Book Reviews

It took a political, economic and jurisprudential upheaval, revolutionary in its ultimate effect if not in its immediate method, to confirm for American constitutional law, the observation of Justice Holmes that the "life of the law has not been logic: it has been experience." Sociological jurisprudence has carried the field before it; its devotees populate the judiciary, the bar, and the rostrum. Most all of them agree that the "felt necessities of the time, the prevalent moral and political theories, intuitions of public policy, avowed or unconscious, even the prejudices which judges share with their fellow-men, have had a good deal more to do than the syllogism in determining the rules by which men should be governed."' The syllogism is dead: Long live sociological constitutional law! Yet, as the cheering subsides and we revert to the business of studying, appraising, and prophesying the course of American constitutional law, the task may be no easier under the rule of the sociologist than it was under that of the logician. Both have their complexities. It is to furnish an understanding of the range and scope of these problems as they beset the United States Supreme Court that Professor Freund has presented us with the published edition of three stimulating lectures which he delivered under the auspices of the Julius Rosenthal Foundation of the Northwestern University School of Law, in April 1949. Few are the eccentrics who cling to the Blackstonian myth that "judges do not create, but merely find the law." The myth is exposed, but the true facts, as is so often the case, are tougher to understand than the fairy tale which they displaced. How does the Court make law? Why? In what frame of reference? When? It is to this type of inquiry that Professor Freund's book is addressed. No pretense is made of detailed study of the Court's philosophy, personnel, or method. The three essays contained therein have been selected for the prime purpose of introducing to us the difficult problem of the One and the Many in our judicial system, i.e. one Supreme Court and many states, many courts, and many organs of government, with this one Supreme Court "speaking with many, often discontentingly many, voices." The first essay, entitled "Concord and Discord," is perhaps the best from the point of view of executing the purpose of the book. The main theme of this

vaccinated, but with very little care or attention. Perhaps not one case in a hundred was examined during the progress of the disease. I make this estimate from knowing that no note was kept by any surgeon of his inoculations, and from the difficulty, or oftener the impossibility, of seeing our patients, when our utmost efforts were bent on keeping a perfect register. " In July, 1811, some cases of small-pox were brought from Madagascar, on board the captured French frigates, and the contagion was established on shore; yet, from that period till the end of November, at which time I left the island, between forty and fifty cases only had occurred; and I have lately been assured that the contagion has long since entirely ceased. On the 13th of November I report to the superintending surgeon on the island, that ' we have a melancholy proof of the carelessness with which vaccination has been hitherto practised, in the numbers attacked by small-pox; of about fifty cases of that disease, seven have been believed to be vaccinated.' " Two months before the introduction of the small-pox, I found it necessary to warn the inhabitants, that, from every information I could gain of the previous practice, I had no doubt that great numbers who were supposed to be duly vaccinated, were still in reality exposed to variolous infection. I gave them a distinct account of the ordinary progress of the disease, and urged every person to have their children and slaves reinoculated, in all cases where the course of the vaccine had not been attentively examined. Great numbers were accordingly subjected to this precautionary measure of a second inoculation; hut I regret that the documents I have by me do not enable me to state the result with precision, and, on this subject, I yvish to avoid any assertion founded merely on memory. 3x2 " The " The exertions of the French surgeons were but little seconded by the people, who were most interested in their success. It is almost incredible, that a people, styling themselves polished and civilized, should evince such apathy, not only where the lives of their children, but their pecuniary interests in their slaves, were concerned. In a report of the 20th of August, 1811, to the superintending surgeon, I mention this indifference of the people, even after the smallpox contagion had been introduced. ' Instead of punctually assembling the subjects for inoculation, at a convenient time and place for the surgeon, he has often the ta,;k of searching the habitations himself, and of coming at various times to catch the opportunity of finding them unemployed. The inoculation once performed, they pay no attention to the necessity of frequent inspection during the progress of the disease; they content themselves with thinking, when they think at all, that if the pustule has been genuine, it vviil leave a mark upon the arm ; a most fallacious mode of judging, since other kinds of matter inoculated may do the same, independent of the frequency of marks made by tattooing.
"' The practice appears lo have been so slovenly, that were a thousand cases to occur of small-pox after alleged vaccination, iny faiih in its efficacy would not be shaken.' " Yet, under all these disadvantageous circumstances, the astonishing contrast already stated, between the progress of the contagion of small-pox in 1792 and 181 J. at the Isle of France, must carry conviction to the most sceptical mind." The efficacy of the dry crust, as suggested and practised by Mr. Bryce, receives the full sanction of Mr. Scot; and the evidence lie produces goes very far to establish the practice. " Mr. Bryce's directions for the employment of the dry crust to propagate the vaccine infection, I applied to practice, perhaps more extensively than most other practitioners. Having found it nearly or fully as successful as the recent virus, I resorted to it, on account of its great conveniency. I shall record one instance sufficiently conclusive on this head. During the existence of small-pox at the Isle of France, in September 1811, some slave-ships were seized at Port Louis, by one of our frigates. The slaves were landed, to the number of 359, and put into one large building ; 39 of them had evidently had the small-pox. As no time was to be lost in' a case of such urgent danger, I immediately inoculated 320 of them, with the matter of crust dissolved in water, there not being sufficient recent virus to be had for this purpose. I had previously taken measures lo have always at hand a large supply of these crusts, to send to distant quarters, or to meet any emergency. Of these 320 inoculations, 174 took effect, and only 53 of the 146 failures took the disease on a second inoculation, which was still performed principally, though not entirely with the matter of crust. The other failures were tried again and again with recent virus; 84 resisted every attempt, and 9 were sent to hospital, of whom I cannot at this time give any On Oil of Turpentine in Epilepsy.

509
Milch is due to Mr. Scot for the exertions he has made to extend the blessings of Jenner's discovery, to the Mauritius.
II. Case of Periodical Day-Blindness. By John Isbell, Surgeon. This case of periodical blindness is concluded to be syphilitic, for it was cured by mercurial ointment rubbed on the thighs. The peculiarities of it are described in the following passage.
alarm. The paroxysms of her disorder occurred chiefly at night, when she had usually two or three mild fits, each enduring about a quarter of an hour. She was admitted to the Hospital for Incurables in the summer of IS 12. During the four preceding years she had experienced no menstrual discharge. Her general health and strength have 510 Critical Analysis. have appeared good, her appetite rather voracious, but her intellect has been obtused, approaching to fatuity. "July 15, 1812.?I directed for her pills of myrrh, steel, and aloes, which, in the course of a few days, induced a return of the catamenia. Her understanding consequently improved, her conduct became more regular and amenable, yet her epileptic fits recurred without any mitigation. She commenced the terebinthinate mixture on ]he 4th of November, in the proportion of three drachms of ol. terebinth, to a pint qf mint-water, which had an immediate effect in abating the frequency and duration of her fits. She became more lively, and for the first time replied to a query of mine, by saying that the medicine had done her great service! " Until the 4th of December her fits of epilepsy had nearly disappeared, when, without any manifest cause, they began to recur in a mitigated and less frequent degree than formerly. I directed for her a mixture, with one ounce of oil of turpentine in a pint of mintwater, of which she took two table spoonfuls every fourth hour, with immediate and decided benefit. On the 29th of the same month it was reported to me that she had relapsed to her former epileptic habits; though her fits were somewhat less frequent, and certainly more gentle than before the ifse of the terebinthinate mixture.
"On the 31st of January, 1813, I directed a decoction of two drachms of the dried jeaves of foxglove to be administered in divided closes, with as little interval as possible. The effect of this medicine was extreme nausea, vomiting, and subsequently purging, which continued fqr the space of eight or ten hours. The fits of epilepsy, however, began shortly to recur as before, with less violence than previous to the use of turpentine, but apparently unmitigated by the administration of digitalis. Her fatuity continued without interval or abatement." IV. Case of Injury to the Feet us, without the Mother being ajfected. By William English, Surgeon.
The facts in this occurrence we will present to our readers, and leave them to judge for themselves. " A lady in my neighbourhood, a month before being delivered of her second child, was standing upon a pair of steps., reaching something off the top of a chest of drawers, when she slipped, and fell backwards. In her fall, her back^ about the middle of the sacrum,, came in contact with the key of the room door, which Was the Jock, and broke the key in two. She lay for some time insensible, but, when she recovered, was surprised to find that she had power to get up, and fright seemed to be the only suffering she had to complain of from so very serious an accident, excepting a slight soreness and stiffness of the whole back and neck, which continued until, and for a few days after, the child was born. " There was nothing untoward happened during labpur, which ?yvas of the class called lingering ; but the child being large, may ?icpount for that circumstance. Soon after birth, a considerable cavity was observed in the child's back, situated about the nuddle of the sacrum.
On the Effects of Cold Applications to Ulcers. $ 11 sacrum.
There had evidently been an extensive abscess, which was barely cicatrized at the bottom, and the skin and cellular substance was thickened and puckered all round the outer edge. For five or six days after the infant was born, there was a slight oozing of thin gummy matter from the sore, caused, I believe, by the friction of the clothes, but it soon healed firmly, and the child continues well. I bad some fears that this case would end in spina bifida; however, the injury happily extended no further." V. On the good Effects of Cold Applications to Ulcers. By P. Johnson, Surgeon.
Mr. Johnson relates one case only, but speaks of his success as very general. This case being short, we shall give in his own words. " On having joined my ship, about five weeks since, I found one of her company with five deep and high-edged ulcers, situated between two and seven inches above the patella, which affected him for many months; some of them healing, while others were suppurating. My predecessor had used every means that he could devise for their cure, with very little good effect. The man had no constitutional appearances of scrofula, though these ulcers most strongly appeared to partake of that disease. The discharge was ill-conditioned ; the ulcers communicated often with each other, as easily ascertained on pressure, or by the probe. Having seen no written document of my predecessor's treatment, I immediately began with poultices of oatmeal, moistened with salt water, to be changed whenever they became dry, with a little lint underneath. From the 21st of January, I used the salt water, by applying a cloth and bandage continually kept wet, the water being every hour changed for more drawn up along-side, up to this day (Feb. 18th), a period of twentynine days, when the ulcers are healed, and the man capable of doing his duty. I have made use of no dressing between the cloth and sores.
The cloths were rinsed three or four times a-day, consequently verj' clean." Very few surgeons are unacquainted with Baynton's admirable method of curing ulcerated legs, though there are some, even in London, who either do not know, or do not feel its value. The constant application of cold water in his method, we have often thought to be serviceable, principally by carrying off the accumulated caloric, and keeping the limb in an under temperature. We should be glad, to  where heretofore the employment of heat had been thought to be beneficial.
The'four cases here related are strongly in point. The 3d of these being short, and one of those in which the application of cold has been considered as peculiarly dangerous, we shall cite, as a specimen of Mr. Smith's practice. " August 20th, 1812, I was called to the wife of Hugh Ross, carpenter, Dunaughton. She had been delivered of a child on the 15th, and on the 17th was seized with cold shivering, and pain in the belly and head, the lochia and secretion of milk being greatly diminished, I found her in the following condition :?respiration quick, oppressed, and suspiratory; pulse 150, extremely feeble, and at times intermitting. She complained of pain in her belly and forehead; her abdomen much tumefied, hot, and so tender that she could hardly bear it to be touched. Her attendants said that she was at limes delirious, and that she had a second shivering of cold a short time before I arrived. She vomits frequently, and the fluid vomited is very acid ; tongue dry and brown. She does not complain of thirst, but drinks with avidity when it is offered her. Hands and feet cold; lochia suppressed j mammae flaccid. She is said to have had one or two loose stools to-day of a frothy appearancu. The chalk mixture was given her, and cloths wet with cold water were desired to be applied over the whole abdomen. " 21st ?I saw her early this day, The cold cloths have been applied f requently, with much relief to the feelings of the patient. She ha<; Case of H&matemesis. 513 has had two or three loose stools; vomiting has ceased; appears less debilitated to-day; abdomen still tumid, hot, and tender; pulse 135.
" I now renewed the cold applications, which had been abandoned for some hours, applying cloths wet with cold water in which salt was dissolved, and renewing them as soon as they became hot. This practice was continued for about an hour, after which, upon examining the pulse, I found it 108 in the minute, and full. The patient expressed no uneasiness from the cold applications; on the contrary, she said they removed that sense of heat internally, which she had felt most distressing; and I observed, that after the cold water had been applied some time, the tenderness of the abdomen became much less, so that at length she could bear it to be firmly pressed wjthout experiencing almost any pain. " 23d.?By message, I was informed to-day that the looseness continued with the effect of weakening her extremely, and that she had considerable cough and pain in the belly, aggravated by cold drinks, which she had taken,by my directions. I sent some chalk powders, with orders to give one after every loose stool; and desired her drinks to be made warm. " The spleen was enlarged to double its natural size, resembling in firmness and color healthy liver. > '' When the stomach was opened, it was found to contain on!/ the sago taken a few hours before death. The villous coat seemed natural, except near the cardiac orifice, where there was a very circumscribed appearance of inflammation, and a more extensive one of ecchymosis. On the membrane of the oesophagus were numerous petechia. The duodenum contained thick yellowish matter. In the jejunum and ilium was a large quantity of dark matter, which in some parts was mixed with blood, and resembled black currant jelly. The colon contained a quantity of black offensive faeces. " The villous coat of the intestines looked natural except in the colon, where it had a deep red color, not from increased vascularity, but ecchymosis. " The pelvis of (he left kidney contained some pus. The bladder was natural. The urine (of which there was about half a pinl), had a sediment of thick matter, probably from the left kidney.
" The blood in the mesenteric veins was so hard as to give them the feel and appearance of injected vessels. The lungs were of a healthy color, the left a little hardened; and some yellow lymph was deposited beneath the pleura pulmonalis.
" The cavity of the chest, and the pericardium, contained more fluid than natural to them.
" On cutting into the lungs, the cells appeared full of a sero-mucous fluid, which had given to the left its unnatural solidity. " The heart and vessels were natural." -X. Pathological and Practical Observations. This paper being only in part published, we postpone ouf account of it, until the whole is before us. XL Severe Affection of the Stomach, ascribed to the presence in it of an Animal of the Lacertct tribe. By John Spence, M.D.
This is one of those extraordinary occurrences which re?quire most positive demonstrative evidence, to give it currency. A stout country girl, 21 years of age, has serious derangement of the functions of the stomach and intestines for several days. On the 17th of December, in the nighttime, after having taken some strong doses of calomel, and a large solution of neutral salts, she passed a reptile of the Lacerta species. This, however, Dr. Spence did not see, but gives the account from an old woman and the girl, who did both of them see it. Dr. Spence says, she thought she perceived something moving in the pot. After examining with a stick, it leaped out with a bound, and ran very nimbly under the drawers, which put both her and her mother, who was in bed in the room, into great fright and consternation. This they saw by the light of the fire. She next lighted a candle, and, in looking under the drawers, was still more frightened, when she saw the animal with staring clear eyes. By the inlreaties of her mother, who was net able to get out of bed herself, and was afraid it should do mischief, she laid hold of it when it turned round, and put it in the fire, and held it down with the poker till it was consumed. It squeaked with a shrill noise, and attempted to get out when first put in the fire.
" The size of the animal, as she described it by comparison with her finger, was between four and five inches long, and considerably thicker than the finger; it had a bluff nose, like the end of the finger, with a considerable mouth and bright staring eyes; the back, of a mahogany color, with a number of small white bright spots; had four feet with claws, not very long; and a short thick flattened tail, about an inch long. Did not lake notice of the belly." Though Dr. Spence believes this relation himself, he justly observes the evidence will not be sufficient to satisfy the incredulity of others. We are among the incredulous, and are much more disposed to believe this lizard to have been only in the pot, and not in the girl's bowels, XII. An Account of some Cases of Puerperal Fever, with their Treatment. By T. Sutton, M.D.
Though there may be some doubt whether these cases may have been what every practitioner would call puerperal fever, yet there can be no hesitation as to their hazardous nature, and their being connected with local inflammation.
The application of cold to the abdominal parietes was most evidently beneficial.
XIII. Case of Scirrhus in the Intestines, arising from Hairs remaining in the Canal. By W. G. Burrell, M.D.
After a variety of dyspeptic symptoms, constipation, and irregular action in the intestinal canal, the patient, a soldier 35 years of age, apparently worn down by irritation, expired in May 1S12. The examination of the body after death, was supposed to ascertain the cause of the morbid actions which had so long afflicted the patient. " Beyond the sigmoid flexion (he intestine was contracted in its diameter, so as hardly to admit the little finger to pass downwards.
" On cutting open the pylorus and small intestines^ the internal coats were found to be covered with a soft substance, which resembled size. The internal coats ot the colon were ot a dark color, and in general were ulcerated completely, and were hanging in shreds. The color of the colon was of a dark lurid red. At the sigmoid flexure there was much contraction, and the thickening was so great on one side, and the valve found so considerable, as hardly to admit a common bougie through it. " The portion forming the sigmoid flexure was cut out; and, on laying it open, and removing some hardened portions of feces, five or six hog's bristles were seen distinctly crossing each other in different directions, and were partially invested in the villous coat, which had grown over them, and had retained them in the different positions in which they were placed; and so firmly were they kept down by those partial coverings, that it required some force to draw them out. The mesenteric glands were of a cartilaginous appearance; the liver was suffused with blood, and the gall-bladder lull of bile.