is founded on logical research and theoretical reasoning, to the simple matron, whose faith is no less strong in the efficacy of her amulet or her

charm.

The influence of the imagination on a painful tooth is sometimes very astonishing. A delicate female in this city has for months succeeded in relieving the pain of two carious teeth merely by the sight of the instrument commonly used for their extraction. Whenever the pain is severe, she sends to me to borrow an instrument, the presence of which never fails to effect the immediate removal of the pain; and though it may not be considered a high compliment to the profession, yet it is a fact, that this silent messenger is, for a time, equally efficient in giving relief as if practically applied by the most skilful operator.

It is the duty of the dentist, when consulted for the purpose of extracting a tooth, to examine the case minutely before he proceeds to the operation, for it is no less a part of his professional duty, than it is of his moral honesty, to investigate the nature of the disease, and to adopt that treatment which if possible may eventuate in the preservation of the tooth. It is a too prevalent idea that extraction is the only remedy for diseased teeth, an idea which often unnecessarily subjects the patient to a painful operation, and to the premature sacrifice of many of these useful organs, which by judicious and well directed skill might probably have been preserved for many years. The teeth and gums, in common with the other parts of the body, occasionally suffer from inflammatory, rheumatic, and various other idiopathic, as well as sympathetic affections, which the skilful operator should be able to detect, since in many of these cases

the extraction of a tooth, so far from giving relief, would rather aggravate the suffering of the patient. Extraction should, in reference to the tooth, always be the last resource ;-it is, in relation to the part, what amputation is to a limb; and that surgeon who should amputate every diseased limb presented to his treatment, would, in a moral point of view, err no less in his duty, except in degree, than the dentist who indiscriminately extracts every tooth because it is painful and decayed.--Among the most useful and important modern improvements connected with the profession, may justly be ranked some of those which relate to the preservation of carious and painful teeth.

It is not to be understood by the preceding remarks that the operation of extraction can in all cases be avoided; on the contrary, it is one often imperiously and unavoidably necessary, and the skill of the dentist is frequently at issue, not only to determine which is the diseased tooth, but it is far more concerned in detecting the great variety of painful sympathetic affections in other parts, occasioned and kept up by a diseased tooth. Affections of this kind are no less common than they are at times perplexing. Cases have occasionally fallen under my observation, in which severe hemicrania, vertigo, dizziness, earache, &c., have resisted a long course of remedial applications, and have yielded at once to the extraction of some unsuspected tooth. A recent singular case of long continued occasional spasmodic rigidity of several of the muscles of the face, has also been relieved by the same operation.

It is a well known fact to every practical dentist, and one no less sensibly appreciated by his pa

tient, that a very considerable source of the pain in the operation of extracting teeth, arises from the motion of one part of the instrument on the gum; as this motion is also accompanied with considerable pressure, it not unfrequently happens in removing teeth that are very firmly fixed, and in which there is much obliquity in the shape of its fangs, that slight injury is sometimes done to the gum, accompanied at the same time with a trifling fracture of the thin edges of the socket of the jawbone.

Another circumstance of no small importance is, that as the fulcrum of the instrument presses on a point nearly opposed to that at which the hook, or claw, acts, it sometimes happens that this pressure is so great, as materially to retard the removal of the tooth from its socket, inasmuch as it firmly binds against the gums and fangs of the tooth in a direction directly opposed to that at which the hook acts.

These circumstances occasionally attending its use, have within the last century led to the exercise of much European invention with a view to the construction of instruments that might operate on different principles from the old one. Of the true excellence of these, however, we need perhaps no better proof than that of their heretofore ephemeral existence, which has arisen from the practical fact, that in point of safety, convenience and adaptation to all cases, they have not been found to possess sufficient merit to supersede the use of the old instrument, notwithstanding its trifling imperfections. In proof of this, it is a fact that at this time, most, and I believe it may be said, all

distinguished dentists on the continent of Europe extract teeth with instruments which act on the principles of the old one, subjected, however, to a great variety of alterations, suited to the particular fancy of different operators. This fact in relation to their comparative advantages, needs no comment. All rational attempts, however, whether by improved instruments or otherwise, which profess to lessen the pain of this sometimes cruel operation, are certainly praiseworthy efforts in the cause of humanity, and on this account alone, deserving of a fair and impartial trial. I have for some years past given considerable attention to this subject,have had instruments altered, modified and made, which in some instances have been rejected, almost without a second trial, but not till quite recently have I ever met with one which seemed to give promise of decidedly holding its rank as an improvement. Of this instrument which acts on the principle of the old one, and is properly merely an alteration of it, the chief ground on which it rests its most prominent claim to an improvement, is, so far as relates to a very simple contrivance, which is interposed between the gum on the one hand, and the fulcrum of the instrument on the other. The advantages attending this, are, that when it is used, the motion, or friction, of the fulcrum instead of being received on the tender gum as with the old instrument, is here made on a part of the instrument itself; it follows that no injury whatever is done to the gum, to the adjoining tooth, or to the jawbone, and that the chance of the tooth itself being broken is also materially less

ened. It has been used in London, where I believe it originated, and is now used in some of the southern cities. From my own experience I am prepared to speak with much confidence as to its advantages, and it gives me much pleasure to acknowledge the obligations I am under to an ingenious medical gentleman of this city, through whose politeness I was furnished with an instrument of this kind, and from which mine was made. Even with this instrument it is not contended that teeth are extracted without any pain, assertions of this kind are as ridiculous as they are untrue.

Every one acquainted with the anatomical connexion of the teeth in their sockets, the various forms which their fangs assume, and the relative pressure which they exert in relation to each other, must be sensible that their removal from the jaw wholly unaccompanied with pain, would present an exception to every other part of the human body, and an anomaly totally inconsistent with the laws by which organized beings are governed.

The great desideratum in this, as well as every other surgical operation, is by the union of the best contrived and most applicable instruments, with a good share of practical skill and experience, accompanied with the no less necessary and pleasing qualities of kindness and attention, to render it as little painful as the nature of the operation and particular circumstances of the case will admit.

In Warsaw, are published, at present, fourteen journals and five political papers.

From the London Literary Gazette. Malaria; Essay on the Production and Propagation of this Poison, the Nature and Localities of the Places by which it is produced, the Diseases caused by it, with the Means of Preventing or Diminishing them, both at Home and in the Naval and Military Service. By J. MACCULLOCH, M.D., F.R.S. London, 1827. AMONG the various subjects which engage the attention of mankind, we apprehend all our readers will agree with us in opinion, that the preservation of human life, and the increase of human enjoyment, claim universal preeminence. Yet it is an extraordinary fact, that those principles and those pursuits which usually impel the actions of all the rational portion of our species, as individuals,should be altogether lost sight of in a collective point of view. An observation has often been made, with homely truth, respecting that portion of our internal police which is connected with sanitary regulations:-"that, what is every body's business is nobody's business." Yet it is the undoubted province of district magistrates, or others who have the superintendence of county hospitals, prisons, &c., to use due vigilance in the selection of such spots of ground as have the reputation of being salubrious, for the erection of edifices destined to contain a large number of individuals. To all such persons we beg leave to recommend the work before us, as containing a most valuable mass of information on a subject that has hitherto been almost entirely neglected in this country, both by medical and other writers,-the nature and effect of marsh miasma, or malaria.

We need not remind our scientific readers of the qualifications of

Dr. Macculloch for the task he has undertaken; his miscellaneous writings in our scientific journals, exhìbiting his talent as an accurate and profound observer in almost every branch of physical science. The subject which he has here brought before our notice is not a mere point of medical inquiry. It is a question which involves the very existence of entire communities in many of our colonies; and is especially worthy of the most mature consideration, in the formation of new settlements by our less fortunate countrymen, who are induced to emigrate from their native soil.

In his introductory remarks "On the Effects of Malaria, and on the Utility of a Knowledge of this subject," Dr. Macculloch observes," serves, How widely malaria is a cause of death, will be apparent almost on a moment's consideration, when we recollect that, in all the warmer, and hence more populous countries, nearly the entire mortality is the produce of fevers, and these fevers the produce of malaria! I have said, elsewhere, that it has been estimated to produce one half of the entire mortality of the human race; nor do I think that this computation, made by physicians of care and consideration, has been exaggerated. If, in our more fortunate climate, it is less destructive than in some others, it is far more so than is commonly imagined; since, of those who die from fevers, it may be safely asserted, that more than nine in ten perish from the fevers of this class, too generally confounded with the contagious disorder of the same name, under the term typhus. And if the deaths produced in England by fevers, in this present season, 1826, alone, be examined,--if I could name a single parish, and that

not a peculiarly unwholesome district,where, in a population of 1600, the mortality in two months was one in thirteen, we have surely abundant reason, if less than our neighbors of France, Holland, and Italy, to take an interest in the cause of such diseases; more particularly if, by an accurate knowledge of the cause, we can avert its power or diminish its influence, and thus reduce this heavy amount of human suffering with all its complicated consequences." The author further observes:-" Can we however forget, that we also suffer with Italy and with Greece, with Africa, and the West and East Indies! East Indies! As travellers, as residents, as warriors, as colonists, we partake with all. If the sword has slain its thousands, malaria has slain its tens of thousands. It is disease, not the field of action, which digs the grave of armies." The truth of these observations requires no further proof than the despatches from our brave army engaged in the late Burmese war, and the annual mortality of our garrisons in the West Indies, and on the dreadful coast of Africa.

After noticing the principal districts of Italy, France, and Holland, which are infested with this pestilence, our author proceeds to prove, that not only our marshy districts and lower levels in England are periodically subject to malaria, but that in places hitherto unsuspected it prevails to a considerable extent." It is a popular opinion that the rushy pools and petty swamps, so common in high moorlands, are innocent, or incapable of producing malaria. I know not why they should be exempt more than other marshy places, unless under a