matic pericarditis are generally greater in the cases in which the accompanying rheumatism is very acute than in those in which it is subacute. Whether pericarditis be more frequent in the more severe than in the less severe form of rheumatism, the author's cases, he confesses, do not enable him with confidence to determine; as far as they go, however, they are opposed to the notion of the frequency of the one being in the direct ratio of the severity of the other, for three fourths of the examples of rheumatic pericarditis occurred in subacute rheumatism. (d) Stage of the rheumatism. In more than one half the cases of rheumatic pericarditis the affection of the heart appeared on or before the fourth day of the disease. With one exception, the pericarditis did not appear sooner in those cases in which it was very severe than in those in which it was much less severe. (e) Influence of repeated attacks of rheumatism. In the cases examined pericarditis was found to be both more frequent and more severe in the first than in subsequent attacks of rheumatism. (f) Previous disease of the heart. Ten out of fifteen patients had no previous disease of the heart; and among these were found all the most severe cases of pericarditis. (g) Age. Of 15 patients 9 were aged 20 or under, 5 from 20 to 26, and 1 above 40. (h) Sex. Of 15 patients 9 were males and 6 females. Rheumatism is, however, more common among men than women. (i) Influence of venesection. 12 of these 15 patients had not been bled before the pericarditis appeared; the remaining 3 were bled, 1 eleven days, 1 five days, and 1 three days before the pericarditis supervened. Even Dr. Taylor must have his hypotheses. Here is an outline of his theory of the manner in which rheumatism produces pericarditis. The cause of acute rheumatism is probably the presence of some morbid matter in the blood, which has an especial affinity for the fibrous and fibro-serous tissues of the body, and which, by fixing itself in one or more of these, induces various local inflammations. The similarity of the structures implicated is probably the reason why rheumatic pericarditis or endocarditis often occurs at the same time with, or succeeds to, rheumatic inflammation in the joints (Bouillaud), just as rheumatic inflammation in one joint occurs with or succeeds to that in another. And the heart is more frequently [??] and more severely affected in severe cases of acute rheumatism for the same reason that more joints are affected, and these more severely affected, and more fever present, in such cases. And the efficient cause of such greater severity may not improbably be a greater abundance of the materies morbi in the blood. Now we cannot, we confess, concede to this theory the quality of close inference; and in some of its elements it is deliberately defective. Observe Dr. Taylor arguing that the heart is more frequently affected in severe than in mild cases; though his facts, as far as they go (see last page), positively demonstrate the reverse. But if he fail, he may console himself with the reflection that this is a matter in which le plus fort perdrait son Latin. II. Next the author enters upon a detailed examination of Bright's disease as a cause of cardiac membranous inflammations.* It has already * Since the production of Dr. Taylor's paper, exhibiting, as it does, clearly and for the first time, the powerful influence of Bright's disease in generating pericarditis, many individuals have undergone abrupt opening of the eyes as to the extensive and accurate information they themselves already possessed on the point. As though the fact, vaguely known even by the most ignorant, that among the been seen that in 13 (or more than one third) out of 35 cases of pericarditis Bright's disease was the only assignable cause of the inflammation. In respect of the frequency of pericarditis and endocarditis in Bright's disease hear Dr. Taylor's facts. 1. In the bodies of 50 patients who had either died of Bright's disease, or who were ascertained to have this disease in an advanced stageAcute pericarditis was found in 5, or in 1 out of 10. Acute endocarditis was found in 4, or in 1 out of 12. 2. On the other hand, in 142 bodies in which the kidneys were not affected with any appreciable disease Acute pericarditis was found in 4, or in 1 out of 35. Acute endocarditis was found in 2, or in 1 out of 71. Pericarditis and endocarditis therefore, being four times more frequent in fatal cases of Bright's disease than in fatal cases without renal disease, it seems clearly to follow that the influence of Bright's disease in producing these inflammations is unquestionable and great. 3. From a comparison of the frequency of other internal inflammations in fatal cases of renal disease, and in fatal cases without renal disease, it appears: (a) that the proportional number of acute internal inflammations (exclusive of those of the heart) is twice as great in the series of cases with renal disease as in that without such disease,-the numbers being respec tively 96 and 42 per cent. (b) That the proportion of patients likewise, among whom these inflammations were distributed, is greater in the former than in the latter series of cases, the numbers being respectively 60 and 36 per cent. Hence the safe inference is drawn that Bright's disease has a great tendency to produce other internal inflammations besides those of the heart. 4. A further examination of the same facts shows that the relative frequency of various internal inflammations is different in fatal cases of Bright's disease and of other diseases taken indiscriminately. The following inflammations (those inquired into by the author in connexion with the present point) are arranged in the order of their frequency, as they were calculated to be due to renal disease, or to the causes operating in other fatal diseases. (a) Inflammations due to renal disease. Cerebritis, pneumonia, pleuritis, pericarditis, endocarditis, meningitis, peritonitis. (b) Inflammations independent of renal disease. Pleuritis, pneumonia, peritonitis, meningitis, cerebritis, pericarditis, endocarditis. 5. The numbers given in the author's paper allows us to calculate the comparative tendency to produce internal inflammations exhibited, on the one hand, by the sum of causes operating in fatal cases of Bright's disease,—and, on the other hand, by the sum of causes present in fatal cases without renal disease. The result is displayed in the following tabular arrangement. secondary serous inflammations of the renal disease, sparse examples of pericarditis might be found, could (except by the most addled of brains) be considered anticipatory of the discovery that Bright's disease (in its advanced, as distinguished from its early, stages) is as active a cause of pericarditis as acute rheumatism! Hear the remarkable profession of faith put forth by Dr. Latham on this point: "My own experience of pericarditis is mainly derived from what it is, as an accompaniment of acute rheumatism. I have seen the disease, indeed, under other circumstances; but it has been very seldom; so seldom, indeed, that I have little acquaintance with other conditions, external or internal, conducing to it. I can neither tell whence to look for it, nor when to expect it, except when it occurs as a part of acute rheumatism... .Separate from acute rheumatism, even the practice of a large hospital does not present me with more than an instance or two of it in several years." (Lec. tures on the Heart, vol. i, p. 136.) Bright's disease produces a. Endocarditis almost 5 times as often as all other causes put together. b. Cerebritis fully 3 times as often as c. Pericarditis 24 times as often as d. Pneumonia just as often as e. Pleuritis 3 times as often as 3 times less frequently than f. Meningitis,, In instituting his next inquiry, namely, into the comparative power of acute rheumatism, and of Bright's disease in producing pericarditis and other internal inflammations, the author meets at the threshold with a difficulty, in the fact that one of these diseases is acute and seldom fatal, the other chronic and generally fatal. Dr. Taylor considers that the best way of steering clear of this difficulty is by comparing fatal cases of Bright's disease with ordinary cases of acute rheumatism. If the object were to ascertain the proportion of cases, in which traces of previously existing inflammation were found, this method would be decidedly objectionable; because the one disease, having run a much longer course than the other, would have had much more time than the latter to produce any inflammation, which it had the power to produce. But if cases of actually existing inflammation alone be counted, the same objection (or certainly not by any means to the same extent) does not exist; and the result should not (we agree with the author) be far from the truth. It appears, then, that of 75 cases of acute rheumatism, 8 were complicated with pericarditis (1 in 94). 50 cases of fatal Bright's disease, 5 were complicated with pericarditis (1 in 10). Hence Bright's disease, in the advanced stage, and acute rheumatism appear to have caused acute pericarditis in a very closely equal proportion of cases. An examination of 20 cases of old adhesion of the pericardium, however, shows (what the considerations already put forward might have led us to anticipate) that old adhesions of the membrane were produced twice as often by Bright's disease as by previous attacks of acute rheumatism. From considerations remarkable for their sustained closeness and sagacity, but for which we must refer our readers to the original, Dr. Taylor infers that acute rheumatism has a greater tendency to produce pericarditis than has Bright's disease in its earlier stages; and consequently that the tendency of Bright's disease to induce pericarditis, and probably also other internal inflammations, increases in proportion as the affection of the kidney is more advanced. This inference (which had on imperfect and theoretical grounds been admitted by others) it is pleasurable to find established, as it is established, in these pages. In conclusion, Dr. Taylor makes some remarks upon the probable occurrence of pericarditis in other blood-diseases besides those observed by himself; and likewise on the importance of the constitutional or predisposing causes of inflammation, as distinguished from the exciting causes. To these we invite the reader's attention. The esteem in which we hold the contributions of Dr. Taylor to the history of pericarditis, appears not only from the closeness with which we have analysed them, but from the simple fact of our having noticed them at all in the pages of this Journal. As our readers are aware, it is not our habit to cull papers from periodical literature, and make for ourselves from the sum of these the basis of an analytical article. The absolute value of the original productions, and the hope that Dr. Taylor's example would lead others to engage in pure clinical observation (apart from chemistry and micrology gone mad) led us to swerve from our usual habits. We trust Dr. Taylor will give us more of his "Contributions;" but whether he do or not, he has established for himself the highest character the physician can aspire to-that of a sagacious and an honest observer. ART. XIX. The Human Brain: its Structure, Physiology, and Diseases. With a Description of the Typical Forms of Brain in the Animal Kingdom. By SAMUEL SOLLY, F.R.S., Senior Assistant-Surgeon to St. Thomas's Hospital, and Lecturer on Clinical Surgery, &c. &c. With numerous Wood-Engravings. Second Edition.-London, 1847. 8vo, pp. 688. THIS very beautiful volume might almost be considered as a new work, rather than as a new edition of the treatise published by Mr. Solly under the same title eleven years since, and noticed by us with much commendation in our Eighth Number, Its size has been greatly augmented; the whole of its matter has been remodelled; and the lithographic plates of the original have been superseded by no fewer than 118 wood-engravings, many of them of the most elaborate character, and all executed in the first style of art. We regret that our limits compel us to present our readers with a much more cursory notice of its contents than their important character might fairly claim; and in justice to Mr. Solly we shall chiefly direct attention to those features of his work which give to it its most distinctive character. The first chapter gives a sufficiently ample description, derived from the most recent and accurate sources, of the elementary structures of which the nervous system is composed. Mr. Solly may very reasonably lay claim to the merit of having been among the first to entertain that view of the functional relations between the white and gray, or the tubular and vesicular forms of neurine, which is now almost universally received amongst physiologists; having expressed himself quite clearly and decidedly on this point in his first edition. Evidence in favour of this doctrine has since been furnished from so many different sources, and it seems altogether so firmly based, that we now are tempted to overlook its very recent origin, and to wonder that it should have been ever doubted. In the second chapter, we find such a general resumé of the comparative anatomy of the nervous system, as is calculated to prepare the student for the due comprehension of its structure in man. Commencing with the starfish, he shows that we find in it the elements of the most highly developed nervous system; namely, ganglionic centres, commissures, and nerves. The brain of man is nothing else than a collection of distinct ganglionic centres, packed together in one mass; its complexity of structure depend ing upon the number of these which the different functions require, and upon the intimacy of relation which is established between them by the various commissures. Mr. Solly proposed, in his former edition, the term hemispherical ganglia to distinguish the cortical substance of the cerebral hemispheres from the other masses of gray matter which are included under the collective designation Brain, or even within the more limited term Cerebrum; and although it is rather too lengthy for ready use, we do not know what other could be advantageously substituted for it. His early perception of the fact, that the various insulated patches of gray matter at the base of the cerebrum and in the medulla oblongata must be regarded as so many distinct and independent ganglia, each of which has its own proper function, was, in our apprehension, the great merit of his original descriptions; and it has been his guide in various subsequent anatomical inquiries, the results of which we shall presently notice. After a brief general exposition of the nature and offices of the principal divisions of the nervous system, Mr. Solly traces these through the higher invertebrata; quoting the anatomical descriptions of Garner and Owen for the mollusca, and of Newport for the articulata; and adopting the physiological explanations given by Dr. Carpenter in his Prize Thesis and subsequent writings. It is to the anatomy of the nervous system in the vertebrated classes that Mr. Solly has more particularly devoted his own attention; and here we find the descriptions drawn almost entirely from his own observations, although he has occasionally profited by the writings of Serres, Leuret, Owen, and others. In attributing to Professor Owen and to Mr. Newport, in a former article, the first indication of the true homology of the cephalic ganglia of the mollusca and articulata respectively, we had overlooked the fact that Mr. Solly had previously stated, in general but distinct terms, his opinion that the hemispheric ganglia are organs confined to the vertebrata, and that the cephalic ganglia of the invertebrata are collective representatives of the ganglia in immediate connexion with the organs of sense, which make up the principal part of the encephalon of the lower fishes. This is another instance of Mr. Solly's clear-sightedness; and we gladly accord him the credit of having been, as we believe, the first to form a stable and permanent bridge over the chasm that was previously supposed to divide the encephalic centres of the vertebrated from those of the invertebrated animals. If, as we believe, our future advances in the physiology of the brain depend more upon a philosophical use of the facts supplied by comparative anatomy, than upon any other single source of information, we shall owe much to Mr. Solly for having thus indicated the right path of inquiry. At the time when Mr. Solly's first edition was published, anatomists and physiologists were far from being agreed respecting the homology of the fish's brain; and many mistakes had been made, in consequence of insufficient scrutiny into the connexions of the elements of which it is composed. Where four ganglia were present in approximation with each other in the antero-posterior direction, as in the encephalon of the eel or pike, the most anterior, from its evident connexion with the olfactory nerves, had been recognised as the olfactory ganglion, whilst the hindmost had been universally and correctly designated as the cerebellum. But of the two intermediate ganglia, the anterior were regarded by some, and the |