Cornell University Library The original of tiiis book is in tine Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924031267713 Cornell University Library AMBULANCE SERMONS. Ambulance Sermons BEING A SERIES OF POPULAR ESSA YS ON MEDICAL AND ALLIED SUBJECTS BY jrAVmUSTIN, M.D. LONDON GEORGE REDWAY 1887. /l-zse^o UNSVERSiTY \ LIBRARY/; '-Weticntztr BY SPECIAL PERMISSION TO HIS GRACE THE DUKE OF SUTHERLAND, K.G., IN MEMORY OF MANY PLEASANT YEARS SPENT IN SUTHERLAND AS DISTRICT MEDICAL OFFICER TO HIS GRACE, AND AS A PERSONAL TRIBUTE TO HIS UNIFORM KINDNESS AND COURTESY TO HIS TENANTRY, AND HIS MANY LIBERAL EFFORTS IN THEIR BEHALF. PREFACE. Ambulance Classes, now so much in vogue, are an advance towards the diffusion of useful medical knowledge among the people — a worthy object, which until quite recently had been almost entirely ignored. In the winter of 1884-85, my colleague and partner, Dr Rice Oxley, of Streatham, organ- ized an Ambulance Class in Norwood, which was numerously attended. An important feature of this class was ^the prominence given to instruction in elementary anatomy and physiology, enabling the pupils to comprehend the principles on which medical treatment is based, and showing the undertaking to have been conceived in the spirit of a true practi- tioner, opposed to every semblance of quackery. Sir Andrew Clark, who addressed the pupils at the end of the course, complimented them highly on the way they had acquitted them- selves at the competitive examination. Subsequently, the author set his pen going viii Preface. in the same cause, and a series of papers appeared from week to week in the columns of the Norwood Review, under the somewhat anomalous title of "Ambulance Sermons," which are now offered to the public in the form of a volume. My thanks are due to the editor of the Norwood Review for throwing open his columns, in the name of philanthropy, to popular medical literature, and thereby risking the censure of those whom Sir David Brewster would charac- terize as " the timid and respectable body who dread innovation, and the scientific tyrants that threaten them with the penalties of knowledge." I am also indebted to my friend Mr Josiah Temple for invaluable assistance in the work of publication ; also to Canon Carver, Mr W. Hodgson, Mr R. Fogg, and Mr F. North, for their kind interest in the work. West Norwood Lodge, West Norwood, S.E. CONTENTS. CHAPTER I. Page How TO TREAT A COLD ON PHYSIOLOGICAL PRINCIPLES I How catarrh is produced — Treatment of catarrh. CHAPTER II. On the Preventive Tbeatment of Colds . Animal heat — Liability to cold from nervous causes — Excessive clothing as a cause of catarrhs-Draughts — Chills — Anomalous sensations during fever — Sudden changes of temperature — Cleansing of the skin — -Local irritants as a cause of catarrh. CHAPTER III. On Coughs, their Nature, Varieties, and Treat- ment ...... Difiference between symptoms and disease — ^Definition of cough — Varieties of cough — Cough not a disease but a conservative provision, and to be treated as such — Cough requires special treatment when accom- panied by fever — Irritant coughs — Sympathetic coughs. CHAPTER IV. Vis Medicatrix Naturae . , 33 Page 38 X Contents. CHAPTER V. Prognostics of Disease and their Interpreta- tion ...... Peculiar symptoms due to worms^Inspection of the tongue in illness — Appearance of the eye — Irregu-* larities of the sense of hearing as signs of disease— Dropsy an evil prognostic-^Signification of pain in the back — Pain in the side — Headache — Giddiness — Various effects of flatulence — Causes of flatulence — Importance of rigors as a prognostic. CHAPTER VI. Review of the Skeleton .... 56 CHAPTER VII. Bone and its Troubles . . . .66 Rickets — Bones become bfittle by age — How bone is nourished — Inflammation of the periosteum — Abscess of bone —Disease of bone called caries — Disease of bone called necrosis. CHAPTER VIII. Fracture of Bones ..... 72 Nature the great repairer of injuries — Different ways in which fractures may occur — Bones most liable to be broken — How to recognise fractures — Nature's and man's part in the cure of fractures — Importance of gentleness in moving and carrying patients — Instability of the human organism — Fracture of the bones of the forearm- — Mode of setting a fracture of the forearm — Fracture of the collar bone — Fracture of ribs — Fractures .of the skull. Contents. xi CHAPTER IX. Page , Lady Doctors and Nurses . . . -93 CHAPTER X. Dislocation of Joints . . . -99 Description of the shoulder joint — The perils of kiss- ing — Causes of dislocation — Reduction of disloca- tions — A simple method of reducing dislocations — Reduction comparatively easy if attempted soon after the accident — What happens if dislocations be left unreduced — Dislocation of the thumb very difficult to reduce. CHAPTER XI. The Ethics of Temperance . . . .107 Intemperance in eating — Alcoholic stimulants — Alcohol as a medicine — Alcohol as a beverage. CHAPTER XII. Work and Relaxation . . . .124 Work a natural and healthy function of mind and body — Evil effects of pursuing distasteful callings — Wearing effects of work on persons who are incom- petent for their calling — Influence of temper in determining the effects of hard work — Our bad habits are frequently responsible for a large share of the evils attributed to hard work — Young people's minds should not be overtaxed. CHAPTER XIII. Rabies and Hydrophobia . . . .136 Symptoms of rabies — Period of incubation — Treatment of bites of rabid animals — Pasteur's method of treating hydrophobia. xii Contents. CHAPTER XIV. Page On Gout ..-..■ i49 Symptoms of an attack of gout— Causes of gout— Why gout attacks the big toe specially— Internal gout — Remedial treatment of goijt- Preventive treatment of gout — Connection of gout viVh lead poisoning. CHAPTER XV. Curiosities of Gunshot Wounds . . . i6o Spent shot — Gunshot wounds produce little or no pain at the moment of infliction — Curious cases con- nected vpith the lodgment of bullets — Windage of shot — Poisonous properties formerly attributed to bullets and cannon shot — Remarkable velocity of falling shot^Multiple Vfounds produced by a single shot — Vitality of the British soldier — A remarkable instance of presence of mind in a wounded soldier — Proportion of hits to misses in warfare — Extraction of bullets — History of portable firearms. CHAPTER XVI. Method of Arresting Haemorrhage in Wounds . i8o Coagulation or clotting of the blood — The use of styptics — Cold water one of the best applications for ordinary incised wounds — Dangerous regions of the hand for cuts — Arteries bleed freely when cut across, but there is no danger of haemorrhage when torn asunder — The scalp and the face are rich in blood vessels. CHAPTER XVII. The Dressing of Wounds . . . • I9S Removal of foreign matter from wounds — How to control bleeding when examining a wound for Contents. xiii Page foreign substances — Methods of bringing the lips of the wound together, with special remarks on the use of sticking plaster — Importance of cleanliness in the treatment of wounds — Exclusion of air from wounds — Employment of antiseptics — Bandages not essential to the healing of wounds. CHAPTER XVIII. Management of Lacerated Wounds . . 205 Antiseptics specially required in dressing lacerated wounds — Plasters in lacerated wounds — Instructions for dressing a simple lacerated wound — -The smallest bridge of skin connecting a torn part with the rest of the body is often sufficient to make it grow on again. CHAPTER XIX. Punctured and Poisoned Wounds . . 209 CHAPTER XX. Contusions ...... 213 CHAPTER XXI. Constitutional Peculiarities of Babyhood . 215 CHAPTER XXII. Ignorance op Young Mothers on the Manage- ment OF Jnfants ... . 219 xiv Contents. CHAPTER XXIII. Page Questions relating to the Suckling of Infants BY THEIR Mothers .... 223 Hereditary disease disqualifies a mother for suckling — Excitable mothers should not suckle their infants — Nursing mothers should avoid gaieties — Nursing to be abandoned when the infant does not thrive — Particulars of feeding, as to frequency and quantity. CHAPTER XXIV. Hand-Feeding of Infants .... 234 Chief differences between cow's and woman's milk, and the method of adapting the former to infant feeding — Diet of infants during the first four weeks — Diet of infants one to four months old — Use of Swiss milk — Sudden changes of diet undesirable during teething — ^The order of eruption in teething — Simple precautions during teething. CHAPTER XXV. The Baby's Cries, and what they mean . . 249 Flatulence — Head affections — Bronchitis and lung inflammation — The fontanelle in disease. CHAPTER XXVI. Food ....... Classification of foods — Proteids — Fats — Amyloids — Minerals. 259 Contents. xv Chapter xxvii. Page Digestion ...... 263 Mastication — The teeth— Digestion commences in the mouth— A peep into a living stomach — Digestion in the stomach — The gastric juice— Perversion of gastric juice — Excess of gastric juice — -Diminution of gastric juice — Appearances of the tongue. CHAPTER XXVIII. Indigestion or Dyspepsia .... 280 Bilious attack — Three classes of dyspepsia — General causes — Causes referable to food — Causes referable to the stomach — Constitutional causes and tight lacing — General features of atonic dyspepsia — Diet in atonic dyspepsia — Medical treatment — A dinner pill — Hygienic treatment ^ Nervous sources of dyspepsia — Irritative dyspepsia and its treat- ment — Diet and clothing — Stimulants contrain- dicated in irritative dyspepsia — Nervous dyspepsia. CHAPTER XXIX. A Model Medicine Chest . . . .315 CHAPTER XXX. Outdoor Games and Pastimes 324 CHAPTER XXXI. The Skin as a Multiple Organ . . -331 Absorption through the skin — Regulation of animal heat by means of the skin. xvl Contents. CHAPTER XXXII. Page The Skin under the Microscope . . . 338 The epidermis — Structure of corns — Pigment. CHAPTER XXXIII, The True Skin or Derma .... 346 Sweat glands — Sensible and insensible perspiration— Diaphoretics — Sweat glands in fever — Effect of depressing emotions on sweat glands — A chill. CHAPTER XXXIV. Origin of Skin Diseases .... 354 Causes in the blood — Causes in the skin^Causes originating in the nervous system. CHAPTER XXXV. The Skin as the Organ of Touch . . .361 The tactile sense — Sense of temperature — Sense of pressure. CHAPTER XXXVI. The Hair and Nails ...... 369 CHAPTER XXXVII. Classification and Treatment of Skin Diseases 377 Ringworm — Scabies — Eczema — Roseala — Nettle- rash — Acne or pimples — Diet in skin disease. AMBULANCE SERMONS. CHAPTER I. HOW TO TREAT A COLD ON PHYSIOLOGICAL PRINCIPLES. If we analyze the life of this corporate body of ours, we shall find that it consists of a series of vital processes or functions, such as motion, alimentation, nespiration, circulation, innerva- tion, secretion, and excretion. They are distinct operations, though dependent on one another for their individual well-being, and that of the body to which they minister. There is nothing mysterious about these functions because they are vital, being conducted and governed by familiar forces and recognised laws. The purifying of the blood, for example, is a simple instance of combustion, the oxygen inhaled by the lungs seizing the molecular particles of used-up tissue, and burning them, evolving heat, carbonic acid, and water as the products of combustion. Digestion is a plain chemical process that may be imitated faithfully A 2 Ambulance Sermons. in the laboratory by the aid of pepsin, hydro- chloric acid, and heat. Absorption of nourishment by the blood from the stomach and intestines is conducted in obedience to a law of chemical physics called osmosis, and may be illustrated by an animal membrane stretched between two fluids of different densities. Excretion by the skin and kidneys is nothing more mysterious or complicated than the simple process of filtering. When we come to the functions of the nerves and nerve centres, though we know well how they behave under varying conditions, and though we have a vague idea that they are allied to the phenomena of electricity, we cannot- find their true counterpart in the inorganic- world, and consequently cannot readily explain them. When we come to the all-mysterious will, the fountain-head and origin of every voluntary act, the primum mobile of volitional power, we are fairly beyond our depth. We know enough, however, of our fearful and wonderful structure and its mechanism, to enable us to appreciate the ordinary ailments of life, and relieve them by rational modes of treatment. How Catarrh is produced. — The morbid con- dition, familiarly known as " a cold," and tech- nically called catarrh, is an illustration of the mutual dependence of the various functions on one another. We have little idea of the bnorth- How to Treat a Cold. 3 ening chain of disturbances clinging to the most ordinary ailments of life. Like the undu- lations of air when sound vibrates through space, or like the ever widening circle of ripples when a stone is dropped into water, the slightest disturbance of molecular arrangement in the economy by disease, affects even remote parts by the contiguity of close mutual dependence and sympathy. When we catch cold, it is through the medium of the nervous system that we become affected. The great producer of catarrh is cold ; not absolute, but relative cold. The estimation of cold varies in each individual case, and at different times in the same case, according to two important con- ditions.' The first is the degree of temperature to which any particular body has habituated itself For instance, a person who has lived much in tropical climates will estimate cold differently from one who has spent all his life in Northern regions. This may be illustrated in another way. Take three basins. Fill the first with very hot water, the second with tepid water, and the last with ice-cold water. Dip your hand in the first basin for a moment, then transfer it suddenly to basin No. 2, containing tepid water, and the latter will feel cold by contrast. But if the hand be kept awhile in the ice-cold water and then transferred to the tepid water, the latter will feel v/arm. 4 Ambulance Sermons. The second condition is the state of the nervous system at the time. Even natives of cold climates, if they feel depressed, or fatigued, or out of sorts, are apt to feel the cold more acutely at such times. We shall treat more particularly of relative cold and nervous condi- tions, when we discuss the preventive treatment. The action of cold on the skin causes an impression on the nervous system, which is con- veyed to the cutaneous arteries, causing them to contract, checking the supply of blood to the skin, and consequently diminishing evaporation through the sweat glands. • When we take into consideration that the skin is one of the great eliminators of the body — that is, a medium through which waste matter is thrown out of the body — we can readily understand the gravity of having its functions impaired, whereby dele- terious substances, are retained in the blood. Surgeons are familiar with the fact that in burns, the danger of a fatal issue is not in pro- portion to the depth of the . injury so much as the extent of "the skin involved. If the burn is extensive, it means that a large area of eliminat- ing surface is hopelessly destroyed, and that a proportionate amount of morbific material is thus retained in the blood. Unable to leave the body by its natural outlet, the noxious matters expend themselves through the intes- tines, setting up fatal diarrhoea. Hence diar How to Treat a Cold. 5 rhoea setting in some days after an extensive burn, is a symptom of the worst omen. Why the excretion should invariably select the mucous membrane of the intestines under such circumstances, is one of the things we cannot explain. Again, when during convalescence from scarlet fever, the epidermis or outer skin is peeling off, the tender denuded underlying structure is very apt to be affected by cold and have its functions suddenly checked. When this happens, the cutaneous excretion does not expend itself through the intestines, as in the case of burns, but through the kidneys. The burden is in this instance thrown on them, and inflammation of the kidneys and dropsy follow in consequence. Hence the great necessity of specially guarding against cold after scarlet fever. Amongst the poor people, whose children run about bare- footed as soon as they leave their beds after a scarlet fever attack, it is very common to find swelled limbs and bodies, with pallid puffed-up features, like so many little old men and women in the last stages of Bright's disease. Why the intestines are chosen in the one instance and the kidneys in the other, as the collateral channels of cutaneous excretion, I cannot ex- plain. When the functions of the skin are partially checked by the action of the cold, the regions that most usually suffer in consequence 6 Ambulance Sermons. are the mucous membrane of the nose, throat, and other parts qf the respiratory tract, which become more or less inflamed, relieving them- selves by a discharge of mucus. Here again we cannot explain the elective principle which selects this region for the defluxion. Catarrhs, however, are not confined to the respiratory passages, but may attack any organ affording an outlet, such as the stomach, kidneys, lungs, and bladder. Treatment of Catarrh. — Now having before us tke combination of circumstances producing a cold, let us indicate briefly the principles of treatment ; only principles can be given. Hard and fast prescriptions can only be given with the particulars of each individual case before us ; but principles are applicable to every case. The quack sits, so to speak, on a particular branch of treatment. The true practitioner, on the other hand, commands the trunk — the principle — whence issue all the branches. The first thing to be done is, to aff'ord suitable protection to the skin against cold, by warm clothing, avoidance of undue exposure, and, above all, sudden changes of temperature. Gentle exercise should be taken, but fatigue depresses the system, and must be avoided. The second indication is to try and restore the functions of the skin and relieve the congested mucous membrane, by warm baths, warm drinks. How to Treat a Cold. 7 and medicines, such as Dover's powder, which promote perspiration. The addition of alcohohc stimulants to warm drinks is a mistake, as stimulants are contra- indicated in acute febrile conditions. The third indication is to soothe the inflamed mucous membrane, by some simple emollient, such as glycerine jujubes, the glycerine and gum being admirably adapted for lubricating the parts which otherwise would be dry and harsh. It is only in the early stages that a cold can be cured. If the discharge of mucus be once fairly established, it is idle to attempt to cure. The cold must then be left to expend itself, a process which occupies more or less time, according to the peculiarity of the patient's constitution and other circumstances, the treat- ment being confined to protecting the skin, and treating symptoms as they arise. Cough mixtures are useful remedies, when chosen with discretion, to suit the peculiarities of each case ; but aggravating and distressing compounds when chosen haphazard and recklessly by the ignorant. Sedatives, expectorants, and demul- cents have their respective uses, which should be duly recognised in connection with the nature of the cough to be allayed, and there is no such thing as a mixture or preparation to cure all coughs, except in the flaming advertise- ments of quacks and speculative chemists. 8 Ambulance Sermons. When the throat feels dry, hot, and irritable, when the head aches, when vague sensations of creepiness, lassitude, and thirst tell you that you are " going in " for a cold, as it is commonly phrased, then is your moment for active treat- ment. But if you delay until the catarrh is established, and you are partially recovering from the premonitory symptoms above referred to, then you have lost your chance of curing the cold, in the sense of cutting short its course. The preventive treatment of colds is a more important and pertinent matter, and will form the subject of the following chapter. CHAPTER II. ON THE PREVENTIVE TREATMENT OF COLDS. In common with birds and a large class of the animal kingdom known as mammals — i.e., animals whose females suckle their young — man is called a. warm-blooded animal. By the term " warm-bloo(Jed animal " we mean one that possesses within certain limits the peculiar capa- city of maintaining a uniformly high tempera- ture in its body, independent of that of the air or other medium by which it. is surrounded. For instance, whether a man is exposed to severe cold in winter, or to excessive heat in summer ; whether he lies immersed in a bath of cold or hot water, the temperature of his blood remains the same. It never varies, or only does so within very narrow limits. This is a remarkable fact, as, apart altogether from external in- fluences, the constant supply of heat to the blood by the oxidation of disintegrated tissue, and certain elements of food which have not been converted into tissue, which goes on during every moment of our lives, must alone tend to raise its temperature. It does not do so, how- lo Ambulance Sermons. ever, and the explanation' of this phenomenon of animal heat, on which so much of our subject hinges, I shall presently explain. Cold-blooded animals, on the other hand, are those whose habitual temperature is low and inconstant, varying with the changes in the temperature of the surrounding medium. Fishes, amphibia, and reptiles belong to this class, as well as the myriads of beings in the lower forms of life, with the exceptioh of two sub-kingdoms which have no proper blood system, and can hardly be spoken of as cold- blooded. Animal Heat. — The warmth of our bodies is mainly derived from the union of inspired oxygen with the carbon and hydrogen of waste tissue, a chemical process essentially the same as that of the burning of coals, and, like the latter, evolving heat during its combustion. There is no stationary condition in living tissue. Decay and renewal are the essence of life. The primordial cells of which the various parts of the body are built up are constantly dying, and new ones drawn from the blood are as regularly taking their place. Every act of inspiration, every beat of the heart, every word we utter, every sigh we breathe, is an expenditure of structural matter. The debris composed of dead and unused structures is swept away by the blood currents, from which it is removed by On the Preventive Treatment of Colds. 1 1 oxidation, tlie heat evolved being utilized, an"d the other products of combustion, carbonic acid and water being expelled by the lungs. The income of animal heat being chiefly de- rived from the combustion of used-up tissue, we can easily understand that the supply, though constant, must needs be very irregular. On taking, exercise, for instance, there must be increased waste of tissue, and consequently more heat evolved, which, as we know by ex- perience, is actually the case. In the case of hybernating animals, on the other hand, the degeneration of tissue and the evolution of heat must be reduced to its minimum. And yet, the mean temperature under these extreme con- ditions is practically the same, viz., 98-5° F., or thereabout. The regulation of animal heat is one of the most interesting phenomena in physiology. The superfluous heat is disposed of by con- duction and radiation in the capillaries of the skin, and by evaporation through the sweat glands and air passages. Hence, after severe exertion we find our breathing accelerated and the skin moist and warm. In some animals, such as dogs, in whom the skin does not act with the same freedom as in man, the bulk of the exhalation takes place through the lungs, causing them to pant. Thus the balance is maintained. • These functions, again, are under 1 2 Ambulance Sermons. the immediate control of the nervous system. Cold acts on the latter in such a way, that the vessels supplying the skin are constricted, and the flow of blood to the surface checked, loss of heat by conduction, radiation, and evaporation being thus prevented ; while heat, on the other hand, relaxes the blood vessels and favours the escape of heat from the body. By means of this exquisite self-regulating ap- paratus, therefore, and the artificial aids of fires and warm clothing, we are enabled, amid the varying conditions of our body, and the capri- cious operation of external influences, to maintain a pretty uniform animal heat. But, in spite of all, irregularities will sometimes occur ; and the most lenient penalty we are made to pay for failure or violation is a cold in the head. Generally speaking, the human constitution is a forbearing mechanism, and will long and patiently endure the abuses to which the frail- ties, follies, and vices of man often subject it, before it resents. It will even connive at his errors by brave efforts to repair or make com- pensation for the mischief they have wrought. In heart disease, for instance, when the valves ©f that organ are diseased and the pumping of the blood embarrassed, the muscular walls acquire increased thickness and power to enable them to overcome the difficulty. When a joint is dis- located, and no attempt made to reduce the dis- On the Preventive Treatment of Colds. 1 3 location, the head of the bone in process of time sets about making a joint for itself in its new situation, making the best of the misfortune and accommodating itself to its new surroundings. The intemperate man's liver and kidneys do not usually succumb in a year or two to the toxic effects of alcohol, but long years of patient pro- test precede the final breaking up. Bullets lodged within the body often become enclosed in a fibrous case, which compassionate Nature patiently weaves round them, and they cease to give trouble. If a particle of foreign matter enter the nose, windpipe, or stomach, does Nature complacently permit the intruder to remain and set up injurious if not fatal inflam- mation in these parts .' On the contrary, she promptly resents its presence, and by violent sneezing, coughing, and retching, exerts herself to reject it. Such is faithful, generous, patient Nature. It is we, or the anomalies of our artificial life, that are usually to blame for the aches and ailments which haunt our lives. Modern medicine is a comparatively precise science, and the suffering humanity of the pre- sent day are much better off than their grand- parents in the resources of the healing art. But better even than good doctoring is the art of preventing disease, and strangely enough, this branch of medical treatment — the most im- 14 Ambulance Sermons. portant in a sense — seldom comes, or is seldom brought under the direction of the physician, whose chief function is apparently confined to drugging. Let each person therefore, by famili- arising himself with the leading principles of Physiology, and applying them to the rules of daily life, constitute himself his own preventive doctor. Liability to Colds from Nervous Causes. — The mode in which animal heat is generated and regulated being clearly understood, the rules for the preventive treatment of colds lie in a nut- shell. First, then, we shall speak of the Nervous System, as the most important factor in heat regulation. It is an essential condition for the due administration of animal heat, that the nervous system be in a healthy condition. If it be irritable and respond too readily to external impressions, or sluggish and slow to convey stimuli, it equally operates in vitiating the orderly government of this important depart- ment. For instance, a person with a feeble or disordered nervous system is easily thrown into a state of uncomfortable heat or perspiration, because enfeebled nerves are incompetent, to control the supply of blood to the surface capil- laries. The consequence of that again is, that he is apt to be chilled and to take cold by ftie rapid evaporation of the moisture on the skin. Due attention, therefore, to the state of the On the Preventive Treatment of Colds. 1 5 nervous system is the first aphorism in the pre- ventive treatment of colds. Fresh air, exercise, and nervine tonics are the best remedies for strengthening the nervous system, while all enervating influences, such as late hours, over- indulgence in alcoholic liquors, undue exertion of mind and body, excessive smoking, worry, anxiety, and depressing emotions are to be avoided. When depressed and out of sorts from any cause, the liability to take cold is increased, and special precautions should be taken to protect the body from cold when ex- posing ourselves at such times. As we have said in a previous chapter, what we have to cope with is, relative cold as measured or estimated by our varying nervous perception, and not the actual condition of the atmosphere as indicated by the thermometer. If our nervous system is depressed, our power of resisting cold is lowered, and it is the same thing practically, whether the attacking force is augmented or the prey enfeebled. Excessive Clothing as a cause of Catarrh. — Excessive clothing should also be avoided as a fruitful cause' of colds. By piling too many clothes on us, an undue amount of heat accumu- lates on the surface, compared with which, the temperature even of ordinary air is relatively cold, and a chill is the result. This error should Le especially avoided by those v;ho lead active 1 6 Ambtilance Sermons. lives, or who habitually undergo severe bodily- exertion, for under these circumstances too large a quantity of sensible perspiration accumu- lates on the skin, the rapid evaporation of which robs the body of an undue amount of animal heat. Draughts. — Draughts are dangerous, and should be carefully avoided, as the cold current causes the body to give up its heat very rapidly. Damp clothes are perilous from the rapid evapo- ration they induce. Going out into the cold air after partaking of stimulants is a pernicious practice, though regularly resorted to by many people under the false impression that it is a pro- tection against cold. It is a perfidious fallacy. The effect of alcohol 'is to dilate the surface capillaries and to produce a sensation of warmth, this sensation being derived from the cutaneous nerves. The capillaries being relaxed, loss of heat goes on unchecked, and the internal organs are fast getting chilled, while the cutaneous nerves lull us into a treacherous sense of security, by conveying an empty sensation of warmth to the brain. When the action of the alcohol is spent and the bloodvessels of the skin — the capillaries — are empty, when the cutaneous nerves are no longer stimulated, we suddenly realize our true condition, and from a state of exalted complacency, we fall to shivering and chattering. On the Preventive Treatment of Colds, i 7 Chills. — Why are we apt to catch cold, if we sit or stand about in the cold when we are warm and perspiring, or after getting wet ? Because we allow too great evaporation' ; and everybody kijows that heat, in passing from moisture to vapour, is lost by becoming latent. . By walking about or exercising our muscles in some other way, we bring about increased waste of tissue. In other words, we add fuel to the fire, increase the heat supply, and thus make compensation for the incidental loss. Anomalous Sensations during Fever. — Let me here say a few words on fever. In fever the temperature rises considerably, the skin feels hot, and the thermometer placed in the armpit shows an actual rise, ranging from 1° to 7° or more over the normal heat. But the sensations of the patient are those of cold. He complains of creepiness and shivering and begs for more coverings This is an apt illustration of the fact that our sensations are no true criterion what- ever of the actual temperature of the blood. The explanation is this, that in fever, the capillaries of the skin are empty, and conse- quently the cutaneous nerves, which are the real media through which sensations of heat and cold are conveyed to the brain, receive the negative impression of cold, and it is perceived by the brain as such. The moment the capillaries become charged, perspiration sets in, the sensa- B 1 8 Ambulance Sermons. tion of cold disappears, and abnormal heat begins to subside. One of the principal indica- tions in the treatment of fever therefore is to promote perspiration. Sudden changes of temperature are to be avoided on account of the risk of collapse of the whole heat-regulating apparatus by shock. Cleansing of the Skin. — The orifices of the sweat glands, popularly called the pores of the skin, are liable to become clogged by the accu- mulation of dried excretions and particles of dust acquired from the air and clothing. Fre- quent bathing is therefore necessary to remove these and to preserve the potency of the minute apertures for free exhalation of moisture. To those who can stand it, the daily use of the cold tub is a powerful preventive, by inuring the skin to cold and bracing the nervous system. Local Irritants as a cause of Catarrh.—^ Catarrhs are also induced by the direct effect of certain substances on the mucous membrane of the throat and air passages. Breathing very cold air may thus produce catarrh by its local effect on these parts. Minute particles of wood, steel, cotton, wool and other substances are, by their mechanically irri- tant effect, capable of producing the same morbid condition of parts as that which characterises what may be called reflex or re-actionary catarrL The use of ardent spirits, especially in a con- 0?i the Preventive Ti'eatment of Colds. 1 9 centrated form, immoderate smoking, and exces- sive use of the voice may also be classed among the direct irritant causes. They induce a state of chronic congestion in the throat and its neighbourhood, which is ready on the slightest provocation to kindle into acute inflammation. Persons with weak hearts have a special tend- ency to catarrh, on account of the congestive troubles accompanying deficient heart action and a sluggish circulation. More often, however, the catarrh induced by heart affections, deviates into the stomach ; and some of the most intract- able forms of dyspepsia that medical men have to cope with, are those associated with heart disease. In conclusion, the best protective against colds is, to cultivate such habits and to adopt such modes of life, as tend to harden, invigorate and brace the system, and to avoid effeminacy, silki- ness, and coddling. CHAPTER III. ON COUGHS— THEIR NATURE, VARIETIES, AND TREATMENT. Consistently with my object in designating these essays sermons, I shall take occasion to refer to certain important truths in connection with my subject, and endeavour to deduce from them the practical lesson I wish to convey. It will be the aim of the author, not merely to lay down rules for the guidance of his readers, in matters relating to health, but to explain the principles on which they are framed, entering briefly on such scientific points only as may be necessary to elucidate the subject. Difference between Symptoms and Disease. — The lesson I desire to inculcate on this occasion is, the importance of distinguishing between symptoms and disease. It may be surmised that I am imposing on myself a gratuitous task — that the distinction is obvious and unmistakable. But it is not so. In the popular mind at least, the error is frequently made of mistaking symp- toms for disease, with what results we shall see hereafter. Let me give a few instances. Para On Coughs. 21 lysis is generally regarded as a disease. It is however not a disease, but a symptom. Paralysis is most frequently the result of apoplexy, where the pressure on the brain of effused blood, ex- tinguishes the functions of all those nerves which issue from that portion of the brain injured by the pressure. The disease is in the brain, of which the limb bereft of motion and sensation, is but a manifestation or symptom. Dropsy also is usually reckoned a disease. If one is told that such and such a person is suffer- ing from dropsy, it invariably satisfies the en- quirer, though dropsy is nothing more definite than the symptom of at least five different diseases, viz., heart disease, Bright's disease of the kidneys, liver disease, disease of the peri- toneum, and certain diseases of the blood. We also hear jaundice spoken of as a disease, but the real disease to which the term refers is an affection of the gall duct, of which jaundice is the prominent symptom. Palpitation, a disease par excellence in the estimation of timorous females and morbid hypochondriacs, may be the symptom of nothing more than excessive indulgence in tea or immoderate use of tobacco, or it may be the ominous signal of distress of a heart sinking under the ravages of disease. Colic, another painful condition claiming the title of disease, is the writhings of the intestines labouring to expel irritant matter. 2 2 Ambulance Sermons. The great difference between disease and symptom is, that the former invariably implies derangement or deterioration in some degree or form, whereas the latter is in the majority of instances the exhibition of a conservative process. I do not say that it is always so. A symptom may be simply a coincidence or sequence of disease, without having any special signification, or a collateral disease may be called a symptom from association. As a rule, however, what we usually call symptoms, will be found to be the result of certain conservative processes or reactions, which Nature sets up to counteract the evil effects of disease. Let me give one or two examples : — Blood poisoning is a disease. What are its leading symptoms } Excessive action of the heart is one, i.e., the effort of this organ by increased labour — by contracting 120 to 150 times in a minute, instead of 70 to 80 times, as in health, to expel the injurious substance from the blood ; for the more rapidly blood circulates, the quicker it is likely to get rid of offending substances in it, through the excretions. This symptom there- fore is the result of a conservative process. Excessive sweating is another symptom of blood poisoning, and is the effort of another member of the economy, the skin, to do its own share of work in repelling the enemy. Sick- ness and diarrhoea are also symptoms, and are On Coughs. 23 the contributions of the stomach and intestines respectively, towards the- same conservative o'bject. When any danger threatens the purity of the blood, the excretory organs, like the members of a united clan, combine in common cause against the intruder, each doing its utmost to drive the malignant foe from the peaceful fold. Take again heart disease, the variety we will suppose, known as valvular disease, where, as a result of rheumatic fever, the valves of the heart are injured and the due propulsion of the blood through its cavities embarrassed. This is the disease, and a most serious one it is. How does Nature act on this emergency .■' Does she look on with folded hands while the crippled organ, overwhelmed with its troubles and faint with futile resistance, threatens to succumb. It would be very unlike her if she did. True to her temper, she comes to the rescue, and in view of the increased demands on the heart's action, endows it with more muscle, taking for her motto, " As thy need, so shall thy strength be " — ^just as Government sends out reinforcements to meet a military contingency. How much truth there is in Emerson's words, "it takes as much life to conserve as to create," we have an opportunity of judging by the evidences here adduced. Increased power is employed to overcome the i24 Ambulance Sermons. obstacle, and the subjective symptom we call palpitation, is the sehsation of this conservative action of the heart. Shortness of breath — another symptom of . heart disease— is the struggles of the lungs to overcome a mechanical difficulty produced by obstructed circulation and a congestive state of those organs. Cough is another symptom, and is an attempt on the part of Nature to clear the bronchial tubes of the mucous products of congestion. Dropsy, another leading symptom, is a result of obstruction of the circulation and consequent stagnation of the blood in the veins, the fluid portion of the blood oozing out into the tissues, and thus relieving itself of the abnormal hydraulic pressure. Jaundice is produced when, from any cause, such as inflammation or the impaction of gall stones in the gall duct, the bile or gall is obstructed from flowing into its natural outlet, the intestines, and the pent-up matter seeks relief by escaping into the blood, tinging it with its peculiar colour and imparting its character- istic yellow hue to the skin through which it circulates. Colic, as we have said before, is caused by the spasmodic contraction of the in- testines in their endeavour to expel undigested and irritant matter. Pain itself, the cardinal symptom — the symptom of symptoms — is the On Coughs. 25 greatest conservator and guardian of animal life and health. It promptly warns us of approach- ing danger — as we know from our acute sensa- tions on the slightest burn, when otherwise we might be charred to the bone before perceiving the injury — and when rest is essential for the recovery of an injured limb or a diseased organ, pain compels us by a power we can ill afford to resist, to refrain from movement. Now I think I have said enough to show that the symptoms of disease may be accepted as the expression of a conservative reaction, to meet the contingencies of such disease. This being so, it becomes a matter of vital import- ance not to mistake the one for the' other, and to treat symptoms instead of disease. By so doing, we oppose the wise dispensations of Providence, alienate our best ally. Nature, and by our officiousness and bungling, make the last state of our patient infinitely worse than the first. Definition of Cough. — Let us now ask our- selves, what is cough } How the hapless martyr to it would smile scorn at the question ! It is enough for him to feel the irresistible impulse convulsing his sides and fretting his frame, breaking through his slumbers and mak- ing night as well as day a torment grievous to be borne, without waiting to ask, " What is cough ? " arid getting for answer, the miserable 26 Ambulance Sermons. crumbs of comfort contained in a scientific definition. His wretched experience tells him too well what cough is, and the nearest chemist's shop, where he could purchase a moment's stupor from Paregoric Elixir, is his chief concern, and speculative science may go to the winds. Cough is the result of a combination of muscles acting together to expel some foreign substance irritating the air passages. It is essentially a conservative act for maintaining these passages free for the entrance and exit of air. It is a symptomatic phenomenon, and not a disease per se. Coughing is an involuntary or reflex act. " We call it involuntary, because it is independent of the will. If Nature left these conservative processes to be regulated by the will, it is a question whether they would be conducted with the same promptness and efficiency as under the existing, arrangement. We might lose our presence of mind on an emergency, or when danger threatened them, we might fail to realise the peril. Even though we did, we certainly could not adopt means more energetic than those wisely ordained for us, and planted beyond our control. We call it reflex, because the impression of irritation is conveyed by the sensory nerves to the nerve centres, and there bent or turned back, as it were, into the motor nerves controlling the On Coughs. 27 group of muscles exercised in the act of cough- ing, without any reference to the will. The act of breathing is another example of involuntary or reflex action. The sensation of want of oxygen is conducted to the nerve centres, and thence to the motor nerves supplying the muscles called into play in the collective act of respiration. If the function of respiration were left to the direction of the will, we should probably forget to breathe when our attention was absorbed in other matters, and it would be utterly neglected during sleep, when the will is dormant. It would never do to leave functions of such vital importance to the mercy of an erratic and capricious will. Nature, therefore, wisely removes them from our management, and places them under automatic government The most frequent cause of cough is the accu- mulation of expectoration in the air tubes. Varieties of Cough. — There are a great variety of coughs, which may be grouped according to their character and source. Thus, a dry cough is one that is unattended by expectoration, and a loose cough is one accompanied by expectoration. A hard metallic or brassy cough is one in which the vocal cords are affected, the vibration of which, during the act of coughing, produces the peculiar ringing sound, as in croup. Irritable coughs are those which result from tickling or irritation of the passages by an elongated and 28 Ambulance Sermons. relaxed uvula, or from the hypersensitiveness produced in the mucous membrane, during the first stages of inflammatory catarrh. The bark- ing cough is usually the result of hysteria or nervousness, confirmed by habit, and is almost exclusively a complaint of timid, sensitive young females. There is also the stomach cough pro- duced by long continued dyspepsia, the stomach, the lungs and air passages being intimately con- nected through the medium of nerves. Certain diseased conditions of the liver, the gall duct, and brain, are also admitted by eminent medical authority to give rise to coughs through the complex sympathy of nerves. A hollow cough is so called on account of a certain resonance, which characterises the cough when the lungs are extensively diseased by consumption. The spasmodic cough is one where the spasmodic element unduly preponderates over voluntary effort and causes a paroxysm. Irritable con- ditions of the nervous system often tend to pro- tract these coughs long after the original causes have been removed. Whooping cough is charac- terised by a whoop, which is caused by air rush- ing in through a spasmodically closed windpipe after a fit of coughing. A single sharp cough is characteristic of the disease we call Pleurisy, where the pleura — the membrane covering the lungs and lining the chest walls — is inflamed, and is of great assistance to the physician in On Coughs. 29 diagnosing the disease. It also occurs in the first stages of inflammation of the lungs and consumption. Cough not a Disease but a Conservative Provi- sion, and to be treated as such. — Seeing, then, that cough is a distinctly conservative act, we must be careful how we check it. Our inter- ference must be confined to moderating its in- tensity, when it is excessive and out of all proportion to the occasion. In cases where the bronchi are loaded with expectoration, if we administer powerful remedies such as opiates, to check the cough, the result might be fatal, especially in old people and young children. Nature's efforts to get rid of the offending material being checked, the minute tubes be- come clogged and impermeable to air, leading to failure of respiration, collapse of the air cells and death from suffocation. Such is an example of the danger of treating symptoms instead of the disease. When children are distressed with an abundance of mucus in the bronchial tubes, as they have not the sense to aid the natural impulse by voluntary efforts to expectorate, the most efficient remedy is to administer an emetic, which effectually clears the tubes. The best emetic for children is a teaspoonful of ipecacu- anha wine in sweetened water administered every quarter of an hour until vomiting takes place. In old people the tendency is generally 30 ' Ambulance Sermons. to exce;ssive secretion from feebleness of the sys- tem. , In their case, it is usual to combine ex- pectorant medicines with astringents to check excessive secretion, and tonics to give tone to the system. If narcotics are given to allay cough in the foregoing cases, while the tubes are loaded, the results are certain to be disastrous. Cough requires Special Treatment if accom- panied by Fever. — The first thing to do before administering remedies for cough, is to ascertain whether it is accompanied by fever. This can only be done with the help of the thermometer. Acute bronchitis is always attended with in- crease of temperature ; and when fever is present, the use of the ordinary mixtures tends invariably to aggravate the cough and increase general distress. Ipecacuanha wine is the only remedy which may be used safely for the relief of cough irrespective of the presence of fever. It may be taken in five-drop doses, diluted with a tea- spoonful of glycerine and a little water, every three hours. For children, smaller doses will be required, say, two or three drops ; and there is no safer nor more appropriate medicine in the whole Pharmacopeia. Mothers can never err in administering it to their children, if they do not desire to have medical assistance. In bronchitis also this is a correct remedy, supple- mented by the use of linseed poultices to the chest in adults and older children, and to the On Coughs. 31 back and chest in very young children, the bulk of the lungs in the last being situated at the back beneath the shoulder blades. To allay irritation and preserve the mucous membi-ane of the throat in a moist condition, glycerine jujubes may be used. If fever be known to be present, the ipecacuanha may be com- bined with small doses of sweet spirits of nitre, or a few grains of nitre dissolved in water. If the fever abate by the employment of these remedies, the cough also frequently subsides without special remedies to allay the latter. The disease being cured, the symptom also usually disappears. But cough often remains by sheer force of habit after the exciting cause is removed, and then we have no hesitation in taking prompt measures to check it. A cough mixture usually consists of a combination of an expectorant with a narcotic, and the different varieties of drugs used and the number of ingredients employed are legion, varying with the necessities of each case and with the ideas of the prescriber. When ex- pectoration is excessive, it is useful to employ acids. Even raspberry vinegar or lime juice often serves the purpose. Irritant Cougfis. — The class of irritant spas- modic coughs must be treated by different remedies, such as chloral, morphia, prussic acid, chloric ether, opium, &c., combined with a 32 Ambulance Sermons. demulcent, such as dissolved gum or glycerine, the latter remedies being also useful by their mechanical property of clinging to the parts about the throat. Sympathetic Coughs. — Those coughs again, which are the sympathetic signs of disorder in the stomach and liver, must be attacked by treatment directed to the relief of those organs. CHAPTER IV. VIS MEDICATRIX NATURE. He takes an ignoble view of the medical craft who imagines that the whole duty of doctors consists in administering physic. The part which drugs play in a course of judicious, thoughtful treatment is often a comparatively minor one. The first duty of the physician is to study nature — to comprehend her in all her attitudes and all her moods, to sit meekly at her feet and learn patiently the lessons she teaches ; to administer to her in want and woe ; to soothe, to encourage, to guide, to check and otherwise assist her, as occasion demands ; and medicine is only one of the agents employed in this service. Nature is the great restorer, ncit man. Not physic, but Nature glazes and seals the bleeding surfaces of an incised wound, or throws out healthy tissue to fill up the gaps and jagged cavities of a corroding ulcer. Not the pills and potions of learned doctors, but Nature with healing in its wings, hovering over the sick one, cools the fevered brow, and brings the glad tidings of dawning health to the weary sufferer. C 34 Ambulance Sermons. Who nurtures the creeping thing, the denizen of the air and of the waters, when it is wounded — the wild beast licking its wounds in its solitary- lair, or the luckless bird as he hobbles away on one leg, the victim of some cruel boy's sport ? Is there no balm for the sufferings of these humble creatures, apart from that which flows from the Royal College of Physicians or the Apothecaries' Hall ? Must they lie down and die, these forlorn and friendless fellow-sufferers, because, forsooth, there is no surgeon at hand with lint and with balsam to bind up their wounds, or a physician with his omnipotent draught and pill to lull their pains ? They have better attendance, these protigis of Nature, in a sense, than the patients of an erring Faculty. The most skil- ful, the most experienced doctor, may err, and he is not the last to own his fallibility; but Nature is infallible. As soon may we look for the subversion of the laws of attraction — . which impartially regulate the grand move- ments of the heavenly bodies in their respective spheres, as well as that of the tiny drop of fluid ascending in the capillary tube — as expect Nature to fail in the fixed laws which govern the natural and unaided healing pro- cesses. Where failure occurs, it is attribut- able to extrinsic conditions unfavourable to Nature and thwarting her designs. None can accuse her of being false to her principles. Vis Medicatrix Naturce. 35 If Nature were fickle and capricious, there could be no such thing as scientific medicine, or science of any kind. For instance, is Nature ever known to have thrown out new material to cement the broken ends of a fractured bone, by mistake, when no fracture existed ; or was she ever known, under ordinary circumstances, to over- look the reparation of bone when the occurrence of fracture rendered it imperative. Broken bones, it is true, occasionally refuse to heal from some constitutional vice referable to the indi- vidual, but never from simple failure of Nature. If a foreign substance pierce the skin and be- come located in the tissues, is there the slightest possibility of Nature overlooking the wrong done to her .'' Does she ever fail to resent the injury' by inflammatory protest and patient dogged endeavours to the last to expel the intruder t How else could the experienced surgeon con- fidently predict inflammation and suppuration under such circumstances, unless Nature were uniformly true and inviolable } On the contrary, he knows the foreign substance must be ex- tracted, if these untoward events are to be avoided, and that there can be no compromising with Nature to make exceptions to her rule. While unstintingly giving Nature her due, it must still be admitted that a very great deal can be done to assist her operations, by abetting her in all her plans, removing obstacles from her 36 Ambulance Sermons. path, and otherwise acting towards her the part of a sagacious and able confederate. This is exactly the rdle of the physician. He has more- over to check the impetuosity of Nature, when .she is carried away, as it were, by the wealth of her resources, just as the mind of ordinary capa- city often controls a gifted one. What accomplishments are necessary to qualify a person to hold this position under Nature } To begin with, he must thoroughly understand the construction of the human frame, its behaviour in health and disease, the nature and forces of the agents he employs as medi- caments, be they drugs or other agents, such as dietetic and sanitary measures — the limpid panacea of the hydropath or the inert globules and mother tinctures of the homoeopath, not to be dignified by the name of drug ; and above all he must study Nature in all her phases, and cul- tivate the faculty of observation at the bedside. .= The prescription is evidently the denoument of a physician's accomplishments, the palpable embodiment of all his mysterious knowledge, and by the prescription he must stand or fall. His fame and reputation are pinned to the scrap of paper disfigured with undecipherable hierogly- phics or affixed to the phial of murky compound called the " mixture." But the thoughtful con- sideration of the case, the complex reasoning, the judicial sifting of conflicting evidence, the Vis Medicatrix Naturce. 3 7 correct interpretation of mysterious and contra- dictory symptoms, the hopes, fears, and antici- pations, the unravelling of the tangled skein, the creating of light and order out of chaos, which every skilled and conscientious practitioner brings to bear on each individual case, be it great or small, for which he is consulted, and on which his reputation and success properly de- pend — these, I say, go for nothing in the com- mercial transaction of paying a fee and receiv- ing medical advice. The administration of medicine is not the thing in treatment. It is the true appreciation of the state of affairs and tlie knowledge of what one is about. The whole duty of doctors is the administration of medi- cine, only in as far as the latter is held as an index to the complexity and travail of the labours which give it birth. Neither is medicine the gross power which popular esteem makes of it. Many people have no faith in medicine unless it smells and tastes strong, the idea being that it effects its purpose by virtue of its own strength and not by virtue of its gentle influence on the strength of Nature. Great vessels are commanded by a diminutive helm, fiery horses are curbed by the mere touch of the rein, and a whole army is swayed hither and thither by one individnal mind. So also Nature, fierce in some of her bitterest moods, is nevertheless as docile as a child, in the hands of a rational physician. CHAPTER V. PROGNOSTICS OF DISEASE AND THEIR INTERPRETATION. Disease is often foreshadowed by certain pre- monitory signs and symptoms which, similar to the terrestrial perturbations before an earth- quake, or the mutterings and grumblings that precede a volcanic eruption, gather like an ominous cloud in the horizon and presage the coming storm. These are as closely studied and observed by medical men as weather prog- nostics by the meteorologist or the mariner, and are taken advantage of for making suitable preparations for meeting the coming event. During the course of disease also, certain favour- able signs occur, like a peep of bright blue sky amid heavy masses of dark cloud, by which we are enabled to predict a hopeful termination of the case ; while others again of sinister omen make their appearance only to denote impend- ing trouble and danger. Lastly, we have the appalling symptoms, whose dark presence chases away the last lingering ray of hope, and fore- bodes with awful certainty the approach of Prognostics of Disease. 39 dissolution. The import of these signs or prog- nostics may be studied to some advantage by those whose duty it is to watch the sick, either as regular nurses or by the necessity of family obligations. During an epidemic of scarlet fever for ex- ample, it is the duty of mothers to watch their children closely for signs of infection. If a child at such a time becomes sick.and complains of sore throat, the probability is very great that it is contracting the disease, and it is a manifest advantage to know this beforehand, that the doctor may be sent for at once, and that the child may be placed as early as possible under proper medical treatment. If again, during the height of a fever, copious perspiration takes place, with a simultaneous fall in the tempera- ture of the patient ; or if, in the case of a child, a free bleeding from the nose occurs, we are fully justified in putting a favourable interpre- tation on the events, and predicting recovery. If, on the contrary, the temperature runs up to 107°, we are compelled to admit that the case is one of great gravity, and if the fever runs much higher than this there is little or no hope of recovery. There is nothing that the experienced practi- tioner dreads more than those terrible symptoms that are the certain harbingers of a fatal ter- mination. They often steal on the scene like 40 Ambulance Sermons. unwelcome spectres when they are little ex- pected, and not infrequently when some delusive improvement has raised our hopes for the better, as if to give depth to despair. There is a relentless cruelty about them. They are the black indices of a stern uripitying fate. Not long ago, a melancholy duty devolved on the writer in connection with the case of an infant six months old, whom he had been attending for an inflammatory affection of the brain. The mother of the child, with all a fond mother's instincts, watched her little charge hour by hour through the solitary watches of the night as well as by day, and yearning for some token of recovery — some little symptom to bid her hope. One morning saw the poor little thing freed for a moment from its pains and convulsions, and nestling quietly in its parent's lap, the mother shedding tears of joy at the unexpected change for the better. One little symptom, however, which the child had developed since it was last seen, viz., a squint, showed that the improvement was a delusion and that recovery was hopeless. It was a pain- ful task to communicate the fact to the mother and crush the new-born hope within her, but it would have been more cruel to permit her to indulge the delusion longer. Peculiar Symptoms due to Worms. — The presence of worms in the intestines in children Prognostics of Disease. 4 1 gives rise to many peculiar symptoms, which are all referable, however, to irritation of the nervous system by these parasites. Grinding of the teeth during sleep is a very common one. So also is perpetual picking of the nostrils. A swollen or tumefied condition of the lips, and a voracious appetite, combined with an ill- nourished condition of the body, are not an infrequent trio, appearing together as a sign of worms. The most important symptom, how- ever, is the occurrence of certain kinds of fits, resembling epilepsy, for which they are some- times mistaken by the unwary. The fits are not uplike epileptic fits, and naturally cause the gravest fears and anxiety in the minds of the patient's friends. The consequence, also, of not recognising the true cause in time is serious, for not only is the source of irritation allowed to remain and increase, but the innocent victim is made the object of a species of undesirable compassion, with which persons liable to fits are usually regarded, and the harm that may be thus done to a sensitive shrinking nature is incalculable — not to speak of the injury that may be inflicted by potent drugs administered for the purpose of curing a disease which does not exist. Inspection of the Tongue in Illness. — The tongue is a frequent tell-tale of certain impor- tant conditions of the system. In the course of 42 Ambulance Sermons. fevers, much may be learned by asking the patient to put out his tongue. If he finds difficulty in doing so, or if the tongue trembles in the attempt, and if there is at the same time hesitation and tremulousness of speech, it is a sure sign of dangerous prostration of the powers. An illness begun under these unfavourable auspices, if it do not .terminate fatally, is sure to be of long continuance, accompanied by great debility and tending to a tardy recovery, and brandy and beef tea will have to be the watch- words of the nurse. In most fevers, at the early stage the tongue presents a thick white coat or fur on its surface, which is moist to begin with. The medical attendant carefully watches the condition of this organ, asking at each visit to see it. If the coat begins to clear away, and does so gradually and equally, commencing at the edge, recovery is taking place and will be satisfactory. If it clear in patches, it is not so satisfactory, and recovery will probably be retarded or arrested by some untoward event. If the tongue become dry and harsh like a rasp, while the coat changes its colour from white to brown, dangerous weakness is supervening, and unless stimulants and concentrated nourishment be administered immediately, and with an unsparing hand, the patient will surely sink. A dry and brown tongue is a sure sign that stimulants are urgently required, and that it Prognostics of Disease, 43 will be tolerated in large doses. It is remark- able how much brandy may be taken with impunity in certain excessively weakened con- ditions of the system. I can testify to one case occurring in my practice, where an old lady, who was seriously prostrated by an alarming haemorrhage from the nose, consumed more than half a bottle of brandy in six hours, and it was the means of saving her life. There was not the slightest symptom of intoxication, although when in her ordinary health, this lady, her husband informed me, could not take the smallest quantity of brandy without experienc- ing uncomfortable sensations in her head. Dyspepsia is accompanied by a more or less furred state of the tongue. In liver disorders the furring takes on a yellowish tinge. A highly glazed, bright, raw-looking, or patchy tongue betokens inflammatory conditions of the stomach. In scarlet fever, the tongue has quite a character of its own, not observable in any other complaint. Numerous little red points appear through the fur, giving the tongue what is called a strawberry appearance, by which alone scarlatina may often be recognised. Appearances of the Eye. — The appearances of the eye are of greatest service, when considered in connection with disorders of the brain. At the commencement of inflammation of the brain, the pupil of the eye is contracted, indicating 44 Ambulance Sermons. irritation of the great nerve centre. In the later stages, when as a product of inflammation, fluid is effused and presses on the brain, the pupil becomes dilated as a result of paralysis of the brain. When, therefore, in the course of brain disease, sudden dilatation follows upon a con- tracted state of the pupil, we know exactly what has taken place internally to give rise to the change, and modify our treatment accord- ingly to suit the altered circumstances of the case. In health, the eye shrinks before a strong light, the pupil contracting by reflex action, to guard the tender retina from the injurious stimu- lus of powerful rays of light. If a candle be held close to the eyes, it will be observed that the pupils are in a state of close contraction, and as the candle is withdrawn, the pupils gradually resume their usual size. This property of the eye is called its sensibility to light. When it is lost, it indicates a condition of profound insensi- bility, as in persons under the influence of chloroform or an epileptic fit, and in some other abnormal conditions of the brain. The opposite condition, viz., increased sensibility to light, is also frequently seen, and is a sign of irritation in the brain or the structures of the eye. It is frequently associated with the exalted sensibility that usually accompanies hysteria. If the two pupils be observed during the course of brain Prognostics of Disease. 45 disease to be unequally contracted, or if squint- ing supervene in the latter stages, the prognosis is rendered extremely unfavourable. While on the subject of brain disease, I may mention yet another prognostic of most unfa- vourable import, and frequently observable in rapidly fatal cases of brain disease in children. The symptom referred to is a peculiar constant motion of the lips as though the child were busy sucking something in its mouth. Once seen, this symptom is never forgotten, as, together with a characteristic restlessness and alarmed expression of face, it makes up a bedside picture painful to contemplate. Brain disease is not infrequently foreshadowed by prognostics connected with perversion of sight, such as a mistiness, or spots before the eyes, flies floating in the air, objects appearing double, and other strange disturbances. Occa- sionally patients are the subject of spectral illu- sions, as in the remarkable case of Mrs A., quoted by Sir David Brewster in his " Natural Magic." In elderly people,, a peculiar pale- coloured opaque ring is occasionally to be seen round the edge of the coloured portion of the eye, which is now understood to be a sign of some importance, as indicating the probable presence of fatty degeneration in the internal organs. Although it can tell us nothing by itself, it is a highly suggestive symptom, and, 46 Ambulance Sermons. taken in connection with other concurrent evi- dence, is a valuable aid in detecting degenera- tion or decay of the various organs. This pecu- liar appearance is called Arcus senilis. When it is present, and when at the same time there is a feeble pulse and great liability to attacks of fainting, we are warranted in inferring that the muscular fibres of the heart are undergoing fatty degeneration. When patients sleep with the lids half-closed, it is a sign of exhaustion. Children who are brought to the last extremity through chronic and neglected indigestion, and inability to assimi- late their food, often display this symptom, as well as older people reduced to great weakness by hemorrhagic or other discharges. Dark circles round the eye and burning of the lids also denote exhaustion in a minor degree. Irregularities of the Sense of Hearing as Signs of Disease. — Irregularities connected with the sense of hearing also furnish some important prognostics. Preternatural acuteness of hearing is sometimes observed to be a precursor of de- lirium, and its occurrence in the course of a severe illness is generally understood to be an unfavourable sign. The opposite condition, viz., obtuseness of hearing, though of less significance as a prognostic, is an unwelcome symptom when associated with organic brain disease, concussion of the brain, or epilepsy. Prognostics of Disease. 47 The sense of hearing is often perverted, and patients complain of annoying noises in the ears, which they variously compare to the singing or hissing of a teakettle, the rushing of the wind, the roaring of the sea, or the beat of a drum. They may be the forewarningsof a fit of apoplexy, or simply the precursors of a bleeding from the nose. Excessive accumulation of waxy secre- tion in the ears may produce these sounds, or they may be the symptoms of destructive ear disease. Their greatest practical value however is in connection with poverty of blood, of which they are a sure indicator when associated with a blanched condition of the lips. Young females, especially servant girls, are very liable to anoemia or poverty of blood. Every trace of colour vanishes from the face, the lips are bloodless, the ears are constantly assailed with ringing or roaring sounds, the countenance is expressive of weariness, energy is gone and langour and apathy prevail. Anoemia is a condition by no means to be trifled with, leading in some per- nicious forms to a rapidly fatal issue, and in others, laying the foundation of future organic disease. Dropsy an Evil Prognostic. — Dropsy is a symptom that always forebodes evil. Excep- tionally it is referable to temporary conditions of the blood, on the improvement of which this form of dropsy, never very marked, soon disap- 48 Ambulance Sermons. pears. But in the majority of cases it is an incident of grave organic disease, and its ap- pearance is a signal that the quiescent stages are passed, and that calamity and disaster are approaching. A slight puffiness of the eyelids is often the first symptom manifesting itself in Bright's disease of the kidneys. Later on, the victims of this melody develop a highly characteristic expression of countenance, consisting of pale, puffy features and a dry, harsh, and pasty skin, very suggestive, to the practised observer, of kidney disease. In heart disease, dropsy usually makes its appearance first in the lower ex- tremity ; and in disease of the liver, fluid first makes its appearance in the abdomen. Dropsy is a simple transudation of the watery con- stituents of the blood through the veins into the surrounding tissues, being the result, either of excessive hydraulic pressure, or an impoverished and attenuated state of the blood. As an illus- tration of the one, we have obstruction of the circulation caused by an incompetent heart or liver, followed by the blood forcing itself out of its containing vessels and inundating the sur- rounding tissues. As an example of the other, we see consumptive patients exhibiting symp- toms of dropsy in the last stage of the disease, the blood having become so thin and watery that it easily permeates the porous walls of the Prognostics of Disease, 49 veins. The same thing often occurs in women worn out with prolonged suckling. Inflamma- tion of the peritoneum — the membrane lining the abdominal cavity and covering the intes- tines — also gives rise to dropsy, which is signifi- cant or otherwise of danger, according to the' cause of the inflammation. If it be due to cancerous or tubercular deposit, the prognosis is necessarily gloomy, while inflammation due to idiopathic or traumatic causes are more amen- able to medical treatment. Signification of Pain in the Back. — Pain in the back is a common complaint; what does it denote ? It may be due to lumbago — a rheu- matic aff"ection of the muscles of the spine — which may usually be recognised by the pain being aggravated during the act of stooping, and at night, and by rheumatic pains occurring in other parts of the body. When it is per- sistent, and described by the patient as an aching or weariness in the lower part of the back, it may be due to chronic disease of the kidneys or to some affection of the -spinal cord. The great importance, however, attaching to this symptom is derived from its association with disease of the generative organs in women. Wearing high-heeled boots is said to cause pain in the back by disturbing the equilibrium of the muscles employed in maintaining the erect posture, the high heels having a tendency to D 50 Ambulance Sermons. throw the body forward and straining the muscles of the back. Pain in the 5/o., lorapper. Price Is. 6d. THE " Occult World Phenomena," AND The Society for Psychical Research. BY A. P. SINNETT, AUTHOR OF "the OCCUIT WORLD," " ESOTEEIO BDDDHISM," ETC. With a Protest by Madame Blavatskt. " An interesting addition to the fast-expanding literature of Tlieosophy."— Literary World. " All who are interested in Theosophy should read it."— Glasgow Herald. "Mr. Sinnett scores some points against his adversaiy. and his pamphlet is to be followed by some memoirs of Madame Blavatsky, which may contain further refutations. 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"—lAUrary World, "A delightful mock essay on the exoteric philosophy of the pipe and the pipe bowl . . . reminding one alternately of ' Melancholy ' Burton and Herr Teufelsdroch, and implying vast reading and out-of-the-way culture on the part of the aMthor."— Bookseller. GEORGE REDWAT, YORK STREET, COVENT GARDEN. In demy 8vo., with Illustrative Plates. Price Is. 6d. Chirognomancy ; Or, Indications of Temperament and Aptitudes Manifested by the Form and Texture of the Thumb and Fingers. BT BOSA BATJGHAIf. " Miss Bauglian lias already established lier fame as a writer upon occult subjects, and what she has to say is so very clear and so easily verified that it comes with the weight of authority." — Lady's Pictorial. " Ingenious and not uninteresting." — The Queen. QEOBQB BBDWAY, YORK STREET, COVENT GARDEN. 18 MR. redway's publications. Annual svhscription, payable m advance, post free, 5s. The East Anglian^ OR, Notes and Queries ON SUBJECTS CONNECTED WITH THE COUNTIES OF SUFFOLK, CAMBRIDGE, ESSEX, AND NORFOLK. Issued Monthly. EDITED BY THE Rev. 0. H. EVELYN WHITE, F.R.Hist.S., Ipswich, HONORARY SECRETARY OF THE SUFFOLK INSTITUTE OF ARCHiEOLOGY AND NATURAL HISTORY. "Antiquities are history defaced, or remnants that have escaped the ship- wreck of time .... wrecks of history wherein the memory of things is almost lost; or such particulars as indiistrious persons, with exact and scrupulous diligence can anyway collect from genealogies, calendars, titles, inscriptions, monuments, coins, names, etymologies, proverbs, traditions, archives, instruments, fragments of private and public history, scattered passages, of books no way historical, etc., by which means something is re- covered from the deluge of time In this imperfect history no deficiency need be noted, it being of its own nature imperfect." — LordSacon, Advance- ment of Learning. GEORGE REDWAY, YORK STREET, COVENT GARDEN. Ill imperial 16mo., Dutch paper^ cloth extra. Price 2s. Qd. The Rueing of Gudrun, And Other Poems, BY THE Hon. iVErs. GREVILLE- NUGENT. " It is clear from many exquisite passages that Mrs. Nugent, if she were so minded and in earnest, might be a real poetess." — Daily Telegraph. " The writer touches the various chords of her lyre with no inexperienced hand." — Morning Post. * ' Mrs. Greville-Nugent has succeeded very fairly well with her villaneUes and rondeaux, her triolets and sesttnes, her ballades and chants royal." — S^t. James's Gazette. ' ' Where she shows herself at her best is in the French forms of verse, which exactly suit her talent." — The TiTnes. GEORGE REDWAY, YORK STREET, COVENT GARDEN. MR. RED WAY'S PUBLICATIONS. 19 In preparation. THE PLATS OF &EORGE COIMAN THE YOUNGER. The Comedies and Farces OF GEORGE COLMAN THE YOUNGER. Now first collected and carefully reprinted from the Original Editions, with Annotations and Critical and Bibliographical Preface, BY RICHARD HERNE SHEPHERD. In Two Volumes. "Mr. R. H. Shepherd is engaged in collecting and reprinting, with a critical and biographical introduction and annotations, the dramatic works of George Colman the younger, which will shortly be published in two volumes by Mr. Redway, of York Street. Most of them were issued in Colman's life- time in pamphlet form, but many have, nevertheless, become scarce, and of those which, like the 'Heir-at-Law,' ' John Bull,' and ' The Poor Gentleman,' have held the stage, the text has become more or less corrupted. Considering the great popularity of Colman's plays, the spirit and humour of their scenes, and their association with the names of great actors in the past, It is a curious fact that Mr. Shepherd's publication, though it appears more than a century after the production of the earliest of Colman's pieces on the stage, wUl be the first collected edition. It will comprise, of course, the suppressed preface to 'The Iron Chest,' in which Colman made his famous personal attack upon John Kemble."— iJaiij/ News. GEORGB EBDWAY, YORK STREET, COVENT GARDEN, 20 ME. EEDWAY'S PUBLICATIONS. An edition de luxe, in demy ISmo. Price Is. Confessions of an English Hachish Eater. "There is a sorfc of bizarre attraction in this fantastic little book, with its weird, unhealthy imaginations." — Whitehall Review. " Imagination or some other faculty plays marvellous freaks in this little hook." —Lloyd's Weekly. "A charmingly written and not less charmingly printed little volume. The anonymous author describes his experiences in language which for picturesqueness is worthy to rank with De Quincey's celebrated sketch of the English Opium Eater." — Lincolnshire Chronicle. " A weird little book. . . . The author seems to have been delighted with his dreams, and .... carefully explains how hachish may be made from the resin of the common hemp plant."— ZJaii^/ Chronicle. "To be added to the literature of what is, after all, a very undesirable subject. Weak minds may generate a morbid curiosity if stimulated in this direction."— 5rad/brd Observer. " The stories told by our author have a decidedly Oriental flavour, and we would not be surprised if some foolish individuals did endeavour to procure some of the drug, with a view to experience the sensation described by the writer of this clever brochure." — Edinhwrgh Courant. GEORGE EEDWAT, YORK STREET, OOVENT GARDEN. Monthly, One Shilling. Walford's Antiquarian : A Magazine and Bibliographical Review. EDITED BY EDWARD WALFORD, M.A. *** Volumes I. to IX. ^ Now Ready, price Ss. 6rf. each. " The excellent archaeological monthly."— CosseiE's Art and lAteratv/re. " This magazine is dear to the hearts of the lovers of antiquities. The meet- ings of the various learned societies are also described. . . . and a number of articles of both antiquarian and bibliographical inteTest."— Nonconformist. " Inhere is not much in Waif ord's Antiquarian that any connoisseur in literary curiosities would care to pass over."— Si. James's Gazette. GEORGE REDWAY, YORK STREET, COVENT GARDEN. MR. REDWAY's publications. 21 Monthly, Is.; Yearly Suhsoription, 20s. The Theosophist : A Magazine of Oriental Philosophy, Art, Literature and Occultism. OONDUOTED BY H. p. BLAVATSKY. Vols. I. to VII. Now . "Theoaophy has suddenly risen to importance. . . . The movement im- plied by the term Theosophy is one that cannot be adequately explained in a few words . . . those interested in the movement, which is not to be confounded with spiritualism, will find means of gratifying their curiosity by procuring the back numbers of The 'I'/ieosophist and a very remarkable book called ' Isis Unveiled,' by Madame Blavatsky."— iiierar;/ World. GBOEGE EEDWAT, YORK STBBET, COVENT GARDEN". NEW WORK BY JOHN H. INGRAM. The Raven. BY EDGAR ALLAN POE. With Historical and Literary Commentary. By John H. Ingkam. Grown 8w. , parchment, gilt top, un^ut, price 6s. " This is an interesting monograph on Poe's famous poem. First comes the poet's own account of the genesis of the poem, with a criticism, in which Mr. Ingram declines, very properly, we think, to accept the history as entirely genuine. Much curious information is collected in this essay. Then follows the poem itself, with the various readings, and then its after- history ; and after these ' Isadore,' by Albert Pike, a composition which undoubtedly suggested the idea of ' The Raven ' to its author. Several trans- lations are given, two in French, one in prose, the other in rhymed verse ; besides extracts from others, two in German and one in Latin. But perhaps the most interesting chapter in the book is that on the ' Fabrications.'"— The Spectator. " There is no more reliable authority on the subject of Edgar Allan Poe than Mr. John H. Ingram . . . the volume is well printed and tastefully bound in spotless vellum, and will prove to be a work of the greatest interest to all students of English and American literature. "—The Publishers' Circular. GEORGE EEDWAT, YORK STREET, COVENT GARDEN. 22 MR. redway's publications. Now ready, at all Booksellers', and at Smith's Railway Bookstalls. Popular Edition, price 2s. 6d. Burma : As it Was, As it Is, and As it ¥ill be. BY J. G. SCOTT. Crown 8vo., cloth. " Before going to help to govern them, Mr. Scott has once more written on the Bm-mese . . . Mr. Scott claims to have covered the whole ground, to show Burma as it was, is, and will be ; and as there is nobody competent to criticise him except himself, we shall not presume to say how far he has suc- ceeded. What, however, may he asserted with absolute confidence is, that he has written a bright, readable, and useful book." — Saturday Review, March 27. "Very lively and readable."— Paii Mall Gazette. " The author knows what he writes about." — St. Stephen's Reoieuo. " There is a good deal of curious reading in the book." — Literary World. "The book is amusing and instructing, and Mr. George Redway, the publisher, will have done the public and himself a service." — Court Journal. "The print is clear, and the binding in excellent taste." — BooJcseller. " Evidently full of genuine information." — Society. " A handy guide to Burma, as readable as it is accurate." — Globe. ' ' Mr. Scott should have called this volume ' A hook for Members of Parlia- ment.' " — London and China Telegraph, * ' The sketch of Burmese cosmogony and mythology is very interesting." — Nature. " A competent historian. He sketches Burma and the Burmese with minute fidelity." — JDaily Chronicle. " Probably no EngUshman knows Burma better than Mr. J. G. Scott." — Contemporary Review. " An excellent description both of land and people." — Contemporary Review. " Most interesting."— St. James's Gazette. "Shway Toe is a graphic writer . . . no one can supply this information better than Mr. Scott." — Asiatic Quarterly Review. GEORGE REDWAY, TORK STREET, COVENT GARDEN. MR. REDWAY'S PUBLICATIONS. 23 Just published, handsomely printed and tastefully hounds 4.^% pages, large crown 8vo. , cloth extra, Is. Qd. Essays in the Study of Folk-Songs. BT THE GOTTNTESS ETEITN MABTINENGO-GESARESOO. '*A pleaaant volume on a pleasant topic. . . . The Countess, with her sincere enthusiasm for what is simple, passionate, and sensuous in folk-song, and with her lucid and unafEected style, well understands the mode in which the educated collector should approach the shy singers or story-tellers of Europe. . . . Her introduction is perhaps, to the scientific student of popular culture, the hest part of her book. . . . Next to her introduction, perhaps her article on ' Death in Folk- Poetry' is the most serviceable essay in the volume. . . . • Folk Lullabies ' is perhaps the most pleasant of the remaining essays in the admirable volume, a volume remarkable for knowledge, sym- pathy, and good taste." — Extracts from a page notice in the Saturday Review^ April 24, 1886. " This is a very delightful book, fuU of information and thoughtful sugges- tions. It deals principally with the Folk-songs of Southern peoples, Venetian, Sicilian, Armenian, Provence, and Greek Songs of Calabria, but there are several essays devoted to the general characteristics of Folk-Poetry, such as the influence of Natxure, the Inspiration of Death, the idea of fate, the nume- rous songs connected with the rites of May, Folk-Lullabies, and Folk-Dirges. There is also an interesting essay on what is called the White Paternoster, and Children's Rhyming Prayers. This is one of the most valuable, and certainly one of the most interesting, books which has been written on a subject which has of late years been exciting an ever-increasing attention, and which in- volves many important problems connected with the early histoi-y of the human race." — Standard. " * Folk-Songs,' traditional popular ballads, are as tempting to me as King Charles's head to Mr. Dick. But interesting as the topic of the origin and diffusion and literary merit of these poems may be — poems much the same in all European countries — they are rather caviare to the general. The Countess Martinengo-Cesaresco is, or should be, a well-known authority Mnong special students of thisjbranch of literature, to whom I heartily commend her 'Essays in the Study of Folk-Songs.' The Countess is, perhaps, most familiar with Southern volksldder, as of Greece, Italy, and Sicily. Her book is a treEisure- house of Folk-lore of various kinds, and the matter is handled with much poetic appreciation and a good deal of learning." — Saily News. "A kind of popular introduction to the study of Folk-lore." — St. James's Gazette. GEORGE REDWAY, YORK STREET, COVENT GARDEN. 24 MR. EEDWAY'S PUBLICATIONS. EBEIEZER JOIES'S POEMS. In post 8uo., cloth, old style. Price 5s. Studies of Sensation and Event. Poems by Ebbnbzbe Jones. Edited, Prefaced, and Annotated by Richard Heenb Shbphebd. With Memorial Notices of the Author by SuMiraiB JONBS and W. J. Linton. A new Edition. With Photographic Portrait of the Poet. "This remarkable poet affords nearly the most striking instance of neg- lected genius in our modem school of poetry. His poems are fall of vivid disorderly power." — D. G. Rossetti. GEORGE RED WAY, YORK STREET, COVBNT GARDEN. In demy Svo., elegantly printed on Dutch hand-made paper, and bound in parchment-pwper cover. Price Is. The Scope and Charm of Anti- quarian Study. BY JOHN BATTY, F.R.Hist.S., Membek op the Yobkshire Aech^ological and Topogeapical Association. "It f 01:1118 a useful and entertaining guide to a, beginner in historical researches." — Notes and Queries. "The author has laid it "before the public in a most inviting, intelligent, and intelligible form, and offers every incentive to the study in every depart- ment, including Ancient Kecords, Manorial Court-Rolls, Heraldry, Painted Glass, Mural Paintings, Pottery, Church Bells, Numismatics, Folk-Lore, etc,, to each of which the attention of the student is directed. The pamphlet is printed on a beautiful modem antique paper, appropriate to the subject of the work." — Brighton Examiner. "Mr. Batty, who is one of those folks Mr. Dobson styles * gleaners after time,' has clearly and concisely summed up, in the space of a few pages, sSX the various objects which may legitimately be considered to come within the scope of antiquarian study."— ..Academy. GEORGE RBDWAY, YORK STREET, OOVENT GARDEN. MR. KEDWAY'S PUBLICATIONS. 25 A few large-pajper cojiies, with India proof portrait, in imperial Svo., parchment. Price 7s. Qd. An Essay on the Genius of George Cruikshank. "THETA" (WILLIAM MAKEPEACE THACKEEAY). With all the Original Woodcut Illustrations, a New Portrait of Okuikshank, etched by Pailthoepe, and a Prefatory Note on Thaokekay as an Aet Critic, by W. E. Chuech, Secretary of the Urban Club. " Thackeray's essay 'On the Genius of George Cruikshank,' reprinted from the Westminstei' JiCTiew.ls a piece of work well calculated to drive a critic of these days to despair. How inimitable is its touch ! At once familiar and elegant, serious and humorous, enthusiastically appreciative, and yet just and clear.sighted ; but, above all, what the French call personneL It is not the impersonnel reviewer who is going through his paces . . . it is Thackeray talking to us as few can talk— talking with apparent carelessness, even ramblingly, but never losing the thread of his discourse or saying a word too much, nor ever missing a point which may help to elucidate his subject or enhance the charm of his essay. . . . Mr. W. E. Church's prefatory note on 'Thackeray as an Art Critic" is interesting and carefully compiled."— ircsf- miTistei' Beview, Jan. 15th. "As the original copy of the Westminster is now excessively rare, this reissue will, no doubt, be welcomed by collectors."— Birmmy/im/i Sailtj Mall. "Not only on account of the author, but of the object, we must welcome most cordially this production. Every bookman knows Thackeray, and wiU be glad to have this production of his which deals with art criticism- a sub- ject so peculiarly Thackeray's own."— TAe Antiquary. "It was a pleasant and not untimely act to reprint this well-known delightful essay. . . . the artist could have found no other commentator so sympathetic and discriminating. ... The new portrait of Cruikshank by F. W. Pailthorpe is a clear, firm etching."— Z'/ic AHist. GEORGE REDWAY, YORK STBEET, COVENT GARDEN 26 MR. EEDWAY'S PUBLICATIONS. Edition limited to 500 copies, handsomely printed on antique paper and tastefully bound. Price 75. ?)d. THE ASTROLOGER'S GUIDE. Anima Astrologiae; OR, A Guide for Astrologers. Being the One Hundred and Forty-six Considerations of the Astrologer, GuiDO BoNAins, translated from the Latin by Henry Coley, together with the choicest Aphorisms of the Seven Seg- ments of Jerom Cardan, of Milan, edited by William Lilly (1675) ; now first republished from the original edition with Notes and Preface BY WILLLA.M CHARLES ELDON SERJEANT, '* Mr. Serjeant deserves the thanks of all who are interested in astrology for rescuing this important work from oblivion The growing interest in mystical science will lead to a revival of astrological study, and advanced students will find this book an indispensable addition to their libraries. The book is well got up and printed." — Theosophut, GEOEGB REDWAY, YORK STREET, COVBNT GARDEN. In the Press. Incidents in the Life OF Madame Blavatsky, Compiled from Information supplied by her Relatives and Friends, AND EDITED BY A. P. SINNETT. With a Portrait reproduced from an Original Painting by Hebmann SOHMIECHEN. GEORGE REDWAY, YORK STREET, COVENT GARDEN. MR. REDWAY'S PUBLICATIONS. 27 To he piMished shortly, handsomely printed and bound in one vol. Small demy 8vo.,j>rice 10s. 6d. The Kabala Denudata (Translated into English), CONTAINING THE FOLLOWIXG BOOKS OF THE ZOHAE ; — 1. Th Book of Concealed M'^stery. 2. The Greater Holy Assembly. 3 . The Lesser Holy Assembly. . Collated with the original Hebrew and the Latin text of Knorr de Eosenroth's " Kabala Denudata,'' BY S. LIDDELL MACGREGOB, MATHERS. GEORGE REDWAY, YORK STREET, COVENT GARDEN. Nearly ready. Price Is. Low Down. Wayside Thoughts in Ballad and other Verse. BY TWO TRAMPS. " This is a coIlGction of short pieces, most of wliich can fairly be considered poetry— no slight merit, as verse runs just now. Some of the pieces are singu- larly pathetic and mournful ; others, though, in serious guise, are permeated by quaint humour ; and all of them are of considerable merit. From the variety and excellence of the contents of this bundle of poetical eSusious, it is likely to attract a great number of readers, and many passages in it are particularly suitable for recitation."— ^nji,y and Navy Gazette, Aug. 14, 1S86. "But 'Low Down,' as it is called, has the distinction of being multi- coloured, each sheet of eight pages consisting of paper of a special hue. To turn over the leaves is, in fact, to eu joy a sort o£ kaleidoscopic efEect, a glimpse of a literary rainbow. Moreover, to complete the pecularity of the thing, the various poems are printed, apparently at haphazard, in large or small type, as the case may be. There are those; perhaps, who would take such jokes too seriously, and bring them solemnly to the bar of taste, there to be as solemnly condemned. But that is scarcely the right spirit in which to regard tliem. There is room in life for the quaint and curious as well as for the neat and elegant."— TAe Globe. GEORGE REDWAY, YORK STREET, COVENT GARDEN. MR. KEBWAY'S publications. In croion 8z30., cloth. Price 7s. Gd. Theosophy, Religion, and Occult Science. BT HENRY S. OliCOTT, PEKSIDBNT OP THE THEOSOPHICAL SOCIETY. WITH GLOSSARY OF INDIAN TERMS AND INDEX. "This book, to which we can, only allot an amount of space quite incom- mensurate with its intrinsic interest, is one that will appeal to the prepared student rather than to the general reader. To anyone who has previously made the acquaintance of such books as Mr. Sinnett'a * Occult World, ' and ' Esoteric Buddhism,' or has in other ways familiarised himself with, the doctrines of the so-caUed Theosophical Society or Brotherhood, these lectures of Colonel Olcott's will he rich in interest and suggestiveness. The American officer is a person of undoubted social position and unblemished personal reputation, and his main object is not to secure belief in the reality of any ' phenomena,' not to win a barren reputation for himself as a thaumaturgist or wonder- worker, but to win acceptance for one of the oldest philosophies of nature and human life — a philosophy to which of late years the thinkers of ttie "West have been turning with noteworthy curiosity and interest. Of course, should the genuineness of the phenomena in question be satisfactorily estab- lished, there would undoubtedly be proof that the Eastern sages to whom Colonel Olcott bears witness do possess a knowledge of the laws of the physical universe far wider and more intimate than that which has been laboriously acquired by the inductive science of the West ; but the theosophy expounded in this volume is at once a theology, a metaphysic, and a socio- logy, in which mere marvels, as such, occupy a quite subordinate and unim- portant position. We cannot now discuss its claims, and we will not pro- nounce any opinion upon them ; we will only say that Colonel Olcott's volume deserves and will repay the study of all readers for whom the bye- ways of speculation have an irresistible choxm." —Manchester Exaviiner. GEORGE REDWAY, YORK STREET, COVENT GARDEN. ME. REDWAY'S PUBLICATIONS. 29 Post free, price Zd. The Literature of Occultism and Archaeology. Beinsr a Catalogue of Books ON SALE relating to Ancient Worships. Astrology. Alchemy. Animal Magnetism. Anthropology. Arabic. Assassins. Antiquities. Ancient History. Behmen and the Mystics. Buddhism. Clairvoyance. Cabeiri. China. Coins. Druids. Dreams and Visions. Divination. Divining Kod. Demonology. Ethnology. Egypt. Fascination. Flagellants. Freemasonry. Folk-Lore. Gnostics. Gems. Ghosts. Hindus. Hieroglyphics and Secret Writ- ing. Herbals. Hermetic. India and the Hindus. Kabbala. Koran. Miracles. Mirabilaries. Magic and Magicians. Mysteries. Mithraic Worship Mesmerism. Mythology. Metaphysics. Mysticism. Neo-platonism. Orientalia. Obelisks. Oracles. Occult Sciences. Philology. Persian. Parsees. Philosophy. Physiognomy. Palmistry and Handwriting. Phrenology. Psychoneurology. Psychometry. Prophets. Eosioruoians. Round Towel s. Rabbinical. Spiritualism, Skeptics, Jesuits, Christians and Quakers. Sibylls. Symbolism. Serpent Worship. Secret Societies. Somnambulism. Travels. Tombs. Theosophioal. Theology and Criticism. Witchcraft. GEOEGE EEDWiY, YORK STEEET, COVBNT GARDEN. 30 MR. EEDWAY'S PUBLICATIONS. Quarterly, Is. 66^. Annual suhscription, 5s. Northamptonshire Notes and Queries. An illustrated quarterly Journal devoted to the Antiquities, Family History, Traditions, Parochial Records, Folk- Lore, Ancient Customs, etc., of the County. ■ EDITED BY Tlie Bev. W. D. SWEETING, BI.A. GEORGE EEDWAY, YORK STREET, COVENT GARDEN. The Mysteries of Magic 5 BEING THE SUBSTANCE Ol' The Writings of " Eliphas Levi " (ALPHONSE LOUIS CONSTANT). BY ARTHXJE, EDWAE.D WAITE. GEORGE REDWAY, YORK STREET, COVENT GARDEN. In demy 8vo., wrappered, uncut for binding, with Extra Portrait. Price 5s. J niZ (Hablot Knight Browne) : A Memoir ; including a, Selection from his Correspondence and Notes on his Principal Works. By Fred. G. Kitton. With a Portrait and numerous Illustrations. SS" A few copies only remain. GEORGE REDWAY, YORK STREET, COVENT GARDEN. ME. EEDW ay's ■ PUBLICATIONS. 31 One vol., crown 8vo., iOO pages. Price 6s. A Regular Pickle : How He Sowed his Wild Oats. BY HENRY "W. NESFIELD. "Mr. Nesfield's name as an author is established on such a pleasantly sound foundation that it is a recognised fact that, in taking up a book written by him, the reader is in for a delightful half -hour, during which his risible and humorous faculties will be pleasantly stimulated. The history of young Archibald Highton Tregauntly, whose fortunes we follow from the cradle to when experience is just beginning to teach him a few wholesome lessons, is as smart and brisk as it is possible to be." — WMUhall Review. " It will be matter for regret if the brisk and lively style of Mr. Nesfield, who at times reminds us of Lever, should blind people to the downright wickedness of such a perverted career as is here described." — Daily Chronicle. GEORGE EEDWAY, YORK STREET, COVENT GARDEN. In post Svo.j with numerous plat$s coloured by hand. Price 7s. Gd. Geometrical Psychology ^ OE, T/ie Science of Representation. Being the Theories and Diagrams of B. W. Betts. EXPLAINED BY LOiriSA S. COOK. " His attempt (B. W. Betts') seems to have taken a similar direction to that of George Boole in logic, "with the difference that, whereas Boole's expres- sion of the Laws of Thought is algebraic, Betts expresses mind-growth geome- trically ; that is to say, his growth-formulge are expressed in numerical series, of which each can be pictured to ; the eye in a corresponding curve. When the series are thus represented, they are found to resemble the forms of leaves and &f Mr. Charles Dickens, and of a good quantity of books written about him. It also contains copious extracts from reviews of his works and from sermons on his character. The criticisms are so various, and some of them are so much at variance with others, that the reader of them can complain of nothing less than a lack of material on which to form his judgment, if he has not formed it already, on the claim of Mr. Dickens to oi:cupy a front place in the rank of English classics. Asser- tions, if not arguments, are multiplied on either side." — Saturday Review. " Mr. Kitten's task has obviously involved much labour and research, and it has, on the whole, been very ably performed." — Scotsman. "The labour involved in the preparation of such a volume is, of course, enormous, but all Dickens students and collectors will thank Mr. Kitton for his work. The volume contains a finely-executed portrait of Dickens, from a drawing by Samuel Lam-ence." — Graphic. " It is a very full and delightful hook ; for open it at any page, and you are almost certain to come upon some interesting fact or fancy, the thought of a man of genius, or an incident bearing on a memorable life and its work." — St. James's Gazette. " A great deal that relates in numberless ways to the best known and most loved of English humorists will be found in this volume, certainly the most comprehensive that has yet essayed to illustrate his popularity from every personal and critical point of ■sti&w."— Daily Telegraph. "Mr. Fred. G. Kitton .... has done his work with remarkable thorough- ness, and consequently with real success. It is a subject on which I may fairly claim to speak, and I may say that all J know, and a great deal I did not know, about Dickens is to be found in Mr. Kitton's work." — " Atlas," in the World. "DICKENSIANA." " If with your Dickens-lore you'd make Considerable headway, The way to be well-read's to take This book brought out by RED WAY. 'Tie clear, exhaustive, and compact. Both well arranged and written ; A mine of anecdote and fact, Compiled by F. G. KITTON."— Punc/i. GEORGE REDWAY, YORK STREET, COVENT GARDEN. INDEX PAGE Astrology Theologized ,. . . 32 Anatomy Oif Tobacco 17 AntUiuarian Study . . . . 24 Astroloaer's Guide 26 Arch(voloay and Occultiam, . . . . 29 Adams, F.W.L 32 Adams, Mrs. Davenport . . . . 34 Arundale, Miss 36 Baughan, Rosa 8, 14, 17 Blavatsky, H. P 21, 26 Burma 22 Batty, John 24 Bonatus 26 Browne. Habldt K 30 Betts.B. W 31 Beauty and the Beast 34 Chirognomancy 17 Gosmo de' Medim- . . . , ii Curate's Wife, The 14 Colm/in's Plays 19 Confes»ions of an English Hachish Eater 20 Cruikshank, George 25 Church, "W.E 25 Cardan 26 Cook, Miss Louisa S 31 CoUette. C. H 36 Chatterji, Mohini M 36 Dickens 5 DickensiaTia 38 East Anglian 18 Eliphas Levi's Writings . . . . 30 Forlong, Major-General J. G. R, . . 12 Forty Ve^rs 13 Eolk-Songs 23 Geometrical Psychology .. . . 31 George, G. M 7 Gibb^ E. J. W 13 Greville Nugent 17 Hints to Collectors 5, 6 Hubbe-Schleiden, J. TJ 35 Heptameron 10 Home, R. H 11 Hartmann, F 10, 16 Hermea ., .. 33 Illumination 15 Incidents in the Life of Mme. Blavatsky 26 Ingram, John H 21 Johnson, C. P 5, 6 Jones, Ebenezer 24 Jones, Sumner 24 Judge, W. d . . . . . 33 Jennings, Hargrave . . . . 37 Keightlev, B 36 Kitton. F. G 13, 30, 38 Kent, Charles 7 Kahala Denudata 27 Kingsford, Mrs. Anna, M.D. 32, 33 Lamb 34 Leech 13 Linton, W. J 24 Lilly 26 Leolinus Siluriensis 17 PAGE Lew Down 27 Literature ofOccultUm and Arch-