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hending the case, yet knowing how deceitful such symptoms fometimes are, examined and attempted the reduction by such gentle means as they thought the high state of inflammation and tenderness of the parts would bear. An operation having been considered as absolutely necessary, the surgeons were assembled in the morning; when the house-clerk, with no small selfgratulation in his countenance, informed the surgeons that he had reduced the hernia without allistance, and that the man was completely relieved. The poor man was relieved ; but it was by the harbinger of death : gangrene had taken place of pain and great suffering--the mortified intestine was indeed res duced.
But, in considering this question of the operation proposed by the elder Dr Monro, we must not forget our' author, and that his intention was to write on CRURAL HERNIA. As introductory to this subject, we are favoured with an elaborate, but imperfect description of the crural arch. And here, ainong other matters of great importance, he has discovered that there are distinctions betwixt male and female. The Doctor then pays some compli. ments to M. Gimbernat, which we really do not conceive to be merited, and proceeds to expatiate on the advantage of his plan of operation.
If there be any particular object more than the intention of writing implies here, it is to draw a parallel betwixt the operation of M. Gimbernat and the common operation for crural hernia. We are sorry to find, however, that our author leaves us without the fanction of his authority for either manner of operating; his judgement is held in complete fufpense, between the novelty of M. Gimbernat's operation, and the merits of that description which he has himself given us of the common method. We ihall therefore endeavour to throw out some hints to aililt our readers in forming their judgement on this point.
The study of anatomy must certainly be the principal and fundamental branch of education of him who is to attempt the improvement of surgery-but it is not the whole; for, without having observed the parts in their diseased state (not in bottles), and often having watched the skilful surgeon in his operation, and having alto practised with his own hands, most erroneous ideas may be entertained. Gimbernat's operation has evidently been fuggetted by speculation upon the view of parts in their natural state, and not from any observation of the difficulties which enbarrais the surgeon in his operation.
This gentleman, intreducing his directory and bistoury on the Gide of the fac next the pubes (moit aukwardly with both his hands), runs them inwards, to as to cut op the attachment of
the poupart ligament to the os pubis. By this rude operation, there is danger of wounding arteries—there is great danger of wounding the intestine; which, being much diftended, will, even in the common operation, get before the knife; and much more probably will chis happen, when you have got under the protruded bowel, and are cutting with both hands. Those who have seen the operation for the femoral hernia,, and have observed the depth of the neck of the fac, and the manner in which the bowel sometimes rises up, and conceals its strangulated part, may form a just conception of the danger of this deep lateral cut. , Further, the great foundation, and the strength of the ligamentous connexion of all the lower parts of the belly is done away by this operation; of course, it must leave the parts open to future hernia, in a greater degree, than when the operation is performed in the common and approved method.
In regard to the description we have of the operation, as commonly performed, we need only observe, that the author speaks of cutting the tendon, fibre after fibre, without entering the knife deep under the tendon ; which is just our idea; but he afterwards alarms us 'with a sweep, and extensive incision.'
In concluding, we may observe, that, through the whole treatise, the author shows a most depraved appetite for strange and uncommon cases, with an unaccountable reluctance to dism close the results of his investigation. Indeed, we are sometimes led to imagine that he requires some external excitement to divulge his secret knowledge ; for he has a way of saying he knows of a case, which seems to imply that his intelligence and information are greater than he chooses to express. There is mention made of some facts, to which we should object, did our limits permit: yet we must, at all events, protest against the practice related in the case, p. 17. There are also, we conceive, several mistakes in pathology; which, however, we hope will have no very bad influence upon the practice of surgery. On the subject of the diverticula ilii, and the history of the subject of anus at the groin, he shows a want of reading and investigation, that surprised us; and, instead of speculating on the formation of these appendices, we should recommend to the author's perusal Morgagni, Ruysch, and Palfin, and the papers of M. Mery and M. Littre ( Acad. R. des Sciences ), where he will find both sufficient speculation, and well told cafes.'
With regard to the following subjects, he is exceedingly deficient :-unibilical hernia ; congenital hernia ; general sympsoms; diagnosis and prognosis. · Indeed, were it not for the glaring titles, we thould sometimes have been at a loss to discover the subject of discussion, and yet this small performance is every VOL. 11. NO. 5
no very be the divertiethows a wazad of (pecunimend
at surpire append Ruysch, a des Sciencesles.
where eked out with large extracts from the most common and familiar books.
Upon the whole, we are rather inclined to assign this author a few years of additional probation, before we pass any defini. tive judgement on his merits as an author, and to look upon his present defects as the consequence of inexperience, and a premature thirst for distinction. As he is neceffarily secluded from the practice of surgery, we would advise him, if he continues to write on surgical operations, to converse with those who are most in the habit of performing them, and to enter into all their difficulties, and the occurrences and disappointments they meet with in the practice of their profeilion. After he has thus made himself master of the facts, let him labour to explain and do away their difficulties and prejudices, inform them of their errors, and rem lieve their minds of their perplexities and apprehenfions. Above all, let him remember, that, in proportion to the rarity of a case, is the smallness of its importance in practice; and let him either cease to boast of his opportunities, or prove more satisfactorily to the world that he has known how to profit by them.
Art. XII. Travels through the Southern Provinces of the Ruffian
Empire, in the years 1793 and 1794. Translated from the original German of Profeffor Pallas, Counsellor of State to the Emperor of Russia, Member of the principal Literary Societies of Europe, &c. &c.
Vol. II. 410. Longman & Rees, London. 1803. W hile France and England were prosecuting voyages of dis
covery over the whole face of the globe, and examining the limits of many regions with a curiosity wholly unknown to those who inhabited them, the Empress Catherine indulged her magnificent spirit, by exploring the empire which she governed; and, without quitting its limits, brought to light as much knowledge, as other princes who sent round the earth to cellect it.
Po us, whom a few days may convey with ease and security, from one end of our territory to the other, it is a sublime novelty to hear of learned men being absent for years on their travels through the dominions of their Sovereign; ranging from civilized to barbarous, and from barbarous to polished men; and emerging from frost and snow into the fine regions of the sun, under the protection of the same name, and the authority of the same laws.
The principal persons selected by the Academy of Petersburgh for these important excursions were, Mef. Lepechin, Guldænftedt, Gmelin, and Pallas.
inge of hivand reached of countries in the we
Gmelin began his travels in 1768 or 1769. His journey was through Moscow and Paulousk to Azof. From this place he paffed through Tzaritzin to Astracan; travelled through the north of Persia ; returned to Entzili on the south shore of the Caspian ; and from thence to Astracan in 1772. He was seized on his return, when only four days journey from the Russian dominions, by Uimei Khan, a Tartar prince, and expired in prison at Achmet Kent, in Mount Caucasus.
Guldänstedt, in the year 1769, passed through Tżaritzin and Astracan to the confines of Perfia, near the western shore of the Caspian ; examined various countries in the eastern extremity of Caucasus ; and reached Offetia in the moit elevated part of that range of hills. He proceeded to North Caucasus, Cabarda, and Georgia : from thence he pasied into Tmeretia, the middle chain of Mount Caucasus, the confines of Mingrelia, Middle Georgia, Eastern and Lower Tmeretia, and from thence returned to Killar. In the spring of 1773, he set out for Moldok, and then went upwards to the Malka; thence to the mountains of Beschran, from which he took the route of Tschekash. From this town he made a tour to Azof, croiled the Kalmius, following at the fame time the Berda and the new lines of the Dnieper, till he arrived at Krementschuk, the capital of New Rullia, where he was recalled.
Lepechin proceeded to the government of Nishney-Novogorod, to Simbrisk in the province of Kazan, surveyed the course of the river Tscheremschan, and travelled over much of the district of Orenburg. From Astracan he crossed the mountains which see parate the rivers Volga and Yaik, and wintered in the Ural of Orenburg on the river Brelaya. In the month of May following, he pursued the course of the Brelaya, came to Ekaterinenburg, advanced into the Ural, and pafled the winter at Tobolk. In 1771, he visited the province of Vratka, and einbarked at Archangel to visit the coaits of the White Sea. After wintering at Archangel, he pursued the same object, in the ensuing fuminer, as far as the western and northern coasts; and proceeding to the mouth of the White Sea, returned by the Gulf of Mezen to Petersburgh. During the summer of 1773, he surveyed various parts of the governments of Picore and Mobilef, proceeded along the Duna to the Riga, and soon after terminated his travels at Peteriburgh.
Profesor Pallas was abfent from Petersburgh six years. In 7768, he pailed through Moscow and Musom to Casan. After his examination of this province, he pafled the winter at Sima britk. In 1769, he penetrated to the mouth of the river Yaic, where he examined the confines of Calmuc Tartary, and the
neighbouring shores of the Caspian. After returning through Orenburgh, he passed the winter at Ufa, which he quitted the following summer, and pursued his journey through the Uralian mountains to Tobolsk. The next year, he traced the course of the Irtish, after examining the Altai mountains; and remained that winter at Krasnoyarsk, a little town on the Yenisei. From Krasnoyarsk he crossed the lake Baikal to Kiatka. Having pene. trated into Dania, he went on between the rivers Ingoda and Argoon : thence, tracing the lines which divide Ruflia from the Chinese Mongol Hordes, he returned again to Krasnoyarsk. In the summer of 1773, he visited Tara, Yaitzk, and Aitracan, con. cluding that year's route at Tzaritzin on the Wolga; from whence he arrived at Petersburg the ensuing spring 1774. *
The travels, of the latter part of which we are now to give an account, were undertaken in the years 1793 and 179-4, by the special permission of her Imperial Majesty, for the recovery of the Professor's health. With this publication, M. Pallas proposes to take leave of the literary world, and expresses, in a very feel. ing and affecting manner, thofe warnings of age which have admonished him that he is on the eve of bidding adieu to much more important relations. The first volume of this work contains an account of M. Pallas's journey from St Petersburg to Tzaritzin ; remarks made in various excursions on the southern banks of the Volga ; a journey in the spring of the year to Altracan; another from Altracan to the lines of Caucasus; observations made during a journey along the Caucasus; an account of the nations inhabiting Mount Caucasus; journey from Gengiefsk to Tfherkasf and Taganrof, and from Taganrof to the Taurida :-to the description of which latter country, the volume now before us is exclusively confined.
The population of the Crimea formerly amounted to at least half a million. Its first diminution took place in 1778; when, in consequence of the peace concluded with the Turks, 30,000 Chriftians, comprehending many artisans and manufacturers, were removed to the country between the Don and the Berda, beyond the sea of Azof. Soon after the Crimea fell under the dominion of Russia, and between the years 1785 and 1788, many thoufand Tartars sold their property at the lowest prices, and withdrew to Anatolia and Romelia; whither the surviving individuals of the family of Ghirei, and many nobles, also retired ; not to mention those who were killed in the troubles, or afterwards destroyed by the plague: So that, according to Professor Pallas, the population of the Crimea is not at present more than 200,000 persons of all nations and conditions.
* This tour was po? "
in five volumes 4to. by M. Pallas.