Imagens das páginas

terization and moderate mercurialization, when the chancre is indurated. To the value of the Turkish bath, " which may now be procured in London” (p. 109), for stimulating the cutaneous function, in the treatment of secondary symptoms, we are glad to have this opportunity of bearing a corroborative testimony. The successive applications of hot vapour, soap, thorough friction, and water douches, of which our own metropolitan form of that Oriental luxury consists, constitute, when made with proper precaution, a powerful means of elimination from that vast and important organ, the skin, the benefit of which we have had opportunities of witnessing in some cases, and desire to extend.

In conclusion, although obviously disagreeing with Mr. Coote on some fundamental doctrinal points in the pathology of sypbilis, we regard this essay as a record of thoroughly practical labour, and most assuredly desire to thank him for the search after facts which it is evidently always his object to attain.




Art. X.-Archiv für Ophthalmologie. Erster Band, Erste Abtheilung,

herausgegeben von Dr. A. von GRÄFE. Zweite Abtheilung, beraus-
gegeben von Prof. F. ARLT, Prof. F. C. DONDERS, and Dr. A. VON
GRÄFE.—Berlin, 1854–5. pp. 358. Zweiter Band, 1855–6. pp. 346.

Dritter Band, Erste Abtheilung, 1857.
The Archives of Ophthalmology. Vol. I., Part 1, edited by Dr. von

GRÄFE. Part 2 edited by Prof. ARLT, Prof. DONDERS, and Dr.

von GRÄFE. Vol. II. Vol. III., Part 1. We owe an apology to our readers for having so long delayed noticing this new organ of ophthalmic science. It is in every way a worthy rival of the well-known ‘Annales d'Oculistique,' which for so many years have been the medium of communication between Continental ophthalmologists and the profession at large. There is ample room for both publications to labour harmoniously in the same field, which they cultivate in a somewhat different manner. While in the 'Annales' the reader is kept au courant with the literature and ophthalmic news of the day, the « Archiv,' instead of aiming at the character of a journal, rather resembles the · Transactions' of our medical societies.

The volumes now before us contain several essays of sterling merit, and the chief editor, von Gräfe, has contributed a rich collection of miscellaneous cases from his public and private practice. Associated with him as contributors, we find the well-known names of Helmholtz, the inventor of the ophthalmoscope, von Ammon, Rass, Donders, Liebreich, Zehender, and others. Among many papers of interest in Vol. I., we mar notice a careful essay by von Gräfe On the Action of the Ocular Muscles; and his miscellaneous notes of cases are all more or less interesting. He has been so fortunate as to detect, by the aid of the ophthalmoscope, the presence of entozoa—cysticercus cellulosa within the vitreous chamber. No fewer than nine cases of this singu. lar atletion have come under his observation; the entozos being either fixed to the resina, or floating freely in the humours of the eye. We

are not aware of such cases having been met with by any other observer, either in Germany or elsewhere. Among the essays in Vol. II. we may specially notice a very elaborate one, by Dr. Meissner, On the Movements of the Eyeball; a Contribution towards the Histology of the Choroid, by Dr. Wittich; and a further Series of Cases, by Dr. von Gräfe.

Only one-half of Vol. III. has yet appeared; but it well sustains the character of the work by the variety and interest of its contents. Dr. H. Müller contributes original researches On the Anatomy of the Ciliary Body and the Mechanism of Accommodation ; the Histology of Capsular Cataract, &c.; Dr. Zehender, a paper On the Refracting Powers of the Media of the Eye ; Dr. Donders continues his Pathological Contributions ; and Dr. von Gräfe, in an article of more than two hundred pages, commences a review of the whole question of Strabismus, and the operations for its cure.

We heartily wish success to a work which so well sustains the high character of German ophthalmology; and we shall not fail, from time to time, to lay before our readers some of the more important facts recorded in its pages..

ART. XI.-- Notes on the Belgian Lunatic Asylum, including the Insane

Colony of Ghed. By JOHN WEBSTER, M.D., F.R.S., &c.—pp. 68. To the philanthropist, we know no subject more gratifying than the treatment of the insane, and the management of lunatic asylums as at present conducted, compared with the past of no remote date. We are old enough to remember the time when chains were in use,—when punishment was considered necessary, and coercion essentially so. We would fain hope that the progress which has been made in this most important branch of medical practice, and which is mainly due to the exertions of enlightened physicians, betokens not only an advance in the right line, but may be viewed also as some makeweight against the degrading influences of the various delusions which have of late prevailed, and are still prevailing, in society, under the names of mesmerism, table-turning, spirit-rapping, and the like,-delusions which, one after the other, have started up, as if to show the weakness of human reason, and to check us in our too lofty aspirations regarding its efforts.

The lunatic asylums in Belgium, it would appear, from the account given of them by Dr. Webster, in his interesting Notes,' are an example of the progress we have alluded to, and are perhaps as good an example as could be adduced in any part of the civilized world ; and we say civilized with emphasis, for where there is want of civilization, there we are sure no humanity is shown to the suffering insane. We may mention in proof that in Constantinople, a very few years ago, we had the pain to witness lunatics, chained like wild beasts, made a sight of, and allowed to be the sport of mischievous boys, and separated only from a menagerie by an intervening wall.

In Belgium, this progress, this change of system from severe to mild, we learn, has only been effected within the last five or six years. In 1852, we are assured by a native writer, M. Guislain, in his lectures, “Sur les Phrénopathies,' that “ Lunatics in Belgium remain forgotten in sombre prisons;" that

“They resemble merchandize amongst speculators, who make them the objects of nefarious traffic, like animals from the farm-yard, fit only to be bought and sold as horses or swine.”

Adding, "Much talk has certainly taken place during the last thirty years; but so little has yet been accomplished, that our afflicted maniacs have only been turned round in a vicious circle of selfish and fatal administrative influence." (p. 11.)

We must refer to Dr. Webster's Notes on the several asylums for the particulars of the beneficial change, briefly remarking that it is connected with a radical change of the administrative system, organized as a public department, and directed by rules founded on just views of the malady; of the more important of these rules a summary is given by the author. The inspection of the asylums, whether public or private, at least three times yearly, by a different class of persons, and the sanction of the Government for the erection of new, or for alterations even in existing, asylums, are particularly worthy of attention.

Belgium is a country of all others distinguished for its mixed breed of people; nowhere, not even in England, have races been more crossed; yet in Belgium it is worthy of remark, that the proportion of the insane is large-larger than in England, and indeed than in most countries of which we have trustworthy statistics. In a population of about 4,520,000, the number of recognised lunatics was recently 4907; in towns, in the proportion of one for every 470 residents; in the country, one for 1368 inhabitants. In regard to sex, too, it is worthy of remark that the male preponderates, their number being 2630 to 2277 females.

The unusual prevalency of insanity in this country seems to be owing to various causes: those on which the author lays most stress are poverty-poverty especially—and vice; the former conducing to it by a low and inadequate diet; the latter, through the intemperate use of ardent spirits and tobacco, and sensual excesses.

We trust that all who take an interest in the subject (and who are they who ought not to take an interest in it ?) will read Dr. Webster's remarks in their details. The few remarks we have to offer must be limited chiefly to the “ Insane Colony of Gheel,” the oldest establishment for maniacs in Europe, which on many accounts is deserving of special attention, and most of all by our Government, and of all under it exercising authority in matters of lunacy.

The great peculiarity of this colony, of which the town of Gheel is the centre-situated in a country, a barren waste by nature, rendered fertile by industrial labour, and partly by that of the insane themselves-is, that the lunaties sent there become the inmates of private families. At the time of the author's visit, the number of the receiving families was 500, of which about 300 possessed cottages or farm-houses in the country, the rest residing in the town. The number of lunatics thus distributed was 774. Dr. Webster, speaking of their distribution, says : '

"I visited numerous houses in the town, and a great many cottages scattered over the adjoining country, in which often one, although most frequently two, and occasionally three, insane persons resided.”

Adding, "That is the general system followed, with but very few exceptions,—seeing not more than five instances exist throughout the entire colony where beyond four patients are placed with the same family, but only then for special reasons, and after an express authorization from the Committee of Inspection is obtained.” (p. 41.)

This unique colony is as singular in its origin as in its nature. Its origin goes back to a remote period, and to a tragic and atrocious act—the flight and beheading of an Irish princess-a saint and virgin, St. Dympna, in the sixth century, by a king, her father, a Pagan, and, something worse, amorous of his child, and enraged at her virtuous resistance, and to her change of religion and firm adherence to Christianity. The cruel acts perpetrated on her, according to the legend,

“Greatly frightened several lunatics said to be present, and, tradition reports, cured them immediately, through the strong impression this terrible spectacle produced on their excited feelings. Immediately the cry of 'A miracle ! a miracle!' was raised by the wondering bystanders; and thus Dympna, saint and virgin, became ever after the patron of all mad persons. This faith having been spread abroad, lunatics were brought to Gheel to get cured through St. Dympna's intercession, and firmly established its reputation.” (p. 32.)

Our readers may be interested to know that Gheel is now easy of access; that it may be reached from Brussels, by rail and a daily twohorse oinnibus, in the short space of two hours and a half, and that in the town there are two inns, both good, affording very comfortable accommodations, and on surprisingly reasonable terms; three francs per diem-we record it as a matter of curiosity-covered the entire hotel charges of our author.

Amongst the more remarkable circumstances noticed by Dr. Webster in describing this colony, is the part taken by children in the service and management of the insane, the security attending the freedom allowed the patients, and their few escapes, and the many and useful occupations on which they are employed. The particulars on these points, and on others given by the author, we have read with extreme interest; and we can recommend the perusal of them to others, confident that they must excite in them the same feeling; and more, that much in the system that distinguishes the colony of Gheel is worthy of the serious attention of our Government officials, and of being followed in our establishments for the insane.

We see that Dr. Webster raises his voice against palatial asylums constructed at an enormous amount of expense, burdening the ratepayers, without perhaps commensurately benefiting those unfortunates for whom they are designed; and the placing them, at a like extravagant cost, not on waste grounds, such as the locality of Gheel was, but on already reclaimed or fertile land of high marketable value, capable of little further improvement.

Art. XII.-On the Diseases, Injuries, and Malformations of the

Rectum and Anus. By T. J. Ashton. Second Edition.—London,

1857. 8vo, pp. 390. The rapidity with which the works upon diseases of the rectum, by Curling, Quain, and the present author, have passed into second editions, testifies at once to the prevalence of these affections, and to the insufficiency of the accounts given of them in the general treatises upon Surgery. Mr. Ashton's work must be regarded as the most complete one we possess upon the subject; and while he exhibits in it a considerable acquaintance with what has been written by others, the practical facts he contributes quite prevent the treatise being characterized as a mere compilation. We have heard it objected that it has been too much based upon the work of the late Dr. Bushe; but even were this true, which we do not think it is, it would in our eyes constitute rather a merit than a reproach. Dr. Bushe's treatise, though highly valued by those acquainted with its contents, never met with that general acceptance it deserved ; and the wider diffusion of his views by an intelligent critic and a good practical surgeon would be very desirable.

Mr. Ashton's style is somewhat too diffuse, and his book would have gained by compression ; but, even with this drawback, it well deserves the success it has met with.

Art. XIII.-Practical Hints on the Management of the Sick-room.

By R. HALL BAKEWELL, M.D., Member and Licentiate in Midwifery of the Royal College of Surgeons of England, L.S.A.; formerly House Surgeon to the Middlesex Hospital, and to the Stafford County Infirmary; late of the Medical Staff in the Crimea; author of letters of “Sanitary Reform in Rural Districts.'

London, 1857. pp. 47. Dr. BAKEWELL informs us, that when a patient lies in bed “very little waste is going on in the system, and that that part of the food which is required for sustaining animal heat is almost wholly unnecessary-artificial heat being supplied.” Does this mean that people who are confined to bed invariably use, or ought to use, hot waterbottles and stomach warmers? Again, Dr. Bakewell, in speaking of "mustard plasters," says only they “should always be made with fresh mustard and cold water;" in a book intended specially for “ lady readers with lily-white hands," we should have thought that some further information on the subject would have been necessary. We know from experience that such information would not have been thrown away. One more specimen of the instruction conveyed by Dr. Bakewell, and we have done : in speaking of pills, the observation “ that it is advisable to take some fluid afterwards in order to assist in dissolving them in the stomach," is followed by the statement, that “it is better to take aperient pills immediately after a meal, as then they are digested with the food."

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