hension; and the ill-consequences of their imperfect acquisition are not limited to the individual dabbling with them, but may injuriously affect many other portions of society. Hence it is the duty of all members of our profession to discountenance instead of encouraging such pretensions ; and we are of opinion that the egregious manner in which Mr. South has violated such a duty should, ipso facto, forfeit the responsible seat he holds at the board of one of its governing bodies.

SPEECH OF LIeut.-General SIR HOWARD DOUGLAS, Bart., M.P. for Liverpool, on the ARMY SURGEONS' BILL, in the House of Commons, Monday, April 12, 1847.

WE publish with real satisfaction certain passages in the speech of the gallant Sir Howard Douglas, on the ill-treatment of the Army Surgeons-a class of officers forming a considerable portion of the entire body of the medical profession, whose honour and reputation it has nobly upheld, under every circumstance of service-in peace and in war.

The friends of the Army Surgeons, in the Army, have at all times been of the class to which we know that Sir Howard Douglas belongs-those emphatically designated as of "the heroic school"-the school of Abercrombie, Moore, Hope, and Graham.

The honoured commanders named were sterling friends to our brethren in the army; but the two first were killed in action ere they had done more than record their sentiments on the merits and deserts of the surgeons whose conduct in battle had excited their admiration and gratitude. The others, owing to party or political circumstances, were impeded in their endeavours. Sir Howard Douglas, then, follows in a noble wake.

After exposing the low rate of pay comparatively, causing surgeons "to cling to active service long after their physical powers were too much impaired to discharge sufficiently their laborious duties," the gallant General proceeded in detail to recite the grievances of "that learned, most important, and, as he thought, rather neglected class, entitled on every account to the first consideration and distinction."

"The army surgeon, it is true, does not purchase his commission; but the expense necessarily invested on his education must not be forgotten; and he, like the paymaster, cannot realize this by sale, for the benefit of his family. No one who knows anything of the severe and painful duties which a medical officer has to discharge, and the services in which he must be engaged, in the presence of disease of every kind, facing death in every shape, can doubt of the hardships which officers of that class must have undergone during a service of thirty years. The surgeon, too, let it be remembered, must be in full possession of all his energies, keep himself well up to the mark in every improvement in practical surgery and in medical science. Paymasters and quartermasters may, with rather diminished powers, cling to the service without any great detriment to it, or inconvenience to themselves, after these had somewhat faded; but there was a period of life beyond which the medical officer, however perfect his intellect, could not discharge effectually his duties on the field as surgeon of the regiment--a period beyond which vision becomes imperfect, the nerve unbraced, the hand too unsteady, in the difficult and delicate operations which a surgeon was called upon to perform. No man of the age of sixty or sixty-two could be expected to retain these faculties unimpaired; and as the great bulk of medical officers enter the

1847] Sir H. Douglas on the Claims of Army Surgeons.

245

army at the age of twenty-four, thirty-two years' service would bring them near to that stage in human existence, beyond which it would be vain and unreasonable to expect that a medical officer of thirty or thirty-five years service in all climates should retain his efficiency. Officers so circumstanced are aware of this sad truth, but continue to serve, knowing that the half-pay to which they are entitled is insufficient for their wants; that, from bodily infirmities and deficiency of mental energy, they cannot add to their income by private practice, being unequal to compete successfully with younger and more recently educated practitioners, and therefore cling to the service. It is for the interests of the service, then, that men so circumstanced should cede their avocations to younger individuals; but this they can only be tempted to do, or are justified in doing, by our increasing their rates of retirement. The medical officer, while on full-pay, has no cause for complaint-this is sufficient to attach him to the service, but binds him too long, from the rates of retirement being so inadequate. The hon. and gallant Member then cited, from official returns, the cases of many deputy inspectors general of hospitals, and surgeons, who had been from thirty-six to forty-three years in the service.

"Having explained the ordinary duties of medical officers, he would now beg to say a few words which he hoped would take these officers as a class out of the category of civil functionaries and non-combatants. The medical officer cannot be considered a non-combatant in the sense of personal exposure, nor in many cases, as he could tell, of personal military gallantry. The medical officer is suddenly called upon to discharge duties which require the vigour and powers of endurance of less advanced age; to partake of the fatigue, privations, and diseases incidental to actual service; to brave every climate, to witness death in every form, and to suffer it himself in the field, when administering to those whose lives he is endeavouring to preserve. Two surgeons of Her Majesty's regiments were killed on the field of battle in the operations of the Sutlez; three at Cabul. How many of the Honourable Company's service he knew not. He requested the House to let him endeavour to depict the duties of medical officers on the field of battle. The action is about to commence. The medical officers attached to the troops take post in the immediate rear of their respective corps, and then prepare the implements of their mourn ul and painful calling. The battle begins; the active combatants, unmindful and regardless of danger, buoyed above the terror of death or of wounds by ardour and excitement, which few can imagine, heed not the casualties that happen around them. Not so the medical officer. The fallen and the disabled that are not beyond the reach of his skill, become the subjects of his immediate care. The fiercer the fight, the more numerous these sad consignments. There, on the naked field, exposed to personal risk, and within reach of the bullets, which may have previously ploughed the ranks of the columns, or lines in his front, the medical officers, with unflinching eye, steady hand, and well-braced nerves, discharge their melancholy functions, and frequently lose their lives in endeavouring to save others. Is the battle won ? The troops move forward with exultation to reap the fruits of their victory. The medical officers remain on the blood-stained field, amidst the havoc of war, to collect the mutilated victims, and administer to the sacrifices that victory exacts. Is the battle lost? or is the field, though won, abandoned, as ofttimes happens? The medical officers perform their still more painful duties on the forsaken field, and become themselves captives, in common with those who, by their aid, may survive. Then there was the assault of the fortress, and the storming of the breach, at which medical officers are invariably aiding. And this is the classsuch the persons, from whom you withhold advantages enjoyed by the practitioners of a less exalted surgery. The horse is a noble animal; the veterinary science is an important and useful profession; but man is a nobler animal still, and a soldier, apart from other considerations of humanity, a more important

and valuable agent. He appealed, then, in the strongest terms, to the feelings and generosity of Her Majesty's Government, to the House, and to the country, against the exclusion of the class of officers whose case he had taken up, from advantages which are extended to others-from a boon which all public servants, civil and military, now enjoy. The hon. and gallant member stated that he would not enter further into detail, but leave the case to the consideration of the House and the Government, and he hoped he had not appealed in vain to the noble Lord at the head of the Government, and would be consoled by the reflection that he had done his best in behalf of these officers."

I. INHALATION OF ETHER. By J. Mason Warren, M.D., one of the Surgeons of the Massachusetts General Hospital. Octavo, pp. 18.

II. PRACTICAL REMARKS ON THE INHALATION OF THE VAPOUR OF SULPHURIC ETHER. By W. Philpotts Brookes, M.D., Surgeon to the Cheltenham General Hospital, &c. &c. Octavo, pp. 68. Churchill, 1847.

It is a pleasing duty to have to record that the general result of the immense number of experiments upon the effects of the Inhalation of Ether, which have been repeated throughout entire Europe during the last few months, has been of the most satisfactory character-that expectations have not been disappointed, or fears and forebodings realized. We are not however aware that there are any new facts, whether as regards the modus operandi of the substance or the description of cases to which its employment may be extended, that call for notice. For some time to come the cautious observation and candid record of the various phenomena that present themselves will constitute the most important and responsible duty of those whose opportunities are numerous; for, at present, we are but on the threshold of the investigation. Amid the points towards which attention may be yet advantageously directed is, the conferring greater simplicity and portability upon the apparatus employed; for innumerable as are the varieties of those hitherto invented, all we have seen are defective in these essentials. We observe M. Roux of Toulon (Gazette des Hôpitaux, No. 61) speaks highly of a bag which he employs, shaped like a lady's reticule, and lined with a pig's bladder, which he says is very easily breathed from even by young children. M. Sichel (who discountenances ether in the more delicate operations of the eye), in some cases in which he desired to subdue excessive spasm of the eyelids preventive of the extraction of foreign bodies, and having no apparatus at hand, poured the ether into a teapot, and directed the patient to inspire through the spout, with success.

The two pamphlets before us contain, besides the detail of some cases, no observations with which the profession is not already well acquainted. That of Dr. Brookes is not at all to our taste. He says, in his preface, “ I have never, in any way, endeavoured to shroud this question with mystery; for I have freely and willingly invited any professional or non-professional gentleman to view the operations that have fallen under my notice. These few pages have, therefore, been written as much for the general as for the medical reader."

It is little to Dr. Brookes' credit to have converted the operating theatre into a show-box for all the idlers of Cheltenham. We are as little willing to advocate mystery in this ether question as can be; but we are still less disposed to countenance its being made a vehicle for puffery. His pamphlet has not been written as much for the general reader," but entirely for him.

1847]

Hunt on Diseases of the Skin.

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PRACTICAL OBSERVATIONS ON THE PATHOLOGY AND TREATMENT OF CERTAIN DISEASES OF THE SKIN, GENERALLY PRONOUNCED INTRACTABLE. By Thomas Hunt. Octavo, pp. 152. London, Churchill, 1847.

If we are to believe our author, Arsenic, administered according to his method, is all but an infallible remedy in the worst case of Lichen, Prurigo, Lepra, Psoriasis, Pityriasis, chronic Urticaria, Purpura, Ecthyma, Eczema, Acne, and Sycosis, and also in Lupus and in non-congenital Nævus. All the varieties of these diseases, if not of a syphilitic origin, or not associated with feverishness or other derangement of the constitutional health, are declared by him to be under the dominion of "one antidote, which, under proper regulations, acts with such uniform efficiency as to leave nothing to be desired. That remedy is arsenic."

Let us first see what these "proper regulations" are. In place of the usual method of giving arsenic in small doses at first, and gradually increasing them until either some impression is made upon the existing disease, or certain toxical symptoms are induced, Mr. Hunt contends that it is much safer and better to begin with full or tolerably large doses at first, and reduce them by degrees as their effects become palpable. The most characteristic of these effects is a pricking sensation in the tarsi, and slight inflammation of the conjunctiva. On this subject, the author makes the following remarks.

"At this crisis (the supervention of these ophthalmic symptoms) the disease is brought under arrest, and generally from this period appears to be shorn of its strength. The return of healthy action in the cutaneous vessels often becomes visible, and is sensibly felt by the patient, on the very day on which the eyes become suffused with tears. The dose may now be reduced, and in some cases a very small dose taken with exact regularity will suffice to keep the eyes tender and the skin healing, until at length even the disposition to disease appears to die away under the influence of the poison. And as in the exhibition of mercury we are content with making the gums sore without distressing the bowels, so in administering arsenic we should never allow the mucous membranes to suffer: for supervening gastritis, and even cholicky pains, most clearly contraindicate its use. Fortunately a slight degree of conjunctivitis, in about fortynine cases out of fifty takes precedence of the more grave affections which indicate an over-dose. Both the safety of the patient and the prospect of his recovery will much depend upon the vigilance with which a knowledge of this fact inspires the surgeon. Ignorance of the existence of this safety-valve has caused many a cautious practitioner to repudiate the medicine altogether; and an acquaintance with this important sign would, doubtless, on the other hand, have checked the temerity which, in its results, has attainted with unmerited suspicion the reputation of a valuable remedy." P. 13.

Arsenic, when taken for a considerable length of time, is said to produce in some cases a discolouration of the skin:

"The trunk of the patient first, and subsequently all those parts of the body which are by the dress protected from the access of light and air, become covered with a dirt-brown, dingy, unwashed appearance, which, under a lens, reveals a delicate desquamation of the dermis, and is, in fact, a faint form of pityriasis. This may be considered as a secondary form of arsenicalization; for I have observed that when the primary dose is diminished on the appearance of conjunctivitis, the eye-lids may be allowed to get well, yet if the patient's skin be kept brown, the disease will vanish just as rapidly as though the conjunctiva were kept sore. The first and larger dose appears to knock the disease on the head, (so to speak,) and to exhaust its energy. Its less malign, or secondary form, being subjugated by the secondary or pityriatic action of arsenic." P. 15.

In old chronic cases of cutaneous affections, "the arsenical course should be protracted (in reduced doses) for about as many months after the final disap

pearance of the disease, as it had existed years before. This will prove the best security against a relapse, and will generally succeed in preventing it."

After narrating the details of upwards of 40 successful cases-we hear indeed of no unsuccessful ones-of various forms of skin-disease, including four of lupus exedens and one of nævus, in which a cure was effected by the use of arsenic, Mr. Hunt favours us with some general observations. From these we select the following passage as a fair specimen of his mode of handling his subject.

"It is now many years since I resolved to try what could be accomplished by arsenic in the treatment of the more unmanageable disorders of the skin, and the result has filled me with astonishment and delight. Whenever I have had a fair trial and a fitting case, I can truly say that for many years arsenic has never once failed me. In the few cases which have not done well, either there was irreparable organic disease existing, or else the irregular habits or whims of the patient, or some accidental interruption to the course, sufficiently accounted for the failure. It is possible that in some cases related as cured, relapses may have occurred unknown to me. I can only relate facts as far as they have come to my knowledge, and leave others to draw their conclusions. In the majority of the cases, I have ascertained that the patient has for a greater or lesser period, after the termination of the course, enjoyed immunity from the disease which had tortured him for years.

"Of other alteratives, as respects their efficiency in cutaneous disease, I know but little except from report. Of their very general inefficiency I had painful experience in the early part of my practice. I have long abjured medicated baths, and external applications generally; and, excepting where the antiphlogistic regimen was required, I have placed no restriction whatever upon the diet of my patients. I never could understand the principles on which the dietetic system of treating disease, is founded. If the appetite is not depraved by gross intemperance, I look upon it to be the only safe indication of the proper quality and quantity of food required in a given case, both in health and disease. I do not say it may never prove false: and I will promise never to trust it, if any man will supply me with a more intelligent or more philosophical guide. Neither local treatment nor diet therefore, (with the above exception,) have had any influence in determining the results of my experiments. But in order to submit the agency of arsenic to a still more severe test, I have in almost every protracted case, interrupted the course again and again, and have found to my unspeakable satisfaction that, in every case unshackled by complications, I could as readily check the disease, and allow it to advance at pleasure, as the engineer can control the progress of his locomotive. The power of the medicine in these cases is therefore established beyond the reach of doubt or cavil. And its safety is not less demonstrable. By discovering the efficacy of its continued use in small and decreasing doses, and thus securing for the medicine an innocuous operation, I trust I have removed the only valid objection to its use, namely, its dangerous properties. And now, with the exception of its name, and the horrors associated with the idea of a poison, one can scarcely conceive a remedy less objectionable than arsenic. Sarsaparilla, besides being nearly useless, is expensive; the preparations of cantharides irritate the urinary organs; iodine, besides that it is no respecter of tissues,' is a nauseous medicine, and few patients could be prevailed upon to take it, were it safe to do so, for a lengthened period. But none of these objections apply to arsenic. A medicine which, besides being almost or quite certain in its operation, is safe, cheap, tasteless, and elegantwhich may be taken at meal-times through a whole life, if necessary, without creating disgust or nausea,-which interferes (in curative doses) with no healthy function, which gives no pain, and inflicts no inconvenience-has surely recommendations which are not easily surpassed." P. 134.

We must close our notice of Mr. Hunt's volume with the same words of hesitating belief with which we began it. His style of writing is not likely to beget