1846.] INFLUENCE OF CLIMATE. 145 est in India, where it has been assumed to be least, and least in England, where it has been assumed to be greatest." P. 207. A little farther on, he again vindicates the cause of his country :"It has been usual to point to Holland and to England, as cold and damp countries, in which Scrofula is more than usually prevalent; and the prevalence being assumed, a cause was also assumed, and that cause was humidity. But although we may admit that those countries are comparatively cold and damp, we deny the unusual prevalence of Scrofula, at least in England, because it is now demonstrated, that in no European country do the people suffer less from Scrofula than in England." P. 213. Mr. Phillips admits, however, that cold weather favours the development of the disease; for we find it subsequently stated that “whoever considers the question fairly, will be struck by one fact, which cannot be denied, that, in European countries at least, scrofulous diseases are evolved or aggravated, during the cold of winter." As we mentioned before, there is no little discordancy among Mr. Phil. lips's correspondents as to the prevalence of Scrofula in the East Indies. Mr. Martin expressly states, as the result of very extensive observations, during many years, on the natives of Bengal, both civil and military, that "Scrofula, as an idiopathic disease, is seldom seen amongst them." goes on to remark : He "At the Native Hospital of Calcutta, of which I was Surgeon for ten years, I saw, however, many cases of scrofulous disease amongst the poorer Bengalees, caused, as it appeared to me, by the abuse of the rude preparations of Mercury and Arsenic, so liberally administered by the native empirics. Arsenic is given liberally in every form of fever, carefully avoiding evacuants, and as carefully excluding ventilation. It will be no matter of surprise then, that the survivors from such treatment should be troubled in after-life with various glandular enlargements. Of Mercury a rude sort of Chloride is prepared by the native doctors, containing a goodly proportion of Bichloride. This mineral is quite as freely exhibited as the first-mentioned, and with fully as evil an effect on public health amongst the indigent natives. "In all rheumatic cases, in eruptive diseases, as well as in every chronic ailment that puzzles the empiric, this horrible preparation is given in large quantities, and often alternated with Arsenic, while salivation and enlargement of the glands, consequent on this treatment, are never considered as reasons prohibitory of bathing in rivers or tanks even during the cold season. It is needless to describe the lamentable consequences, or the frequency with which protracted suffering from glandular disease and premature death ensue. "Now as to European residents in India; the civil and military inhabitants of the better classes are almost exempt from Scrofula, and so are their children. This exemption is equally true of parents and their offspring in Bengal, whose families in England are notorious sufferers. During an extensive observation of twenty years in the capital of British India, I do not remember three instances of scrofulous disease declaring itself, though numberless persons were known to me in whom the disease remained latent; and, as it appeared to me, solely through the influence of climate." P. 339. He then compares the mortality arising from "every disease that can fairly be corsidered strumous "-viz., phthisis, hæmoptysis, scrofula, hydarthrus, and atrophia-among the British troops (European and Native) in the East Indies, with that among our soldiers at home; and what is the result of this comparison? No. 105. 10 "The comparative exemption from pulmonary disease of those serving in Bengal in particular, is very remarkable; the ratio of admissions per 1000 being only 1.8 per annum, while in England, it is 6-4; and the annual deaths, which in England average 5.3 per 1000 by this disease, are all over India too small to calculate into Ratios." “The ratio of death by all descriptions of scrofulous disease in India generally is 1.6 per 1000 annually, whereas in England it amounts to 5.7." P. 340. Mr. Martin concludes, his letter to our author with these truly practical remarks, which, be it remembered, perfectly coincide with the opinions held by the profession generally. “On the question of the general influence of the climate of India in scrofulous disease, I would observe in conclusion, that it is pre-eminently beneficial. The equable determination to the surface relieves from glandular obstruction and disease, while the phlegmatic of habit, with dyspepsia, languid circulation, and cold extremities, improve under a residence within the Tropics. The weak chested, as they are called in England, and such of them especially as are of scrofulous habit, are saved by going to India; and I have known instances without number in the curable stage of consumption, that is, labouring under the preceding stage of Tubercular Cachexy,' to enjoy good health in Bengal, and to survive their brothers and sisters at home. The fate of those, on the other hand, who go to India with suppurative Tubercles, or even in the stage immediately approaching to it, is only precipitated." P. 341. We thus see that Mr. Martin is clearly of opinion that "scrofulous disease is not very frequent in India." Drs. Stewart and Spry have however come to a somewhat different conclusion. The former of these gen. tlemen observes: "In short, all half castes in Bengal may be said to be scrofulous, though the disease does not develop itself so early in this climate as at home, in the forms you describe, but in cutaneous troublesome sores, weak eyes, mesenteric diseases, spleen, &c. What is very striking is, that 3 half-caste children will exhibit these symptoms for 1 English one, though all 4 be equally carefully brought up, fed, clothed, and tended. “The climate seems to have a favourable effect in retarding, if not even arresting entirely the development of Scrofula in English children, while it has exactly an opposite effect on half-castes. I will not pretend to account for this, though it would be easy to theorize, but I am sure that I have seen the lives of several English scrofulous-looking children saved, by keeping them in Bengal instead of sending them home, and I have known many scrofulous-looking half-caste children turn out stout fellows who were sent home very young, and must have grown up to be consumptive striplings had they been kept in India." P. 343. After giving some figures, he adds :— "Thus it is evident that the scrofulous constitution is the prevailing one in Bengal, a fact well known to all Indian practitioners, and that among those who have comparatively soft skin, thin hair, and light brown eyes, the proportion is great." P. 343. Dr. Spry examined 75 children of mixed parentage, of whom all had swelled cervical glands; 4 had open scrofulous sores; 136, of pure English parentage, of whom none were scrofulous; and 504 native children, of whom no fewer than 300 were scrofulous. Dr. Jackson's report is to a similar effect: "I have examined, at different schools, indiscriminately, under ten years of 1846.] TREATMENT. 147 age, 100 boys, all born in India, and of Creole extraction, of whom 80 may be called of dark complexion, eighteen have flaxen hair and olive eyes, 2 very fair, with gray eyes. Of the 80, a majority are subject to glandular disease; of the 18, none are free from glandular tumours, but not suppurating. The 2 fairest are also scrofulous." * P. 90. We cannot reconcile these and such-like discrepancies, without supposing that different medical men are not agreed as to what diseases are to be considered as scrofulous, and what are not. It seems to us, therefore, that it would have been judicious on the part of our author, had he hesitated more in placing much reliance on some of his statistical positions. Can we, for example, after what we have just read, yield our assent implicitly to the assertion, that “in India, in China, in Russia, in Greece, hot, cold, and temperate countries, Scrofula is unusually prevalent? It is comparatively rare in Barbaboes, with a warm climate, in New Brunswick with a cold, and in the Bermudas with a temperate climate.” Many other instances might be quoted where, by trusting too unreservedly to reports of unsufficient authority and trustworthiness, Mr. P. has been led, we think, to adopt conclusions that will not stand the test of future scrutiny. Nevertheless, the highest praise is due to him for the great labour and earnest zeal that he has expended upon the object of his inquiries. The very difference of opinion elicited cannot fail to do good, by directing more general attention to the subject. The concluding chapter of the present treatise is occupied with the important subject of the Treatment of Scrofula. Our readers will not expect that we do more than merely glance at some of its contents, as we had occasion very recently, while examining the works of M. Lugol and Dr. Smith, to discuss the various remedies and hygeienic means that are generally employed for the prevention and cure of this cachexy. Mr. Phillips is too sound a practitioner to have any novelty to propound, or any favourite remedy to recommend. In all his remarks, he displays much good sense and discriminating judgment. He is far from thinking so highly of Iodine and its preparations, as most practitioners, we fear, do. “What the exact influence of Iodine is in Scrofula, it is difficult to determine -I mean when not administered in combination with other substances than Potass. I am satisfied, however, that in many cases under the influence of Iodine, the tongue will become much cleaner, the appetite will improve, and the secretions will acquire a healthier character. And the impression left on my mind is, that the good which may be experienced from the use of this medicine, is not owing to any specific influence which it exerts over Scrofula, but to its occasional power of modifying the mucous surfaces, so as to enable them to assist in producing healthy nutrition. "Whatever good may be derived from Iodine when uncombined, I think that, when associated with particular substances, with Iron, for instance, its power "I think 8 out of 10 half-caste children scrofulous. 5 out of 10 native kind. 4 out of 10 English. over the disease may be increased; but it would be difficult to prove that there are not other forms of Iron which act as favourably as the Iodide in cases of Scrofula. If that impression be correct, as much, if not more, of the benefit may be owing to the Iron as to the Iodine." P. 276. As to Iodine having direct anti-scrofulous virtues, we quite agree with Mr. Phillips in his negative conclusion. The muriate of Barytes is regarded by him as little, if at all, inferior to Iodine, as a discutient of scrofulous glandular tumours. The muriate of Lime is believed to have very little, if any, efficacy. Alkalis are often useful, if their use be associated with a tonic regimen, and exercise in pure air; but then, how much of the benefit is to be attributed to the medicine? According to our author's experience, Alkalis have been mostly useful in cases "in which much acidity pervaded the secretions, and acted upon the general economy." Cod-liver oil unquestionably produces good effects in some cases: its modus operandi is then ascribed by Mr. P. to its power of improving the digestion and nutrition, and not to its having any direct or specific anti-scrofulous virtues from the Iodine which it contains, or otherwise. With respect to the effects of residence at the sea-side, bathing in the sea and drinking sea-water, our author will not agree in the extravagant praises that have been bestowed upon them by some writers ; "I am by no means convinced," says he, "that the sea-side is more desirable for the residence of persons suffering from Scrofula, than healthy inland situations. I have been accustomed to send scrofulous patients to the sea-side, because it is usually a thorough change of air, and on their return home, I have commonly found a certain improvement in their general health; but the glandular tumours, though reduced, were usually still present. I do not mean to say that, in the majority of the patients sent, the tumours still remained, but this has certainly been the case in a large minority; and even in those patients where the cure has been apparently most complete, the tumours have frequently re-appeared during the following winter or spring." After alluding to various other remedies that have, on the whole, far too highly praised, he sums up in these words :— been "If change of air, good food, and exercise, cannot be procured, the difficulty of treatment is in a ten-fold measure enhanced, and the chances of cure infinitely lessened. For good food, pure air, and proper exercise, the vaunted anti-scrofulous specifics are a poor compensation; we may try one after another, and often find all fail. All that is left to us in such cases, and unhappily they are many, is to endeavour to improve the mucous surfaces and the blood by alteratives and tonics. In this way we can do some good; but it can avail but little to labour by medicine to make the stomach fitter to digest good food, when the patient cannot procure such food." P. 305. In closing our notice of this volume, we cannot but again express our very cordial admiration of the industry, talent, and zeal―philanthropic no less than professional-displayed by its author. We have not agreed with him upon several points, and we have frankly expressed our difference of opinion. This is indeed nothing more than what Mr. Phillips expected himself; for he candidly acknowledges that several of his positions might be found wanting in precise accuracy. We trust that Mr. Phillips may be encouraged, by the success of his present work, to apply his active mind to the elucidation of some other subject of medical inquiry. 1846.] REVEILLÉ-PARISE ON MAN IN HEALTH AND DISEASE.. 149 ETUDES DE L'HOMME DANS L'ETAT DE SANTÉ ET DANS L'ETAT DE MALADIE. Par J. H. Reveillé-Parise, M.D. Observations on Man in Health and Disease. By J. H. ReveilléParise, M.D. 2d Edition. 2 Vol. pp. 1000. Paris, 1845. THE perusal of any production of the pen of this accomplished physician and able writer always affords us great pleasure. His just appreciation of what should be the noble objects of our profession and the attributes of its members, the importance he attaches to the psychical as distinguished from the mere material investigation and management of disease, the great extent of his professional and classical erudition, the kindness of heart which pervades his pages, and the elegance and ease which mark their composition, combine to render the present two volumes highly attractive, especially to contemplative readers. Several of the papers they contain have before appeared, but are modified by the results of subsequent reflection and experience. "This book," says the author, "is the result of my researches, endeavours, and reflections for more than twenty years, although the fragments which compose it have but very indirect relations with each other, by reason of the variety of the subjects treated. While endeavouring to avoid falling either into scientific common-place or into paradoxical subtlety, I have been desirous of boldly and freely stating my opinion upon many points relating to our art, and then submitting it to the good sense and equity of the public-a tribunal generally just (of course the professional public is here only alluded to by M. P.) and often without appeal. To intolerant and exclusive affirmation, I have preferred calm and reflecting examination, and the search for and legitimate interpretation of facts; being also fully persuaded that it is sometimes advantageous to bring down scientific questions from the loftiness of theory to the reality of application, and sometimes, on the other hand, to mount up by the aid of facts to a rational certitude. Science should not become too materialized, nor should it be allowed to evaporate amid vague principles.' The following are the titles of the various subjects. "The Condition of Health "-" Eclectism in Medicine "- 66 Management of the Convales. cence of Acute Disease "—"On the Imagination as a Cause of Scientific Progress"-" On the Employment of Plates of Lead for the Cicatrization of Wounds". "On the Science and Profession of Medicine "-" On Moral Medicine "-" On a New Method of Hastening the Cure of Recent Wounds "On the Existence and Cause of the Melancholic Temperament"-" Hygeiene of the Corset "-"The Basis of the Progress of the Science of Man "—" The Medical Gallery," comprising able sketches of several modern celebrated medical men. Our limited space will prevent our doing justice to all these, besides which, some of the papers hardly admit of compressed notices at all. On the Condition of Health. Two opposite errors are usually committed by mankind in reference to their health, the one being, the paying insufficient attention to its preser |