the external use of digitalis. Little attention was paid by surgeons to these results; but very recently M. Laforgue, chief surgeon in the Hopital de la Grave, at Toulouse, has made trial of the new mode of treatment, and found it to be as efficacious as was alleged by M. Bellucci. A man, æt. 60, had a large hydrocele of the right testicle, and being unwilling to submit to the usual operation, besought M. Laforgue to try some other method. Daily friction of the tumour was ordered with the following ointment :-B. Pulv. folior. digitalis, 6 grammes axung, 30 grammes; misce. The patient was also ordered to wear a suspensory bandage. In a few days the man presented himself completely cured. He had enjoyed excellent health during the process, and had used, in all, 18 grammes of the powder of digitalis.—L'Union Méd. 30th Sept. 1854.

VII. CYANURET OF MERCURY.-M. Desmartis, of Bourdeaux, after a careful comparison of the effects produced by the different preparations of mercury, has come to the conclusion that the cyanuret is superior to all others, especially in syphilis. He believes it to be at the same time efficacious and innocuous in its action; he never saw it occasion salivation or any intestinal irritation; and often when all the preparations of the metal had failed to produce benefit, he has seen it restore to health patients whose cases seemed hopeless in the extreme. He has found its use to be efficacious in certain cases where the patients had suffered for a long period, obscure pains, for which no cause could be discovered. He has employed it with benefit in iritis, and in syphilitic affections of the nose and fauces.

VIII. APTITUDE OF INDIVIDUALS FOR ANESTHESIA BY CHLOROFORM.-M. Ancelon read a memoir on this subject to the Academie des Sciences on the 9th of October last. The following are his conclusions:

1st, The aptitude of subjects for anæsthesia is in a direct ratio to the degree of emptiness or fulness of the stomach. Its action is more rapid, and more innocuous when the stomach has been long empty, and when, consequently, absorption is more active.

2d, It is also in relation to the rapidity and action of the digestive processes in the individual.

The medium dose, according to M. Ancelon, is 3iij; and the quantity to be used at the longest operation should not exeeed 3v. (!) He thinks we should only add 3 or 4 drops at a time when we are increasing the dose of the anæsthetic.-Gaz. des Hôpitaux, 21st October 1854.

The Edinburgh experience of chloroform shows that no such extreme caution is requisite in its administration, as M. Ancelon recommends, and that in doses much larger than those indicated it is perfectly harmless and beneficial.-Translator.

Part Fourth.

MEDICAL NEWS.

THE INEFFICIENT STATE OF THE PUBLIC MEDICAL SERVICES IN GREAT BRITAIN-AND ITS REMEDY.

If ever there was a period when the importance of medicine in its relation to the welfare of nations, is capable of being impressed on the public mind, it seems to be the present. We can no longer have any doubt, that a noble army, equipped in every essential for mere warlike purposes, has in a few months melted away to one-fifth of its original strength, principally from the effects of

disease. It is also certain that these effects might, to a great extent, have been avoided by a proper staff of medical men, properly provided with medicines, diet, and hospitals. The British nation has had the humiliation of seeing that, whilst the medical arrangements of its army has presented nothing but confusion and inefficiency, the French army by its side has been supplied with active medical officers, abundant medicines, and every comfort. After a glorious battle in which both armies were engaged, whilst the British wounded soldier was obliged to remain for days on the spot where he fell, his French comrade was conveyed in a spring cart or ambulance to a general depôt, where an efficient staff of medical officers attended to his wants. Whilst the British army was shivering for want of clothing, the French army, out of its abundance, furnished it with 12,000 great coats. Whilst the British soldier was starving on biscuit, a quarter of a pound of salt pork, and unusable green coffee, the French soldier was enjoying abundant rations. The very transport of the wounded over a few miles of country to be embarked for a distant hospital, could not have been accomplished without the aid of mules and panniers for the sick, supplied for that purpose by our allies. Then the conveyance of these wounded from Balaklava to Constantinople, reminds us of the horrible accounts we have read as occurring on board slavers, more than of anything else, five hundred men, suffering under various kinds of wounds, some sick and others affected with cholera, packed together in a single vessel, rolling on the sea, and attended by some one or two assistant-surgeons. We read of amputations, performed on account of frost-bite, although stoves were abundant, but could not be obtained; of hundreds sinking from diarrhoea, when the medical attendants could not procure the most simple remedies. The result is that, while the French army is strong, vigorous, and prepared to reap the glory of a successful enterprise in war, the British army has given up to its allies the defence of its batteries, and been converted into a rear-guard, to watch the progress of events.

The real cause of all these disasters is, in our opinion, the inferior position occupied by the profession of medicine in this country, in its relation to the state. The medical directors of the army are mere no-bodies, unregarded and unhonoured by the other departments. Here they are embarked without stores— there censured without cause. In the army a physician or surgeon holds a very subordinate position to his equal in rank who is a mere fighting man. Dr Wilson, who rallied a few men to repel a charge in a skirmish, was lauded to the skies, whereas the skilful exercise of his profession whereby thousands of lives might have been saved, would never have gained him the slightest attention. In the navy medical men are so treated that scarcely any man of education and knowledge of his profession will enter it. It is a service completely tabooed to men of ability and distinction, and we consequently read of a long list of ships in commission with not one-half of the necessary complement of surgeons. To supply the deficiency, our Royal Colleges have remitted some of the studies of students, so that the evils of an improper administration, are sought to be counteracted by diminished professional education. In short, these institutions look after their petty interests, quarrel with one another, oppose every plan having for its object a national rather than a local policy, and so assist in rendering the present confusion worse confounded.

The only remedy for the cure of the evils under which the profession and the country groan, is the introduction of a national system of medical reform, by a minister who will think only of the public good: Government ought surely to see by this time how essentially the efficiency of an army is dependant on judicious medical superintendence, and that medical influence should be superior to that of the commissariat, rather than the contrary. What is required, is the introduction of a simple state mechanism, similar to what prevails in France, whereby the education and examination for medical practice shall be equallized throughout the empire, and whereby the pri vileges of the qualified practitioner shall be every where the same. It must

be clear that a young man well educated to practise medicine, is as fit to treat a soldier or sailor, as a civilian. What then can be the use of extra army and navy boards; such a one also could practise as well on one side of the Tweed as on the other. Away, then, with your local collegiate privileges. Let our examiners be chosen, because they are qualified for the duties they have to perform, and not because they belong to this or that party, and let those who best distinguish themselves at such or other examinations, recieve the medical appointments of the country, whether civil or military. On the other hand, let the whole system of job, which now infects the entire profession, be abolished, and let the claims of merit and hard work have fair play. Let good judgment, sound knowledge, and mental activity be the characteristics of the heads of our medical departments, and we will venture to say, no commander-in-chief, no commissary-general, and no slavish system of routine, will be allowed to produce those evils which the nation has now to deplore evils, however, which are not confined to its military system, but exist in every public department where medicine is concerned. For our own part, we can scarcely conceive the possibility of a really eminent chief of the medical department, permitting such melancholy disorder in affairs purely professional, as have existed in the Crimea. Can we imagine a man like Larrey being controlled in his own departinent, even by such a general as Napoleon? No, and the attempt failed. Nor would it have been possible for a great and sagacious physician or surgeon to have embarked unprepared with the troops from Varna, even though commanded to do so by Lord Raglan, or even by a Mr Commissary-General Fidler.

These remarks, it will be readily seen, are of much wider application than to the state of things in the Crimea, and extend equally to the health of our towns and rural population. To this view of matters we may, perhaps, take another opportunity of adverting.

ON THE PROPRIETY OF TEACHING THE GENERAL LAWS OF PHYSIOLOGY AND OF HYGIENE IN OUR PUBLIC SCHOOLS. Ar a meeting of the Governors of George Heriot's Hospital on the 8th ultimo, it was moved by the Rev. Dr R. Lee-" That a Committee be appointed to consider the propriety and practicability of instructing the boys in the Hospital and the scholars in the Foundation Schools, in physiology and the laws of health, and other matters connected with the physical wellbeing of the community." In support of this motion, the Rev. Doctor said that it had long appeared to him, and indeed to every one who paid any attention to the subject, that the misery which oppressed so large a portion of our poorer citizens and countrymen arose from causes which might be either removed or at least greatly mitigated. It arose evidently in a very large measure, from their ignorance their ignorance of those things on which their physical wellbeing depends. The question he seriously pressed upon the Governors was, whether, with the means in their possession, they could do nothing to teach those thousands of the community who attended their schools how to prevent diseases-how to preserve that health which, however precious to all, was to the working-man even more precious than to others. Every boy and girl before leaving the school might be taught so much of the structure and functions of the human body as should give them a good notion of the house they live in, and they might all be made familiarly acquainted with those conditions which are indispensable to health, as also with those which are deleterious and fatal to it. They should know-and therefore we should let them know-what are the laws which God has ordained for them to observe in relation to health, and which they cannot violate without incurring the penalties which He has also ordained. Was it not strange that we should pretend to educate youth without informing them regarding the effects of bad air, bad water, want of cleanliness, NEW SERIES.-NO. III. MARCH 1855.

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intemperance, and other things which are the great springs of those maladies from which the community suffers so much? Thousands of the most promis ing youths could testify that they had been taught everything but what concerned most their health, comfort, and life of all which they paid the penalty through that ignorance. He was of opinion that the education of the girls at tending their schools should engage particular attention. It was notorious that the ignorance of the female part of the community was the cause of the most wide-spread and dreadful evils. Not one woman in twenty knew how to manage a labouring man's house or cook his victuals in an economical and comfortable manner. All was discomfort, mismanagement, and waste. The consequence was that whisky was resorted to, to make up for the want of nutritious food and to satisfy the craving which that want created. This was the standing cause of drunkenness; and if they could succeed in diffusing among the thousands of girls, who will soon be wives and mothers, a knowledge of the proper methods of cooking, washing, and rendering a cottage a comfortable abode, they would supply one of the most effectual checks to intemperance and all its train of vices and miseries, and would perform a service of inestim able benefit to the community. The same ignorance showed itself in another way which was most distressing. The mismanagement of themselves and of their infants by the class of women now alluded to was such as to produce a mortality frightful to contemplate, and an amount of suffering on which they should not look with indifference. The proportion of children who die in the crowded habitations of this city, and he believed of all other cities, and generally among the poorer classes everywhere, is such as may well excite compassion. He did not believe that any amount of intelligence would be able to prevent this entirely, but he felt sure that it might and would prevent the greatest part of it. Some persons, he understood, thought this kind of knowledge could not be made intelligible or interesting to children. The sufficient reply was, that it had been made, and was daily made, both the one and the other. If, indeed, you should give lectures on physiology, full of hard words and long disquisitions, you might save yourselves the trouble. But children, though deaf to words, are quick-sighted for things; and if you will exhibit to them the objects which you wish to instruct them about, you will find they will look very earnestly and listen very attentively to your explanations. It would be easy to produce a great mass of evidence to show that such children as attend the more advanced classes in the Heriot Schools can both compre hend this sort of instruction, and that they greatly relish it; but he would content himself with reading a document which would settle that question; it was signed by all the most eminent Professors and medical men in London, including Sir James Clark, Sir Henry Holland, Dr Forbes, Dr Paris, Professor Owen, Dr Southwood Smith, Dr Todd, and a whole list of great names:"Medical Opinion on the Importance of Teaching Physiology and the Laws of Health in Common Schools. Our opinion having been requested as to the advantage of making the elements of human physiology, or a general knowledge of the laws of health, a part of the education of youth, we, the undersigned, have no hesitation in giving it strongly in the affirmative. We are satisfied that much of the sickness from which the working-classes at present suffer might be avoided: and we know that the best-directed efforts to benefit them by medical treatment are often greatly impeded, and sometimes entirely frus trated, by their ignorance and their neglect of the conditions upon which health necessarily depends. We are therefore of opinion that it would greatly tend to prevent sickness and to promote soundness of body and mind were the elements of physiology, in its application to the preservation of health made a part general education; and we are convinced that such instruction may be rendered most interesting to the young, and may be communicated to them with the utmost facility and propriety in the ordinary schools by properly instructed schoolmasters." He hoped that such a testimony as this, coming from sixty of seventy of the most eminent scientific men in Europe, so clear, strong, and

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unequivocal, would make a very deep impression upon the Governors of George Heriot's Hospital.

Dr Lee's motion was unanimously adopted, and a large Committee appointed. [We are of opinion that such kind of instruction would be as useful among the higher as among the lower classes. The ignorance of the laws of health is the same, but the desire for information being greater, they are led to adopt any plausible theory presented to their minds. They consequently become the patrons of every species of quackery, and thereby not only inflict an amount of physical suffering on mankind, but by fostering deceit and other vices, give rise to an amount of moral evil that is too great to be readily appreciated.]

RECENT EXAMINATION AT THE INDIA BOARD.

We are, like some of our contemporaries, much surprised at the result, not to say the failure, of the first examination of candidates for the medical service of the Honourable East India Company. We have always looked upon that service, not only as the best paid, but the best pensioned service in the wide world. How, then, has it happened that, for thirty appointments to be filled up, only twenty-eight candidates have appeared? We see that a report of the examinations has been laid on the table of the House of Commons, which does not throw much light upon this subject; we are therefore left to conjecture that the advantages of the Indian service are but imperfectly known in the medical schools.

We apprehend also that the Government has not been fortunate in the selection of an examining board; that board, as at present constituted, has not secured the confidence of those most conversant with the nature of the East India Company's service. We have nothing to say against the talents of the gentlemen appointed, and we are very far from adopting the objection sometimes urged against teachers, or hospital physicians and surgeons, being placed on examining boards, namely, the allegation of partiality to the pupils of particular individuals, or particular schools. This argument is, in our opinion, altogether unfounded. No man, we believe, ever objected to the great surgeons of Guy's, or St Bartholomew's, such men as Sir Astley Cooper or Mr Lawrence, being examiners at Surgeons' Hall; but, on the contrary, every one possessing the diploma of that body considers its value greatly enhanced by having such names attached to it.

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For such a purpose, however, as the Examining Board of the East India Company has been appointed,-for the purpose of sifting the qualifications for a special service, of gentlemen who have already passed the colleges,-we conceive that not only teachers of reputation, but some men who had themselves acquired experience in the camps, cantonments, barracks, and hospitals of India, should have been selected. The present appointments, we find, are looked upon as a heavy blow and great discouragement to the many excellent men who, from the comparatively early period at which they are enabled to retire from the Company's service, have returned to this country full of health, vigour, energy, and intelligence. Many such men might have been found altogether unconnected with what Dr Bird calls the "scholastic medical establishments" of the metropolis; men who could have had no object but the honour and interest of that service to which they had devoted themselves; men who would have been in the position of Cæsar's wife, not only pure, but unsuspected.

There is one question connected with this subject which we think of grave importance to the medical schools of Edinburgh and of Dublin. If the examinations are conducted exclusively in London, our Scotch and Irish students will be placed at a disadvantage. The Scottish student, with that constitutional caution for which his countrymen get credit, will be slow to undertake the trouble and expense of a journey to London with the chance of being sent "empty away." The Irish student again, we have sometimes found prone to