acquainted some years ago with Staff-Surgon Marshall, an old Indian officer, who stated that in the early outbreak of cholera they were all anxious to determine the nature of the disease by post mortem examinations; but he found it difficult to go on with the dissection, for the moment the incision was made in the sternum, the body would spring up with frightful gestures, as if galvanized, and it was very hard, he said, "to make the young hands go on." As to treatment, no cure had been discovered for cholera, and no cure, no specific was sought for. In this respect cholera was not peculiar. There was no cure for any essential disease. No man could venture to say that this or that treatment will cure an essential fever. The physician guides it to recovery. He knows the system is exposed to two dangers-debility and secondary diseaseand steering between these two rocks, he guides it until the time when the clock strikes and the disease ends of itself, either in death or recovery. So it is with cholera. In the reports from some of the hospitals, there were columns apparently recording the results of special treatment, and this was objectionable, for it led to misconception as to the practice of the hospital. They read of so many cases treated by calomel, so many by white of eggs, so many by stimulants, and so forth. The objection to such a column as this was, that it might lead the public or medical men at a distance to the erroneous impression that in the Dublin Hospitals there had been any cases treated by this thing or that thing alone. The great characteristic of Irish medicine, as Sir Dominic Corrigan had said, was its eclectism; and when they inquired into the treatment of cholera patients, they found that it had been decidedly eclectic, and no one mode of treatment had been adopted in any number of cases. But with respect to palliative treatment something might be said. It had been found in some of our hospitals that an admirable method of relieving painful spasms was by the inhalation of chloroform. This might be done with perfect safety, and repeated again and again-not to such a degree as to produce insensibility, but to act as an anesthetic, and procure the patient relief. So also they found in the Meath Hospital great value, in the collapse, from Sir D. Corrigan's button cautery along the spine. In cases of suppression of urine, even when uremic symptoms had appeared with complete suppression for forty-eight hours, cupping repeated again and again, drawing a few ounces of blood, had restored the secretion of urine, and been attended with success. The treatment by saline injections had been tried by him, and with the usual result of apparent and almost instantaneous relief; but in the course of a few hours purging came on again, and the case was as bad as ever. In the Mater Misericordiæ and the Meath Hospitals the treatment by calomel was tried, and with some fortunate results. It was found that when bilious stools were produced, the patient's chances of recovery were greatly increased. Now, as regards the question of contagion, Dr. Kennedy spoke of negative evidence, by

which he meant the general opinion among gentlemen who practised in India, against the doctrine of contagion. It would be quite wrong to shut their ears to the evidence of these gentlemen. It was extremely important, however, on the other hand, that they should remember they were not to infer the phenomena of disease in one part of the world from those in another. The question of contagion in the North-in European countries-had some elements of difference from the question of contagion in tropical climates. The principal mortality in India occurred among the natives; and here we got another element-the comparative mortality of the disease in coloured men and in white men. It might be that the natives of the tropical climates, and the coloured races generally, were more liable to the exciting causes of cholera than the whites. He thought that extremely probable, and it also might be that contagion was apt to be more rife in the colder than in the warmer climates. It might be said, also, that the European constitution was less liable to contagion in India than in a more northern climate. So far as he could collect from Dr. Mackesy, who had had great experience, that was his opinion. Dr. Lyons, who advocated the non-contagion theory, had dwelt on the fact of the immunity of a large proportion of the staff of the Hardwicke Hospital. A similar circumstance was observed in the Mater Misericordiæ Hospital, where there was a large staff of physicians, and of Sisters of Mercy and hospital nurses, in constant attendance on patients, and yet there was not a single case of contagion. This showed, in a striking manner, that the disease, during the late epidemic, was not eminently contagious. But when they recollected the epidemic of 1849, and recalled to mind the terrible mortality among medical officers who were sent down to the country-five medical men, for instance, having been struck down in Sligo-they had a set-off against the immunity of Dublin during the late epidemic. The outbreak in Mountjoy Prison might be set against the contagion theory, and seemed to point to the spontaneous origin of cholera. But it was to be remembered that at the time of this outbreak there was a general epidemic prevalent, and they had to balance the chances of some communication from without, with those of the spontaneous generation of the disease within. It was remarkable that, coincident with the outbreak of malignant cholera in the prison, there was a great number of cases of choleraic diarrhea, and this furnished them with arguments for the philosophic view put forward by Dr. Darby--that when there was an epidemic of cholera, all those cases of diarrhea which were apt to run into cholera must be considered a species of cholera of a mild form. If this be so, and he had no doubt of it, it would greatly diminish the per centage of mortality, which, in place of being 50, would be only 20 or 30 per cent. The proofs of contagion in any epidemic mainly depend on a balance of probabilities, and the application of the doctrine of chances might be well made to clear up the

matter. This was done in reference to fever by the late Dr. Whitley Stokes, who proposed certain problems to the Bishop of Cloyne, who was well skilled in the calculation of chances, as to the probabilities for and against the occurrence of ascertained events, assuming that the illness of one person did not promote that of another. The society will find the results in Dr. Stokes' observations on contagion. This mode of proceeding was eminently deserving of the attention of the society. Dr. Stokes concluded by congratulating the society on the three meetings, and thought that great good would come of the discussion which had taken place.

On the motion of Sir D. Corrigan, seconded by Rev. Professor Haughton, a vote of thanks was passed to the military medical officers for the information which they had given to the meeting.

The meeting then separated.

INDEX

TO THE FORTY-THIRD VOLUME.