on the Influence of the Sun and Moon on the Human Body and on Disease.

"Gilbert Blane* was of opinion that the ungenial climate of England was in itself a cause of the moral and physical excellence of its inhabitants. Necessity, and the resolution to make the best of those advantages which nature had distributed but sparingly, had thus obtained their influence from unfavorable outward circumstances.

"The victory of the will over matter is there everywhere apparent. Amongst my agreeable recollections, I place a stroll in the neighbourhood of London as far as Highgate with a friend, where at leisure we enjoyed the influence of retirement. You will remember that this was the place where, at a former period, the greatest thinker of England was struck by the angel of death on the first day of Easter, 1626. Lord Bacon was riding there with his household physician, Dr. Wilberborne. Snow was on the ground, and an idea struck him that it might be used to preserve meat from putrefaction like salt. Immediately they dismounted, went into a cottage close by, bought a fowl, had it drawn, and then stuffed it with snow. In this occupation Bacon became so unwell, that he was immediately afterwards compelled to go to bed, and in a few days after expired.

"The peculiarity and remarkable character of the natives occasioned me to make a reflection from which I will no more wander. There appears to be in England a kind of necessity to know the contrary side of everything which is revered and admired. They are as eager for the caricature

* Remarks on the comparative health of England at different periods in his Select Dissertations,' London, 1822. 8vo, p. 159: "It would not be difficult to prove that the strenuous exertion of mind and body called forth to counteract this apparent unkindness of nature, have been the essential causes of that superiority of character which distinguishes the inhabitants of this island, as well as of that pre-eminent power, prosperity, and happiness which they enjoy."

as for the original. This seems to brace them like a cold sea-bath against a diseased sensibility. Their seriousness calls forth humour, their spirit of contradiction, satire. Out of the great they extract the ludicrous, not to trample it to the dust, but to survey it on the other side, to preserve themselves from over-valuing it, and to maintain a fitting moderation with regard to it.

"It is to you that the medical body is in a great measure indebted for the high esteem which they enjoy in that kingdom, and as there is an invisible church in science as well as in religion, even a foreigner may on this account be grateful to you.

REMARKS ON THE LETTER TO DR. MEAD.

Those who are acquainted with Professor Marx's lively and graphical description of his visit to England, entitled Erinnerungen an England,' are no strangers to the kind and friendly interest which he always exhibited in English institutions, and amongst these his admiration was, it would seem, peculiarly excited by those ancient seats of learning, Oxford and Cambridge. He says of the former,* "There are impressions of the mind which, like moral events, seize the

*"Es giebt sinnliche Eindrucke, die wie moralische Ereignisse den ganzen Menschen ergreifen und als etwas Neues Grosses in seine Lebensgeschichte eintreten. So mir der Anblick von Oxford. Noch nie hat eine Stadt von einem verhaltnissmassig so gernigen Umfange einem so machtigen, kaum zu beschreibenden Zauber auf mich ansgeubt. Das ist eine Residenz der Studien; hier thronen Professoren und die Studenten mit Barett und Talar schreiten wie Cavaliere einher. In ganz Deutschland, in der ganzen Welt is kein anhlicher Punkt.... Ich finde hier ein allgemeines Gefuhl von Selbststandigkeit, Unabhängigkeit, Zufriedenheit, wie man solches anderswo auf Universitaten in jetziger, dem unabhangegen Gelehrtenstande so ungungstigen Zeit nicht leicht antrifft." (Erinnerungen an England, pp. 159, 165.)

whole man, and appear in the history of his life like something great and new. Such was to me the sight of Oxford. Never yet has a city relatively so small exercised over me so mighty, so indescribable a charm. Here is a palace of study; here are enthroned professors; here students in cap and gown parade the streets like so many cavaliers. In all Germany, in all the world there is nothing similar." And again. “I find here a general feeling of independence and contentment, which we shall not easily meet with elsewhere in universities, in these times unfavorable to an independent position for men of letters." Similar remarks occur in the present Letter, addressed appropriately to one who was the associate of the literati, and the munificent patron of the arts; but as the subject of academical foundations does not come within the scope of our purpose, we turn from them to his citation of the well-known anecdote of Mead's generous conduct to Friend, to which he appends many excellent and facetious observations on the jealousy which medical men are too apt to entertain of each other. The anecdote itself may appropriately introduce what we have to say respecting the conduct of practitioners when called to attend for each other.

Dr. Percival says, "Whenever a physician or surgeon officiates for another who is sick or absent during any considerable length of time, he should receive the fees accruing from such additional practice: but if this fraternal act be of short duration it should be gratuitously performed, with an observance always of the utmost delicacy towards the interest and character of the professional gentleman previously connected with the family." Perhaps a better plan would be to divide the fees, and we know many instances in which this is the practice adopted. Dr. Percival's hint as to delicacy towards the character of a former practitioner ought not to be overlooked. It is truly dishonorable to abuse our confidential position with regard to our brother by allow

ing ourselves to insinuate anything depreciating of his judgment and practice. It is like stabbing in the dark, and though with weak-minded and capricious patients it may sometimes gain a little present advantage, it seldom answers in the end, even as to worldly success.

If, indeed, according to the judgment of the practitioner thus attending for another, the treatment hitherto pursued is erroneous, he is bound by his duty to the patient to adopt a different course, but this he may ordinarily do without awakening suspicion in the mind of the invalid, and weakening his confidence in his regular attendant, and, on resigning the case to him, he will in general sufficiently discharge his duty if he fully explains to his medical brother his own view of the treatment required, and his reasons for its adoption. The attendance of a medical man is considered entirely to cease when the practitioner for whom he has been attending resumes the case, and we think it dishonorable, as is sometimes done, to make, subsequently, calls of inquiry, which have at least the appearance of wishing to keep a place in the good graces of the patient.

It sometimes happens that when one medical man has been attending for another that, without the slightest unfairness on his part, or any undue efforts to ingratiate himself, either owing to his real superiority, or to those changes of taste and opinion to which all are liable, the patient or family becomes prepossessed in his favour, in preference to their former attendant, and profess their intention to employ him in future. Perhaps they may have long felt dissatisfaction with their professional adviser, and may have only hesitated to dismiss him from an uncertainty as to whether they should find a successor to whom they could trust-an uncertainty now removed. This, far from being a desirable circumstance, is one of the most painful and difficult positions in which an honor

able man can be placed. We do not see how he can refuse to attend, for to do so would be to establish a kind of medical despotism, and to say, in effect, to the public, "You shall not change your medical man, or at least you shall not exercise your power of choice in appointing his successor;" and yet a delicate mind could scarcely ever feel secure that some inadvertent word or look on his part may not have operated to the injury of his friend.

We think the only course to be adopted in these very trying circumstances is frankly and candidly to state the matter to the medical man formerly in attendance, and to procure from the patient or family a written statement of their reasons for making a change. This would give opportunity for removing any misunderstanding as to the conduct of the former practitioner, if any such should have occasioned disgust in the mind of the patient, and led to the withdrawal of confidence from him. "But when," says Hufeland," the sick man has entirely lost confidence in his physician, and is resolved to give himself up to the care of another, the latter dare not and cannot refuse to comply, nor the other take it ill, for the confidence of a man rests with himself and is to be respected." Every conscientious man will, however, desire most earnestly that this confidence should not be withdrawn during the period of his temporary attendance.

Professor Marx comments upon Mead's conduct to Friend as indicative of the total absence of jealousy and envy. Would that such instances of cordial medical friendship were more common! It is gratifying to meet with one in the agreement of Cullen and William Hunter, who associated in partnership, with the understanding that each was alternately to spend the winter in study, the other meanwhile attending to the practice until the education of both was perfected—a true alliance für Künst und Wissenschaft, as a German would have expressed it.