the knife may sometimes be advantageously employed I do not deny, but instead of being the rule, it should be the exception; the majority of honourable and enlightened surgeons will admit how little it has served them in most cases beyond the mere purpose of temporary palliation. When you hear a man now-a-days speaking of the advantage of early operating, you may fairly accuse him of ignorance, with which, I regret to say, interest, in this instance, may occasionally go hand in hand. The fee for amputating a breast enters into the calculation of some operators.

I have twice in my life seen Cancer of the male Breast-the subject of one was a European, the other a native of India.

Let me now say a few words on

TUMORS

1

generally; premising that the term "Tumor" is merely the Latin word for any Swelling, though we usually employ it in the more limited sense of a morbid growth. It is a very common error on the part of medical men, to state in their reports of cases, that a "healthy" person presented himself with a particular tumor in this or that situation. Now, such practitioners by this very expression show how much they have busied themselves with artificial distinctions-distinctions which have no foundation in nature or reason -to the neglect of the circle of actions which constitute the state of the body termed Health. Never did a tumor spring up in a perfectly healthy subject. In the course of my professional career, I have witnessed Tumors of every description, but I never met one that could not be traced, either to previous constitutional disturbance, or to the effect of local injury on a previously unhealthy subject. Chills and heats have been confessed to by almost every patient, and the great majority have remembered that in the earlier stages their Tumor was alternately more or less voluminous.

Every individual, we have already shown, has a predisposition to disease of a particular tissue. Whatever shall derange the general health may develope the weak point of the previously healthy, and this may be a tendency to Tumor in one or more tissues. The difference in the organic appearance. of the different textures of the body, will account for any apparent differences betwixt the Tumors themselves; and where Tumors appear to differ in the same tissue, the difference will be found to be only in the amount of the matter entering into such tissue, or in a new arrangement of some of the elementary principles composing it. It is a law of the animal economy, that when a given secretion becomes morbidly deficient, some other makes up for it by a preternatural abundance. If you do not perspire properly, you will find the secretion from the kidneys or some other organ increase in quantity. I was consulted some time ago by a female patient, whose bosom became enormous from excess of adipose or fatty deposit. Now, in the case of this female, the urine was always scanty, and she never perspired. Every tissue of the body is built up by secretion. The matter of muscle, bone, and skin, is fluid, before it assumes the consistence of a tissue, and the atoms of one texture are constantly passing into some other. "The great processes of nature," says Professor Brande, "such as the vegetation of trees and plants, and the phenomena of organic life generally, are connected with a series of chemical changes." But, Gentlemen, this chemistry is of a higher kind than the chemistry of the laboratory; it is Vital Chemistry, under the influence, as I shall afterwards show you, of Vital Electricity. Secretion of every kind is the effect of this vital chemistry; and Tumors, instead of being produced, as Mr. Hunter supposed, by the organisation of extravasated blood," are the result of errors of secretion. They are principally made up of excess of some portion of the tissue in which they appear, or the result of new combinations of some of the ultimate principles which enter into its composition. If you search the records of Medicine upon the subject of Tumors, you will find that the agents by which these have been cured or diminished, come

at last to the substances of greatest acknowledged efficacy in the treatment of ague. One practitioner (Carmichael) lauds Iron; another (Alibert) speaks favourably of the Bark; the natives of India prefer Arsenic; while most practitioners have found Iodine and Mercury more or less serviceable in their treatment. Gentlemen, do you require to be told that these substances have all succeeded and failed in ague! Marvel not, then, if each has one day been lauded, another decried, for every disease which has obtained a name, Tumors of every description among the number. We now come to

PREGNANCY.

I must

But this, you will very likely say, is not a disease. In that case, beg to refer you to ladies who have had children, and I will wager you my life, that they will give you a catalogue of the complaints that affected them during that state, equal in size to Cullen's Nosology. In the case of every new phenomenon in the animal economy, whether male or female, there must be a previous corporeal revolution. We find this to be the case at the periods of Teething and Puberty-and so we find it in the case of Pregnancy. Can the seedling become an herb in the frost of winter, or the sapling grow to maturity without a series of changes in the temperature and motion of the surrounding earth? No more can the fœtal germ become the infant without a succession of FEBRILE revolutions in the parent frame! Once in action, it re-acts in its turn.

The influence of the mother's Brain over the growth of the child while in the womb, is sufficiently proved by the effects of frights and other passions, induced by the sight of objects of horror, and so forth, while in the pregnant state. Hare-lip, distortions, moles, marks, &c., have been traced by the mother to such passions in far too many instances to render us in the least sceptical upon that point. Now, in this particular instance, some of the parts or divisions of the mother's Brain must act in association or simultaneously, while others act independently or in alternation; for otherwise you could not understand how the Brain of the mother should influence the growth of the child in utero, and at the same time continue to play its part in the parental economy. Some of its various portions must act in these respects alternately, for they cannot do both at one and the same moment of time. But, here again, as in other instances, a want of harmony may arise the Brain may continue to exercise its influence over the child too long; in other cases it may forget the child for the mother. How such want of harmony affects the child, we can only guess from analogy. How a too long cerebral neglect of the mother's economy may influence her, we daily see in the numerous disorders to which she is then liable-more particularly in the periodic vomitings, and also in the swoon or faint which occasionally comes on during the pregnant state. Are not these the very symptoms that happen in the case of a person who has had a blow on the head, or who has been much bled? It appears to me probable that the infant's growth must take place principally during the period of maternal sleep; for it is chiefly in the morning, just as she awakes, that the mother experiences those vomitings and other symptoms, from which I infer the Brain has been too long neglecting her own economy. But even as a natural consequence of the more favourable alternations of cerebral movement which take place during pregnancy, the mother for the most part experiences Chills, Heats, and Sweats, she has symptoms, or shades of symptom at least, of the same.disorders that may arise from any other agency affecting the Brain in a novel or unusual manner-she becomes at certain times pale and flushed alternately, and, as in the case of other Fevers, frequently complains of headache. When blood-letting-the usual refuge of the ignorant-is in such cases tried, the blood drawn exhibits the same identical crust which, under the name of "buffy-coat," "inflamed crust," &c., so many practitioners have delighted to enlarge upon as the great peculiarity of true inflammatory fever!"

Pregnancy has been defined by some very great doctors, to be a "natural process." Now, that certainly is a very great discovery; but they might have made the same discovery in the case of Disease and Death. Is not every thing in Nature a natural process, from the fall of an apple to the composition of the Iliad? Every thing that the eye can see or the ear can hear, is natural; miracles only are miraculous; for they are events that are coNTRARY to the natural order of things. Pregnancy, then, is a natural process; but is it on that account the less surely a FEBRILE state? Is it for that reason the less certainly an Intermittent Fever ? What disorders have not originated in Pregnancy? What, in cases where they previously existed, has it not, like every other Fever, cured? If it has produced Epilepsy, Apoplexy, Toothache, Consumption, Palsy, Mania,-each and every one of these diseases have I known it to ameliorate, suspend, or cure! I remember he case of a lady who, before her marriage, squinted to perfection. But when she became pregnant her squint diminished, and long before the period of her confinement it was cured; never did I see such an improvement in the face of any person. Still, if Pregnancy has cured squint, I have known cases where it produced it. How completely, then, does this harmonise with the Unity which pervades Disease generally!

PARTURITION,

I have already said, is a series of pains and remissions, but it is NOT an intermittent fever; nor, indeed, has it any resemblance to that affection! So, at least, I have been assured by very clever doctors: and they have told me the same of pregnancy! Is this question, then, completely settled in the negative? Certainly; it is settled to the satisfaction of all who pin their faith upon mere human authority. But human authority seldom settled any thing with me; for wherever I have had an interest in knowing the truth, I have generally appealed from the decree of that unsatisfactory court to the less fallible decision of the court of fact. And what does fact say in this instance? Fact says that child-labour, in almost every case, commences with chills and heats, and that these are again and again repeated with longer or shorter periods of immunity during its progress. But how do I know all this? you will ask-I who hold modern midwifery in horror! I will tell you truly -I first guessed it; for I could not suppose that parturition, unlike every other great revolution of the body, could be either a pain-less or an unperilous state; or that it could be free from the chills, heats, and remissions, which 1 had always observed in cases of that character. Still, not being a person easily satisfied with guess-work, I took the trouble, in this particular instance, to interrogate nature. And as sure as the sun ever shone on this earth, nature completely verified the fact of my anticipation, that parturition, in every instance, is an intermittent fever. In some of my medical books, too, I found shiverings among the numerous other symptoms mentioned as incidental to women at this period. "Sometimes," says Dr. Ramsbotham, himself a manmidwife, "they are sufficiently intense to shake the bed on which the patient lies, and cause the teeth to chatter as if she were in the cold stage of an aguefit; and although she complains of feeling cold, the surface may be warm, and perhaps warmer than natural." Now, this cold sensation, as you well know, is often complained of by ague patients, even in the hot stage. In spite of every assertion to the contrary, then; in spite of every declaration on the part of medical or other persons, pregnancy and parturition are agues; agues in every sense of the word; for not only do their revolutions take place in the same manner as those of ague, but, like ague, both may be influenced by medicines, as well as by mental impressions. Indeed, in most cases of parturition, the labour-fit, mark the word! will stop in a moment from the new cerebral movement induced by fright or surprise. In some, the fit never returns, and the most terrible consequences ensue. When the fœtus is fairly

developed in the case of pregnancy, and the labour completed in that of parturition, health is the general result; but in the course of both, as in the course of other fevers, every kind of disease may show itself, and, when developed, may even proceed to mortality. An occasional termination of pregnancy is

ABORTION OR MISCARRIAGE;

and this, in every case, is preceded by the same constitutional symptoms as pregnancy and parturition, namely, the symptoms or shades of symptom of ague. Moreover, when a woman gets into a habit of miscarrying, such miscarriage, like an ague, recurs periodically, and takes place almost to a day at the same month as the first. A lady who had been married several years, but who had never borne a living child, although she had had frequent abortions, consulted me upon the subject. Her miscarriages having always taken place at the same period of pregnancy-about the end of the third monthI desired her when she should again become pregnant, to let me hear from her within a fortnight of the time she might expect to miscarry. She did so, telling me at the same time she knew she should soon be taken ill, as she had already had shiverings. I directed her to use an opium suppository nightly, which she did for a month, and she was thus enabled to carry her child to the full time. She had two children since, and all three are well and thriving. I have succeeded in similar cases with the internal exhibition of quinine, iron, hydrocyanic acid, &c. But opium, where the drug does not decidedly disagree, will be found the most generally useful of our medicines in checking the habit of miscarriage. Need I tell you, that in no case should it be continued where it excites vomiting.

The tendency to return of any action which has once taken place in the constitution, is a law even in some effects of accidents. A lady who, from fright during a storm, miscarried of her first child, a boy, never afterwards, when pregnant with boys, could carry them beyond the time at which she miscarried of the first. On the other hand, she has done well with every one of her daughters, five in number, all of whom grew to womanhood.

To mothers and nurses, next to pregnancy and parturition, there is no subject so interesting as

TEETHING.

By both, the birth of the first tooth, like the birth of a first child, is commonly expected with a certain degree of anxiety, if not of fear. Why is this? Why, but because, as in the case of pregnancy, before the dormant germ can be called into action-before the embryo tooth can be developed-there must be a complete corporeal REVOLUTION, an intermittent FEVER of more or less intensity, varying according to the varying conditions of particular constitutions? And what a curious unity runs through all creation, producing those wonderful analogies that alone can lead us to the proper study of nature!The embryo tooth, like the embryo infant, is the offspring of a womb-tiny indeed, but still rightly enough termed by the profession matrix, that being only another Latin word for uterus or womb. Both, also, are ushered into the world by fever. The more healthy and vigorous the child, the more subdued will the teething fever for the most part be, and the teething itself will consequently be less painfully accomplished; just as under the same circumstances the parturient mother will more surely bring forth her young in safety. In those cases, on the contrary, where the child is weakly or out of health, the fever will be proportionally severe. The generality of teething children, after having been comparatively well during the day, become feverish at a particular hour in the night. Now, the newly developed tooth, though in the first instance itself a mere effect of the fever, very soon contributes, by the painful tension which its increasing growth produces in the gum, to aggravate and prolong the constitutional disorder. It is first an effect, and then

a superadded cause or aggravant. Gentlemen, in this fever, we have a fresh illustration of the unity of disease; a fresh proof that intermittent fever, in some of its many shades, is the constitutional revolution which ushers in every kind of corporeal disorder. How many varieties of local disease may be produced during the intermittent fever of teething! Every spasmodic and paralytic distemper you can name; convulsion, apoplexy, lock-jaw, squint, curved spine, with all the family of structural disorders, from cutaneous rash and eruption to mesenteric disorganisation and dysentery. Should the gum be lanced in these cases? Who can doubt it? If you found the painful tension produced by the matter of an abscess keeping up a great constitutional disorder, would you not be justified in letting out the matter with a lancet ?— The cases are similar. In many instances of teething, then, the gum-lancet may be used with very great advantage; but with greater advantage still may you direct your attention to the temperature of the child's body. When that is hot and burning, when its little head feels like fire to your hand, pour cold water over it, and when you have sufficiently cooled it throughout, it will in most cases go to sleep in its nurse's arms. During the chill-fit, on the contrary, you may give it an occasional tea-spoonful of weak brandy and water, with a little dill or aniseed to comfort and warm it; having recourse also to friction with hot flannel, or to the warm bath. During the period of remission, the exhibition of small doses of calomel, quinine, or opium, with prussic acid occasionally, will often anticipate the subsequent fits, or render them trifling in comparison with those that preceded them.

But, Gentlemen, I should explain to you that you may sometimes be met with considerable opposition on the part of the wiseacres of the profession, when you propose Quinine or Prussic Acid in infantile disease,-in the cases of infants suffering from convulsions and flatulence. You remember what I told you of this disease that infantile convulsion depends in every instance upon cerebral exhaustion. It is often the effect of cold, and frequently follows upon a purge; I have known the disease come on after the application of a leech. "No fact," says Dr. Trotter, "is better known to the medical observer, than that frequent convulsions are a common consequence of the large loss of blood." And you may recollect that in the experiment of the animal bled to death by Dr. Seeds, flatulence and convulsions were among the symptoms produced by the evacuation. Some years ago, I was requested to visit a child affected with convulsions; before I saw it, the poor little thing had been the subject of thirteen distinct fits, with an interval of remission of longer or shorter duration between each. What do you think was the treatment to which this infant had been in the first instance subjected by the practitioner, then and previously in attendance? Though its age was under six months, and the disease clearly and obviously remittent, he had ordered it to be cupped behind the ear, afraid, as he explained to me, of the old mechanical bugbear, PRESSURE on the brain. How compatible this doctrine, permanency of cause, with remission of symptom! The quantity of blood taken was about an ounce, but the convulsions recurred as before. This was the reason why I was called in. The child at that particular moment had no fit so after taking the trouble to explain the nature of the symptoms to the attending Sangrado, I suggested Quinine as a possible preventive. The man of cups and lancets started, but acceded. The quinine, however, upon trial, proving abortive in this instance, I changed it, according to my custom, for prussic acid-after taking which, the infant was free from fits for a period of at least five or six weeks,-when the convulsive paroxysm recurred from what cause, I know not, unless it might be from a Purge which its mother injudiciously gave it on the morning of recurrence. The flatulence, too, with which the child was all along troubled, began to diminish from the moment it took the prussic acid. You may perhaps ask me in what dose I prescribed the acid here. I ordered one drop to be mixed with three ounces of cinnamon water, and a tea-spoonful of the mixture to be given