tion, and a diminished quantity of oxygen gaining access to the lungs. This is the case with the phthisical, as also with the healthy, when a plethoric state of the lungs is induced by great exertion. Spirit-drinkers, owing to the changes wrought in the blood by alcohol, are in an analogous position to the phthisical; and it is in such subjects that spontaneous combustion generally occurs. The congestion of parts with dark blood, as in the case of ulcers, may give rise to it; as also the sweat of an over-heated skin, the urine of persons suffering from syphilis, or other cause of diminished strength. Animals that normally give rise to the phenomenon of illumination are all low down in the scale, and possess but imperfect respiratory apparatus. Much light-producing material enters into the composition of the body; and although, in the normal conditions, phosphorus, sulphur, and carbon are expelled from the frame, combined with acids, by the kidneys, yet, as in diseased states, we may find carbon in the bronchial glands, and sulphur in the abdominal flatus, so may we suppose phosphorus may sometimes remain uncombined with oxygen. Such escape of unburnt phosphorus would be favoured by whatever limits the respiratory powers and diminishes the quantity of free oxygen in the blood. In experiments upon dogs, it has been found that phosphorus, mixed with oil and injected into the blood, if time be not given it to combine with the oxygen of the the body, escapes unburned from the lungs.-Casper's Wochenschrift, No. 15.

PATHOLOGY AND PRACTICE OF MEDICINE.

On the Comparative Pathology of the different Races of Men. By M. Boudin. M. BOUDIN has for some considerable time been engaged in furnishing statistical proof of the erroneousness of the doctrines of acclimatization, which suppose that fong residence habituates men to climates otherwise unfitted for them. He has brought forward, in his various communications, of which this forms one, ample proof of the little success and the great mortality that have attended the attempts at the colonization of Algeria. In the same way, the European has always failed in fixing himself in Egypt, and the French cannot propagate their race in Corsica. He pays a well-deserved compliment to the British government for having availed itself of a knowledge of these deleterious influences, in the more judicious distribution of its troops in recent times. Thus, by adding to the British troops auxiliaries recruited among races whose physiological and political aptitudes suited them to the respective climates, by selecting for the European troops serving in warm climates the most elevated regions, and by shortening the time of service abroad, it has effected a remarkable diminution of mortality,-a diminution which, in the most unhealthy possessions, has amounted even to 50 per cent. He contrasts this with the large mortality which still prevails among the French troops serving in analogous regions. The differences of the comparative mortality of the different races placed under different circumstances is seen by examining that of the white and the negro population. Thus, while at Philadelphia the mortality of the whites is 24 per 1000, that of the negroes is 47; that of the whites 10 years old and upwards being, at New York, 15 per 1000, that of the negroes 26. At the Eastern Penitentiary, 20 per 1000 whites and 70 blacks die; while at Weathersfield, the numbers are 28 and 100 respectively; and the same enormous disproportion is observed in other prisons. The great mortality is especially due in the negro tribes to phthisis and typhus; while the negro is so proof against malaria, which carries off so many whites, that a due observation of this fact has enabled the British government to diminish wonderfully the mortality of their troops employed in the East and West Indies. In the West Indies, the mortality of the negro soldier, compared to the white one, is but as 40 to 78 per 1000; and in Sierra Leone, it is 16 times less than that of the white. The latter are 160 times more fatally affected by fevers than the negro; and it is only in diseases of the chest that they enjoy a somewhat greater immunity (4.9 to 6.3 per 1000). Even in the

most southern station of Europe, Gibraltar, however, the negro mortality (62) greatly exceeds that of the white soldiers (214), though these are also strangers to the soil-the diseases of the chest in the negro amounting to 43 per 1000.

In respect to the Sepoys, their mortality at the different stations is three or four times less than that of the English soldier; and they enjoy a remarkable immunity from diseases of the chest and liver, but are more prone to dropsies, owing to the endemic prevalence of the beriberi. The mortality of the Hottentot soldier at the Cape is very small, half of the deaths arising from diseases of the digestive organs. They, too, are more prone to diseases of the chest than the white soldier. Many facts tend to show that the Jews, even amidst wide-spreading pestilences, have enjoyed great immunities; and that they pre-eminently possess the power of acclimatization.

M. Boudin concludes the present paper with some observations on the diseases and mortality of the war-horse. In 1845, of an effective force of 33,618 horses, the French cavalry lost by death 2603, and by discharge 2511. Of an effective force of 41,793 in 1846, 2679 died, and 3314 were discharged. While the general loss by death and dismissal in France was 143 per 1000, it was in Algeria 240. In 1836 the mean annual mortality was 197 per 1000; 126 in 1841; 108 in 1842; 71 in 1843; 76 in 1844; 77 in 1845; and 66 in 1846,-a diminution constituting one of the greatest triumphs achieved by the application of sound hygienic and administrative measures. How much yet remains to be done, however, is shown by the fact that the Prussian cavalry only loses 20 per 1000, and the French gendarmerie 14 per 1000. The largest mortality takes place in the finest quarter of the year,―from April to October; while the smallest corresponds to the cold season of the year, a fact chiefly attributable to the suspension of manœuvres during the latter period. The most frequent causes of death, both in France and Algeria, are glanders and diseases of the respiratory organs. The glanders gives rise to 10 times the mortality in Algeria to that produced in France,-a difference, M. Boudin thinks, that may be in part explained by the fact of so many mules (5695 in a force of 18,538) being employed in the former country,-the disease almost always attacking these animals in the acute form. In 1846, the Minister of War consulted 136 army veterinary surgeons, as to whether this disease is contagious. No answer was returned by 12; 24 were uncertain; 36 were noncontagionists; and 64 contagionists.-Annales d'Hygiène, tom. xlii, pp. 38-80.

On Nervous or Convulsive Cough. By M. SANDRAS.

THERE are several varieties of this:-1. The patient can receive no physical or moral impression, without suffering from a cough almost convulsive in its character. In examining the chest of such a person, the physician may be led into grievous error, and the unnecessary fear of incipient phthisis, unless he examines it on various occasions and under different circumstances. Patients with incipient phthisis also cough from the slightest cause; but it will be generally found that in those cases the impression is physical, while in those we are alluding to it is oftener moral.

2. Another form of cough, having some analogy to this, is observed whenever certain functions are brought into play, or when they are more actively exerted than usual. Thus, it is found in some whose meals have been too long delayed, in others as soon as they have eaten, especially if rather fully. Other persons cannot take a little extra muscular exertion without bringing on a tormenting cough of this kind. In both this and the preceding form the cough is dry and capricious, exhibiting very inconstant physical signs; but this latter form is somewhat more fixed in character than the first, inasmuch as in the same person it is always when the same function is fulfilled that it is produced; and it seems, too, to be more dependent upon disorder of the organs in connexion with the exercise of whose functions it appears; and this should be our chief guide for its treatment.

3. Another cough is observed upon the slightest irritation of the bronchi being

produced; so that the least cold brings on a convulsive cough nearly as bad as that of pertussis. Sometimes, and especially in children and very young adults, it takes on this form at the very commencement of the cold, and retains it until coction is produced. Each paroxysm is accompanied by a dry, raucous sound, and attempts at vomiting. Sometimes it is periodical, the disease only gradually assuming the characters of an ordinary ripening catarrh. In other cases the spasmodic character is only observed as the cough is drawing towards an end. Instead, however, of coction taking place, the expectoration continues frothy and transparent, and is only ejected by convulsive efforts and vomiting-the paroxysm being brought on by the slightest cause, and a state of spasmodic suffocation being almost induced, until a little transparent and frothy matter is expectorated, when all becomes quiet and normal until a new paroxysm. In some cases the cough suddenly ceases, without the expectoration having undergone any change; but this is rare. The causes of this pertussoid cough are not of easy appreciation. At the commencement, all is like a common cold; and it is the reiterated catching cold in an eminently neuropathic subject that seems to induce the aggravation. The prognosis, as regards immediate danger, is favorable; but is more serious in respect to future consequences, owing to the various evil consequences which may ensue upon the congestions the paroxysms give rise to. The destruction of sleep and disturbance of digestion which it causes are other important circumstances. Among the more serious results, is the production of hernias and of emphysema pulmonum. The irritation of the glottis and larynx should be relieved by tepid aqueous or narcotic vapours, and by the use of demulcent emulsions with laurel-water. When the expectoration is difficult, syrup of poppies, with small doses of tartar emetic, should be given, the antimony, whether it causes vomiting or not, affording great relief. So, too, small doses of extract of belladonna every night, or night and morning, should be given when the expectoration is somewhat modified, and in a few days the convulsive character of the cough usually abates. When this drug disagrees with the patient, it should be used endermically.

4. This variety may be called hysterical, from its occurring in hysterical patients. In a subject whose respiratory organs are habitually in a good condition, all at once an irregularly paroxysmal cough comes on, occurring at frequent intervals, and sometimes almost without intermission. It does not terminate with the expulsion of mucosities, but is either dry and objectless, or is accompanied by a true phlegmorrhagia. Hysterical phenomena sometimes precede or accompany the cough; while at others it ceases instantly that these appear. The cough is found to get worse and worse, in proportion to the development of the hysteria; and this without any physical explanation of its intensity. The pulse is not febrile, but may be irregular, and such a one as is found in nervous subjects. The prognosis is favorable, unless the cough is mistaken for a phlegmasia, and aggravated by maltreatment. The treatment is, in fact, that which is proper for hysteria; but two means are especially indicated-the use of belladonna, and the employment of baths. Belladonna, given in doses of one seventh of a grain every half-hour, is highly efficacious; and it is rare for five or six doses to be given before improvement is visible. Baths at from 84° to 89° act as if by enchantment; but sometimes it is useful to give them at from 75° to 82°; and this is the temperature which will in most cases prove the best, after the patient has already employed the higher.-Bulletin de Thérapeutique, tom. xxxvi, pp. 385-96.

On Modern Humorism. By M. TESSIER.

M. TESSIER arrives at the following conclusions from an examination of the results obtained by M. Andral in his investigations of the condition of the blood in different diseases:

"We have not been able to lay hold of any one etiological fact having any value whatever. This suffices to show that in our opinion what is called modern humorism, purified humorism, does not and cannot exist as a medical doctrine, and

that, consequently, organicism, or the principle of the localization of disease is but a chimera. The title of a celebrated work (De Sedibus et Causis Morborum') has too easily deceived many. The belief that the lesions of the solids and liquids of the body are the seat and cause of disease has been credulously received, and the phantom of localization has been pursued with a zeal worthy of a better result. While believing that a reform in medical doctrine has been accomplished, we have been carried back to whatever is most false and most hypothetical in Galenism. It would seem as if medicine is never to leave the track marked out for it by Hippocrates and Galen. In the sixteenth century, reform in medicine consisted in reasserting the errors of Hippocrates, while in the eighteenth and nineteenth centuries we have been content with Galenism. It has been thought that, by ornamenting it with the results of modern physics and chemistry, a reform has been accomplished; but we have only complicated a system in whose trammels we are yet kept.

"Nothing is more dangerous in science than to attach importance to mere probabilities, and of this modern humorism furnishes us with a proof. For any man, who has not a well-defined idea of what disease really is, or who has not yet passed the abyss of general pathology, nothing seems more probable than the supposition that a certain number of diseases proceed from changes in the blood. The part this fluid plays in the economy renders this so easy to believe; and how many physicians with Galen have believed it! Yet this belief, at first sight so simple and seductive, is a mere medical extravaganza, an absurdity unworthy of a serious thinker.

The history of the alterations of the blood is and will always be a question in semeiotics, and no more, inasmuch as such alterations are but symptoms. Supposing chemistry and the microscope succeed in exposing the minutest modifications of this fluid, that will not convert a symptom into a disease, a sign into a cause, a question of semeiology into one of etiology. He who enters on a study of the alterations of the blood as the cause of disease, seems to me to act very much as a surgeon who would study crepitation as a cause of fracture. It does not follow that he should not study crepitation, nor do 1 mean to assert that it is not highly advantageous to study the blood in disease, by all the procedures that physics, chemistry, and physiology have placed in our hands. I am happy in adding that the labours of M. Andral abundantly furnish the proof of this. To that physician will always remain the honour of having verified and classified a certain number of the alterations of the blood, and having furnished useful indications in semeiotics. Thanks to his labours, we are now able to say that humorism is an error, and that the changes in the blood are facts."-Rev. Med.-Chir., t. v., p. 264.

On the Treatment of Psoriasis and Lepra Vulgaris. By M. EMERY.

M. EMERY states, that when appointed to the St. Louis, several years ago, he tried all the various remedies so warmly recommended by authors, and of all these arsenic proved the best internal medicine; but besides the inconveniences which it sometimes gave rise to, its operation was very slow. The external use of strong tar ointment (to of tar) produces, in fact, a far more rapid cure than any other means. Of from 1500 to 1800 patients who have employed it, five sixths have been rapidly cured, and that without any ill consequence, or any greater frequency of relapse than after internal means. In 228 cases of psoriasis, the arsenic and tar were used conjointly, and 200 were cured within two months. Of all the preparations of mercury, the protiodide is alone efficacious (); but it excites much irritation of the skin, and if applied to large surfaces, produces salivation. The iodide of sulphur is useful in psoriasis of the head; but if applied to large surfaces, produces erysipelas. The conjoined use of the arsenic and tar-ointment constitutes, in fact, the best medication. In a disease so apt to recur, the greatest attention to diet is essential; and on the least symptom of recurrence, resort should be had to medicine, without waiting until it has become very bad. Before commencing, the patient takes a

bath, and rubs in the ointment with gentle friction three times a day. In two or three days the strength of the ointment and activity of the friction are increased; and when the disease is of old standing, linen rags smeared with the ointment are to be kept applied. A tepid bath is taken once or twice a week. It is only in very irritable skins that the treatment is interrupted by the appearance of impetiginous pustules or furunculi. In about ten days we perceive, where the squamæ have fallen, a whitish circle circumscribing the patches, and extending from the circumference towards the centre. This is a sign of a decrease of the disease, which usually disappears in two or three months. With respect to the arsenic, we should begin with five drops of Fowler's solution, in four ounces of sugared water, which are to be divided into two doses. Every other day the dose is to be increased a drop, until twelve are reached. If we observe that the patches are becoming thinner, and acquiring a blackish-gray colour, this is a sign of saturation, and the dose is not to be increased; but even when this is not present, it is rarely proper to go beyond twelve or fifteen drops. Sometimes the skin becomes hot and painful around the patches; but this is relieved by tepid lotions, demulcent drinks, and diminution of the dose. After twelve or fifteen drops are reached, a feeling of constriction of the throat, or severe pain of the stomach, is perceived; and then the medicine should be suspended for a day or two, and recommenced de novo with the small dose. Pain near the heart, with palpitation, sometimes renders venesection requisite. If any contraction of the extensors of the limbs is observed, the medicine must be at once abandoned; and as soon as the blackish-gray colour of the patches appears, which announces saturation and an approaching cure (though such spots may remain for months), the arsenic must be discontinued.-Bulletin de Thérapeutique, tom. xxxVİ, pp. 481-90.

SURGERY.

On Granular or Egyptian Ophthalmia. By MM. THIRY and BUYS. Two highly interesting papers have recently appeared in the Annales d'Oculistique' upon this disease, which, heretofore so destructive in the French and British armies, has of late years especially attacked the Belgian troops. This has given rise to most praiseworthy investigations on the part of the Belgian military surgeons; among the fruits of which is a new theory of the disease advanced by M. Thiry, and a new and efficacious mode of treating it discovered by M. Buys.

M. Thiry's views are detailed at great length by his pupil M. Crocq, but a brief abstract is all we have space for. He considers the disease as a special inflammatory affection, having its peculiar signs, the most characteristic of which are the granulations, which have been erroneously regarded by prior authors as a hypertrophied condition of anatomically-normal elements; whereas, in the author's view, they are a new and special element. Their existence may be suspected when the eyelids are swollen, slightly everted, and of a venous tint. On everting the lids, a mass of little red projections is seen upon a very light red surface, especially under the upper lid, and near the oculo-palpebral fold. When a little older, the conjunctiva looks slightly bronzed, and the little red bodies uniting together, present an appearance like the surface of a strawberry or of velvet pile. Little furrows radiate between these in every direction, in each of which a lens detects a streak of purulent matter, which in some places is sufficiently abundant to conceal the granules. Slight pressure on the granules renders them pale, only to become the more red when this is removed, which M. Thiry regards as a pathognomonic sign, due to the great congestion of the parts, owing to which, also, the furrows are then found streaked with blood. The irregularities seen on inspection are not the granulations, but merely their summits. The granulations are imbricated; and to see them completely, the finger must be passed along the reverse way to that in