CRITICAL NOTICES OP NEW PUBLICATIONS. 323 



V 



dentals, anterior to the existing malady — in his previous state of health and 



sometimes in maladies to which his family are particularly liable. 



" The end proposed, however, accordinj? to Pinel, may be obtained by 

 means much more simple and direct. If the patient's mind is in a sound 

 state, he may be at once interrogated as to the pains and affections he feels. 

 If he is delirious, or incapable of exercising his mental faculties, the informa- 

 tion desired may be derived from those who surround him. Inquiries may 

 next follow, as to whether the seat of the disease be in the head, chest, or 

 abdomen. 



" When a certain number of observations have been thus sketched out, the 

 student may advance to the study of the progress of diseases, beginning with 

 the acute, — carefully remarking their severalperiods of advancement and de- 

 cline, and not forgetting their terminations, whether favourable or otherwise. 

 All confusion may be avoided by confining the attention to one malady at a 

 time, and studying it in various individuals. The influence which air, regi- 

 men, place, and moral affections exert upon the disease, should also be accu- 

 rately noted, and mention made of its crisis, metastases, morbid transforma- 

 tions, and so forth. The observation may then be considered complete, if it 

 include daily expositions (if an acute disease) of the most important morbid 

 phenomena, from its commencement to its termination. 



After having collected cases of simple maladies, the student should pro- 

 ceed to the clinical study of complicated ones — to those, namely, which pre- 

 sent two or three orders of symptoms appertaining to different affections. 

 He should redouble his carefulness in avoiding disorder ard confusion, while 

 proceeding to the exact separation of the signs of each of the diseases before 

 him, and remarking the several circumstances which have produced the com- 

 plication. As to ultimate arrangement, it is advisable to at first inscribe, 

 rtpon a loo'ie sheet, all the phenomena, signs, or symjitoms offered to his obser- 

 vation, and afterward select those which are characteristic of the maladies 

 composing the complication. For this difficult and complex task, the observer 

 ought to choose acute, and leave chronic diseases for subsequent study.'* — 

 pp. 295—6. 



Part IV. consists of a redaction, from various sources, British 

 and continental, of the general appearances under which disease 

 presents itself; with an attempt to appreciate the influence ot each 

 particular symptom. 



We cannot terminate a review upon the subject of bedside medi- 

 cine, without bearing our indiiddual testimony to the excellence and 

 liberality of the arrangements offered for its study by the French ; 

 and, also, without acknowledging the debt of gratitude we owe to 

 them for the information we have thereby acquired. All Europe 

 rings with the fame of Dupuytren. His admirable Legons Orales 

 recall to his pupils the rapidity and accuracy of his analysis of dis- 

 ease — the extent of the resources which he opposed to its progress— 

 and, above all, the clear and familiar eloquence with which, in the 

 Amphitheatre, he explained and enlarged upon his views. To the 

 medical clinique, Chomel, with every qualification necessary to the 

 most minute investigation of disease, brings an extensive informa- 

 tion on the various theories which, unbiassed by prejudice and with 

 a rare conscientiousness, he subjects to the test of a long-continued 

 series of observations. 



In conclusion — We can, with safety, recommend to perusal Dr. 

 Thorburn's work, as a well-selected digest, drawn from a variety of 

 sources, correctly estimating the value of clinical medicine, and 

 pointing out the true mode of attaining perfection in it. 



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