'Gaze on yon forms, corroded and defaced- Ages have vanish'd since those hearts were cold, And they have borne, to light another land, The quenchless ray that soon shall gloriously expand.' We earnestly hope that this sanguine prediction may be realized; although it is, we think, tolerably clear that we shall not live to see it. The efforts of Chantry, however, are cheering and ennobling to the English mind; and we have even heard them preferred to the truly classical and chaste productions of his contemporary, Canova. The height of Phidias has been lowered from the Acropolis of Athens to the level of the London pavement. Let us trust that, in the contemplation of these unrivalled fragments in their present unexpected situation, some northern and native genius may be awakened, and give the world another object to admire, although not to adore, like the Olympian Jupiter. Art. V. Commentaries on some of the most important Diseases of Children. By John Clarke, Esq., * M.D., &c. &c. Part I. Royal 8vo. pp. 200. 10s. 6d. Boards. Longman and Co. FOR OR a long course of years, the author of these Commentaries has been known as an able lecturer on the diseases of women and children, and as having enjoyed extensive opportunities of making observations on them, during a very enlarged practice both public and private. In the present work, he proposes to lay before his readers the result of his experience on some of the most important maladies to which the * This unscientific appendage to the author's name we suppose to have been added by the bookseller. early early period of life is incident, but does not aim at a regular systematic account of the whole of them. The volume, which appears to be only the first of a series, is divided into eight chapters, by a typographical error numbered seven; and the first is intitled General Observations on the Diseases and Mortality of Children, and on the State of Medical Knowlege on these Points.' Dr. Clarke shews, in a striking manner, the great proportion of children who are cut off in infancy, by arranging, in the form of a table, the total number of deaths that have occurred in the metropolis for a space of forty years; next, those of children under two years of age, during the same time; and, lastly, the deaths between the ages of two and ten. The result is, that the total number of deaths amounts to 836,285; the number of those who died under two years is 281,408; and of those who died between two and ten, 113,393. On this statement he remarks; If the assumption above stated be true, that in early life the births and burials are equal, then it follows, that of all the children born within the district comprehended in the bills of mortality, nearly a fourth die under two years of age, and of the survivors, about a fifth in the succeeding eight years, that is, under ten years of age. In some years, as in 1760, 1765, 1766, 1767, 1768, 1769, and many others which may be easily referred to, more than a third of all the burials are of children under two years of age.' Although some circumstances may exist in the constitution and habits of children, which render them more subject to mortality than when they have reached a more advanced period, yet a considerable part of this destruction may pro bably be traced to mismanagement or neglect; and it becomes a most important object to inquire what those causes are, and how far they may be remedied. Those on which Dr. Clarke particularly insists are the effects of cold and moisture; and especially the injudicious manner in which children among the higher classes are clothed, from a mistaken idea of hardening them by exposure to the severities of the weather. Many circumstances prevail among the poor, which seem almost unavoidably to act in a very unfavourable manner on the lives of infants: but one of the principal causes of mortality is conceived to arise from the propagation of infectious diseases; and this is an evil which, by proper management and legislative interference, it is presumed might in a great measure be obviated. Besides these sources of destruction, there are diseases peculiar to children, many of which are necessarily of a fatal tendency; and the author thinks that this tendency is much aggravated by the little attention which regular practitioners have paid to infantine D 2 infantine complaints, and by the consequent abandonment of them to the destructive nostrums of quacks, or the baneful recipes of old women. That the neglect, of which Dr. Clarke complains, did exist, and even not more than half a century ago, we think is undeniable: but we apprehend that his remarks scarcely apply to the present order of things, and that all well-educated men consider the diseases of children to form as essential a part of their studies as those of any other description of individuals. Chapter II. treats On the Structure of the Mouth and Organs of Digestion in Children, and the Diet proper for them at different Ages dependant upon it.' The great object of this part is to shew that the progress of dentition tends to produce an inflammatory state; that this tendency is much increased by a full diet, and that from this cause many of the diseases of infancy immediately flow. The conclusion deduced from reasoning on the subject coincides with the dictate of nature, that the mother's milk is the most proper diet for her offspring; and that, in those rare cases in which an insurmountable obstacle prevents the parent from nursing her child, a food should be prepared as nearly as possible resembling milk, which, by means of a suitable apparatus, may be taken in by suction. The plan of wet-nurses is justly reprobated, as never admissible. Animal food should not be taken until children have obtained all their teeth, and then sparingly: neither their stomachs nor their palates require any diversity of diet; and fermented liquors of all kinds, and in all quantities, are strictly prohibited. This section contains many minute directions, which deserve the attentive perusal of those who are interested in the subject. The third chapter relates to Dentition. It is remarked that the process of dentition is a natural one, and does not seem to produce any injurious effects on other animals; yet we all know that it is often attended with danger to the human subject. To a certain extent, this may be a necessary evil, but it is often augmented by improper management, and more especially by the excessive quantity and improper quality of food. Another circumstance, on which Dr. Clarke insists, is the custom of keeping the heads of children too warm; thus increasing the natural tendency to the inflammatory state which always attends the process of dentition. After some useful advice on these topics, he thus sums up his opinion: • In conclusion it may be observed, that fewer inconveniences attend on dentition, when the process goes on slowly, than when it is more rapid-when the head has been kept cool than when a contrary practice has been pursued-in those children whose 3* diet diet has been properly regulated, than when less attention has been paid to it—and, lastly, in those whose constitutions are least prone to plethora.' In the two next chapters, both numbered four, the Doctor treats on Convulsion; in the first, on the disease in general; in the second,' On a peculiar Species of Convulsion in Infant Children.' The term convulsion is often employed very indefinitely, but in its most correct acceptation may be considered as approaching to epilepsy. Having described the symptoms, the author remarks that it is never an idiopathic disease, but may generally be traced to some pre-existing cause; or the cause, as in the case of infectious eruptive diseases, such as small-pox, scarlet fever, and meazles, will develope itself in the course of a day or two, if the exposure to infection was previously unknown.' It is important to be aware of the dis ease on its first approach, and the following are pointed out as the symptoms which precede the attack: fever, drowsiness, yawning, sighing, increased irritability, impatience of sound and light, indigestion, and an uneasy state of the respiration. The 'peculiar species' of convulsion is said to consist in a peculiar mode of inspiration, which it is difficult accurately to describe.' It is thus characterized: The child having had no apparent warning, is suddenly seized with a spasmodic inspiration, consisting of distinct attempts to fill the chest, between each of which a squeaking noise is often made; the eyes stare, and the child is evidently in great distress; the face and the extremities, if the paroxysm continues long, become purple, the head is thrown backward, and the spine is often bent, as in opisthotonos; at length a strong exspiration takes place, a fit of crying generally succeeds, and the child, evidently much exhausted, often falls asleep.' The As to the pathology of convulsion, the author thinks that the brain is always organically affected, either directly or indi- ́ rectly; directly in phrenitis, hydrocephalus, &c., and indirectly from an overloaded stomach, inflammation of the chest or heart, glandular tumours, or other similar causes. paroxysm is immediately produced by pressure on the brain, either from excessive fullness of the vessels or from morbid substances within the skull. Dr. C. lays down the general principle that it is more conformable to reason and observation to infer that convulsive affections arise from some derangement of organization, however temporary, than to resort for an explanation of them to imaginary causes, and such as offer to the mind no satisfactory conclusions.'-In the fifth chapter, on the "Treatment of Convulsions,' it is observed that many cases of the disease, depending on disorganization of the brain, are obviously irremediable: but in the majority of cases which are D 3 203281 curable, curable, the discase arises from an undue fullness of the vessels of the brain, and our chief dependence must be placed on evacuation, especially topical bleeding and active purgatives. The application of ice to the head is strongly recommended: but the author has no confidence in what are usually styled anti-spasmodics. - 6 We have incautiously extended our observations so far with` respect to the opening chapters, that we shall be obliged to pass more hastily over the next, which treats On Phrenitis, or Inflammation of the Brain in Children,' although it is very interesting. Dr. Clarke considers this malady to be a far more common disease of children than it has been suspected to be; and numbers who have been supposed to be cut off by idiopathic convulsions, have probably died of inflammation of the brain, of which the convulsive paroxysms were only symptomatic. It is supposed by the author to be more frequent in children than in adults, because the different processes which are going forwards in the system during the early period of life require a greater portion of blood to be sent to the head. Peculiarities of structure also subsist in certain individuals, and in certain families, which produce corresponding peculiarities of action, and lay the foundation for this and other diseases. The symptoms are described with minuteness, and it is particularly remarked that they exhibit themselves under two forms; sometimes coming on so gradually as to be scarcely observed, and at other times being very violent from their commencement. They are divided, as usual, into two stages; 1st, that of increased irritability, while the inflammatory action of the vessels is going forwards; 2dly, that of diminished irritability, when the patient is suffering from the effects of the previous inflammatory state, and when effusion has taken place. The whole progress of the complaint is traced with great minuteness and at considerable length; and, although we are not to look for much that is absolutely new, or has not been described before, we perceive marks of original and accurate observation that is always interesting and instructive. The prognosis must be very unfavourable, but the disease is certainly curable in the first stage, and possibly even in the second; and the author apprehends that a contrary opinion has occasionally caused the death of the patients, by preventing the attendants from applying those prompt and decisive measures which are alone adapted to the case. Copious bleeding, in different ways, is the grand remedy, and that on which we are to place our chief dependance; next in importance are to be ranked purgatives; and, among remedies of minor utility, but not to be disregarded, are antimony and ipecacuanha, to promote |