1823.] ° 
[ 461 °] 
© © MEDICAL REPORT. 
RePort of Diseases and CAsuatties occurring in the public.and private Practice 
of the Physician who has the cave of the Western District of the City Dispensary. 
——=—— 
tT is mortifying for physiology to reflect 
that, after all our researches into the 
laws of ‘life;jwe are still not even skin-deep 
in the scieuce of ‘structure and functions, 
We stumble atthe very threshold, and 
have yet much to learn before we can say 
with truth, that‘even the common integu- 
ments of the bodies’ surface are correctly 
understood, either as to their organization 
‘or their propesties, Against medicine an 
objection has been advanced, that neither 
pathologist nor practitioner sees his way 
before him; and some individuals have 
" autitletically preferred the art of surgery, 
on account of ‘its. dealing with demon- 
strable matter; but even the “ visible 
things” of therapeutic science are found 
as debatable as the more hidden. At this 
moment, two of the ablest surgeons in the 
gountry are high in dispute respecting 
doctrines” and facts which, @ privrz, one 
should suppose would be easily set at rest 
by an appeal tothe instructions of sight 
and sense; and who does not know that 
disorders of ‘the’ skin, both as to their 
rationale and remedies, are amongst those 
maladies about which medical principtes 
and practice ate the farthest removed 
from unanimity or uniformity. Under all 
this uncertainty;the writer of the present 
paper felt gratified in perusing a philoso- 
phical treatise from the able pen of his 
friend Mr. Chevalier, on tlie anatomy and 
physiology of the common integuments ; 
which, lad it no other merit than remind- 
ing the profession of its ignorance, and 
pointing to the proper path of pursuit, 
would be entitled to considerable praise. 
But the tract in question possesses posi- 
live as well as negative worth; and the 
reader of it will find the puzzling question 
of the permeability of the outer skin to 
transpired fluid, while it retains the results 
of inflammation, treated of, to say the 
jeast, with much ingenuity and acumen.* 
Now, with respect to those morbid 
zffections which present themselves on 
the supertices of the body, what discre- 
* References to matters of taste inva 
Medical Report may be considered out of 
place, but the writer cannot forego the 
opportunity of objecting, in the present 
instance, to the occasional illegitimacy of 
expression, and even coinage of words, 
which will: be’ found to mar the otherwise 
excellentmatier and manner of Mr, Che- 
valicr’s treatise., It is the same in the 
elaborate and. admirable work of Dr. 
Good;. swriteys, such as these onght to 
be especially on their guard against sins in 
composition, since their influence and 
authority must necessarily be extensive. 
paney, as just intimated, do we find both 
in theory and practice ; and we need only 
take cancerots change of siracture in 
proof of this allegation., Some tell ns that 
cancer is a local disease, acknowledging a 
constitutional origin; others say:that it is 
ab origine ad finem, a topical, and a merely 
topical, affection. One tells you that it is 
of hydatid origin, and tubercniar essence ; 
another says, aud perhaps says truly, that 
both its specific nature and absolute loca- 
lity, have been judged of with too much 
respect to the limits of nosology and no- 
menclature ; that cancareous disorganiza- 
tion may implicate other than mere glan- 
dular structure; and that what the stickler 
for nosological niceties should hesitate in 
calling schirrous or carcinomatous, is in 
strict propriety, and especially in regard 
to its remedial demands, often the same 
with actual cancer; and to be arrested in 
its progress by the duc application of that 
principle, to which the Reporter has re- 
ferred in preceding papers, as in his mind 
worthy of more sanction and encourage- 
ment than it has hitherto met from the 
profession, The naturam expellus furcad 
charge hasbeen brought against the pro- 
priety of treating caucerous, and other 
cutaneous or glandular disorders, by ban- 
daging and pressure; but a most.respec- 
table female, who formerly had a schirrous 
breast, has just called upon the Reporter 
actually in rnde health, and “ without a 
vestige remaining (to use her own expres- 
sions,) of those symptoms which used to 
excite so much alarm.” ‘I was told (she 
adds,) by one of the most respectable sur- 
geons ir London, that no remedy could 
be found for me but the knife, bat [ pre- 
ferred the plan of pressure and bandaging 
as recommended by Mr. Young, and it is 
now two years since I have found myself 
free both from local and general com- 
plaint.” ‘The case of Mrs. Desormeaux, to, 
which allusion has before been made, is - 
proceeding to the satisfaction and surprise 
of the parties concerned; and the partial 
good operated in some other forlorn cases, 
which the Reporter -has recently seen, 
certainly favour, as far as they go, the 
rectitude and \practical value of the 
principle. 
Rheumatism has proved the prevailing 
disorder of the past month; but it bas not 
in general been marked by a regular, or, 
so to say, articular character,—it has for 
the most part been more deep-seated 
among the muscular fibres, and when the 
especial locality of the complaint has 
proved. that of the breast-muscles, the 
practitioner has found the disorder not 
very casily distinguishable fvom proper 
plourisy ; 
