"The influence of sight in maintaining the sense of equilibrium is even better exemplified by disturbing visual impressions than by wholly excluding them. A person who, without previous practice, looks upon a mirror swinging to and fro, or upon the ripple of an extensive sheet of water, or down a steep declivity, becomes giddy: he has no longer a sense of steadiness, or of equilibrium. The visual impressions on which he habitually rests, now are uncertain: the objects upon which his eyes used to dwell are either in motion, or at an uncertain distance; there is a relative unsteadiness, and whether it be in the object or in himself be cannot determine, and becomes giddy.

"Habit enables one to disregard these uncertain impressions, and by confining the attention to the muscular sense, to preserve the sense of equilibrium on shipboard, or amid alpine scenery. Bodily debility, on the other hand, weakens our reliance upon our senses, and makes us doubly susceptible of giddiness on the kind of occasions which are here adverted to.

"It is, perhaps, in the state of nervous debility alone, that the influence of hear ing, in maintaining or disturbing the sense of equilibrium, can be observed. At such a time, when loud and confused sounds strike upon the ear, the frame is perceptibly less steady, and the patient nervously looks around for external support.

"The distress produced by removing the support of one sense is greatly aggravated by taking away that derived from a second. Such is the distress at first commonly experienced in a swing, or on board ship.

"As a practice will do so much in enabling one to preserve his steadiness, while all around is moving, and when for each second of time there must be a fresh adaptation of the frame to its shifting position, so is there a prodigious natural diversity among men in this respect. Some instinctively and at once adapt themselves, like boys placed on horseback, pliantly and easily to each variation of position. In others the body is unmanageable and unadaptive, and giddiness is immediately produced. I have generally remarked, that those who, without practice, can bear the motion of a swing or of a vessel, bear with equal freedom from uneasiness the looking down from great elevations.

"The continuance of giddiness that has been produced by the motion of a vessel, or by turning round many times in succession, after the cause has ceased, deserves to be examined. It is referable to a principle of universal operation through all the mental actions. There is a law of mental induction, which extends the effects of an impression to some period after it has ceased. The anatomist who has been

VOL. VI.

busied all day in teazing out filaments of nerves, when he closes his eyes to rest, is perplexed by the entanglement of threads, which his vivid conceptions force upon him. In the same manner, in one of the instances before us, the strong conception of turning remains for a long time after the body has been stopped, and we feel no little tendency to follow the conception, and realise the motion.

"Giddiness strongly excited, either by continued turning or by the motion of a swing, or of a vessel, leads to nausea and vomiting. Dr. Wollaston referred the effect in some of these instances to the altered momentum of the blood in the brain. I believe that they admit of another, and a more general and a more just explanation. Giddiness, nausea, and vomiting, appear to me the natural consequences of the disturbed sense of equili brium: there appears to be the same alliance between this sense and the effect on the stomach, as between some of the othersenses (taste, for instance, or smell,) and the same. Disturb the sense of equilibrium, or present any extremely nauseous effluvia to the nose, and in either case vomiting follows.

"Those who are very susceptible of disturbance of the sense of equilibrium, know that one of the different causes which most excite distress and nausea, is the feeling of sinking or descending from want of support; as, for instance, when one is in a vessel that is pitching, or when a person is seated in a carriage with his back to the horses. The sense of being lifted on, on the other hand, is a strong relief, after the distress attending the sensation of failing support. As far as I can see, this difference is entirely arbitrary.

"The following argument appears to me conclusive in favour of hypothesis, that nausea, in these instances, is directly dependent upon disturbance of the sense of equilibrium. When a person has taken wine too freely, if he closes his eyes, a sensation of vertigo arises, accompanied by nausea. The vertigo no doubt results from some affection of the brain, analogous, in its temporary effects at least, to the injury of the tubercles in Magendie's experiments. Now, if the patient, under these circumstances, opens his eyes, and fixes them upon any distinct and stationary object, the internal source of whirling appears arrested, and the sense of equilibrium is quickly restored. At the same time the nausea goes off,-so closely and directly is it connected with the sense of disturbed equilibrium. On the recommencement of the inward whirl, pro. duced by again closing the eyelids, the nausea returns; on steadying by the eye the whirling sense, the nausea again disap pears."

In a subsequent paper, the author favours the medical world with the following attack

R

on Sir Charles Bell, which many will regret. We insert this verbatim, without note or comment, though we shall shortly place before our readers some facts which will convince most of them that Sir Charles Bell is alone entitled to the modern discoveries, respecting the uses of the nerves,

To the Editor of the Medical Quarterly Review. "SIR,-So much effrontery has been of late so systematically shown, in claiming for Sir Charles Bell, at my expense, credit to which he is not entitled, that I am driven the following statement upon the authorship of the modern discoveries respecting the uses of the nerves.

"I am, sir, your obedient servant,

HERBERT MAYO.

"Some time before 1812, Sir Charles Bell printed and distributed an Essay on a New Idea of the Brain and Nerves: a copy of this essay is in my possession. In this essay he describes experiments upon the spinal nerves, which, combined with anatomical observations, led him to adopt the following opinions:

:

"That the anterior roots of the spinal nerves, the anterior columns of the spinal

marrow, and the cerebrum, are for sense, volition, and the other affections of consciousness.

"That the posterior roots of the spinal nerves, the posterior columns of the spinal marrow, and the cerebellum, regulate growth, nutrition, the sympathies of parts, and the like.

"In the Philosophical Transactions for 1821, a paper, by Sir Charles Bell, was published, being the first of a series, on the Uses of the Nerves. In this paper Sir Charles Bell asserted the existence of a set of superadded or respiratory nerves, which he described as different from the nerves of sense and deliberate voluntary motion, and as channels for conveying the stimulus to muscular action in breathing, and bodily expression. In the face, he said, that the infraorbital and mental branches of the fifth were for sensation and deliberate volition, and that the branches of the seventh formed the superadded or respiratory nerves.

"An account of these experiments was published by Magendie, in his Journal of Experimental Physiology, for October, 1821, in which he adopted Sir Charles Bell's views as to a supposed respiratory system; although one experiment upon one branch of the fifth nerve did not, upon its repetition, appear to him satisfactory. Magen. die's words are these:

"Nous avons répété ces expériences à l'école vétérinaire d'Alfort, avec MM. Shaw et Dupuy; et le résultat que nous avons obtenu s'accorde parfaitement avec celui que nous venons de rapporter, à l'exception toutefois de l'influence de la section du sous orbitaire sur la mastication, influence qui n'a pas été évidente pour moi.'

"It thus appears that the examination of Sir Charles Bell's theory left Magendie in no doubt as to the use of the seventh nerve being what Sir Charles Bell asserted.

"In August, 1822, I published, in the first part of my Anatomical and Physiological Commentaries,* a refutation of Sir Charles Bell's theory, that there exists a distinct set of superadded or respiratory nerves. By varied experiments, I proved that the facial branches of the fifth are nerves of sensation alone, and that those of the seventh are nerves of voluntary as well as of instinctive motion. I further observed, that other branches of the fifth, those, namely, distributed to the temporal, masseter, and pterygoids, must be voluntary nerves.

"In following out the latter idea, I came upon the fact, and its physiological bearing, that the ganglionless portion of the fifth is distributed to the muscles just named. I was thence led to conjecture analogically the existence of the true difference of func tion between the ganglionic and ganglion. less roots of the spinal nerves; and I engaged myself in making experiments to establish the justness of my conjecture.

"Sir Charles Bell now likewise came upon the same idea. In his first paper in the Philosophical Transactions, it is indeed demonstrably clear that he had not at that time the smallest idea of this difference; and proved since his early experiments, pubthat his views upon the subject had not imlished before 1812. But now, I repeat, Sir Charles Bell and myself were both intent upon finding evidence to prove the conjectured uses of the double roots of the spinal

THIS is a vesiculo-pustulous eruption occurring on the thighs, fore-arms, and sometimes between the interstices of the fingers, and on the backs of the hands. The skin is red and inflamed, and becomes elevated in small points, which very soon become large pustules containing a sero-purulent fluid. The pustules dry up and are followed by a brown scab.

There is an acute, and a chronic form of this disease.

Preceding the acute form there is severe and pungent itching which is diminished as the pustule arrives at maturity. In its commencement this affection is as ardent as erysipelas. In its decline, it is as itching as the itch itself. The chronic form is longer in developing itself, and is unaccompanied by irritation. It attacks debilitated constitutions, when the patients have been badly nourished. It is known in the provinces by the name of "rogne." It is seen among the meanest classes of society only.

The acute form is known by the larger size of the pustales, which are surrounded by a bright redness of the skin, denoting active inflammation. The pustules are distant from each other, and when their desiccation is completed, the crusts which they form are thick, rugous, and are strongly adherent to the surface. When these are accidentally detached, or drop off in the course of time, there remain spots on the cutis which gradually disappear. The suppuration of the different pimples or vesciles is accomplished in eight or nine days. Sometimes the patient tears them off in rubbing or scratching the part, in which case the discharge continues to flow and forms a new scab. I have been consulted by an adult who had under his chin a vesiculous pustule surrounded by a red areola. On its first appearance it had the character of a boil. On the ninth day it had run through its course, the scab fell off, leaving the skin of a brownish colour, without the slightest depression. The disease is chiefly seen among hard-working artizans whose occupations are of a sedentary nature, and the dried purulent secretion forming the scab is according to circumstances separated more or less early.

The fever which ordinarily accompanies this eruption, ceases after it has fully come

out. The pulse previously accelerated returns to its natural state. The eruption is sometimes extensive and confluent, the summit of the pustule is flattened, and the base much inflamed. When they are totally dried and the scabs fall the skin remains some time hardened and wrinkled, and poultices are necessary to bring the skin to a sound state.

The chronic form is, perhaps, the more common of the two. We often meet with it in our hospitals, in barracks and garrisons. It is in such places called "phlysacie scorbutique," or "gale sordide." I have found it among people living in narrow unhealthy streets, without a due supply of clean linen, and other means of contributing to their health. The course the pustules take in the chronic form is the same as in that before detailed. The vesciles become pustular, scale, and drop off according to their age; at times they resemble the spurious vaccine pustule, and occasionally attain the size of a Their contents are ill-conditioned pus of a stringy nature.

pea.

The pustule of this form goes slowly on, and when the scab drops off, it leaves an indentation of the cutis, but no cicatrix. The itching and uneasiness at the beginning of the disorder are great, sometimes as severe as those of erysipelas. A sensation of extreme tension occasionally of the skin prevails, but when the pustule begins to dry up and take the appearance of a scab these symtoms entirely disappear.

The phlysacion diaonicum or P. scorbu ticum of former authors has enabled an English physician to make out and name a particular disease, which he has called Rupia. The name is very well chosen to express what he wished to describe. It is from the Greek word furos, filthiness, or dirt, or corruption. The Jews used the term in times past with reference to women during the periods of menstruation. The Rupia of Willan and Bateman does not appear to me to be anything but another form of Ecthyma, and that opinion I am borne out by Mr. Plumbe.

The subjects of this disease are for the most part in a very debilitated state of constitution. There are no marks of general debility absent, and the cutaneous affection proceeds more or less slowly towards a healthy termination, according to the powers of the system. The pustules are distinct and widely separated from each other, according to the degree of debility present. They contain a sero-purulent matter, which dries in the form of unhealthy scabs, and the latter are broken up into the form of a brown or grey colour, if you attempt to detach them from the surface.

This disease is particularly noticed in Autumn, in the hospital St. Louis. We shall select from a number of cases that of a young man, twenty years of age, who suffered from this disease more than six months. The thorax and abdomen are covered with

pustules which have been enlarging for three or four days from the size of a pin's point. Several of the earlier formation running together and forming a large vesicle, which cracks and allows of the escape of a glutinous fluid. These are slowly followed by others of a like character. They are more numerous in some parts of the body than in others. The backs of the hands and wrists are often so covered as to leave no intervening healthy skin. The habit of the skin is such that the patient has only to scratch himself to produce a new crop of eruptions; and the disease is rendered in this way of a character resembling confluent small pox. Some pustules on the penis have been attended by much irritation; and have given rise to nocturnal emissions. The patient dreads the heat of the bed, and when he attempts to use it for the purpose of rest, he finds it impossible to sleep, and describes his sensations of pricking, tearing, &c. to be intolerable. He feels as if attacked by a swarm of bees, and in the restless change of position, the scales become detached in flakes like the bark of a tree.

Etiology of Ecthyma.-The causes have been too positively stated by authors. There is much uncertainty on the point. Is the disease engendered by diet? Is it caused by peculiarities in the nature of the food, and their influence on the secretions? Does it arise from the abuse of wine and spirituous liquors ?

It

There was lately in one of the divisions of Paris, a sort of rendezvous to which the beggars of the town could retire in an evening on the payment of a small consideration. was occupied by all the outcasts and vagabonds of society in the most miserable and abject condition, and who found enjoyment only in drunkenness and brutal pursuits. So degraded were these wretched people, that few could tell their places of birth, their parents, or even their names! They entered for the most part at night, péle mêle, into the same chamber, a dirty floor with a little straw for their bed, and no covering but a sheepskin. At this time I remember a great many cases of this disease appearing at St. Louis of the severest form, the skin disfigured, and all the humours of the wretched systems of the sufferers utterly depraved. Large hard pustules were distributed over the body, each surrounded by a red and inflamed base.

I may relate here the deplorable case of a Chiffonier who suffered in a frightful degree from this disease. He had no fixed residence; and obtained his ordinary living in the quarries of Mont-Martre. When drunk with brandy, he would sleep for hours surrounded by the carcases of putrefying animals, his body exposed to the flies which abound in these unhealthy places. He at length became a victim to the disease; and when brought to St. Louis was found covered by the larvæ of the musca camaria. After he had been cleaned, we found phlysacious pustules spread over

This disease is not contagious. It may attack persons of all ages, and all temperaments. It ordinarily shews itself among paupers, the inhabitants of prisons, drunkards, and those who are obliged to consume bad provisions. It prevails in times of scarcity, and afflicts those more particularly who follow laborious trades or employments.

Treatment. When the pustules or scabs are surrounded by much inflammation, we direct fomentations of mallow decoction, &c. The warm bath is useful; and the patient should be directed to avoid scratching. Children who cannot be restrained from this, tear off and excoriate the skin, and render the disease much more formidable; the scabs become much enlarged, and the sores more difficult to heal. If the inflammation which occupies the interstices of the scab is considerable leeches ought to be applied, and even general bleeding is sometimes necessary.

In the acute form the ulcerations following the scratching off the scabs are not unhealthy, not so those which occur under the same circumstances in the chronic form. These are almost always of a black or livid hue, and extremely difficult to heal. Some practitioners use in such cases a lotion of honey, wine, and decoction of bark, but the simple saturnine lotion is often preferable. Turpentine cerate is useful as a dressing. Barege-water, though advised by some who think this disease approaching in character to itch, is not of much use. Sulphur and shower-baths are powerful agents in the cure.

Cooling drinks assist the effects of external applications. Barley-water, gruel, frog and chicken broths, acidulated fluids, and in fact every thing tending to allay irritation and excitement, as also mild saline aperients, and, if the stomach is disordered, emetics of the tartarized antimony, or of ipecacuanha, are necessary, after these bitters and antiscorbutics are resorted to. By these means our cases of cure in St. Louis are numerous. The several sufferers from this disease have a strong preference for cool and free air, they leave their beds early and expose themselves to the atmosphere as freely as possible, and find they obtain thereby a great mitigation of their sufferings.

Species VI.-CNIDOSIS, or URTICARIA, English-Nettlerash.

Nettlerash manifests itself on one or more parts of the skin in spots, or plates of pim

* We have much abridged the description of this case, and divested it of much of its loathsomeness. It is one of many descriptions of M. A. which have no parallel in this country. Trans.