We have very little to offer respecting the cure of Rickets, more than that we must adopt every means Nvhich lies in our power for removing the supposed ex citing causes, and for promoting the general health. The disease seldom exhibits any inflammatory symp toms, so as to render bleeding necessary ; but the de rangement of the digestive organs, and the torpor of the alimentary canal, make purgatives an essential part of the treatment. To these tonics and stimulants may be occasionally added ; but we do not conceive that any great benefit is to he derived from them, unless where the appetite is particularly defective, and when the bowels are thought into a natural state. Still less confidence do we place in any of those remedies, which have been from time to time offered to our notice, as possessing a specfic effect in Rickets, such as phosphate of link, upon the principle of supplying the deficiency of this sub stance in the bones, or the carbonate of ammonia, for neutralizing the supposed acid in the blood,—remedies which we believe will be found as useless in practice as we apprehend them to be incorrect in theory. It is a difficult point to determine upon the means that ought to be adopted for counteracting the mechanical defor mity that arises from the state of the hones. Perfect rest in the horizontal posture has been recommended ; but in very young children this is almost impossible to be strictly adhered to, while the want of exercise is itself a means of increasing the tendency to disease ; nor in deed does it appear, that, with all our care, we are able to prevent the bones from being distorted by the action of the muscles that are attached to them, or by the weight of the different parts pressing upon each other. Upon the whole it may be desirable to recommend the horizontal in preference to the erect posture during a part of the clay ; but we should not sacrifice to this sys tem, the benefit that may be supposed to arise from the general salutary influence of air and exercise. It ap pears to be agreed, that the mechanical contrivances for supporting or straightening the limbs are not of much use in Rickets.
The treatment of this disease is considered as rather falling under the province of the surgeon than of the physician, yet it offers so many curious subjects for spe culation, and involves so many interesting questions of pathology, that we cannot pass it by in our system, al though exclusively appropriated to the practice of me dicine. Notwithstanding Syphilis is a disease of the most frequent occurrence, and one that has engaged the attention of medical men for some centuries, there are many very important points respecting it which still remain undecided. The first accounts that we have of the unequivocal symptoms of Syphilis appeared about the end of the 15th century ; but how it was produced, or from what quarter of the world it proceeded, arc not yet correctly ascertained. The disease, in its ordinary form, is communicated by the actual contact of parts previously infected, which necessarily happens most frequently to the generative organs, and, independent ly of their situation, it is probable that their structure, as possessing a surface covered by a thin cuticle, and furnished with secreting glands, is peculiarly liable to receive the infection. The first symptom is a local ul cer, to which the name of chancre has been applied, and which seems to be altogether a local affection; but it is a property of the chancre to generate contagious matter, which is capable of being absorbed, and of con taminating the system at large. Besides the local sy philitic ulcer or chancre, there is another form of vene real infection, in which, without any wound or breach of the cuticle, a mucous, or secreting surface, becomes inflamed, and exudes a large quantity of semi purulent matter, which has the property of inducing the same state on a similar mucous surface with which it is in contact ; to this the name of Gonorrhoea has been ap plied. It has been a much disputed question, in what manner these two affections are related to each other, whether they are distinct diseases, or whether they ori ginate from the same poison having experienced some modifications, or assume a different aspect from the dif ferent nature of the parts to which it is applied. Upon
the whole, perhaps the most decisive facts are in favour of the diversity of the two diseases ; but, at the same time, we must remark, that some authors of the first eminence profess the contrary opinion. It would be inconsistent with the brief and general view which we profess to take of the subject, to detail all the symptoms of this proteiform disease, which, as it affects a great variety of parts and structures, and attacks indiscrimi nately all constitutions and temperaments, exhibits a greater diversity of appearances than perhaps any other complaint to which the human frame is obnoxious. If the local ulcer be not cured by the appropriate remedies, and if means be not taken to prevent the contamination of the system, a portion of the infectious matter is taken up by the lymphatics, and seems to be carried into the mass of the circulating fluids. In its passage along these vessels it usually affects some of the glands, pro ducing in them tumours, which are styled buboes, and afterwards abscesses, which partake of the same infec tious nature with the original chancre, and still farther contribute to the general diffusion of the disease. When the system becomes in this manlier completely contami nated, there are certain parts of the body which are pe culiarly disposed to manifest the presence of the poi son, and in these it exhibits itself in a uniform order of succession. It first appears in the mucous membrane of the throat and fauccs, producing an inflammation and superficial ulceration, which terminates in an erosion and loss of substance, so as materially to injure the form and organization of the part. About the same time, various portions of the skin begin to exhibit the effects of the disease ; brown or copper-coloured spots make their appearance, from which a quantity of mat ter exudes, which concretes into a scurf. This, when it falls off, is succeeded by another scurf, and so on un til at length ulceration is established. The next set of symptoms, or the next order of parts that is infected, is the periosteurn, and the various appendages of the bones; these become thickened, and at length give rise to painful tumours, called nodes, until the structure of the bones themselves is finally disorganized. There are ceatain bones which seem peculiarly disposed to suffer by the syphilitic poison, especially the small bones of the palate and the nose ; and when the disease has got firm hold of the constitution, they are entirely corroded, so as to cause a great defect in the speech, and the most dreadful deformity of the countenance. Along with these symptoms, which are all more or less of a local nature, although depending upon the general diffusion of the poison, the powers of the constitution begin to suffer, the appetite fails, emaciation and loss of strength ensue, hectic supervenes, and the disease terminates fa tally. These symptoms are usually recognized as the effects of chancre, and it has been a much disputed point, whether a similar train of complaints can be in duced by the poison of gonorrhoea. This we are dis posed to decide in the negative ; but we do so, as in the former case, in opposition to the judgment of many persons, who are the best able to decide upon the sub ject. Whatever opinion, however, we may form re specting the contamination of the system by the matter of gonorrhoea, the infl immation with which it is attend ed has the power of extending itself along the urethra, and the ducts connected with it, thus producing tu mours of tile neighbouring glands, and especially of the testes. The tumours thus formed, unless the inflam matory action be subdued by proper applications, may proceed to suppuration ; but the matter thus generated does not appear to be capable of contaminating the sys tem at large ; at least this is the opinion of those who regard the poison of gonorrhoea to be different from that of chancre, or the proper Lues venerea.