NOTE ON PEROXIDE OF HYDROGEN IN DIPHTHERIA.

AGREE with Dr. F. H. Williams, of Boston, U.S.A., as to the value of a thirty-volume solution of the peroxide of hydrogen in the local treatment of diphtheria, as described in the Medical Press and Circular of October 26th, p. 436. I wish, at the same time, to add to this commendation the important warning that the thirty-volume solution should never be used except on open surfaces. In 1857, when I began to experiment with it, the peroxide was the rarest of chemical curiosities; it had never been used in medicine, and I had not a spark of light to guide me as to the number of volumes that could safely be employed medicinally. I began with strengths of four and five volumes; then I moved up to twenty and thirty volumes; but I soon learned that with the higher volumes the oxidation was so rapid in the presence of pus and similar disturbing substances, that the effect was practically explosive in character. In a case of abscess of the antrum I injected a drachm of a thirty-volume solution through an opening into the cavity made by the extraction of a tooth and free perforation, and witnessed an action which for a few seconds alarmed me, owing to the gush of purulent foam that followed. I found afterwards that for the destruction of pus weaker solutions would answer well enough, and from that time until my first paper on the substance read to the Medical Society of London in 1860 I gave to this question of volumes the most careful study. In the end I came to the conclusion that on the whole the ten-volume strength was the most practical, and I fixed on that as a standard which has been generally adopted by the

profession. I have never seen occasion to suggest the alteration of that standard, but there are exceptional cases where a solution of greater strength may be used, and diphtheria is one of these. By the local application of the thirty-volume solution to destruction of the diphtheritic membrane and adhesions of it are more rapidly secured than by the lower volumetric strength, and, as the surface is open, there is no danger of creating tension or forcible rupture of parts. The same rule applies to the use of the thirty-volume solution on the cutaneous surface in phagedæna, syphilitic sore, and senile gangrene.

On the other side, there are cases in which the tenvolume standard solution may be advantageously used in very small quantities. I have a case in hospital just now which illustrates this point. A woman is suffering from a circumscribed abscess discharging from a fistulous opening in the abdominal wall. Here I introduce the solution in small quantities by saturating a pledget of cotton with the solution, introducing it through the sinus by the probe, and repeating the dressing frequently. By this plan I have seen a large cavity close up in the most satisfactory manner. In the treatment of fistula in ano this method ought often to supplant operation by the knife.

MAS SYDENHAM, M.D., AND HIPPO

CRATIC PHYSIC.

N the three last numbers of ASCLEPIAD I have studied three historical characters, all of one nation, and all belonging to one peculiar and critical time in the history of the English people and of medical art. Thomas Willis, Kenelme Digby, Thomas Browne, have passed before us: the first, the profound physiological physician; the second, the versatile scholar in philosophy, including physic in some of its departments; the third, the antiquarian, and I had almost said theologian of medicine, the poet and the practitioner, strange as the combination was and ever will be-Sir Thomas Browne.

I pass now to a man of the same time, a man of very different quality of mind from either of his distinguished cotemporaries, a man who has made in the family of medicine by far the deepest impression; a man whose practical work is still in our exclusive fraternity a household word-Thomas Sydenham. Why Sydenham has left so indelible a mark in medicine is a question we shall have to discover in the course of this essay. He had none of the genius of Willis, or the learning of Browne, and yet his name is spoken now a hundred times to one compared with either, nay

VOL. IX.

both. In fact, dead and gone as he is, he lives yet amongst us. We gild a society with his name. An American physician of the past rejoiced most when he was designated the modern Sydenham, as Sydenham might have rejoiced at hearing himself called the modern Hippocrates. I remember the late Sir Thomas Watson being compared to Sydenham, and he told me that he had never felt himself more honourably mentioned.

There must have been some remarkable mind in this man to win such ever-progressing admiration. Let us look at him in his mortal life as best we can.

EARLY CAREER.

It is agreed on all sides that we have very little knowledge of an exact kind of the early career of Sydenham. We know that his father, a gentleman of good position, was William Sydenham, of Winford Eagle, in Dorsetshire. His mother was Mary Geffery, daughter of John Geffery, of Catherstone. He had five brothers: William, the eldest, Francis, John, George, and Richard; and three sisters: Mary, Elizabeth, and Martha. He himself was born in 1624, at a time when his parents had been married thirteen years. The family seems to have been parliamentarian in a political point of view, and to have fought well on the parliamentary side. William became a colonel in the parliamentary army, and was for a time Governor of the Isle of Wight and Vice-Admiral of that island and of Hampshire. Francis was major of a regiment, and, as Dr. Nias has recently shown, John and Richard were both captains on the same side. One of his sisters, Martha, married into a parliamentary family, being the wife of a lawyer named Lawrence, a staunch republican.

It is a curious circumstance that the mother of Sydenham and his brother Francis were both killed in the wars, but not at the same time. In some way Mrs. Sydenham was killed by a royal officer, one Major Williams. Afterwards, in November 1664, a fight took place at Poole, in Dorset, between the King's troops, under the command of Sir Lewis Dives, and a body of parliamentarians, under Major Francis Sydenham. In one of the charges Major Sydenham recognised Major Williams, by whom his mother had been slain, and, coming up to him, slew him and put his men to flight. In the same year he (Francis Sydenham) was himself slain.

It is supposed that our Sydenham in his early life had charge of a troop of horse on the republican side; and, as Dr. Gordon Latham skilfully contends, there is excellent reason for believing this to have been the case, but proofs of a direct kind are still wanting. We get a glimpse of our man as a youth of eighteen years of age at Magdalen College, Oxford, in 1642, but he did not remain there for a long period. Oxford became a garrison of the King, Charles I., and the centre of the Court. Harvey and Willis and Digby were there as staunch royalists; but Sydenham left for London, "and did not," says Ward, "bear arms for him as other scholars did." He came to London, where his brother William was then located, and while there met with a physician, Dr. Coxe, who was in attendance on that brother in a serious illness. Coxe made, it is thought, a great impression on Sydenham, and persuaded him to give up everything in order to devote himself to the study of the science and art of medicine.

When, after the great fight at Naseby (1645) Oxford