likely to be to the service, the impression being so large that every medical officer of the United States army can be supplied with one (1500 copies are reserved for this purpose), we cannot but regret that the medical statistics of our own army, occupying so many folio Blue-books, had not been drawn up in a similar manner, and by an officer of the medical departments rather than by a military officer, able in some respects as he has proved himself. We are confident such a work would have been more interesting and more useful; and we are as sure that it would have been creditable to the department-a department the officers of which have so few opportunities of distinguishing themselves, and whose exertions, however great, are so little brought under the eye of the public, and are, as a rule, so sparingly rewarded. Even now we are of opinion that it is not too late to follow the example before us. A compilation, in the way of selection from the materials already collected in the statistics edited by Colonel Tulloch, with additions from the ample documents lying neglected at the Medical Board Office in London, so compressed as not to exceed one volume, could hardly fail of being eminently useful; it might serve as a manual and guide to the young medical officer; be a record of scientific and professional ability, and an incentive to research.

We have said, and we repeat it, that a work such as the one under consideration, is worthy of being consulted by army officers in command. This leads us to remark that in the Staff College now in process of organization at Sandhurst, judging from the curriculum of studies announced, we see no provision made to indoctrinate the student-officers in Hygiene. The work before us, and all experience in our own army, show how great is the ignorance of military officers on this most important subject, and what sacrifices of life have been made in consequence. Stations are selected, barracks and military hospitals are commonly constructed, without a medical officer being consulted respecting either; and the consequence is, that in too many instances the locality in relation to health has been ill chosen, and the plan of building, on the same score, sorely defective. It is a strong assertion to make, yet we can make it honestly, that after a pretty long experience and an extensive acquaintance with our hospitals and barracks at home and in our colonies, we cannot point out one of either kind not open to objection on sanitary considerations. The matter is one of national importance, and ought to have adequate attention, especially now that the value of the British soldier is becoming better known and appreciated, and his stalwart services more required and in increasing demand, especially in troubled India, where, for a long time to come, we fear, the grateful words, cedant arma toga, will hardly be utterable, and even after the inhuman and unchristian va victis shall have ceased to be the war-cry.

Having allowed so much space to the army medical statistics, we can afford but little, less than we could wish, to the larger subject, that comprised in the "Report on the Vital Statistics of the United States." It, too, is a work deserving of commendation, and will well repay the reading, rather we should say the careful study of it. It is a good

example of logical and inductive reasoning from materials obtained from various sources, though, as regards the American ones, less complete and reliable on than could be desired. Nor is this surprising, when we consider that the collection of vital statistics upon a comprehensive scale is, as the author remarks, for the most part, new on that side of the Atlantic.

As we have seen that in the army of the United States and in our army there is much similarity of disease, and no very great difference of mortality, so, on consulting this work, we find a like similarity of results in the vital statistics of the two countries; tending to show that there is that belonging to man as a species, a vis insita, a power or influence, more operative and energetic than any external cause, whether in the form of diet or climate; the one, the former, maintaining the species; the other, the latter, having only a modifying effect.

Some of the more striking of these similarities, with occasional differences, we shall briefly notice, such as we consider clearly proved by Dr. Wynne from satisfactory evidence.

Commencing with birth, it would appear that in both countries there is an average preponderance of the male sex. Next, that there is a proportionally greater mortality of that sex before puberty and after the age of forty; and, in consequence of this greater mortality, an excess of the female sex-an excess most remarkable in the rural districts.

In both countries the chances of life in relation to age appear to be not very different, and to be similarly affected by extraneous circumstances, whether of place of residence in infancy, or of residence and occupation when arrived at maturity. The following table in its results, as regards occupations, tolerably accords with the English estimates. It applies to Massachusetts, and comprises a period of eleven years and eight months. The age given is that attained by the deceased in each of the selected occupations.

Age.
47.16 359 Masons
40.10 408 Mechanics

Age.

41.61

42.85

"Of these 33,580 individuals, the combined ages amounted to 1,724,031 years, or 5134 years to each man." (p. 208.)

The influence of climate in both countries varies with the seasons as marked by the mortality: whilst in England it is greater in winter and least in summer, in the United States generally it is greatest in summer and autumn, and least in winter and spring. This difference, we have little doubt, is connected with a greater prevalency of malaria in the new country than in the old; and the circumstance, that whilst the population of England is pretty equally divided between the towns and the rural districts, that of the United States is so distributed that only about one-fourth of the whole are collected in towns, and consequently the great majority are more exposed to the influence alluded to.

As might be expected, the diseases of the two countries exhibit some marked differences: those of the United States more resemble the diseases prevailing in England in the time of Sydenham than at the present time, more those of the camp than of the city. The following table is illustrative; it is extracted from the last census, and shows the total deaths in 1849-50, and the diseases productive of them arranged according to Dr. Farr's classification.

"From zymotic diseases the deaths were 131,813; of which died

Of Cholera.
Diarrhoea
Dysentery

31,506

The deaths from sporadic diseases and unknown were 192,210; of which died—

What we find here may aid to account for the difference of seasons in their effects in the two countries just before alluded to. We see how dysentery and fever and consumption rank highest as to fatality, with the exception of cholera, of occasional occurrence. Now, dysentery, in the United States, is specially a disease of the hot months; and with the exception of typhus, the same remark is applicable to the fevers; they are most prevalent in the summer and autumnal months. Consumption, though more independent of seasons, yet is not altogether; from the tables given it would appear that the deaths from it are somewhat more numerous in the warmer than in the colder months—an accordance this with the previous remarks on the effect of cold when conjoined with a dry air in checking the progress of the disease, and even preventing its formation.

As to length of life in the people of the two countries, at present it seems difficult to arrive at any satisfactory conclusion, and this chiefly owing to the imperfect state of the data required for determining the 42-XXI.

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averages in the United States. Where there is so great a variety of climate, so great a variety of condition of surface of country, also of the habits and occupations of the people, marked differences may be expected in the ratio of life in the several States. From the imperfect information hitherto obtained, it would appear that in the older and more northern States, the average length of life approaches nearer that of the parent country than in the southern and western. It appears also that the general average is on the increase-in itself an auspicious circumstance. The average of the productive class, that is, as has been defined, all between fifteen and sixty, as being "in full possession of their energies, and competent not only to produce a sufficiency for themselves, but likewise for those who are dependent on them," is also on the increase; this class, which in England is 56-70 per cent., in the United States, in 1830, was 51-01, in 1840 was 52-35 of the whole population.

We must now conclude. We have already commended the work for the logical precision and the inductive reasoning which it displays. It has other claims to commendation: its contents are rich in varied, and, we believe, as far as possible, exact information, tending to elucidate the many interesting problems in vital statistics, the solution of which is of the first importance in conducting fairly the business of insurance companies-the special object of the work-and is hardly of less moment as regards the history of man in his social state. We rejoice to see that the subject of vital statistics is beginning to have in the United States the attention it deserves. Let us hope that it will have the necessary attention of the central government, and that the great desideratum-that of a uniform system, on a liberal scale, and with a permanent staff for collecting the requisite data in their fullest amplitude-will not be much longer wanting.

REVIEW VI.

Guy's Hospital Reports. Edited by SAMUEL WILKS, M.D., and ALFRED POLAND. Third Series. Vol. III.-London, 1857. 8vo, pp. 513. THE present volume of the 'Guy's Hospital Reports' contains twenty original communications, which are illustrated by nine lithographic plates, and numerous woodcuts. Many of these papers are of much interest and value. We would only observe, that some of them appear to us to be unnecessarily prolix; and that condensation of their contents would, in our opinion, have rendered them more readable and practically useful. We shall follow our usual plan of giving a brief analysis of the contents of the volume:

I. Report of Seventy-two Cases of Tetanus occurring in Guy's Hospital since the year 1825. By ALFRED POLAND.-This paper extends over eighty-eight pages. The author commences by giving a brief history of the whole seventy-two cases, which he then proceeds to analyse in a most elaborate manner, comparing his results with

those of the Sir Jamsetjee Jejeebhoy Hospital at Bombay, as published by Mr. Peat and Dr. Morehead; with Dr. Laurie's Statistics of Tetanus in the Glasgow Infirmary; the Reports of the RegistrarGeneral, &c. The following are the chief results which he arrives at :

1. The frequency of the disease.-During thirty-two years the cases of tetanus admitted into Guy's Hospital constituted only ·0063 of the total admissions; and of the total deaths, 056 per cent. were from tetanus. In Bombay, on the other hand, during six years, tetanus constituted 0.8 per cent. of the total admissions, and 3-9 per cent. of the total deaths.

2. Tetanus in the two sexes. Of the 72 cases, 12 were females and 60 males. This result corresponds with that arrived at by Dr. Laurie; but the difference between the two sexes is greater than appears from the Registrar-General's Returns. These make tetanus little more than twice as frequent in males as in females.

3. Ages of tetanus cases.—Of the Guy's cases, 48 out of 72 cases, or 66-6 per cent., occurred between ten and forty; and of the Bombay cases, 139 out of 166, or 83.7 per cent., between fifteen and forty-five.

4. Constitution, diathesis, condition of body, habits, and previous health.-Constitution and diathesis appear to exercise no influence either on the prevalence, duration, or mortality of the disease. On the other hand, of the robust and well-developed, there were 5 recoveries to 30 deaths; whereas, of the unhealthy, spare, and emaciated, there were 11 deaths and no recoveries. The temperate appeared to be equally liable to the disease as the dissipated and intemperate, but the data for this statement are very meagre. Out of 12 cases in which the previous diseases of the patients had been recorded, 2 had been the subjects of epilepsy; 3, of rheumatism; 2 were complicated with worms, &c.

5. Season of the year, climate, &c.-The prevalence and rate of mortality in the various months and seasons of the year are given with great minuteness; but on the whole, there appears to be little or no agreement between the returns of Guy's Hospital and those derived from other sources; so that the author concludes "that no great reliance can be placed on isolated returns." Of the whole 72 cases, however, he was "able to refer no less than 17 cases to exposure and change of temperature, either solely or associated with injury and disease;" and he quotes numerous instances from the records of military surgery, which "bear strongly in favour of atmospheric influence as the real point of causation."

6. Form of the disease, &c.-Three cases only, or 4.16 per cent., were idiopathic; in Glasgow, also, the number of idiopathic cases amounted to only 3-84 per cent. ; but in Bombay to 38.46 per cent. With regard to traumatic tetanus, numerous details are given as to the situation of the disease, and its relative frequency in injuries and surgical diseases; and it is shown that "the severity of the symptoms bears no relation to the degree of local injury."

7. The interval between the injury and the symptoms varied in