552 formation of an efficient hospital corps, our soldiers will have the best chance that can be given them of recovery when prostrated by fever. Dr. Marston calls attention to the " increased proclivity of the meat-eating and spirit-drinkingraces to enteric fever," and gives some details respecting the diet of the soldier in India, and the want of sufficient exercise to counteract its effects. He concludes that "it would be most undesirable, as well as wrong perhaps, to make him conform to the habits of the native, or deprive him of meat and alcohol; but that is no reason why some attempt in this direction should not be made at the advent of the hot season by curtailing his powers to eat and drink-especially drink-too much. Some men are tempted to drink beer or rum to secure sound sleep -difficult enough in a barrack room in the hot weather, when tormented with flies, mosquitoes, and possibly bugs. At such seasons it is very questionable whether the soldier’s health would not be improved, too, by his remaining longer in bed in the morning, when sleep is more practicable, than by attending unreasonably early parades." The paper is followed by carefully drawn up "remarks on the diagnosis and treatment of enteric fever," which well deserve the thoughtful study of the medical officer. We caùnot enter into any detail on these remarks, but we may briefly notice one or two of Dr. Marston’s conclusions. And, first, as to the occurrence of enteric fever in India, he remarks " whatever be the causes, there can be no doubt as to its nature. Enteric fever in India is, both in its clinical phenomena, when taken as a whole, and in its post-mortem appearances, perfectly identical with what is elsewhere z, known as enteric fever.... In short, it conforms to the description by which enteric fever is almost universally recognised." And again, he thus sums up his views on the subject. "The point which it is desired to emphasise is this-that one of the most common and fatal fevers in this country is enteric fever; that it chiefly attacks soldiers during their first years of Indian service; that it appears to prevail, though unequally, both in the plains and the hills especially during the hot and rainy seasonand that by its symptoms during life, and by its pathological appearances after death, it can be recognised as genuine enteric or intestinal fever; and that where the period of observation is sufficiently extended it can, in a large majority of cases, be diagnosed by the conformity of its symptoms as a whole to the descriptions given of enteric fever elsewhere." The treatment of enteric fever is discussed under the various heads of accommodation, nursing, diet, reduction of temperature, regulation of the bowels, and the medicines most appropriate to the treatment of the various symptoms which arise in the course of the disease. A caution is given against the too early return to duty after an attack of enteric fever, and the value of a sea voyage or hill climate in restoring the patient to excellent health is pointed out. We consider this paper to be a valuable addition to the history of disease as it occurs among our fellow- countrymen in India. Although there are many points still to be cleared up with reference to enteric fever in that country, Dr. Marston has done good service in bringing to the notice of the Army Medical officers in a condensed form the information which already exists on the subject, and has thus cleared the way for further inquiry into the controverted points connected with it. We trust that the example he has thus set may not have been thrown away, and that in the next annual report of the Surgeon-General we may have a continuation of these inquiries, conducted in the same spirit which has hitherto characterised his labours in this field.
building then occupied, that the hospital was transferred to its present quarters, the old home of the Royal Hotel. Its 981 square yards of freehold ground were purchased on very advantageous terms, through the instrumentality of the
senior surgeon, Mr. Edwin Chesshire; and it was found prac. ticable and profitable to devote 400 yards of the site to the purposes of the hospital, and to let off the remainder, with goodwill and licences, as a Royal Hotel within reduced limits. The reputation of the staff, the wise management of the committee, and the rapid growth of Birmingham and its surrounding district, concurred in producing the natural result. The patients steadily increased ; so much so that they have more than trebled since 1860. Structural altera. tions have been made from time to time to meet the growing requirements ; but since old drains will leak and brick walls are not elastic, the inevitable block has come at last. The medical officer of health has pronounced against the hospital building in its present state, and no one seems bold enough to defend it. On the necessity of a new hospital everyone If the 981 square seems agreed, not so as to its site and size. yards of freehold land belonging to the charity were de. voted to the purposes of a new hospital, the architects would have an easy task ; all present requirements could be ful. filled, with reserve space for years to come. But the hotel licence is so valuable, that it has been proposed to reconstruct the hospital on the 400 yards which it now covers, and gain additional cubic space by making the wards and corridors more lofty, and adding two new storeys. This plan has commended itself to Mr. Vose Solomon, whose position would have entitled his opinions to greater consideration from the governors if not opposed by his three colleagues, who are substantially of one mind. Mr. Chesshire is against building a hospital on a site not large enough for a good private residence. Only the other day he ordered the application of half-a-dozen leeches to one of his hospital patients, and erysipelas followed. Mr, H. Eales states that erysipelas is in the hospital at the present time, two patients suffering from it; while another of the surgeons (Mr. Lloyd Owen) urged " that the area on which it is proposed to reconstruct the hospital is totally insufficient for the needs of the institution." Yet stronger werethe statements of Mr. J. D. Goodman, a magistrate and one of the leading merchants of Birming. ham, who filled the office of chairman of the Committee of the Eye Hospital during many of its most prosperous years. We gather from a report of his speech in the Birmingham Daily Post that " in the old building there was no accom. modation for infectious cases. From time to time they had suffered from erysipelas, and even scarlet fever, in the institution, and it was most important that there should be some special ward for such cases. There was no such provision made in the new plans. In the old building there was no dead-house, and the practice had been to put the bodies of those who died in the operating room. Would was no remedy for this in the they believe it, that there " proposed new building ? Such a state of things, attested on such authority, could not fail to produce a deep and serious impression on the governors, and the meeting adopted the prudent course of referring the whole matter back to the committee for reconsideration. Birmingham should have an eye hospital worthy of its old repute, and equal to the wants of the community, according to the present high standard of sanitary and ophthalmological science. The recent census has proved how rapidly the Midland metropolis is growing, and its municipality and people are showing themselves alive to their honourable responsibilities by planning new streets and erecting colleges, libraries, art galleries, and museums, on a truly imperial scale. The public interest, the calls of THE BIRMINGHAM EYE HOSPITAL. humanity and science, and the honour of the medical pro. that hospitals should not lag behind in A SPECIAL meeting of the governors of this institution fession, require wants. After all, the difficulty of legitimate supplying was held on the 15th inst., for the purpose of considering the the Committee of the Birmingham Eye Hospital is an report of the committee on the reconstruction of the hospital. honourable one. It has been brought about by the The question at issue and the discussion to which it has success of their operations, and the repute of their staff. If they have now an unhealthy hospital they possess given rise are of more than local interest. Founded by the late Mr. Joseph Hodgson in 1823, and a splendid freehold site with valuable rights, and a goodly celebrated as the field of the classic labours of Mr. Richard reserve at their bankers. To spend eight or ten thousand in a reconstruction, which would scarcely be equal Middlemore, the Birmingham Eye Hospital is only second pounds to the wants of the next ten years, could not be called to Moorfields, for the extent of its beneficent operations economy, and it is to be hoped that, when they report to amongst similar institutions in the United Kingdom. the governors, the committee will be prepared with reconiTwenty years ago its patients (341 in, 3992 out) were so mendations worthy of the institution, and of the town on much more numerous than could be accommodated in the which it has conferred such signal benefits.
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