776 
case shews the powers of nature in reco- 
very from such serious injury, but we 
question whether amputation would not 
have been preferable. 
Art. XLVI. 
the LEsophagus. 
pital. Vol. I. 8vo. 
OUR readers are too well acquainted 
with the former volume of this work to 
require to be informed of its contents, 
any further than to remind them, that in 
it the author treats very fully.of the me- 
thod of removing stricture by caustic first 
proposed by John Hunter, explains the 
structure of the parts, gives very full di- 
rections for the application of the caus- 
tic, and relates a variety of cases, both of 
the more freyuent kind, and where other 
morbid sympronis accompanied the stric- 
ture, and often interfered with the pro- 
posed mode of cure. The stricture of 
the esophagus is also noticed briefly in 
the first volume. 
In the present volume Mr. H. takes 
a much wider range; he first endea- 
voulrs to point out a sufficient diagnosis 
between temporary spasm of the urethra 
and permanent stricture ; after which he 
assumes the position, that stricture is in 
itself a primary cause of a great variety 
of diseases, chiefly of the organs connect- 
ed with its seat, or contiguous to it, often 
unsuspected, and often going on. to a 
fatal termination after severe and pro- 
tracted misery. 
The general complexion of the work, 
therefore, is to direct the attention of the 
practitioner more particularly to this dis- 
ease than has hitherto been done, to in- 
duce him to bear constantly in mind the 
possibility of its existence, where any 
morbid affection of the organs exist ; 
and to lead him to have recourse to the 
Hunterian method of cure with caution, 
and ‘perseverance. ; 
The propriety of use of the caustic in 
the extensive manner in which Mr. H. 
recommends, and very largely practises, 
has been, and still is, the subject of much 
controversy. We do not thinkit incum- 
bent upon ws to enter into it in this place, 
our present object being briefly to state 
the arguments for the practice here 
brought by its ablest defender. 
‘The author in the preface relates the 
particulars of a successful case where 
the caustic was condemned by Mr. Ben- 
jamin Bell, the only one of his cpposers 
whom he personally notices, ; 
“ MEDICINE, SURGERY, ANATOMY, &c. 
The plates are executed in an extreme- 
ly coarse style. The work is very hand- 
somely dedicated to the governors of the 
Gloucester Infirmary. 
Practical Observations on the Treatment of Strictures in the Urethra and in 
By Everarv Tome, £sg. F.R.S. Surgeon to St. George’s Hos 
The first chapter contains general ob- 
servations upon strictures, from which, 
as itis in some degree the summary of 
the opinions afterwards maintained, and 
unembartrassed by cases, we shall extract 
several passages, 
Yirst, of the symptoms of constitu- 
tional diseases, induced by stricture, the 
author thus speaks. 
«« The constitutional symptoms, which bee 
long to a stricture in the urethra, have been 
more frequently mistaken for an original dis- 
ease than those of any other local complaint; 
and it is only within these few years that this 
error has been detected. I have been ena- 
bled to determine, that the following consti- 
tutional affections, which I shall soon men- 
tion, occasionally belong to strictures in the 
urethra, by three different modes. The first 
is, that patients are liable to them when la- 
bouring under that disease; the second, that 
they very often are brought on in the course 
of a few hours after an armed bougie has been 
applied to the stricture; and whenever they 
follow such an application, it has been found 
that the symptom then produced has, at a tor- 
mer period, We met with in the same pa- 
tient. The third is, that after the removal 
of the stricture the symptoms disappear, al- 
though the patient had been liable to them 
for a number of years. Such evidence, when 
collected upon a large scale by a person of ex 
tensive experience, can admit ot little if any 
fallacy.” 
The particular symptoms are paroxysms 
resembling that of a regular intermit- 
tent, (also often brought on by the ap- 
plication of caustic,) feverish indisposi- 
tion, extreme irritability both of mind 
and body, derangement in the digestive 
organs, sometimes erysipelas, and erups 
tions of the skin. 
‘The stricture, when of long duration, 
often changes from being only a mem- 
branous band to a hard cartilaginous 
body, requiring all the skill of the sur- 
geon, and we imagine that: degree of re- 
solute patience in the sufferer, which 
would only be endured, generally speak- 
ing, in diseases of the part here affected. 
The inference, from much experience, 
Mr. H. lays down with confidence. - 
« This mode of treating strictures having 
