110 REVIEW— MR. PERCIVALL’S HIPPOPATHOLOGY. 
know little or nothing, and what little we do know is most un- 
satisfactory, — the diseases of the brain and nervous system ; and 
it is in some measure for the straightforward and honest manner 
in which he has treated it that we accord the author this praise. 
There are no second-sight pretensions to the perceiving of symp- 
toms which never were perceptible ; there are no clap-trap spe- 
cifics for curing incurable diseases, but the truth is plainly and 
often feelingly told. Take an illustration of this : — “ The treat- 
ment of tetanus, I fear, will turn out the least satisfactory part 
of our account, for it is one of those diseases with whose nature 
we are but imperfectly acquainted, and over which, in its worst 
forms, medicine exerts its power in vain : nevertheless, it is our 
duty to set about our task energetically, and in accordance with 
the best rules of our art. Our treatment, in whatever it may con- 
sist, must have regard to the origin, the kind, the stage, and 
intensity of the disease, and the age, constitution, and condition 
of our patient but <c our prognosis from the beginning must be 
one of hopelessness : with a few remarkable exceptions, most of 
which will be found recorded, tetanus and death have proved 
cause and effect.” This is manly, this is honest, and, as far as 
our own experience goes, it is true; for, without denying that 
some slight cases of trismus have been cured, we never saw a de- 
cided case of tetanus which the patient survived. In noticing 
the distinction between the symptoms of phrenitis and coma, 
we think Mr. Percivall has omitted a point of some little conse- 
quence : it is this, that in phrenitis the paroxysms are frequent 
and long continued, with very short intermissions; while in 
coma the lethargic state is most continuous, the exacerbations 
being fewer and much shorter; and we would call his attention 
to a most valuable adjunct, if not a principal part of the treat- 
ment of coma, which is, after the purgative has been given, the 
introducing of some powerful stimulus into the stomach every 
half hour or hour, until its energies are aroused. We have seen 
cases in which every dose has been followed by marked though 
evanescent effects, and the favourable results may be in a great 
measure attributable to their aid. The compound spirits of am- 
monia, or what is, perhaps, still better, the water of ammonia 
moderately diluted, will be found highly efficacious in these cases. 
