nerves (varying in different persons,) by which false impressions are transmitted to the brain, in the manner of the soldier above-mentioned who had lost his leg. Persons having their nervous systems so constituted as to be susceptible of strong impressions from slight causes-having, in short, what is usually called a nervous temperament, have always been regarded as particularly liable to this disease. Rousseau and Cowper may be taken as good illustrations-men who were unable by any degree of temperance to starve themselves into tranquillity and cheerfulness. Indeed, it is consistent with general observation, that pursuits leading to the cultivation of the fancy or indulgence of feeling are powerful auxiliaries in the development of morbid nervous irritability. Among the various classes of artists, for example, musicians are perhaps the most subject to those wayward fancies which mark the hypochondriac; witness Viotti, Sacchini, Mozart, and others; whilst the effect of music upon minds gifted with undue sensibility is strikingly illustrated by the melancholy and passionate desire of revisiting their native country,' produced on Swiss soldiers on hearing the Ranz des Vaches. Yet I apprehend it would be very difficult to show in what manner the stomach was affected by their sounds. Shakspeare, who was a tolerably correct observer of nature, speaks of the "soul inspiring drum," the "earpiercing fife," and even attributes certain nameless effects to the bagpipe "singing in the nose"-but so far as I know, mentions no music which held any sympathy or communion with the stomach. The fact is, as it appears to me, that the stomach is of a very jealous disposition, and will not work unless attended to; take off the mind too frequently and too long, no matter in what way, and the dissention is proportionally affected; the individual, after becoming melancholy or capricious, in vulgar language, hipped, Women are said to be less liable to the disease than men, which may be accounted for either by the fact of their prudently abstaining from the fatigue of very profound meditations; or, by supposing the same causes to produce a different train of phenomena, constituting hysterics, a complaint, however, so analogous to the subject of this paper, that many have regarded them as the masculine and feminine of the same species. Talking of the ladies, I may remark, that a French writer of some celebrity (M. Falret,) argues that the abdominal viscera cannot be the seat of bypochondriasis, because the disease does not prevail among his fair country-women, who, according to his insinuation, wear stays so contrived as to produce great impression "sur les bas ventre." Now, without underrating the sacrifices made by the French ladies in the cause of fashion, we may be allowed to question whether the sufferings of the male sex in this country have not for some years been quite as exquisite; but, to whichsoever the merit may belong of wearing the tightest stays, I must say, that I never met with any instance of hypochondriasis from this cause: in fact a certain degree of intellect seems necessary for its production. From this digression I return to the moral or intellectual causes which are very numerous. It is very uncommon to meet with any one who has been much given to study of any kind who has not experienced this affection to a greater or less extent-but at the same time, among the various kinds of reading, none are so apt to produce hypochondriasis among unprofessional persons, as the perusal of medical works; so generally is this acknow. ledged, that M. Villernay has enumerated "lecture habituelle de Buchan"* among the exciting causes. Rousseau, too, not only admits this cause, but describes in forcible language the effect of such injudicious studies upon his singularly constituted mind. He says, "having read a little on physiology, I set about studying anatomy: and passing in review the numbers and varied actions of the parts which compose my frame, I expected twenty times a day to feel them going wrong; far from being astonished to find myself dying, my astonishment was that I could live. I did not read the description of any disease which I did not imagine myself to be affected with; and I am sure that if I had not been ill I must have become so upon this fatal study. Finding in every complaint the symptoms of my own, I believed I had got them all, and thereby added another much more intolerablethe phantasy of curing myself, a thing difficult to avoid when one reads medical books. By means of plodding, reflecting, and comparing, I came to the conclusion that the root of my complaint was a polypus of the heart." The passions may be ranked next to mental exertion in the production of hypochondriasis, particularly fear; after which may be placed chagrin and ennui. This last is very remarkable in men of business who Reading Buchan habitually. abandon their affairs to seek for tranquillity and repose in retirement those in short, who pass from a life of activity to one of idleness. Under these circumstances, the fancy first conjures up the evil, and then the mind dwells upon it with morbid pertinacity. has much influence on hypochondriIt would not appear that climate asis, which, however, bears a distinct relation to the progress of civilization, becoming more frequent as it advances. It likewise occurs par have been subjected to great polititicularly, in those countries which cal events, a circumstance which accounts for the number of hypochondriacs observed by Zacchias, during the eventful reign of Louis XIV: the duced in Spain and Germany by the same effect is said to have been prolate invasions of the French. With regard to the symptoms of this disease, or the manner in which it develops itself, this varies in almost every different case; but the part most frequently fixed upon as the seat of some incurable malady, is the heart, especially among young medical hypochondriacs. I am told the late eminent professor of physic in Edinburgh, used to mention that he was every season consulted by a great number of young medical students on the state of their heartsand it is asserted by the French writers, that when Corvisart first drew the attention of the pupils at the Ecole de Medicine to the organic lusus of this organ, it brought on an epidemic of imaginary aneurisms. The sight, hearing, smell, and taste, are sometimes subject to painful or depraved affections, and at others are endowed with a marked sensibility; this is particularly the case with regard to touch, the slightest degree either of heat or cold, producing strong impressions-in some, the in teguments become preternaturally tender, and the patient even complains of exquisite pain in the hair. The whims and phantasies of hypochondriacs are very numerous, and many of them such as to provoke a smile, even when we most pity the subjects of such strange delusions. Some describe the sensation of a great explosion, as of a piece of firearms in the head, chest, or abdomen; while others imagine that they feel the movements of some living animal within them. One lady thought her skin had become rough and scaly like that of a carp, an impression which she removed at will by calling to her assistance the sense of touch. Greding mentions the case of a medical man who was impressed with the belief that his stomach was filled with frogs, which had been spawning ever since he bathed when a boy in a pool where there were a few tadpoles. The life of this unfortunate man was spent in travelling from place to place, to consult the most eminent physicians concerning this imaginary evil." He argued himself," says M. Greding," into a great passion in my presence, and then asked me if I did not hear the frogcroak." Marcellus Donatus mentions the case of a baker of France, who imagined himself a great lump of butter, and durst not sit in the sun or pear a fire for fear of being melted-rather an unhappy phantasy bythe-bye for a baker. Zimmerman met with an individual who fancied himself a barleycorn, and did not venture to go abroad lest he should be picked up and swallowed by the first sparrow that espied him. One of the most annoying and vexatious absurdities into which hypochondriacs are led, is the degree of vacillation in every purpose, and the deliberation which precedes the most unimportant actions; thus Dr. Reid mentions that he called one day upon a young friend who had injured his health by the intensity of his application. It was afternoon, but he was still in bed, not having been able to decide whether he should wear his small-clothes or pantaloons; having renewed his reasoning upon this important matter, he at length determined in favour of the latter; / but he had not been dressed many minutes before he changed his mind, and during the rest of the day wore breeches. From these and similar instances we acquire the fidelity of the picture of a hypochondriac, as given by Moliere in his "Malade Imaginaire," when he makes Argan say, "Monsieur Pyon m'a dit de me promener le matin dans ma chamber douze allées et douze venues, mais j'ai oublié à lui demander si c'est en long ou en large." No strength of mind or extent of cultivation seems capable of protecting us against these ludicrous imaginations. Even Pascal, remarkable as he was for the depth and clearness, as well as piety of his mind, was yet unable to conquer the force of hallucination. He fancied himself always placed at the edge of an abyss, into which he was constantly afraid of falling, and it was only by pushing a chair over the supposed verge of the precipice and finding it did not fall that he was able to undeceive himself. This experiment he is said always to have had recourse to before he ventured to sit down when labouring under a fit of this disease. This brings to my mind the case of an individual who had an equal fear of sitting down, but for a very different cause: it has occurred to the writer to know of a gentleman who supposed his "nether bulk" to be made of glass, and who, therefore, never sat down without extreme caution, lest he should break it all to pieces. With regard to treatment in this complaint, I am satisfied that medical men are wrong in endeavouring, as they generally do, to argue their patients into better health. This will not do; and I am satisfied, from my own experience, that till he has gained the confidence of his patient by listening to, appearing to believe, and prescribing gravely and formally for his most fanciful ailments, he has The MEDICAL Intelligencer will in future be edited by Dr J. G. COFFIN, the present proprietor, who will speak for himself in the next number. This sale will make no other difference to those subscribers who have paid in advance, than the probable improvement of the work, under the care of a gentleman so well qualified for the business. To those subscribers who have paid regularly their subscription, the publisher returns his thanks; those who have not paid for the preceding volumes, are requested to forward arrearages as soon as they can make it convenient;-the sums due, though trifling to individuals, will collectively be very useful. LEPROSY. This disease rarely if ever occurs in this country. We are sometimes informed such a person "has the leprosy," and asked if there is any cure for it. But when we come to examine the patient, the disorder proves to be one of a different nature, and in some cases so totally and radically different, that it is hard to imagine how the name of leprosy was ever associated with it. Surely this appellation could not have been applied by any one who had ever seen a case of genuine lepra or, we had almost added, of any other cutaneous disease. We apprehend the fact may be, that the difficulty, usually found in conquering any extensive and obstinate disorder of the surface, gives the idea of leprosy to the practitioner, and as that is generally considered an incurable malady, the affair rests better so than in any other state in which it could be placed. There is one peculiarity of the true le prosy which is never absent in that disease. It is the circular, or nearly circular figure of the patches. This characteristic is so uniform, that no case, even though resemblant in all other particulars, can liarity be present. be considered leprosy unless this pecuFrom its very com mencement in a small pimple on the extremity, through all its stages to large and deep sores, the circular figure of each patch is uniformly maintained; and although there are other disorders which assume this form, the leprosy never assumes any other. When, therefore, a disease prevails extensively over the surface, sinks deep into the structure of the skin, and resists the usual remedies, it should not be at once condemned by affixing to it the dreaded name of leprosy. Unless the circumstance we have mentioned attends these symptoms, it has no title to the appellation, and even where all these appearances are combined, not one case in an hundred would yet be leprosy. The disorder most commonly denominated lepra by those whose knowledge of the subject is limited, is that usually known by the name of salt rheum. When the scales and patches of this disorder continue to be formed after the common remedies have produced but temporary relief, it is set down as leprosy, and at once abandoned. But there are strong marks of distinction between the two complaints. The scales of leprosy are usually round, as well as the patches on which they are formed; those of the salt rheum are of various shapes and sizes, and sometimes the diseased epidermis may be taken off in pieces half as large as the hand. The patches of leprosy have an elevated border, and an inflamed margin; two circumstances which are seldom if ever noticed in the salt rheum. The latter disease appears sometimes in spots, sometimes in lines, and often continuous over the whole surface of the body; the patches of leprosy are not only either circular or oval, but always intercepted by healthy skin. In the salt rheum there is frequently, and especially in the worst cases, a slight discharge of transparent lymph, when the scales are rubbed off too harshly in consequence of intense itching; but in lepra the scales have a shining appearance, and there is no such discharge in any case. Other points of difference might be mentioned, but enough have already been detailed to show that a careful examination would detect the difference; besides what has been told, there is, too, a general aspect, a countenance, as it were, to each, by which an experienced eye can recognize it at once. The salt rheum, even in its worst forms, we believe to be perfectly and easily cur able; of the genuine leprosy, we have never seen but one case in which a thorough cure was effected, and that was not without great difficulty and perseverance. A popular idea has maintained that all diseases which produce scales on the surface, are of a leprous character. This erroneous impression has grown out of the superficial attention this class of diseases has received from the faculty in general. There were four genera of scaly eruptions recognized by Willan; and the cases of either of the three last genera are infinitely more frequent than those of leprosy, which is placed first. But, say some, they all resemble each other in many particulars--the distinction is of little moment. This doctrine is both unscientific and totally inapplicable to the case in question. To one who is acquainted with the subject, it seems as absurd to call all scaly diseases leprosy, because they are scaly, as all vesicular diseases tetter, because they are vesicular. It is certainly no less ridiculous than to say that the measles is the scarlatina, because both are exanthematous, or to call porrigo the itch, because both are pustular. This loose and erroneous habit ought to be allowed to exist no longer. To attempt to correct it ourselves would be presump tion-each practitioner must make himself familiar with the diagnosis of the squamous diseases, and by study, observation, and attentive examination of the cases which chance within his view, he will soon be aware of the total absurdity of his former views on this subject. HEALTH OF BOSTON. Since the departure of the influenza, which last winter and spring was so generally prevalent, our city has enjoyed such an unusual immunity from the prevailing diseases of the season, that it may seem superfluous in us to descant upon a subject of such notoriety. But notwithstanding it has been a dull time for our business, we cannot but congratulate our fellow citizens on a subject of so much interest, presuming that their feelings in this respect are at least as grateful as those of their medical brethren. Our last spring's guest-we hope to be pardoned for this slight remembrance of an old friend-of such wide-spread influence departed as it came, though not "like a baseless fabric," for the wrecks of constitution it has left behind are many; but like a scourge, the smarts of which are felt long after the strokes have ceased. The tightness across the chest, irritation in the lungs, and cough, which so many experience since the damp weather and chilly evenings have commenced, lead one to suspect that the impression which was made upon these organs in the severe attack which they then suffered, has not been effaced; and that the apprehension which was so general that the epidemic to which we allude would hasten the breaking up of many constitutions, was but too well founded. Such affections occurring at this season of the year, double care should be taken to remove them thoroughly, before the approaching winter shall give them a more serious character. Physicians know, and people generally cannot be too often apprized, that an or. gan which has once suffered from an attack of disease, is afterwards the more likely to yield to morbid influences, or is |