illusions, set in, but they also soon disappeared. In the performance of the sections he had not injured himself, but he had examined the cavities of the animals with his left hand, upon which there was a recent cicatrix; he had, however, taken the precaution of oiling his hand previous to making the post-, mortem examinations.

ART. 15.-On the Murrain. By Professor SIMONDS.

(Medical Times and Gazette, Jan. 2, 1858.)

The following conclusions are appended to Dr. Simonds' able and valuable report on the cattle plague :

1. That all the countries of Northern and Western Europe from which cattle are exported to England are perfectly free from the rinderpest; and that the only disease of an epizootic or destructive nature which prevails therein is the one known to us as pleuro-pneumonia-which disease has existed here since 1841.

"2. That in the greater part of the official dispatches and reports which have been forwarded to the Government, and by them transmitted to the Royal Agricultural Society of England, the rinderpest has been confounded with pleuro-pneumonia, milzbrand,' and other destructive maladies to which cattle are liable.

"3. That the rinderpest is a disease which specially belongs to the Steppes of Russia, from which it frequently extends in the ordinary course of the cattle trade into Hungary, Austria, Galicia, Poland, &c.

"4. That whenever circumstances have arisen which called for the movements of troops, and consequently the transit of large numbers of cattle in Southern and Eastern Europe, and particularly when Russian troops have crossed the frontier of their territory, the disease has been spread over a far greater extent of country.

"5. That the disease which has recently prevailed in Galicia-where it was specially investigated by ourselves-as well as in Poland, Austria, Hungary, the Danubian Provinces, Bessarabie, Turkey, &c., is the true rinderpest or Steppe Murrain of Russia.

"6. That with the exception of a few places in the kingdom of Prussia and in others in Moravia, near to the frontier of Galicia and Poland, the disease in its outbreaks of 1855, 1856, and 1857, did not extend to any country lying westward of a line drawn from Memel on the Baltic to Trieste on the Gulf of Venice.

"7. That speaking in general terms, rinderpest has not existed in Central and Western Europe for a period of forty-two years; its great prevalence at that time being due to the war which was being then carried on between the different continental kingdoms and states.

"8. That all the facts connected with the history of its several outbreaks concur in proving that the malady does not spread from country to country as an ordinary epizootic. And that if it were a disease exclusively belonging to this class, the sanitary measures which are had recourse to throughout Europe would be inefficient in preventing its extension, and consequently that in all probability we should long since have been both painfully and practically familiar with it in this country, as hundreds of our cattle would have succumbed to its destructive effects.

"9. That it is one of the most infectious maladies of which we have any experience, and that it is capable of being conveyed from animal to animal by persons, and various articles of clothing, &c., which have come in contact with the diseased.

"10. That the ox tribe is alone susceptible to the disease; and that the morbific matter on which it depends lies dormant in the system for a period of not less than seven days, and occasionally, according to some continental authorities, as long as twenty days before the symptoms declare themselves.

"11. That an attack of the disease which has terminated favorably renders the animal insusceptible to a second action of the materies morbi which gives origin to the pest.

66

12. That the deaths often amount to 90 per cent.

"13. That the malady is one in which the blood is early, if not primarily affected; and that subsequently the mucous membranes throughout the entire body become the principal seat of the morbid changes.

14. That the symptoms are in general well marked and quite characteristic of the affection.

"15. That all varieties of medical treatment which have as yet been tried have failed in curing the disease; the recoveries which take place having for the most part depended on the vis medicatrix naturæ.

"16. That no fear need be entertained that this destructive pest will reach our shores. Its present great distance from us would, of itself, afford a fair amount of security; but when we add to this that no cattle find their way from thence directly or indirectly to the English market, and also that in the event of the disease spreading from Galicia, it would have to break through hundreds of military cordons, one after the other, before it could possibly reach the western side of German states; and, moreover, that for years past commerce has been unrestricted with regard to skins, hides, bones, &c., of cattle from Russia and elsewhere, all alarm, we believe, may cease with reference to its importation into the British Isles."

(c) CHRONIC DISEASES.

ART. 16.-On the Antagonism of Ague and Consumption.
By Dr. COCKLE.

(Sanitary Review, Jan. 1858.)

The following passage is from an address on General Pathology, recently delivered at the Grosvenor Place School of Medicine,

"Dr. Green, of Whitehall, in the province of Washington, U. S., where intermittents are of unusual frequency, declares that there did not exist one single instance of phthisis developed in the district; and that the consumptive invalids arriving there experienced a relief as decided as it was permanent. The same author also states that a morass near Rutland, having been converted into a pond, the intermittent fevers disappeared from that part of the country, and were replaced by pulmonary consumption. The population having solicited and obtained the suppression of the pool, or, what amounted to the same thing, the re-establishment of the morass, the original agues returned, and antagonized the development of phthisis."

ART. 17.-The Effects of Ague and Quinine upon the Urine. By (1) Dr. W. A.
HAMMOND; (2) Dr. H. M. STEWART; and (3) Dr. RANKE.

1. (American Quarterly Journal of Med. Science, April, 1858.)
2. (Charlestown Med. Jour. and Rev., May, 1857.)

3. (Medical Times and Gazette, May 30, 1857.)

1. Dr. Hammond's investigations were made upon himself during a recent attack of intermittent fever of the tertian type, his attention having been called to the subject by the papers of Dr. Ranke and Dr. Stewart, which are also referred to in this article. The results of five carefully conducted experiments are collected together in the accompanying table.

1st day. Paroxysm.

2d day. Intermission.

3d day. Paroxysm.

4th day. Administration of Quinia.

5th day.

Urea

325.18 grs.
28.31"

480.37 grs.
16.84
34.73 "
114.58 "

Quantity of urine 1221.7 c. cm. 1650.4 c. cm. 1387.2 c. cm. 1750.3 c. cm. 1806.3 c. cm. Specific gravity. 1020.06 1022.17

1019.45

1024.67

300.16 grs. 489.43 grs.

1024.81

638.20 grs.

12.71 25.80" 138.27"

31.54 "

13.79

"From these data it is perceived that, during an attack of intermittent fever, the uric acid and phosphoric acid are very much increased in amount, and the urea and chlorine greatly diminished. During the intermission, there is a close approach to the normal proportions of these constituents, but a subsequent paroxysm restores the former condition. The disulphate of quinia, however, produces a permanent impression on the character of the urine, and, with the return to the natural relations existing between the several substances entering into the composition of this excretion, the disease disappears." 2. As the uniform result of five experiments which Dr. Ranke has made upon three healthy individuals, it appears that the disulphate of quinine has the effect of diminishing the quantity of uric acid in the urine.

"The usual method was employed for the determination of the uric acid; that is to say, 100 cubic centimetres of the urine were mixed in a test-glass with 6 cubic centimetres of concentrated hydrochloric acid, and left to stand for 48 hours. Then the uric acid, which had been precipitated, was carefully collected upon a filter. The weight of the filter in a perfectly dry state had been determined in the watch-glass apparatus. The uric acid was washed until the water that ran off the filter had ceased to have an acid reaction. The filter was then again dried in the air-bath and weighed, and the difference between the first and second weighing was calculated as uric acid.

"The following are the numbers I thus obtained, and from these the reader may draw his own conclusions. I excrete, on an average, when in a healthy state, and living on a mixed diet, 0.629 grammes of uric acid during 24 hours. This average is taken from 20 observations. Maximum, 0.832; minimum, 0.455; and the figures of this series are distributed thus: 0.8 and 0.7 occur twice each; 0.6 eight times; 0.5 seven times; and 0.4 once.

"Now, in the first experiment I took 20 grains of disulphate of quina in the course of the day; and during the next 48 hours the excretion of uric acid amounted in all to 0.542 grammes, which gives for 24 hours 0.271 grammes, or less than half my normal quantity.

"The second experiment gave a similar result, the quantity of uric acid excreted during 48 hours, after 15 grains of quina had been taken, being equal to 0.790 or 0.395 for 24 hours. On the third day, after quina had been taken, I excreted again about my normal average, namely 0.621 grammes, and on the two following days 0.543 and 0.656 grammes respectively. I now took quina for a third time, and the quantity of uric acid again fell to 0.438 grammes on the first, and to 0.192 grammes on the second day.

"The fourth and the fifth experiments were made on two of my medical friends, who kindly volunteered to take quina. Here are the results.

"Dr. S. excreted during the two days previously to his taking quina 0.544 and 0.543 grammes of uric acid. On the third day he took 20 grains of disulphate of quina in two 10 grain doses, and on that day he excreted 0.376 grammes of uric acid. The next morning he again took 5 grains of quina, and the quantity of uric acid subsequently fell to 0.317 grammes. During the three following days he excreted 0.483, 0.450 and 0.654 grammes respectively. "Dr. M. excreted during four days prior to his taking quina 0.662, 0.774, 0.585, and again 0.585 grammes of uric acid. Then he took 10 grains of quina, and on that day excreted 0.358, and on the next 0.387 grammes of uric acid. On the third day after he had taken quina the uric acid rose again to 0.670 grammes, and remained there stationary, amounting to 0.671, and 0.668 grammes on the two following days.

"To the foregoing statement I have to add that in two of the experiments I have also determined the other constituents of the urine. The solids in general, and the urea, I found not materially affected under the influence of quina, but the phosphoric acid appeared to be augmented. However, these points require a good deal of further investigation, and I therefore abstain here from giving details.

"I hope to read very soon that others have repeated the experiment, and that we shall thus get more materials towards arriving at the truth.

"To those who might be inclined to repeat the experiment I have to add one or two remarks. There are occasionally persons met with who, though appa

rently in good health, excrete uric acid with great irregularity, the maximum and minimum being widely separate from each other; such persons should not be used for the experiment, as it would be necessary in these cases to take the average of a great many observations in order to obtain reliable results. Moreover, it is advisable to take during the time of observation not too much fluid, as great dilution of the urine tends to make the determination of the uric acid less accurate."

This fact, Dr. Ranke considers, may tend to throw some light upon the nature of ague, and the modus operandi of quinine in its cure, as "in ague there is, according to all observers, a considerable increase of uric acid in the urine." 3. The observations of Dr. Stewart form the subject of a thesis, which received the college premium of the Medical College of South Carolina. Before the treatment was commenced, the urine of seven patients, suffering from ague, was found to contain uric acid, urate of soda, biliary matter and mucus. After the administration of quinine triple phosphates were found in addition, and the specific gravity was increased. Dr. Stewart does not notice the diminution of uric acid noticed by Dr. Ranke. The author also examined the urine of three healthy persons before and after the administration of quinine, and found in each case that the medicine increased the specific gravity. How increased the specific gravity he does not say. The inference drawn in the paper is, that quinine is a "blood depurator," and that in ague the blood is hyper-phosphatic.

ART. 18.-On the Advantage of large Doses of Quinine in the treatment of Intermittents. By Dr. JOHN SHORT.

(Indian Annals of Med. Science, Jan., 1858.)

"In the administration of quinine," says Dr. Short, "a complete revolution has been effected with unparalleled success in the treatment of the intermittent fever of Kamptee. Hitherto large and small doses were administered daily, and continued for several successive days, causing a large expenditure without any commensurate advantage; whilst a single dose of twenty five grains of the salt in Europeans, and twenty in natives, has been found to be quite adequate to arrest the fever, by exhibiting the medicine immediately after the sweating stage, and following it up by bark and acid, chiretta and powdered galls, or sulphate of iron."

ART. 19.-Of the Use of Quinine in Intermittents, with or without "Preparatory Measures." By Dr. NICHOLS, of Buffalo.

(Buffalo Med. Journal; and North American Med.-Chir. Review, March, 1858.) The object of this paper is to study the effect of treating cases of intermittent fever without resorting to the preparatory treatment by emetics, cathartics, &c., which are still deemed important by many practitioners; and also to institute a comparison as regards relapses and the duration of the disease, between a section of country where the disease prevails to a great extent every year, and a region not malarious.

Of 69 cases, 46 were treated in a malarious section, and 33 in a region not malarious.

Of 46 cases occurring in a malarious section, 17 were treated at once with quinia, in doses sufficient to arrest speedily the paroxysms, and 29 received preparatory treatment-viz., ipecacuanha and calomel, or calomel combined with rhubarb or jalap. Relapses were observed in 14 of the latter and in 4 of the former cases, the ratio being as 1 to 4 in the cases which did not receive, and 1 to 24 in the cases which received the preparatory treatment. The average duration of the disease, dating from the commencement of the use of quinia, was found to be less in the cases which did not receive preparatory treatment, being a fraction over six days; while in the cases which received preparatory treatment, the average duration was a fraction under eight days. Adding the period occupied by the preparatory treatment, the ratio is as 6 to 8 days.

Of 23 cases occurring in a region not malarious, all had no preparatory treatment. Of these cases, in ten previous attacks had occurred. In the latter, the

average duration of the disease, after treatment was commenced, was 3 days. In ten of the recent cases, the average duration was 2 days. Of the latter, relapses were observed in two cases; of the former, in three cases.

Comparing the results as regards duration and relapses in the cases occurring in the malarious section and not receiving preparatory treatment, and in the cases occurring in the region not malarious, the contrast is striking: the average duration in the former being 6 days, and the average of relapses 1 in 41; in the latter, 213 days, and the average of relapses 1 in 23 cases. These results are greatly in favor of the region not malarious.

The reporter analyzes his collection of cases with reference to the types of the disease; the number of paroxysms in each type; the number of relapses and the duration in each type. He also analyzes separately the cases of tertian type.

The following summary embodies the practical conclusions which he deduces from the results of his analytical investigation :

"From the foregoing analysis it will be seen that in cases of first attack the duration is somewhat less, and the number of cases relapsing about one-half that in cases having had one or more prior attacks. In a section of country where this fever is prevalent to a great degree every year, or in a malarious region, the duration is nearly three times that in a country not malarious, and the relapsing cases occur as frequently even under the same plan of treatment. It will be found that in a malarious region the treatment of patients by quinia alone not only diminishes the number of paroxysms and abridges the duration of the disease, but that fewer relapsing cases occur than where a preparatory course of treatment has been adopted. Even in the analysis of 40 tertian cases, although the duration of the number of paroxysms are nearly the same under the two different methods of treatment employed, yet the cases of relapse are found to be nearly twice as numerous where the preparatory plan was adopted."

ART. 20.-On the Treatment of Chronic Rheumatism. By Dr. INMAN.

(Liverpool Med.-Chir. Journal, July, 1857.)

In a paper read some time ago before the Liverpool Medical Society, Dr. Inman adverted to the frequency of its occurrence and the multiplicity of the plans of treatment employed for it; remarking that they all, however, possessed something in common. Difficulty as to diagnosis, and confusion as to treatment, he thought had arisen from the practice of classing all sorts of aching pains under one head, as rheumatic. The uneasy sensation experienced before the access of eruptive fevers, and during the course of malignant disease, or felt by those exposed to the action of mercury or lead, and by those suffering from gout, gonorrhoea, or syphilis, and in cases where it was evident that bile or urea was mixed with the blood, and by children affected with struma-had all been set down as rheumatic, though due to most varied causes. The term "chronic rheumatism," he believed strictly applicable to cases in which there is dull pain usually coming on during the night, referred to the tendinous expansions of the muscles, the pulse not quickened, the skin warm, excepting over the seat of pain, where the temperature is usually low; the pain remitting about 4 P. M., and not recurring till some time during the night. There is usually no error of secretion, nothing visible at the seat of pain. The duration may be from one or two days to six weeks. Deposits in the joints rarely take place; and that form which causes gradual contraction of joints and crippling of limbs, is rare. The rheumatic pain is usually symmetrical; its chief seats those parts least protected by fat and integuments. Loss of motor power accompanies the pain, which is increased by action and relieved by relaxation of the affected parts. Rheumatism is not occasioned by dry and intense cold, but by the more moderate degrees of cold, especially if the air be moist. The experience of Arctic navigators, and of the army before Sebastopol, as well as the comparative rarity of rheumatism among carmen, carters, and bricklayers, confirm this point. Firemen of ocean-going steamers appear particularly liable to it. Persons of feeble constitution and languid circulation are more obnoxious to it than those with good circulation. It is not common in women,