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EPIDEMIOLOGICAL SOCIETY. MONDAY, FEBRUARY 5TH, 1855.
217 bonate of lime, with a trace of sulphate of lime. It was not On the day after the operation examined microscopically. there was some local inflammation, accompanied with fever; but in a couple of days this subsided, and the patient left the hospital in a short time entirely relieved. There remained only a little numbness in the cicatrix when it was pressed on. Five years afterwards, in the summer of 1850, Elizabeth Mcame to the hospital to ask advice on account of a child born since the operation. She had gained flesh considerably, and had in the interval suffered no inconvenience whatever from the limb. She had suckled her last child. Dr. HARE read a paper on STRICTURE OF THE (ESOPHAGUS.
M-, aged forty-two, was first seen by him in July, She was of delicate complexion then, even somewhat emaciated; her complexion clear, and without any strawcoloured tint. She had never enjoyed good health, and had been subject to liver attacks. She had never had any dysphagia till twelvemonths before the abovedate; at that time she began to have difficulty in swallowing, and especially when she took meat; she was "long" in swallowing, but deglutition caused her no pain; with care, she alwaysmanaged to get the food down, and it never returned. She then, as since, referred the chief obstruction to a point behind the larynx. About ten days before he (Dr. Hare) saw her, deglutition had become Mrs. 1854.
and also painful, and the pain had been especially bad for two days, during which period also she had had difficulty in swallowing fluids, so that she had to take a wineglassful of water in several distinct portions; an alcoholic fluid, such as wine, caused more pain than water. She never brought up any blood except once, twelve months ago, when a few streaks were mixed with some phlegm at a time when she had a bad cough. There was no hoarseness; pulse 90. There was no swelling, nor anything abnormal, on examination of the neck externally, but a little tenderness on moving the larynx from side to side and at the same time pressing it backwards. An attempt to pass a stomach-pump pipe down the oesophagus was made, but it met with very firm resistance at a point about fiveinches and a half or six inches from the incisor teeth, and it was impossible to get it further. A blister was applied, and some sarsaparilla and iodide of potass, and subsequently codliver oil; a solution of nitrate of silver was also applied to the strictured part two or three times. Her deglutition decidedly improved for two or three weeks, as also her general health; but subsequently the swallowing again became difficult, and she ultimately sank, at the end of September, of inanition, though efforts were made to prolong life by using enemata of beef-tea. At the commencement of August, a much smaller bougie was used, but it equally failed in passing the point of the obstruction. On this occasion the matters adherent to the end of the bougie when it was removed were examined under the microscope, but they were found to consist only of epithelium cells and blood discs mixed with some starch granules, &c.; there were no cancer cells. It may be mentioned that on each of several occasions when the bougie was used, the patient went into a well-marked cataleptic condition, and remained in it some minutes; such attacks she had for some time been subject to under the influence of considerable excitement. The left side became dislocated, so as to keep the mouth open till the dislocation was reduced. The oesophagus, with part of the pharynx, as well as the trachea and larynx, of the patient were exhibited to the Society. There was not a trace of cancer, but opposite the cricord cartilage the ctsophagus was suddenly narrowed and contracted so as barely to admit a small quill; the most constricted part did not occupy more than a quarter or three-eighths of an inch vertically; at this part there were slight traces of superficial ulceration. The mucous membrane around the constricted portion was much thickened. Mr.. QuAIN next introduced a paper worse
ON EXCISIOX OF THE SHAFT OF THE FIBULA.
The subject of the operation, who was submitted to the examination of the members of the Society, was a little boy of healthy appearance, somewhat florid complexion, with large dark eyes. He walked without the slightest lameness. In fact, there was no evidence whatever of any want of the natural power of the limb, or of the extent or facility of its movements. One operation was performed about eight months ago. The following is an outline of the case:-W. N——, aged seven, had a slight accidental knock, while playing with another child, upon the the outer side of the leg, at the beginning of last year. There was no mark on the surface, and for some days he was quite free from pain;in fact, quite well. But, at the expiration of
arose, followed quickly by inthe whole leg, and was attended by severe symptomatic fever. He came under the care of Mr. Wildbore, who, on account of the persistence and eftension of the local mischief, sent him to the hospital. The leg was swollen from the knee to the ankle, especially at the outer side, where, towards the lower part, a sinus led to the bone. Pus was abundantly discharged from that opening, and likewise from another at the inner side of the leg, high up in the calf. The shaft of the fibula, at its lower end, was thickened for about an inch, the necrosed piece being then covered with a new osseous case. On account of the extent of the local mischief, and the rapidly advancing failure of the general health, an operation was obviously necessary. An incision being made over the necrosed part of the fibula where it was encased by new deposited osseous matter, it was found that the whole shaft of the bone was perfectly bare of its periosteum. With another short incision below it, the upper end or head of the shaft was easily separated, and it came away entire, being drawn down through the lower opening. This one small part of the dead bone was covered in the ordinary way with new deposit, while much the larger part was without such covering. The boy rapidly got well. At first, after the healing process was complete, there remained some stiffness of the ankle-joint, but in a couple of months the free movement of the joint was restored. The author directed attention to the fact of the part of the bone, the presence of which is of most importance to the functions of the limb, having been preserved, not having been involved in the disease-namely, the lower end, the support of the ankle-joint on its outer side, and the upper end, with which the large double-headed hamstring muscle, one of the principal flexors of the knee-joint, is connected. The removal of the upper end would have endangered the knee-joint, as the synovial membrane between it and the tibia is often a continuation of the large synovial membrane of the knee-joint. An interesting discussion arose, in which Dr. Millar and Mr.
about
a week, an aching pain flammation, which extended
Hainworth took
’
over
part.
WEDNESDAY, FEBRUARY 14TH. THE following gentlemen were elected to fill the offices of£ the Society for the ensuing year:-President: C. J. Hare, M.D.-Vice-P-nesidents: R. Quain, Esq. ; Dr. Jenner; Dr. Greenhalgh; H. B. Norman, Esq.-Treasurer: Donald Fraser, Esq.-Tnl8tees: N. H. Clifton, Esq. ; J. Part, Esq. ; S. Sandys, E. Cousins, Esq.; J. T. LawEsq.—.SoHonM-!/
W. Sedgewick. After the presentation of several pathological specimens by fellows of the Society, the annual oration was delivered by Dr. Ballard, to whom a vote of thanks was passed unanimously, and the oration ordered to be printed and circulated at the expense of the Society. The next meeting of the Society was postponed from Feb. 28th (the day appointed for the dinner of the Medical Benevolent College) to the following day, March 1st.
EPIDEMIOLOGICAL SOCIETY. MONDAY, FEBRUARY 5TH, 1855. DR. BABINGTON, PRESIDENT. A paper
was
read
by Dr.
HEADLAM
GREENHOW,
ON THE CHOLERA IN TYNEMOUTH IN 1831-2, 1848-9, &
1853.
The author entered into an able and elaborate history of the disease, as it appeared in Tynemouth during the various visitations enumerated above. Our space will not allow us to give a lengthened abstract of his paper; but the following conclusions, to which the author arrived, were based upon a number of very striking facts. 1. That cholera was not imported into Tynemouth either in 1831 or in 1849, by direct human intercourse-as from patient to patient. 2. That if cholera be communicable from person to person, such mode of its propagation is of insignificant importance. 3. That the propagation of cholera by means of the water supply, either in 1831-2, or in 1849, may be said to have been impossible. 4. That the pestilence having almost invariably fixed its seat in the dirtiest and worst-drained portion of the town, and especially in situations the atmosphere of which was more or
218 less vitiated by decaying organic substances, combined with He (Mr. Burnell) also thought that the occurrence of the moisture, these appear to have acted as localizing causes of greatest number of fatal attacks of cholera in the beginning of cholera. 5. That poverty alone had little influence in predis- the week proved that moral causes had a large degree of influ-
posing persons to cholera, for many of the victims were, if not ence over the spread of the disease. After a few remarks by Dr. M’WiLLlAM, Mr. TUCKER, and wealthy, at least in comfortable circumstances. 6. That the Dr. DONALD FRASER, Dr. GpEENEOw replied, and the Society mere overcrowding of houses, and the defective construction of streets, as regards their ventilation, appeared only to aggravate adjourned. the disease, so far as they increased the above-named localising
causes. 7. That mere elevation or lowness of site, apart from the existence of some other cause, had no effect on the disease; North-street, with an elevation varying from sixty to seventy feet, and Reid-street, with an elevation of 110 feet, in both of which the pestilence prevailed in its worst forms, having suf- Practical Treatise on the Diseases of C7tilclreiz and Infants at fered much more severely, in proportion to their population, the Breast, inclueling the Hygiene and Physical Ed1&cat’ion than Duke-street, Clive-street, Bell-street, or Liddle-street, of You72g Ckilcl1’en. Translated from the French of whose average elevation is under twenty-fi ve feet above the tidal M. BOUCHUT, with Notes and Additions, by PETER datum. 8. That where cholera is impending, it may either Ilrr; cKES BIRD, F.R.C.S., Author of the Jacksonian Prize be averted, or, at least, the visitation be much mitigated by Essay for 1849-" On Erysipelas."London: John Churchill. active precautionary measures; and that probably sound sani1855. pip. 776. tary arrangements which provided for the complete and rapid BUT few years back, and we were sadly deficient in removal of all the excretse and other exuvise of towns, would so improve their condition as to remove the local sources of scientific treatises on the pathology of early life. "Mothers’ atmospheric impurity which would appear necessary to the Guides," on the one hand, and Dr. Underwood’s frequently full development of cholera in a pestilential form. Lastly. re-edited and metamorphosed pages, on the other, were almost The correctness of several of the preceding conclusions appears the sources of instruction on the hygiene and medical only to be confirmed by the singular immunity from cholera enjoyed of infantile treatment the frame. The little broclaure of Dr. the less the inhabitants by troops, and, although perfectly, by of the village of Tynemouth in 1849, and by the entire borough Coombe, and the later editions of Evanson and Maunsell, were in 1853, as well as by a converse series of facts which show the first steps towards a scientific elucidation of the two dethe tendency of the pestilence to return upon its former footpartments named. The cotemporaneous publication in the steps, and to re-appear at a subsequent visitation, not only in serials of the day of some lectures of Drs. West and Willshire the same localities, but even in the same houses and rooms which it formerly visited, provided no essential improvement (physicians to the Infirmary for Children) more directly, however, attracted the attention of the profession to the necessity has, in the meantime, been made in their condition. Dr. MILROY said that the late Dr. Gillkrest, author of an of bestowing a little more favour on the subject of paediatrics excellent treatise on Yellow Fever, had remarked, at one of than had hitherto been the case. The most important progress, the meetings of the Society, that no man is qualified to write however, was made when Dr. West collected his lectures a history of that disease until he had witnessed, and carefully studied, its characters, on at least three different occasions. together, and published them as a substantive volume. This The observation of a single epidemic is insufficient to justify a has become the standard work in our language upon its peculiar, writer in drawing general conclusions respecting either its subject, and most worthily so, as it is the result of very great. natural history or its treatment. What Dr. Gillkrest had said practical experience and extended knowledge of the medical of yellow fever held true of cholera also. It was for this very literature of Germany and France. In the interim, also, (it reason that Dr. Greenhow’s observations were entitled to great be we were presented with a valuable should mentioned,) respect. They served to show, in a striking manner, the intimate connexion between the virulence and fatality of cholera, scientific compilation by Dr. Churchill, of Dublin; and special and the existence of local causes of unwholesomeness. This care seems to have been, and is yet, taken, by the British and, great practical truth was proved, on the one hand, by the .Foreign -3fedico- Chirurgical Ra’iew, that the important subject almost invariable discovery of some nuisance or another within of the diseases of children should receive that attention which or near to houses where the disease had prevailed, and, on the other hand, by the comparative immunity of a locality which it merits. We point out these details, because it is but fair to had once suffered severely upon subsequent visitations, when recognise the source of such endeavours to elevate the departthe locality had been much improved in its sanitary condition. ment of medicine we are discussing to a position amongst our. Dr. Sxow said that the remarks of Dr. Greenhow respecting selves equal to that it has long since maintained in the medical the water supply of North Shields and Tynemouth entirely schools &c. of the continent. At the latter, M. Bouchut’s confirmed his views respecting the propagation of cholera. When this disease was communicated by means of a supply of treatise enjoysagood reputation; it has reached its second" water containing the evacuations of the patients, it extended edition-and this is saying much, when we consider how well at once as far as the water supply reached, and attacked all supplied French literature is with works on our present: classes of the community; whereas, in Tynemouth and Shields, spécialité, and how formidable a rival the classical volumes of where the water supply was not contaminated, the epidemic MM. Rilliet and Barthez constitute to all intruders into their cdnsistecl of a number of separate outbreaks in distinct localities. In Newcastle and Gateshead, on the contrary, in the autumn field. The introduction of M. Bouchut in an English dress is of 1853, when the epidemic was propagated by the impure one that should be cordially welcomed by both student and water, it extended amongst all classes of the people throughout practitioner: It is a complete encyclopaedia in its way, and both towns. If it was rather worse in the crowded habitations we believe it may prove no mean opponent in fighting for some. of the poor and dirty than in the houses of respectable people, of the honours now claimed by the lectures of Dr. West.. this was because, in the former, the disease spread also from we think it Indeed, possesses certain recommendations that person to person, besides- being communicated by the water. constitute it the best work in our language for the student and He considered that Dr. Greenhow did not attach sufficient imshould be borne in mind, however, that It the to There several of cholera. were communication young practitioner. portance striking cases of its propagation from person to person in the M. Bouchut’s teachings only relate to the pathology &c. of paper, affording the only real explanation of the disease, anclinfccncg, while other treatises often neglect this period, and it was probable that the cause was the same in the instances: specially refer to later childhood. M. Bouchut is not without’ where it could not be traced. Mr. G. R. BuRNELL, after making some observations on thehis faults, is open to some severe criticism occasionally, and difference of opinion which existed amongst medical practi- rides certain hobbies rather too hard; but, on the whole, we. tioners respecting the nature of cholera, expressed his beliefare satisfied the present volume, as presented to us by Mr. Bird, that sufficient attention had not, in this country, been bestowedl is deserving of becoming a favourite and established handbook. upon the influence which the geological constitution of a district The hygiene of young children is most ably treated, as is also must have upon the diffusion of that disease. Dr. Greenhow’s’: " on observations, as well as those of certain French authorities, the subject of their General .PeAoo." The chapters the Diseases of 1Vw’ses, on Growth in its Relations appeared also to show, that the elevation of a locality had less; Lactation, influence, in this respect, than Dr. Farr was inclined to believe. to the D:scctse3 of Chilcl1’en, and on Syphilis, are unequalled by’
Reviews and Notices of Books.
.
.
,
M-, aged forty-two, was first seen by him in July, She was of delicate complexion then, even somewhat emaciated; her complexion clear, and without any strawcoloured tint. She had never enjoyed good health, and had been subject to liver attacks. She had never had any dysphagia till twelvemonths before the abovedate; at that time she began to have difficulty in swallowing, and especially when she took meat; she was "long" in swallowing, but deglutition caused her no pain; with care, she alwaysmanaged to get the food down, and it never returned. She then, as since, referred the chief obstruction to a point behind the larynx. About ten days before he (Dr. Hare) saw her, deglutition had become Mrs. 1854.
and also painful, and the pain had been especially bad for two days, during which period also she had had difficulty in swallowing fluids, so that she had to take a wineglassful of water in several distinct portions; an alcoholic fluid, such as wine, caused more pain than water. She never brought up any blood except once, twelve months ago, when a few streaks were mixed with some phlegm at a time when she had a bad cough. There was no hoarseness; pulse 90. There was no swelling, nor anything abnormal, on examination of the neck externally, but a little tenderness on moving the larynx from side to side and at the same time pressing it backwards. An attempt to pass a stomach-pump pipe down the oesophagus was made, but it met with very firm resistance at a point about fiveinches and a half or six inches from the incisor teeth, and it was impossible to get it further. A blister was applied, and some sarsaparilla and iodide of potass, and subsequently codliver oil; a solution of nitrate of silver was also applied to the strictured part two or three times. Her deglutition decidedly improved for two or three weeks, as also her general health; but subsequently the swallowing again became difficult, and she ultimately sank, at the end of September, of inanition, though efforts were made to prolong life by using enemata of beef-tea. At the commencement of August, a much smaller bougie was used, but it equally failed in passing the point of the obstruction. On this occasion the matters adherent to the end of the bougie when it was removed were examined under the microscope, but they were found to consist only of epithelium cells and blood discs mixed with some starch granules, &c.; there were no cancer cells. It may be mentioned that on each of several occasions when the bougie was used, the patient went into a well-marked cataleptic condition, and remained in it some minutes; such attacks she had for some time been subject to under the influence of considerable excitement. The left side became dislocated, so as to keep the mouth open till the dislocation was reduced. The oesophagus, with part of the pharynx, as well as the trachea and larynx, of the patient were exhibited to the Society. There was not a trace of cancer, but opposite the cricord cartilage the ctsophagus was suddenly narrowed and contracted so as barely to admit a small quill; the most constricted part did not occupy more than a quarter or three-eighths of an inch vertically; at this part there were slight traces of superficial ulceration. The mucous membrane around the constricted portion was much thickened. Mr.. QuAIN next introduced a paper worse
ON EXCISIOX OF THE SHAFT OF THE FIBULA.
The subject of the operation, who was submitted to the examination of the members of the Society, was a little boy of healthy appearance, somewhat florid complexion, with large dark eyes. He walked without the slightest lameness. In fact, there was no evidence whatever of any want of the natural power of the limb, or of the extent or facility of its movements. One operation was performed about eight months ago. The following is an outline of the case:-W. N——, aged seven, had a slight accidental knock, while playing with another child, upon the the outer side of the leg, at the beginning of last year. There was no mark on the surface, and for some days he was quite free from pain;in fact, quite well. But, at the expiration of
arose, followed quickly by inthe whole leg, and was attended by severe symptomatic fever. He came under the care of Mr. Wildbore, who, on account of the persistence and eftension of the local mischief, sent him to the hospital. The leg was swollen from the knee to the ankle, especially at the outer side, where, towards the lower part, a sinus led to the bone. Pus was abundantly discharged from that opening, and likewise from another at the inner side of the leg, high up in the calf. The shaft of the fibula, at its lower end, was thickened for about an inch, the necrosed piece being then covered with a new osseous case. On account of the extent of the local mischief, and the rapidly advancing failure of the general health, an operation was obviously necessary. An incision being made over the necrosed part of the fibula where it was encased by new deposited osseous matter, it was found that the whole shaft of the bone was perfectly bare of its periosteum. With another short incision below it, the upper end or head of the shaft was easily separated, and it came away entire, being drawn down through the lower opening. This one small part of the dead bone was covered in the ordinary way with new deposit, while much the larger part was without such covering. The boy rapidly got well. At first, after the healing process was complete, there remained some stiffness of the ankle-joint, but in a couple of months the free movement of the joint was restored. The author directed attention to the fact of the part of the bone, the presence of which is of most importance to the functions of the limb, having been preserved, not having been involved in the disease-namely, the lower end, the support of the ankle-joint on its outer side, and the upper end, with which the large double-headed hamstring muscle, one of the principal flexors of the knee-joint, is connected. The removal of the upper end would have endangered the knee-joint, as the synovial membrane between it and the tibia is often a continuation of the large synovial membrane of the knee-joint. An interesting discussion arose, in which Dr. Millar and Mr.
about
a week, an aching pain flammation, which extended
Hainworth took
’
over
part.
WEDNESDAY, FEBRUARY 14TH. THE following gentlemen were elected to fill the offices of£ the Society for the ensuing year:-President: C. J. Hare, M.D.-Vice-P-nesidents: R. Quain, Esq. ; Dr. Jenner; Dr. Greenhalgh; H. B. Norman, Esq.-Treasurer: Donald Fraser, Esq.-Tnl8tees: N. H. Clifton, Esq. ; J. Part, Esq. ; S. Sandys, E. Cousins, Esq.; J. T. LawEsq.—.SoHonM-!/
W. Sedgewick. After the presentation of several pathological specimens by fellows of the Society, the annual oration was delivered by Dr. Ballard, to whom a vote of thanks was passed unanimously, and the oration ordered to be printed and circulated at the expense of the Society. The next meeting of the Society was postponed from Feb. 28th (the day appointed for the dinner of the Medical Benevolent College) to the following day, March 1st.
EPIDEMIOLOGICAL SOCIETY. MONDAY, FEBRUARY 5TH, 1855. DR. BABINGTON, PRESIDENT. A paper
was
read
by Dr.
HEADLAM
GREENHOW,
ON THE CHOLERA IN TYNEMOUTH IN 1831-2, 1848-9, &
1853.
The author entered into an able and elaborate history of the disease, as it appeared in Tynemouth during the various visitations enumerated above. Our space will not allow us to give a lengthened abstract of his paper; but the following conclusions, to which the author arrived, were based upon a number of very striking facts. 1. That cholera was not imported into Tynemouth either in 1831 or in 1849, by direct human intercourse-as from patient to patient. 2. That if cholera be communicable from person to person, such mode of its propagation is of insignificant importance. 3. That the propagation of cholera by means of the water supply, either in 1831-2, or in 1849, may be said to have been impossible. 4. That the pestilence having almost invariably fixed its seat in the dirtiest and worst-drained portion of the town, and especially in situations the atmosphere of which was more or
218 less vitiated by decaying organic substances, combined with He (Mr. Burnell) also thought that the occurrence of the moisture, these appear to have acted as localizing causes of greatest number of fatal attacks of cholera in the beginning of cholera. 5. That poverty alone had little influence in predis- the week proved that moral causes had a large degree of influ-
posing persons to cholera, for many of the victims were, if not ence over the spread of the disease. After a few remarks by Dr. M’WiLLlAM, Mr. TUCKER, and wealthy, at least in comfortable circumstances. 6. That the Dr. DONALD FRASER, Dr. GpEENEOw replied, and the Society mere overcrowding of houses, and the defective construction of streets, as regards their ventilation, appeared only to aggravate adjourned. the disease, so far as they increased the above-named localising
causes. 7. That mere elevation or lowness of site, apart from the existence of some other cause, had no effect on the disease; North-street, with an elevation varying from sixty to seventy feet, and Reid-street, with an elevation of 110 feet, in both of which the pestilence prevailed in its worst forms, having suf- Practical Treatise on the Diseases of C7tilclreiz and Infants at fered much more severely, in proportion to their population, the Breast, inclueling the Hygiene and Physical Ed1&cat’ion than Duke-street, Clive-street, Bell-street, or Liddle-street, of You72g Ckilcl1’en. Translated from the French of whose average elevation is under twenty-fi ve feet above the tidal M. BOUCHUT, with Notes and Additions, by PETER datum. 8. That where cholera is impending, it may either Ilrr; cKES BIRD, F.R.C.S., Author of the Jacksonian Prize be averted, or, at least, the visitation be much mitigated by Essay for 1849-" On Erysipelas."London: John Churchill. active precautionary measures; and that probably sound sani1855. pip. 776. tary arrangements which provided for the complete and rapid BUT few years back, and we were sadly deficient in removal of all the excretse and other exuvise of towns, would so improve their condition as to remove the local sources of scientific treatises on the pathology of early life. "Mothers’ atmospheric impurity which would appear necessary to the Guides," on the one hand, and Dr. Underwood’s frequently full development of cholera in a pestilential form. Lastly. re-edited and metamorphosed pages, on the other, were almost The correctness of several of the preceding conclusions appears the sources of instruction on the hygiene and medical only to be confirmed by the singular immunity from cholera enjoyed of infantile treatment the frame. The little broclaure of Dr. the less the inhabitants by troops, and, although perfectly, by of the village of Tynemouth in 1849, and by the entire borough Coombe, and the later editions of Evanson and Maunsell, were in 1853, as well as by a converse series of facts which show the first steps towards a scientific elucidation of the two dethe tendency of the pestilence to return upon its former footpartments named. The cotemporaneous publication in the steps, and to re-appear at a subsequent visitation, not only in serials of the day of some lectures of Drs. West and Willshire the same localities, but even in the same houses and rooms which it formerly visited, provided no essential improvement (physicians to the Infirmary for Children) more directly, however, attracted the attention of the profession to the necessity has, in the meantime, been made in their condition. Dr. MILROY said that the late Dr. Gillkrest, author of an of bestowing a little more favour on the subject of paediatrics excellent treatise on Yellow Fever, had remarked, at one of than had hitherto been the case. The most important progress, the meetings of the Society, that no man is qualified to write however, was made when Dr. West collected his lectures a history of that disease until he had witnessed, and carefully studied, its characters, on at least three different occasions. together, and published them as a substantive volume. This The observation of a single epidemic is insufficient to justify a has become the standard work in our language upon its peculiar, writer in drawing general conclusions respecting either its subject, and most worthily so, as it is the result of very great. natural history or its treatment. What Dr. Gillkrest had said practical experience and extended knowledge of the medical of yellow fever held true of cholera also. It was for this very literature of Germany and France. In the interim, also, (it reason that Dr. Greenhow’s observations were entitled to great be we were presented with a valuable should mentioned,) respect. They served to show, in a striking manner, the intimate connexion between the virulence and fatality of cholera, scientific compilation by Dr. Churchill, of Dublin; and special and the existence of local causes of unwholesomeness. This care seems to have been, and is yet, taken, by the British and, great practical truth was proved, on the one hand, by the .Foreign -3fedico- Chirurgical Ra’iew, that the important subject almost invariable discovery of some nuisance or another within of the diseases of children should receive that attention which or near to houses where the disease had prevailed, and, on the other hand, by the comparative immunity of a locality which it merits. We point out these details, because it is but fair to had once suffered severely upon subsequent visitations, when recognise the source of such endeavours to elevate the departthe locality had been much improved in its sanitary condition. ment of medicine we are discussing to a position amongst our. Dr. Sxow said that the remarks of Dr. Greenhow respecting selves equal to that it has long since maintained in the medical the water supply of North Shields and Tynemouth entirely schools &c. of the continent. At the latter, M. Bouchut’s confirmed his views respecting the propagation of cholera. When this disease was communicated by means of a supply of treatise enjoysagood reputation; it has reached its second" water containing the evacuations of the patients, it extended edition-and this is saying much, when we consider how well at once as far as the water supply reached, and attacked all supplied French literature is with works on our present: classes of the community; whereas, in Tynemouth and Shields, spécialité, and how formidable a rival the classical volumes of where the water supply was not contaminated, the epidemic MM. Rilliet and Barthez constitute to all intruders into their cdnsistecl of a number of separate outbreaks in distinct localities. In Newcastle and Gateshead, on the contrary, in the autumn field. The introduction of M. Bouchut in an English dress is of 1853, when the epidemic was propagated by the impure one that should be cordially welcomed by both student and water, it extended amongst all classes of the people throughout practitioner: It is a complete encyclopaedia in its way, and both towns. If it was rather worse in the crowded habitations we believe it may prove no mean opponent in fighting for some. of the poor and dirty than in the houses of respectable people, of the honours now claimed by the lectures of Dr. West.. this was because, in the former, the disease spread also from we think it Indeed, possesses certain recommendations that person to person, besides- being communicated by the water. constitute it the best work in our language for the student and He considered that Dr. Greenhow did not attach sufficient imshould be borne in mind, however, that It the to There several of cholera. were communication young practitioner. portance striking cases of its propagation from person to person in the M. Bouchut’s teachings only relate to the pathology &c. of paper, affording the only real explanation of the disease, anclinfccncg, while other treatises often neglect this period, and it was probable that the cause was the same in the instances: specially refer to later childhood. M. Bouchut is not without’ where it could not be traced. Mr. G. R. BuRNELL, after making some observations on thehis faults, is open to some severe criticism occasionally, and difference of opinion which existed amongst medical practi- rides certain hobbies rather too hard; but, on the whole, we. tioners respecting the nature of cholera, expressed his beliefare satisfied the present volume, as presented to us by Mr. Bird, that sufficient attention had not, in this country, been bestowedl is deserving of becoming a favourite and established handbook. upon the influence which the geological constitution of a district The hygiene of young children is most ably treated, as is also must have upon the diffusion of that disease. Dr. Greenhow’s’: " on observations, as well as those of certain French authorities, the subject of their General .PeAoo." The chapters the Diseases of 1Vw’ses, on Growth in its Relations appeared also to show, that the elevation of a locality had less; Lactation, influence, in this respect, than Dr. Farr was inclined to believe. to the D:scctse3 of Chilcl1’en, and on Syphilis, are unequalled by’
Reviews and Notices of Books.
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