the three cases as reported in the "British and Foreign Medical Review," I was struck with the number of hooks which were employed, and the necessity arising therefrom, for many assistants, who, in all operations, but especially in operations upon the eye, too often interfere with each other, and with the operator.

In Professor Dieffenbach's operation, no less than four hooks are employed, and one of these a double one; two for the purpose of keeping the eyelids apart, a third is passed into the conjunctiva, and the fourth, the double one, is fixed into the sclerotica. In none of the cases, with the exception of Catherine Cuthbert's, did I use more than one hook; and in the case of the child, Mary Anne Daly, I used none, having divided the conjunctiva with a knife and forceps. This latter instrument I have since found is not, for many reasons, to be depended upon as much as the hook; it gives more uneasiness to the patient, and is apt to lose its hold of the conjunctiva, which the hook never does until it is intentionally removed.

In deciding upon the best method of performing this operation, many circumstances must be taken into account in regard to the age of the patient; his moral courage; any cause which may disturb the relation of the orbit and its contents, so as to produce a too prominent eye or a too sunken one, as well as the degree of intensity of the strabismus.

In children it requires the greatest exertion to control their struggles. In the child Daly it was as much as two persons could do to steady her trunk and legs, the movements of which retarded the operation materially. On the contrary, in the case of Mr. Crossland, the great firmness he displayed, and the assistance he afforded me by everting his eye to the utmost, at the time I was passing the hook beneath the inner rectus muscle, rendered the operation almost bloodless, and enabled me to complete it in a minute and a half.

I have omitted to mention that I was indebted to the kindness of Mr. F. Kiernan, for the opportunity of operating on the boy Egan.

I have this moment seen the child, Mary Anne Daly; her eyes are perfectly straight, and a slight cicatrix is visible in the site of the operation.

BIBLIOGRAPHICAL NOTICES.

Stearns's Philosophy of Mind.'

The author is evidently an anxious inquirer after truth, and spareth no pains in the investigation. The topic, however, is one of intricacy, and requires a further examination than we can give to enable our readers to comprehend it. The whole subject indeed of metaphysics is presumed to be so obscure, that the word "metaphysical" is often employed synonymously with "incomprehensible ;"-nor do we think the reader will be disposed to have much clearer light after having perused the pamphlet before us. He must judge, however, for himself.

The fundamental principles of Dr. Stearns's Theory are professed to be the following:

"I. Man consists of three entities, BODY, SOUL and MIND.

II. The ideas of sensation are those carnal ideas which constitute the

1 Philosophy of Mind, developing new sources of Ideas, designating their distinctive classes, and simplifying the Faculties and Operations of the whole mind. By John Stearns, M. D., of the city of New York, late President of the Medical Society of the State. 8vo. pp. 25. New York, 1840.

animal propensities, and which we derive, in common with other animals, from the five senses:

III. The intellectual, and moral, and religious ideas, which some philosophers ascribe to reflection, and to innate principles, are derived entirely and exclusively from the soul. In the soul is held the high court of chancery, denominated conscience, or the moral sense.

IV. When the soul operates upon the brain, it produces what may be denominated a moral mind, endowed with intellectual and religious faculties and until excited to action by this operation, the faculties of the brain remain perfectly dormant.

V. When the senses operate upon the brain, they produce what may be denominated sensual mind, which man possesses in common with the inferior animals, but which is essentially changed and improved by the accession of the soul to the body." p. 9.

Mütter on the Salt Sulphur Springs.'

We have frequently drawn attention to Dr. Mutter's successful labours as a skilful surgeon. The pamphlet before us exhibits him in a new sphere -the salt sulphur springs is the subject, and we fear that the very fact of having chosen such a topic has led him, in spite of himself, to too favourable a bias in regard to their virtues, which may hardly bear the test of observation in all cases. If an author commences with a disposition to eulogize—and no one takes up such a subject with a view to disparage-he is apt to be led away in spite of himself far beyond the sober limits within which he ought to be restricted. We have already given, more than once, our opinion of mineral waters in general, and have expressed the belief, that in the large mass of cases to obtain plenary benefit, they must be drunk at the source. Nor has the pamphlet of Dr. Mütter dispelled this belief. We doubt not, that the water in question is energetic in its action on the frame; but in the multitude of nervous and other diseases for which it is advised by Dr. Mütter, we must look to the curative agency of travelling air and exercise, change of society, scenery, social habits, rather than to the water itself. To one, however, who is about to visit the springs in question, we can recommend the pamphlet of Dr. Mütter, as containing much information of great interest to him.

MISCELLANEOUS NOTICES.

Dr. Gross.-Louisville Institute.-This gentleman has been recently appointed Professor of Surgery in the Louisville Medical Institute, on the resignation of Dr. Flint. The appointment we are sure is a judicious one. Dr. Gross has distinguished himself as an enthusiastic promoter of his profession more for its own sake than as a mere means of subsistence, and his recent work on pathological anatomy has exhibited with what success he has prosecuted a difficult and important branch. To that work we have already referred on two occasions; and we have esteemed this a more ad

'The Salt Sulphur Springs, Monroe county, Va. By Thomas D. Mütter, M. D., Lecturer on Surgery, Corresponding Member of the New York Medical Society, Fel low of the College of Physicians of Philadelphia, Member of the Pathological Society of Philadelphia, &c. &c. 8vo. pp. 32. Philadelphia, 1840.

visable plan than giving a lengthened notice of it, which neither our limits nor the nature of the work itself would permit. It is indeed impossible in the compass of a couple of pages to give any extract, which can do more than exhibit the entire inadequacy of the attempt to do justice to a work of two large 8vo. volumes. Yet although our limits restricted us to a brief notice, our opinion of the work was strongly and decidedly expressed, and a farther examination of it confirms those favourable sentiments.

We are not in the custom of speaking in the language of hyperbole, but we can recommend it as strongly to our readers as any work which has fallen under our critical notice for years.

Annual Report of the Pennsylvania Hospital.-The following is the abstract of cases treated in this valuable charity during the year ending April 25, 1840.

Abstract of the Cases of 1155 Patients treated in the Pennsylvania Hospital during the official year ending 4th month 25th, 1840.

Vermont Academy of Medicine.-The number of students in attendance during the last session, according to catalogue, was 57.

Ptyalism from the medicinal use of Arsenic.-By George Jones, St. Leonard's-on-Sea, April 28, 1840.'-In consequence of a paper by Mr. Hunt, reported at p. 77, vol. 2, of the Medical Gazette, I have occasionally prescribed arsenic in cases of monorrhagia, and with manifest advantage. The following very decided cure from its use was attended with symptoms which I have no recollection to have seen recorded as resulting from the medicinal use of this mineral, and may, therefore, not be uninteresting to your readers.

Mrs. L., æt. 46, stout in person, and of a florid complexion, says, that "for several months she has not been free from the menstrual evacuation, and that now she is almost drained by it."

B. Liq. Arsenic, 3iij.; Sp. Lav. C. 3i. M. Capt. gtt. vij. ter quotidie ex aqua. The case was nearly lost sight of for a month, during which she had con

'Lond. Med. Gaz., May 8, 1840, p. 266.