military Gymnasium.

M. Cassimir Broussais' situation gives him good opportunities of ob. serving the effects of gymnastic exercise on mind and body. We agree with the author, that such exercise, if properly regulated, has a powerful influence on the morale through the medium of the physique. On this account, it deserves the consideration of the statesman, the divine, the philosopher-and last, not least, the physician. It interests the latter in a double manner, as an instrument of hygiene and therapeutics. Gymnastics bid fair to exert a considerable influence on the rising generation of both sexes-the inhabitants of schools, colleges, and cities-and very particularly on soldiers, both in field and in garrison. In this article, the author confines himself to an inquiry into the assistance furnished to the physician by gymnastics-first, in preserving health-secondly, in correcting spinal distortions-thirdly, in curing certain diseases and, fourthly, in the acceleration, in certain cases, of the progress of convalescence.

Gymnastic exercise, by putting in action every part of the muscular system, and by diversifying the muscular movements ad infinitum, produces several physiological effects on the human body, which it is very necessary to know, and bear in mind. In the first place, the muscles are strengthened, and, at the same time, rendered more supple by this exercise. In the second place, these muscular movements, and their accompanying gentle succussions, accelerate the circulation, even in the most minute capillaries. Such are some of the general physical effects of gymnastics. But this agent is capable of being directed locally to this or that part-as, for example, to the dilatation of the thorax, and to the invigoration of any of the limbs, or the muscles of the trunk. By a skilful use of this measure, we may enable one organ or system to predominate over another. Thus, supposing we consult the health of a child of a lymphatic temperament, of pallid complexion, flabby flesh, and disposed to scrofula, rickets, or hydrocephalus, what is gymnastic exercise likely to effect? It will cause the muscular and sanguiferous systems to predominate over the lymphatic. In giving activity to the circulating system, it promotes the resorption of the serous fluids, and improves the complexion. In calling forth the vital action of the muscular system, and determining to the extremities, it prevents a concentration of irritation or congestion in the head, thus removing the disposition to hydrocephalus. In fine gymnastics are capable of changing completely the original dispositions of the child into dispositions of health. Our author avers that he has seen several such instances occur at the Gymnasium. If, on the contrary, the child be neither decidedly scrofulous nor ricketty, but suffer merely from bad health; if, in fact, the child be what is commonly called "delicate ;" of irritable habit, and easily fatigued, are we to treat such a patient by "rhubarb, senna, or vile purgative drug?" No; the time, says M. B. is gone by, when we should poison our patient in order to strengthen him! Let the lad

engage in gymnastic exercises, gradually raised from the more gentle and preparatory, up to the more complex and difficult; and we shall soon find that these will accomplish what all the stuff in Apothecaries' Hall never could The same holds good with the individual of bilious and melancholic temperament. Those even who enjoy good health would do well to cultivate what will give power, activity, and suppleness to their limbs, as well as confidence in themselves, and presence of mind in dangerous situations. The man of letters, too, and indeed all engaged in sedentary occupations. would find their account in resorting to gymnastics, which would most certainly lop off that endless series of ills, in the shape of piles and of fistula, which spring up so rankly in the field of science.

It may be asked, at what age should a child commence these exercises? Our author replies, as soon as he can walk firmly. At the Gymnasium of M. Amoros, in Paris, near the Champ de Mars, there is a class of boys from two and a half, to eight years of age, who go through the various evolutions with a remarkable degree of ease and address. It is more difficult to determine when they should be left off; for, although there is a certain period of life at which any great exertion becomes irksome, and perhaps injurious, yet it is not so easy to say, precisely, what that period is. Amongst the Greeks, old and young repaired to the Gymnasium, and we read that Galen dislocated his humerus at thirty-five.

M. Broussais proceeds to consider the effects of gymnastics in distortions and curvatures of the spine. These depend either upon caries of the vertebræ, where, of course, exercise is inadmissible, or upon partial muscular action. In a person of a weak, strumous habit, where, as M. B. believes, the osseous system is soft, and there exists a predisposition to the disease, the greater action of one set of muscles than another, induced by malposition or other accidental circumstances, is a very frequent cause of distortion. In the treatment, two indications are to be followed; 1st, the correction of deformities-2d, the strengthening of the constitution. For the first, machines have been long in use, and, with what effect, the crooked backs of nearly five out of ten of our boarding-school misses can amply tell. It is to Mr. Shaw, in this country, and M. M. Lachaise and Pravaz, on the Continent, that the merit of having combined, with the use of machines, a system of exercise for the muscles of the spine, is justly due. In France, however, they have not been content with the few ropes, and pullies, and sliding boards, employed by the late Mr. Shaw, but have sent their patients to the Gymnasium, and, as it appears, with the happiest effects. Several cases are detailed, in illustration, by M. Broussais.

Case. Jules B. æt. 6, of a lymphatic temperament, and puny debilitated habit, presenting a very marked projection of the spine in the dorsal region, was sent. by the advice of M. Villeneuve, to the Gymnasium of M. Amoros. On his entrance in September, 1826, there was found to be no lateral curvature but a projection to the extent of half an inch of the spinous processes of three of the lower dorsal vertebræ. At first he

evinced a great dislike to the exercises, but, after a time, this subsided; and at the expiration of four months, there was a decided improvement in his health, whilst the prominence in the back was scarcely to be felt. At present (June, 1827) he continues to prosecute gymnastics with the happiest effects upon the morale, as well as the physique. Two other cases are related, but these our limits will not permit us to notice here. Our author thinks that gymnastics might be very advantageously combined with machines for extension, inclined planes, &c. in the treatment of these spinal distortions; in fact, at some of the institutions in Paris, for the cure of these affections, this plan seems to have been already put in practice.

The next subject noticed in this paper is-what are the complaints to the treatment of which gymnastics are applicable? Certainly not, replies our author, to acute inflammations, or active hæmorrhages-not to chronic inflammations of the viscera, to affections of the pulmonary tissue, of the heart or muscles, nor to many or most of those of the skin, &c. But in chronic gastritis and hypochondriasis, (this is a Broussaisan, remember,) in other words, in dyspepsia, gymnastics, aided by proper regimen, are an almost certain remedy. What, in fact, do we commonly recommend for these affections? Proper food-air-exercise. But what kind of exercise? Surely this is not to be confined to a walk or a ride. No; let the individual engage in gymnastics, not as a candidate for prizes, not with an ambition to rival the "professors," but in moderation, as a mean of health; whilst he should, at the same time, combine with them a regulated diet.

The last point which occupies the attention of our author is the efficacy of gymnastics in promoting convalescence, or rather in giving tone to the system, when this is confirmed. Caution is here re

quired, and we must commence even with the elementary exercises, which we shall notice presently, or with the gentle use of the machines. M. Broussais observes that, if some of these were erected under the inspection of competent masters, and the immediate superintendence of the medical officers, in public institutions, particularly in the military hospitals, they might form a good mean of testing the vigour of the convalescents; in short, they might become true dynamometers. We have thus given an abstract of the paper of M. Broussais, and shall now beg leave, in all humility, to offer a few comments of our own. For gymnastics, in the liberal sense of the term, that is, for a system of exercise, which, without being vi olent or immoderate, tends to improve and develope the physical powers, we have always been the warmest advocates. We are confident, and the conviction is becoming more general every day, that exercise and a temperate diet are, after all, the true elixir vitæ. When people substitute for these a multitude of boluses and draughts, they are only poisoning themselves secundum artem, and they seem to forget altogether, that man was never intended by Nature to live upon calomel and jalap.

The gymnastics, as practised abroad, and of late introduced inte VOL. VIII. No. 15.

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