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which operate in one of the ways stated above. Among others, he mentions external heat; and in confirmation of this opinion, he remarks that hernia has been observed by different travellers to be unusually frequent in hot climates. We doubt, however, whether there be sufficient evidence of the fact; and we think that the disgusting spectacles, which have been seen in those countries, rather prove the ignorance of the inhabitants respecting the method of treating the disease, or their inattention to such objects of wretchedness. Its frequency in England is much greater than any one would imagine from such a view of the inhabitants as could be obtained by merely passing through the country; and Mr. Cooper himself informs us that, in examining the bodies of old men, he has seldom found them entirely free from it.
According to the condition in which they exist, herniæ are divided into reducible, irreducible, and strangulated ; and the 5th chapter treats on the first of these species. This subject gives rise to some practical remarks on the employment of trusses, in which the author has occasion to turn to a valua. ble purpose his observation respecting the form of the passage through which the spermatic chord descends to the ring. The pad of the truss is generally applied over the abdominal ring itself: but, in order to prevent the future descent of the intestine, it ought to press on the aperture where it first leaves the abdomen.-Irreducible hernia is a less manageable complaint: but its increase may be prevented by the use of a bag truss; and by the gentle pressure which this application affords, a gradual absorption of the adipose matter is sometimes effected, and the tumour becomes at length capable of reduction.In the 7th chapter, we have an account of strangulated hera nia, and a detail of the symptoms which attend this formidable complaint. The author remarks that the inflammation is caused, not, as in most instances of inflammation, by an increased afflux of arterial blood, but by an obstacle being opposed to the return of the blood by the veins. For this reason, the strangulated part of the intestine assumes a dark hue, even in the early stage of the complaint, which to an inexperienced eye might suggest the idea that mortification of the part had already ensued. The stricture does not, as is commonly imagined, always exist at the ring, but may take place at the aperture mentioned above, where the intestine first leaves the abdomen; and Mr. Cooper observes that it is only when existing in this situation, that it can be affected by spasm : the ring, being composed altogether of tendinous substance, is not capable of this action. Chapter VIII, on the treatment of strangulated hernia, is
one of the most valuable in the work; abounding with mia nute practical observations, the result of sound judgment, directed by ample experience. The means on which Mr. Cooper chiefly depends, for the reduction of the hernia, are the tobacco glister, and the application of ice. These remedies, however, too frequently fail of the desired effect, and a surgical operation is then the only resource: which, although generally regarded as of the most formidable nature, is represented by Mr. C. as by no means necessarily hazardous, but to derive its chief danger from being too long deferred. When. ever, therefore, the means for reducing hernia have been unsuccessfully adopted, the knife should be used without farther delay. Unfortunately, we know not any criterion by which the practitioner can determine the exact state of the diseased parts : but the author apprehends that, when the abdomen. becomes tender and painful on pressure, we have reason to fear an inflammation of the peritoneal cavity, and consequently must augur unfavorably of the event.
In the roth chapter, the operation itself is described, Mr. Cooper advises that the abdominal ring should be divided on the outside of the sac, and that the incision should be made directly upwards, in preference to the usual method of upwards and outwards; since by this means we are certain of not. injuring the epigastric artery, however it be situated with respect to the hernia. When, on opening the sac, the intestine is found to be in a gangrened state, critical as must be the situation of the patient, the case is not absolutely lost :-besides the chance of his existing with an artificial opening in the groin, (a state however, of great wretchedness, and indeed almost more to be deplored than death itself,) it is possible to restore the natural condition of the parts, by cutting out the mortified portion of the intestine, and stitching together the ends, which will sometimes unite without much difficulty. Mr. C. gives an interesting account of some experiments performed on the intestinez of dogs by Mr. Thomson of Edinburgh ; whence it would appear that a transverse division of them is an operation from which they quickly recover, without any extraordinary symptoms of danger being produced ; while a longitudinal wound was attended with much more seri. ous consequences.
Chapter XII. gives some practical directions for the manage. ment of the patient after the return of the protruded parts. The author is decided in his opinion that all attempts at per forming a radical cure, by either cutting away or tying the sac, are not only useless but dangerous. The patient will, indeed, be more liable to the descent of the intestine than he D 2
was originally, in consequence of the enlargement which has been made of the natural openings; and it will therefore be necessary for him ever afterward to wear a truss. - We have next a description of some of the more uncommon varieties of the disease, particularly with respect to the situation of the epigastric artery and the spermatic chord; sometimes, the intestine descends on the inner side of the artery, and at other times behind the chord ; in each case, contrary to its usual direction.
In the last chapter, the author describes the well-known species of hernia called the congenital; and we have an account of a singular variety, in which the intestine, although lying within the tunica vaginalis, was still included in a proper
When this case was observed, it was thought to have been unique : but a similar occurrence was described by Mr. Hey of Leeds, a short time previously to the publication of Mr. Cooper's work.
From the report which we have given of this performance, our readers will perceive that it is possessed of first-rate excellence.
It unites, indeed, every qualification which can render it of value both to the anatomist and the surgeon; the descriptions are perspicuous, the practical directions are unembarrassed, and the style exhibits a specimen of that ele. gant simplicity which is peculiarly appropriate to books of science. Respecting one circumstance, however, we cannot with-hold our objections: we refer to the manner in which the volume is offered to the public. It is printed in very large folio, with magnificent type and paper; from its size, it is inconvenient to read, or to arrange in a library; and it is sold at the large price of two guineas. We have frequently deplored the prevailing taste for fine books, which enhances their price so much as to place them out of the reach of those who would derive most pleasure and profit from them : but we have seldom felt more regret than on the present occa. sion, when a work, which ought to be in the hands of every surgeon in the kingdom, is rendered inaccessible to the greatest part of the profession. The same remarks may be made on the plates as on the letter-press; they are large, and what would be called splendid; and we have no doubt that they are accurate, so far as the shape and size of the parts are conceroed: but, as anatomical engravings, we think that they are very indiflerent, since they are labored, heavy, and stilf, and .appear to us devoid of character and spirit.
Akt. V. Sermons or Education, on Reflection, on the Greatness of
God in the Works of Nature, and in the Government of the World, on Charity, and on various other Topics ; from the German of the Rev. George Joachim Zollikofer, Minister of the Reformed Congregation at Leipsic. By the Rev. William Tooke, F.R.S. Svo. 2 Vols. Pp. 600 in each. 11. is. Boards. Longman and Co.
1806. No preliminary
remarks on the general character and merits of M. Zollikofer, as a preacher and a writer, are necessary from us on the present occasion. He is already well known to our readers; who will be pleased to hear that these sermons are equally valuable with those which have preceded them from the same pen *, and display a similar intimate acquaintance with human nature. The same nice discrimination and animated devotion, the same good sense and appropriate diction, which prevailed in his former volumes, are also conspicuous in those which are now before us.
Agreeably to the title, several of the sermons treat on particular subjects: those on Education are six in number; those on Reflection, five: the number appropriated to the Consideras, tion of the Greatness of God in the Works of Nature and in the Government of the World is eight; and those on Charity, which conclude the first volume, are twelve. The discourses in the second volume are more miscellaneous, and are thirty-three in number : but the subjects to which the greatest attention is paid are Happiness, and the Holy Communion. This volume is concluded with a delineation of the literary, moral, and religious character of M. Zollikofer, in a letter from M. Christian Garve to a friend at Leipsic.
The Sermons on Education form a regular set of discourses on the subject, and are of great excellence. We are of opinion that were this part of the work published in a separate form, it would rank highly among the many treatises which have appeared on this topic; and on account of the many rules which it contains for the right formation of young minds, it would be a very useful manual for most persons. In proof of the justice of our commendation, we make the following selection from many passages equally meritorious, from which the reader may judge for himself:
• To the general rules prescribed in our former discourse, we will to-day subjoin a few that shall more especially relate to the chief particular virtues to which children and young persons should be trained up by those whose duty it is to form their hearts or their moral characters.
• The first of these rules is this : Inure them from their earliest infancy to obedience and submission. He that has not learnt this in his childhood and youth is unhappy for the rest of his life. All of us are occasionally brought into situations where it is necessary for us to submit, where we must comply, if we would not run counter to our duties, or bring harm upon ourselves and others. Either we must avoid human society altogether, renounce all its advantages and pleasures, and take up our abode in the holes of the rock, or the dens of the forest ; or we must sacrifice a part of our natural liberty to the security and quiet enjoyment of the rest, sulject ourselves to certain restraints, and alternately yield to each other. But how unfit must he be for this, who has, for ten, fifteen, or a greater number of years, unmolestedly followed his own inclinations, who has suffered no opposition, whose wishes for every thing he saw were so many commands uniformly submitted to by the blind indulgence of his parents and tutors, and who now all at once must adopt a quite different course of action! The time is arrived when he must make his entrance into the world. At every step he meets with obstructions. His wishes are scarcely noticed, while he expects to see all men running to fulfil them. They much rather openly oppose his desires and aims. His vanity and arrogance will be offended one while in this manner and then in another, but the disease is too inveterate to admit of a cure. Unfortunate man! Deplorable victim of extreme fondness and indulgence! How often, when once thou comest to reflection, how often wilt thou lament this eruel tenderness! How often wilt thou wish that thy parents, thy preceptors, had exerted their proper authority over thee, and taught thee obedience ! 0
ye parents, would you spare your children these sighs, these complaints, and the miseries that extort them; inure them to discipline, į say, 'to discipline, for by precept and exhortation alone you will never succeed ; exercise them in obedience and submission.' Allow yourselves to be easily prevailed on; frequently go before their requests when they ask for things innocent and good ; and shew them by facts how much you liave their real satisfaction and their real happiness at heart; but never should they obtain any thing from you by force ; never yield to their impetuosity or clamour ; let not the tears of stubbornness melt you to an ill-timed compassion. Enjoin them nothing without mature deliberation, without sufficient reason ; let the justice, the equity, the indulgence that is due to their age and weakness, be the rule of all your commands ; but when once you have delivered them, never think of a repeal, but absolutely insist on the most punctual and unreserved compliance; and let neither headstrong opposition, nor art ful flattery, move you to the revocation of them. Beware however of issuing too many, or too different orders at once. You will thereby lay an insupportable yoke on their necks, and in some meature compel them to disobedience; or you will make timid vassals of them, impatiently waiting for the moment when they may misuse their freedom without reproof or observation. Leave there. fore to their own option whatever is in itself indifferent and can have no prejudical influence on their morals ; and be content sometimes in furnishing eliem with useful suggestions and reasons by which they