"England's most unhealthy city"-this being only 33.5 per 1000. Of the three presidencies, Bengal occupies an undue pre-eminence in its high rate of mortality, but this circumstance is mainly attributed to the greater exposure of the Bengal army to the dangers and vicissitudes of war, and to the frequent postings of corps on the Bengal establishment in new stations, which are generally considered as highly inimical to the health of European soldiers. The mortality among the officers in India is about onethird of the general mortality above quoted, and is considerably less among the married than among the unmarried. High as this mortality undoubtedly is, it contrasts very favourably with that which obtains among European officers serving in other tropical stations, and more especially in the West India islands. The mortality among the wives of European soldiers in India is 35-47 per 1000, and here again it is greatest in the Bengal presidency; that of the wives of European officers appears wonderfully small, or only 15.85 per 1000. The mortality among European children in India is shown to be enormous. That of children under fifteen years of age in the Lower Orphan School, Calcutta, for a period of forty years, was 54.85 per 1000; and among male infants during the first year of life, it reached the rate of 17184 per 1000 (the corresponding rate in England being only 71-65). As a remedy for this frightful state of things the author's recommendation is in perfect accordance with that of Mr. Jeffreys.

'Early removal to the hills appears to be the most certain safeguard. The first reports of that admirable institution, the Lawrence Asylum-established at Sunawur, near Kussowlie, in 1847, by the philanthropy of the late Sir Henry Lawrence, for the reception of soldiers' children, chiefly orphans, show that the asylum then had, at the end of its second year's operations, 136 inmates, nearly half of whom were under ten years of age; and that only two deaths had occurred from the first, in children who had been only 'a week in the asylum, and who arrived in a state of disease.'

As regards the rate of sickness in the European army in India, it is shown that the number of admissions into hospital during the year exceeds 2000 per 1000 of strength, or in other words that, on an average, every soldier is admitted into hospital twice during the year. The diseases which produce this great sickness and mortality are fevers, dysentery, diarrhoea, hepatic diseases, cholera, and phthisis; cholera, however, being apparently less frequent in Madras than in the other two presidencies. In reference to these diseases it is justly observed:

"When it is recollected that, unlike many of the most fatal diseases of Europe, the whole of those maladies which yearly commit such dreadful havoc in the ranks of our European army are of that description which all investigators in recent times, unite in proving to be either removable or mitigable by vigorous and liberal measures of sanitation, the military surgeon in India cannot but feel, amidst the many disappointments which attend his labours, that wherever he succeeds in carrying into operation any one Hygienic law, he begins to exercise the greatest of the Almighty's gift to man-the power of arresting death."

In addition to the great sickness and mortality above-mentioned, the Indian army annually loses a large portion of its strength by invaliding. It is shown that 16 per cent. serve less than five years, 43 per cent. less than ten years, and 84 per cent. less than twenty years; leaving 15 per cent. only of men above twenty years of service. Soldiers under twenty years contributed the largest number to the invalids, thus showing the impropriety of sending out young recruits to India. The author concludes the first section of his inquiry by observing that the European army of Bengal has been nearly decimated annually by death and invaliding, having lost 90 per 1000 of its strength every year from these conjoined causes. It is gratifying, however, to find that, since the commencement of the present century, the mortality rates of Europeans serving in each of the three presidencies have considerably decreased. This fact holds out good ground for hope that much may still be done in effecting a still further reduction.

The means for reducing sickness and mortality among European troops in India areconsidered under the following heads:-1. The proper selection of recruits. 2. The provision of well-found ships to convey them to India. 3. The selection of the proper season for their arrival in the country. 4. Judicious sanitation for them on their first landing. 5. The choice of a proper time and place for drilling. 6. The selection of the fittest season for sending newly arrived troops up country. 7. Sanitation for them in the

river trip. 8. Sanitation for them on the march. 9. The provision of proper clothing and food. 10. The encouragement of habits of temperance. 11. The choice of proper military stations in the plains. 12. The choice of sanitaria in the hills. 13. The provision of proper barracks and hospitals. 14. The maintenance of a thorough system of conservancy in cantonments. 15. The improvement of the soldiers' morale, and the profitable occupation of their minds and bodies in cantonment. 16. Sanitation in the field, in standing camps, besieged forts, and entrenched camps. 17. Arrangement for the accommodation and safe conveyance of sick and wounded in the field. 18. The regulation of punishments. 19. Amelioration of the condition of the women and children. 20. Regulation of the mode of invaliding, and the adoption of measures for sending the invalids down country and home in the best manner.

We cannot give more than an enumeration of the many topics just mentioned. Suffice it to say, that they are treated in great detail; and that, while the author has freely availed himself of the investigations of others, he makes many valuable suggestions and recommendations of his own. We would particularly direct attention to the chapters upon the proper selection of recruits and the encouragement among them of

habits of temperance.

In conclusion we would only remark, that no two works could have been published more opportunely than those of Mr. Jeffreys and Dr. Chevers, and that both are well deserving the serious attention of those in authority in India, and of sanitary reformers generally.

1. Syphilisationen som Curmethode. Syphilization as a Method of Cure. pp. 142.

REVIEW X.

Ved W. BoEck.

By WILLIAM BOECK.-Christiania, 1857. 8vo,

2. Discussionen i det Norske Medicinske Selskab i Christiania angaaende Syphilisa

tionen.

Report of the Discussion on the subject of Syphilization in the Norwegian Medical Society. 1857, pp. 161.

3. Undersögelse angaaende Inoculation af Vaccine og Chanker materie, for at constatere Immunitäts forholdene og deres Consequentser. Ved Dr. F. C. FAYE.

Researches upon Inoculation of the Vaccine and Chancre Virus, to ascertain the conditions of Immunity, and consequences thereof. By Dr. F. C. FAYE.-Christiania, 1857, pp. 70.

4. Syphilizationen anvendt mod Syphilis og Spedalskhed. Ved D. C. DANIELSSEN. Syphilization, as employed in Syphilis and Leprosy. By D. C. DANIELSSEN.-Bergen, 8vo, pp. 125.

THE war of the empirics and of the dogmatists rages fiercely just now in the cold north; and party spirit is as warm at the foot of the Dovrefjeld as it was once on either side of the Apennines. Every innovation in medical science is certain to be submitted to the alembic of opposition; its weak points will be brought prominently forward in discussion, and if there be truth in the new doctrine or practice, it is generally only after a long struggle that it becomes firmly established. The profession is right to exercise a just caution under such circumstances, and especially at the present day, when innovations of such daring character have found favour with the public. Above all is this hesitation requisite when we are called upon to adopt a method of treatment totally opposed to our preconceived ideas-a method, in fact, of cure that is devoid of any theoretical foundation whatsoever. In a former article we had occasion to lay before our readers the details of Professor Wm. Boeck's researches into the efficacy of syphilization in the cure of secondary and tertiary venereal symptoms. Our analysis of what

had been done in this respect, both at Christiania and elsewhere, was necessarily somewhat of a partial character, as up to the period at which Dr. Boeck wrote, hardly a voice had been raised in Norway to question the accuracy of his conclusions. But the curious subject of syphilization has now been advanced a step further, it has been brought prominently forward in the Christiania Medical Society, and in a discussion which occupied six meetings, the whole subject has been considered on the basis of the most recent investigations. That a little warmth of feeling should have occasionally shown itself among the disputants, is, to us, not a matter of surprise, but both parties seem to have been influenced by an earnest love of truth, and in many cases they exhibit a degree of candour and honesty not always to be found in the French Academy of Medicine, or elsewhere. That a final conclusion, either adverse or otherwise, has been arrived at, is more than we can say, but much that was before doubtful or obscure has been cleared up, and new theories of the action of this treatment have been proposed, which, if true, may greatly modify the opinions hitherto held by its advocates, as well as by its opponents.

In Norway, as elsewhere, syphilization has now met with serious opposition, though we must confess at once it is more the theory than the facts of this practice that has been disputed. To this question we shall return hereafter; at present we may state that on the 5th of November, 1856, Professor Faye, of Christiania, commenced a discussion in the Norwegian Medical Society upon syphilization, and which was continued throughout five or six meetings to the beginning of March, 1857. The attack, which was led by Professor Faye, was seconded but faintly by his colleagues; indeed, it seems to us, that no one took an active part on that side of the discussion except the Professor himself. It may be objected that, as Professor of Midwifery, and as one who had not personally followed the practice of syphilization, Dr. Faye was not fully qualified to give an opinion upon the subject. The question raised, however, by Professor Faye, was not directly of a practical character; he did not impugn the facts of syphilization, or deny in any way the cures that had thus been effected, but he proposed to account for this success in a different way, and sought to explain the apparent paradoxes of this mode of treatment by the light of modern science. In a word, he endeavoured to bring syphilization within the pale of our present physiological and pathological knowledge, and to strip it of the marvellous and of the unaccountable, which must always impede the progress of true and logical investigation. Professor Boeck did not attempt a direct reply to the arguments of Professor Faye, but while he acknowledged that he could not account pathologically for the success attending this practice, he did not allow the weak points of his opponent's arguments to escape his vigilant observation. We observe, too, that in the course of the discussion, several members of the medical profession in Christiania gave in their adhesion to the practice, if not to the theory of syphilization. Thus Dr. Gjör acknowledges having been totally incredulous until experience had convinced him of the great value of syphilization, while Vogt, one of the committee of control, appointed to watch the progress of the treatment, states, that after having opposed the system as a folly, he has now become so thoroughly convinced of its efficacy, that were he himself ever to become the victim of secondary syphillis, he would at once submit to the treatment, and would advise others to do the same. Egeberg, another member of the committee, expresses himself more cautiously. He states the duty of the committee to be to ascertain, first, that those who are submitted to syphilization really are affected with syphilis; secondly, that those stated to be healed by the method really are free from venereal symptoms when they leave the hospital; and thirdly, to note down and publish any relapses that may occur, as scrupulously as the cases of cure. As judges of the matter they do not consider themselves; the period has not as yet, in Egeberg's opinion, arrived for publishing any positive decision; all that he can say is, that the treatment gives good hopes of success.

On the whole, the result of the debate seems to us to have been decidedly favourable to the practice of syphilization, however much any theories founded upon this practice might be impugned. On the one hand, however, Professor Faye insisted that the question of syphilization, as a means of cure, rested on that of immunity to the venereal virus being at length obtained, while on the other, Dr. Boeck and his supporters urged,

that the theory of the treatment did not affect the practice. Professor Faye maintained that syphilization acted merely as a depurative and suppurative process by the skin, a powerful counter-irritant action being thereby established, under which the original disease, the papular affections, ulcers, nocturnal pains, periostitis, and the long catalogue of secondary symptoms, gradually disappeared. Had this theory been supported by a sufficient array of facts, it would appear deserving of credit, but unfortu nately, in this very point consists the weakness of Prof. Faye's argument, for his experiments with depurative suppurations produced by other means have yet to be made. Until this is done, until his theories, excellently as they are enunciated, are corroborated by actual experiments, we must suspend our judgment on the controversy, though we shall endeavour to lay before our readers the principal arguments employed by Professor Faye to support his opinions. On the other side, theory seems to be altogether at fault, but the undeniable success of this wholly empirical practice calls for our earnest consideration, and demands that the energies of science should be directed to ascertaining, if possible, the true modus operandi of the treatment. Before entering, however, on this part of our subject, let us briefly examine what progress has been made by syphilization during the past two years.

Subsequent to the discussion in the Christiania Medical Society in the early part of last year (1857), Professor Faye published the pamphlet which stands third upon our list, and Dr. Boeck brought out his essay on 'Syphilization as a means of Cure' (No. I.), embodying the result of another hundred cases, wherein syphilization had been employed, and generally with signal success. In September, 1857, Professor Faye visited England and Scotland, and read a paper at the meeting of the British Association at Dublin, wherein he ably brought forward the views he had defended in the Christiania Medical Society. Shortly after, Dr. Boeck followed in his track, and on the 19th September, 1857, he published in the 'Medical Times and Gazette' a well written letter giving the results of his experience in two hundred cases of syphilization. In this letter Professor Boeck wisely abstains from theorizing, and contents himself with the practical details of his treatment, and of the success thereby obtained. In November, Dr. Lauder Lindsay published a very able review of the whole subject in the Edinburgh Medical and Surgical Journal,' and in March last there appeared a letter from Dr. Boeck in the same Journal embodying his most recent experiences. It is only, however, among Edinburgh medical men that the question seems to have excited any interest at all, though it is plain that the period is not far distant, when either accumulated testimony in its favour will force the subject on our notice, or the whole theory fall to pieces at the touch of the wand of science and of logical investigation. We say the theory, for certain it is and undeniable, that remarkable results have been obtained by this mode of treatment, that cases of inveterate secondary affections have been, to all appearance, effectually relieved, nay, we may say completely cured, while the number of relapses in comparison to those known to occur after the usual mercurial courses, has been extraordinarily small. We do not advocate the plan, and judging from a physiological or a pathological point of view, we would unhesitatingly reject it; but the united testimony both of the advocates and opponents of the practice convinces us that herein, or in some similar process, is to be found a powerful means of modifying, and probably of arresting, the progress of secondary venereal affections.

In France, syphilization seems to have made but little progress, though the practice originated in that country. Nélaton has recently, it is said, allowed Auzias Turenne to experiment on a single case in his clinique; but it was not a well-chosen one, as it was a girl in delicate health, suffering from hereditary syphilis. Sperino has continued his studies on this subject at Turin, though they were interrupted by illness during 1856. In Sweden, Dr. Stenberg has published a pamphlet on Syphilization, with accompanying experiments; and in this he relates the histories of three patients whom he treated by this method, and who, after the lapse of two years, remained perfectly well. In Copenhagen, Professor Hassing has turned his attention to the question; but the results of his experiments are not as yet known to us. In Christiania, the headquarters of syphilization in the north of Europe, this treatment has been most extensively practised during the past year (1857), and has been extended even to children of tender years.

In 1856, Dr. Boeck requested three of his colleagues-Vogt, Steffens, and Egebergto form themselves into a committee, to observe the progress and results of his special treatment. No report as yet has been made by these gentlemen; indeed, it would be premature to expect it until further experience has corroborated or contradicted the alleged successes. At present, extensive experiments are being made on the subject by many practitioners in Scandinavia; and among these we may name Dr. Danielssen of Bergen, from whom we may shortly expect a full report of his experiments on syphilization, both in secondary venereal disease, and in the hitherto incurable malady, the old leprosy of Europe. It was quite evident from the very first that so great an innovation in practice, and one apparently so utterly indefensible on theoretical grounds, could not long remain unquestioned among men so fond of investigation, and so earnest in the pursuit of truth, as are our brethren in the north of Europe. Syphilization has here had a fair field laid open for experiment, and its results have been most narrowly watched by those who doubted of its efficacy. In England, little or no attention was excited by the discussions in the French Academy on this subject; and syphilization was placed at once in the company of homoeopathy and of the other fashionable follies of the day. Not so in Norway; there, Professor Faye, dissatisfied-and justly so, we think with the theories propounded by the upholders of the practice, has come forward with a theory of his own, which bids fair to sap the foundation of the edifice so recently and so pleasingly constructed. In the Norwegian Medical Sooiety he maintained, in a protracted discussion, that no analogy exists between the protective powers of vaccination against small-pox, and that of the syphilitic virus against the venereal disease. He denied, indeed, the protective power of syphilization altogether; he called it a delusion, only based on the alleged immunity to the virus; and this he said, was simply a temporary immunity of the over-stimulated skin. After the discussion in the Norwegian Medical Society was closed, Professor Faye turned his attention to the subject of the influence of cow-pox inoculation on the system, in comparison with that said to be produced by the formation of artificial chancres on the body.

The following questions presented themselves to his inquiring mind for solution: I. Is our belief in the alterative powers of vaccination on the constitution based on experience of such a character that it may be regarded as complete, and as doing away with the necessity of revaccination? And again, does it, from its presumed relationship to variola, protect the system from that disease also?

II. Does the producing of chancres on the skin, by the inoculation of chancre virus, create a real immunity (after a greater or less number of inoculations) to syphilis, similar to that presumed to be obtained by vaccination, or by the inoculation of smallpox matter; and in what relation does the intensity of the virus stand to the susceptibility of the system to its effects?

"It might have been expected," observes Dr. Faye, "that Jenner's immortal discovery, after the lapse of half a century, would have been so practically tested by daily observation, and by direct experiment, that positive rules for the guidance of the profession in all matters relating to vaccination could ere this have been laid down. This, however, is far from being the case, and we are still uncertain as to the length of the period during which the system is enabled to resist fresh infection, nor have we fairly decided on the general prophylactic powers of vaccination in regard to small-pox."

Cow-pox, however, differs from variola in so far as that it cannot be propagated by atmospheric infection-it requires actual contact with the skin; while the poison of variola may be inhaled by the respiratory organs, as well as conveyed by direct contact. with the blood.

Dr. Faye seems, therefore, to doubt the identity of small-pox and cow-pox, in opposition to the opinions of Thiele, of Ceeley, and many others. He admits, however, that there is a great similarity between the two diseases. Small-pox, as we might naturally infer, is often epidemic; cow-pox is never so; but both are true blood-diseases, and, when introduced into the system, we cannot destroy or stay their progress. The great question, however, is, whether the variolic and vaccine virus stand so closely related in their